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PSIO202 > Lecture: Renal > Flashcards

Lecture: Renal Flashcards

1
Q

What ions does the kidney regulate?

A

Na, K. Ca, Cl, and phosphate

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2
Q

What four things do the kidneys regulate in relation to blood?

A
  • Blood pH and osmolarity
  • Blood glucose via gluconeogenesis
  • Regulation of blood volume by conserving or eliminating water
  • Regulation of blood pressure
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3
Q

How do the kidneys regulate blood pressure?

A

By secreting the enzyme renin or adjusting renal resistance

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4
Q

Which two hormones are released by the kidney

A

Erythropoietin and calcitriol

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5
Q

How much blood plasma is filtered by the kidneys every minute?

A

125 mL

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6
Q

How much blood plasma is filtered by the kidneys each day?

A

180 L

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7
Q

What are the four major physiological functions of the kidneys?

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Excretion
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8
Q

What do kidneys perform their actions on?

A

Blood plasma not blood cells

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9
Q

What percent of a kidney must be damaged in order for it to be evident

A

More than 75%

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10
Q

Components of the renal corpuscle

A

Glomerulus: a knot of capillaries where filtration occurs
Glomerular capsule: epithelial cup that collects filtrate

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11
Q

Site of plasma filtration

A

Renal corpuscle

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12
Q

Site of reabsorption from filtrate and secretion into filtrate

A

Renal tubules

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13
Q

In which capillaries does blood filtration occur?

A

glomerular capillaries

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14
Q

Which capillaries carry away substances reabsorbed from filtrate?

A

Peritubular capillaries and the vasa recta

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15
Q

What is the role of sympathetic vasomotor nerves in the blood supply of the kidney?

A

Sympathetic vasomotor nerves regulate blood flow and renal resistance by altering the diameter of aterioles

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16
Q

Which cells are hormone receptors found on in the nephron loop?

A
  • DCT cells
  • Principle cells of the collecting duct
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17
Q

Which cells are microvilli found on in the nephron loop?

A
  • PCT cells
  • Intercalated cells of the collecting duct
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18
Q

What produces the filtration pressure in the glomerulus?

A

Blood pressure

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19
Q

Fenestrated endothelium filter…

A

blood cells

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20
Q

Basement membrane (basal lamina) filter…

A

Large proteins

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21
Q

Podocytes filter…

A

medium-sized proteins

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22
Q

Total pressure that promotes filtration

A

Net filtration pressure

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23
Q

Equation for net filtration pressure

A

Glomerular blood hydrostatic pressure - capsular hydrostatic pressure - blood colloid osmotic pressure

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24
Q

Amount of filtrate formed in all renal corpuscles of both kidneys per minute

A

Glomerular filration rate

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25
Q

Average glomerular filtration rate in adults

A

125 mL/min

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26
Q

What happens if the glomerular filtration rate is too high?

A

The useful substances are lost due to the speed of the fluid passage through the nephron

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27
Q

What happens if the glomerular filtration rate is too low?

A

Sufficient waste products may not be removed from the body

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28
Q

A glomerular blood hydrostatic pressure lower than ___ stops filtration

A

45 mmHg

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29
Q

Thickened part of ascending limb of loop of henle

A

Macula densa

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30
Q

Modified muscle cells that line the afferent arteriole

A

Juxtagomerular cells

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31
Q

What composes the juxtaglomerular apparatus

A

Macula densa + juxtaglomerular cells

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32
Q

Contractile cells associated with capillaries

A

Mesangial cells

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33
Q

Mechanisms that maintain a constant GFR despite changes in arterial blood pressure

A
  • Myogenic mechanism
  • Tubuloglomerular feedback
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34
Q

Which form of autoregulation of the GFR causes smooth muscle contraction reduces diameter of afferent arteriole to return the GFR back to its previous level

A

Myogenic mechanism

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35
Q

Which form of autoregulation of the GFR causes an increase in the blood pressure stretch of the afferent ateriole

A

Myogenic mechanism

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36
Q

Which form of autoregulation of the GFR raises the GFR by elevating systemic BP in order to rapidly push fluid through the renal tubule

A

Tubuloglomerular feedback

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37
Q

Which form of autoregulation of the GFR causes afferent aterioles to constrict therefore reducing the GFR

A

Tubulogolmerular feedback

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38
Q

In tubuloglomerular feedback, what happens when macula densa in the ascending limb detect an increase in Na and Cl?

A

It inhibits the release of NO (a vasodilator) from the juxtaglomerular appartus

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39
Q

In which mechanism are blood vessels of the kidney supplied by sympathetic fibers that cause vasoconstriction of afferent arterioles

A

Neural regulation of the glomerular filtration rate

40
Q

How does vasoconstriction of afferent arterioles occur in neural regulation of the GFR?

A

Norepinephrine releases from sympathetic postganglionic neurons and binds to the alpha 1 adrenergic receptors

41
Q

What are the two main functions of the SNS in the neural regulation mechanism of the glomerular filtration rate?

A
  1. Override renal autoregulation
  2. Stimulate renin release from juxtaglomerular cells
42
Q

At rest, when sympathetic activity is minimal in the kidney, what is the state of the renal blood vessels?

A

They are maximally dilated

43
Q

When there is moderate sympathetic stimulation of the kidney, what is the state of renal blood vessels?

A

The afferent and efferent arterioles are constricted equally

44
Q

Does the GFR increase or decrease in the presence of moderate sympathetic stimulation?

A

The GFR decreases slightly

45
Q

When there is extreme sympathetic stimulation of the kidney, in cases such as exercise or hemorrhage, what is the state of the renal blood vessels?

A

Afferent arterioles are predominately vasoconstricted

46
Q

Does the GFR increase or decrease in the presence of extreme sympathetic stimulation?

A

The GFR decreases substantially

47
Q

In the presence of extreme sympathetic stimulation, how are urine output and blood flow affected?

A

Urine output is lowered in order to maintain the blood volume, allowing a greater blood flow to other tissues in the body

48
Q

Which two hormones contribute to the regulation of the glomerular filtration rate?

A
  1. Atrial Natriuretic Peptide
  2. Angiotensin II
49
Q

Which hormone increases the glomerular filtration rate?

A

Atrial natriuretic peptide

50
Q

What causes a release of atrial natriuretic peptide from the heart?

A

A high blood volume causes atrial stretching signaling a release of ANP

51
Q

What is the function of atrial natriuretic peptide?

A

ANP relaxes glomerular mesangial cells, increasing glomerular capillary surface area and increasing the GFR

52
Q

Which hormone reduces the glomerular filtration rate?

A

Angiotension II

53
Q

What causes the release of angiotensin II?

A

Angiotensin II is activated by ACE in the lungs which is followed by the release of renin from the juxtaglomerular cells

54
Q

What is the function of angiotensin II?

A

Angiotensin II acts as a vasoconstrictor to narrow afferent and efferent arterioles and reduce the GFR

55
Q

Where does most reabsorption occur?

A

The proximal convoluted tubule (PCT)

56
Q

How do small proteins move from the tubular fluid back into blood?

A

Pinocytosis

57
Q

What are the two main purposes of tubular secretion?

A
  1. Control blood pH by secreting H
  2. Eliminating waste substances
58
Q

Difference between tubular reabsorption and tubular secretion

A

Reabsorption - transfers materials from tubular fluid back into blood
Secretion - transfers materials from blood into tubular fluid

59
Q

What type of reabsorption is it when the reabsorbed material is moved between cells by diffusion in parts of the tubule?

A

Paracellular reabsorption

60
Q

What type of reabsorption is it when the reabsorbed material moves through both the apical and basal membranes of the tubule by active transport?

A

Transcellular reabsorption

61
Q

Which membrane does Na/K ATPase pump sodium from the tubule cell cytosol through?

A

Basolateral membrane

62
Q

How is water reabsorbed?

A

Through osmosis

63
Q

Obligatory water reabsorption is when water is…

A

obliged to follow solutes being reabsorbed

64
Q

Facultative water reabsorption is under the control of…

A

antidiuretic hormone (ADH)

65
Q

Na symporters

A

Glucose
Amino acids
Lactic acid
Water-soluble vitamins

66
Q

The reabsorption of nutrient is…

A

Isosmotic - meaning that the water follows the solutes

67
Q

What must the concentration of Na be for reabsorption in the proximal convoluted tubule?

A

Low intracellular concentration

68
Q

What do Na antiporters do in relation to secretion in the proximal convoluted tubule?

A

Secrete acid (H+)

69
Q

What does drug secretion rely on in the proximal convoluted tubule?

A
  • Organic anion and cation transporters in the basolateral membrane
  • MATE (multi-drug and toxin extruder) proteins
  • H+ gradient
70
Q

Which substances have a renal threshold?

A

All substances that are reabsorbed by nephron cells

71
Q

Glucose in urine

A

Glycosuria or glucosuria

72
Q

What is the glucose renal threshold?

A

200 mg/dL

73
Q

Where does osmosis occur in the loop of Henle?

A

Descending limb

74
Q

Where does reabsorption of NaCl occur in the loop of Henle?

A

Thing ascending limg

75
Q

What is the descending limb permeable to?

A

The descending limb is permeable to water, but not to NaCl

76
Q

What is the ascending limb permeable to?

A

The ascending limb is permeable to NaCl but not to water

77
Q

The thick ascending limb of the loop of Henle has Na/K/2Cl symporters that reabsorb these ions…

A
  1. K moves back into filtrate through K leak channels
  2. Na is pumped out of the basolateral side
  3. Cl diffuses across the cell
78
Q

How do cations move across the vasa recta?

A

They are drawn to the negative charge in the capillary

79
Q

What is the early distal convoluted tubule permeable to?

A

It reabsorbs ions, but is more permeable to water

80
Q

All water reabsorption until the late distal convoluted tubules is…

A

obligatory

81
Q

The two types of cells in the late distal convoluted tubule and collecting duct are…

A
  1. Principal cells
  2. Intercalated cells
82
Q

What do principal cells reabsorb?

A
  1. Na
  2. If ADH is present, H2O
83
Q

What do principal cells secrete?

A

K+

84
Q

What do intercalated cells reabsorb?

A
  1. K+
  2. HCO3-
85
Q

What do intercalated cells secrete?

A

H+

86
Q

What is the goal of water reabsorption of H2O in the late DCT and CD?

A

Remove excess fluid from blood by producing dilute urine

87
Q

Process which produces a progressively-increasing osmotic gradient in interstitial fluid of renal medulla

A

Countercurrent multiplication

88
Q

Process which enables oxygen delivery to cells of renal medulla without loss of the osmotic gradient in interstitial fluid of renal medulla

A

Countercurrent exchange

89
Q

Two main factors that contribute to building and maintaining the required osmotic gradient

A
  1. Permeability differences
  2. Countercurrent flow
90
Q

Where are permeability differences present?

A

Sections of the loop of Henle and the collecting duct

91
Q

Where is countercurrent flow present?

A

Within tubular fluid in the descending and ascending loop of Henle

92
Q

Symporters in the thick ascending limb cells of the loop of Henle cause a buildup of…

A

Na and Cl in the interstitial fluid of the renal medulla

93
Q

The descending limb is very permeable to water, but impermeable to solutes except…

A

urea

94
Q

What establishes an osmotic gradient in the renal medulla?

A

Countercurrent flow through the descending and ascending limbs

95
Q

Osmolarity difference between the outer interstitial fluid of the descending limb and the inner tubular fluid

A

Osmolarity of the interstitial fluid outside of the descending limb is higher than the osmolarity of the tubular fluid

96
Q

Why does water move out of the descending limb into the interstitial fluid via osmosis?

A

Osmolarity differences

PSIO202 (15 decks)

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