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Pathophysiology > module 12 regulation > Flashcards

module 12 regulation Flashcards

1
Q

concentration gradient in loop of henle

A

longer loop -> inc. concentration of filtrate

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2
Q

steps of concentration gradient

A
  1. solutes leave ascending loop -> interstitium
    - > inc. concentration gradient in interstitium, inc. osmolality
  2. water leaves descending loop -> interstitium
    - > inc. solute concentration in descending loop, dec. osmolality in interstitium
  3. H2O not permeable in ascending loop, lose solutes -> dec. concentration in ascending loop.
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3
Q

countercurrent multiplier

A

blood of capillaries is running opposite of nephron

continuous cycle of ascending removing solutes and descending release H2O to try and equalize

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4
Q

ADH

A

ADH released in response to high blood osmolality and by low blood volume
-> dec. blood flow to renal medulla -> minimizing depletion of solutes in blood stream
ADH causes walls of collecting ducts to become more permeable to water -> absorption of water into interstitium -> vasa recta

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5
Q

dilution of urine

A

excess extracellular fluid dec. ADH secretion

-> reduce water channels in the collecting ducts

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6
Q

GFR determined by

A

filtration pressure in glomeruli and by permeable surface of glomerular membrane

  • affected by hydrostatic/oncotic pressure on either side of membrane
    • main driving force is hydrostatic pressure in capillaries
    • oncotic pressure d/t proteins in blood opposes filtration
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7
Q

factors affecting filtration pressure

A 
blood volume
autoregulation 
altering pressure in bowmans capsule
low plasma proteins 
mesangial cells in glomerulus
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8
Q

Blood volume and filtration pressure

A
  • inc. blood volume -> inc. BP -> inc. glomerular hydrostatic pressure -> inc. GFR and inc. filtrate
  • dec blood volume -> dec. BP -> dec. glomerular hydrostatic pressure -> dec. GFR and dec. filtrate
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9
Q

auto-regulation and filtration pressure

A

adjusts arterial resistance to maintain relatively steady state of blood flow despite perfusion pressure

  • stretch response of afferent arterioles
  • inc. BP -> vascular smooth muscle constriction to keep blood flow at same rate.
    • myogenic autoregulation
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10
Q

altering pressure in bowmans capsule and filtration pressure

A

obstructin in tubules or collecting ducts -> inc. pressure in bowmans capsule -> dec. GFR r/t inc. hydrostatic pressure in bowmans.

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11
Q

low plasma proteins and filtration pressure

A

dec. albumin -> inc. GFR r/t dec. oncotic pressure

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12
Q

mesangial cells in glomerulus and filtration pressure

A

alter surface area for filtration

  • contraction -> squeezing capillary cells together -> dec. GFR
  • relaxation -> inc. premeable surface area -> inc. GFR
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13
Q

RAAS

A

renin acts upon liver -> angiotensinogen -> inc. angiotensin I -(ACE)-> Angiogensin II -> adrenal cortex -> inc. aldosterone -> distal nephron -> reabsorption of Na and H2O

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14
Q

juxtaglomerulo apparatus

A

regulatory structure, composed of

  • glomerulus
  • macula densa cells
  • juxtaglomerular cells
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15
Q

macula dense cells

A

near end of ascending loop of Henle, which is in contact with glomerulus and JG cells

  • sense change in NaCl concentration:
    inc. GFR -> inc. NaCl delivered to distal tubule -> inc. Na-K pump activity -> adenosine and ATP production
  • Adenosine: contraction of afferent arterioles and relaxation of efferent arterioles -> dec. GFR
  • Helps distribute GFR evenly among nephrons
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16
Q

Justaglomerular cells

A

around glomerular arterioles, release renin
Baroreceptor mechanism:
- inc. blood pressure in afferent arteriole -> inhibition of renin release
- dec. blood pressure -> renin release
SNS mechanism:
- B1-adrenergic nerves stimulate renin release

17
Q

ADH (vasopressin)

A

secreted from post pituitary in response to inc. osmolality

  • > principal cells in collecting tubules translocate aquaporins to apical membrane
  • > H2O reabsorption in vasa recta
18
Q

insufficient ADH

A 
DI
nephrogenic DI (collecting tubules unresponsive to ADH)
19
Q

aldosterone and AII

A

produced when JG cells release renin in r/t
- dec. blood flow to kidney
- dec. Na levels
- activation of SNS
restore blood volume and pressure to nml
reabsorption of Na and H2O

20
Q

ANP

A

released from atrial cells in response to inc. blood volume -> inc. stretch

  • inhibits actions of AII
  • > Na and H2O excretion
  • > dec. blood volume, osmolality unchanged
21
Q

urodilatin

A

peptide secreted by distal and collecting tubules in response to inc blood volume
- inhibits Na and H2O reabsorption

22
Q

uroguanylin and guanylin

A

peptide hormones produced by neuroendocrine cells in intestine in response to NaCl ingestion

  • receptors on proximal tubule and collecting ducts
  • inhibit NaCl and H2O reabsorption

Pathophysiology (80 decks)

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