Physiology 1 - glomerular Filtration Flashcards

1
Q

What is the normal GFR?

A

~180l/day

of which only ~2l ends up in urine so almost all of it is reabsorped too

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2
Q

What is the plasma filtration fraction at the glomerulus?>

A

1200ml/min of blood passes through
Of which 55% = 660ml/min is plasma
GFR of plasma is 125ml/min

Therefore 125/660 = ~19%

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3
Q

Explain the forces behind filtration?

A

Hydrostatic pressure favours filtration
Oncotic pressure favours reabsorption back into glomerular capillaries

For filtration to work capillary hydrostatic pressure (Pgc) must > fluid oncotic pressure

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4
Q

What factors influence filtration rate of a specific particle?

A

Size
Charge
Shape

Small particles like Na+/K+/Water are almost completely filtered out.

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5
Q

Describe the physical structure of the capillary walls that allows filtration?

A

1) Fenestrated endothelial cells allow plasma to pass but not RBC
2) Then basal lamina prevents large proteins passing through
3) Then slit membrane between pedicals under the basal lamina prevent medium proteins passing

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6
Q

How is a high capillary Hydrostatic pressure maintained?

A

Afferent arterioles are wide and short to put up little resistance
Efferent arterioles are long and narrow to put up high resistance

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7
Q

Describe extrinsic control of Glomerular Capillary Pressure

A

Sympathetic vasoconstrictive effect
Circulating catecholamines
Angiotensin II

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8
Q

How do circulating catecholamines affect glomerular Capillary Pressure (Pgc)

A

Cause vasoconstriction primarily in the afferent arteriole. Thus lowering renal blood flow and Pgc to provide more blood to other tissues e.g. heart and muscle

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9
Q

How does angiotensin II affect Pgc?

A

Causes constriction of the efferent at low conc and both efferent/afferent at high concs

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10
Q

Renal vessels have an intrinsic ability to control Pgc. whats the purpose of this?

A

To allow the vessels to react to changes in MAP and so maintain Pgc
Aka autoregulation of the GFR

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11
Q

How do renal vessels autoregulate GFR?

A

The afferent arterioles constrict and dilate in response to changes in blood volume in order to main Pgc.

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12
Q

When would autoregulation of the GFR be overridden?

A

When blood volume faces serious problems such as a large haemorrhage in order to liberate blood for more immediately essential tissues

(Symp nerves and angiotensin II)

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13
Q

What controls autoregulation of the GFR?

A

The renal vessels themselves.

Its independant of nerves and hormones, occuring even in denervated and isolated kidneys

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14
Q

How are the peritubular capillaries capable of resorping almost 180l a day?

A

1) Extremely low hydrostatic pressure thanks to the high resistance efferent arteriole upstream
2) High oncotic pressure in peritubular capillaries thanks to losing 20% of the plasma but still containing 100% of normal blood protein

Net starling forces are much more in favour of reabsorption leading to reabsorption of 50% of urea, 99% H2O, 100% Glc and 99.5% of Na.

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15
Q

What happens when there is vasoconstriction of the afferent/ efferent arterioles?

A
If there is vasoconstriction of the afferent arteriole 
-Lower renal blood flow
-Lower hydrostatic pressure
-Lower GFR 
If vasodilation= opposite

Vasoconstriction of the efferent arteriole

  • More blood “stuck” in the glomerulus
  • Increased hydrostatic pressure
  • Increased GFR
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16
Q

What happens when BP falls below 60?

A

NO FILTRATION

17
Q

What happens when MAP increase

A

vasoconstriction of the afferent arteriole= reduces renal blood flow, reduces hydrostatic pressure, reduces filtration

18
Q

what is the range for auto regulation

A

60-130mmhg

19
Q

what happens during marathons

A

Endurance training for very long events involves adaptation of skeletal muscle so that its requirement for blood flow becomes more efficient and therefore there is less need to take it from the kidneys.