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renal > physiology > Flashcards

physiology Flashcards

1
Q

what two factors need to be known to calculate osmolarity

A
  • molar concentration of the solution

- number of osmotically active particles present

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2
Q

units for osmolality

A

osmol/kg water

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3
Q

osmolarity units

A

osmol/l

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4
Q

what is tonicity

A

effect a solution has on a cell volume

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5
Q

isotonic

A

no change to cell volume

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6
Q

hypotonic

A

increase in cell volume

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7
Q

hypertonic

A

decrease in cell volume

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8
Q

tracer for ECF

A

inulin

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9
Q

tracer for total body water

A

3H2O

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10
Q

tracer for plasma

A

labelled albumin

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11
Q

is there more sodium and chloride ions inside or outside the cell

A

outside

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12
Q

is there more potassium ions inside or outside the cell

A

inside

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13
Q

what is fluid shift

A

movement of water between the ICF and ECF in response to an osmotic gradient

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14
Q

what is regulation of ECF volume vital for

A

long term regulation of blood pressure

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15
Q

what is electrolyte balance important for

A
  • total electrolyte concentrations can directly affect water balance
  • the concentrations of individual electrolytes can affect cell function
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16
Q

what is sodium and potassium balance important for

A
  • major contributors to the osmotic concentrations of the ECF and ICF
  • directly affect the functioning of all cells
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17
Q

is sodium a determinant of ECF volume?

A

yes

a majorrrr one

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18
Q

what happens if there are small leakages or increased cellular up take of potassium

A

muscle weakness - paralysis

cardiac irregularities - cardiac arrest

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19
Q

functions of the kidney

A
  • water balance
  • salt balance
  • maintenance of plasma volume
  • maintenance of plasma osmolarity
  • acid base balance
  • excretion of metabolic waste products
  • excretion of exogenous foreign compounds
  • secretion of renin
  • secretion of erythropoietin
  • conversion of vitamin D into active form
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20
Q

most common type of nephron

A

cortical

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21
Q

what is the least common type of nephron

A

juxtamedullary

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22
Q

which type of nephron has a longer loop of Henle

A

juxtamedullary

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23
Q

how many capillaries for a juxtamedullary nephron

A

one

vasa recta

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24
Q

how is the renal tubule a conveyor belt

A

substances are added or removed as urinary filtrate moves from proximal to distal end

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25
Q

what does the rate of filtration of X =

A

mass of X filtered into the Bowman’s capsule per unit time

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26
Q

what is the calculation for rate of excretion of X

A

Vu is urine flow rate

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27
Q

what does it mean if rate of filtration is greater than rate of excretion

A

net reabsorption has occured

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28
Q

what does rate of reabsorption of X =

A

rate of filtration of X - rate of excretion of X

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29
Q

what does it mean if the rate of filtration is less than rate of excretion

A

net secretion of that substance has occured

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30
Q

what are the filtration barriers

A
  • glomerular capillary endothelium
  • basement membrane
  • slit processes of podocytes
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31
Q

what are the forces that comprise net filtration pressure

A
  • glomerular capillary blood pressure
  • bowmans capsule hydrostatic pressure
  • capillary oncotic pressure
  • Bowman’s capsule oncotic pressure
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32
Q

what is glomerular filtration rate

A

rate at which protein-free plasma is filtered from the glomeruli into the Bowman’s capsule per unit time

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33
Q

what does GFR =

A
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34
Q

what is the major determinant of GFR

A

glomerular capillary fluid blood pressure

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35
Q

does the afferent or efferent arteriole have a larger diameter

A

afferent

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36
Q

what charge is the basement membrane (between bowmans capsule and glomerular capillary)

A

negative

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37
Q

what are starling forces

A

the balance of hydrostatic pressure and osmotic forces

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38
Q

what are the two types of regulation of GFR

A
  • extrinsic

- intrinsic (autoregulation)

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39
Q

what happens if there is an increase in glomerular capillary blood pressure

A

increase in net filtration pressure

increase in GFR

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40
Q

what does vasoconstriction of the afferent arteriole do

A

decreases glomerular capillary blood pressure
decreases net filtration pressure
decreases GFR

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41
Q

fall in blood volume effect on urine volume

A

fall in urine volume

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42
Q

what are the two parts of autoregualtion

A
  • myogenic

- tubuloglomerular feedback

43
Q

what is myogenic regulation

A

vascular smooth muscle is stretched, it contracts thus constricting the arteriole

44
Q

what is tubuloglomerular feedback

A
  • involves the juxtaglomerular apparatus

- if GFR rises, more NaCl flows through the tubule of afferent arterioles

45
Q

what cells sense NaCl content of tubular fluid

A

macula densa

46
Q

will someone with diarrhoea have increased or decreased GFR

A

decreased

47
Q

calculation for the rate of excretion of X

A

could be in exam

48
Q

is inulin absorbed or secreted

A

no

49
Q

is inulin metabolised by the kidney

A

no

50
Q

can inulin clearance be used clinically to determine GFR

A

yes

51
Q

what does it mean is clearance of a substance is less than GFR

A

substance is reabsorbed

52
Q

what does it mean if clearance is equal to GFR

A

substance is neither reabsorbed nor secreted

53
Q

what does it mean if clearance is greater than GFR

A

substance is secreted into tubule

54
Q

what is para-amino hippuric acid

A

exogenous organic anion

55
Q

what is PAH used clinically to measure

A

renal plasma flow

56
Q

pathway of PAH

A
  • freely filtered at glomerulus
  • secreted into the tubule
  • completely cleared from the plasma
57
Q

what should any substance used as a clearance marker be

A
  • non toxic
  • inert
  • easy to measure
58
Q

what is the filtration fraction

A

fraction of plasma flowing through the glomeruli that is filtered into the tubules

59
Q

what things are reabsorbed in the PT

A
  • sugars
  • amino acids
  • phosphate
  • sulphate
  • lactate
60
Q

what things are secreted in the PT

A
  • hydrogen
  • hippurates
  • neurotransmitters
  • bile pigments
  • uric acid
  • drugs
  • toxins
61
Q

what is the transcellar route of reabsorption

A

across the cell wall that makes the nephron

62
Q

what is the paracellular route of reabsorption

A

between cells

63
Q

sodium ions are reabsorbed in sections of nephron apart from where?

A

descending loop of Henle

64
Q

at the proximal tubule what percent of glucose and amino acids are reabsorbed

A

100%

65
Q

what does sodium reabsorption drive

A

chlorine reabsorption

66
Q

function of the loop of Henle

A
  • generates a cortico-medullary solute concentration gradient
  • this enables the formation of hypertonic urine
67
Q

what is the opposing flow in the two limbs termed

A

countercurrent flow

68
Q

which limb reabsorbs sodium and chloride

A

the ascending limb

69
Q

can the ascending limb reabsorb water

A

no

70
Q

can the descending limb reabsorb water

A

yes

71
Q

what does the triple co-transporter do

A

pumps solute from thick ascending limb

72
Q

what happens after fluid enters the descending limb

A
73
Q

what happens in ascending limb

A
74
Q

what is the purpose of countercurrent multiplication

A

to concentrate the medullary interstitial fluid
-this enables the kidney to produce urine of different volume and concentration according to the amount of circulating ADH

75
Q

where does the vasa recta run

A

alongside the long loop of Henle of juxtamedullary nephrons

76
Q

what forms the countercurrent system

A

the loop of henle and vasa recta

77
Q

what happens to ensure that blood flow through the medullar doesn’t wash away NaCl and urea

A
  • vasa recta capillaries follow hairpin loops
  • vasa recta capillaries freely permeable to NaCl and water
  • blood flow to vasa recta is low
78
Q

osmolality of surrounding interstitial fluid of renal cortex

A

300 mosmol/l

79
Q

what hormone increase water reabsorption

A

antidiuretic hormone

80
Q

what hormone increases sodium reabsorption and increases potassium and hydrogen secretion

A

aldosterone

81
Q

what does atrial natriuretic hormone do

A

decrease sodium reabsorption

82
Q

when is ADH released into the blood

A

when action potentials down the nerves lead to calcium-dependent exocytosis

83
Q

what is the effect of ADH on water permeability of the collecting duct

A

triggers cAMP to increase permeability of luminal membrane to H2O by inserting new water channels

84
Q

what happens to urine and water permeability in high and low ADH

A

high ADH - high water permeability and hypertonic urine

low ADH - low water permeability and hypotonic urine

85
Q

presence of maximal ADH what urine is produced

A

small volume of concentrated urine

86
Q

in presence of minimal ADH what is urine

A

large volume of dilute urine

87
Q

what are the two types of diabetes insipidus

A

central and nephrogenic

88
Q

when are the hypothalamic osmoreceptors activated

A

when you’re thirsty

89
Q

what does decreased atrial pressure mean for ADH release

A

increased ADH release

90
Q

what does stimulation of stretch receptors in upper GI tract do to ADH

A

exerts feed-forward inhibition of ADH

91
Q

osmolarity in different parts of the nephron

A
92
Q

when is aldosterone secreted

A

in response to rising potassium or falling sodium in the blood
also when the RAAS system is activated

93
Q

what does sodium retention do to blood pressure

A

increased blood volume and pressure

94
Q

when aldosterone is absent what is that effect on potassium

A

no potassium is excreted in the urine as aldosterone stimulates the secretion of potassium

94
Q

when aldosterone is absent what is that effect on potassium

A

no potassium is excreted in the urine as aldosterone stimulates the secretion of potassium

95
Q

how do the granular cells in JGA control renin release

A
  • reduced pressure in afferent arteriole
  • macula densa cells sense the amount of NaCl in the distal tubule
  • increased sympathetic activity as a result of reduced arterial blood pressure
96
Q

increased RAAS effects on health

A
  • can cause hypertension

- fluid retention which is associated with heart failure

97
Q

what produces ANP (atrial natriuretic peptide)

A

the heart

-stored in atrial muscle cells

98
Q

when is ANP released from the heart

A

when the atrial muscle cells are mechanically stretched due to an increase in circulating plasma volume

99
Q

what does ANP promote secretion of

A

sodium and diuresis

100
Q

once the urine has been stored by the kidneys what happens to it

A

it is propelled by peristaltic contractions through ureters to the bladder for temporary storage

101
Q

what mechanisms is urination controlled by

A
  • the micturation reflex

- voluntary control

102
Q

how much urine can the bladder hold before the stretch receptors initiate the micturation reflex

A

250-400ml

renal (28 decks)

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