Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A & P final > Physiology of the Kidneys > Flashcards

Physiology of the Kidneys Flashcards

1
Q

what is wilm’s tumor (nephroblastoma)

A

tumor of the kidney found in childhood that is associated w/ aniridia (lack of iris) and related ocular complications
-500 cases in the US annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what waste products do the kidneys eliminate?

what else do the kidney eliminate

A

urea, uric acid, creatinine

-drugs and toxic compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how do the kidneys regulate osmotic pressure

what else do they regulate? how?

A

by excreting dilute or concentrated urine

  • ions
  • extracellular fluid by controlling Na and water excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do the kidneys play a role in acid-base balance

A

synthesis and excretion of ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do the kidneys adjust blood prssure

A

by regulating Na excretion and producing renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what do the kidneys produce

A

Vit D3 and erythropietin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what do the kidneys degrade

A

insulin and PTH (parathyroid hormone)

  • insulin broken down by insulinase
  • PTH increases Ca levels in the blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what do kidneys synthesize to affect renal blood flow and Na excretion

A

prostaglandins and kallikreins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

the total body water is _____% of body weight

plasma is ___% of body weight

A

60%
-mostly in intracellular compartment where there’s more K (40%)
-extracllular has more Na (20%)
4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

in body fluid composition, what are the major cations in electrolytes? major anion?

A

cations: Na, K, Ca, Mg
anions: Cl, HCO3 (bicarbonate), Po4 (phosphate), SO4 (sulfate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what charge do proteins and organic acids have

what is the pH to organic acids

A

negatively charged

pH = 7.04

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when is the ability for glucose to be reabsorbed compromised

A

glucose levels above 180mg%

-all glucose is reabsorbed under normal conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

for urine formation, what is the total amount excreted equal to

A

total amt excreted=filtered-reabsorbed + secreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

for the renal clearance ratio, when does secretion occur and when does reabsorption occur

A

> 1=secretion

<1=reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what rate does inulin clearance equal

A

glomerular filtration rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the glomerular filtration rate

A

the rate at which plasma is filtered by the glomeruli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

why is it ideal to measure GFR by inulin (a fructose polymer)

A
  1. freely filterable by glomeruli
  2. not reabsorbed or secreted by tubules
  3. not synthesized, destroyed, or stored in kidneys
  4. nontoxic
  5. concentration in plasma and urine determined by simple analysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the normal values of GFR

A

110-125 mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the clearance ratio

A

Cx (x is compound of interest) / Cinulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are be used to clinically estimate GFR

A

endogenous creatinine clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is creatinine derived from?

  • levels in ____ are stable
  • also secreted by ____ adds ____% to urniary values
A

creatine phosphate

  • levels in plasma are stable
  • also secreted by kidney: adds 20% to urinary values
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

there is an inverse relationship between GFR and…

why?

A

plasma creatinine concentration

-bc kidneys continuosly clear creatine from the plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is it called when these substance are found in urine

  • glucose
  • protein
  • amino acids
  • blood cells
  • ketones
  • bilirubin
A 
glycosuria
-glucose threshold ~200mg% 
proteinuria
-atkins diet 
aminoaciduria
-seen in PKU
hemouria 
ketonuria
-seen in uncontrolled diabetes
bilirubinuria 
-breakdown hemoglobin 
-seen in end stage liver disease/compromised liver function
-newborns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q 
a 70kg person contains how many L of total body water? 
how much intracallular fluid?
extracell fluid? 
interstitial fluid? 
plasma?
A

70x0.6 = 42
intracellular: 42x0.4=28L
extracellular: 42x0.2=14L
interstitial fluid: 14x 3/4=10.5
plasma: 14x 1/4=3.5L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the rate of renal blood flow

  • how much % of cardiac output does this produce
  • how are cortex and medulla related
A
  1. 2L/min => 20% of cardiac output

- cortex>medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is myogenic mechanism

A

-when blood flow it too high
increased pressure stretches vessels and opens cationic channels resulting in depolarization and calcium influx
-vessel diameter decreases and resistance increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

when does the tubuloglomerular feedback mechanism occur?
-what increases?
-what does ATP do?
what kind of secretion is reduced?

A

when blood flow is too high
increased pressure increases GFR
increases NaCl reabsorption and *ATP release from macula densa
-ATP broken down to release adenosine, which vasoconstricts
-renin secretion is reduced bc activation of renin would have opposite effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what do sympathetic nerves do to renal blood flow

A

vasoconstrict and reduce flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the glomeruar membrane shared btwn

A

endothelial cells and the visceral layer of bowman’s capsule

30
Q

what kind of cells comprise the visceral layer of bowman’s capsule?
-what exist btwn these cells?

A
  • podocytes-wrap their fingers around capillary

- filtration slits exist btwn the “feet” of the podocytes

31
Q

in glomerular filtration, how does the fluid going from the capillaries get to bowman’s space

A

fluid going from capiallaries=>fenestrated endothelium=>glomerular BM=> podocyte feet=> bowman’s space

32
Q
  • what do the endothelial fenestrations of the glomerulus prevent?
  • waht does the basal lamina of the glomerulus prevent?
  • what does the slit membrane btwn btwn pedicels prevent?
  • when proteins do pass through, what are they reabsorbed by
A
  • filtration of blood cells but allows all components of blood plasma to pass through
  • prevents filtration of larger proteins
  • prevents filtration of medium-sized proteins
  • anything negative will have a hard time getting through
  • when proteins pass through, they’re later reabsorbed by the proximal CT
33
Q

how many mmHg does net filtration pressure equal
what is the mmHg of the capillary hydrostatic pressure?
what is the pressure in bowman’s space?
what is the colloid osmotic presssure
(pressure generated from a highly concentrated sol’n)

A

10mmHg
55mmHg
15mmHg
30mmHg

34
Q

what is the filtration fraction

A

%age of plasma flowing through kidneys that is filtered (~20%)

35
Q

what does GFR depend on

A
  1. permeability and surface area of filtration barrier
  2. ultrafiltration pressure gradient
  3. capillary hydrostatic pressure (55mmHg)
  4. back pressure in bowman’s space (15mmHg)
  5. colloid osmostic pressure (30mmHg)
36
Q

what does the proximal convoluted tubule reabsorb

A

all glucose and aa (under normal conditoins)

37
Q

what is the driving force for the reabsorption of solutes and water?

  • what come in and what come out
  • where does it enter the cell?
  • where is it pumped out by the Na/K ATPase?
  • what follows
A

Na reabsorption

  • Na/K ATPase: 2K in, 3Na out
  • enters from the lumen
  • leaves on the basolateral side
  • where Na goes, water follows
38
Q

Na has cotransport, what are they

A

Na/glucose
Na/amino acids
Na/Cl

39
Q

what is the countertransport (antiport) used in the prox convoluted tubule

A

Na/H pump

  • important for bicarbonate reabsorption
  • carbonic anhydrase inhibitors block it (acetazolamide)=> reduces bicarbonate reabsorption
40
Q

the tubular transport in the loop of henley creates a gradient such that extracellular fluid is…..
-what does this produce

A

hypertonic

-production of concentrated urine

41
Q

in the descending limb of the loop of henle, what leaves and why

A

ONLY WATER leaves due to hypertonic interstitial fluid

-impermeable to NaCl

42
Q

in the ascending limb of the loop of henle, what is it highly permeable to,

  • what happens to water
  • what does this create
  • what cotransport is used and what is it driven by
  • what can block this cotransport and what can this lead to
A

highly permeable to NaCl-pumps it into interstitium

  • water does not follow
  • creates high ionic interstitial gradient at bottom of loop
  • Na 2Cl K cotransport driven by Na/K ATPase pump on interstitial side
  • diuretic furosemide blocks Na 2Cl K cotransporter-can lead to hypokalemia (low potassium)
43
Q

the distal convoluted tubule is impermeable to water unless…..

A

acted on by aldosterone and/or ADH

44
Q

what cotransporter does the luminal membrane of the distal convoluted tubule contain?

  • inhibited by what
  • what kind of pump does it have on the intersititla side
  • what goes inot the cell, what goes into the interstitium
  • what is this fueled by
  • what goes on the lumenal side
  • what enhances this channel
A

Na Cl cotransporter

  • inhibited by thiazine diuretics
  • NaCa pump on intersitital/capillary side
  • 3 Na into cell, 1 Ca into interstitium
  • fueled by Na/K antiport
  • passive Ca channel on lumenal side
  • parathyroid hormone enhances this channel and increases Ca absorption
45
Q

what does the cortical collecting duct regulate

-how

A

K

  • secretes most of excreted K
  • active uptake by Na/K ATPase followed by lumenal channel diffusion
46
Q

what are the 2 types of cells in the collected duct

A
  1. principal cell
    - K preferentiall goes down its gradient on the tubular luminal side bc the electrical gradient is smaller across the luminal surface than the other side
  2. intercalated cell
    - can lead to increased blood levels of K during conditions of acidosis
    - have pumps which exchange H for K (H/K ATPase present in lumenal membrane)
47
Q

what allows for the maintenance of the concentration gradient

A

vasa recta

48
Q

what are the 2 countercurrent processes in the medulla?

what do they do

A 
loops of henle: countercurrent multipliers
-set up osmotic gradient
vasa recta: countercurrent exchanges 
-maintain gradient 
-reduce dissipation of solute gradient
49
Q

in countercurrent processes, how does fluid flow

A

fluid flows in opposite directions in adjacent structures

50
Q

what do countercurrent multiplier system in loop of henle produce

A

a hyperosmotic renal medulla

51
Q

waht does water do the in decending limb? ascending limb?

A

descending: only water leaves
ascending: no water leaves/salt is pumped out

=> hypertonic renal medulla

52
Q

in the countercurrent exchange in the vasa recta, how does solute go in? out?
-what does it maintain

A

solute goes in one way (descending) and out the other (ascending)
-maintains the gradient being generated by the loop of henle

53
Q

PCT reabsorbs 50% of urea, the DCT has as much urea as the amount filtered bc of…..

A

secretion

54
Q

which limb and which duct are impermable to urea?

  • what rises as water is reabsorbed
  • what does this result in
A

ascending limb of the distal CT and outermedullary collecting ducts

  • urea rises as water is reabsorbed
  • results in high urea concentraion delivered to inner medulla
55
Q

urea contributes to….

-it is _____ of the total osmolarit of the steym

A

hypertonic insterstitium

-1/2 of osmolarity of the system comes from urea

56
Q

ADH doesnt just facilitate water flow, but also ___ flow

A

urea flow

57
Q

what acts on cortical collecting ducts to make them water permeable

A

ADH (vasopressin)

58
Q

inner medulla has facilitated ________ activated by ADH

  • accounts for ____ of osmoalirty of inner medulla
  • favors urea diffusion into _____
A

urea transporter

  • 1/2
  • interstitium
59
Q

what forms when ADH levels are low

  • attempts to maintain what
  • what does ADH promote urea to do
A

dilute urine

  • attempts to maintain the gradient
  • ADH promotes urea flow out
60
Q

what is formed when ADH levels are high

A

concentrated urine

  • ADH => generation and insertion of aquaporins into collecting duct membrane
  • water flows readily into hypertonic interstitum and is quickly collected into the vasa recta so the gradient isn’t disrupted
61
Q

what is diabetes insipidus

A

excretion of large amounts of highly diluted urine (polyuria) that can’t be reduce when fluid intake is reduced

62
Q

what are the 3 types of diabetes insipidus

A
  1. crainal
    - low ADH release from post pitutary
  2. nephrogenic
    - collected ducts insensitive to AD
    - problem in transcription or translation of the aquaporin gene
  3. dipsogenic
    - excessive thirst due to damage to thirst mechanism in hypothalamus
63
Q 
what cells produce atrial natriuretic factor? 
what do they sense? 
facilitates excretion of what? 
what follows this
what does this decrease? 
what does this lead to?
A

atrial muscle cells

  • sense volume expansion
  • Na
  • water follows
  • decreases renin
  • leads to natriuresis and diuresis
64
Q

aldosterone release is triggered by what?

what is its action on the kidneys

A 
high plasma (K) in the blood OR decreased blood volume 
-increases Na reabsorption and increases K secretion
65
Q

what movement does insulin promote

A

K movement into cells
therefore reduces K in the blood

-K levels must be closesly watched corrected w/ DKA

66
Q

how does the body compensate for alkalosis?

A

slowing down breathing

67
Q

what does a loss of H cause in the blood?

what cna this cause

A

increases in HCO3

-causes metabolic alkalosis, hypochloremia and extracellular fluid volume contraction

68
Q

which is harder for the body to deal w/, alkalosis or acidosis?

A

alkalosis bc in acidosis, at least the kidney can pump out H.

69
Q

what kind of muscle does the bladder neck have

what innervates the body and neck

A

internal spincter (smooth muscle)

body (detrusor) and neck innervated by pelvic and hypogastric nerves

70
Q

what is the external spincter innervated by

A

pudendal nerve

71
Q

what mediates the contraction of detrusor and relaxation of the internal spincter in mictrition aka urination

A

parasympatheic nerves

sympathetic innervation not essention (mostly to blood vessels)

A & P final (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions