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GU BLOCK > PHYSIOLOGY: RENAL system > Flashcards

PHYSIOLOGY: RENAL system Flashcards

1
Q

Role of kidneys

A

–blood filtration

–excretion of metabolic waste, endogenous and exogenous (drugs & toxins) compounds

–producing hormones (Calcitriol and erythropoietin)

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2
Q

Kidneys are the primary regulators of?

A
  • fluid, blood volume and pressure
  • ph
  • electrolyte balance
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3
Q

Cell types:

A

Intercalated cells

Principal cells

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4
Q

How is blood filtered in the glomerulus?

A

Under pressure

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5
Q

Anything that has a lower molecular mass than ……can pass through the filtration membrane

A

68 KDa

Proteins >68 KDa

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6
Q

Forces in favour of filtration

A

Glomerular blood hydrostatic pressure (GBHP)

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7
Q

How much is the Glomerular blood hydrostatic pressure (GBHP)?

A

60 mmHg

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8
Q

Why is the Glomerular blood hydrostatic pressure (GBHP) high?

A

Due to resistance of efferent arteriole

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9
Q

Forces opposing filtration

A

Capsular hydrostatic pressure (CHP)

Blood colloid osmotic pressure (BCOP)

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10
Q

How much is the Capsular Hydrostatic pressure (CHP)?why is the Capsular Hydrostatic pressure (CHP) 15 mmHg?

A

15 mmHg due to accumulated fluid in the capsule

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11
Q

How much is the Blood Colloid Osmotic Pressure (BCOP)?

A

30 mmHg

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12
Q

What is the Blood Colloid Osmotic Pressure (BCOP)30 mmHg?

A

Due to the presence of proteins such as albumin and fibrinogen in the plasma

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13
Q

Glomerular filtration rate is maintained at a relatively constant rate between MAP of?

A

80-180 mmHg

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14
Q

Three main regulatory mechanisms of ultrafiltration

A

Auto regulation

Neural regulation

Hormonal regulation

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15
Q

Glomerular filtration (GFR) in males?

A

125 ml.min -1

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16
Q

GFR in female

A

115 ml.min -1

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17
Q

Increased stretch of smooth muscle in afferent arteriole walls - reflex constriction of arteriolar smooth muscle is auto regulation is ?

A

Myogenic

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18
Q

Renin secretion increase when arteriolar pressure falls – increase vasoconstriction in auto regulation is due to?

A

Intra-renal baroreceptor mechanism

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19
Q

Renin secretion is inversely proportional to the amount of Na+ and Cl− entering the distal renal tubules from the loop of Henle in autoregulation is due to?

A

Macula dense sensor

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20
Q

Both afferent and efferent arterioles are supplied by ……………….. causing vasoconstriction, effect predominates in the afferent arteriole

A

Sympathetic neurons

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21
Q

In neural regulation, sympathetic activity is low and both afferent and efferent arterioles are dilated – autoregulation is the prevalent control mechanism

When?

A

At rest

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22
Q

In neural regulation, both arterioles constrict to the same degree with little effect on GFR when?

A

During increased sympathetic activity (e.g. movement, stress)

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23
Q

In neural regulation, when sympathetic activity increases: effect on afferent arteriole is greater, resulting in reduced blood flow, reduced GFR and reduced urine volume

When?

A

During exercise or significant MAP drop (e.g. haemorrhage )

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24
Q

In hormonal regulation, reduction in BP or reduction in delivery of NaCl causes release of

A

Renin

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25
Q

In hormonal regulation, Renin causes the conversion of circulating angiotensinogen to……….., which is then converted to ……….in the lungs

A

Angiotensin I

Angiotensin II

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26
Q

In hormonal regulation, Angiotensin II is a potent vasoconstrictor and constricts both

A

Afferent and efferent arterioles

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27
Q

In hormonal regulation, Increased blood volume causes stretching of the atria. Atrial muscle releases

A

ANP= Atrial Natriuretic Peptide

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28
Q

In hormonal regulation, ANP causes ?

A

Relaxation of the glomerular mesangial cells

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29
Q

Relaxation of the the glomerular mesangial cells is caused by?

A

ANP

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30
Q

Relaxation of the glomerular mesangial cells increases what ?

A

Surface area of filtration - increases GFR

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31
Q

The amount of blood filtered per unit time (usually a minute). The amount of liquid filtered out of the blood (GFR) that gets processed by the kidneys

Is called?

A

Renal clearance

32
Q

High clearance values indicate?

A

Effective excretion

33
Q

Low clearance values indicate

A

Ineffective excretion

34
Q

What is used to estimate Renal clearance = GFR?

A

Creatinine

35
Q

What is Responsible for the medullary osmotic gradient?

A

Juxtamedullary nephron

36
Q

Most numerous nephron ?

A

Cortical nephron

37
Q

Nephron that make short loop of Henle

A

Cortical nephron

38
Q

Nephron that makes long loop of Henle and extends into medulla

A

Juxtamedullary nephron

39
Q

What nephrons produce urine?

A

BOTH: Cortical nephron & Juxtamedullary nephron

40
Q

The thick ascending loop has…… permeability to water

A

LOW

41
Q

The descending loop has……….. to ions, but is permeable to …….

A

LOW

Permeable

42
Q

Urea is reabsorbed from the loop

True or false?

A

False

It’s not

43
Q

Where the nephron is permeable to water, water follows by

A

Osmosis

44
Q

GFR rate

A

105–125 mL/min of fluid that is isotonic to blood

45
Q

Filtered substances in GFR

A

Water and all solutes present in blood (except proteins) including ions, glucose, amino acids, creatinine, uric acid

46
Q

GFR is regulated by

A

RAS

47
Q

Secretion & reabsorption takes place in ?

A

Proximal convoluted tubule PCT

48
Q

Which tubules:

–Make the largest contribution to the process
–Solutes (Na+, glucose) and water reabsorbed by active and passive processes
–H+ secretion to maintain blood pH
–K+, NH3 and certain drugs secreted to eliminate
–HCO3- reabsorption to conserve an important buffer
–Water reabsorbed by osmosis

A

Proximal convoluted tubule

49
Q

Angiotensin II simulates reabsorption of Na⁺, Cl⁻ and H2O in

A

Proximal tubule

50
Q

Where does ONLY reabsorption take place?

A

Loop of Henle

Distal convoluted tubule - DCT

51
Q

Where in the Loop of Henle does water continues to be reabsorbed because of the osmotic gradient in the medulla?

A

Descending limb

52
Q

Where in the Loop of Henle is virtually impermeable to water?

A

Ascending Limb

53
Q

In the ascending limb of the Loop of Henle Cations follow because?

A

Of the potential difference created between the tubule and capillary

54
Q

Where does:

–reabsorption of Na+ and Cl- continues.
–Parathyroid hormone stimulates the reabsorption of Ca2+ by activating a Ca channel on the apical surface

A

Distal convoluted tubule DCT

55
Q

Parathyroid hormone stimulates the reabsorption of Ca2+ by activating?

A

A Calcium channel on the apical surface

56
Q

Reabsorption & excretion takes place in the ?

A

Late DCT and Collecting duct

57
Q

Where do:

–Principal cells reabsorb Na+ and secrete K+
- Aldosterone stimulates principal cells – stimulates Na+ reabsorption
- Antidiuretic hormone - insertion of aquaporins into the apical (luminal) membranes of the principal cells
- Excreting less water – increasing blood volume
–Intercalated cells reabsorb K+ and HCO3- and secrete H+
–Final adjustment of solutes and water

A

Late DCT & Collecting duct

58
Q

In Kate DCT & Collecting duct, aldosterone stimulates principal cells which stimulates?

A

Reabsorption of Na+

59
Q

In late DCT & Collecting duct, Antidiuretic hormone (ADH) causes?

A

Insertion of aquaporins into the apical (luminal) membranes of the cells

60
Q

Excreting less water, increases?

A

Blood volume

61
Q

Intercalated cells in late CDT & collecting duct reabsorb…….and secrete…..?

A

K+ and HCO3-

H+

62
Q

Regulation of reabsorption and secretion hormones

A

Renin-Angiotensin-Aldosterone System (RAAS)

Antidiuretic Hormone (ADH)

Atrial Natriuretic Peptide (ANP)

Parathyroid Hormone (PTH)

63
Q

low blood pressure - Intra-renal baroreceptors
Sympathetic innervation
low Cl- levels - Macula densa cells

They all stimulate?

A

Renin release

64
Q

Renin produces

A

Angiotensin II

65
Q

Effects of production of angiotensin II by renin

A

Salt conservation

Water conservation

Maintainance of blood pressure

66
Q

Renin stimulates the release of which hormone from the adrenal cortex to complement the action of angiotensin?

A

Aldosterone

67
Q

Which hormone is released by increase in blood volume or blood pressure?

A

Atrial Natriuretic peptide - ANP

68
Q

ANP is secreted from the?

A

Cardiac atria

69
Q

Tissues affected by ANP

A
  • Hypothalamus - ADH
  • Adrenal Cortex - Aldosterone
  • Kidney - Renin release
  • Medulla Oblongata - (Blood pressure)
70
Q

Action of ANP

A

Reduces Na+ and water absorption in the PCT and collecting duct.

71
Q

Which hormone reduces Na+ and water absorption in the PCT and collecting duct.

A

ANP

72
Q

What are the main organs that regulate acid-base status/ph?

A

Kidneys and respiratory system main organs

73
Q

Key processes of kidneys to regulate ph

A
  • match excretion of acid/base to intake, and

* produce physiological buffers to minimise changes

74
Q

Urine pH can be altered from around

A

5 to 9

75
Q
  • Reabsorption of bicarbonate mainly in PCT
  • Free acid excretion (minimal) – proton pumps in intercalated cells enable urine to be more acidic than serum
  • Ammonium (major) – renal ammonia produced by glutamine metabolism in PCT. Binds with H ions to make NH4+ which is excreted in urine.
  • Titratable acidity (phosphate, sulphate – ie: H2PO4)

They all cause

A

Urine oh to alter from 5 to 9

76
Q

Distribution of water in the body is defined as

A

Fluid balance

GU BLOCK (10 decks)

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