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Renal 1 Flashcards

1
Q

What does Renal artery do ?

what does Renal vein do?

A

Renal artery: blood and nutrients into the kidney

Renal vein: takes the blood out of the kidney into the body

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2
Q

what consists in the waste products (in the form of urine) ?

A

excess water
urea
excess nutrients

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3
Q

what are capillary beds and their roles?

A

renal arteries connect to the renal vein by capillary beds

  • vasa recta
  • peritubular capillaries
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4
Q

what are the three parts of a nephron?

A

1) renal corpuscle
2) Renal tubules
3) capillary network

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5
Q

what forms renal corpsucle?

A
  • afferent arteriole
  • glomerulus
  • efferent arteriole
  • bowman capsule
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6
Q

what forms renal tubules?

A

Proximal convoluted tubule
loop of henle - ascending and descending
distal convoluted tubules
collecting duct

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7
Q

what forms the capillary network and where are they found ?

A
  • vasa recta - found interwining/surrounds the loop of henle
  • peritubular capillaries - surrounds pct and dct
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8
Q

what are the 3 processes which occur in a nephron?

A

1) filtration
2) reabsorption
3) secretion

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9
Q

what happens in the process of filtration (nephron)

A
  • occurs in the glomerulus & Bowman’s capsule
  • blood enters the glomerulus under a really high pressure
  • constituents from the blood leave the glomerulus and enter the nephron via the Bowman’s capsule
  • this forms the filtrate. As it enters the tubules it is referred to as tubular fluid.
  • complex process then takes place as the tubular fluid passes through the nephrons. End product = urine
  • key relationship between molecular mass and filtration at this stage
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10
Q

in the process of filtration what is its relationship with molecular mass

A

The blood is arriving from the afferent arterioles contain RBCs, WBCs, water, really big proteins, amino acids (smaller proteins), glucose, waste products

The walls of the arterioles consists multiple layers which allow smaller molecules to pass through, but excluding larger molecules such as proteins

  • only lets small molecules enter and pass into the nephron
  • the larger molecules will stay in the blood - therefore it never enters the kidney
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11
Q

what is size of the molecules which is most appropriate to cross into the glomerulus and form a filtrate?

A

Substances that are up to 5000 Da flow freely across the glomerulus and into the Bowman’s capsule to form the filtrate

Substances above 5000 Da are less likely to cross from the glomerulus into the Bowman’s capsule

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12
Q

what happens in the process of reabsorption in the nephron?

A
  • movement of constituents from the tubular fluid back into the blood
  • this is aided by the existence of peritubular capillaries/vasa recta
  • the body is reclaiming these constituents before they are excreted in the form of urine
    • e.g. the reabsorption of water is one of the key regulators of blood pressure
    • can be transcellular of paracellular
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13
Q

what happens in the process of secretion?

A
  • movement of constituents from the blood into the tubular fluid
  • this is aided by the existence of peritubular capillaries/vasa recta
  • the body is removing these constituents so that they are excreted in the form of urine
  • can be transcellular or paracellular
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14
Q

what does the reabsorption of water regulate

A

blood pressure

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15
Q

what are the functions of a kidney?

A
  • Homeostasis
  • PRODUCE an active form of vitamin D that promotes strong, healthy bones
  • Control the PRODUCTION of RED BLOOD CELL
  • Remove drugs from the body
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16
Q

what are the roles of homeostasis within the kidney?

A
  • Removing waste products from the body
  • Regulating the pH of your blood
  • Regulating the blood pressure by regulating inorganic ions
  • Regulating water balance to maintain osmolality
  • Releasing hormones that influence water balance and regulate blood pressure
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17
Q

waste removal (homeostasis) - what products?

A

The kidneys are filtering devices for the blood

Remove the waste products of metabolic processes

- urea
- uric acid
- creatinine
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18
Q
  • what is the main component of urine?

- how can you determine if the kidney is not functioning correctly?

A
  • urine

- if there is high levels of urea, uric acid or creatine in the plasma then the kidney is not functioning correctly

19
Q

how can inorganic ions effect blood pressure (homeostasis):

  • hc03
  • ph of blood vs urine
  • ammonia
A

Due to their low molecular mass, all inorganic ions present in the blood are filtered into the Bowman’s capsule to form the filtrate

These ions are then reabsorbed into the blood at various points along the nephron
60-70% of Na+ and 90% of HCO3- is reabsorbed in the PCT

Bicarbonate (HCO3-)
- Alkaline; important function in maintaining acid-base balance in the blood
- Completely reabsorbed by the kidneys
pH
- pH of urine is much lower than that of plasma
- Acidic waste is removed by the kidneys
- Serious medical conditions can occur if the blood plasma is too acidic

Ammonium (NH4+)
- Almost all ammonium in the blood is removed by the kidneys

Excess sodium, potassium, calcium, phosphate and chloride are also removed by the kidneys

20
Q

Inorganic ions: reabsorption into the blood

PCT

A

Within the cortex

Na/K pumps transporters.

Sodium is actively pumped out of the tubular fluid back into the peri-tubular capillaries

21
Q

Inorganic ions: reabsorption into the blood

Descending limb

A

Within the medulla

IMpermeable to ION

22
Q

Inorganic ions: reabsorption into the blood

Ascending limb

A

Makes medulla very salty

Within the medulla

Na/K pumps
Na/K/Cl transporters

End result is having Na, Cl and K ions leaving the tubular fluid via the vasa recta

23
Q

Inorganic ions: reabsorption into the blood

DCT

A

Na/K and Na/Ca pumps

End result is having Na and Ca ions leaving the tubular fluid into the peri-tubular capillaries

Helps to pick more of the important nutrients to retain in the body

24
Q

How does regulation of water balance work?

homeostasis

A

They control how much water is removed from the blood stream and excreted as urine

  • central role in the regulation of blood pressure

Reabsorption of water takes place in the tubules of the nephrons

Reabsorption of water can occur either of two ways:

- Along an osmotic gradient (passive)
- By the release of hormones from the kidneys 	(active)
25
where ever sodium goes...
water goes aswell
26
PCT, ascending limb, descending limb, DCT and collecting duct and its relationship with water and sodium
PCT – the majority of water is reabsorbed here because the majority of sodium is reabsorbed here Ascending limb – the high sodium content being reabsorbed drives the reabsorption of water in the descending limb. Not permeable to water. Descending limb – impermeable to ions but permeable to water DCT - reabsorbs a little bit more water Collecting duct – re-absorbs some urea and water
27
what hormones are released which regulates blood pressure
Renin-Angiotensin-Aldosterone System (RAAS) Anti-diuretic hormone (ADH)
28
what is the role juxtaglomerlus apparatus | where is it found
intercession where DCT passes through efferent and afferent arteriole -picks up when the BP is low so that the kidney can release hormones
29
what cells are consisted in DCT?
macular densa cells - only found in dct where it intercepts the efferent and afferent arterioles -role with regulating blood pressure = water balance
30
where are juxtaglomerlus cells found?
afferent arteriole
31
where is the mesangial cells found and what is its role
- keep the structure of afferent and efferent arteriole
32
where are sympthatic nerves found
sitting ontop of juxtaglomerlus cells in the afferent arteriole sympathetic nerves have nerve endings which are sitting in the juxtaglomerlus cells
33
which hormone does juxtaglomerlus cells contain?
Renin
34
when is renin released from juxtaglomerlus cell and what happens
- when blood pressure is low | - the renin is released and enters the afferent arteriole which enters into the blood stream
35
what are the triggers for renin release into the bloodstream
a) Low blood pressure b) Sympathetic nerves c) Low sodium levels picked up by the macular densa cells
36
how can low blood pressure trigger renin
- when blood pressure is low it means the pressure of the blood entering the glomerlus via the afferent arteriole is low - this is sensed by the ENDOTHELIAL cells - the endothelial cells give a nudge to juxtaglomerlus cells to release renin - allow renin to enter blood stream
37
how can sympathetic nerves trigger renin
- the nerve ends sit into the juxtaglomerlus cells - when there is low blood pressure it is picked up by the sympathetic nerve along the afferent arteriole - when this is picked up the nerve endings which sit in the juxtaglomerlus cells starts firing - cause the release of renin from the JC.
38
how does low levels of sodium picked up by macular densa cells trigger renin release
- mucular densa cells has all the tubular fluid flowing through it - mucular densa cells are like tasting cells - they taste the amount of sodium are flowing through them - when sodium levels are low its telling macular densa cells that blood pressure is low - when sodium is low the macular densa cells release their own hormones - the hormone is called prostagladin - these travel to the juxtglomerlus cells to release renin
39
what does renin do after it reaches the blood stream
- Liver contains angiotensinogen = an inactive hormone - Renin + angiotensinogen = angiotensin 1 (converted) (angiotensin 1 floating around the blood) Endothelial cells within the tiny capillaries contain Angiotensin Converting Enzyme (ACE) ACE + angiotensin 1 = angiotensin 2 Angiotensin 2 will now go on to perform various functions in response to low blood pressure
40
what is the 4 things angiotensin 2 do to increase blood pressure?
travels to Smooth muscle cells: cause vasoconstriction (blood vessel smaller) = increased resistance (rapid response) ( in efferent as-well - concentrate blood in glomerulus therefore more blood to filter and deliver more oxygen) Kidneys: signal to the cells to re-absorb more Na+ = more H20 reabsorption Pituitary gland: signal to release Anti-diuretic Hormone (ADH) = vasoconstriction of smooth muscle + water reabsorption in collecting duct of nephron goes to Adrenal gland: signal to release aldosterone = (goes to nephron) Na + reabsorption = more H20 reabsorption VASOCONSTRICTION + INCREASED BLOOD VOLUME = INCREASED BLOOD PRESSURE!
41
what is ADH and its role? | -where is it released from?
Released from the pituitary gland with the aim of reabsorbing more water. It’s release is triggered by… Angiotensin 2 (RAAS system – we know this already!) Osmoreceptors: they can detect higher concentration of blood (blood is thicker) = higher osmolarity (not very dilute) = trigger ADH release Low blood volume: sympathetic nerve endings in the VEINS of the heart will sense this - signal to pituitary gland to release ADH Low blood pressure: sympathetic nerve endings in the ARTERIES of the heart will sense this - signal to pituitary gland to release ADH
42
what is Diabetes insipidus and its causes and what can go wrong types
- kidneys are unable to conserve water = pale, water urine; increased frequency of urination (every 15-20 minutes!); increased thirst; always feeling ‘dry’ - Two types of diabetes insipidus… 1) Cranial diabetes insipidus 2) Nephrogenic diabetes insipidus cranial : Brain tumour damaging the hypothalamus or pituitary gland Severe head injury damaging the hypothalamus or pituitary gland Complications that occur during brain or pituitary surgery nephrogenic : Nephrons unable to respond to ADH Congenital (i.e. genetic) Acquired e.g. use of longterm lithium for bipolar disease or other causes such as hypercalcaemia or obstruction of the ureters
43
what hormone does adrenal gland produce? | and its role
goes to Adrenal gland: signal to release aldosterone = (goes to nephron) Na + reabsorption = more H20 reabsorption

resit part 2c (25 decks)

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