Renal 1 Flashcards
Briefly describe the functions of the kidney.
- Regulation of water and electrolyte balance
- Regulation of arterial blood pressure
- Excretion of metabolic waste and foreign substances
- Contribute to acid-base regulation
- Regulation of RBC production through erythropoietin
- Final step in Vit D production
- Gluconeogenesis
Sketch and label the parts of the nephron and its associated blood vessels.
descending aorta -> renal artery -> interlobar arteies -> arcuate arteries -> interlobular arteries -> afferent arterioles -> globerulus -> efferent arteriole –> peritubular arteries
vasa recta is portion that supplies medulla
Describe what is meant by the following terms: lumen of the nephron, luminal side of tubular cell, apical side of tubular cell, and basolateral side of tubular cell.
- lumen of nephron: inside where the urine is made
- luminal side/apical side of tubular cell: inside facing the urine
- basolateral side of tubular cell: sides and outer portion of the lumen
Match functions with each labeled area above. Which nephron area is/are also called a diluting segment? Which area is responsible for most isosmotic reabsorption?
diluting segments: distal tubule and thick ascending limb (not permeable to water)
isosmotic: proximal tubules (solutes and water move together)
Describe how protein is reabsorbed in proximal tubule.
Small aa reabsorbed with ions. Larger use endocytosis and leave via basolateral membrane.
State where ADH acts in the kidney and briefly describe its role in controlling water concentration in urine.
collecting ducts of kidney.
High ECF osmolarity causes osmoreceptors to shrink-> synthesis of ADH -> more aquaporins and reabsorp more water -> decrease osmolarity
List the nerves that innervate the bladder and external sphincter. State which nerve contains each of the following: sympathetic input, parasympathetic input, and voluntary motor input. Which nerve/input is the main cause of bladder contraction? which causes constriction of the external sphincter of the bladder?
sympathetic: Hypogastric n. (L1-3)
parasypathetic: Pelvic n. (S2-4)
volunary motor: Pudendal n. (S2-4)
- bladder contraction is pelvic n.
- external sphincter is pudendal n.
Describe each of the following conditions or reflexes and state when it occurs: vesicoureteral reflex, ureterorenal reflex, micturition reflex, sympathetic storage reflex, somatic storage reflex.
vesicoureteral reflex: ureters path through bladder wall is less oblique and shorter- doesn’t fully close and permits backward flow of urine into ureters.
ureterorenal reflex: kidney stone in ureter cuase pain and sensory n. constriction of the afferent arterioles which will decrease the amount of fluid produced by the kidney to reduce excessive flow to blocked kidney
micturition reflex: relaxation of the urethral sphincter in response to increased pressure in the bladder. Bladder stretch receptor initiate reflex. As bladder fills, reflex gets stronger/reoccurs faster.
sympathetic storage reflex: bladder distends and generates afferent activity in pelvic nerves. pelvic to hypogastric.
somatic storage reflex: elicited to sudden increase in intrabdominal pressure. pelvic to pudendal
Describe what is meant by the term atonic bladder. What type of lesion can cause an atonic bladder? Does this type of dysfunction cause overflow incontinence?
atonic bladder: sensory nerve fibers from bladder to spinal cord are destroyed. overflow incontinence.
(tabetic bladder, crush to sacral region of spinal cord)
Describe what is meant by the term automatic bladder. What type of lesion can cause an automatic bladder? Do the symptoms of automatic bladder appear immediately after the lesion?
damage to spinal cord above sacral region
initial short term overflow, then automatic bladder due to spinal shock
Describe the possible cause and symptoms associated with uninhibited neurogenic bladder.
partial damage in spinal cord/brain stem that interrupts most of descending inhibitory signals but leave facilitory signal ok
frequent and uncontrolled micturition
