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PHSL101 > Renal > Flashcards

Renal Flashcards

1
Q

why do we need the kidneys

A

to control what is in the blood and how much blood we have

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2
Q

what is the main function of kidneys

A

filter blood

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3
Q

what do our kidneys regulate

A

blood osmolarity, volume and pressure, red blood cell production, pH

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4
Q

what waste do the kidneys eliminate

A

nitrogen (from breaking down amino acids) and drugs/toxins

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5
Q

the __ kidney is slightly higher than the other

A

left

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6
Q

what do juxtamedullary nephrons do

A

concentrate and dilute urine

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7
Q

what do cortical nephrons do

A

regulatory functions

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8
Q

is the afferent arteriole the higher or lower arteriole on the glomerulus

A

lower

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9
Q

each kidney contains how many nephrons

A

1 million

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10
Q

the renal tubules are lined with

A

epithelial cells

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11
Q

where is the apical side of the cell

A

facing into the lumen (inside)

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12
Q

where is the basolateral side of the cell

A

faces the interstitial fluid (outside)

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13
Q

what are epithelial cells in the nephron joined by

A

tight junctions

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14
Q

what is the path of reabsorption

A

lumen, apical side, through/between cells, basolateral side, interstitial space, bloodstream

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15
Q

what are the capillaries surrounding the nephrons called

A

peritubular capillaries

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16
Q

what is the transcellular pathway, what does it require

A

through the cells, requires permeability (transport proteins etc), driving force (gradient or energy), can be automatic or controlled by hormones

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17
Q

what is the paracellular pathway and what does it require

A

between cells, transport proteins not required, permeability depends on tightness of junction

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18
Q

diffusion/osmosis travels in which pathways

A

through the membrane or tight junction driven by a gradient

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19
Q

how is facilitated diffusion possible

A

through a channel or transporter

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20
Q

primary active transport uses

A

ATP for energy

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21
Q

secondary active transport uses

A

the movement of one substance down its gradient to drive the movement of another substance against its concentration gradient (these may be moving in the same direction but gradients are opposite)

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22
Q

what is an electrical gradient

A

positive attracted to negative and vice versa

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23
Q

water moves to where there is more

A

solute

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24
Q

which molecules need a channel or transporter

A

larger and not lipid soluble or have a charge

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25
Q

which molecules are able to pass through or between cells on their own

A

very small or lipid soluble

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26
Q

when there is leaky tight junctions, which pathway can water move through

A

both trans and para cellular

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27
Q

when there are tight tight junctions, which pathway can water move through

A

has to go through the transcellular pathways using aquaporins

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28
Q

what are aquaporins

A

channels in the transcellular pathways for water to move through

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29
Q

what do the adding or removing of aquaporins result in

A

more reabsorption or more excretion of water

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30
Q

reabsorption uses which forms of transport

A

all of them

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31
Q

pressure is __ in the capillary than in the capsular space so things move __ of the capillary __ the capsular space

A

higher, out, into

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32
Q

why do things move out of the capillary into the capsular space

A

pressure gradient, higher in the capillary, lower in the capsular space

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33
Q

what molecules from the blood become filtrate

A

water, ions, glucose, amino acids, hormones

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34
Q

what molecules are too big to become filtrate

A

red and white blood cells, plasma proteins

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35
Q

how much blood do the kidneys filter per min

A

125mL

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36
Q

how much blood do the kidneys filter per day

A

180L

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37
Q

how many times is your entire blood supply filtered per day

A

36

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38
Q

how much urine do we produce a day

A

1.5L (500mL-20L min and max)

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39
Q

why is our blood filtered so any times per day

A

if something in the body changes they can change the way it is filtered accordingly

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40
Q

the absorption of 90% water, 90% Na+ and 100% nutrients (glucose, amino acids) by the proximal tubule is an __ process

A

automatic (obligatory reabsorption), they absorb this regardless

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41
Q

which type of epithelia are in the proximal tubule

A

leaky

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42
Q

what type of pathways are used in the proximal tubule

A

both trans and para cellular

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43
Q

describe the Na+ and K+ concentrations in and out of cells

A

low Na+ inside cell and high outside, high K+ inside cell and low outside

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44
Q

glucose and amino acids are reabsorbed through the apical membrane using __ driven by __

A

sodium coupled secondary active transport driven by the sodium electrochemical gradient created by the Na+/K+ ATPase pump

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45
Q

glucose and amino acids are reabsorbed through the basolateral membrane using __ driven by __

A

facilitated diffusion driven by concentration gradients created by the secondary active transport of glucose and AA’s through the apical membrane

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46
Q

reabsorption of glucose and AA’s causes __ reabsorption as well

A

sodium, this is a big contributor to the 90% of sodium reabsorption that has to happen

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47
Q

once sodium is reabsorbed _ follows

A

water by osmosis

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48
Q

where sodium goes __ follows via the paracellular pathway, down its electrical gradient (all of the positive ions that have just be reabsorbed are going to attract the negative ion chloride into the bloodstream)

A

chloride, helped by leaky junctions (paracellular)

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49
Q

the distal tube regulates blood volume, osmolarity and pH by determining how much ______ is reabsorbed

A

water, Na+, H+/HCO3-

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50
Q

the distal tubule is regulate by

A

hormones

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51
Q

what type of epithelia lines the distal tubule

A

tight epithelia

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52
Q

what pathway is the only one used in the distal tubule

A

transcellular

53
Q

what do tight tight junctions let through

A

nothing

54
Q

what do leaky tight junctions let through

A

some things

55
Q

how do hormones regulate reabsorption of water and sodium

A

if need more/less of something they add/take away channels/transporters fro sodium and water

56
Q

which tubule is under hormonal control

A

distal

57
Q

what hormone regulates water reabsorption

A

ADH

58
Q

what hormone regulates sodium reabsorption

A

aldosterone

59
Q

is ADH a fast or slow response

A

fast

60
Q

what type of hormone is ADH and where is it released from

A

peptide hormone, from the posterior pituitary

61
Q

what type of hormone is aldosterone and where is it released from

A

steroid hormone, from adrenal cortex

62
Q

is aldosterone a fast or slow response

A

slow, long term response

63
Q

ADH needs which driving force

A

osmotic gradient

64
Q

water can only use the

A

transcellular pathway

65
Q

water needs __ to enter and exit the nephron cells

A

aqauporins

66
Q

water cannot use the

A

paracellular pathway

67
Q

what is the osmolarity of the blood, ICF, ECF and renal cortex

A

300mosmol/L

68
Q

is the osmolarity in the Rena medulla higher or lower than the cortex

A

much higher

69
Q

the gradient of osmolarity from the renal cortex to medulla is the driving force for

A

water to be reabsorbed in the distal tubule

70
Q

what is an increase/decrease in ECG osmolarity detected by

A

osmoreceptors in the hypothalamus

71
Q

an increase in ECF osomolarity leads to more or less ADH being released

A

more

72
Q

increase in ADH results in increase of

A

aquaporins in the apical membrane of distal tubule cells

73
Q

ADH and aldosterone acts on the __ tubule

A

distal

74
Q

what is the driving force for sodium reabsorption

A

electrochemical gradient

75
Q

sodium cannot use the _ pathway

A

paracellular, they must use the transcellular pathway just like water

76
Q

what does sodium need to enter the cells

A

sodium channels

77
Q

how does sodium leave the cells

A

pumped out by Na+/K+ ATPase pump

78
Q

what is ADH stimulated by

A

change in osmolarity

79
Q

what is aldosterone stimulated by

A

loss of water and ions - isosmotic fluid loss e.g. blood loss, vomiting or diarrhoea (this is not a change in osmolarity as both water and ions have been lost) there is no gradient for water to move in or out of cells due to this, only a change in ECF and therefore blood volume and pressure

80
Q

what is a decrease in blood volume detected by

A

pressure receptors in the kidney

81
Q

what is the response to a decrease in blood pressure (due to a loss of isosmotic fluid) detected by pressure receptors in the kidney

A

increased released of aldosterone from the adrenal cortex and increased release of ADH from the posterior pituitary

82
Q

why are both aldosterone and ADH released after a drop in blood pressure

A

blood pressure drops due to a loss of both water and ions (isosmotic fluid) in the ECF so need to stimulate the increased reabsorption of both

83
Q

aldosterone levels cause the addition/reduction of

A

sodium channels

84
Q

does ADH affect driving force for water reabsorption in the kidney

A

no the driving force is the osmolarity gradient, ADH increases permeability

85
Q

when the body loses water does ECF or ICF volume change

A

both change

86
Q

when the body loses water and ions does ECF or ICF volume change

A

just ECF

87
Q

why is ADH fast and aldosterone is slow

A

blood osmolarity is an emergency, blood volume is less urgent

88
Q

sweat is hypo osmotic, this means it is __ salty than plasma

A

less

89
Q

what is hyponatremia

A

sodium deficiency, over hydration

90
Q

ADH is released at anticipation of water loss during exercise, this process is called

A

feedforward

91
Q

if the feedforward of the body releasing ADH during exercise is combined with the athlete drinking a lot of water this will lead to

A

the body keeping too much water, over hydration (hyponatremia), body can’t release the extra water as ADH has been released to conserve this

92
Q

which is more dangerous, dehydration or overhydration

A

overhydration

93
Q

why is blood volume less urgent for the body

A

because there is another system that can rapidly adapt to changes in volume and pressure (CVS), when we lose isosmotic fluid there is no change in cell volume only a change in blood (ECF) volume

94
Q

what is the fast and slow response to replacing isosmotic fluid loss

A

fast - CVS, slow - kidneys (increase sodium and water reabsorption to replace blood volume), this is longer term

95
Q

what is the neutral pH range of the ECF

A

7.35-7.45

96
Q

what is too much acid called

A

acidosis

97
Q

what is too much base called

A

alkalosis

98
Q

plasma below 6.8 or above 7.7 is usually

A

lethal

99
Q

acid is a H+

A

donor, releases H+, lowering pH

100
Q

base is a H+

A

aceptor, binds to and removes H+, increasing pH

101
Q

the body produces how much acid per day

A

1300mmol

102
Q

to keep pH normal we have to

A

buffer the acid, remove excess acid

103
Q

what processes are pH sensitive

A

enzyme activity, ion transport mechanisms, cell metabolism, DNA synthesis and growth

104
Q

the acidity of the body is increased by

A

gaining H+ or losing HCO3-

105
Q

how is H+ gained

A

from CO2 production by metabolism, protein breakdown (amino acids), lactic acid, ketones

106
Q

how is HCO3- lost

A

diarrhoea (GI fluid)

107
Q

the acidity of the body is decreased by

A

loss of H+ by vomit (acid from the stomach) or medications that cause H+ loss, hyperventilation (decreased CO2)

108
Q

which three systems work together to control the pH of the body

A

buffering systems (fast response), respiratory system (fast response), urinary system (long term)

109
Q

what is a buffer

A

a substance that minimises changes in pH, when H+ concentration is altered

110
Q

when the H+ concentration increases, buffers __ the excess H+ molecules to__ the amount of acid (__ the pH)

A

bind, decrease, increase

111
Q

when the H+ concentration decreases, buffers __ H+ molecules to__ the amount of acid (__ the pH)

A

release, increase, decrease

112
Q

when there is too much H+, it is converted to __ until equilibrium is reestablished

A

water, through carbonic acid resulting in CO2 and H2O it is then diffused out of the blood into the lungs and is breathed out (blown off)

113
Q

the partial pressure of CO2 in the blood affects the

A

pH of tissues, when CO2 increases it increases H+ and when CO2 decreases, it decreases H+

114
Q

when body pH is normal (7.35-7.45) how much bicarbonate is reabsorbed back into the blood

A

all of it

115
Q

how much acid do the kidneys secrete per day

A

4-5000mmol

116
Q

what is the kidneys response to metabolic acidosis

A

increasing excretion of acid

117
Q

what is a metabolic source of acid

A

breaking down proteins

118
Q

is increasing HCO3- absorption in the GI tract related to buffering

A

no

119
Q

what is metabolic acidosis due to

A

increased acid production from metabolism (increased ATP production leading to increased CO2 and H+ production) or loss of HCO3-

120
Q

why do the kidneys kick in to help the respiratory system get rid of acidosis

A

the lungs don’t want to be continuously increased breathing to get rid of it (this is ok for short term e.g. running for bus)

121
Q

how is H+ excreted into the urine and HCO3- reabsorbed to counteract acidosis

A

combine to make carbonic acid and then H2O and CO2 which can get into cells, then once in the cells, reassemble to H+ and HCO3-, HCO3- is reabsorbed into the blood, H+ is excreted back into the urine to increase pH to normal range

122
Q

what is metabolic alkalosis caused by

A

loss of H+ or increased HCO3- production due to vomiting or medication

123
Q

what does the pH need to be less than to be acidosis

A

7.35

124
Q

what does the pH need to be more than to be alkalosis

A

7.45

125
Q

how does CO2 cause a increase in H+

A

CO2 and water is combined to make carbonic acid which is broken down to make H+ and HCO3-

126
Q

how does breathing increase H+

A

decrease ventilation to increase CO2 and H+ back to within the normal range

127
Q

how is HCO3- excreted in the urine and H+ reabsorbed to counteract alkalosis

A

the same way as the reverse, they are combined in to carbonic acid and then broken into CO2 and H2O to go into renal tubule cells, then reassembled to carbonic acid and broken into H+ and HCO3-, H+ is reabsorbed and HCO3- is excreted in urine to decreased pH to normal range

128
Q

simple terms how to counteract acidosis

A

secrete H+ in urine, generate/reabsorb HCO3-

129
Q

simple terms how to counteract alkalosis

A

secrete HCO3- in urine, generate/reabsorb H+

PHSL101 (10 decks)

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