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Physiology of human organ systems > Renal > Flashcards

Renal Flashcards

1
Q

What are 3 hormones produced by the kidneys?

A

Renin, EPO and calcitrol

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2
Q

How many nephrons are found in the body in total?

A

around 2.5 million.

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3
Q

How much blood is filtered out from the glomerular arterioles?

A

around 20%

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4
Q

Which fibres alter the blood flow to the glomeruli?

A

Sympathetic fibres

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5
Q

How many nephrons are juxtamedullary?

A

Between 15-25%

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6
Q

What is the importance of juxtamedullary nephrons?

A

They have very long loops of henle and collecting ducts allowing them to concentrate urine more than other types of nephrons.

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7
Q

What do efferent arterioles recombine into?

A

The peritubular capillaries.

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8
Q

What do the peritubular capillaries become when they are closely linked to the collecting duct and loop of henle?

A

The vasa recta

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9
Q

Where does the majority of reabsorption take place?

A

The PCT.

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10
Q

What does the PCT reabsorb?

A

Ions, Water and organic nutrients

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11
Q

What does the PCT secrete?

A

Metabolites and other drugs such as xenobiotics.

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12
Q

Name a renal tracer and explain its importance.

A

Para-aminohippurate is a renal tracer. It cannot be reabsorped by the nephorn once filtered so its concentration in urine is a useful indicator of GFR

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13
Q

How much plasma do the glomeruli filter per minute?

A

125ml/min which is around 180l/day

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14
Q

Which forces help to push solute out of afferent capillaries and what is it greater than?

A

Hydrostatic forces is greater than oncotic pressure.

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15
Q

What is the net filtration pressure across the glomeruli?

A

10mmHg

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16
Q

What components form the GFR co-efficient?

A

The slit surface area and barrier permeability.

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17
Q

Which hormones can influence afferent arteriole resistance and flow to glomeruli?

A

Catecholamines and angiotensin 2

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18
Q

What is the range of kidney autoregulation of GFR?

A

130-60mmHg

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19
Q

What happens to 50% of the urea which is filtered by glomeruli?

A

It is reabsorbed.

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20
Q

What substances are reabsorped by channel or carrier proteins?

A

Glucose, amino acids, phosphates and organic ions.

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21
Q

What is a normal value of ECF [Na+]?

A

142mmol

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22
Q

How much sodium is reabsorbed in the PCT?

A

65-75%

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23
Q

Is Na+/K+ transport affected by transport maximum?

A

No.

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24
Q

WHere are the hydrogen ions that are excreted in urine formed?

A

They are formed in the tubular lumen epithelium

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25
Q

What does the inability to reabsorb everything mean for urine concentration?

A

It means that there will be a minimum amount of effective osmoles still in the urine, which draws water into the urine. This means that there is a maximum attainable concentration for urine.

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26
Q

What happens to metabolites which are too large or charged to pass the glomerular barrier?

A

They are secreted into the PCT by unspecific carriers.

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27
Q

What is the primary intracellular cation?

A

K.

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28
Q

What is a normal ECF [K+]?

A

4mmol

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29
Q

What concentration might be classed as hyperkalaemia?

A

> 5.5mol

30
Q

What concentration might be considered hypokalaemia?

A

<3mmol

31
Q

What does hypokalaemia mean for cells?

A

They are hyperpolarised so struggle to reach threshold for action potential propagation.

32
Q

Name another tracer molecule.

A

inulin.

33
Q

What is renal clearance?

A

A measure of how well the kidneys are excreting substances.

34
Q

What is average plasma mOsm/l?

A

~285mOsml/l

35
Q

What is reabsorbed in the descending loop of henle?

A

Water, no ions

36
Q

What is reabsorbed in the ascending loop?

A

Ions, no water.

37
Q

What can alter ADH secretions?

A

Stress, pain and emotion

38
Q

What is neurogenic diabetes insipidus?

A

Deficiency of ADH production.

39
Q

What is nephrogenic diabetes insipidus?

A

Nephrogenic ADH insensitivity

40
Q

A moderate decrease in ECF is detected by which receptors?

A

Atrial receptors

41
Q

When do all baroreceptors detect a change in ECF volume?

A

When the change is very significant.

42
Q

Where is angiotensin secreted from?

A

The liver.

43
Q

Where is renin secreted from?

A

The kidneys.

44
Q

What does renin do?

A

Converts angiotensin to angiotensin 1

45
Q

Which enzyme converts angiotensin 1 to angiotensin 2?

A

Angiotensin converting enzyme (ACE)

46
Q

What is special about ACE?

A

It is an ectoenzyme meaning it is bound to a membrane

47
Q

What effect does ANG II have on the adrenal cortex?

A

Stimulates it to secrete aldosterone and initiate vasoconstriction.

48
Q

How does ANG II decrease heart rate?

A

By acting on the medullary cardiovascular centre

49
Q

What effect does aldosterone have on sodium and water reabsorption?

A

It stimulates the DCT to reabsorb more sodium and water to increase the blood pressure.

50
Q

Which cells in the DCT are directly stimulated by aldosterone?

A

P-cells

51
Q

When is atrial natiuretic peptide secreted?

A

When the atria are hyperdistended.

52
Q

What does 2 main roles does ANP have?

A

To inhibit aldosterone and increase GFR

53
Q

Why does ANP perform these roles?

A

To decrease the amount of sodium and therefore water that is being reabsorbed. This will result in reduced ECF volume and blood pressure.

54
Q

What is a normal pH range?

A

7.35-7.45

55
Q

What is a normal PCO2?

A

40mmHg or 5.33kPa

56
Q

What is a normal [HCO3-] concentration?

A

24mM

57
Q

What can cause metabolic acidosis?

A

Diabetic ketoacidosis.

58
Q

What can prolonged vomiting cause in terms of acid/base disorders?

A

metabolic alkalosis

59
Q

Acute respiratory acidosis may be cause by?

A

Breathing 7% CO2

60
Q

What acid/base disorder might emphysema cause?

A

Chronic respiratory acidosis.

61
Q

Prolonged time in high altitude might cause which acid/base disorder?

A

Chronic respiratory alkalosis.

62
Q

What might be a cause of acute respiratory alkalosis?

A

Hyperventilation.

63
Q

What is the first step in determing the acid/base disorder?

A

Is the pH high or low?

64
Q

What is the second step in determing the acid base disorder?

A

Whether it is metabolic or respiratory.

65
Q

How can you determine whether the acid/base disorder is metabolic or respiratory?

A

If it is respiratory then PCO2 is likely to be affected.

If it is metabolic then PCO2 is likely to be unaffected.

66
Q

What is the 3rd step in determining acid/base disorder?

A

Whether or not it is chronic or acute.

67
Q

How can you determine whether an acid/base disturbance is chronic or acute?

A

If the [HCO3-] has signficantly moved from a normal level then it is likely to be chronic, if not, then it is likely to be acute.

68
Q

If the acid/base disturbance is caused by a change in [HCO3-] is the cause likelt to be respiratory or metabolic?

A

Metabolic.

69
Q

When might renal compensation for an acid/base disorder occur?

A

When the cause if the disturbance is respiratory.

70
Q

What is respiratory compensation in response to?

A

A renal/metabolic issue causing an acid/base disturbance.

Physiology of human organ systems (5 decks)

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