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Human Physiology > Renal > Flashcards

Renal Flashcards

1
Q

three main functions of the kidney

A
  1. excretion
  2. regulation
  3. absorption
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2
Q

six major functions of the kidney

A
  1. stabilizing electrolytes
  2. water balance/proper osmolarity
  3. excretion of nitrogenous waste
  4. acid/base regulation
  5. maintaining the blood concentration and ridding of hormones, drugs, pesticides, food additives, and nonnutritive materials
  6. production of 2 VIP hormones
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3
Q

what two VIP hormones do kidneys produce?

A

erythropoietin and renin

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4
Q

what is the smallest functional unit of the kidney?

A

nephron

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5
Q

two types of nephrons

A

juxtamedullary and cortical

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6
Q

cortical nephron

A

glomeruli in the outer cortex, smaller loops of Henle, ~80% of nephrons

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7
Q

juxtamedullary nephron

A

glomeruli next to medulla, long loops of Henle penetrating into medulla, ~20% of nephrons

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8
Q

five major regions

A
  1. Bowman’s capsule/glomerulus
  2. proximal convoluted tubule
  3. loop of Henle
  4. distal convoluted tubule
  5. juxtaglomerular apparatus
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9
Q

region 1

A

glomerulus and Bowman’s capsule

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10
Q

Bowman’s capsule and glomerulus primary function

A

filtration

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11
Q

ultrafiltration

A

pressure inside the capillaries is greater than outside, driving fluids through pores

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12
Q

fenestrae

A

pores in Bowman’s capsule

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13
Q

what size substrates fit in the fenestrae

A

less than 6 nm or 68 kDa

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14
Q

four types of filtrate entering the proximal convoluted tubule

A
  1. carbohydrates
  2. electrolytes
  3. H2O and small particles
  4. plasma and free cellular material
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15
Q

to be filtered a substance must pass through…

A
  1. the pores between endothelial cells of the glomerular capillaries
  2. an acellular basement membrane
  3. the filtration slits between the foot processes of the podocyte
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16
Q

podocyte

A
  • contraction causes foot processes to flatten, decreasing pore diameter
  • contraction under sympathetic stimulation, acts upon actin-like filaments
  • can also decrease the number of slits, decreasing glomerular filtration rate
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17
Q

glomerular filtration rate

A

how many pore of the glomerulus are available for permeation

(Kf)(NFP)

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18
Q

Kf in glomerular filtration rate

A

filtration coefficient

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19
Q

NFP in glomerular filtration rate

A

net filtration pressure based on 3 pressures

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20
Q

what three pressures are NFP based on?

A
  1. glomerular-capillary bp
  2. plasma-colloid osmotic psi
  3. Bowman’s hydrostatic psi
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21
Q

glomerular-capillary bp

A

systemic bp, favors filtration

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22
Q

plasma-colloid osmotic psi

A

blood osmolarity, opposes filtration

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23
Q

Bowman’s hydrostatic psi

A

the psi pushing against the glomerular capillaries, opposes filtration

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24
Q

greatest factor in changing GFR is…

A

systemic bp

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25
Q

how does exercise affect systemic bp?

A

increases blood pressure

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26
Q

how does hemorrhage affect systemic bp?

A

decreases blood pressure

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27
Q

how does excess fluids affect systemic bp?

A

decreases blood pressure

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28
Q

what does diarrhea do?

A

increases/decreases plasma osmolarity

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29
Q

what do burns and trauma do?

A

decreases NFP

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30
Q

what do kidney stones do?

A

increase Bowman’s hydrostatic psi

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31
Q

vasa recta

A

straight (vertical) vessels

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32
Q

peritubular capillaries

A

convoluted

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33
Q

region 2

A

proximal convoluted tubule

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34
Q

main function of the proximal convoluted tubule

A

glucose uptake

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35
Q

what particles does the PCT take up?

A

small mw amino acids and proteins, 100% of glucose, polypeptides, organics, salts, and water

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36
Q

hyperglycemia

A

high concentrations of glucose in the blood

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37
Q

glucosuria

A

glucose in urine

38
Q

glucose has a _____ _____ because of limited supply of glucose transporters

A

renal threshold

39
Q

renal threshold

A

the amount of glucose the renal system can filter at any given point, 300mg/100mL

40
Q

tubular maximum

A

375mg/min

41
Q

how is glucose reabsorbed via the PCT?

A

secondary active transport via Na+ support

42
Q

how is sodium reabsorbed via the PCT? (4 steps)

A
  1. luminal membrane
  2. basal lateral membrane *
  3. interstitial fluid
  4. endothelial membrane

*requires Na/K pump, making the whole process active

43
Q

what does alcohol block?

A

secondary active transport

44
Q

uremia

A

renal failure

45
Q

water moves through the tight junction attracted by the _____ _____ of sodium

A

osmotic force

46
Q

water is osmotically attracted to _____ _____ in the blood

A

plasma proteins

47
Q

plasma proteins can/cannot pass through podocytes?

A

cannot

48
Q

region 3

A

loop of henle

49
Q

counter-current multiplication

A

descending loop of Henle is very permeable, ascending loop is not permeable

50
Q

as you enter the medulla, there will be…

A

a steep salt gradient

51
Q

salts act as an attractant to _____

A

water

52
Q

descending loop of Henle does what

A

releases lots of water, leaving salts behind

53
Q

ascending loop of Henle does what

A

releases a lot of salt, so the water can be reabsorbed

54
Q

region 4

A

distal convoluted tubule

55
Q

distal convoluted tubule primary function

A

hormone regulation

56
Q

hormones produced by the distal convoluted tubule

A

ADH and aldosterone

57
Q

aldosterone

A

increases Na+ and K+ secretion

58
Q

aldosterone is what type of hormone?

A

steroid hormone

59
Q

how does aldosterone work?

A

turns on gene transcription in the nucleus to produce new Na/K pumps and Na channels

60
Q

ADH - vasopressin

A

increases H2O absorption, lowers blood pressure and volume

61
Q

what type of hormone is ADH?

A

protein hormone

62
Q

how does ADH work?

A

activates cAMP, triggering the insertion of aquaporins into the DCT membrane

63
Q

where is ADH released from?

A

posterior pituitary

64
Q

what molecule inhibits aldosterone when blood volume is too high?

A

ANP

65
Q

what does a high concentration of K+ cause?

A

more production of aldosterone via the adrenal cortex

66
Q

what does low sodium/blood pressure trigger?

A

renin-angiotensin-aldosterone pathway

67
Q

what does high K+ cause?

A

a decrease in resting membrane potential, lowering AP threshold, causing hyperexcitability of the heart (arrhythmias)

68
Q

what does lower K+ cause?

A

increase in resting membrane potential. leading to hyperpolarization, skeletal muscle weakness, abnormal heart conduction etc.

69
Q

region 5

A

juxtaglomerular apparatus

70
Q

what does an increased flow rate cause the macula densa cells to do?

A

secrete a vasoactive chemical to contract smooth muscle

71
Q

macula densa cells

A

detect blood flow rate; release a chemical that helps restrict the afferent arteriole if GFR is too high

72
Q

vasoconstriction

A

decreases blood flow to the glomerulus

73
Q

vasodilation

A

increases blood flow to the glomerulus

74
Q

granular cells

A

detect low bp, and [Na+] to release return

75
Q

hypertension

A

bp is greater or equal to 140-180
abnormally high increase in the renin-angiotensin-aldosterone activity

76
Q

glomerulonephritis

A

thickening of podocytes, fall of GFR, too much water leading to hypertension

77
Q

congestive heart failure

A

blood volume is elevated (15%-20% more)
excess ECF

78
Q

albuminuria

A

protein in urine

79
Q

pseudonephritis

A

after extreme exercise, protein in urine

80
Q

edema

A

fluid retention

81
Q

inappropriate triggers to heart failure (1/2)

A

activates autoregulation, sympathetic control to try and get GFR back up

82
Q

inappropriate triggers to heart failure (2/2)

A

stimulates renin to increase H2O reabsorption and increase Na/K pumps to stabilize

83
Q

patient treatments

A

low salt diet
diuretic drug therapy
ACE inhibitors
ANP treatment

84
Q

ACE does what?

A

converts angiotensin I to angiotensin II

85
Q

ANP (atrial natriuretic peptide)

A

acts to decrease bp, increase urine output, and increase Na+ loss

86
Q

acute renal failure

A

rapid reduction in urine, only 500 or less in a day
reversible

87
Q

chronic renal failure

A

slow, progressive loss of nephron function
undetectable
up to 75% of nephrons are not functioning

88
Q

end stage renal failure

A

90% or more nephrons are not working
every organ is affected
irreversible loss
fatal

89
Q

two treatments for end stage renal failure

A

transplant
dialysis

90
Q

CAPD

A

continuous ambulatory peritoneal dialysis

91
Q

advantages of dialysis

A
  1. 4x faster than normal
  2. increase life from 15-20 years
  3. feed individuals
92
Q

disadvantages of dialysis

A
  1. not great quality of life
  2. 4-6 hours three times a week
  3. still affects organs
  4. take anticoagulants

Human Physiology (11 decks)

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