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ILA > Renal > Flashcards

Renal Flashcards

1
Q

Are kidneys retra or intra peritoneal?

A

Retroperitoneal

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2
Q

What spinal lvl kidneys sit?
Which lower

A

T12-L3
Right usually lower- liver

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3
Q
A
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4
Q

What is outer and inner layer of kidney called?

A

Outer- Cortex
Inner- Medulla

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5
Q

Describe urine flow in kidney?

A

Renal pyramid
Papilla
Minor calyx
Major calyx
Renal pelvis
Proximal ureter

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6
Q

Function ureter?

A

Carry urine from kidney to bladder

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7
Q

Where are 3 points ureter narrows?

A

Where pelvis of kidney becomes ureter
At the pelvic brim
Where the ureter passes through the bladder

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8
Q

What muscle is ureter walls composed of? Why?

A

Smooth
Peristaltic

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9
Q

What prevents urine passing bladder to ureter?

A

Ureter enter bladder oblique angle
Pressure rises- press ureter- stop urine pass up kidney

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10
Q
A

Bladder

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11
Q
A
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12
Q

Function urethra?

A

Tube through which urine passes from bladder to exterior

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13
Q

How long is male urethra?
How long is female urethra?

A

Male- 8-10 inch
Female- 2 inch

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14
Q
A

Urethra

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15
Q

What is functional unit of kidney?

A

Nephron

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16
Q

What are two different types nephron?

A

Cortical- tubules short distance medulla- main cortex
Juxtamedullary- tubules long distance medulla- have vasa recta

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17
Q

What is part of nephron in which blood plasma is filtered called?

A

Renal corpuscle

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18
Q

What does renal corpuscle contain?

A

Glomerulus- afferent and efferent arteriole
Bowmans capsule- first step urine prod

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19
Q

What are 4 renal tubules, what occurs?

A

Proximal conv tubule- bulk reabsorption
Loop of Henle- descending loop- H20 permeable
- ascending loop- H20 impermeable- solute reab
Distal convoluted tubule- fine regulation- Ca2+, Na+, K+, HCO3 (is Cl- dependent)
Collecting duct- urine fine tuned

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20
Q
A
21
Q

What size can travel from glomerulus to nephron?

A

10kDa smaller

22
Q

What can’t tracel from glomeruls to nephron?

A

Bigger 10kDa
Large negative
Albumin- podocytes prevent

Form glomerular filtrate

23
Q

State 5 things determine filtration glomerulus?

A

1) Size of molecule
2) Pressure
3) Size of molecule
4) Charge of molecule
5) Rate of blood flow

24
Q

What proportion of CO is renal blood flow?

A

20%

25
Q

Define GFR?

A

The volume of fluid filtered by the renal glomeruli per unit of time

26
Q

How much fluid filtered/day?

A

180L
125ml/in

27
Q

How many L of plasma?

A

3L

28
Q

How many times is blood plasma filtered?

A

60 times/day

29
Q

What is decisive factor for normal regulation GFR?

A

Hydrostatic pressure- arterial bp

30
Q

State 3 ways GFR regulated?

A

1) Autonomic vasoreactive (myogenic) reflex
Smooth muscle capillaries glomerulus/kidney
2) Tubuloglomerular feedback
Increased hydrostatic pressure in glomerulus- increased fluid load
Macula densa sense- vasoconstriction of afferent arteriole
3) RAAS- low bp sensed granular cells- release renin

31
Q

Define renal clearance?

A

Virtual plasma volume/min from which substance is completely eliminated
GFR

32
Q

What is used measure GFR?Why?

A

Creatine- freely filtered not reabsorbed

33
Q

How is PCT adapted?

A

Villi- increase SA

34
Q

Where is 2/3 primary urine volume reabsorbed?

A

Proximal tubule
Descending part LOH

35
Q

Function ascending part LOH?

A

Impermeable water- transport electrolyte to interstitium
Produce high osmotic pressure
Na K 2Cl co-transport

36
Q

Function distal tubule?

A

Active Na transport- Na-Cl cotransporter
10% filtered sodium reabsorbed

Thiazides inhibit

37
Q

Function collecting duct?

A

Permeability water- concentration urine

38
Q

What is responsible for force urine concentration in collecting duct?

A

High osmotic pressure of renal medulla

39
Q

What does deficiency of ADH lead to?

A

Diabetes insipidus

40
Q

What is rate determining step of RAAS?

A

Renin

41
Q

Where is renin produced?

A

juxtaglomerular cells of the afferent arteriole in the kidney

42
Q

What controls release renin?

A

Macula densa- sense reduced Na and Cl conc in distal tubule
Baroreceptors- decreased bp
Neural mechanisms – the juxtaglomerular cells are innervated by abundant beta 1 adrenergic sympathetic nerve fibres, their activation leads to renin secretion

43
Q

Function angiotensin II?

A

Act adrenal cortex release aldosterone
Stimulate release ADH from posterior pituitary
Stimulate thirst centre

44
Q

What is aldosterone?

A

Mineralocorticoid

45
Q

Function aldosterone?

A

Increase Na+ reabsoprtion exchange K+
Regulate amount Na+ reabsorbed in DCT through ENAC

46
Q

Function ADH/vasopressin?

A

Affect bp
Release Aq2 channels into principle cells in collecting ducts
Increase water retention

47
Q

What can cause prerenal, renal, post renal desease

A

Prerenal- sudden reduction blood flow kidney
hypotension
Renal- direct damage
- ecalmpsia
Post renal- obstruction urinary tract
- kidney stones

48
Q

What can chronic renal failure cause?

A

1) Fluid retention- swelling, high bp, pulmonary oedema
2) Hyperkalaemia- potassium not removed
3) Cardiovascular disease- blood pressure not regulated
4) Weak bones- unregulated phosphorous- pull calcium

ILA (12 decks)

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