Renal Flashcards
what four things does the urinary system consist of?
kidney
ureters
urniary bladder
urethra
what is the four functions of the urinary system?
- regulate blood volume and composition, regulate blood pressure, pH, and glucose levels and excretes waste
- ureters transport urine from the kidneys to urinary bladder
- urinary bladder stores urine and expels it into urethra
- urethra discharges urine from blood
what are the eight kidney functions?
regulation of blood ionic composition
regulation of blood pH
regulate blood volume
regulate blood pressure
maintenance of blood osmolarity
regulation of blood glue levels
production of hormones
excretion of waste
where is the kidney located?
between the levels of the last thoracic and third lumbar vertebrae
is the left or right kidney higher?
left
what is the difference between an adult kidney and a child’s kidney?
the adult kidney is 4-5 inches (bar of soap)
Childs kidney is smaller
what is the renal hilum?
an indent where ureters emerges from the kidney along with blood vessels, lymphatic vessels and nerves
what are the three layers of the kidney?
renal capsule
adipose capsule
renal fascia
what layer of the kidney is the deepest and gives the kidney its shape?
renal capsule
what layer of the kidney is the middle layer which helps protect the kidney from trauma?
adipose capsule
which kidney layer is most superficial and anchors the kidney in place?
renal fascia
what is the renal cortex?
superficial region
extends from Renal capsules to bas of renal pyramids
what is the inner most region of the kidneys that consist of pyramids?
renal medulla
what are the cone-shaped structures that are found in the medulla?
renal pyramids
what are the renal papillas?
the apex of the renal pyramids
what are the portions of the renal cortex that extend between the renal pyramids?
renal columns
what is the renal lobe?
consist of a renal pyramid, it overlying area of the renal cortex and one half of each adjacent column
what is the most functional portion of the kidney?
parenchyma
what is the functional unit of the kidney?
nephrons
what are the papillary ducts?
extend through the papilla of the pyramids
filtrate formed by the nephrons and drains into there’s large dicts
what are the cup like strictures that the papillary ducts drain into?
minor and major calyces
how many minor calyces do we have?
8-18
how many major calyces do we have?
2-3
what is the renal pelvis?
single large cavity that the major calyces drain into
what is the renal sinus?
a cavity within the kidneys that the hilum expands into
what is the order of drainage starting with the nephron?
nephrons
papillary ducts
minor calyces
major calyces
ureters
urinary bladder
what percentage of resting cardiac output is received by the kidneys ?
20-25%
how much blood flow does an average adult receive through the kidneys?
1200mL per minute
what two parts make up the nephrons?
renal corpuscle
renal tubules
what part of the nephron is used to filter blood plasma?
renal corpuscle
what part of the nephrons receives filtered fluid?
renal tubule
what is the Bowmans capsule?
double walled cup surrounded by the glomerulus
where would you find the loop of henle?
within the renal tubule extending to the medulla
what kind if turn does the loop of henle make?
hair pinned
what makes up 80-85% of nephrons?
cortical nephrons
what males up 15-20% of nephrons?
juxtamedullary nephrons
based on the glomerular capsule, what are the two locations in which they can be found (glomerular capsule)?
visceral layer
parietal layer
what are podocytes?
modified simple squamous epithelial cells
what is the function of the globular capsule?
forms inner wall of capsule (v) and outer wall (p)
where are the locations of the renal tubule and collecting ducts?
proximal convoluted tubule
loop of henle
most of distal convoluted tubule
The last part of the distal convoluted title and all of collecting ducts
what cells are found in the ascending limbs?
macula ducts
what is the function of primary cells?
receptors for antidiuretic hormones and aldosterone
what is the function of intercalated cells?
plays a role in blood pH balance
what does the juxtaglomerular apparatus do?
regulates blood pressure in kidneys
what two things does the juxtaglomerular have?
macula dense juxtaglomerular cells
what is retropertioneal?
pertaining to organs closely attached to the posterior abdominal wall and partly covered by peritoneum
what structures are in the renal cortex?
renal capsule
renal pyramids
what are the three processes of the nephron and collecting ducts to produce urine?
glomerular filtration
tubular reabsorption
tubular secretion
how much water is reabsorbed by tubule cells?
99%
where would reabsorption take place during tubular reabsorption?
from the renal tubules to the Blood stream
what things are removed from the blood plasma into the renal tubule?
waste
drugs
excess ions
what is the name of the fluid that drains from the minor and major calyces and then into the renal pelvis?
urine
what is the calculation for rate of solution of urine?
rate of solute = rate of glomerular + rate of secretion - rate of reabsorption
what is glomerular filtrate?
fluid that enters capsular space
what is the daily volume of glomerular filtrate?
150-180 liters
how much urine do humans excrete daily?
1-2 liters
what is the leaky barrier called?
filtration membrane
what are the three filtration barriers that substances will pass?
glomerular endothelial cells
basement membrane
pedicels
what are the large pores found in the glomerular endothelial cells?
fenestrations
what are mesangial cells?
help regulate fluid and are found in the cleft of afferent and efferent arteroles
what are your foot like processes?
pedals
what is created in the space between pedals?
filtration slits or membranes
what things make the renal capsule high in full filtered?
large surface area
filtration membrane
glomerular capillary blood pressure is higher
what is the total pressure promoted by filtration?
net filtration pressure
what are the three pressures controlling glomerular filtration?
glomerular blood hydrostatic pressure
capsular hydrostatic pressure
blood colloid osmotic pressure
what pressures influences / increased net filtration pressure?
capsular hydrostatic pressure
blood colloid osmotic pressure
what is the amount of filtrate formed in all the renal corpuscles of both kidneys each minute?
glomerular filtration rate
what is the average GFR in male adults? female adults?
125mL men
105mL women
what happens when too much GFR is present?
substances pass too quickly and are not reabsorbed
what happen when too little GFR is present?
nearly all reabsorbed and some waste products not adequately excreted
what things control the GFR?
renal auto regulation
neural regulation
hormonal regulation
when does the myogenic mechanism occur?
stretching triggers the contraction of smooth muscle cells in afferent arterioles
increase BP and GFR
when does the tubuloglomerular mechanism occur?
when macula dense in the renal tubules provide feedback
BP increases will trigger this
what hormones contribute to hormonal regulation of GFR?
angiotensin II (reduce GFR)
atrial natriuretic peptides (increases GFR)
is reabsorption passive or active?
both
what solutes are actively and passively reabsorbed?
glucose
amino acids
urea
ions
what things are more fine tuned for reabsorption and help balance water and selected ions?
small proteins
peptides
what is secretion?
transfer of material from blood into glomerular filtrate
what is reabsorption?
return of most of the filtered water into bloodstream
is paracellular reabsorption passive or active?
passive
what is the filtered organic solutes that are 100% reabsorbed?
glucose
amino acids
how much water is reabsorbed into the ascending loop of henle?
little to none
what things get reabsorbed into the early distal convoluted tubule?
Na- cl
what percentage of filtered solutes and fluids are returned tp the blood stream In the late distal tubule and collecting duct?
90-95%
what is a major system for maintaining homeostasis of body fluid?
kidneys
what is ADH responsible for?
controls weather dilute or concentrated urine is formed
what happens with a low ADH level?
diluted urine
what happens with a high level of ADH?
more concentrated urine
what is osmolarity?
the concentration of a solution in terms of osmoses of solutes per litre of solution
what things can lead to diluted urine?
osmolarity of fluid increases as it goes down the loop of Henle
osmolarity decreases as it goes up the ascending limbs
osmolarity decreases still more as it flows through nephrons
what happens when the osmolarity of interstitial fluids of the renal medulla progressively increase?
water is absorbed more by the tubular fluid, the remaining fluid in lumen is greatly concentrated
what things are absorbed in the supporting cells of the ascending limb of the loop ?
Na
K
Ci
when is water permeability low in the pathway of tubular fluid movement?
in the thick ascending limb
when fluid enters the DCT is it more concentrated or diluted?
diluted
are DCT regulated by ADH hormones?
no
is the concentration of tubular fluid high or low when it drains into the renal pelvis?
low
what happens when water intake is low or water loss is high?
urine becomes highly concentrated
how much more concentrated can urine be to the blood plasma?
1200 in urine
300 in blood plasma
what solutes are highly osmolalic in the renal medulla?
Na
Cl
urea
what does it mean when something is countercurrent flowing?
flow of fluid in the opposite direction
what can urea recycling cause?
buildup of urea in the renal medulla
what is an example in the body of countercurrent flow?
when solutes and water are passively exchanged between blood and fluid in the renal medulla
what are the ureters responsible for?
transporting urine from the renal pelvis of the kidney to the bladder
what things help move urine in the ureters?
gravity
contraction of muscle wall
hydrostatic pressure
what is the frequency of peristaltic c waves which pass through the renal pelvis to the bladder?
1-5 per min
how long are the ureters?
25-30 cm or 10-12 inch
are ureters and kidneys retroperitoneal?
yes
what are the three layers of the ureters?
mucose
muscular
adventia
how does bladder infections occur?
when the bladder fills, it compresses the opening to prevent backflow and this can allow microbes to travel up in the ureters
what is a hollow distensible muscular organ situated in the pelvic cavity?
bladder
where is a male bladder located?
anterior to rectum
where is a female bladder located ?
anterior to vagina and inferior to uterus
What holds the bladder in position?
folds of peritoneum
what is a trigone?
a small triangle area in the floor of the bladder
what three layers makes up the urinary bladder?
muscose
muscularis
Adventita
what is micturition reflex?
discharge of urine from bladder
combination of involuntary and voluntary muscle contraction in the bladder
how much volume of urine can the bladder exceed?
200-400mL
what sacral spinal cords are activated by the micturition reflex?
s2-s3
what are the urethras?
small tubes leading leading the floor of the bladder
where does male discharge occur?
same as semen
what are the three anatomical regions of a male urethra?
prostatic urethra
intermediate urethra
spongy urethra
how would you describe the female urethra?
short tube
how long is the male urethra?
20 cm
how long is the female urethre?
4 cm
what are the other tissue which contributes to wasting of materials?
body buffers
blood
liver
lungs
sweat glands
gastrointestinal tract
what is diuretic drugs often prescribed for?
why?
hypertension
to lower blood volume and this reduces blood pressure
what is a molecule that an release an H+?
acid
what is a molecule that can accept or combine H+?
base
what is the measure of concentration of H+ ions in a solution?
pH
what does the pH scale run from?
0-14
what does a low pH indicate?
high concentration of H+
what does a high pH indicate?
low concentration of H+
what is normal range of pH?
7.35-7.45
what three things regulate pH in body fluid?
chemical buffers
lungs
kidneys
what is metabolic acidosis?
decreased pH due to increase acid or decrease HCO3
what does hyperventilation do for metabolic acidosis?
decrease PCO2
what is metabolic alkalosis?
increased pH due t H+ loss or HCO3 gain which the kidney cannot excrete excess of
what does hyppoventilate do for metabolic alkalosis?
retains PCO2
what happens with hypercapnia?
increase PCO2
what will happens in hypocapina?
decrease PCO2
what things can cause metabolic acidosis?
excessive production of metabolic acid
impaired elation of metabolic acid
what happens when the body has no insulin?
diabetic ketoacidosis
what can lead to ketoacidosis?
fasting and starvation
what things lead to excessive bicarbonate loss?
loss of intestinal secretion
increased renal loss
what are some manifestations of metabolic acidosis?
increased extracellular H+ ion concentration
decrease pH
decrease in HCO3
decreased heart rate
increase rate and depth off respiration
increase ammonia
what causes metabolic alkalosis?
an excessive gain in bicarbonate
excessive loss of hydrogen ions
increased bicarbonate retention
volume contraction
what are some manifestations of metabolic alkalosis?
increased pH die to primary excess of plasma HCO3 ions
what tings cause respiratory acidosis?
depression of respiratory center
lung disease
airway obstruction
breathing in high CO2 content
what are some manifestations of respiratory acidosis?
pH decrease
increase PCO2
warm fleshed skin
is cystic disease inherited?
yes
is cystic diseases autosomal dominant?
yes
what things can cause urinary tract obstruction?
development delays
stones
pregnancy
benign prostatic hyperplasia
scar tissue
tumors
spinal cord injuries
what are the manifestations of urinary obstruction disease ?
pain
UTI symptoms
renal dysfunction
what are kidney stones called?
nephrolithiasis
what factors influence the formation of kidney stones?
the concentration of stone components in the urine
ability for stone to form
presence of substance that inhibits formation
what are the types of kidney stones?
calcium
magnesium
uric acid
cystine
what causes a UTI?
escherichia coli
what things are obstructed with a UTI?
neurogenic bladder
infrequent voiding
detrusor muscles
constipation
what are the manifestations of bladder infections?
frequency urination
lower abdominal pain
back discomfort
burning pain
cloudy or foul smell of urine
disappear after 48 hrs of treatment
what is renal failure?
a condition in which the kidneys fail to remove metabolic end products from the blood and regulate the fluid etc
what are the underlying causes of renal failure ?
renal disease
systemic disease
urologic defects
what are the types of renal failure?
acute
chronic
what are the stages of chronic kidney failure?
damage and increased GFR
mild reduction of GFR
moderate reduction of GFR
severe reduction of GFR
kidney failure need of replacement
