Renal Flashcards
1
Q
the cortex is ___osmotic
A
iso (300 mosm)
2
Q
the medulla is ____osmotic
A
hyper (over 300 mosm)
3
Q
what are the two types of nephron?
A
cortical, juxtamedullary
4
Q
what percent of nephrons are cortical?
A
80
5
Q
what percent of nephrons are juxtameduallary?
A
20
6
Q
what type of nephron is responsible for reabsorption from plasma?
A
cortical
7
Q
what type of nephron is responsible for water balance and urine concentration?
A
juxtameduallary
8
Q
___ ____ cells sense ions
A
macula densa
9
Q
_____ cells sense blood pressure/mean arterial pressure
A
juxtaglomerular
10
Q
what two cells compose the juxtaglomerular apparatus?
A
macula densa, juxtaglomerular
11
Q
what type of cells line the distal tubule?
A
macula densa
12
Q
what type of cells line the afferent arteriole?
A
juxtagomerular
13
Q
what is the primary determinant of filtration?
A
glomerular capillary hydrostatic pressure (mmhg)
14
Q
what two things promote filtration?
A
glomerular capillary hydrostatic pressure, bowman’s space onconic pressure
15
Q
RBC are ____ in the capillary
A
kept
16
Q
large proteins are ____ in the capillary
A
kept
17
Q
Bowman’s space oncotic pressure is related to ____ content
A
protein
18
Q
Bowman’s space oncotic pressure should be ___
A
0
19
Q
what two things oppose filtration?
A
plasma oncotic pressure, Bowman’s space hydrostatic pressure
20
Q
what are the three layers of the filtrating membrane?
A
fenestrated endothelial cells, podocytes, basement membrane
21
Q
what things are filtered from the glomerular capillaries?
A
ions, water, small molecules (glucose, amino acids), drugs
22
Q
the basement membrane is ___ charged
A
negatively
23
Q
what is the role of the basement membrane?
A
prevent proteins or RBC from entering
24
Q
what is the barrier that is the last defense of filtration?
A
podocytes
25
the glomerular filtration rate (GFR) is a measure of what?
kidney function
26
the ___ ____ ____ is the amount of filtrate formed per minute
glomerular filtration rate
27
what is the average GFR?
120-125 mL/min
28
how many times is blood filtered per day?
45
29
what will this do to GFR? vasoconstriction of efferent arteriole
increase
30
what will this do to GFR? vasodilation of afferent arteriole
increase
31
what will this do to GFR? vasoconstriction of afferent arteriole
decrease
32
what will this do to GFR? vasodilation of efferent arteriole
decrease
33
as you decrease Pgc, you _____ GFR
decrease
34
as you increase Pgc, you ___ GRF
increase
35
if you increase mean arteriole pressure, afferent arterioles ____
constrict
36
if you decrease mean arteriole pressure, afferent arterioles ____
dilate
37
tubulogomerular feedback is a ___ loop
negative
38
what is the input/afferent path in the tubulogomerular feedback loop?
Na, Cl, H2O
39
what is the control center in the tubulogomerular feedback loop?
juxtaglomerular cells
40
what is the output/efferent path in the tubulogomerular feedback loop?
decrease in nitric oxide
41
what is the role of nitric oxide?
vasodilation
42
low GFR and low MAP is what medical condition?
hypotension
43
high GFR and high MAP is what medical condition?
hypertension
44
what is the healthy range for MAP?
80-120
45
if your blood pressure increased, GFR _____ to get rid of fluid
increases
46
what hormone is responsible for increases GFR when blood pressure is high?
atrial natriuretic peptide (ANP)
47
when blood pressure is high, the atrial stretch and ___ is released
ANP
48
if blood pressure is decreased, GFR ____ to save fluid
decreases
49
what ways do kidneys regulate blood?
ionic composition, pH, blood volume, MAP, osmolarity
50
what hormone released from the kidneys increases number of RBCs?
erythropoetin
51
what hormone released from the kidneys regulates calcium levels?
active vitamin D
52
what hormone released from the kidneys increased MAP?
renin
53
cell concentrations of Na
ECF: 145 ICF: 15
54
cell concentrations of K
ECF: 5 ICF: 150
55
cell concentrations of Cl
ECF: 100 ICF: 7
56
RBCs are ___% of blood
40
57
the concentrations of ions (Na,K,Cl) in the blood plasma are the same as where?
interstitial space
58
plasma is ___% of blood
60
59
what is the name of the kidney hormonal process that regulates blood pressure?
Renal Angiotensin Aldosterone System (RAAS)
60
changes in blood pressure are detected by _____ cells
juxtaglomerular
61
____ is released from the kidney when low blood pressure is detected by juxtaglomerular cells
renin
62
____ in the first hormone released from the liver
angiotensinogen
63
____ causes the conversion of angiotensinogen to angiotensin 1
renin
64
where is angiotensin 1 converted into angiotensin 2?
blood vessels
65
what in the blood vessels converts angiotensin 1 to angiotensin 2?
angiotensin converting enzyme
66
what is the active enzyme of the liver?
angiotensin 2
67
angiotensin 2 acts on ___ ___ in the CV system
smooth muscle
68
what three things occur when blood pressure decreased and angiotensin 2 acts on the CV system?
increase vasoconstriction, decrease radius, increase resistance
69
when angiotensin 2 acts on the adrenal gland, what hormone is released?
aldosterone
70
aldosterone released from the adrenal gland is sensed by what in the kidneys?
macula densa cells
71
what occurs in the kidney when aldosterone is released from the adrenal gland and sensed by macula densa cells?
increase salt retention, increase water retention
72
what does aldosterone do to the K concentration in kidneys?
more excretion, greater urine output
73
what can occur if K concentration is too high in the plasma?
improper activity, irregular heart beats, difficulty repolarizing
74
does glucose make blood more basic or acidic?
acidic
75
what substances can be found in filtrate?
water, Na, K, Cl, Ca, H+, HCO3-, glucose
76
what substances are not found in filtrate?
RBCs, large proteins
77
___ ____ is when blood plasma moves from the glomerular capillaries into Bowman's capsule
glomerular filtration
78
______ ______ is when substances move from Bowman's capsule back to the capillaries and useful molecules such as glucose and bicarbonate are returned
tubular reabsorption
79
____ _____ is substances moving from the capillaries into the proximal tubule
tubular secretion
80
what are the 3 tasks of urine production?
glomerular filtration, tubular reabsorption, tubular secretion
81
at rest, kidneys have ___L of cardiac output
1
82
what are the 2 routes of reabsorption?
peracelluar, transcellular
83
what substances are reabsorbed via peracellular reabsorption?
ions, water
84
what substances are reabsorbed via transcellular reabsorption?
water (osmosis)
85
____ of water is reabsorbed into the kidneys
2/3
86
peracelluar reabsorption occurs through ___ ____
tight junctions
87
transcellular reabsorption uses ____ to transport water through the cell
aquaporins
88
reabsorption of glucose and single amino acids involves __-____
co-transport
89
what is transported with glucose and single amino acids?
Na
90
what is the name of the system that reabsorbs H+ and HCO3-?
carbonic anhydrase system
91
what is the role of the carbonic anhydrase system?
maintain body pH at 7.2-7.4
92
how does water enter the carbonic anhydrase system?
aquaporins
93
how is H+ secreted from the carbonic anhydrase system?
sodium/hydrogen exchanged
94
what is transferred into the epithelial cell when hydrogen is secreted out?
Na
95
how does sodium leave the epithelial cell in the carbonic anhydrase system?
NA/K ATPase
96
how does HCO3- (bicarbonate) leave the epithelium to be reabsorbed into the capillaries?
bicarbonate transporter
97
as you decrease blood pH, you ____ CO2 production
increase
98
what is the enzyme that converts H2O and CO2 into H2CO3?
carbonic anhydrase
99
the ____ tubule is the workhorse
proximal
100
____% of solutes are reabsorbed
65
101
___% of water is reabsorbed
65
102
____% of organic solutes are reabsorbed (i.e. glucose, amino acids)
100
103
____% of HCO2- is reabsorbed
80-90
104
where does the secretion of drugs and acids occur?
proximal tubule
105
most transport in the proximal tubule is coupled with what molecule?
Na
106
drugs are secreted from the proximal tubule via ___ ____
active transport
107
where is the proximal tubule located?
cortex
108
____ is a measure of the volume of plasma over time that is cleared of a particular substance
clearance
109
clearance is defined in terms of ___ ____
blood plasma
110
each substance has it's own ___ value
clearance
111
what is calculated by (urine flow*urine concentration of substance)/plasma concentration of substance
clearance
112
if the substance is reabsorbed, clerance is ___ ___ GFR
less than
113
if the substance is secreted, clearance is ___ ___ GFR
greater than
114
what is the best, most accurate calculator of GFR?
inulin
115
inulin is freely ____ and not ___
filtered, secreted
116
____ is the most practical measure of GFR
creatinine
117
how is creatinine produced?
break down of creatine phosphate from muscle
118
creatinine is freely _____ and not ____
filtered, reabsorbed
119
creatinine is slightly ____
secreted
120
when there is no secretion and no reabsorption, clearance ____ GFR
equal
121
when there is secretion and no reabsorption, clearance is ____ ____ GFR
greater than
122
when there is reabsorption and no secretion, clearance is ___ ____ GFR
less than
123
what substances have clearance greater than GFR?
H+ ions, drugs, toxins
124
what substances have clearance less than GFR?
glucose, amino acids, Na+, HCO3-
125
water gained:
___% metabolism
___% food
__% liquids
10%, 30%, 60%
126
water lost:
___% feces
____% lungs
____% skin
_____% urine
5%, 10%, 25%, 60%
127
____ nephrons are the ones most involved in water balance
juxtaglomerular
128
urine becomes ___ concentrated as it travels down the descending loop because water is being removed
more
129
urine becomes ____ concentrated as it travels up the ascending loop
less
130
what is transferred out of urine in the thick ascending limb?
Na, K, Cl
131
the ___ ____ ____ has a Na/K/Cl symporter
thick ascending loop
132
what is the target of diuretics?
Na/K/Cl symporter in the thick ascending limb
133
the Na/K/Cl symporter is ____ by diuretics
blocked
134
what is the final goal of diuretics?
keep water in urine
135
how does Na leave the thick ascending loop into capillaries?
Na/K ATPase
136
how does K leave the thick ascending loop into capillaries?
leak K channels
137
How does Cl leave the thick ascending loop into capillaries?
Cl- channels
138
___ is cycled between the nephron and collecting duct to keep osmolarity high in the medulla
urea
139
urea helps keep osmolarity ___ in the medulla
high
140
the trapping of ____ and ____ in medulla keeps it hyperosmotic
Na, Cl
141
what is exchanged in the countercurrent exchange?
water, NaCl
142
the vasa recta runs along the ___ ____
basement membrane
143
vasa recta use ___ ____ to recirculate salt and urea
concentration gradients
144
a concentrated medulla helps save ___
water
145
what anti-diuretic hormones are involved in the cycling of the loop of Henle?
ADH, Vasopressin
146
when you are dehydrated, the plasma concentration of ADH is _____ and you ____the number of aquaporins in collection ducts
increase, increase
147
as you add aquaporins, the urine becomes more ____
concentrated
148
when you ingest excess water, plasma concentration of ADH _____ and the number of aquaporins ____
decreases, decreases
149
as you remove aquaporins, the urine becomes more ____
diluted
150
where is ADH released from?
posterior pituitary
151
what are the 3 roles of ADH?
water reabsorption at collecting duct, regulate osmolarity, act on principal cells in the collecting ducts
152
where are principal cells found?
collecting ducts
153
where is the area of calcium homeostasis?
early distal tubule
154
fine tuning occurs in the ___ ___ ___
late distal tubule
155
what type of distal tubule cells reabsorb sodium, secrete potassium, note aldosterone from adrenal gland
principal cells
156
what type of distal tubule cells maintain pH, reabsorb HCO3- (bicarbonate), and secrete hydrogen
intercalated cells
157
what two hormones regulate the distal tubule?
ADH, aldosterone
158
what regulated the proximal tubule?
concentration gradients
159
how does hormonal regulation via RAAS manage blood pressure?
volume of plasma and concentration changes of Na in plasma
160
what is the neural regulation of blood pressure?
baroreceptors
161
aldosterone is ___ lasting and ____ acting
long, slow
162
___ ____ reabsorbs HCO3- and secretes H+ in the proximal tubule
carbonic anhydrase
163
the ____ ____ pump is essential for pH balancing in the proximal tubule
hydrogen potassium
164
____ cell sense mean arterial pressure
juxtaglomerular
165
two ways to increase GFR
dilate afferent, constrict efferent
166
two ways to decrease GFR
constrict afferent, dilate efferent
167
_____ cells are what add aquaporins
principal
