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Human Physiology > Renal > Flashcards

Renal Flashcards

1
Q

the cortex is ___osmotic

A

iso (300 mosm)

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2
Q

the medulla is ____osmotic

A

hyper (over 300 mosm)

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3
Q

what are the two types of nephron?

A

cortical, juxtamedullary

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4
Q

what percent of nephrons are cortical?

A

80

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5
Q

what percent of nephrons are juxtameduallary?

A

20

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6
Q

what type of nephron is responsible for reabsorption from plasma?

A

cortical

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7
Q

what type of nephron is responsible for water balance and urine concentration?

A

juxtameduallary

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8
Q

___ ____ cells sense ions

A

macula densa

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9
Q

_____ cells sense blood pressure/mean arterial pressure

A

juxtaglomerular

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10
Q

what two cells compose the juxtaglomerular apparatus?

A

macula densa, juxtaglomerular

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11
Q

what type of cells line the distal tubule?

A

macula densa

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12
Q

what type of cells line the afferent arteriole?

A

juxtagomerular

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13
Q

what is the primary determinant of filtration?

A

glomerular capillary hydrostatic pressure (mmhg)

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14
Q

what two things promote filtration?

A

glomerular capillary hydrostatic pressure, bowman’s space onconic pressure

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15
Q

RBC are ____ in the capillary

A

kept

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16
Q

large proteins are ____ in the capillary

A

kept

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17
Q

Bowman’s space oncotic pressure is related to ____ content

A

protein

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18
Q

Bowman’s space oncotic pressure should be ___

A

0

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19
Q

what two things oppose filtration?

A

plasma oncotic pressure, Bowman’s space hydrostatic pressure

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20
Q

what are the three layers of the filtrating membrane?

A

fenestrated endothelial cells, podocytes, basement membrane

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21
Q

what things are filtered from the glomerular capillaries?

A

ions, water, small molecules (glucose, amino acids), drugs

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22
Q

the basement membrane is ___ charged

A

negatively

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23
Q

what is the role of the basement membrane?

A

prevent proteins or RBC from entering

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24
Q

what is the barrier that is the last defense of filtration?

A

podocytes

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25
Q

the glomerular filtration rate (GFR) is a measure of what?

A

kidney function

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26
Q

the ___ ____ ____ is the amount of filtrate formed per minute

A

glomerular filtration rate

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27
Q

what is the average GFR?

A

120-125 mL/min

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28
Q

how many times is blood filtered per day?

A

45

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29
Q

what will this do to GFR? vasoconstriction of efferent arteriole

A

increase

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30
Q

what will this do to GFR? vasodilation of afferent arteriole

A

increase

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31
Q

what will this do to GFR? vasoconstriction of afferent arteriole

A

decrease

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32
Q

what will this do to GFR? vasodilation of efferent arteriole

A

decrease

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33
Q

as you decrease Pgc, you _____ GFR

A

decrease

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34
Q

as you increase Pgc, you ___ GRF

A

increase

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35
Q

if you increase mean arteriole pressure, afferent arterioles ____

A

constrict

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36
Q

if you decrease mean arteriole pressure, afferent arterioles ____

A

dilate

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37
Q

tubulogomerular feedback is a ___ loop

A

negative

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38
Q

what is the input/afferent path in the tubulogomerular feedback loop?

A

Na, Cl, H2O

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39
Q

what is the control center in the tubulogomerular feedback loop?

A

juxtaglomerular cells

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40
Q

what is the output/efferent path in the tubulogomerular feedback loop?

A

decrease in nitric oxide

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41
Q

what is the role of nitric oxide?

A

vasodilation

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42
Q

low GFR and low MAP is what medical condition?

A

hypotension

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43
Q

high GFR and high MAP is what medical condition?

A

hypertension

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44
Q

what is the healthy range for MAP?

A

80-120

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45
Q

if your blood pressure increased, GFR _____ to get rid of fluid

A

increases

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46
Q

what hormone is responsible for increases GFR when blood pressure is high?

A

atrial natriuretic peptide (ANP)

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47
Q

when blood pressure is high, the atrial stretch and ___ is released

A

ANP

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48
Q

if blood pressure is decreased, GFR ____ to save fluid

A

decreases

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49
Q

what ways do kidneys regulate blood?

A

ionic composition, pH, blood volume, MAP, osmolarity

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50
Q

what hormone released from the kidneys increases number of RBCs?

A

erythropoetin

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51
Q

what hormone released from the kidneys regulates calcium levels?

A

active vitamin D

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52
Q

what hormone released from the kidneys increased MAP?

A

renin

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53
Q

cell concentrations of Na

A

ECF: 145 ICF: 15

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54
Q

cell concentrations of K

A

ECF: 5 ICF: 150

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55
Q

cell concentrations of Cl

A

ECF: 100 ICF: 7

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56
Q

RBCs are ___% of blood

A

40

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57
Q

the concentrations of ions (Na,K,Cl) in the blood plasma are the same as where?

A

interstitial space

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58
Q

plasma is ___% of blood

A

60

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59
Q

what is the name of the kidney hormonal process that regulates blood pressure?

A

Renal Angiotensin Aldosterone System (RAAS)

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60
Q

changes in blood pressure are detected by _____ cells

A

juxtaglomerular

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61
Q

____ is released from the kidney when low blood pressure is detected by juxtaglomerular cells

A

renin

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62
Q

____ in the first hormone released from the liver

A

angiotensinogen

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63
Q

____ causes the conversion of angiotensinogen to angiotensin 1

A

renin

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64
Q

where is angiotensin 1 converted into angiotensin 2?

A

blood vessels

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65
Q

what in the blood vessels converts angiotensin 1 to angiotensin 2?

A

angiotensin converting enzyme

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66
Q

what is the active enzyme of the liver?

A

angiotensin 2

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67
Q

angiotensin 2 acts on ___ ___ in the CV system

A

smooth muscle

68
Q

what three things occur when blood pressure decreased and angiotensin 2 acts on the CV system?

A

increase vasoconstriction, decrease radius, increase resistance

69
Q

when angiotensin 2 acts on the adrenal gland, what hormone is released?

A

aldosterone

70
Q

aldosterone released from the adrenal gland is sensed by what in the kidneys?

A

macula densa cells

71
Q

what occurs in the kidney when aldosterone is released from the adrenal gland and sensed by macula densa cells?

A

increase salt retention, increase water retention

72
Q

what does aldosterone do to the K concentration in kidneys?

A

more excretion, greater urine output

73
Q

what can occur if K concentration is too high in the plasma?

A

improper activity, irregular heart beats, difficulty repolarizing

74
Q

does glucose make blood more basic or acidic?

A

acidic

75
Q

what substances can be found in filtrate?

A

water, Na, K, Cl, Ca, H+, HCO3-, glucose

76
Q

what substances are not found in filtrate?

A

RBCs, large proteins

77
Q

___ ____ is when blood plasma moves from the glomerular capillaries into Bowman’s capsule

A

glomerular filtration

78
Q

______ ______ is when substances move from Bowman’s capsule back to the capillaries and useful molecules such as glucose and bicarbonate are returned

A

tubular reabsorption

79
Q

____ _____ is substances moving from the capillaries into the proximal tubule

A

tubular secretion

80
Q

what are the 3 tasks of urine production?

A

glomerular filtration, tubular reabsorption, tubular secretion

81
Q

at rest, kidneys have ___L of cardiac output

A

1

82
Q

what are the 2 routes of reabsorption?

A

peracelluar, transcellular

83
Q

what substances are reabsorbed via peracellular reabsorption?

A

ions, water

84
Q

what substances are reabsorbed via transcellular reabsorption?

A

water (osmosis)

85
Q

____ of water is reabsorbed into the kidneys

A

2/3

86
Q

peracelluar reabsorption occurs through ___ ____

A

tight junctions

87
Q

transcellular reabsorption uses ____ to transport water through the cell

A

aquaporins

88
Q

reabsorption of glucose and single amino acids involves __-____

A

co-transport

89
Q

what is transported with glucose and single amino acids?

A

Na

90
Q

what is the name of the system that reabsorbs H+ and HCO3-?

A

carbonic anhydrase system

91
Q

what is the role of the carbonic anhydrase system?

A

maintain body pH at 7.2-7.4

92
Q

how does water enter the carbonic anhydrase system?

A

aquaporins

93
Q

how is H+ secreted from the carbonic anhydrase system?

A

sodium/hydrogen exchanged

94
Q

what is transferred into the epithelial cell when hydrogen is secreted out?

A

Na

95
Q

how does sodium leave the epithelial cell in the carbonic anhydrase system?

A

NA/K ATPase

96
Q

how does HCO3- (bicarbonate) leave the epithelium to be reabsorbed into the capillaries?

A

bicarbonate transporter

97
Q

as you decrease blood pH, you ____ CO2 production

A

increase

98
Q

what is the enzyme that converts H2O and CO2 into H2CO3?

A

carbonic anhydrase

99
Q

the ____ tubule is the workhorse

A

proximal

100
Q

____% of solutes are reabsorbed

A

65

101
Q

___% of water is reabsorbed

A

65

102
Q

____% of organic solutes are reabsorbed (i.e. glucose, amino acids)

A

100

103
Q

____% of HCO2- is reabsorbed

A

80-90

104
Q

where does the secretion of drugs and acids occur?

A

proximal tubule

105
Q

most transport in the proximal tubule is coupled with what molecule?

A

Na

106
Q

drugs are secreted from the proximal tubule via ___ ____

A

active transport

107
Q

where is the proximal tubule located?

A

cortex

108
Q

____ is a measure of the volume of plasma over time that is cleared of a particular substance

A

clearance

109
Q

clearance is defined in terms of ___ ____

A

blood plasma

110
Q

each substance has it’s own ___ value

A

clearance

111
Q

what is calculated by (urine flow*urine concentration of substance)/plasma concentration of substance

A

clearance

112
Q

if the substance is reabsorbed, clerance is ___ ___ GFR

A

less than

113
Q

if the substance is secreted, clearance is ___ ___ GFR

A

greater than

114
Q

what is the best, most accurate calculator of GFR?

A

inulin

115
Q

inulin is freely ____ and not ___

A

filtered, secreted

116
Q

____ is the most practical measure of GFR

A

creatinine

117
Q

how is creatinine produced?

A

break down of creatine phosphate from muscle

118
Q

creatinine is freely _____ and not ____

A

filtered, reabsorbed

119
Q

creatinine is slightly ____

A

secreted

120
Q

when there is no secretion and no reabsorption, clearance ____ GFR

A

equal

121
Q

when there is secretion and no reabsorption, clearance is ____ ____ GFR

A

greater than

122
Q

when there is reabsorption and no secretion, clearance is ___ ____ GFR

A

less than

123
Q

what substances have clearance greater than GFR?

A

H+ ions, drugs, toxins

124
Q

what substances have clearance less than GFR?

A

glucose, amino acids, Na+, HCO3-

125
Q

water gained:
___% metabolism
___% food
__% liquids

A

10%, 30%, 60%

126
Q

water lost:
___% feces
____% lungs
____% skin
_____% urine

A

5%, 10%, 25%, 60%

127
Q

____ nephrons are the ones most involved in water balance

A

juxtaglomerular

128
Q

urine becomes ___ concentrated as it travels down the descending loop because water is being removed

A

more

129
Q

urine becomes ____ concentrated as it travels up the ascending loop

A

less

130
Q

what is transferred out of urine in the thick ascending limb?

A

Na, K, Cl

131
Q

the ___ ____ ____ has a Na/K/Cl symporter

A

thick ascending loop

132
Q

what is the target of diuretics?

A

Na/K/Cl symporter in the thick ascending limb

133
Q

the Na/K/Cl symporter is ____ by diuretics

A

blocked

134
Q

what is the final goal of diuretics?

A

keep water in urine

135
Q

how does Na leave the thick ascending loop into capillaries?

A

Na/K ATPase

136
Q

how does K leave the thick ascending loop into capillaries?

A

leak K channels

137
Q

How does Cl leave the thick ascending loop into capillaries?

A

Cl- channels

138
Q

___ is cycled between the nephron and collecting duct to keep osmolarity high in the medulla

A

urea

139
Q

urea helps keep osmolarity ___ in the medulla

A

high

140
Q

the trapping of ____ and ____ in medulla keeps it hyperosmotic

A

Na, Cl

141
Q

what is exchanged in the countercurrent exchange?

A

water, NaCl

142
Q

the vasa recta runs along the ___ ____

A

basement membrane

143
Q

vasa recta use ___ ____ to recirculate salt and urea

A

concentration gradients

144
Q

a concentrated medulla helps save ___

A

water

145
Q

what anti-diuretic hormones are involved in the cycling of the loop of Henle?

A

ADH, Vasopressin

146
Q

when you are dehydrated, the plasma concentration of ADH is _____ and you ____the number of aquaporins in collection ducts

A

increase, increase

147
Q

as you add aquaporins, the urine becomes more ____

A

concentrated

148
Q

when you ingest excess water, plasma concentration of ADH _____ and the number of aquaporins ____

A

decreases, decreases

149
Q

as you remove aquaporins, the urine becomes more ____

A

diluted

150
Q

where is ADH released from?

A

posterior pituitary

151
Q

what are the 3 roles of ADH?

A

water reabsorption at collecting duct, regulate osmolarity, act on principal cells in the collecting ducts

152
Q

where are principal cells found?

A

collecting ducts

153
Q

where is the area of calcium homeostasis?

A

early distal tubule

154
Q

fine tuning occurs in the ___ ___ ___

A

late distal tubule

155
Q

what type of distal tubule cells reabsorb sodium, secrete potassium, note aldosterone from adrenal gland

A

principal cells

156
Q

what type of distal tubule cells maintain pH, reabsorb HCO3- (bicarbonate), and secrete hydrogen

A

intercalated cells

157
Q

what two hormones regulate the distal tubule?

A

ADH, aldosterone

158
Q

what regulated the proximal tubule?

A

concentration gradients

159
Q

how does hormonal regulation via RAAS manage blood pressure?

A

volume of plasma and concentration changes of Na in plasma

160
Q

what is the neural regulation of blood pressure?

A

baroreceptors

161
Q

aldosterone is ___ lasting and ____ acting

A

long, slow

162
Q

___ ____ reabsorbs HCO3- and secretes H+ in the proximal tubule

A

carbonic anhydrase

163
Q

the ____ ____ pump is essential for pH balancing in the proximal tubule

A

hydrogen potassium

164
Q

____ cell sense mean arterial pressure

A

juxtaglomerular

165
Q

two ways to increase GFR

A

dilate afferent, constrict efferent

166
Q

two ways to decrease GFR

A

constrict afferent, dilate efferent

167
Q

_____ cells are what add aquaporins

A

principal

Human Physiology (9 decks)

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