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human physiology > renal > Flashcards

renal Flashcards

1
Q

intracellular fluid

A

all fluid in cells, 2/3 total body fluid, has water, ions, proteins and enzymes

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2
Q

extracellular fluid

A

interstitial fluid (holds cells in place), plasma and trans-cellular fluids

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3
Q

difference between interstitial fluid and plasma

A

plasma has more proteins than interstitial fluid

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4
Q

forces that move water

A

hydrostatic pressure and colloid osmotic pressure

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5
Q

hydrostatic pressure

A

force from a fluid against a wall, causes movement of fluid between different compartments

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6
Q

colloid osmotic pressure

A

relies on selectively permeable membranes, small ions moving

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7
Q

osmolality

A

conc of substance in 1L solvent (water) measured in mosmoles / Kg

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8
Q

renal cortex

A

outermost ring of the kidney, start of the urine making

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9
Q

renal medulla

A

inner region of kidney, loops of nephrons drop down into it

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10
Q

how many nephrons in a kidney on average

A

1.5million

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11
Q

the juxtoglomerular apparatus

A

afferent arteriole brings blood to glomerulus, HP forces fluid through bowmans capsule

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12
Q

what do macula densa cells dp

A

sense DCT flow and release factors that affect afferent arteriole diameter

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13
Q

main components of Juxtaglomerular apparatus

A
  1. macula densa cells
  2. granular cells
  3. mesangial cells
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14
Q

granular cells

A

respond to macula densa cells and then signal to vasoconstrict/dilate

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15
Q

what is the glomerular filtration rate dependent on

A
  1. capillary permeability
  2. HP in capillaries
  3. HP in tubules
  4. osmotic pressure of plasma and tubular filtrate
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16
Q

BP in a capillary compared to bowmans capsule

A

bowmans capsule is lower

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17
Q

GFR equation

A

GFR = Kf (Pcap - Pbc - Pi cap)

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18
Q

what happens to GFR if there is afferent vasoconstriction

A

GFR decreases

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19
Q

what happens in the PCT

A

reabsorption of glucose, bicarbonate and Na+, Na+ sets up gradient so water is reabsorbed. Secretion of H+ ions so there can be bicarbonate reabsorption

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20
Q

what happens in loop of henle

A

water reabsorption by osmosis in descending limb, ascending limb impermeable to water, reabsorption of salts

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21
Q

what happens in DCT

A

Na+ actively reabsorbed

22
Q

what is the countercurrent multiplier

A

by reabsorbing NaCl in ascending limbs the filtrate becomes more concentrated which therefore drives the water to be reabsorbed.

23
Q

where is most of the Na+ reabsorbed

A

PCT (60-70%)

24
Q

hormonal control of the kidney - Renin-angiotensin-aldoserone system (RAAS)

A

regulates fluid balance, stage 1: release renin (enzyme) from granular cells, stage 2: release of ACE, stage 3: angiotensin 2 exerts actions on body

25
Q

what is renin released in response to

A

decrease in perfusion pressure, increase in SNS drive, decrease in Na+ conc at DCT

26
Q

what does angiotensin converting enzyme (ACE) do

A

converts angiotensin 1 to 2 by cleaving

27
Q

what does renin do

A

convert angiontensinogen into angiotensin 1

28
Q

what does angiotensin 2 effect

A

adrenal gland, kidneys and vasculature

29
Q

what do renal baroreceptors do?

A

decrease renal perfusion, increasing renin release

30
Q

what do catecholamines do

A

beta-adrenoreceptor stimulation leads to renin release

31
Q

what is aldosterone

A

steroid hormone from zona glomerulosa

32
Q

what are the consequences of aldosterone

A

Na+ retention, K+ loss, H+ loss

33
Q

hormonal control of the kidney - ADH

A

synthesised in hypothalamus, 2 main receptors are osmoreceptors and baroreceptors

34
Q

what does ADH do

A

makes urine more concentrated, pulls water back into the body. It causes vasoconstriction which increases arterial pressure

35
Q

where does ADH act and how

A

late part of DCT and in collecting duct, increases aquaporins

36
Q

hormonal control of the kidney - ANP

A

opposite of RAAS, inhibits renin, causes Na+ and water loss and increases GFR. Acts to reduce plasma volume

37
Q

what diuretics work mainly work in PCT

A

osmotic diuretics and carbonic anhydrase inhibitors

38
Q

what do diuretics do

A

trap ions etc to increase urine volume (diuresis)

39
Q

osmotic diuretics

A

alter osmolarity of plasma, suck water into tubule. issue is it doesn’t block sodium reabsorption so water can be reabsorbed in DCT

40
Q

Mannitol

A

osmotic diuretic for when there is a build up of volume in brain or eye

41
Q

carbonic anhydrase inhibitors

A

in PCT, carbonic anhydrase is inhibited. stops the absorption of bicarbonate back into the body by blocking the conversion of carbonic acid into water and CO2. water and Na+ trapped in tubular fluid

42
Q

why are carbonic anhydrase inhibitors not great

A

the Na+ they trap in the PCT causes an increased delivery to the macula densa cells so there is a reduced GFR

43
Q

what are carbonic anhydrase inhibitors used for

A

glaucoma - ocular swelling, heart failure and altitude sickness

44
Q

Acetazolamide

A

carbonic anhydrase inhibitor, inhibits reabsorption of bicarbonate, is a weak diuretic and is associated with metabolic acidosis

45
Q

what are loop diuretics

A

act on ascending limb to block Na+/ K+ and 2Cl- symporter. 1/4 of the Na+ is trapped in tubules and therefore water follows.

46
Q

what do loop diuretics treat

A

pulmonary oedema

47
Q

Furosemide

A

loop diuretic used to treat chronic heart failure and renal failure

48
Q

What are thiazides

A

DCT diuretics, rely on good GFR, block Na+ and Cl- reabsorption at DCT

49
Q

Bendroflumethiazide

A

moderately powerful diuretic, traps Na+ in tubular fluid, effective as a hypotension treatment and for heart failure

50
Q

Potassium sparing diuretics

A

dont act on Na+ pump, block Na+ channels and less H+ and K+ are exchanged and therefore less K+ and H+ lost compared to other diuretics

51
Q

spironolactone

A

potassium sparing diuretics, blocks effects of aldosterone

52
Q
A

human physiology (15 decks)

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