Renal Flashcards
1
Q
Normal filtration fraction
A
19%
2
Q
Normal Renal plasma flow
A
660mL/min
3
Q
Normal GFR
A
125mL/min
4
Q
Normal renal blood flow (mL/min and %CO)?
A
1100mL/min
22% CO
5
Q
Normal oncotic pressure in afferent arteriole
A
28mmHg
6
Q
Normal oncotic pressure in glomerular capillaries
A
32mmHg
7
Q
Normal oncotic pressure in efferent arteriole
A
36mmHg
8
Q
Normal hydrostatic pressure in afferent arteriole
A
60mmHg
9
Q
Normal hydrostatic pressure in renal tubule
A
18mmHg
10
Q
auto-regulation of GFR is primarily dictated by?
A
Resistance of efferent arteriole
11
Q
Constriction of efferent arteriole causes ________ of GFR
A
increase upstream pressure = increase GFR
12
Q
Dilation of efferent arteriole causes _______ of GFR
A
decreased upstream pressure = decreased GFR
13
Q
Normal oncotic pressure in peritubular capillaries
A
32mmHG
14
Q
Normal blood pressure/hydrostatic pressure in peritubular capillaries
A
13mmHg
15
Q
Normal BP in efferent arteriole
A
18mmHg
16
Q
Normal Net filtration pressure
A
10mmHg
17
Q
Normal Net reabsorption pressure
A
10mmHg
18
Q
Filtration rate calculation
A
Kf x NFP
19
Q
Kf
A
Filtration coefficient = 12.5 mL/min/mmHg
20
Q
% of plasma filtered
A
~19%, 1/5th, 125mL/min
21
Q
Secretion occurs from the ___________
A
Peritubular capillaries
22
Q
filtration occurs in the ____________
A
glomerular capillaries
23
Q
auto-regulation of renal blood flow is primarily dictated by
A
resistance of afferent arterioles
24
Q
plasma oncotic pressure favors _________ (filtration/reabsorption)
A
reabsorption
25
Normal renal interstitial pressure (Pisf)
15mmHg
26
Normal renal oncotic pressure (π isf)
6mmHg
27
to INCREASE renal blood flow, the ________ arteriole will _________, causing a _________ in glomerular pressure and ______ in GFR
afferent, dilate, increase, increase
28
to DECREASE renal blood flow, the ________ arteriole will _________, causing a _________ in glomerular pressure and ______ in GFR
afferent, constrict, decrease, decrease
29
to INCREASE glomerular filtration rate, the ________ arteriole will _________, causing a _________ in glomerular pressure and ______ in GFR
efferent, constrict, increase, increase
30
Roles of the Kidney
LT BP regulator
LT pH regulator
LT [RBC] regulator
LT [electrolyte] regulator
LT Vit D regulator
LT serum glucose regulator
Drug clearance
LT metabolic waste disposal
Osmolarity regular
31
Route blood flows starting from Renal Artery through Renal Veins
Renal Art -> Segmental art. -> Interlobar art -> Arcuate art -> inbterlobular art. -> AA -> Glom Cap -> EA -> Peritubular cap -> Interlobular vein -> arcuate vein -> interlobar vein -> segmental vein - > renal vein
32
90-95% of nephrons exist where?
Cortical - superficial
33
5-10% of nephrons exist where?
Medullary - deep
34
The vasa recta exists where?
inner medulla
35
What is the significance of the ascending vasa recta splitting into multiple vessels
Decreases the velocity in ascending blood which is important to maintain normal levels of solutes in the deep inner medulla.
Too high velocity would wash out medullary interstitium
36
Another name for the adrenal glands are the ________ glands
Suprarenal
37
Renal Interstitial is comprised of
Gel
Collagen
Proteoglycan filaments
Hyaluronic acid
free fluid rivulets
38
The imperfect autoregulation of the kidney allows for ________
Long term BP management; allows for
39
Which vessel in the kidney has the highest vascular resistance?
Efferent arteriole: has the largest drop in pressure downstream
40
Specialized holes in the renal glomerular endothelium are called _________
fenestrations
41
The layer of the renal glomerular capillary between the endothelium and epithelium is the ___________ and is made up of ____________
basement membrane, connective tissue
42
What is the importance of the renal capillary epithelium?
provide support d/t high pressures
43
What specialized cells provide support to the capillary epithelium?
Podocytes
44
Podocyte foot processes form _______
slit pores
45
The endothelium and basement membrane of glomerular capillaries are ____________ charged, which helps do what?
negatively charged, helps repel proteins from slipping through fenestrations
46
Which substance would have the highest filterability?
a) small and - charge
b) small and + charge
c) small and neutral
d) Large and - charge
e) Large and + charge
f) Large and neutral
small and + charged
47
The pudendal nerve branches from which spinal nerve(s)?
S2, 3 and 4
"S2, 3 and 4 keeps stuff off the floor"
48
What is the function of the pudendal nerve?
maintain continence via constriction of external anal and external urinary sphincters. Erections in men.
49
Prostate removal surgery has high likelihood of damaging which nerve?
pudendal nerve
50
The macula densa is located where in the nephron?
Thick ascending limb
51
The function of the macula densa
Monitor filtration rate
52
Low flow detected by macula dense cells cause release of what?
renin
53
Angiotensin II (ANG II) preferentially constricts ______, and causes _________ reabsorption in the __________
efferent arteriole, NaCl, proximal tubule
54
Outermost layer of adrenal gland
Zona glomerulosa
55
What hormone is secreted by the Zona glomerulosa?
aldosterone
56
Aldosterone is a _______
mineralcorticoid
57
The medial layer of the adrenal cortex is the
Zona fasciculata
58
The deepest layer of the adrenal cortex is the
Zona reticularis
59
The zona fasciculata and zona reticularis secrete ________
cortisol and androgens
60
The adrenal medulla secretes _________
catecholamines
61
What is the enzyme in principle cells that destroys cortisol, preventing binding to aldo receptors
11B-HSD Type 2
11 Beta-hydroxysteroid dehydrogenase, Type 2
62
Increased aldosterone levels causes what to potassium?
Increases potassium secretion from principle cells leading to hypokalemia
63
What inhibits 11B-HSD?
Licorice
(often found in tobacco mixes)
64
What is the primary function of intercalated cells
acid/base regulation
65
What are the two types of intercalated cells and what do they secrete/reabsorb
Type A= secretes protons, H+
Type B= secretes bicarb, HCO3- and reabsorbs H+
66
What transporters does Type A intercalated cells use to secrete
Hydrogen ATPase
and
Hydrogen/Potassium ATPase
67
Both Type A and B intercalated cells are sensitive to ______
vasopressin (ADH)
68
Vasopressin receptors in the kidney are _____
V2 receptors
69
What type of receptor are V2 receptors?
GPCR, Gs
70
Binding of vasopressin to V2 receptors causes
activation of adenylyl cyclase --> ^cAMP ---> activate protein kinase A --> protein phosphorylation ---> AQP-2 channels to move to apical membrane, allowing water reabsorption
71
Which aquaporin channels are always on the basolateral membrane?
AQP-3 and 4
72
________ is the disease caused by abnormality in how kidney responds to ADH
nephrogenic diabetes insipidus
73
________ is the disease caused by insufficient release of ADH from pituitary gland
Central/neurogenic diabetes insipidus
74
_______ is the example of one cause of nephrogenic diabetes insipidus
Lithium
75
lower limit of urine osmolarity
50 mOsm
76
Which section of the nephron is also called the "diluting segment"
Thick ascending limb, because lots of reabsorption of ions, but impermeable to water causes dilution of the urine.
77
How does alcohol affect ADH?
alcohol reduces ADH secreted by the pituitary gland, and decreases response of ADH by principal cells
78
When osmoreceptors shrink it _________ action potential firing rate
increases
79
When osmoreceptors expand it ______ action potential firing rate
slows
80
2/3 of all reabsorption occurs where?
Proximal convoluted tubule
81
In addition to water retention, ADH also affects reabsorption of what?
Urea
82
Which Urea transporters are in the collecting duct
UT-A1 and UT-A3
83
Which Urea transporter secretes urea into the loop of henle?
UT-A2
