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Physiology 3 > renal > Flashcards

renal Flashcards

1
Q

What is the role of the renal system

A

Excretion
Water/electrolyte balance
pH regulation
Control of circulating volume

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2
Q

What vertebra level are the kidney located at

A

L1-L4 when standing

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3
Q

What is the inner portion of the kidney

A

Medulla

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4
Q

What is the outer part of the cortex

A

Medulla

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5
Q

What cord level innervates the kidneys

A

T12

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6
Q

What does sympathetic stimulation of the kidneys do

A

Constriction of arterioles
decrease flow of fluids = decreased output

Increase sodium reabsorption
Increase renin release

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7
Q

how many capillary beds does the kidneys have

A

2 capillary beds

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8
Q

What are the two capillary beds in the kidneys

A

Glomerular capillaries

Peritubular capillaries

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9
Q

What is the order of kidney blood flow (in)

A

Afferent arterioles
Glomerular capillaries
Efferent arteriole
peritubular capillaries

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10
Q

What causes the rapid fluid filtration at the glomerular capillaries

A

High hydrostatic pressure

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11
Q

What allows for rapid fluid reabsorption at the peritubular capillaries

A

Low hydrostatic pressure

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12
Q

What are the two different nephron structures

A

Cortical nephron

Juxtamedullary nephron

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13
Q

What is the difference between cortical and juxtamedullary nephron

A

Juxtamedullary nephron is longer and penetrates deeper into the medulla

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14
Q

Can the kidney regenerate new nephrons

A

No

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15
Q

how many functional nephrons do you lose each year

A

10% every 10 years

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16
Q

does filtration effectiveness change as we age/lose nephrons

A

no

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17
Q

what encases glomerular capillaries

A

Bowman’s capsule

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18
Q

What type of nephron is most common

A

Cortical

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19
Q

what nephron is surrounded by Vasa recta

A

Juxtaglomerular

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20
Q

what precent of nephrons are juxtaglomerular

A

20-30%

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21
Q

how much does the pressure in the urinary bladder increase by when detrusor muscle contracts

A

40-60 mmHg

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22
Q

What part of the urinary bladder do the ureters enter

A

The upper trigone

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23
Q

Where is the trigone of the bladder located

A

The posterior wall

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24
Q

What is special about the surface of the trigone

A

It is smooth muscle with no rugae

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25
Q

What prevents backflow of urine into the ureters

A

THe tone of the detrusor muscle

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26
Q

Is the external urinary sphincter voluntary or involuntary

A

Voluntary

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27
Q

What nerve innervates the external urinary sphincter

A

The pudendal nerve

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28
Q

what cord levels provide parasympathetics to the urinary bladder

A

S2
S3

Via sacral plexus

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29
Q

What is the order of urine flow

A 
Nephron
Collecting ducts
Renal calyces
Ureters
Bladder
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30
Q

What is the Ureterorenal reflex

A

When there is pain in ureters renal arterioles constrict and decrease flow of fluid to kidneys

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31
Q

The ureterorenal reflex sends sympathetic or parasympathetic signals to the kidneys

A

Sympathetic

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32
Q

What is micturation

A

The process of emptying the bladder

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33
Q

What does it mean by the micturation reflex is self-regerative

A

Contracture of the detrusor muscle causes further activation of the stretch receptors

The longer you hold it in you will feel more pain and the sensation to pee will come back faster

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34
Q

What happens to micturation reflex as the bladder fills

A

Increase frequency of reflex

Increase intensity of reflex

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35
Q

Can the micturation refelx affect the external sphincter

A

Yes, and eventually the relaxation of it will be involuntary if held too long

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36
Q

What starts the micturation reflex

A

Sensory stretch receptors in the bladder wall

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37
Q

What is the average amount of fluid excreted via kidneys each day

A

1400ml/day

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38
Q

What are the parts of extracellular fluid

A

Interstitial fluid
Blood plasma
Transcellular fluid

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39
Q

what ions are high and low in intracellular fluid

A 
Low= sodium, calcium, chloride
High= potassium, phosphate
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40
Q

what ions are high and low in extracellular fluid

A 
Low= potassium, phosphate, proteins
high= sodium, chloride, bicarbonate
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41
Q

what is the definition of Osmolarity

A

Osmoles per liter of water

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42
Q

what is it called when a solution has a lower concentration of solutes than the cell

A

Hypotonic

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43
Q

What is it called when a solution has a higher concentration of solutes than the cell

A

Hypertonic

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44
Q

What is the most variable source of water loss from the human body

A

Urine

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45
Q

what type of blood vessels deliver blood to the renal corpuscle

A

Afferent arteriole

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46
Q

what should not filter out of the blood under normal circumstances

A

Red blood cells and plasma proteins

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47
Q

What is special about the membrane of glomerular capillaries

A

They have 3 layers instead of two

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48
Q

What prevents the passage of plasma proteins in the glomerular capillaries

A

The endothelium is negatively charged

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49
Q

What part of the basement membrane has a strong negative charge that prevents proteins from passing though

A

The proteoglycans

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50
Q

Is the epithelium layers of the renal corpuscles negativley charged

A

yes

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51
Q

What allows for filtration in the bowmans capsule

A

Blood colloid osmotic pressure caused by proteins

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52
Q

What is renal plasma flow

A

Volume of blood plasma delivered to the kidneys

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53
Q

What is Filtration Fraction

A

Proportion of the fluid reaching the kidneys which passes into the renal tubules

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54
Q

What is the average filtration fraction

A

20%

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55
Q

What is the average renal plasma flow

A

550 ml/min

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56
Q

How can renal plasma flow be altered

A

Increase overall cardiac output

Dilate afferent arterioles

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57
Q

How can Filtration Fraction be altered

A

Contract efferent arterioles, increasing glomerular pressure

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58
Q

What causes/favors filtration

A

Glomerular hydrostatic pressure 60mmHg

Bowman’s capsule colloid osmotic pressure 0mmHg

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59
Q

What causes/inhibits filtration

A

Bowmans capsule 18mmHG

Glomerular cap colloid pressure 32mmHg

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60
Q

What is the equation to calculate Filtration fraction

A

FF=GFR/RBF

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61
Q

What happens to glomerular filtration when membrane permeability decreases

A

it decreases

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62
Q

What happens to GFR when bowmans capsule pressure increases

A

Decrease GFR

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63
Q

What happens to GFR when Glomerular colloid pressure increases

A

Decreases GFR

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64
Q

What happens to GFR when Glomeular hydrostatic pressure increases

A

Increase GFR

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65
Q

What happens to GFR when arteriol pressure increases

A

GFR increases

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66
Q

Dilation of afferent arterioles will do what to GFR

A

Increase GRF

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67
Q

What part of the kidney receives most of the renal blood flow

A

The cortex

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68
Q

What supplies the Renal medulla with nutrients

A

The vasa recta

69
Q

What does Angiotensin II do to the kidneys

A

Maintain GFR when BP drops (prevents drop in GFR)

70
Q

What changes to filtration when Angiotensin II is released

A

Increase reabsorption of sodium and water

71
Q

What happens when renal cells sense a decrease in sodium concentration

A

Decrease blood flow in afferent arterioles (increase GFR)

Renin released (increase GFR)

72
Q

Filtration and reabsorption are high/low compared to excretion rate

A

High

73
Q

What is excretion rate equal to for electrolytes

A

Filtration rate - reabsoption rate

74
Q

What does it mean when excretion rate = 0

A

NO exretion in the urine

75
Q

What is excretion rate equal to for organic acids and bases, foreign substances, and drugs

A

Filtration rate + secretion rate

76
Q

What happens if the basement membrane loses its electrical charge

A

Albumin is filtered and will be in urine

77
Q

What is vital in determining excretion rate

A

Tubular reabsorption

78
Q

What is more selective; Glomerular filtration or Tubular reabsorption

A

Tubular reabsorption is more selective

79
Q

What are the steps of tubular reabsorption

A

Transported across the epithelial membrane
into interstitial fluid
through peritubular membrane
into blood

80
Q

What can travel through tubular epithelium

A

Water and solutes

81
Q

Where is sodium transported

A

Proximal tubule

82
Q

What type of transport is required to transport sodium from the proximal tubule cells into the interstital fluid

A

Active transport via sodium potassium ATPase pump

83
Q

What transports glucose into cell against concentration gradient

A

SGLT2

SGLT1

84
Q

What process allows for the movement of glucose

A

Release of energy from ATP (secondary active transport)

85
Q

What is counter transport in the kidney

A

Secretion of a substance into the tubule by secondary active transport

86
Q

What substances do not demonstrate a transport maxium

A

Substances that are passivly absorbed

87
Q

Which is greater:
Maxiumum transport capacity of basolateral sodium ATPase pump

Or

THe actual rate of sodium reabsorption

A

The maximum transport capacity of basolateral sodium ATPase pump

88
Q

what is the limit to the rate at which a solute can be transported during active reabsorption or secretion

A

Transport maximum

89
Q

How are proteins and amino acids reabsorbed in the kidneys

A

Pinocytosis

90
Q

What percent of filtered water and sodium is reabsorbed

A

65%

91
Q

What can transport sodium across a cell

A

Co-transporters
Counter-transport mechanism
Sodium-potassium ATPase pump

92
Q

What allows the proximal tubule to keep a constant osmolarity

A

It is highly permeable to water

93
Q

What is secreted in the proximal tubules

A

Organic acids + bases

Drugs + toxins

94
Q

What is the primary function of the thin desceding segment of the loop of henle

A

Allow for simple diffusion

95
Q

What happens in the thick ascending segment of the loop of henle

A

Active reabsorption of sodium, chloride and potassium

96
Q

Can water pass in the thick ascending loop of henle

A

No

97
Q

What is the first portion of the distal tubule called

A

Macula densa

98
Q

What % of sodium is absorbed in the proximal distal tubule

A

5%

99
Q

What is the job of Principal cells

A

Sodium reabsorption

Postassium secretion

100
Q

What is the job of intercalated cells

A

Hydrogen secretion

Bicarbonate+potassium reabsorption

101
Q

What determines water permability in the distal tubules

A

ADH (Vasopressin)
high=high permeability
low=low permeability

102
Q

What is water reabsorbtion dependent on in the medullary collecting ducts

A

ADH levels

103
Q

What portion of the loop of henle do we significant sodium transport

A

Thick ascending

104
Q

How has osmolarity changed when the filtrate reaches the end of the proximal tubule

A

Stayed the same

high permeability to water keeps it the same

105
Q

What percent of water and most solutes are reabsorbed

A

99%

106
Q

what determines reabsorption across peritubular capillaries

A

Hydrostatic and colloid osmotic forces

107
Q

What forces favors reabsorption

A

Plasma colloid osmotic pressure = 32mmhg

Hydrostatic pressure in interstitum = 6mmHg

108
Q

What forces oppose reabsorption

A

Peritubular hydrostatic pressure = 13mmHg

Osmotic pressure of the renal interstitum = 15mmHg

109
Q

What is the glomerular capillary net filtration forces

A

10mmHg

110
Q

What is the peritubular capillary net re-absorptive forces

A

10mmHg

111
Q

What determines filtration coefficient

A

Surface area of capillary

Permeability of capillary

112
Q

What happens if we raise peritubular capillary pressure

A

Decrease reabsorption rate

113
Q

What happens if peritubular capillary pressure decreases

A

Increase reabsorption

114
Q

What happens if we increase resistance at the effernt arteriole

A

Incresae glomerular pressure

Decrease peritubular pressure

115
Q

What is Natriuresis

A

Na excreted in urine

116
Q

What is Diuresis

A

Water excretion to regulate BP

117
Q

What secretes aldosterone

A

Zona glomerulosa cells of adrenal cortex

118
Q

What does aldosterone do to kidneys

A

Regulates sodium reabsorption and potassium secretion

119
Q

When is aldosterone relseased

A

Increased extracellular potassium

increased angiotensin II levels

120
Q

What does ADH do

A

Increase water permability in the
Distal tubule
Collecting tubule
Collecting duct

121
Q

What does ANP do

A

Inhibit renin

inhibit reabsorption of sodium potassium

122
Q

When is ANP released

A

In congestive heart failure

123
Q

What does angiotensin II do

A

Increase sodium and water reabsorption when BP is low

124
Q

What does angiotensis II do to the efferent arterioles

A

Constricts them

125
Q

What pH would make someone be in a state of acidosis

A

Below 7.4

126
Q

What pH would make someone be in a state of alkalosis

A

above 7.4

127
Q

What is the most powerful regulator of pH in the body

A

Kidneys

128
Q

How long does it take for the kidneys to react to a change in pH

A

hours to days

129
Q

What part of the tubule does Hydrogen secretion no occur

A

Thin ascending and thin descending limb of the loop of henle

130
Q

Where does HCO3- reabsorption occur

A 
Proximal tubules (80-90%)
Thick ascending (10%)
131
Q

Where is H+ secreted

A

Proximal tubule
Thick ascending limb
Early distal tubule

132
Q

Where does Primary active transport of HCO3- occur

A

Late distal tubule and collecting tubule

133
Q

What causes respiratory acidosis

A

increase Pco2

134
Q

What causes metabolic acidosis

A

Fall in HCO3-

135
Q

How does urine become acidic

A

Excess H+ in renal tubules causing complete reabsorption of HCO3-

136
Q

What amino acids get used by the kidneys for Gluconeogenesis

A

Lactate
Glutamine
Glycerol

137
Q

What is the osmolarity of the filtrate in the proximal tubule

A

300mOsm/L

138
Q

When does Osmolarity start to increase

A

The descending segment of the loop of henle

139
Q

What happens to osmolarity in the ascending portion of the loop of henle

A

It decreases

140
Q

What happens to the osmolarity at the collecting tubules in the absence of ADH

A

Dilute urine

Low osmolarity

141
Q

What happens to the osmolarity at the collecting tubules in the presence of ADH

A

Concentrated urine

high osmolarity

142
Q

what are the basic requirments for forming a concentrated urine

A

High levels ADH

High osmolarity in medulla tissue

143
Q

What creates hyperosmotic renal medullary interstitial fluid

A

Justamedullary nephrons

Vasa recta

144
Q

What is the concurrent multiplier

A

Repetive reabsorption of sodium chloride in thick ascending loop and continued inflow of new sodium from the proximal tubule

145
Q

what is the contribution of Urea to osmolarity of the renal interstitium

A

40-50%

146
Q

What might be recycled many times between the medulla tissue and the filtrate in the renal tubule

A

Urea

147
Q

What can be used to determine concentration of urine

A

Colour

Urine specific gravity

148
Q

What happens if sodium content increases 2mEq/L above normal

A

Causes a desire to ingest fluid (threshold for drinking)

149
Q

What can be done to control extracellular fluid if the kidneys can’t

A

Change BP
Change circulating hormones
Change sympathetic NS

150
Q

What is it called when there is a rise in sodium that ocures with elevated BP

A

pressure natriuresis

151
Q

What is it called when increased BP raises urinary volume

A

Pressure diuresis

152
Q

What mechanism as long as it is working handles increases in fluid and salt intake

A

Pressure diuresis mechanism

153
Q

a small Change in blood volume do what to cardiac output

A

Marked increase in cardiac output

154
Q

A small change in cardiac output would do what to BP

A

Increase BP

155
Q

a small change in BP does what to urine output

A

Increase urine output

156
Q

What happens to urine output if there is a small change in blood volume

A

Increase urine output

157
Q

What happens to a persons BP if they are salt sensitive and take in a small amount of salt

A

Marked increase in BP

158
Q

What is the bodies more powerful controllers of sodium excretion

A

Angiotensis II

159
Q

What drugs increase ADH secretion

A

Morphine
Nicotine
Cyclophosphamide

160
Q

What drugs inhibit ADH

A

Alcohol
Clonidine
Haloperidol

161
Q

What happens to pH when there is an increase of Extracellular postassium

A

Acidosis

162
Q

What happens to pH when there is a decrease in potassium levels

A

Alkalosis

163
Q

WHere is most of the potassium reabsorbed

A

Proximal tubule

164
Q

What cells secrete potassium for excretion

A

Principal cells

165
Q

What controls potassium secretions by the principal cells

A

Sodium-potassium ATPase pump
Electrochemical gradiant
Luminal membrane permebility

166
Q

What cells reabsorb potassoium

A

Intercallated cells

167
Q

Calcium in the blood is attached to what

A

Proteins

168
Q

Where is most of the calcium in the kidneys reabsorbed

A

Proximal tubules

Physiology 3 (4 decks)

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