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Phys exam 5 > Renal 6 > Flashcards

Renal 6 Flashcards

1
Q

Normal function requires ECF Osmolarity = ____ mOsm

A

300 mOsm

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2
Q

___ and ____ input via diet:
–Too much
–Not enough.

A

H2O and Na+

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3
Q

How are water and Na lost? 4 ways

A

–Insensible
–Sweat
–Feces
–Urine

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4
Q

To a large extent, kidneys balance the books by adjusting ____ reabsorption and excretion

A

water

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5
Q

Mechanisms to eliminate excess water excrete a ____ urine

A

dilute

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6
Q

Mechanisms to conserve water excrete a _____ urine

A

concentrated

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7
Q

Concentration and Dilution of the Urine Accomplished independently of major changes in ___ excretion

A

solute

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8
Q

Renal feedback mechanisms that control the ________ concentration and osmolarity

A

extracellular fluid sodium

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9
Q

_____ and ______ mechanisms that determine the intakes of water and salt, which also help to control extracellular fluid volume, osmolarity, and sodium concentration.

A

Thirst and salt appetite

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10
Q

independently of major changes in solute excretion to concentrate and dilute urine are a function of what hormone?

A

ADH

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11
Q

Filtrate is _____ in proximal tubule (osmolarity)

A

isosmotic

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12
Q

Filtrate Becomes Becomes ______ as passes through tDL
–Water reabsorption
–No solute reabsorption.

A

hyperosmotic

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13
Q

Filtrate Becomes _____ as passes through TAL and early distal tubule
–Solute reabsorption
–No water reabsorption

A

hyposmotic

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14
Q

T/F: Osmolarity of fluid will vary as pass through distal tubule and collecting duct

A

True

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15
Q

Osmolarity of filtrate Stays _____ in absence of ADH

A

hyposmotic

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16
Q

_____ increases H2O permeability of distal tubule and collecting duct

A

ADH

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17
Q

In response to _____:
Large volume of H2O diffuses into interstitium.
Enters capillaries of Vasa Recta and removed.
Creates concentrated urine

A

ADH

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18
Q

The maximal concentration ability of the kidney dictates how much urine volume must be excreted each day to rid the body of metabolic waste products and ions that are ingested.

A

Obligatory urine volume

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19
Q

Adult must excrete ____ mosmol daily

A

600 mOsm

20
Q

What 2 things are required for excreting a concentrated urine?

A
  1. High levels of ADH

2. Hyperosmotic medullary interstitial fluid

21
Q

Surrounds collecting duct
Sets gradient for water reabsorption
Requires Counter Current Multiplier Mechanism
Function of Juxtamedullary nephrons

A

Hyperosmotic medullary interstitial fluid

22
Q

Which nephron:

  • Long Loop of Henle
  • Vasa Recta
  • Slow flow rate
A

Juxtamedullary nephrons

23
Q

_______ is a result of:

  • Active transport of Na+ and other ions by ascending limb of LOH
  • Active transport of ions from collecting duct into interstitium
  • Facilitated diffusion of Urea by Inner medullary collecting ducts
  • Movement of only small amounts of water into medullary interstitium
A

High Interstitial fluid Osmolarity

24
Q

When there is a high level of ADH, what type of urine is produced and at what volume?

A

Small volume of concentrated urine

25
Q

When there is a low level of ADH, what type of urine is produced and at what volume?

A

Large volume of dilute urine

26
Q

In _____ of ADH
Reabsorb solute
Little to no water reabsorption

A

Absence of ADH

27
Q

In _____ of ADH
Distal tubule and collecting ducts become highly permeable to water and reabsorb much water into cortical interstitium
Medullary collecting duct cells reabsorb water but overall amounts much lower (keeps medullary interstitium from being diluted).
Reabsorbed water carried away by Vasa Recta

A

Presence of ADH

28
Q

In presence of ADH, _____ and ______ become highly permeable to water and reabsorb much water into cortical interstitium

A

Distal tubule and collecting ducts

29
Q

In presence of ADH, _______ cells reabsorb water but overall amounts much lower (keeps medullary interstitium from being diluted).

A

Medullary collecting duct

30
Q

In presence of ADH, Reabsorbed water carried away by ______

A

Vasa Recta

31
Q

Waste product of protein metabolism; produced continuously by liver.

A

Urea

32
Q

Normally excrete 20-50% of filtered load
Non-toxic, but constitutes an osmotic load that must be excreted
Contributes 40-50% of medullary interstitial osmolarity (500-600 mOsm/L)
Reabsorbed passively by medullary collecting duct cells
Secreted into descending limb and thin ascending limb of Loop of Henle
 Requires: ADH

A

Urea

33
Q

What percentage ranges of urea are excreted in filtered load?

A

20-50%

34
Q

What percentage is urea’s contribution to the medullary interstitial osmolarity?

A

40-50%

35
Q

Concentrates urea in filtrate (water reabsorption in cortical and medullary collecting ducts)
Activates carriers (UT-A1; UT-A3) for the facilitated diffusion of urea by medullary collecting duct cells

A

ADH

36
Q

Where is urea secreted along the nephron?

A

Thin limbs of loop of henle

37
Q

Where is urea reabsorbed along the nephron?

A

Medullary collecting duct

38
Q

What do you think happens to the ability to concentrate urine in someone suffering from malnutrition?

A

Decreased urea causing less ability to form hyperosmotic interstitial fluid leading to a more dilute urine

39
Q

What do you think happens to the ability to concentrate urine in someone on a high protein diet?

A

More urea causing more urea excretion causing a more concentrated urine

40
Q

Depends on anatomical relationships of loop of Henle, vasa recta, & collecting ducts.
~25% of nephrons are juxtamedullary, with long loops of Henle that extend into renal medulla parallel to vasa recta & collecting ducts.
Filtrate in descending & ascending limbs of loop of Henle flows in opposite directions of blood flow in Vasa Recta
Clears Reabsorbed water so does not dilute medullary interstitial fluid

A

Countercurrent Multiplier Mechanism

41
Q

What 3 structures of the nephron/kidney are involved in the countercurrent multiplier mechanism?

A

Loop of henle, vasa recta, and collecting ducts

42
Q

In the Countercurrent Multiplier Mechanism, ______ Preserves Hyperosmolarity in Medulla Interstitium

A

Vasa Recta

43
Q

In the Countercurrent Multiplier Mechanism, Vasa Recta Preserves _______ in Medulla Interstitium

A

Hyperosmolarity

44
Q

In what segment of the nephron is 70% of water reabsorbed and the filtrate osmolarity isosmotic?

A

Proximal tubule

45
Q

In what segment of the nephron is 20% of water reabsorbed and the filtrate osmolarity hyperosmotic?

A

Descending limb of Loop of Henle

46
Q

In what segment of the nephron is 0% of water reabsorbed and the filtrate osmolarity hyposmotic?

A

Ascending limb of loop of henle

47
Q

What is the reason for the variability of water absorbed in the late distal tubule and collecting ducts due to?

A

ADH

Phys exam 5 (9 decks)

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