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Physiology > Renal > Flashcards

Renal Flashcards

1
Q

Components of renal fxn

A
  • Glomerular filtration
  • Tubular secretion
  • Tubular reabsorption
  • Excretion
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2
Q

Renal corpuscle

A
  • Where ultrafiltrate originates

- Glomerulus & Bowman’s capsule

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3
Q

Renal pelvis

A

Where ultrafiltrate leaves kidney

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4
Q

Renal vasculature

A

Renal artery –> interlobar a –> arcuate a –> interlobular a –> afferent arteriole –> glomerular capillary –> efferent arteriole –> peritubular capillary

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5
Q

What are the 3 capillary beds?

A
  • Glomerular: filtration
  • Peritubular: reabsorption, secretion
  • Vasa recta - specialized peritubular: Osmotic exchangers
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6
Q

Renal blood flow (RBF)

A

Total volume of blood delivered to kidneys per unit time = 1.25

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7
Q

Renal plasma flow (RPF)

A
  • Volume of plasma delivered to kidneys per unit time
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8
Q

How much of plasma is filtered?

A

20%

- Becomes ultrafiltrate in Bowman’s

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9
Q

Glomerular filtration

A
  1. Forming urine

2. RBF enters glomerular capillaries & portion of blood is filtered into 1st part of the nephron

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10
Q

Corpuscle

A

A glomerulus & Bowman’s capsule

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11
Q

Filtration barriers consist of what 3 layers?

A
  • Capillary endothelium
  • Basement membrane
  • Capsular epithelial cells
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12
Q

What is the most significant layer of the filtration barriers?

A

Basement membrane

- Barrier to plasma proteins

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13
Q

Sympathetic nn

A
  • Vasoconstriction by binding to alpha1 receptors on afferent arteriole
  • Response to hemorrhage
  • Decrease RBF
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14
Q

Angll

A
  • Vasoconstriction of both afferent & efferent arterioles, but efferent is more sensitive
  • Decrease RBP
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15
Q

How can RPF & GFR be controlled?

A

By controlling resistance of the afferent arteriole

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16
Q

Prostaglandins (PGE2, PGI2)

A
  • Vasodilate
  • Protective effect
  • Increase RBF
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17
Q

Dopamine

A
  • Vasodilate via dopamine receptors (D1, D3, D5)
  • Protective effect; admin in shock
  • Increase RBF
18
Q

Other vasodilators

A
  • ANP

- NO

19
Q

Changes in GFR can be brought about by changes in what?

A

Starling forces

20
Q

What does GFR depend on?

A

The sum of starling forces

- Forces favoring vs. forces opposing

21
Q

Reabsorption

A

Returns substances to circulation

22
Q

Secretory

A

Remove substances from blood & add to urine

23
Q

What is the most important fxn of the kidney?

A

Reabsorption of sodium

24
Q

Descending thin limb

A
  • Passive permeability to H2O, NaCl & urea
25
Q

Ascending thick limb

A
  • Active NaCl reabsorption
  • Load dependent
  • Impermeable to H2O
26
Q

Principal cells (late DT & CD)

A
  • Aldosterone & ANF sensitive sodium reabsorption
  • Also reabsorbs H2O & secretes K+
  • Driving force established by Na-K- ATPase in basolateral membrane
27
Q

ADH

A

Reabsorbs H2O & NaCl

28
Q

Role of ADH

A
  • Binds V2 receptors in basolateral membrane
  • Stimulates Gs (activates adenylate cyclase, increases cAMP)
  • Activates protein kinase A
  • Phosphorylates intracellular structures
  • H2O channels shuttled to apical membrane
  • Inserted into membrane –> H2O reabsorption
29
Q

Hypoosmolarity

A

Excess H2O in body

- Kidneys excrete urine w/ low osmolarity (H2O diuresis)

30
Q

Hyperosmolarity

A

Deficit of H2O

- Kidneys concentrate urine (Antidiuresis)

31
Q

Normal urine

A

Slightly hypertonic

32
Q

Control of BP

A
  • Baroreceptor reflex (neurally-mediated, reacts in secs)

- Renin-angiotensin aldosterone (hormonally-mediated, reacts in mins to hrs)

33
Q

What determines volume?

A

Amount of Na+ in ECF

34
Q

What is the single most important controller of sodium?

A

Renin-angiotensin-aldosterone

35
Q

What conditions lead to hyponatremia?

A
  • Excess retention or intake of H2O
  • Inappropriate or uncontrolled secretion of ADH
  • Increased loss or decreased intake of Na+
36
Q

What conditions lead to hypernatremia

A
  • Impaired thirst
  • No access to drinking H2O
  • Loss of extracellular H2O
37
Q

Acute water load

A

Osmolarity < 290
- Drink free H2O
- Increased ECF volume, decreased ECF osmolarity
- Shift of water from ECF to ICF:
Decreased  ICF osmolarity
- New steady state:
Hypoosmotic volume expansion, TBW increases

38
Q

Infusion of isotonic NaCl

A
  • Increased ECF volume
  • No change in osmolarity, as infusion is isosmotic
  • No need for fluid shift
  • ICF volume remains unchanged
  • New steady state:
    Isosmotic volume expansion
  • TBW increases
39
Q

What does the renin-Ang II-Aldo system regulate?

A
  • Arterial pressure by regulating blood volume
  • Achieved by regulating Na+ reabsorption –> affects H2O reabsorption
  • Amount of Na+ in ECF determines volume
40
Q

Production of hyposmotic urine

A

W/out ADH, H2O reabsorption does not occur in late DT & CD.

  • A dilute urine is produced
  • H2O is impermeable to thick ascending limb & CD
41
Q

Production of hyperosmotic urine

A
  • When ADH is present, a concentrated urine is formed
  • H2O is impermeable to thin ascending limb
  • H2O reabsorption is maximal at CD

Physiology (7 decks)

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