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CRR Renal > Renal > Flashcards

Renal Flashcards

1
Q

What verterbrae levels are the kidneys located?

A

T12-L3

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2
Q

which kidney is lower?

A

right

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3
Q

3 layers of kidney wall; deep to superficial

A
  • renal capsule
  • adipose capsule
  • renal fascia
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4
Q

what forms the renal parenchyma?

A

renal cortex & medulla

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5
Q

what venules do the vasa recta drain into?

A

arcuate and interlobular

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6
Q

2 parts of nephron

A
  1. renal corpuscle

2. renal tubule

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7
Q

2 pars of renal corpuscle

A
  1. glomerulus

2. bowmans capsule

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8
Q

name of cells in bowmans capsule that hug the glomeular capillary

A

podocytes

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9
Q

which segment of the loop of Henle is highly permeable to water?

A

thin - descending

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10
Q

what ducts does the collecting duct have?

A

ducts of bellini

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11
Q

where do the ducts of bellini drain into?

A

minor calyces

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12
Q

3 regions of male urethra

A
  1. prostatic
  2. membranous
  3. penile
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13
Q

which muscle is under volunatary control in terms of urination?

A

external urethral sphincter

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14
Q

3 embryological systems to develop

A
  1. pronephros
  2. mesonephros
  3. metanephros
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15
Q

which 2 parts does the intermediate mesoderm lie between?

A

lateral mesoderm + paraxial mesoderm

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16
Q

when does the pronephros dissapear?

A

week 4

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17
Q

what 2 things does the mesonephric tubules differentiate into?

A
  1. glomerulus

2. bowmans capsule

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18
Q

what stems from the mesonephric duct?

A

ureteric duct

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19
Q

in what stage is the mesonephric excretory unit functional?

A

mesonephros

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20
Q

what important region is formed during metanephros?

A

metanephric blastema

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21
Q

what is a cloaca?

A

cavity at the end of the digestive tract

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22
Q

what causes a bifid ureter?

A

early splitting of ureteric bud

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23
Q

what is an effective osmoles?

A

molecules which are impermeable to the membrane - exert osmotic pressure

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24
Q

what is plasma protein onctotic (colloid) pressure?

A

osmotic pressure exerted by plasma proteins

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25
Q

which cells are involved in tubular-glomerula feedback regulation?

A

macula dense of juxtaglomerular apparatus

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26
Q

what is nephroptosis?

A

floating kidney - kidney moves down into pelvis when standing

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27
Q

what receptors do principle cells have?

A

ADH + aldosterone

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28
Q

which cells does carbonic anhydrase work in?

A

intercalated cells

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29
Q

name of ducts in collecting ducts

A

ducts of belllini

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30
Q

what occurs during reabsorption?

A

fluid moves from tubule to blood

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31
Q

what occurs during secretion?

A

fluid moves from blood to tubule

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32
Q

where does secretion occur?

A

proximal tubule

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33
Q

2 modes of transport through the tubule endothelium

A
  1. paracellular - tight junctions

2. transcellular - active transport

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34
Q

which part of the nephron has the greatest amount of water and solute reabsorption?

A

proximal convoluted tubule

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35
Q

example of Na+ antiporter

A

Na/K+ pump

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36
Q

does Na+/K+ require ATP?

A

yes

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37
Q

where does obligatory water reabsorption occur?

A

PCT

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38
Q

Where does facultative water reabsorption occur?

A

collecting duct

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39
Q

what type of transport does the Na/K pump drive?

A

secondary transport

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40
Q

what does the Na/K+ provide secondary transport of ?

A

amino acids, glucose, bircarb, Cl-

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41
Q

what is carbonic acid formed from

A

HCO3- and H+

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42
Q

what enzyme breaks down H2CO3 and what into?

A

carbonic anhydrase

CO2 + H20

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43
Q

where does bicarb reabsorption occur?

A

early proximal tubule

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44
Q

where does cl- reabsorption occur?

A

throughout prox tubule

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45
Q

where is urea reabsorbed?

A

pars recta - proximal tubule

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46
Q

by what process does urea move out of tubule?

A

diffusion

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47
Q

what conc gradient does urea follow?

A

na+ and water move out of tubule

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48
Q

how does water move out of the tubule?

A

aquaporin

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49
Q

what process is required for secretion ?

A

active transport

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50
Q

what is PAH?

A

para-aminohippuric acid

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51
Q

when PAH is secreted out of the blood, what does it anti-port with to get into the tubular cell?

A

alphaketogluterate

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52
Q

symport with alphaketogluterate into the cell?

A

na+

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53
Q

what 3 ions anti-ports with PAH into the tubular lumen?

A

Cl-, HCO3-, OH-

54
Q

what concept is used to assess the functioning of the kidney

A

renal clearance

55
Q

what type of molecule is inulin?

A

polysaccharide

56
Q

3 advantages of using inulin for renal clearance

A
  1. freely filtered
  2. not reabsorbed
  3. not secreted
57
Q

disadvatage of using inulin for renal clearance

A

has to be infused (vein)

58
Q

what is used to measure renal clearance?

A

creatinine

59
Q

advantage of using creatinine

A

endogenous - produced by body

60
Q

disadvanatafe of using creatinine

A

only a small amount is secreted

61
Q

does the fluid get more diluted or concentrated along the loop of Henle? is this hyper/hypotonic?

A

more diluted- hypertonic

62
Q

explain the Na+ conc the futher down the medulla

A

more concentrated

63
Q

which loop of Henle is permeable to water?

A

descending

64
Q

what does the ascending loop of Henle have which allows it to move Na+ out into the intersitium?

A

Na+/K pumps

65
Q

what is the conc difference between AL + DL (interstitium)?

A

200

66
Q

what is the purpose of counter-current multiplication?

A

to allow concentrated urine in collecting duct

67
Q

what is the osmolality of proximal tubule ?

A

290

68
Q

when does the counter current multiplication stop? at what osmolality?

A

when the DL + AL are isotonic- 1400

69
Q

2 sections of collecting duct?

A

cortical

medullary

70
Q

what hormone controls H20 reabsorption in the collecting duct?

A

ADH

71
Q

what effect does ADH have on the collecting duct?

A

prev- impermeabele to water, urea and NaCl

ADH- permeable to waterp; so water can move out

72
Q

where has the highest urea concentration?

A

interstitium

73
Q

nonapeptide

A

ADH

74
Q

where is ADH synthesised

A

hypothalamus

75
Q

where in the briain is ADH released from?

A

neurohypophysis (posterior pituitary)

76
Q

what does ADH bind to on the principle cell?

A

V2 receptor

77
Q

what enzyme does ADH activate? what does itt do?

A

adenylate cyclase

ATP to cAMP

78
Q

what does cAMP do?

A

causes activation of protein kinase A

79
Q

what does the phosphorylation of PKA cause?

A

aquaporin vesicles to impant on apical wall

80
Q

what is the max urine osmolality?

A

1400

81
Q

what cells initiate peristalsis of urine? and where?

A

pacemaker cells in renal pelvis

82
Q

which nerves keep the external uretheral sphincter closed?

A

pundendal nerves

83
Q

what is diabetes inspidus?

A

when reabsorption of water in the collecting duct is prevented

84
Q

what does increased ECF Na cause?

A

increased osmolality - increased water retention and thirst

85
Q

decapeptide

A

angiotensin 1

86
Q

octapeptide

A

angiotensin II

87
Q

where is aldosterone synthesided?

A

zona glomerulosa of adrenal gland

88
Q

what type of molecule is aldosterone

A

mineralocorticoid

89
Q

when is ANP released?

A

hypervolaemia

90
Q

what does renovascular hypertension increase the secretion of?

A

renin, Ang II, aldosterone - increase BP

91
Q

what does renal hypertension lead to?

A

increased extracellular volume

92
Q

what is primary hyperaldosteronism?

A

increased aldosterone secreiton

93
Q

what can increased aldosterone secretion cause?

A

increase in Na+ and secretion of K+= hypokalemia

94
Q

what effect does acidosis have on the CNS?

A

decreased CNS acitivity

95
Q

what effect does alkalosis have on the CNS?

A

increased CNS acitivity

96
Q

what does increased H+ cause on K+

A

decreased = hypokalemia

97
Q

which 2 molecules control pH of the blood, where are they located?

A 
HCO3-= kidneys 
CO2 = lungs
98
Q

explain the importance of buffers & renal compensatory mechanisms for those with resp diseases

A

cannot control level of CO2 - only realiant on buffers etc.

99
Q

which cells in the kidneys produce EPO? 2

A

mesangial cells

tubule cells

100
Q

why do renal failure patients contract anaemia?

A

produce less EPO - less RBC production

101
Q

what stimulates the productio of EPO?

A

hypoxia

102
Q

how much Ca2+ is bound to albumin?

A

50%

103
Q

3 places in the nephron where Ca2+ is reabsorbed. and by what process

A

passive

  1. PCT
  2. Loop of H

active
3. DT

104
Q

what 2 things regulate Ca2+ reabsorption

A

parathyroid hormone

Vit D

105
Q

which cells produce PTH?

A

principle cells of parathyroid gland

106
Q

when is PTH released?

A

LOW Ca2+

107
Q

active form of Vit D

A

calcitriol

108
Q

what causes calcitrol to become active

A

PTH

109
Q

which hormone works against PTH?

A

Calcitonin

110
Q

where is calcitonin produced?

A

parafollicular cells of thyroid gland

111
Q

what stimulattes calcitonin producted?

A

increased Ca2+

112
Q

for which condition can be treated by calcitonin?

A

osteoporosis

113
Q

which other two elements PTH and vitamin D regulate?

A

Magnesium and phosphate

114
Q

type of diabetes insipidus is caused by underproduction of ADH?

A

central DI

115
Q

what is nephrogenic diabetes insipidus

A

when collecting ducts dont respond to ADH

116
Q

DI which is due to an unsual thirst response

A

dipsogenic

117
Q

dialysis using a machine

A

haemodialysis

118
Q

majority of kidney stones are composed of?

A

Ca

119
Q

what is hydronephrosis?

A

swelling of kidney due to urine build up

120
Q

2 treatments for kidney stones

A
  1. lithotropsy = ultrasound
  2. ureteroscopy = insert through ureter
  3. nephrostomy = opening to the skin - urinary diversion
121
Q

which type of dialysis uses a bag at home?

A

continious ambulatory peritoneal dialysi

122
Q

which type of dialysis uses a machine at home?

A

automated peritoeneal dialysis

123
Q

what is poisueille’s law?

A

flow of liquid depends on;

  • pressure graient
  • diameter
  • length
  • viscosity
124
Q

what 4 things are reabsorped in the proximal tubule?

A
  • bicarb
  • glucose & AA
  • Cl-
125
Q

what is secreted in the proximal tubule?

A

PAH

126
Q

what does PAH stand for?

A

para-aminohippurtae

127
Q

whatr 3 ions are reabsorbed in loop of henle

A

Na, K+, Cl-

128
Q

which part of the nephron does ADH work?

A

collecting duct

129
Q

what 3 thing increase Na+ reabsoption

A

aldosterone, renin, AngII

130
Q

what cells detect low Na

A

macula densa

131
Q

what chemical does macula densa secrete - what does this do?

A

Prostaglanin I2 - stimulates renin release

132
Q

which hormone reduces Na+

A

ANP

CRR Renal (1 decks)

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