Renal Flashcards
1
Q
What verterbrae levels are the kidneys located?
A
T12-L3
2
Q
which kidney is lower?
A
right
3
Q
3 layers of kidney wall; deep to superficial
A
- renal capsule
- adipose capsule
- renal fascia
4
Q
what forms the renal parenchyma?
A
renal cortex & medulla
5
Q
what venules do the vasa recta drain into?
A
arcuate and interlobular
6
Q
2 parts of nephron
A
- renal corpuscle
2. renal tubule
7
Q
2 pars of renal corpuscle
A
- glomerulus
2. bowmans capsule
8
Q
name of cells in bowmans capsule that hug the glomeular capillary
A
podocytes
9
Q
which segment of the loop of Henle is highly permeable to water?
A
thin - descending
10
Q
what ducts does the collecting duct have?
A
ducts of bellini
11
Q
where do the ducts of bellini drain into?
A
minor calyces
12
Q
3 regions of male urethra
A
- prostatic
- membranous
- penile
13
Q
which muscle is under volunatary control in terms of urination?
A
external urethral sphincter
14
Q
3 embryological systems to develop
A
- pronephros
- mesonephros
- metanephros
15
Q
which 2 parts does the intermediate mesoderm lie between?
A
lateral mesoderm + paraxial mesoderm
16
Q
when does the pronephros dissapear?
A
week 4
17
Q
what 2 things does the mesonephric tubules differentiate into?
A
- glomerulus
2. bowmans capsule
18
Q
what stems from the mesonephric duct?
A
ureteric duct
19
Q
in what stage is the mesonephric excretory unit functional?
A
mesonephros
20
Q
what important region is formed during metanephros?
A
metanephric blastema
21
Q
what is a cloaca?
A
cavity at the end of the digestive tract
22
Q
what causes a bifid ureter?
A
early splitting of ureteric bud
23
Q
what is an effective osmoles?
A
molecules which are impermeable to the membrane - exert osmotic pressure
24
Q
what is plasma protein onctotic (colloid) pressure?
A
osmotic pressure exerted by plasma proteins
25
which cells are involved in tubular-glomerula feedback regulation?
macula dense of juxtaglomerular apparatus
26
what is nephroptosis?
floating kidney - kidney moves down into pelvis when standing
27
what receptors do principle cells have?
ADH + aldosterone
28
which cells does carbonic anhydrase work in?
intercalated cells
29
name of ducts in collecting ducts
ducts of belllini
30
what occurs during reabsorption?
fluid moves from tubule to blood
31
what occurs during secretion?
fluid moves from blood to tubule
32
where does secretion occur?
proximal tubule
33
2 modes of transport through the tubule endothelium
1. paracellular - tight junctions
| 2. transcellular - active transport
34
which part of the nephron has the greatest amount of water and solute reabsorption?
proximal convoluted tubule
35
example of Na+ antiporter
Na/K+ pump
36
does Na+/K+ require ATP?
yes
37
where does obligatory water reabsorption occur?
PCT
38
Where does facultative water reabsorption occur?
collecting duct
39
what type of transport does the Na/K pump drive?
secondary transport
40
what does the Na/K+ provide secondary transport of ?
amino acids, glucose, bircarb, Cl-
41
what is carbonic acid formed from
HCO3- and H+
42
what enzyme breaks down H2CO3 and what into?
carbonic anhydrase
| CO2 + H20
43
where does bicarb reabsorption occur?
early proximal tubule
44
where does cl- reabsorption occur?
throughout prox tubule
45
where is urea reabsorbed?
pars recta - proximal tubule
46
by what process does urea move out of tubule?
diffusion
47
what conc gradient does urea follow?
na+ and water move out of tubule
48
how does water move out of the tubule?
aquaporin
49
what process is required for secretion ?
active transport
50
what is PAH?
para-aminohippuric acid
51
when PAH is secreted out of the blood, what does it anti-port with to get into the tubular cell?
alphaketogluterate
52
symport with alphaketogluterate into the cell?
na+
53
what 3 ions anti-ports with PAH into the tubular lumen?
Cl-, HCO3-, OH-
54
what concept is used to assess the functioning of the kidney
renal clearance
55
what type of molecule is inulin?
polysaccharide
56
3 advantages of using inulin for renal clearance
1. freely filtered
2. not reabsorbed
3. not secreted
57
disadvatage of using inulin for renal clearance
has to be infused (vein)
58
what is used to measure renal clearance?
creatinine
59
advantage of using creatinine
endogenous - produced by body
60
disadvanatafe of using creatinine
only a small amount is secreted
61
does the fluid get more diluted or concentrated along the loop of Henle? is this hyper/hypotonic?
more diluted- hypertonic
62
explain the Na+ conc the futher down the medulla
more concentrated
63
which loop of Henle is permeable to water?
descending
64
what does the ascending loop of Henle have which allows it to move Na+ out into the intersitium?
Na+/K pumps
65
what is the conc difference between AL + DL (interstitium)?
200
66
what is the purpose of counter-current multiplication?
to allow concentrated urine in collecting duct
67
what is the osmolality of proximal tubule ?
290
68
when does the counter current multiplication stop? at what osmolality?
when the DL + AL are isotonic- 1400
69
2 sections of collecting duct?
cortical
| medullary
70
what hormone controls H20 reabsorption in the collecting duct?
ADH
71
what effect does ADH have on the collecting duct?
prev- impermeabele to water, urea and NaCl
| ADH- permeable to waterp; so water can move out
72
where has the highest urea concentration?
interstitium
73
nonapeptide
ADH
74
where is ADH synthesised
hypothalamus
75
where in the briain is ADH released from?
neurohypophysis (posterior pituitary)
76
what does ADH bind to on the principle cell?
V2 receptor
77
what enzyme does ADH activate? what does itt do?
adenylate cyclase
| ATP to cAMP
78
what does cAMP do?
causes activation of protein kinase A
79
what does the phosphorylation of PKA cause?
aquaporin vesicles to impant on apical wall
80
what is the max urine osmolality?
1400
81
what cells initiate peristalsis of urine? and where?
pacemaker cells in renal pelvis
82
which nerves keep the external uretheral sphincter closed?
pundendal nerves
83
what is diabetes inspidus?
when reabsorption of water in the collecting duct is prevented
84
what does increased ECF Na cause?
increased osmolality - increased water retention and thirst
85
decapeptide
angiotensin 1
86
octapeptide
angiotensin II
87
where is aldosterone synthesided?
zona glomerulosa of adrenal gland
88
what type of molecule is aldosterone
mineralocorticoid
89
when is ANP released?
hypervolaemia
90
what does renovascular hypertension increase the secretion of?
renin, Ang II, aldosterone - increase BP
91
what does renal hypertension lead to?
increased extracellular volume
92
what is primary hyperaldosteronism?
increased aldosterone secreiton
93
what can increased aldosterone secretion cause?
increase in Na+ and secretion of K+= hypokalemia
94
what effect does acidosis have on the CNS?
decreased CNS acitivity
95
what effect does alkalosis have on the CNS?
increased CNS acitivity
96
what does increased H+ cause on K+
decreased = hypokalemia
97
which 2 molecules control pH of the blood, where are they located?
```
HCO3-= kidneys
CO2 = lungs
```
98
explain the importance of buffers & renal compensatory mechanisms for those with resp diseases
cannot control level of CO2 - only realiant on buffers etc.
99
which cells in the kidneys produce EPO? 2
mesangial cells
| tubule cells
100
why do renal failure patients contract anaemia?
produce less EPO - less RBC production
101
what stimulates the productio of EPO?
hypoxia
102
how much Ca2+ is bound to albumin?
50%
103
3 places in the nephron where Ca2+ is reabsorbed. and by what process
passive
1. PCT
2. Loop of H
active
3. DT
104
what 2 things regulate Ca2+ reabsorption
parathyroid hormone
| Vit D
105
which cells produce PTH?
principle cells of parathyroid gland
106
when is PTH released?
LOW Ca2+
107
active form of Vit D
calcitriol
108
what causes calcitrol to become active
PTH
109
which hormone works against PTH?
Calcitonin
110
where is calcitonin produced?
parafollicular cells of thyroid gland
111
what stimulattes calcitonin producted?
increased Ca2+
112
for which condition can be treated by calcitonin?
osteoporosis
113
which other two elements PTH and vitamin D regulate?
Magnesium and phosphate
114
type of diabetes insipidus is caused by underproduction of ADH?
central DI
115
what is nephrogenic diabetes insipidus
when collecting ducts dont respond to ADH
116
DI which is due to an unsual thirst response
dipsogenic
117
dialysis using a machine
haemodialysis
118
majority of kidney stones are composed of?
Ca
119
what is hydronephrosis?
swelling of kidney due to urine build up
120
2 treatments for kidney stones
1. lithotropsy = ultrasound
2. ureteroscopy = insert through ureter
3. nephrostomy = opening to the skin - urinary diversion
121
which type of dialysis uses a bag at home?
continious ambulatory peritoneal dialysi
122
which type of dialysis uses a machine at home?
automated peritoeneal dialysis
123
what is poisueille's law?
flow of liquid depends on;
- pressure graient
- diameter
- length
- viscosity
124
what 4 things are reabsorped in the proximal tubule?
- bicarb
- glucose & AA
- Cl-
125
what is secreted in the proximal tubule?
PAH
126
what does PAH stand for?
para-aminohippurtae
127
whatr 3 ions are reabsorbed in loop of henle
Na, K+, Cl-
128
which part of the nephron does ADH work?
collecting duct
129
what 3 thing increase Na+ reabsoption
aldosterone, renin, AngII
130
what cells detect low Na
macula densa
131
what chemical does macula densa secrete - what does this do?
Prostaglanin I2 - stimulates renin release
132
which hormone reduces Na+
ANP
