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MEDSCI142 > Renal > Flashcards

Renal Flashcards

1
Q

Main functions of the Kidneys

A

1) Regulation of water and electrolyte balance
2) Regulation of arterial pressure
3) Excretion of metabolic waste products or foreign chemicals from the body
4) Regulation of blood pH
5) Regulation of erythrocyte production
6) Regulation of hormone production
7) Regulating blood glucose

Homeostasis
Blood essentially.

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2
Q

What happens when the kidney goes wrong

A

1) Swelling
2) High blood pressure
3) Shortness of breath
4) Fatigue
5) Nausea

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3
Q

Osmosis

A

The movement of water through a selectively permeable membrane

1) from an area of lower solute concentration
2) to an area of higher solute concentration

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4
Q

Osmolarity

A

A measure of the osmotic pressure exerted by a solution across a perfect semi-permeable membrane compared to pure water

basically only concentration of particles needed

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5
Q

Tonicity

A

The concentration of a solute and it’s ability to cross a semi permeable membrane.

The difference is well illustrated in Urea
where you got some water passing through into cytosol

Hypertonic: The solution has a higher POsm, so water leaves, and causes cell shirnkage

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6
Q

Why maintain osmolarity

A

1) Setting membrane potential
2) generating electrical activity in nerve and muscle
3) initiation of muscle contraction
4) Providing energy for the uptake of nutrients and the expulsion of waste products
5) Generation of intracellular signaling cascades.

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7
Q

The make up of the fucken human body

A 
A 70kg male is 
60% fluid
of that fluid 2/3 is intracellular fluid, 1/3 is extracellular fluid
80% is interstitial fluid
20% is plasma
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8
Q

Major sources of water intake

A

1) Metabolism 8% 200ml
2) Foods 28%
700ml
3) Beverages 64%
1600ml

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9
Q

Major sources of water output

A 
1) Feces 4% 
100ml
2) Lungs 12%
300ml
Skin 24%
600ml
Urine 60%
1500ml
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10
Q

Electrolyte concentration of blood

A

Sodium, chloride and calcium ions have high extracellular

Potassium has high intracellular

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11
Q

Water stats

A

Filtration 180
Reabsorption 178.6
Excretion 1.4

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12
Q

Sodium

A

Filtration 25560
Reabsorption 25410
Excretion
150

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13
Q

Glucose

A

Filtration 180

Reabsorption 180

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14
Q

Creatinine

A
  1. 8

1. 8

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15
Q

Glmerular filtration rate

A

about 25% of total renal plasma flow

about 180 L/day

it’s really similar to solute concentration and similar to plasma

It lacks proteins and other high molecular weight compounds-obviously.

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16
Q

Why is glomerular filtration rate relatively constant

A

Because Glomerular filtration rate is relatively constant

Renal blood flow is relatively constant

Urine output is directly proportional to renal pressure.

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17
Q

GBHP

A

The only capillary bed that has arterioles before and after to it.

This allows for tight regulation of pressure gradients to maintain near constant glomerular filtration rate.

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18
Q

Glomerular blood hydrostatic pressure stats

A

Glomerular BP is the average of the Afferent arteriole P and Efferent arteriole P

Increases in arterial pressure can be buffered by vasoconstriction of arteriole

Decreases in pressure can be buffered by vasoconstriction of efferent arteriole

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19
Q

Capsular hydrostatic pressure is exerted by

A

The elastic recoil of the glomerular capsule (15mmHg)

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20
Q

Hormonal regulation of Glomerular filtration

A

Angiotensin II via vasoconstriction of afferent and efferent arterioles

Atrial Natriuetic relaxation of mesangial cells, increase SA for filtration via relaxation process

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21
Q

How is Glomerular filtration regulated

A

Autoregulation
Neural
Hormonal

Anything that alters the glomerular hydrostatic blood pressure
and anything that alters the surface area available for filtration.

22
Q

Tubuloglomerular feedback

A

1) Increased GFR
2) Increased tubular flow rate
3) Increased tubular Na+,Cl-, water content sensed by macula densa cells
4) Juxtaglomerular apparatus NO release decreased
5) Afferent arteriole vasoconstriction

23
Q

The role of cortical nephrons

A

dilute urine

24
Q

The role of juxtamedullary nephrons

A

important in the production of concentrated urine

25
Q

What happens in the proximal convoluted tubule

A

largest amount of solute and water reabsorption from filtered fluid occurs here
It has hydrogen ion antiporters and glucose sodium symporters

And it has a highly developed brush border that increases surface area
60% glomerular filtrate
60%NaCl and water
100% glucose

26
Q

Characteristics of proximal convoluted tubule

A

Highly active in membrane transport processes with reabsorption of water, ions, and glucose

Highly developed brush border increasing surface area

27
Q

Active transport in PCT

A

Sodium is pumped into the interstitial space by Na K+ ATPase on basal surface on epithelial

Na+move into tubule cell via glucose antiporters and symporters

Glucose and other solutes then diffuse down concentration gradient

Na+ movement then allows water movement via osmosis

Osmolarity in proximal convoluted tubule similar to plasma

28
Q

What does the renal capsule do

A

It’s a physical barrier, and protection against trauma

29
Q

What does the adipose capsule do

A

1) It’s padding, physical protection

2) Maintains the position of the kidneys

30
Q

What does the renal fascia do

A

It anchors the kidneys to the surrounding structures

31
Q

Whats the thing between 2 medullary pyramids

A

Renal columns

32
Q

Write out the pathway of blood from renal artery to vein

A

1) Renal artery
2) Segmental artery
3) Interlobar artery
4) Arcuate artery
5) Cortical radiate
6) Afferent arteriole
7) Efferent arteriole
8) vasa recta-in the medulla
9) Peritubular capillaries in the Cortex
10) Cortical radiate/interlobular veins
11) arcuate vein
12) interlobar vein
13) renal vein

33
Q

What is the endothelium of the renal corpuscle

A

The glomerulus, it is a knot of capillaries

34
Q

What is the epithelium of the renal corpuscle

A

It is the Bowman’s capsule

The visceral epithelium is the podocytes

The parietal epithelium is simple squamous epithelium

35
Q

What is the basal lamina made up of

A

It’s made up of podocyte+ Endothelial cell

36
Q

What is the electrolyte concentration in Intracellular fluid

A

Sodium=10mM
Potassium=140mM
Cl=4mM

37
Q

What is the electrolyte concentration of extracellular fluid

A

Sodium=145mM
Potassium=5mM
Cl=110mM

38
Q

Function of the descending loop of henle

A

Low permeability to ions and urea, but highly permeable to water

At the bottom of the loop of Henle the filtrate is very concentrated at 1200mOsmol/L

39
Q

Thick ascending loop of Henle

A

sodium impermeable to water. Sodium, potassium, and chloride are actively reabsorbed

By the time the filtrate gets to the top of the loop of Henele it is very dilute

10mOsmol/L

40
Q

What happens at the distal convoluted tubule and collecting duct

A

Additional reabsorption of NaCl

Water permeability dependent on ADH.

41
Q

ADH

A

acts on the last part of the convoluted distal tubule and the collecting duct.

Aquaporin 2 added onto the APICAL MEMBRANE OF PRINCIPLE CELLS

the basolateral membrane is always relatively permeable to water

42
Q

What does alcohol do

A

Alcohol inhibits ADH, resulting in dilute urine and dehydration

43
Q

How is ADH made

A

ADH is made in the hypothalamus and stored in the vesicles in the posterior pituitary.
Osmoreceptors innervating the hypothalamus sense an increase in sodium concentration and an increase in osmolarity.

A signal is sent to the posterior pituitary and ADH is released into the blood stream

44
Q

Osmoreceptors

A

Osmoreceptors have “stretch-inhibited” cation channels. When the cell shrinks due to hypertonic stimulus, the cation channels open, and the sodium entering the cells triggers action potentials

45
Q

When is ADH activated

A

It increases as osmolarity increases

This is sensed by the osmoreceptors in the hypothalamus and baroreceptors in the heart and large vessels

and this triggers more ADH to be made in the posterior pituitary

46
Q

ADH release sensitivity

A

Under 280 is when it usually gets released,

If the blood volume is low, ADH is more sensitive

If the blood volume is high, the ADH release is less sensitive

47
Q

Renin-Angiotensin-Aldosterone

A

Important in maintaining sodium balance and blood pressure regulation.

This is detected by sodium from the juxtaglomerular apparatus

48
Q

Renin triggers

A

1) Low salt concentration in the distal tubule
1) Macula densa cells respond to a decrease in Salt content by increasing prostaglandins

2) Decreased perfusion pressure
a) A decrease in pressure in afferent arteriole also acts on the juxtaglomerular cells to cause the release of renin

Increased sympathetic activity

49
Q

Angiotensin II

A

Potent vasoconstrictor, thus it decreases glomerular filtration by vasoconstricting the afferent arterioles

2) It has a small direct effect on reabsorption in the proximal convoluted tubule
3) Stimulates release of aldosterone from the adrenal cortex

50
Q

Aldosterone

A

acts on distal tubule and collecting ducts to increase transcription of Sodium/potassium ATPas pumps thus increasing sodium reabsorption and potassium excretion

MEDSCI142 (11 decks)

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