Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal Anesthesia > Renal Anatomy > Flashcards

Renal Anatomy Flashcards

1
Q

What is the FUNCTION of the ureters?

A

Transportation of urine from the kidneys to the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the length of the ureters?

A

The ureters are muscular tubes that are 25 - 30 cm long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the FUNCTIONS of the urinary bladder?

A

Functions as a temporary storage of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the urinary bladder composed of?

A

The urinary bladder is composed of:

Smooth Muscle

(DETRUSOR MUSCLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the function of the Detrusor muscle of the bladder?

A

The Detrusor muscle of the bladder functions by CONTRACTION to ultimately empty the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the urinary bladder.

A

The urinary bladder is HOLLOW, VISCUS, & VERY DISTENSIBLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the THREE parts of the urinary bladder?

A

Two Parts of the Urinary Bladder:

BODY

Bladder TRIGONE - triangular region, DIRECTLY above the neck

NECK - funnel shape connection that connects to the urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the function of the Urethra?

A

The urethra functions to transport urine from the bladder our of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the length of the male urethra? Female?

A

Male

18 - 20 cm long

Female

4 cm long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the location of the kidneys?

A

The kidneys lie RETRO-PERITONEALLY (external to the peritoneal cavity) in the SUPERIOR LUMBAR REGION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the two surfaces of the kidneys?

A

Lateral Surface

Convex

Medial Surface

Concave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Renal Hilum? Location? Function?

A

THE RENAL HILUM

Location

On the medial side of the kidney

Function

It is where the Ureters, Blood vessels, Lymphatics, and Nerves EXIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the function of the

Fibrous Capsule

Adipose Capsule

Renal Fascia

A

Fibrous Capsule

Surround the kidney and PROTECTS it from renal infection

Adipose Capsule

The fat surrounding the kidney and CUSHIONS the kidney and helps attach it to the body wall

Renal Fascia

Outer layer of DENSE CONNECTIVE TISSUE that helps to ANCHOR the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How much does the adult kidney weigh?

A

Adult kidney weighs 150 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the THREE major areas of the kidneys?

A

Renal Cortex

Renal Medulla

Renal Pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is the CORTEX of the kidney located?

A

The Cortex is the light colored, GRANULAR, SUPERFICIAL (outer) region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What structures are located in the CORTEX?

A

Renal Corpuscles

Proximal Renal Tubules

Distal Renal Tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the renal columns?

A

The Renal Columns are extensions of the Renal Cortex

They extend douwn between the Renal Mudulla Pyramids

They contain Urinary Tubules and Blood Vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where is the MEDULLA of the kindey located? Composition?

A

Medulla (inner layer)

Exhibits 8 - 10 cone-shaped medullary (renal) pyramids separated by Renal Columns

**The medullary pyramid and its surrounding capsule constitutes a LOBE

The renal medulla is further divided into cone shaped Renal Pyramids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The Medullary Pyramids are further divided into what structures?

A

The Medullary Pyramids are further divided into RENAL PYRAMIDS

  1. Base of Pyramid: located at the border, where the Renal Cortex and the Renal Medulla meet
  2. Apex of Pyramid:“Renal Papilla” projects into the Renal Pelvis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What structures are located in the Renal Medulla?

A

ASCENDING & DESCENDING Limbs of the Loop of Henle

Collecting Ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the Renal Sinus?

A

The Renal Sinus is a cavity within the kidney which is occupied by the Renal Pelvis, Major and Minor calyces, blood vessels, nerves and fat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the Renal Pelvis? What structures form it?

A

The Renal Pelvis is a flat funnel shaped tube lateral to the hilus within the renal sinus

It is a Continuation (extension) of the proximal ureter

Composed from:

Major and Minor Calyces

They Collect the urine from the tubules of the papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How much of Cardiac Output is Renal Blood Flow?

A

Renbal Blood Flow is 22% of Cardiac Output

(1,100 ml/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the steps (Flow) of Renal Blood Flow

A

Renal Artery

Interlobar Arteries

Arcurate Arteries

Interlobular (Renal) Arteries

Afferent Arterioles

Glomerulus

Efferent Arterioles

*Peritubular Capillaries

Interlobular Veins

Arcurate Veins

Interlobular Veins

Renal Vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the TWO capillary beds of the Renal Blood supply?

A
  1. GLOMERULAR Capillary Bed

Afferent arteriole - Capillary bed - Efferent arteriole

  1. PERITUBULAR Capillary Bed

“Come off of” the efferent arterioles and suround the renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the function of the GLOMERULAR capillary bed?

A

FILTRATION

Filtration of blood entering through the Afferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the HYDROSTATIC PRESSURE within the glomerular capillary bed?

A

60 mmHg

The HIGH hydrostatic pressure is what is effectively pushing fluid out/causing filtration of fluid from capillaries in the glomerulus into bowman’s capsule tubules to become urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the COLLOID OSMOTIC PRESSURE within the glomerular capillary bed?

A

34 mmHg

The Colloid Osmotic pressure is what is the PULLING pressure of protiens within the glomeular capillaries

*Bowman’s capsule has ZERO proteins, thus its Colloid Osmotic pressue is 0 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the function of the PERITUBULAR capillary bed?

A

REABSORPTION

HYDROSTATIC PRESSURE in the peritubular capillary bed is significantly lower (13 mmHg), so favors fluid going from the tubules back into peritubular capillaries

Venous side: peritubular capillaries empty into venous system that runs parallel to arteriole system into interlobar vein etc until it gets to renal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the FUNCTIONAL unit of the kidney?

A

The NEPHRON

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does the Nephron consists of?

A

Glomerulous

+

Renal Tubules

33
Q

How many Nephrons does one kidney consists of?

A

1 Million

*You CANNOT make more

34
Q

What percentage of nephrons does one lose after the age of 40?

A

We lose 10%/ decade after the age of 40

35
Q

Where is the glomerulous located?

A

The Glomerulous is located within the BOWMAN’S CAPSULE

36
Q

Name the different renal tubules locared within the kidney.

A

Proximal Convoluted Tubule (PCT)

Loop of Henle (LOH)

Distal Convoluted Tubule (DCT)

Collecting Duct

37
Q

What is contained within the DCT?

A

The JUXTAGLOMERULAR APPARATUS

which constains the MACULA DENSA. It is involved in autoregulation & control of RBF

38
Q

What are the two types of Nephrons?

A

Cortical Nephrons

+

Juxtamedullary Nephrons

**All nephrons have same parts, but differences based on:

Their LOCATION within the kidney

+

The LENGTH of their LOH

39
Q

Describe the Cortical Nephrons.

A

Originates in the OUTER 2/3 OF THE CORTEX

Significantly SHORTER LOH and only goes part way into the medulla

*Contains pertubualr capillaries that run parallel to the tubules

40
Q

Describe the Juxtamedullary Nephrons.

A

Its renal corpuscle Originates in the INNER 1/3 OF THE CORTEX (the deepest part of the cortex), closest to the junction with the medulla

LOH are LONGER and go deep into the medulla of kidney

Comprises 20 - 30% of nephrons

Because the LOH runs deeper into the medulla, uxtamedullary Nephrons are responsible for creating an osmotic gradient within the medulla

41
Q

How is the blood supply of the Juxtamedullary Nephrons different from the Cortical Nephrons?

A

The Juxtamedullary Nephrons have VERY LONG EFFERENT ARTERIALS.

The Efferent arterial runs deep into the medulla and they become A VERY SPECIALIZED peritubular capilary network:

the VASA-RECTA

The capillaries in the Vasa-Recta in the lie side by side with the LOH

Its specifically this anatomic relationship of the Vasa-Recta lying side by side w/ the long LOH that creates CONCENTRATED URINE

42
Q

What are the three layers of the glomerulous capillaries?

A

Endothemium

Usually just a single cell layer

*Perforated with fenestrations (holes) - like swiss cheese

These fenestrations make it freely permeable to everything except for RBC/ WBC/ Platelets and plasma proteins

Plasma proteins don’t pass b/c too large, and also b/c there is a negative charge on the cells and negative charge on the plasma proteins - prevents it from passing

Basement Membrane

Gel-like mesh with large spaces, through which large amount of water and small solutes can pass. Like a kitchen sponge.

No RBC/ WBC/ Platelets and plasma proteins can pass, partly b/c of size and partly b/c of negative charge

Epithelium (PODOCYTES)

Rests on the basement membrane and surrounds the outer surface of glomerular capillaries

They are not continuous

Foot-like projections = podocytes

43
Q

What is the functional significance of 3 layers to the glomerulous capilaries?

A

Functional significance of the arrangement is that it permits large volumes of fluid from capillaries into bowman’s capsule, but still restricts RBC/ WBC/ Platelets/ Albumin and plasma proteins

Most capillaries only have 2 layers including endothelium and basement membrane

44
Q

What are Mesangial Cells? Function? Location?

A

Located between the basement membrane + endothelium

Functions as PHAGOCYTES- can remove trapped material

Also contain myofilaments so can contract in response to stimuli just like vascular smooth muscle cells

*Between and within the loops of glomerular capillaries, but not a layer in and of themselves

45
Q

What is an important feature of Mesangial Cells?

A

They contain MYOFILAMENTS, so they can contract in response to stimuli just like vascular smooth muscle cells

When they contract, will DECREASE FILTRATION b/c DECREASE SURFACE AREA available for filtration

Mesangial cells contract = area for filtration will decrease

46
Q

What substances causes contraction Mesangial Cells? Which substances causes relaxation?

A

Causes Contraction:

Angiotensin II

Vasopressin

NE

Histamine

Causes Relaxation:

Dopamine

47
Q

What are the function(s) of the kidneys?

A
  1. Excretion of metabolic waste products
  2. Regulation of:

Water & Electrolytes

Osmolarity

Acid-base balance

Blood Pressure - RAAS

  1. Secretion, metabolism, & excretion of hormones erythropoietin to stimulate RBC production
  2. Gluconeogenesis
  3. Activation of Vitamin D
48
Q

What are the THREE broad processes that take place in the kidney?

A
  1. Glomerular Filtration
  2. Tubular Reabsorption
  3. Tubular Secretion
49
Q

Describe the process of Glomerular Filtration.

A

Glomerular Filtration

Moving from the curculation (Blood) → Tubular Fluid (Urine)

Filters the blood as goes through glomerular capillaries, so that b/c of those three layers - fluid & solutes (but not cells or plasma proteins) go from blood into effectively urine (but not final product yet)

b/c just about everything except proteins and cells will go into glomerular filtrate, the concentration of those

substances (electrolytes, etc) will be the same as it is in the plasma as glomerular filtrate

but most patients aren’t spilling protein in urine, so minimal amount of protein in urine is often from shed epithelial cells, not from albumin or protein in plasma

shouldn’t have protein or cells in urine

50
Q

Describe the process of Tubular Reabsorption.

A

Tubular Reabsorption

Tubular Fluid (Urine) → Peritubular Capillaries (Blood)

Composition changes based on what the body needs

More important quantitatively

Whatever substance is goes from tubular fluid/urine back into the blood

51
Q

Describe the process of Tubular Secretion.

A

Tubular Secretion

Peritubular Capillaries (Blood) → Tubular Fluid (Urine Secretion)

Composition changes based on what the body needs

Something going from blood lower down in tubule from peritubular capillaries into the urine

Two substances that get secreted from blood into renal tubules to get excreted

  1. Hydrogen ions
  2. Potassium ions
52
Q

Between Reabsorption vs Secretion, which is more important?

A

Quantitatively REABSORPTION is more important!

53
Q

What is the major goal of glomerular filtration?

A

Goal of glomerular filtration is to eliminate the waste products but by reabsorption to retain water and electrolytes!

54
Q

Urine formation is determined by by what processes?

A
  1. Glomerular Filtration
  2. Tubular Reabsorption
  3. Tubular Secretion
55
Q

What is filtered INTO the tubular fluid?

A

Waste products of metabolism:

Urea – from the breakdown of amino acids

Creatinine – from the breakdown muscle creatine

Uric acid – from the breakdown nucleic acids

Bilirubin – from the breakdown of hemoglobin

Hormone Metabolites

Electrolytes (mostly reabsorbed)

Amino Acids (mostly reabsorbed)

Glucose – (mostly reabsorbed) - glucose is reabsorbed only when Blood Glucose levels are BELOW the “renal threshold” (160 - 190 ml/ dL), above this, glucose spills into the urine

**The concentration of these products are the same as in plasma

56
Q

How much is filtered? (What is Glomerular Filtration Rate?)

A

Glomerular Filtration Rate (GFR):

125 ml/ min

180 ml/ day

Correlates w/ the surface area for filtration (# of nephrons)

GFR ~10% less in women

57
Q

What determines GFR?

A

GFR is determined by:

  1. Starling Forces:

Hydrostatic Pressure

+ Colloid PRessure

  1. Capillary Filtration Coefficient (Kf)
  2. Filtration Fraction
58
Q

What are Starling Forces?

A
  1. Hydrostatic Pressure - Pushing Pressure

60 mmHg in glomerular capillaries pushing fluid from glomerulus into bowman’s capsule

18 mmHg in bowman’s capsule opposing filtration - pushing fluid from bowman’s capsule into glomerulus

60 mmHg - 18 mmHg = 42 mmHg

  1. Colloid Osmotic Pressure - Pulling Pressure

32 mmHg - plasma proteins in glomerular capillaries pulling in pressure opposing filtration

0 mmHg - colloid osmotic pressure in bowman’s capsule

* Net pressure favors filtration by about 10 mmHg!*

Net Pressure = 42 mmHg - 32 mmHg

Net Pressure = 10 mmHg

59
Q

What is Capillary Filtration Coefficient (Kf)?

A

Kf = Capillary Filtration Coefficient

A product of permeability and the available filtering surface area of capillaries. A measure of the product of the hydraulic conductivity and surface area of the glomerular capillaries.

** Kf is usually HIGH to accomodate a HIGH hydrostatic pressure of the glomerular capillaries, THUS resulting in a HIGH GFR

GFR = Kf x Net Filtration Pressure

GFR = Kf x 10 mmHg

60
Q

What is Capillary Filtration Fraction?

A

Filtration Fraction is the fraction of plasma filtered per minute

Filtration Fraction = GFR / Renal Plasma Flow

61
Q

How do we figure out Renal Plasma Flow?

A

Renal Blood Flow

CO = 5000 ml/min, 20% is RBF

5000 x 0.2 = 1000 mL/min

Renal Plasma Flow

Average Hct = 45, and 55% is Plasma

1000 mL/min x 0.55 = 550 mL/min of Plasma

Filtration Fraction = GFR / Renal Plasma Flow

= 125 mL/min / 550 mL/min = 22%

*This is the percent of plasma filtered = Filtration Fraction

62
Q

Why does the body need a HIGH GFR?

A

A HIGH GFR allows us to rapidly remove the waste & have precise control of volume and composition of ECF

* This occurs 60x / Day

63
Q

What are the different pressures in the Renal Corpuscle?

Glomerular Hydrostatic Pressure?

Bowman’s Capsule Hydrostatic Pressure?

Glomerular Hydrostatic Pressure?

A

Net Filtration Pressure =

Glomerular Hydrostatic Pressure (60 mmHg)

-

Bowman’s Capsule Hydrostatic Pressure (18 mmHg)

-

Glomerular Hydrostatic Pressure (32 mmHg)

= 10 mmHg

64
Q

How is the permeability of glomerular capillaries different from regular capillaries?

A

The permeability of glomerular capillaries is 50x that of other capillaries

The glomerular capillary membrane is THICKER than most other capillaries, but it is also much MORE POROUS and therefore filters fluid at a high rate.

65
Q

How does size relate to “filterability” when discussing permeability of glomerular capillaries?

A

Molecular diameters < 4 nm are freely filtered

EX. Sodium and small organ compounds like glucose

Molecular diameters > 8 nm not filtered

EX. Albumin not filtered at all

66
Q

What is “Minimal Change Nephropathy”?

A

In certain kidney diseases, the negative charges on the basement membrane are lost even before there are noticeable changes in kidney histology.

As a result of this loss of negative charges on the basement membranes, some of the lower molecular weight proteins, especially albumin, are filtered and appear in the urine, a condition known as proteinuria or albuminuria.

EX. Nephritis (Kidney Disease)

67
Q

Why is Albumin not filtered within the glomerulus?

A

The basement membrane of glomerular capillary has NEGATIVE CHARGE

Albumin has NEGATIVE CHARGE & this more than molecular size prevents albumin from being filtered.

Proteinuria results if charge on basement membrane is lost in disease (EX. Nephritis (Kidney Disease))

(small amount of protein that may show up in urine is epithelial cells shedding)

68
Q

If a patient is having protein in their urine, what is the first cause that comes to mind?

A

If protein ends up in the urine, it usually means that there is a problem with the basement membrane, and the negative charge on the basement membrane has been lost!

69
Q

Why isn’t Albumin filtered within the glomerulous?

A

Most important reason albumin isn’t filtered is SIZE but also THE NEGATIVE CHARGE that it carries!

CHARGE IS MORE IMPORTANT THAN SIZE FOR FILTRATION

70
Q

What factors effect GFR?

A

Renal Blood Flow

Glomerular capillary hydrostatic pressure

Bowman’s capsule hydrostatic pressure

Glomerular capillary osmotic pressure

Changes in filtration coefficient

71
Q

What is the autoregulation range of RBF and GFR?

A

80 - 170 mmHg

72
Q

What percentage of body weight are the kindeys?

A

1%

73
Q

What are the main RESISTANCE vessels of the Kidney?

A

AFFERENT & EFFERENT Arterioles

* If EITHER the Afferent or Efferent arteriles is contracted, it will REDUCE RBF

74
Q

Why does the kidney have such a HIGH RBF rate?

A

RBF is 20% of CO

RBF is 10x more than required for metabolic rate

It is this HIGH because we need to produce enough renal filtrate in order to eliminate waste products

75
Q

What part of the kidney is perfused the MOST?

A

The CORTEX

This is where all of the Renal Corpuscles (glomeruli) are located

HOWEVER, the blood flow to the medulla is EQUIVALENT to the blood flow to the brain!

76
Q

What happens to RBF during SNS stimulation?

A

STRONG SNS Activation causes VASOCONSTRICTION of both afferent & efferent arterioles

= ↓ Renal Blood Flow

= ↓ GFR

MILD/MODERATE SNS acitivation has LITTLE EFFECT on RBF or GFR

77
Q

The SNS effect in DECREASING GFR is most significant when?

A

The SNS effect in DECREASING GFR is most significant with SEVERE HEMORRHAGE

Normal SNS stimulation in a healthy adult, rarely changes GFR

78
Q

Can Acute Renal Failure due to iscemia be reversed?

A

YES! As long as renal blood flow does not fall below 20% of normal, acute renal failure can usually be reversed as long as the cause for ischemia is corrected before there is cellular damage

79
Q
A

Renal Anesthesia (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions