Identify the apperance of RTEs in the following: collecting duct: distal convoluted tubule: proximal convoluted tubule:

collecting duct: _cuboidal_ distal convoluted tubule: _round_ proximal convoluted tubule: _cast-like/rectangular_

Complete the ff: 1. blood enters nephron’s capillaries via ___(1)___. 2. flows through ___(2)___ and into __(3)___ 3. before returning to renal vein, blood enter __(4)__ & __(5)__ 4. flows slowly through the __(6)__ & __(7)___.

1. blood enters nephron’s capillaries via _afferent arteriole_ 2. flows through _glomerulus_ and into _efferent arteriole_ 3. before returning to renal vein, blood enter _peritubular capillaries_ & _vasa recta_ 4. flows slowly through the _kidney's cortex_ & _medulla_

Renal Anatomy & Physiology Flashcards by Angela Divino

functional unit of the kidney

nephron

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kidney’s location

12th thoracic vertebrae &
3rd lumbar vertebrae

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Which kidney is situated higher? (Left or right)

left kidney

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main excretory organ responsible for urine formation

kidney

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liver conjugates ___ to convert it into water soluble

B1 (bilirubin monoglucuronide)

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funnel like structure
collects all nephron
calculi (stones) formation

renal pelvis

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connects the kidneys to the urinary bladder

ureter

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stores urine and is sterile

urinary bladder

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passageway out of urine

urethra

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biggest cell
lower origin
block relevant structures

Squamous epithelial cells

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caudale
upper origin
more common with catheterized specimens

Transitional Epithelial cells/Urothelial cells

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found in the nephron
- collecting duct
- distal convoluted tubule
- proximal covoluted tubule
- loop of Henle
tubular necrosis

Renal Tubular Epithelial cells

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Identify the apperance of RTEs in the following:

collecting duct:
distal convoluted tubule:
proximal convoluted tubule:

collecting duct: cuboidal
distal convoluted tubule: round
proximal convoluted tubule: cast-like/rectangular

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Give the 2 types of nephrons

Cortical nephrons
Juxtamedullary nephrons

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Which nephron is located in the kdiney’s cortex?

Cortical nephrons

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Cortical or Juxtamedullar nephron?

removes waste products

Cortical nephron

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Cortical or Juxtamedullar nephron?

urine/renal concentration

Juxtamedullary

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Cortical or Juxtamedullar nephron?

reabsorbs nutrients

Cortical nephron

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Give 2 renal functions

clearing waste products from blood
water & electrolyte balance maintenance

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It carries blood from the heart

renal artery

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It takes blood away from the kidneys.
It carry blood filtered by the kidney.

renal vein

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It carries unfiltered blood.

renal artery

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kidneys receive _____ of blood via the heart

20-25%

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Complete the ff:

blood enters nephron’s capillaries via ___(1)___.
flows through ___(2)___ and into __(3)___
before returning to renal vein, blood enter __(4)__ & __(5)__
flows slowly through the __(6)__ & __(7)___.

blood enters nephron’s capillaries via afferent arteriole
flows through glomerulus and into efferent arteriole
before returning to renal vein, blood enter peritubular capillaries & vasa recta
flows slowly through the kidney’s cortex & medulla

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lower the efferent arteriole size, \_\_\_ glomerular capillary pressure

increases

unfiltered blood passageway

afferent arterioles

receives filtered blood

efferent arterioles

* provide immediate reabsorption of essential substances * passage of substances from blood to tubular filtrate (secretion)

peritubular capillaries

surround proximal & distal convoluted tubules

peritubular capillaries

adjacent to ascending & descending loops of Henle

vasa recta

* maintains osmotic gradient (salt concentration) in medulla * necessary for renal concentration

vasa recta

It is the volume of blood delivered to the kidneys per unit time

Total Renal Blood Flow (TRBF)

It is a measurement for the exact amount of blood flowing through the kidney

Effective Renal Plasma Flow

1st process in urine formation

Glomerular filtration

plasma substances’ non-selective filter

glomerulus

glomerulus' walls are known as

glomerular filtration barrier

Where is the glomerulus located?

Bowman's capsule

What factors affect the actual filtration? ## Footnote *\*There are four infuences*

1. Bowman's capsule & capillary walls' cellular structure 2. hydrostatic pressure 3. oncotic pressure 4. RAAS

inflammation of the kidney's filters

glomerulonephritis

What are the 3 glomerular filtration barrier that plasma filtrate must pass?

1. capillary endothelial fenestrations 2. basal lamina/basement membrane 3. podocyte

capillary wall's endothelial cells contain \_\_\_\_

fenestrated pores

pores increase

capillary permeability

True or False Glomerulus' cellular structure has barrier which repels molecule with a (+) charge such as albumin. Shielf of negativity

True

In when hydrostatic pressure, filtration enhances through:

In when hydrostatic pressure, filtration enhances through: * **smaller efferent arterioles** * **smaller glomerular capillaries** *\*glomerular capillary pressure will increase*

maintains glomerular capillary's pressure consistency

hydrostatic pressure

overcomes opposition pressures from **Bowman’s capsule fluid** & unfiltered plasma proteins’ **oncotic pressure**

hydrostatic pressure

Given that blood pressure drops, what will the arterioles do to prevent decreased blood flow

dilate afferent constrict efferent

Given that blood pressure rises, arterioles will do what to prevent overfiltration/glomerulus damage

constrict afferent

regulates blood flow to and within the glomerulus

Renin-Angiotensin-Aldosterone System (RAAS)

responds to blood pressure & plasma sodium content changes

Renin-Angiotensin-Aldosterone System (RAAS)

justamedullary apparatus consists of?

juxtamedullary cells & macula densa

* enzyme produced by juxtaglomerular cells * secreted and reacts with blood-borne substrate angiotensinogen

renin

Explain RAAS' chemical reaction

renin + angiotensinogen → **alveoli:** angiotensin I ***(angiotensin-converting enzyme)*** → angiotensin II

``` aldosterone: antidiuretic hormone (ADH): ```

``` aldosterone: **_adrenal cortex_** antidiuretic hormone (ADH): **_hypothalamus_** ```

filtrate’s specific gravity (plasma ultrafiltrate)

1.010

filtrate & plasma difference

plasma protein absence

Active or Passive: substance + carrier protein

active transport

Active or Passive gradients/physical difference

passive transport

Active or Passive: renal tubular epithelial cells

active trasnport

In active transport, these substances are reabsorbed: *\*There are 5 substances.*

1. glucose: p. CT 2. amino acids: p. CT 3. salts: p. CT 4. chloride (Cl): a. Henle 5. sodium (Na): p & d CTs

In passive transport, molecules move across a membrane as a result of differencen in:

* concentration * electrical potential

Passive transport absorbs what substances? *\*There are 3 substances.*

1. water: all nephron parts *except ascending loop* 2. urea: proximal CT & ascending loop 3. sodium (Na): ascending loop

Renal concentration begins in?

ascending & descending loops of Henle

Tubular Concentration * descending loop of Henle: * ascending loop of Henle:

* descending loop of Henle: **_water is removed_** * ascending loop of Henle: **_NaCl is reabsorbed_**

* selective reabsorption * maintains osmotic gradient of medulla * Na & Cl leaving the filtrate in the ascending loop prevent dilution of medullary interstitium by water reabsorbed from descending loop

countercurrent mechanism

collecting duct receives ____ of urine

1 mL/min

* anouria: * oliguria: * polyuria:

* anouria: **_no urine release (heart disease and blockage)_** * oliguria: **_little amount of urine (≤ 400 mL) is release (hydration)_** * polyuria: **_excessive urination (x \> 2500 mL)_**

ADH is determined by

body’s hydration

↓ body hydration: * __ ADH * __ permeability * __ H2O reabsorption * __ urine volume

↓ body hydration: * ↑ ADH * ↑ permeability * ↑ H2O reabsorption * ↓ urine volume

↑ body hydration: * __ ADH * __ permeability * __ H2O reabsorption * __ urine volume

↑ body hydration: * ↓ ADH * ↓ permeability * ↑ urine volume

* eliminate waste products not filtered by the glomerulus * regulate acid-base balance through hydrogen ion secretion

tubular secretion

major removal site of non-filtered substances

proximal convoluted tubule

True or False cellular respiration creates CO2 and makes urine acidic

true

Which process is indicated below? glomerular filtration barrier

Glomerular filtration

Which process is indicated below? glomerulus cellular structure

glomerular filtration

Which process is indicated below? hydrostatic pressure

glomerular filtration

Which process is indicated below? RAAS

glomerular filtration

Which process is indicated below? active & passive transports

tubular reabsorption

Which process is indicated below? countercurrent mechanism

tubular reabsorption

Which process is indicated below? collecting duct concentration

tubular reabsorption

Which process is indicated below? tubular/renal concentration

reabsorption

Give the 3 different urine formation processes

1. glomerular filtration 2. tubular reabsorption 3. tubular secretion

crystals found in urine

crystalluria

**_Types of Urine Specimens_** routing screening *only*

random specimen

**_Types of Urine Specimens_** * routine screening * pregnancy tests

first morning specimen

**_Types of Urine Specimens_** * orthostatic proteinuria * ideal screening specimen

first morning specimen

**_Types of Urine Specimens_** quantitative chemical tests

24-hour (or timed)

**_Types of Urine Specimens_** * bacterial culture * specimen is forwarded first to **Bacteriology section** before urinalysis

catheterized specimen

**_Types of Urine Specimens_** * routine screening * bacterial culture * alternative to catheterized specimen

Midstream clean-catch specimen

**_Types of Urine Specimens_** bladder urine for bacterial culture

suprapubic specimen

**_Types of Urine Specimens_** cytology

aspiration

**_Types of Urine Specimens_** prostatic infection

three-glass collection

contains solutes that affect the movement of water

interstitial space/interstitium

* represents the plasma portion (55%) of the TRBF * 55% of 1200 mL = 660 mL * usually 600-700 mL/min

Effective Renal Plasma Flow

* represents the 45% of 1200 mL = 540 mL

Packed Cell Volume

What is the Gomerular Filtration rate? *\*reference value*

120-125 mL/min

* releases ultrafiltrate * cell-free filtrate * protein-free

glomerulus

* positive pressure which promotes blood filtration * pressure coming from water

hydrostatic pressure

* negative pressure coming from the proteins in the blood * counteracts hydrostatic pressure

oncotic pressure

receives newly formed filtrate

Bowman's capsule

filtrate passes to series of renal tubules

tubular reabsorption

movement of essential substances out of the tubule and returns them to the blood for them to be used once more

reabsorption

* 15% of reabsorption partakes in this region * hairpin-like appearance

loop of Henle

transverses the medullary interstitium

descending loop of Henle

membrane is **impermeable** to water

ascending loop of Henle

* remaining 19% of the filtrate is reabsorbed * far from glomerulus

distal convoluted tubule

inflammation of the bladder

cystitis

Urine is slightly acidic due to the presence of more \_\_\_\_.

H⁺ ions

**Tubular Secretion** * Kidney maintains the blood pH \_\_\_\_ * ___ & ___ are secreted to prevent blood from becoming acidic

* pH 7.35-7.45 * H⁺ & CO₂

ERPF's 55% of 1200 mL range

600-700 mL/min

normal urine excreted per day

1200-1500 mL/day

In glomerular filtration, what pressure is needed to form a filtrate?

10mm mmHg

Identify which part contributed to the ff: 65% reabsorption: 15% reabsorption: 19% reabsorption:

65% reabsorption: **_proximal convoluted tubule_** 15% reabsorption: **_loop of Henle_** 19% reabsorption: **_distal convoluted tubule_**

glucose's renal threshold range

160-180 mg/dL

What is the 1st filtration mechanism?

size exclusion *(capillary endothelial fenestrations)*

What is the 2nd filtration mechanism?

charge exclusion *(basement membrane)*

What is the 3rd filtration mechanism?

size & charge exclusion

term used for spaces in between the endothelial cells

fenestrations

It prevents RBCs & proteins from passing through

capillary endothelial fenestrations

term used for WBCs who are capable of passing through intact capillary walls and into surrounding tissue

diapedesis

protein of interest

albumin

It is the primary filter

basement membrane

Goodpasture Syndrome is also known as?

Anti-glomerular basement membrane disease

Antibody that attaches to the GBM and forms a complex

Anti-GBM antibody

contains foot processes

podocytes

lipid nephrosis is also known as?

Minimal change disease

Minimal change disease can cause? *\*There are three.*

* edema * heavy proteinuria * transient hematuria

Minimal change disease's HLA-B12 stands for? It responds well to?

Human leukocyte antigen-B12 responds to corticosteroids

What is ultrafiltrate's pH & specific gravity?

pH: **_7.4_** SG: **_1.010_**

isosmotic with plasma (300 mOsm/L)

ultrafiltrate

\_\_(1)\_\_ & \_\_(2)\_\_ are not reabsorbed throughout the renal tubule when passing through the glomerulus

1. RBCs 2. WBCs

_True or False_ RBCs are hyposthenuric

False ## Footnote *\*RBCs are isosthenuric.*

hyposthenuria's SG & urine condition

\< 1.010 SG & diluted urine

RBC remnants due to bursting

Ghost cells

hypersthenuria's SG & urine condition

x \> 1.010 SG & concentrated urine

**_Renal Tubule_** more solutes are inside the cell

hyposthenuria

**_Renal Tubule_** more solutes are outside the cell

hypersthenuria

presence of intact RBCs in urine

hematuria

red & cloudy urine and indicative of glomerular damage/glomerulonephritis

hematuria

* red & clear urine * RBCs burst along the way * Hb is present * no intact cell

hemoglobinuria

* found when RBCs burst along the renal tubule * deposits themselves on epithelial cells

hemosiderin deposits

hemosiderin products can be identified through what stain?

Prussian blue stain

_Granules or Nuclei_ WBCs in urine, which is more distinguishable?

granules

presence of WBC in urine

pyuria

Term used when WBC granules are suspended inside

Glitter cell

presence of protein in urine

proteinuria

**Proteinuria** What color of foam is seen for presence of protein?

white foam

concentration greater than 30 mg/dL

clinical proteinuria

Bilirubinuria presence of bilirubin in urine gives what color of foam?

yellow foam

common finding in patients with jaundice

bilibinuria

What is stasis?

slowdown in flow in the renal tubule which will form a matrix

cylinder-like or rectangular like structures in urine

casts

simplest type of cast

hyaline cast

cast initially forms where?

ascending loop of Henle

presence of cast in urine

cylindruria

* primary coloring pigment * endogenous metabolism product

urochrome

urobilinogen's oxidized form

urobilin

imparts a **pinkish apperance** from *amorphous urates* and *specimen refrigeration*

uroerythrin

The darker the urine, the ____ specific gravity

higher SG ## Footnote *\*Dark urine is a sign of dehydration*

Urine is ____ water + ____ solute

95-97% water + 3-5& solute

Solutes: Cl + Na

inorganic solute

Solutes: urea + creatinine

inorganic solutes

markers that the sample is urine

urea & creatinine

* determines glomerulus' integrity * measures clearance

Clearance test

What type of specimen is used for Clearance test?

24-hour urine specimen

* measures volume completeness * requires substances that should neither be reabsorbed nor secreted

Clearance test

products of metabolism

endogenous products

Give 4 endogenous products

* urea * creatinine * B-microglobulin * cystatin C

Give 3 exogenous products

* inulin * mannitol * iothalamate

* expressed in mL/min * requires: * 24-hour urine * blood

Creatinine clearance

Give the formula for creatinine clearance

(U/P) (V/t) (1.73 m²/SA)