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REnal > Renal Blood Flow/GFR > Flashcards

Renal Blood Flow/GFR Flashcards

1
Q

Characteristics of cortical nephrons

A

short loops of henle

surrounded by peritubular capillaries

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2
Q

chracteristics of juxtamedullary nephrons

A

long loops of henle
vasa recta, specialized peritubular capillaries
concentrates urine

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3
Q

glomerular filtrate is almost identical to plasma besides the fact that it

A

is free of RBC and proteins

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4
Q

are urine and glomerular filtrate similar

A

no

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5
Q

what is an index of functioning renal mass

A

total GFR

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6
Q

What does a fall in GFR indicate

A

disease progression (decrease in net permeability due to loss of SA)

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7
Q

what is allowed to pass thorugh glomerular membrane

A

water, small solutes

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8
Q

what are the three layers of the glomerular membrane

A

fenestrated capillary endothelium
glomerular BM- collagen and proteoglycan anionic charge
Podocyte epithelium with slits

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9
Q

what prevents proteins from crossing glomerular membrane

A

negative charge in the BM because some can fit. also the gate between podocytes is the last resort to keep large molecules from filtering out

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10
Q

when there is a loss of negative charge in the BM of glomerulus what do we call this disease state

A

minimal change disease or nephropathy

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11
Q

What are the physical forces affecting glomerular filtration

A

Hydraulic conductivity(permeability) Lp
Surface Area for filtration
Capillary ultrafiltration pressure (PUF)

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12
Q

what determines the ultrafiltration coefficient (Kf)

A

product of Lp and SA

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13
Q

how can you calculate GFR from the 3 physical forces

A

multiply them all

LpSAPUF

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14
Q

what are the driving forces for GFR, or net filtration

A

(hydrostatic pressure of GC + oncotic bowmans which is 0) - (hydrostatic in BC + colloid glomerular capillaries)

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15
Q

how do glomerular and skeletal mm capillary starling forces differ

A

in skel mm equal on afferent and efferent

glomerular the colloid oncotic pressure of GC increases as enter distal tubule

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16
Q

How can the Kf or ultrafiltration coefficient be altered

A

mesangial cell contraction in intersitium that decreases the SA so you can decrease GFR to retain fluid

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17
Q

How is the capillary ultrafiltration pressure changed

A

you change the pressure in the GC

18
Q

what factors determine Pressure of GC

A

renal arterial BP
afferent arteriole R
efferent arteriole R

19
Q

Where are glomerular mesangial cells located

A

in the capillary loops

20
Q

what happens when mesangial cells contract

A

shorten the capillary loops, lower the Kf and so GFR lowers.

21
Q

What is the primary way to change GFR

A

the Pressure in GC

22
Q

What occurs to GFR as pressure of GC increases

A

GFR will increase until RBF decreases too much then GFR will decrease to supply blood

23
Q

What consumes more Oxygen the brain or kidneys and why?

A

kidneys because need Na reabsorption so need Na/K ATPase activity

24
Q

/how is RBF determined

A

pressure gradient between renal A and renal v divided by the vascular R

25
Q

what controls the vascular R to RBF

A

sympathetic nervous system, hormones and the autoregulation mechanisms

26
Q

What is the GFR MAP

A

80-170 mmHg

27
Q

What are of kidney receives more blood supply

A

the cortex

28
Q

What happens with sympathetic activation to renal

A

constric afferents and lesser extent efferents, decreasing RBF and GFR to divert fraction to vital organs
Renin release by granular cells
ANG II
Na reabsorption in prox tubule, thick ascending limp and distal convoluted tubule and collecting duct

29
Q

in what scenarios will the SANS be activated to renal system

A

hypovolemia, stress, hemorrhage

30
Q

how do the arterioles not constrict too much when undergoing SANS stimulation

A

an increase in renal PGs synthesis and release that act to dilate the arterioles

31
Q

why would you not give a hypovolemic patient NSAIDs

A

renal damage because then would prevent PGs release and arterioles would constrict too much

32
Q

What hormones increase GFR

A

PGs and Endothelial derived NO

33
Q

What hormones decrease GFR

A

Norepi, epi and endothelin

34
Q

what hormone equalizes GFR and prevents a further decrease

A

ANG II

35
Q

How does the renal system compensate for marked changes in systemic BP

A

afferent and efferent arteriole constriction

36
Q

What are the 2 mechanisms for autoregulation

A

Myogenic response from strech receptors in arterioles

tubuloglomerular feedback from and increased or decreased GFR by sensing NaCl in macula densa

37
Q

what does the myogenic response prevent

A

and increase in RBF and GFR when there is high BP

38
Q

Where is the macula densa and type of cells

A

in the begining of the distal convoluted tubule and contains extraglomerular mesangial cells (lacks)

39
Q

What is the response of the macula densa sensing an increase NaCl level

A

wants to decrease GFR so secretes adenosine which causes vasoconstriction of afferent arteriole

40
Q

how does macula densa respond to sensing low NaCl

A

increase renin release to increase ANG II that increases efferent arteriole vasoconstriction thus increasing GFR
aslo will dilate afferent arteriole

41
Q

When does the tubuloglomerular feedback get activated usually

A

when the difference in volume is around 20% or more

42
Q

describe what owuld happen if giving someone with renal stenosis and hypertension and ACE inhibitor

A

ANG II production would decrease and then wouldnt have as much efferent vasoconstriction so GFR then is disrupted and could lead to more damage

REnal (7 decks)

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