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Physiology > Renal-Chapter 27 > Flashcards

Renal-Chapter 27 Flashcards

1
Q

Give blood flow through renal blood vessel

A 
Aorta
Renal a
Segmental a
Interlobar a
Arcuate a
Interlobular a
Afferent arteriole
Glomerulus capillaries
Efferent arteriole
Pertibular capillaries (vasa recta)
Interlobular v
Arcuate v
Interlobar v
Renal v
Caudal vena cava
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2
Q

Give filtrate flow

A 
Bowman's capsule
Proximal convoluted tubule
Descending LOH
Thin ascending LOH
Thick ascending LOH
Macula densa
Distal convoluted tubule
Connecting tubule
Cortical collecting tubule
Medullary collecting tubule
Collecting duct
Renal papillae
Calyces
Renal pelvis
Ureters
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3
Q

What is filtration fraction

A

Fraction of renal plasma flow that is filtered through the glomerular capillaries

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4
Q

Filtration fraction equation

A

Glomerular filtration rate/Renal plasma flow

Renal plasma flow=Renal blood flow X (1-hematocrit)

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5
Q

In general, are proteins or blood cells normally filtered through the glomerulus? Why?

A

No

They have a large molecular weight and are negatively charged.

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6
Q

In general, do electrolytes, small organics, and water filter easily through glomerulus?

A

Yes

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7
Q

In general, do calcium and fatty acids filtrate easier through glomerulus?

A

No

Calcium is normally bound to proteins in plasma and fatty acids are negatively charged.

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8
Q

What are the 3 major layers of the glomerular capillary?

A

Capillary endothelium that is fenestrated with small negatively charged holes (most deep layer)

Basement membrane made up of collagen and proteoglyancas that are negatively charged (to prevent passage of plasma protein) (middle layer

Epithelial cells (podocytes) with negative charge that have slit pores to allow filtrate movement. (most superficial layer)

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9
Q

Glomerular filtration rate equation

A

GFR= Kf X NFP

Kf=Glomerular capillary permeability
NFP=Net filtration pressure: hydrostatic and Bowman’s colloid osmotic forces across the membrane

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10
Q

Unlike in other capillary beds, what pressure is absent in glomerular capillary beds?

A

Colloid osmotic pressure in interstiium

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11
Q

In glomerular capillary bed, what pressure is pushing out of the capillary bed? (AKA favors filtration)

A

Glomerular capillary hydrostatic pressure

Bowman’s capsule colloid osmotic pressure (normally 0)

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12
Q

In glomerular capillary bed, what pressures are pushing towards the capillary bed? (AKA opposes filtration)

A

Bowman’s capsule hydrostatic pressure

Glomerular capillary colloid osmotic pressure

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13
Q

An increase in arterial plasma colloid osmotic pressure would cause…

A

That means there is an increase amount of protein in plasma traveling through the glomerular capillary.

So…to “dilute” the amount of protein in capillary, there would be a strong opposition to filtration thus a decrease in GFR.

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14
Q

What would happen if there was an increase in filtration fraction

A

Increase in FF concentrate plasma proteins and increase rate in colloid osmotic pressure along capillary bed thus decreasing GFR.

Increase FF would result in a decrease in renal plasma flow. Decrease in RPF=Decrease in GFR

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15
Q

An increase in glomerular hydrostatic pressure would have what effect on GFR?

A

Increase GFR

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16
Q

What are 3 things that affect glomerular pressure

A

Arterial pressure (blood pressure)

Afferent arteriolar resistance

Efferent arteriolar resistance

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17
Q

Increase of resistance on efferent and afferent arterioles would result in what for renal blood flow?

A

Decrease in renal blood flow

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18
Q

Increase afferent resistance would do what to GFR?

Give example where this happens

A

Decrease GFR
and decrease RBF

Increase sympathetic activity, vasoconstrictor hormones

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19
Q

Increase in efferent resistance would do what to GFR?

A 
Raise GFR (UNTIL capillary colloid osmotic pressure is raised to compensate)
and decrease RBF
20
Q

Decrease in efferent resistance would do what to GFR?

Give example where this happens

A

Lowers GFR

Decrease in angiotensin 2

21
Q

Decrease Kf what would happen to GFR

Give examples

A

Decrease GFR

Renal disease, diabetes mellitus, hypertension

22
Q

Increase in bowmans capsule hydrostatic pressure would do what to GFR?
Give examples

A

Decrease GFR

Urinary tract obstruction (kidney stones)

23
Q

Increase in colloid osmotic capillary pressure would do what to GFR?

A

Decrease

Also decrease RBF and increase plasma proteins

24
Q

T/F Kidneys consume 2x as much oxygen as brain

A

T

25
Q

T/F Brain has 7x more blood flow than kidney

A

F

Kidney has 7x more bloodflow than brain

26
Q

What are some extrinsic controls of GFR and RBF?

A

Neural and hormonal mechanisms

27
Q

What do extrinsic controls of GFR and RBF regulate?

A

Regulate GFR to maintain systemic blood pressure

28
Q

T/F extrinsic controls will override intrinsic controls if blood volume needs to be increased

A

T

29
Q

Under normal conditions, is the sympathetic nervous system stimulated with the kidneys? How are the blood vessels normally?

A

No. Normally at rest

Renal blood vessels are dilated.

30
Q

When sympathetic nervous system is activated, what happens with GFR?

A

Decrease

31
Q

Does moderate/mild innervation of the sympathetic nervous system have a big effect on RBF and GFR?

A

No…only STRONG

Baroreceptor reflex maintains moderate/mild stimulations

32
Q

When there is a STRONG sympathetic activation, what happens?

A

Constriction of renal arterioles and decrease in RBF and GFR

33
Q

What are some examples where there would be STRONG sympathetic innervation to the kidneys?

A

Brain ischemia or severe hemorrhage

Decreasing RBF to these areas and decreasing GFR will direct blood to a more needed place, the brain.

34
Q

Noepinephrine, epinephrine, and endoethlin would have what effect on GFR?

A

Decrease

35
Q

Angiotensin II has what effect on GFR

A

Constricts efferent arterioles to increase GFR or just prevent decrease of GFR.

36
Q

Endothelial NO and prostaglandins would have what effect on GFR?

A

Vasdodilation

Increase GFR

37
Q

What are intrinsic mechanisms to regulate GFR and RBF

A

Myogenic

Tubuloglomerular feedback

38
Q

Intrinsic controls regulate…

A

Kidneys to keep RBF and GFR constant with changes in arterial BP

39
Q

Myogenic autoregulation of GFR

-Linked to changes in? Explain effect

A

Blood pressure

When there’s an increase in BP local smooth muscles stretch and begin to contract the afferent arterioles.

Constriction of afferent arterioles results in decrease RBF and decrease GFR. This protects glomeruli from damaging high BP.

When there’s a decrease in BP, the smooth muscles relax and causes dilation of afferent arterioles.

40
Q

Tubuloglomerular feedback autoregulation of GFR

-Linked to changes in? Explain effect

A

NaCl concentration at the macula densa

Decrease in NaCl concentration will cause a decrease in afferent resistance.

This will cause an increase in GFR and RBF

There’s also an increase in renin released from juxtoglomerular cells in afferent and efferent arterioles. (renin will go on to make angiotensin II). Angiotensin OO will constrict arterioles and increase GFR.

41
Q

If ACE inhibitors are present during a decrease in NaCl, what could happen?

A

Disrupt Angiotensin II production.

So efferent arterioles would not be constricted.

There would not be an increase in GFR or RBF

42
Q

Where are macula densa cells located? What do they do?

A

Juxtaglomerular complex

Initial portion of the distal tubule

Sense NaCl concentrations

43
Q

Where are juxtaglomerular cells located and what do they do?

A

Juxtaglomerular complex

In walls of afferent and efferent arterioles

Release renin

44
Q

Does angiotensin II have an effect on afferent arterioles?

A

NO (due to nitric oxide protection and prostaglandins)

45
Q

If you eat a lot of protein, what could happen to RBF and GFR? Why

A

RBF and GFR increase

There’s an increase in AA reabsorption and increase in Na reabsorption in proximal tubules. So macula densa senses a decrease in NaCl.

This triggers tubuloglomerular feedback to increase RBF and GFR

46
Q

An increase in blood glucose levels would cause what effect on RBF and GFR?

A

Similar to tubuloglomerular feedback mechanism when low NaCl.

Try to increase GFR and RBF.

Physiology (18 decks)

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