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AP2 B4 > Renal - filtration > Flashcards

Renal - filtration Flashcards

1
Q

Although still ___, pressure is higher in these than in any other capillaries in the body

A

capillaries

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2
Q

Characteristics of glomerulus

A

Larger surface area
Larger fenestrations for easier filtration
Efferent arteriole is smaller than the afferent

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3
Q

This then requires more pressure to get plasma OUT of the glomerulus through the efferent arteriole

This pressure builds backwards into the glomerulus increasing filter pressure (positive pressure)

A

Efferent arteriole is smaller than the afferent

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4
Q

Pressure in glomerulus pushing outward into capsular space

A

Glomerular blood hydrostatic pressure (GBHP)

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5
Q

Glomerular blood hydrostatic pressure (GBHP) normal?

A

Usually 55mmHg

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6
Q

Hydrostatic pressure exerted by the fluid in capsular space that pushes inward on the visceral glomerular membrane

A

Capsular hydrostatic pressure (CHP)

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7
Q

“back pressure”

A

Capsular hydrostatic pressure (CHP)

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8
Q

Normal Capsular hydrostatic pressure (CHP)?

A

15 mmHg

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9
Q

Pressure due to proteins in blood plasma (mainly albumin)

A

Blood colloid osmotic pressure (BCOP)

“gravitational pull”

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10
Q

Opposes filtration

A

Blood colloid osmotic pressure (BCOP)

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11
Q

Pulls on fluid/solutes to keep them in the glomerulus if possible

A

Blood colloid osmotic pressure (BCOP)

Usually 30mmHg

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12
Q

GBHP-CHP-BCOP

A

NFP

NFP= 55mmHg-15mmHg-30mmHg

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13
Q

NFP

A

GBHP-CHP-BCOP

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14
Q

As long as the NFP is a ___ number, filtration will occur

A

positive

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15
Q

If NFP calculates into a ___ number, NO FILTRATION is occurring

A

negative

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16
Q

Promoting filtration eventually leads to ___

A

urine production

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17
Q

the amount of blood filtered by the kidneys’ glomeruli into capsular space per unit time

A

Glomerular Filtration Rate

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18
Q

Glomerular Filtration Rate

A

the amount of blood filtered by the kidneys’ glomeruli into capsular space per unit time

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19
Q

Normal GFR?

A

125 mL/min

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20
Q

If GFR too fast?

A

filtrate may pass too quickly and required substances may not be reabsorbed

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21
Q

If GFR too slow?

A

nearly all filtrate may be reabsorbed and certain wastes may not be excreted efficiently

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22
Q

GFR is calculated as an estimated rate (no actual measurements).

Using what 5 components?

A

Creatinine

Age

Race

Weight

Gender

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23
Q

waste from the breakdown of muscle (normal)

A

Creatinine

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24
Q

As blood is filtered through the nephrons, the kidney neither reabsorbs or metabolizes this substance?

A

Creatinine

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25
Q

Should freely pass through the filtration membrane and be urinated out?

A

Creatinine

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26
Q

In a normal healthy adult, the serum level should be near or at the same level of the urine creatinine clearance (24hour urine collection)

A

Creatinine

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27
Q

If the urine level is low, this means the kidneys are not filtering the serum ___ properly (kidney damage)

A

creatinine

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28
Q

Usually means that the creatinine serum level will be elevated if what is low?

A

urine level (i.e., not be excreted thus held in the serum)

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29
Q

GFR directly related to pressures that determine ____

A

net filtration pressure

Ex: Severe blood loss reduces mean arterial pressure as well as glomerular blood hydrostatic pressure

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30
Q

If GBHP drops by even 10mmHg, filtration in the glomerulus ___ (remember the NFP is what is needed to force filtration)

A

stops

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31
Q

Mechanisms that regulate GFR

A

Renal autoregulation

Neural regulation

Hormonal regulation

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32
Q

Renal autoregulation

Neural regulation

Hormonal regulation

A

Mechanisms that regulate GFR

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33
Q

Innate actions that occur within the kidney

Mechanisms that regulate GFR

A

Renal autoregulation

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34
Q

Sympathetic nervous system input (or reduction of input)

Mechanisms that regulate GFR

A

Neural regulation

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35
Q

Angiotensin II
Atrial natriuretic peptide (ANP)

(Mechanisms that regulate GFR)

A

Hormonal regulation

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36
Q

GFR- Renal Autoregulation Mechanisms

A

Myogenic mechanism

Tubuloglomerular feedback

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37
Q

increased BP (as in exercise) causes stretching of afferent arteriole, this causes smooth muscle contraction of afferent arteriole, reduces renal blood flow, which reduces GFR

A

Myogenic mechanism

38
Q

This helps to preserve nephron integrity with increased blood pressure
When threat of increased BP is reduced, afferent arteriole may vasodilate to increase GFR to balance out the system

A

Myogenic mechanism

39
Q

When GFR increases, rate through the tubules increase

Reabsorption of Na+, Cl- and water reduce due to rate of flow

Macula densa cells sense the increased levels of these in filtrate

These levels inhibit the release of nitric oxide (NO; vasodilator)

If NO inhibited, afferent arterioles constrict, lowers GFR

Lowered GFR slows rate through tubules

A

Tubuloglomerular feedback

GFR- Renal Autoregulation

40
Q

DCT runs very close to the JGA… the macula densa cells (of DCT) sense a chemical shift in the JGA (through extraglomerular masangial cells cells)

A

leading to constriction… slide 91ish

41
Q

A complex structure that has the ability to affect systemic blood pressure through the autoregulation of tubuloglomerular feedback

A

Juxtaglomerular Apparatus (JGA)

There is one JGA for every nephron

42
Q

JGA contains?

A

Juxtaglomerular cells

Macula densa cells

Lacis cells (modified mesangial cells)

43
Q

Found in the walls of the afferent arteriole

A

Juxtaglomerular cells

44
Q

Found in the walls of the distal convoluted tubule

A

Macula densa cells

45
Q

Located between afferent arteriole, efferent arteriole, and DCT

A

Lacis cells (modified mesangial cells

46
Q

The afferent arterioles contain juxtaglomerular cells

A

Modified smooth muscle cells that have two functions
Detect when blood pressure is too low (by sensing the lack of stretch of the afferent arteriole wall)
They synthesize, store, then secrete hormone/enzyme Renin (described later in RAAS)
Renin causes a cascade of events that helps to increase blood pressure when needed

47
Q

Modified smooth muscle cells that have two functions
Detect when blood pressure is too low (by sensing the lack of stretch of the afferent arteriole wall)
They synthesize, store, then secrete hormone/enzyme Renin (described later in RAAS)
Renin causes a cascade of events that helps to increase blood pressure when needed

A

juxtaglomerular cells

48
Q

Detect increase in NaCl (Sodium Chloride) concentrations in the filtrate

In response to this concentration check, these cells release

ATP, Adenosine in various concentrations which act locally
These trigger contraction of afferent arteriole

This causes GFR to reduce, which reduces the rate tubule flow

A

macula densa of DCT (part of JGA)

49
Q

located in between the afferent, efferent and distal convoluted tubule junction

Contract or relax to make small regulatory changes in response to the signals that the other JGA cells are sending

A

Lacis Cells (Modified Mesangial cells)

50
Q

Together the macula densa, juxtaglomerular cells, and Lacis cells make the ____

A

Juxtaglomerular Apparatus

51
Q

This is tubuloglomerular feedback

A

Together the macula densa, juxtaglomerular cells, and Lacis cells make the Juxtaglomerular Apparatus

52
Q

Depending on the filtrate analysis at this location, the filtration performance of the glomerulus can be changed

Helps regulate blood pressure within the kidneys
This can eventually effect systemic blood pressure

A

This is tubuloglomerular feedback

53
Q

Blood vessels of the kidney are supplied by __ nervous system fibers only

A

sympathetic

54
Q

At rest, sympathetic stimulation is low, so?

A

Afferent and efferent arterioles are dilated

Blood flow into and out of the glomerulus is relatively equal

55
Q

With greater sympathetic stimulation, what happens to the kidneys?

A

Vasoconstriction of the afferent arteriole occurs

Blood flow decreases into glomerulus

GFR decreases

We need blood elsewhere in the body during these times
This also protects the nephrons from the rapid rise in blood pressure

56
Q

Two hormones control regulation of GFR

A

Angiotensin II

Atrial natriuretic peptide (ANP)-

57
Q

Very potent vasoconstrictor

Mostly acts on efferent arterioles

Reduces renal blood flow

A

Angiotensin II- reduces GFR

58
Q

reduces GFR (hormone)

A

Angiotensin II

59
Q

Secreted by the atria (heart)

Usually secreted in response to increase in volume

Markedly vasodilates afferent and efferent arterioles

GFR increases

A

Atrial natriuretic peptide (ANP)-

60
Q

increases GFR

hormone

A

Atrial natriuretic peptide (ANP)

61
Q

Glomerular filtration occurs from pressures alone, not from ATP expenditure

A

Passive Movement

62
Q

Epithelial cells all along the renal tubule and ducts reabsorb, but the ___ make the largest contribution to reabsorption

A

PCT cells

63
Q

Solutes that are both actively and passively reabsorbed include

A

Glucose, amino acids, urea, sodium, potassium, calcium, chloride, magnesium, bicarbonate, and phosphates

CCUBA GSMPP

64
Q

Once fluid passes through the PCT, cells located more distally “fine tune” the reabsorption process. Where?

A

Loop of Henle, DCT, Collecting duct

65
Q

If small proteins and peptides are passed through the glomerular filter, they are ____

A

reabsorbed by pinocytosis (usually in PCT)

66
Q

between adjacent tubule cells

Passive movement only

Thought to account for up to 50% of reabsorption

A

Paracellular reabsorption

67
Q

through the tubule cell itself
(e.g., active transport, pinocytosis)

Passive and Active movement

A

Transcellular reabsorption

68
Q

the lumen side of the cell

A

Apical membrane

69
Q

the interstitial side of the cell

A

Basolateral membrane

70
Q

Solute reabsorption drives water reabsorption via osmosis

A

This is called obligatory water reabsorption

71
Q

90% of actual water reabsorption by the kidneys occurs with the reabsorption of

A

Sodium (Na+)
Chloride (Cl-)
Glucose

72
Q

These segments are always permeable to water!!!!!!!!!

A

PCT and the descending limb of the loop of Henle

73
Q

facultative water reabsorption

A

Regulated by ADH

Occurs in the late DCT and collecting ducts

74
Q

Regulated by ADH

Occurs in the late DCT and collecting ducts

A

facultative water reabsorption

75
Q

The transfer of materials from the capillaries (peritubular and/or vasa recta), interstitial spaces and tubule cells into the filtrate

A

Tubular Secretion

76
Q

Secreted substances include (but not limited to)?

A

Hydrogen ions
Secretion of hydrogen ions helps to control the blood pH

Potassium

Ammonium ions

Creatinine

Certain drugs like penicillin

77
Q

There is a constant turnover of new blood coming into the kidney’s

The body signals the need for certain elements to be reabsorbed or secreted based on an attempt for homeostasis

This constant movement generates an osmotic gradient as well as an electric gradient (+/-)

A

The body signals the need for certain elements to be reabsorbed or secreted based on an attempt for homeostasis

Because of this, there is constant movement of things across these membranes (tubule cell : interstitial fluid : capillary)

78
Q

nitrogenous waste created when proteins are catabolized (broken down)

A

Ammonia

79
Q

much less toxic than ammonia, but can still be deadly if left to accumulate

A

Urea

Urea plays a significant role in creating and maintaining the osmotic gradient in the renal medulla

80
Q

Most of the ___ is reabsorbed in the PCT.

This “safeguards” the body’s supply of an important buffer

A

bicarb (HCO3-)

slide 116

81
Q

Largest amount of solute and water reabsorption from filtered fluid occurs in the PCT

A

100% of glucose, amino acids, vitamins

i.e., not in DCT

82
Q

80-90% of filtered HCO3- (bicarb)

A

Proximal Convoluted Tubule

83
Q

~65% of Na+, K+, and water

A

Proximal Convoluted Tubule

84
Q

Sodium (Na+) is actively transported out of tubule and into interstitial fluid
Glucose and amino acids are co-transported with Na+

A

Proximal Convoluted Tubule

85
Q

As Na+ moves into blood, this creates a significantly positive environment in blood, so ___ ions passively move from filtrate into interstitial fluid to help balance this

(PCT)

A

Cl-

86
Q

Cells lining the PCT and the descending LOH are especially permeable to water because of the presence of

A

aquaporin-1 channels

87
Q

These are protein water channels that increase the rate of water movement

A

aquaporin-1 channels

88
Q

Movement of Na+ and Cl- into interstitium creates a significant osmotic imbalance now, so water is obligated to move out of filtrate and into interstitum by ___

A

osmosis

89
Q

The osmosis of water will often bring K+ and Ca++ with it in a motion called ___

A

solvent drag

90
Q

stimulates cells in the PCT to secrete phosphate

stimulates calcitriol (Vitamin D) to be made in PCT cells and then be absorbed into blood

stimulates cells in the DCT to reabsorb more calcium

A

Parathyroid Hormone (PTH)

AP2 B4 (3 decks)

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