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REnal > Renal function > Flashcards

Renal function Flashcards

1
Q

What are the physiological functions of the kidneys

A

regulate extracellular fluid solute concentrations
regulate plasma electrolye concentrations
regulate acid-base balance
regulate extracellular fluid volume, arterial blood pressure
eliminate metabolic wastes, foreign chemicals

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2
Q

What hormones do kidneys produce

A

erythropoietin, vit D and renin

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3
Q

what compunds are synthesized in kidneys

A

ammonia, PGs, kinins and glucose

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4
Q

What other body systems are the kidneys intergrated with

A

GI, endo, CNS, ANS, CNS, resp, CV, liver

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5
Q

what are some of the key sequlae to kidney failure

A

anemia due to loss of forming new RBC
osteoporosis due to loss of forming bone
disregulation of Ca and phosphates

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6
Q

what is another name for interlobular aa

A

cortical radial arteries

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7
Q

what portion of CO does the renal blood receive

A

20%

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8
Q

are the glomerular capiilaries high or low P and why?

A

high pressure to cause filtration of blood

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9
Q

are the peritubular capillaries high or low P and why?

A

low because want to reabsorb

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10
Q

how are the P in the capillaries altered in renal system

A

changes in afferent and efferent arteriolar resistance

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11
Q

What are the two types of nephrons

A

Juxtamedullary which go deeper to renal papilla

Superficial cortical

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12
Q

characteristics of superficial cortical nephrons

A

short loops of henle

surrounded by particular capillaries

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13
Q

characteristics of juxtamedullary nephrons

A

long loops of henle
efferent arterioles are covered by vasa recta (specialized peritubular capillaries)
mainly functions for urine concentration

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14
Q

describe the renal microcirculation path

A

afferent arteriole
glomerular capillaries
efferent arteriole
peritubular capillaries

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15
Q

describe venouse drainage of nephrons

A

interlobular v
arcuate v
interlobar v
renal v

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16
Q

what are the advantages of high renal blood flow

A

high filtration rate

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17
Q

how does renal fraction change during exercise

A

it decreases because shunting to skel muscle and want to retain H2O

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18
Q

What regions of the kidneys receive more blood

A

the cortical nephrons

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19
Q

how does blood perfusionc hang with aging

A

decreases because we lose the number of functioning nephrons

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20
Q

where do sympathtetic neurons synapse in kidneys

A

smooth muscle to cause arteriolar constriction to protect from high BP
granular cells to cause renin secretion in afferent arterioles

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21
Q

what is the function of renin

A

to cause retention of Na and H2O

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22
Q

what are the net effects of sympathetic stimulation

A

decrease renal blood flow and diver renal fraction to vital organs

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23
Q

what is glomerular filtration

A

filtration of plasma from glomerular capillaries into Bowmans capsule

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24
Q

what is tubular reabsorption

A

transferal of substances from tubular lumen to pertibular capillaries

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25
Q

what is tubular secretion

A

trasnferal of substances from peritubular capillaries to tubular lumen, like waste such as urea

26
Q

what is excretion

A

voiding substances in the urine

27
Q

how can we calculate urinary excretion

A

amount filtered-amount reabsorbed+amount secreted

28
Q

how can we measure tubular reabsorption

A

glomerular filtration- urinary excretion

29
Q

what is glomerular filtration rate

A

volume of plasma filtered per unit time

30
Q

the filtration rate of a substance is calculated how

A

GFR x plasma concetration of substance

31
Q

how do we calculate urinary excretion rate

A

product of urine flow rate x concentration of substance in the urine

32
Q

if excretion is less than filtration what does that indicate

if excretion is more than filtration what does that indicate

A

when excretion filtration- net secretion occurred

33
Q

what is the definition of clearance

A

the volume of plasma from which a substance is completely removed by kidneys in a given time period

34
Q

what are the units of clearance

A

volume/time
ml/min
L/hr

35
Q

Is clearance the same for all substances

A

no

36
Q

how do we calculate clearance

A

concentration of X in urine * urine volume
___________________________________
concentration of x in plasma

37
Q

Under what conditions can GFR be estimated from clearance

A

compound can freely filter thorugh glomerulus, cannot be secreted, reabsorbed, produced nor degraded by kidneys

38
Q

What molecules do we use to calculate GFR

A

inulin because it is not secreted reabsorbed or metabolized

Creatinine- not perfect and used for long term

39
Q

describe how the BUN creatinine ration works

A

because creatinine is unaffected by hydration status it acts as a constant.
so we can tell when urea is too high or low.. where the problem may be in kidney problems
Cystatin C

40
Q

describe what a BUN/C ratio above 20 indicates

A

prerenal problem
BUN reabsorption is increased
reduced perfusion due to hypovolemia

41
Q

What is a normal BUN/C level

A

10-20/1

42
Q

what does a BUN/C ratio below 10 suggest

A

intrarenal problem

renal damage causing reduced reabsorption of BUN

43
Q

what are the advantages of using Cystatin C to measure GFR rather than creatinine

A

no affected by muscle mass, age or gender

44
Q

What measurement of clearance can give an estimate of renal plasma flow

A

Para-amino hippuric acid

45
Q

What is the filtration fraction

A

part of renal plasma flow that is filtered/diverted into tubule

46
Q

what is the calculation for filtration fraction

A

FF= GFR/RPF

47
Q

the kidney is the only place that can rid the body of what acids

A

sulfuric acid and phosphoric acid

48
Q

what stimulates the kidneys to secrete erythropoeitin

A

hypoxia

49
Q

where is the macula densa

A

at the end of the ascending limb

50
Q

what type of reflex is micturition

A

autonomic spinal cord reflex

51
Q

how can the trigone be distinguished by the rest of the bladder

A

its mucosa is smooth unlike the extensive foldings of the rest of the bladder

52
Q

which sphincter of the bladder is voluntary

A

the external

53
Q

what spinal cords innervate bladder

A

S2S3 through sacral plexus, sensory and motor

54
Q

what type of fibers innervate detrusor mm

A

PANS

55
Q

what nerves innervate the external sphincter

A

skel mm nerves, pudendal

L2 also but not much

56
Q

a person with vesicoureteral reflex suffers the condition because

A

their ureters don’t quite protrude as far into the bladder so the ureter is not completely blocked when bladder contracts

57
Q

what does the ureterorenal reflex prevent

A

preventing excessive flow of fluid into a blocked ureter

58
Q

what substances usually are filtered but then completely reabsorbed

A

amino acids and glucose

59
Q

what substances are filtered in glomercular capillaries and completely secreted in peritubular capillaries

A

organic acids and bases

60
Q

what molecules in plasma do not get filtered

A

plasma Ca and plasma FA because are bound to protein

REnal (7 decks)

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