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2023 Systems Phys > Renal - High Yield Information > Flashcards

Renal - High Yield Information Flashcards

1
Q

The functional unit of the kidney is the…

A

Nephron

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2
Q

The nephron consists of…

A

Glomerulus
Proximal Tubule
Loop of Henle
Distal Tubule
Collecting Duct

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3
Q

What effect do Starling forces have in the nephron?

A

Starling forces across the glomerular capillaries provide the driving force for the ultrafiltration of plasma from the glomerualr capillaries into Bowman’s capsule

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4
Q

Glomerular filtrate is devoid of/has very little…

Devoid = entirely lacking

A

cellular elements - red/white blood cells and platelets
protein

Filtrate is otherwise identical to plasma

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5
Q

What is the purpose of autoregulation in the kidney?

A

it allows GFR and RBF to remain contant depsite fluctuations in arterial blood pressure between 80 and 180 mmHg

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6
Q

Define

Juxtaglomerular Apparatus (JGA)

What is it? What does it do?

A

important feedback mechanism
regulates renal blood flow and GFR

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7
Q

What structures make up the JGA?

A

Macula Densa
Extraglomerular Mesangial Cells
Granular Cells

Granular cells produce renin

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8
Q

What can be used to measure GFR?

A

Creatinine and inulin

Plasma Creatinine concentration is used to measure GFR Clinically

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9
Q

The clearance of PAH is equal to…

A

the effective renal plasma flow

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10
Q

Renal Blood Flow is about ____% of CO

A

25%

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11
Q

What does Renal Blood Flow do?

A

indirectly determines GFR
Modifies the rate of solute and water reabsorption by the proximal tubule
Delivers O2, nutrients, and hormones to the cells of the nephron
Returns CO2 and reabsorbed fluid and solutes to general cirulation
Delivers substrates for excretion in the urine

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12
Q

What are the major hormonal regulators of GFR and RBF?

A

Sympathetic Nerves
Angiotensin II

prostaglandins, NO, endothelin, natriuretic peptides, bradykinin, and adenosine affect GFR and RBF too

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13
Q

The major body fluid compartments are…

A

Extracellular Fluid (ECF)
Intracellular Fluid (ICF)

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14
Q

Na+ is confined to the…

A

ECF

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15
Q

What is the result of Na+ being confined to the ECF?

A

the amount of Na+ in the body determines the volume of the ECF

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16
Q

_ of the volume of total body water is in the ICF

A

2/3

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17
Q

_ of the volume of total body water is in the ECF

A

1/3

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18
Q

Plasma volume makes up _ of the ECF

A

1/4

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19
Q

Why are plasma and interstitial fluid nearly identical in composition?

A

Most plasma constituents are freely exchanged across the capillary wall

except for the lack of plasma proteins in IF

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20
Q

What causes the significantly different compositions between the ECF and ICF?

A

Cell membrane barrier

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21
Q

Fluid balance is controlled by…

A

Regulation of ECF volume by maintaining salt balance
Regulation of ECF osmolarity by maintaining water balance

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22
Q

Changes in ECF volume occur by…

A

changing Na+
Because of the osmotic holding power of Na+, changing a body’s total Na+ content changes ECF volume

alters arterial blood pressure in the same direction

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23
Q

What is the major cation in the ECF?

A

Na+

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24
Q

How is salt intake and output controlled?

A

Intake is uncontroled
Output is closely regulated by the kidney by changing urine concentration of Na+

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25
Q

How do blood pressure regulating mechanisms vary GFR and amount of Na+ filtered/reabsorbed?

A

GFR and Na+ filtered are varied by adjusting the caliber of the afferent arterioles supplying the glomeruli
Na+ reabsorption is varied by varying secretion of aldosterone which promotes Na+ reabsorption in renal tubules

26
Q

T or F

Varying Na+ filtration and reabsorption has no effect on ECF Volume?

A

False

varying Na+ filtration/reabsorption alters ECF volume

27
Q

Changes in ECF osmolarity occur by…

A

changing H2O balance

28
Q

Why is varying H2O balance important?

A

It is vital in avoiding osmotic shifts between the ECF and ICF cells

29
Q

What occurs in the ECF when there is excess H2O?

A

ECF solutes are diuted
H2O is driven into the cells due to ECF hypotonicity

30
Q

What occurs in the ECF when H2O is deficit?

A

ECF solutes are concentrated
H2O is driven out of the cells and into hypertonic ECF

31
Q

What helps prevent the fluxes of excess/deficit H2O?

A

ADH (primarily) and thirst (lesser extent) stimulated by hypothalamic osmoreceptors

32
Q

Volume concentration and expansion refer to…

A

ECF volume

33
Q

Define

Isosmolar Volume Expansion or Contraction

A

If ECF volume changes and the solute concentration remains the same

34
Q

Define

Hyperosmolar Expansion or Contraction

A

If ECF volume changes but the solute concentration increases

35
Q

Define

Hypo-osmolar Expansion or Contracton

A

If the ECF volume changes but the solute concentration falls

36
Q

What is the overall function of the four major segments of the nephron?

Proximal Tubule, LoH, Distal Tubule, Collecting Duct

A

Determine the composition and volume of the urine by the processes of selective reabsorption of solutes and water and secretion of solutes

37
Q

Define

Tubular Reabsorption

A

allows the kidney to retain the substances that are essential and regulate their levels in the plasma by altering the degree to which they are reabsorbed

38
Q

What are the major solutes/ions reabsorbed by the nephron?

A

Na+
Cl-
K+
HCO3-
Ca2+
PO4-3
organic anions and cations
water

39
Q

The nephron reabsorbs _ % of filtered water, _ % of filtered sugar, and _ % of filtered salt

A

99% filtered water
100% filtered sugar
99.5% filteres salt

40
Q

How do the distal segments of the nephron participate in reabsorption?

A

They have a more limited reabsorptive capacity
The final adjustments in the comosition and volume of urine and most of the regulation by hormones occur in these segments

41
Q

Tubular Secretion

A

Secretion of substances into tubular fluid is a means for excreting various byproducts of metabolism, exogenous organic anions and cations (i.e. drugs), and toxins from the body

42
Q

What regulates NaCl reabsorption in the kidneys?

A

Various hormones (Angiotensin II, Aldosterone, ADH, Natriuretic Peptides)
Sympathetic Nerves
Starling forces

43
Q

What is the major hormone that regulates water reabsorption?

A

ADH

44
Q

How is K+ homeostasis maintained by the kidneys?

A

They adjust K+ excretion to match dietary K+ intake, and by the hormones insulin, epinephrine, and aldosterone which regulate the distribution of K+ between the intracellular fluid and ECF

45
Q

What regulates K+ secretion by the distal tubule and collecting duct?

A

Na+ reabsorption
plasma [K+]
aldosterone
changes in tubular fluid
acid base disturbaces

46
Q

What regulates Ca2+ reabsorption by the thick ascending limb and distal tubule?

A

Primarily PTH and Vitamin D (calcitriol)

both stimulate Ca2+ reabsorption

47
Q

What inhibits PO43- reabsorption by the proximal tubule?

A

PTH

48
Q

How do the kidneys maintain acid-base balance?

A

Through excretion of H+

49
Q

How do the kidneys prevent the loss of the HCO3- in the urine?

A

By reabsorbing virtually all the HCO3- filtered at the glomeruli

50
Q

Both the reabsorption of filtered HCO3- and the excretion of acid are accomplished by…

A

The secretion of H+ by the nephrons

51
Q

The thick ascending limb is _ to water.

A

impermeable

52
Q

How does the thick ascending limb reabsorb Na+ in the apical membrane?

A

via a Na+-K+-2Cl- cotransporter

53
Q

How does the thick ascending limb reabsorb Na+ in the basolateral membrane?

A

via a Na+-K+ ATPase

54
Q

The distal convoluted tubule is _ to water

A

impermeable

55
Q

How does the distal tubule reabsorb Na+?

A

via a thiazide-sensitive apical membrane NaCl cotransporter

56
Q

Cortical collecting duct principal cells reabsorb _ and secrete _.

A

Reabsorb Na+
Secrete K+

57
Q

The kidneys return _ to the body and produce urine with a total solute concentration greater than…

A

water
plasma

58
Q

What is the purpose of the countercurrent multiplication system?

A

To return water to the body via the blood stream

59
Q

What does it mean that the Loops of Henle are countercurrent multipliers?

A

They create an osmotic gradient in the kidney medulla

60
Q

What does it mean that the vasa recta are countercurrent exchangers?

A

They passively help maintain the medullary gradient

61
Q

The collecting ducts have a low _ , which can be increased by _.

A

Low water permeability
increased by ADH

2023 Systems Phys (41 decks)

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