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Bioscience > Renal I > Flashcards

Renal I Flashcards

1
Q

What are the general considerations of the kidneys?

A
  • -Regulate volume and composition of body fluids
  • -Excretion (secretion) of end products of metabolism
  • -Retention (reabsorption) of nutrients
  • -Secrete hormones
  • -Metabolize hormones
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2
Q

Excretion is also known as what?** In terms of end products of metabolism?

A

Excretion (secretion) of end products of metabolism (urea)**** Uric acid, creatinine, and end products of hemoglobin break down

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3
Q

What hormones dose the kidney secrete??**

A

Secrete hormones Renin, erythropoetin activated form of Vitamin D**

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4
Q

The kidneys metabolize hormones such as?

A

Metabolize hormones

insulin

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5
Q

The kidneys regulate volume and composition of body fluids, such as?

A

Regulate volume and composition of body fluids (electrolytes, minerals, and ions)

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6
Q

What are the three essential functions of the kidneys?**

A
  1. Glomerarly filtration
  2. Tublar reabsorption
  3. Excretion
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7
Q

In terms of the essential function of the kidney, what is glomerarly filtration?**

A

1.Glomerarly filtration – forcing of fluids through a membrane under pressure
GFR 125ml/min
20% of CO are sent to the kidneys
Kidneys will bleed if you cut it, that will be the difference between a total nephrectomy vs. partial

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8
Q

In terms of essential function of the kidney, what is Tubular reabsorption?**

A

2.Tubular reabsorption – retention – movement of filtrate back into the blood form the renal tubule (these are the nutrients, such as amino acid and glucose)

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9
Q

In terms of essential function of the kidney, what is Excretion or secretion?**

A

3.Excretion – secretion - Movement of substances from the blood to the filtrate such as urea, uric acid, and creatinine

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10
Q

In terms of anatomy, where is the right kidney in relation to the left kidney?

A

Right kidney slightly lower than left kidney (due to the liver)

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11
Q

What is the sympathetic innervation of the kidneys?

A

Sympathetic innervation: renal plexus nerves are vasomotor, they regulate circulation of blood in the kidneys

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12
Q

What are the three layers of the kidneys?

A

Three layers to the kidneys

  1. Fiberous membrane that covers the kidneys itself
  2. Adipose capsule
  3. Renal facisa – anchors the kidneys to the abdominal wall and surrounding structures
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13
Q

What is the inner and outer portion of the kidneys called?*****

A

Each kidney consists of cortical portion (outer) and medullary portion (inner)*****

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14
Q

What contains the short loops of henle?**

A

Cortical nephrons contain “short loops of henle”*****(in the cortex)

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15
Q

What contains the longer loops of henle???***

A

Juxtamedullary nephrons contain “longer loops of henle”**** located in the medulla

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16
Q

What is the ratio for cortical nephron to juxtamedullary nephrons

A

7 to 1… cortical nephron to juxtamedullary nephrons

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17
Q

About how many nephrons does each kidney contain?

A

Each kidney contains 1-1.2 million functional units called nephrons

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18
Q

What are the components of the nephron?

A

Components include glomerulus and renal tubule 6 segments

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19
Q

what part of the nephron is the ultrafiltrate formed?

A

Ultrafiltrate is formed at proximal end

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20
Q

What is the final product of the nephron eliminated as?

A

Final product eliminated as urine

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21
Q

Filtered fluid is converted to urine in what part of the nephron?**

A

Tubule system is where Filtered fluid will convert to urine**

GFR 125ml/min

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22
Q

Glomerulus composed of tufts of capillaries that jut into Bowman’s capsule, what is reason for tufts of capillaries?**

A

Glomerulus composed of tufts of capillaries (increases surface area) that jut into Bowman’s capsule**

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23
Q

What is the major function of the proximal tubule?

A

Major function: reabsorption (retention) of sodium**

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24
Q

How is the Flomerulus feed? in terms of blood supply?***

A

Glomerulus is feed by one Afferent Arterial and drained by one efferent arterial**

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25
Q

How much of plasmids are filtered as they pass through Glomerulus??***

A

20% of plasmids are filtered as they pass through Glomerulus***

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26
Q

What is Glomerular filtration pressure?

A

Glomerular filtration pressure is about 60% of MAP***

27
Q

What is responsible for maintaining a hypertonic medullary interstium??**

A

Loop of Henle - responsible for maintaining a hypertonic medullary interstium**

28
Q

What happens if you vasodilate the afferent arterial?

A

If Vasodilate afferent arterial, we will decrease arterial tone and decrease arterial resistance, will increase renal blood flow and increase GFR

29
Q

What happens if you vasoconstrict afferent arterial?

A

If we vasoconstrict afferent arterial, increase arterial tone and arterial resistance, this will decrease renal blood flow and decrease GFR

30
Q

Distal tubule receives what type of solution?

A

Distal tubule: (receives hypotonic solution from the loop of henle)

31
Q

What is the collecting tubule known for????*****

A

Collecting tubule:

  • Divided into cortical and medullary portions
  • Known for it’s concentrating ability***
  • This would be in the presence of ADH
32
Q

If we increase ADH, what happens to urine output?

A

If we increase ADH, decrease urine output (this is the concentrating ability)

33
Q

If we decrease ADH, what happens to urine output?

A

If we decrease ADH, increase urine output (this is the concentrating ability)

34
Q

what Contains the macula densa located near the glomerulus?

A

JUXTAGLOMERULAR
APPARATUS
Contains the macula densa located near the glomerulus

35
Q

What does the Juxtaglomerular cells contain? and are they innervated
with?*****

A

Juxtaglomerular cells contain renin and are innervated by the sympathetic nervous system***located near the afferent arterial, which is next to the glomerulus

36
Q

What is the major function of the JUXTAGLOMERULAR

APPARATUS?**

A

Major function: secretion of renin*****

37
Q

The macula densa is Sensitive to NaCl concentration, It will sense sodium chloride.

If there is a decrease in NaCl, What two two things happens?

A
  1. decrease resistance to blood flow via the afferent arterial, leads to increase blow flow via vasodilation
  2. increase renin release from juxtaflomerular cells
38
Q

what happens in the macular desa senses an increase in NaCl?

A

If it sense an increase in NaCl -> increase resistance that will decrease blood flow, this will vaso constrict, and decrease renin release

39
Q

What two things will cause the release of Renin?

A

Beta adranergic sympathetic stimulation can also release Renin
Changes in afferent arterial wall pressure can release renin release as well,

40
Q

Explain the RAAS?

A

Renin is release into the blood stream (released by the juxtaglomerular cells),
act on angiotensinogen (a protein that is synthesized by the liver) to form angiotensin I,
angiotensin I is converted into angiotensin II (in the lungs) by the ACE (plays a major role in BP regulation)

41
Q

What brings blood to the bowmans capsule?

A

Afferent brings blood to the bowmans capsule

42
Q

Renal function is intimately related to what?*

A

Renal function is intimately related to renal blood flow (normal urine formation denotes normal renal blood flow)

43
Q

Oxygen consumption is determined by what?*

A

Oxygen consumption is determined by renal blood flow

44
Q

Combined blood flow through both kidneys accounts for 20-25% of total cardiac output, what is Renal blood flow is going to be per min?*

A

Combined blood flow through both kidneys accounts for 20-25% of total cardiac output (Renal blood flow is going to be 1200ml per min.* each kidney is supplied by a single renal artery that will arise form abd aorta)

45
Q

What is normal urine output?

A

0.5cc/kg/ml is normal urine output

46
Q

Renal artery will turn into 6 segmental arteries divide, how are they divided?

A

5 anterior segmental arteries

1 posterior segmental artery

47
Q

What is renal blood flow?***

A

Renal blood flow: ~1200mL/minute 20-25%***

48
Q

What is Glomerular filtration rate?***

A

Glomerular filtration rate: ~125mL/minute 180L/day***

49
Q

The control mechanisms, in terms of renal blood flow, what is intrinsic regulation?

A

Control mechanisms:

  • -Intrinsic regulation - autoregulation of renal blood flow – occurs between MAP 80-180 (outside these limits it will be pressure dependent, the blood flow)
  • -Renal blood flow will be generally decrease if MAP less than 70,
  • –Glomerular filtration will cease or stop during 40-50torr
50
Q

The control mechanisms, in terms of renal blood flow, what is Tubuloglomerulo balance?

A

Tubuloglomerulo balance (self limiting and feedback system), If it sense a increase in tubular flow, it will decrease GFR. If you have a decrease in tublar flow, it will send a message out to let more in.

51
Q

If it sense a increase in tubular flow, what happens to GFR?

A

If it sense a increase in tubular flow, it will decrease GFR

52
Q

If you have a decrease in tubular flow, what happens to GFR?

A

If you have a decrease in tubular flow, it will send a message out to let more in

53
Q

With Renal blood flow, what is Hormonal regulation?***

A

Hormonal regulation Angiotensin II, epi and Noriepi, all will effect AFFERENT arterial tone, renal filtration rate will generally stay the same***

54
Q

Dopamine will dilate afferent as well as efferent arterials, what will happen to the GFR???***

A

Dopamine will dilate afferent as well as efferent arterials, this will increase GFR***

55
Q

With the renal blood flow, what is neuronal regulation?

A

Neuronal regulation – sympathetic innervations is responsible stressed induction in renal blood flow, this will decrease urinary output. Stress response to a decrease urinary output.

56
Q

What are the overview effects of anesthesia on renal function?

A
  • -Reversible decrease in renal blood flow and GFR
  • -Typically will be less if you provide regional anesthesia as long as hypotension is avoided.
  • -Maintain hydration and pressure (give them a drink)
57
Q

What are the indirect effects, in terms of the cardiovascular effects?

A

Cardiovascular effects - Keep MAP between 80-180 (outside these ranges will be pressure dependent)

58
Q

What are the indirect effects, in terms of the neural effects?

A

Neuronal effects – reduction in renal blood flow, caused by sympathetic system, this can be the stress response

59
Q

What are the indirect effects, in terms of the endocrine effects?

A

Endocrine effects – reduced blood flow, reduced urinary blood flow, increase in catecholamine due to the stress response

60
Q

What are the direct effects of volatile agents on renal function?

A

Direct effects
Volatile agents – watch out for fluride (sevo), be aware of compound A (keep flow greater than 2L), watch out for the cardiac depressive effects of the gases

61
Q

What are the IV agent effects on renal function?

A

IV agents – minimal effects renal function if used alone

62
Q

What is the overview of diuretics on the renal system?

A

Overview:

  • Increase urinary output by decreasing reabsorption of sodium and water
  • Classified according to their mechanism of action
63
Q

What are the different classes of diuretics?

A

—Osmotic diuretics Mannitol
Loop diuretics lasix
—Thiazide-type diuretics SE hypokalemia
—Potassium-sparing diuretics (watch out for those on beta blockers) aldactone
—Carbonic anhydrase inhibitors diamox (for head cases)

Bioscience (9 decks)

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