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pathophysiology > renal objectives 1-5 (kidney function and hormone stuff) > Flashcards

renal objectives 1-5 (kidney function and hormone stuff) Flashcards

1
Q

What is the glomerulus?

A

A group of capillaries that loop into a circle, serving as a filtration membrane.

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2
Q

How does blood enter and exit the glomerulus?

A

Blood enters via the afferent arteriole and exits via the efferent arteriole.

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3
Q

What is the function of the glomerular capillary walls?

A

They serve as a filtration membrane, pulling water and small solutes out of the blood.

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4
Q

What happens to water and small solutes filtered by the glomerulus?

A

They enter Bowman’s capsule.

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5
Q

Name some of the small solutes that pass through Bowman’s capsule.

A

Glucose, sodium, chloride, amino acids, and urea (similar to blood plasma).

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6
Q

What large solutes do not pass through Bowman’s capsule?

A

Red blood cells (RBCs), platelets, and proteins.

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7
Q

After leaving Bowman’s capsule, where does the fluid go?

A

It moves to the proximal convoluted tubule (PCT).

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8
Q

What does the proximal convoluted tubule reabsorb?

A

Sodium, water, glucose, amino acids, phosphate, and 80% of filtered bicarbonate (HCO3-).

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9
Q

What is secreted from the bloodstream into the tubules for excretion?

A

Potassium (K+), hydrogen ions (H+ or acid), and medications.

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10
Q

How do the kidneys regulate blood pH?

A

By adjusting the reabsorption of bicarbonate (HCO3-) and the excretion of hydrogen ions (H+).

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11
Q

Which part of the nephron is important for acid-base balance?

A

Both the proximal convoluted tubule (PCT) and the distal convoluted tubule (DCT) are involved.

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12
Q

What is the proximal convoluted tubule (PCT) responsible for?

A

It reabsorbs sodium, water, glucose, amino acids, phosphate, and 80% of filtered bicarbonate (HCO3-), helping to maintain acid-base balance.

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13
Q

After the Loop of Henle, where does the fluid go?

A

It moves to the distal convoluted tubule (DCT).

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14
Q

What substances are reabsorbed in the distal convoluted tubule (DCT)?

A

Some sodium (Na+) and calcium (Ca2+).

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15
Q

How is calcium reabsorbed in the DCT?

A

By the effects of parathyroid hormone (PTH), which enhances the synthesis of calcium transport proteins.

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16
Q

How does the DCT adjust pH depending on blood acidity?

A

The DCT may either: - Excrete H+ (acid) and reabsorb bicarbonate to raise blood pH. - Excrete bicarbonate and reabsorb H+ to lower blood pH.

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17
Q

How much of the cardiac output do the kidneys receive?

A

20-25% of the cardiac output.

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18
Q

What is the glomerular filtration rate (GFR)?

A

The amount of plasma filtered by the glomerulus per minute. Normal GFR is 125 mL/min.

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19
Q

What percentage of plasma is filtered by the glomerulus each minute?

A

20% of the plasma that flows through is filtered per minute.

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20
Q

What is the relationship between GFR and capillary perfusion pressure?

A

GFR is directly related to the perfusion pressure in the glomerular capillaries.

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21
Q

What happens to GFR if mean arterial pressure decreases or vascular resistance increases?

A

There is a drop in glomerular filtration.

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22
Q

What role does renal blood flow play in GFR?

A

Renal blood flow supplies the capillaries with plasma for filtration, which is essential for maintaining GFR.

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23
Q

What are the three mechanisms that regulate renal blood flow?

A
  1. Autoregulation 2. Neural regulation 3. Hormonal regulation (Renin-Angiotensin-Aldosterone System - RAAS)
24
Q

What is the goal of autoregulation in the kidneys?

A

To maintain a consistent GFR by preventing large fluctuations in BP from affecting the glomerular capillaries.

25
Q

What happens to afferent arterioles when systemic BP increases?

A

Afferent arterioles constrict to prevent an increase in GFR and filtration pressure.

26
Q

What happens to afferent arterioles when systemic BP decreases?

A

Afferent arterioles dilate, allowing GFR and filtration pressure to increase.

27
Q

What system innervates the blood vessels of the kidneys in neural regulation?

A

The sympathetic nervous system.

28
Q

What happens when systemic arterial pressure drops (e.g., in shock)?

A

Baroreceptors send messages to the brain, triggering increased sympathetic activity, which constricts the arterioles, decreasing renal blood flow and GFR.

29
Q

Why does GFR decrease during neural regulation?

A

To retain salt and water in the bloodstream, helping to maintain systolic blood pressure.

30
Q

What is an example of neural regulation during exercise or dehydration?

A

Mild arteriole constriction decreases GFR to retain salt and water, preventing dehydration.

31
Q

How does the body respond to hypoxia?

A

Chemoreceptors in the carotid and aorta trigger sympathetic stimulation in the kidneys, decreasing renal blood flow and GFR to conserve water and improve perfusion.

32
Q

What does the renin-angiotensin-aldosterone system (RAAS) regulate?

A

Blood volume, electrolyte balance, and systemic vascular resistance.

33
Q

How does angiotensin II affect blood vessels?

A

It constricts blood vessels, increasing systemic vascular resistance.

34
Q

What is the role of aldosterone in the kidneys?

A

Aldosterone triggers the retention of salt and water, increasing systemic vascular resistance and capillary hydrostatic pressure.

35
Q

Which hormones act on the kidneys?

A
  1. Antidiuretic hormone (ADH) 2. Aldosterone 3. Natriuretic peptides
36
Q

Which hormones are activated or synthesized in the kidneys?

A
  1. Vitamin D (activated) 2. Erythropoietin (synthesized)
37
Q

What hormone increases water reabsorption in the distal tubule and collecting ducts?

A

Antidiuretic hormone (ADH), secreted by the posterior pituitary gland.

38
Q

What is the function of ADH?

A

Increases blood pressure by promoting water reabsorption in the distal tubule and collecting ducts.

39
Q

Where does aldosterone act on the kidneys?

A

Distal tubule and collecting ducts.

40
Q

What is the main function of aldosterone?

A

Increases blood pressure by promoting sodium and water reabsorption, prevents hyperkalemia, and regulates pH by excreting potassium (K+) and hydrogen (H+).

41
Q

Which hormone prevents hyperkalemia and promotes pH regulation in the kidneys?

A

Aldosterone, secreted by the adrenal gland.

42
Q

What is the role of natriuretic peptides?

A

Inhibit sodium and water reabsorption, inhibit renin and aldosterone secretion, and promote vasodilation of afferent arterioles.

43
Q

Where are natriuretic peptides secreted from?

A

Atria and ventricles of the heart in response to wall dilation.

44
Q

How do natriuretic peptides affect urination?

A

They promote increased urination by dilating efferent arterioles,

45
Q

How is vitamin D activated in the kidneys?

A

After being initially processed in the liver, it is activated in the kidneys by the action of parathyroid hormone (PTH).

46
Q

What is the role of vitamin D in the body?

A

Promotes absorption of calcium and phosphorus in the small intestine.

47
Q

What hormone stimulates the bone marrow to produce red blood cells (RBCs)?

A

Erythropoietin, which is synthesized in the kidneys.

48
Q

What triggers the release of erythropoietin?

A

Decreased oxygen delivery to the kidneys, leading to secretion by peritubular cells to stimulate RBC production.

49
Q

What is the main function of erythropoietin?

A

To prevent or correct hypoxia by stimulating the bone marrow to produce more red blood cells for oxygen transport.

50
Q

Where does fluid go after the distal convoluted tubule?

A

It goes to the collecting duct.

51
Q

What do several nephrons merge into after the collecting ducts?

A

They form cortical collecting ducts.

52
Q

Which hormones influence the cortical collecting ducts?

A

Antidiuretic hormone (ADH) and aldosterone.

53
Q

What is the effect of ADH and aldosterone on the cortical collecting ducts?

A

They stimulate water and salt reabsorption and promote potassium excretion.

54
Q

What substances can be excreted or reabsorbed in the collecting ducts?

A

Sodium (Na+), potassium (K+), hydrogen (H+), and bicarbonate (HCO3-).

55
Q

What happens to sodium, potassium, hydrogen, and bicarbonate in the collecting ducts?

A

They may either be excreted from the bloodstream into the duct or reabsorbed into the bloodstream.

pathophysiology (54 decks)

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