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physio- exam 3 > renal part 1 > Flashcards

renal part 1 Flashcards

1
Q

what are the 2 main ways the kidney maintains homeostasis?

A

regulates or balances intake with excretion

excretes metabolic wastes and drugs

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2
Q

renal functions include:

A

Eliminate metabolic waste (e.g. urea)

Regulation of water and salts (e.g. Na+, K+, Ca++)

Removal of foreign chemicals (e.g. drugs)

Gluconeogenesis

Production of hormones

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3
Q

what 3 hormones do the kidneys secrete?

A

erythropoietin

renin

1,25-dihydroxyvitamin D

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4
Q

Kidney has an _____ cortex and ______ medulla

A

an outer cortex and inner medulla

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5
Q

what is the functional unit of the kidney?

A

the nephron

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6
Q

what occurs to blood in the renal cortex?

A

blood is filtered in the glomeruli and filtrate passes through tubule of nephron

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7
Q

In what section of the kidney are there portions of nephron tubules involved with concentration and collection of urine?

A

the renal medulla

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8
Q

where do nephron tubules empty into?

A

tubules empty into renal pelvis and then into ureter

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9
Q

chronic _____ requires hemodialysis

A

ESRD

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10
Q

In ESRD, Patients have reduced ability to eliminate ___________________

A

nitrogenous wastes

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11
Q

In ESRD, excess nitrogen is converted to what?

A

ammonium

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12
Q

what is the physiological effect of excess ammonium in patients with ESRD?

A

increase pH of oral cavity

blood is alkalized

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13
Q

Manifestations of renal disease include what?

A

ammonia breath

gingival enlargement

xerostomia

tooth problems

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14
Q

what tooth problems are associated with renal disease?

A

premature loss
narrowing pulp chambers
necrosis beneath fillings or crowns

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15
Q

what are the contraindications for ESRD patients

A

nephrotoxic drugs

increased susceptibility to bleeding due to destruction of platelets

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16
Q

what drugs should never be given to patients with ESRD?

A

nephrotoxic drugs:

tetracycline, acyclovir, aspirin, NSAIDs

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17
Q

trace the flow of urine through a nephron, starting with the glomerulus

A

1) glomerulus
2) proximal tubule
3) loop of henle
4) distal tubule
5) collecting duct

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18
Q

what structures make up a renal corpuscle?

A

glomerulus + capsule

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19
Q

the __________ is shared by several nephrons

A

collecting duct

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20
Q

what are the two types of nephrons that differ in the length of tubules

A

superficial or cortical

juxtamedullary

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21
Q

what are the 3 renal processes that regulate blood composition?

A
  1. filtration
  2. Secretion
  3. reabsorption
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22
Q

what occurs during renal filtration?

A

solutes (and the water they are dissolved in) pass from the blood into tubular fluid in Bowman’s space or the renal capsule

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23
Q

what occurs during renal secretion?

A

substances are transported from the blood in the peritubular capillaries into the tubular fluid

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24
Q

what occurs during renal reabsorption?

A

substances are transported from the tubular fluid into the blood in the peritubular capillaries

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25
Q

____________ and ___________ occur throughout the length of the tubules

A

Secretion and absorption

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26
Q

composition of the tubular fluid varies with tubular _______

A

region

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27
Q

the ________ is a dense capillary bed where filtration occurs

A

Glomerulus

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28
Q

the glomerulus is surrounded by ______________ (or renal capsule) which collects the filtrate

A

Bowman’s capsule

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29
Q

in the glomerulus, filtered blood leaves via _______ arterioles and flows into peritubular capillaries

A

efferent

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30
Q

how is blood flow through the glomerulus regulated?

A

1) smooth muscle contraction in afferent or efferent arterioles
2) response of the juxtaglomerular apparatus (JGA)
3) sympathetic nervous system

31
Q

where is the juxtaglomerular apparatus (JGA) found?

A

intersection of the macula densa of distal tubule with aff. and eff. arterioles

32
Q

____ secreted from juxtaglomerular cells

A

renin

33
Q

the ____________ reabsorbs 2/3 of flitered salt and water

A

proximal tubule

34
Q

the proximal tubule reabsorbs what molecules?

A

reabsorbs all filtered glucose and amino acids

35
Q

what does the renal capsule drain into?

A

the proximal tubule

36
Q

what are the 3 sections of the loop of henle?

A

thin descending limb

thick ascending limb (TAL)

thin ascending limb

37
Q

The loop of henle is the site of ___________ multiplication

A

countercurrent

38
Q

why is countercurrent multiplication by the loop of henle needed?

A

needed to produce concentrated urine

39
Q

T/F: the loop of henle produces concentrated urine

A

FALSE

it is needed to produce concentrated urine, but the loop itself produces a dilute flitrate

40
Q

where do very powerful diuretics work?

A

on the loop of henle

41
Q

The distal tubule drains the __________

A

loop of Henle

42
Q

what are the functions (2) of the distal tubule?

A

continued reabsorption

regulation of calcium

43
Q

the _____________ extends from cortex through the medulla

A

collecting duct

44
Q

the collecting duct regulates what?

A

regulates sodium, potassium, and water

45
Q

what is renal clearance?

A

the rate of excretion of a solute expressed as how much per unit time (compares in to out)

46
Q

____________ represents the volume of plasma from which all of a particular substance is removed to the urine, e.g. 100 ml/min

A

renal clearance

47
Q

Renal clearance can be used to measure _____________________

A

glomular filtration rate (GFR)

48
Q

what is the GFR of a normal kidney?

A

in a normal kidney, GFR (from all nephrons) is:

125 ml/min or 180 L/day

49
Q

_______ and _______ are substances that can be used to measure renal clearance

A

inulin and creatinine

50
Q

what is inulin? how do nephrons respond to it?

A

small polysaccharide

freely filtered and not secreted or absorbed

51
Q

what is creatinine? how do nephrons respond to it?

A

product of muscle metabolism

freely filtered, not reasbsorbed, almost no secretion

52
Q

what are normal creatinine levels in the bloodstream? when would creatinine levels be so high that they require dialysis?

A

Normal levels are < 1+ 0.5 mg/dl

if > 10 → requires dialysis

53
Q

what are typical GFR’s for men? women?

A

125 ml/min (females)

90-140 ml/min (male)

54
Q

Glomerular capillaries are ________

A

fenestated

55
Q

_______ (cells) around the capillaries form filtration slits in the glomerulus

A

podocytes

56
Q

T/F: glomerular filtrate is acellular and essentially protein-free

A

true

57
Q

what substances are freely filtered in the glomerulus?

A

glucose, salts, and amino acids

58
Q

what factors influence whether or not a solute will be filtered in the glomerulus?

A

Size

charge

59
Q

the basal lamina (basement membrane) of the glomerulus is ________ charged

A

negatively

60
Q

Filtration occurs due to ________ differences between the blood in the capillaries and the fluid in the capsule (Starling forces)

A

pressure

61
Q

what is hydrostatic pressure?

A

pressure due to fluid

62
Q

is hydrostatic pressure higher in the capillaries, or in the capsule fluid?

A

higher in the capillaries

63
Q

what is oncotic pressure (π)?

A

pressure due to solutes in fluid (including those not dissolved)

64
Q

is oncotic pressure higher in the capillaries, or in the capsule fluid?

A

higher in the capillaries

65
Q

Net filtration pressure in the glomerulus favors filtration from _____ into the __________

A

from blood into the capsule fluid

66
Q

_________ is affected by bloodflow into and out of the glomerulus

A

GFR

glomular filtration rate

67
Q

T/F: renal blood flow (RBF) varies depending on systemic blood pressure

A

FALSE

Despite changes in systemic blood pressure, renal blood flow (RBF) remains fairly constant

68
Q

because _______ remains constant, GFR remains constant

A

RBF

renal blood flow

69
Q

what are the 2 primary mechanisms for auto regulation of the bloodflow to the glomerulus?

A
  1. myogenic mechanism

2. tubuloglomerular feedback

70
Q

what causes the myogenic mechanism for blood flow auto-regulation?

A

vascular smooth muscle tends to contract when it is stretched

71
Q

what is tubuloglomerular feedback ?

A

feedback from the JGA adjusts afferent arteriole diameter and, thus, GFR

72
Q

diet, dehydration/hemorrhaging, and the sympathetic nervous system can effect what?

A

the regulation of RBF and GFR

73
Q

what hormones can effect the regulation of RBF and GFR?

A

angiotensin II, aldosterone, and natriuretic peptide

physio- exam 3 (9 decks)

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