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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
____________ and ___________ occur throughout the length of the tubules
Secretion and absorption
26
composition of the tubular fluid varies with tubular _______
region
27
the ________ is a dense capillary bed where filtration occurs
Glomerulus
28
the glomerulus is surrounded by ______________ (or renal capsule) which collects the filtrate
Bowman’s capsule
29
in the glomerulus, filtered blood leaves via _______ arterioles and flows into peritubular capillaries
efferent
30
how is blood flow through the glomerulus regulated?
1) smooth muscle contraction in afferent or efferent arterioles 2) response of the juxtaglomerular apparatus (JGA) 3) sympathetic nervous system
31
where is the juxtaglomerular apparatus (JGA) found?
intersection of the macula densa of distal tubule with aff. and eff. arterioles
32
____ secreted from juxtaglomerular cells
renin
33
the ____________ reabsorbs 2/3 of flitered salt and water
proximal tubule
34
the proximal tubule reabsorbs what molecules?
reabsorbs all filtered glucose and amino acids
35
what does the renal capsule drain into?
the proximal tubule
36
what are the 3 sections of the loop of henle?
thin descending limb thick ascending limb (TAL) thin ascending limb
37
The loop of henle is the site of ___________ multiplication
countercurrent
38
why is countercurrent multiplication by the loop of henle needed?
needed to produce concentrated urine
39
T/F: the loop of henle produces concentrated urine
FALSE it is needed to produce concentrated urine, but the loop itself produces a dilute flitrate
40
where do very powerful diuretics work?
on the loop of henle
41
The distal tubule drains the __________
loop of Henle
42
what are the functions (2) of the distal tubule?
continued reabsorption regulation of calcium
43
the _____________ extends from cortex through the medulla
collecting duct
44
the collecting duct regulates what?
regulates sodium, potassium, and water
45
what is renal clearance?
the rate of excretion of a solute expressed as how much per unit time (compares in to out)
46
____________ represents the volume of plasma from which all of a particular substance is removed to the urine, e.g. 100 ml/min
renal clearance
47
Renal clearance can be used to measure _____________________
glomular filtration rate (GFR)
48
what is the GFR of a normal kidney?
in a normal kidney, GFR (from all nephrons) is: 125 ml/min or 180 L/day
49
_______ and _______ are substances that can be used to measure renal clearance
inulin and creatinine
50
what is inulin? how do nephrons respond to it?
small polysaccharide freely filtered and not secreted or absorbed
51
what is creatinine? how do nephrons respond to it?
product of muscle metabolism freely filtered, not reasbsorbed, almost no secretion
52
what are normal creatinine levels in the bloodstream? when would creatinine levels be so high that they require dialysis?
Normal levels are < 1+ 0.5 mg/dl if > 10 → requires dialysis
53
what are typical GFR's for men? women?
125 ml/min (females) 90-140 ml/min (male)
54
Glomerular capillaries are ________
fenestated
55
_______ (cells) around the capillaries form filtration slits in the glomerulus
podocytes
56
T/F: glomerular filtrate is acellular and essentially protein-free
true
57
what substances are freely filtered in the glomerulus?
glucose, salts, and amino acids
58
what factors influence whether or not a solute will be filtered in the glomerulus?
Size charge
59
the basal lamina (basement membrane) of the glomerulus is ________ charged
negatively
60
Filtration occurs due to ________ differences between the blood in the capillaries and the fluid in the capsule (Starling forces)
pressure
61
what is hydrostatic pressure?
pressure due to fluid
62
is hydrostatic pressure higher in the capillaries, or in the capsule fluid?
higher in the capillaries
63
what is oncotic pressure (π)?
pressure due to solutes in fluid (including those not dissolved)
64
is oncotic pressure higher in the capillaries, or in the capsule fluid?
higher in the capillaries
65
Net filtration pressure in the glomerulus favors filtration from _____ into the __________
from blood into the capsule fluid
66
_________ is affected by bloodflow into and out of the glomerulus
GFR glomular filtration rate
67
T/F: renal blood flow (RBF) varies depending on systemic blood pressure
FALSE Despite changes in systemic blood pressure, renal blood flow (RBF) remains fairly constant
68
because _______ remains constant, GFR remains constant
RBF renal blood flow
69
what are the 2 primary mechanisms for auto regulation of the bloodflow to the glomerulus?
1. myogenic mechanism | 2. tubuloglomerular feedback
70
what causes the myogenic mechanism for blood flow auto-regulation?
vascular smooth muscle tends to contract when it is stretched
71
what is tubuloglomerular feedback ?
feedback from the JGA adjusts afferent arteriole diameter and, thus, GFR
72
diet, dehydration/hemorrhaging, and the sympathetic nervous system can effect what?
the regulation of RBF and GFR
73
what hormones can effect the regulation of RBF and GFR?
angiotensin II, aldosterone, and natriuretic peptide

physio- exam 3 (9 decks)

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