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JKC Med Phys Spring '24 > Renal part 1- Exam 3 > Flashcards

Renal part 1- Exam 3 Flashcards

1
Q

Name the 7 functions of the kidneys

A

-Excretion of metabolic waste products and foreign chemicals
- Regulation of water and electrolyte balance
-Regulation of body fluid osmolality and electrolyte concentrations
- Regulation of arterial pressure
-Regulation of acid-base balance
-Regulation of Erythrocyte Production
-Secretion, metabolism, and excretions of hormones

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2
Q

In high altitudes the kidneys will produce ______, which causes what?

A

erythropoietin, which causes an in RBC which increases the oxygen carrying capacity

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3
Q

Are the kidneys (inside/outside) of the peritoneal cavity?

A

outside of the peritoneal cavity

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4
Q

What is the indented region of the kidney called?

A

hilum

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5
Q

What is the arrow pointing to?

A

the separating the cortex from the medulla

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6
Q

the kidney has _____ renal pyramids

A

8-10

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7
Q

Where are the nephrons located?

A

in the renal pyramids

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8
Q

How much blood is going into the kidneys in one minute?

A

1100 ml/min

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9
Q

The afferent arterioles leads where?

A

to the glomerulus

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10
Q

What are the two capillary beds of the kidney?

A

the glomerulus and peritubular capillaries

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11
Q

How does the kidney change the rate of filtration?

A

by changing the diameter of the afferent and efferent arterioles

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12
Q

What kind of capillary is associated with high hydrostatic pressure causes rapid fluid filtration

A

Glomerular capillaries

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13
Q

What kind of capillary is associated with low hydrostatic pressure permits rapid fluid reabsorption

A

Peritubular capillaries

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14
Q

Nephrons tends to decrease with ____

A

age

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15
Q

total glomerulus is encased in _____

A

Bowman’s Capsule

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16
Q

Fluid filtered from the ______ flows into ______ and then into the (proximal/distal) tubule which lies in the cortex of the kidney

A

glomerular capillaries

Bowman’s capsule

proximal

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17
Q

What things in the blood do NOT get filtered?

A

large proteins, RBC and albumin

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18
Q

What is the filtrate composed of?

A

plasma minus the proteins in your blood

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19
Q

Where is the majority of the work of that is being accomplished completed in the kidneys?

A

Proximal convoluted tubules

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20
Q

The loop of Henle: the ascending limb is (thick/thin)

A

both, has a thick and thin segment

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21
Q

The loop of Henle: the descending limb is (thick/thin)

A

thinner

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22
Q

The loop of Henle is found in the cortex or medulla?

A

Medulla

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23
Q

The cortex tubes are (thicker/thinner) than the tubes of the medulla?

A

thicker

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24
Q

At the end of the thick ascending limb is a short segment that has in its wall a plaque of specialized epithelial cell, known as the _____

A

macula densa

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25
Q

Where is renin being released?

A

at the macula densa

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26
Q

What are the two different types of nephrons?

A

cortical nephrons

juxtamedullary nephron

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27
Q

(Cortical/juxtamedullary) nephrons have nephrons that have glomeruli located in the outer cortex

A

Cortical

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28
Q

(Cortical/juxtamedullary) nephrons have Loops of Henle penetrate only a short distance into the medulla

A

Cortical nephrons

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29
Q

(Cortical/juxtamedullary) nephrons are 70% of the nephrons

A

Cortical nephrons

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30
Q

(Cortical/juxtamedullary) nephrons make up 30% of the nephrons

A

juxtamedullary

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31
Q

What is different about the juxtamedullary nephrons?

A

they have glomeruli that lie deep in the renal cortex near the medulla, they are very deep

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32
Q

_____ nephrons have long efferent arterioles extend from the glomeruli down into the outer medulla and divide into specialized peritubular capillaries called _____

A

Juxtamedullary

vasa recta

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33
Q

_____ nephrons play an essential role in the formation of a concentrated urine

A

Juxtamedullary

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34
Q

What does a GFR test for?

A

how quickly the filtrate is being formed

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35
Q

What is one substance that has no reabsorption

A

creatinine

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36
Q

What does a high serum creatinine indicate?

A

That the kidneys are not filtering as well as they should be

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37
Q

When looking at GFR ____ is quantitatively more important than _____

A

reabsorption

tubular secretion

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38
Q

______does play an important role in determining the amounts of K+ and H+ excreted in the urine

A

Secretion

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39
Q

what are the end products of metabolism that are poorly reabsorbed and end up in large amounts in the urine

A

urea, creatinine and uric acid

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40
Q

What 3 electrolytes are highly reabsorbed?

A

sodium, chloride and bicarb

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41
Q

____ and ____ are completely reabsorbed from the tubules and do not appear in the urine

A

glucose and amino acids

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42
Q

What does a high GFR indicate?

A

that the body is filtering the blood in the body very fast

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43
Q

How many liters of blood do the kidneys filter in a day?

A

180 Liters a day

44
Q

How many liters of plasma do you have in your body?

A

3 liters

45
Q

GFR = ____ of the Renal Plasma Flow

A

20%

46
Q

What are the two main things that determine GFR

A

surface area for filtration and permeability/size of the substance

47
Q

What is the capillary filtration coefficient?

A
48
Q

What is

A

The product of the permeability and filtering surface area of the capillaries

49
Q

The gomerular capillary membrane has __ layers

A

3

50
Q

The glomerular capillary membrane all have strong _____ charges in the membrane hinder the passage of _____

A

negative

plasma proteins

51
Q

The glomerular capillary membrane is more _______ but thicker

A

permeable

52
Q

What does filtration depend on ?

A

size and electrical charge

53
Q

____ will cause the surface area of the nephron to decrease

A

Diabetes

54
Q

What three layers make up the filtration barrier?

A

Endothelium
Basement membrane
Epithelial cells

55
Q

Layers of the glomerular capillary membrane: ______ Perforated by thousands of small holes (Fenestrations)

A

Endothelium

56
Q

Layers of the glomerular capillary membrane _______: Negative charges to hinder the passage of plasma proteins

A

Endothelium

57
Q

Layers of the glomerular capillary membrane _______: composed of a meshwork of collagen

A

basement membrane

58
Q

Layers of the glomerular capillary membrane _______: Large spaces through which large amounts of water and small solutes can filter

A

Basement membrane

59
Q

Layers of the glomerular capillary membrane _______: Line the outer surface of the glomerulus

A

Epithelial cells

60
Q

Layers of the glomerular capillary membrane _______: not continuous continuous but have long foot-like processes that encircle the outer surface of the capillaries

A

Epithelial cells

61
Q

What are long foot-like processes that encircle the outer surface of the capillaries?

A

(podocytes)

62
Q

Epithelial cells are separated by gaps called _____

A

slit pores

63
Q

Large substances cannot get through ____

A

nephrins

64
Q

What does a filterability of 1 mean??

A

the substance is just as freely filtered as water

65
Q

What 3 substances have the same filterability as water?

A

sodium
glucose
insulin

66
Q

The pressure in the glomerulus might be (higher/lower) in order for it to go into the bowman’s capsule

A

Higher to force it into the Bowman’s capsule

67
Q

Do we need to know these numbers?

A

dont know yet

68
Q

What is the net filtration pressure?

A

10mmHg to force fluid out of the blood and into the bowman’s capsule

69
Q

A kidney stone blocks the urethra and does not allow urine to flow, the urine backs up into the renal pelvis, collecting duct. What effect will this have on the Bowman’s capsule and GFR?

A

increases the pressure in the bowman’s capsule and decrease GFR

70
Q

If the filtration coefficient increases, what happens to GFR?

A

GFR will increase

71
Q

In what instances does the filtration co-efficent decrease?

A

in kidney disease due to destroyed glomeruli (chronic hypertension and diabetes)

72
Q

Increasing Bowman’s capsule pressure (increases/decreases) GFR

A

decreases

73
Q

A greater rate of blood flow into the glomerulus tends to (increase/decrease) GFR

A

increase

74
Q

a lower rate of blood flow into the glomerulus tends to (increase/decreases) GFR

A

decreases

75
Q

What is the Glomerular capillary hydrostatic pressure?

A

60mmHg

76
Q

What are the three physiological regulations of GFR controlled by?

A

Arterial pressure
Afferent arteriolar resistance
Efferent arteriolar resistance

77
Q

Increased arterial pressure (increases/decreases) glomerular hydrostatic pressure and (increases/decreases) GFR

A

Increases

increases

78
Q

Increased resistance of afferent arterioles (increases/decreases) glomerular hydrostatic pressure and (increases/decreases) GFR

A

decreases

decreases

79
Q

Constriction of efferent arterioles (Increases/decreases) the resistance to outflow – increases GFR

A

increases

80
Q

Renal artery pressure is about equal to _______

A

systemic arterial pressure

81
Q

The kidneys have an ______ system to maintain renal blood flow and GFR between _____ and ____

A

auto-regulation

80 and 170 mmHg

82
Q

Under what condition would the SNS control the blood supply to the kidney?

A

under severe hemorrhage

under normal circumstances the kidney regulates itself

83
Q

Very Strong Stimulation from SNS causes (dilation/constriction) of renal arterioles and (increase/decreases) flow and GFR

A

constriction

decrease

84
Q

What 3 hormones constrict renal blood vessels and decrease GFR

A

Norepinephrine, Epinephrine and Endothelin

85
Q

_____ is released by damaged vascular endothelial cells

A

Endothelin

86
Q

Where is angiotensin II produced?

A

in the kidneys

87
Q

Angiotensin II acts on (Afferent/Efferent) arterioles

A

Efferent

88
Q

Afferent arterioles are protected from constriction by ____ and ______

A

nitric oxide and prostaglandins

89
Q

What two effects does angiotensin II have on the efferent arteriole?

A

-raises glomerular hydrostatic pressure

-reduces renal blood flow

90
Q

Decreased arterial pressure or volume depletion tends to (increase/decrease) GFR

A

decrease

91
Q

Angiotensin II (increases/decreases) renal blood flow

A

decreases

92
Q

Decreasing flow to peritubular capillaries causes a greater reabsorption of ___ and ____ and ____

A

Sodium

Potassium

Water

93
Q

Memorize this chart

A

know this chart

94
Q

What is Tubuloglomerular Feedback measuring? at what location?

A

Sodium chloride concentration NOT PRESSURE with the control of renal arteriolar resistance

macula densa

95
Q

What kind of cells are located on the outside of the afferent and efferent arteriole?

A

juxtaglomerular cells

96
Q

Where are the macula densa cells?

A

group of epithelial cells in the distal tubules of the macula densa

97
Q

If GFR decreases, filtrate has (more/less) time to be reabsorbed

A

more time

98
Q

What does a decrease in macula densa sodium chloride concentration cause?

A

dilation of the Afferent arterioles and increased in renin release

99
Q

Be able to draw this flow chart

A

be able to draw this chart

100
Q

What are the two effects of the macula densa in response to low sodium

A
  1. Decreases resistance to blood flow in the afferent arterioles
  2. Increase renin release from the juxtaglomerular cells of the afferent and efferent arterioles
101
Q

When renin is released, what happens?

A

Functions as an enzyme to increase the formation of angiotensin I which is converted to angiotensin II

102
Q

____ provides auto-regulation in the kidney

A

juxtaglomerular complex

103
Q

T/F: The GFR changes drastically with large fluctuations in arterial pressure

A

False: GFR only changes a few percentage points, even with large fluctuations in arterial pressures between 75 – 160 mm Hg

104
Q

What is the MOA of ACE inhibitors? What does this cause?

A

Preventing angiotensin II formation causes reductions in GFR

105
Q

What are 3 complications of ACE inhibitors

A

Renal artery stenosis
Decreases GFR
Sudden Renal failure

JKC Med Phys Spring '24 (18 decks)

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