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Practice Topics/PID Exam 7 > Renal Phys 1 > Flashcards

Renal Phys 1 Flashcards

1
Q

The kidney filters

A

The entire body blood supply - blood flow 20% of CO

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2
Q

Kidney contributes less than ___ % of total body weight

A

Less than 0.5% of total body weight

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3
Q

Kidney functions

A

1 Excretion of metabolic waste products and foreign substances

2 Regulation of body fluids and electrolytes balance, acid base balance and arterial blood pressure

3 Elaboration of endocrine hormones

4 Synthesis of glucose

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4
Q

System approach to kidney functions - How the kidney communicates with the rest of the body - Kidney to extrarenal environment (body)

A

Excretion of - metabolic waste products, foreign substances
Adjustment of - fluid volume, solute concentration
Elaboration of endocrine hormones
Gluconeogenesis

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5
Q

System approach to kidney functions - Extrarenal environment (body) to Kidney

A

Blood pressure and volume
Plasma composition
Neuroendocrine

Body sends signals to kidney when changes in these occur

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6
Q

System approach to kidney functions - Intrarenal process

A

Basic kidney process

Local control of - renal auto regulation and autocrine/paracrine systems

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7
Q

Kidneys are located

A

just below the rib cage, one on each side of the spine

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8
Q

Urine flows from the kidneys to the ___ through two thin tubes of muscle called ___, one on each side of the bladder

A

Urine flows from kidney to bladder

Through ureters

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9
Q

When bladder fills with urine - the bladder walls are

A

relaxed

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10
Q

When the bladder empties, urine flows out through the

A

urethra

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11
Q

In a bisected kidney, the two major regions visualized are the

A

Cortex (outer region)

Medulla (inner region)

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12
Q

The medulla of the kidney is divided into

A

Multiple cone shaped masses of tissue called renal pyramids

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13
Q

The base of each renal pyramid terminates in the ____ which projects into the ____

A

Base of pyramid terminates in papilla which projects into space of renal pelvis

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14
Q

Functional unit of the kidney

A

Nephron

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15
Q

Each kidney in the human has how many nephrons

A

About 1 million

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16
Q

Each nephron of the kidney has was

A

A filtering component called the glomerulus

A transporting component called the tubule

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17
Q

The glomerulus consists of

A

A network of capillaries (glomerular capillary) that is supplied by the afferent arteriole and drained by the efferent arteriole

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18
Q

Glomerulus is encased in

A

Bowman’s capsule

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19
Q

Permeability of the glomerular capullaries is what compared to skeletal muscle

A

About 50 times that of capillaries in skeletal muscle

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20
Q

The glomerular capillary membrane is similar to other capillaries except

A

It has 3 (instead of 2) major layers:
Endothelium of capillary
A basement membrane
A layer of epithelial cells (podocytes)

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21
Q

The glomerular capillary membrane is similar to other capillaries except it has 3 major layers - these layers make up the

A

Filtration barrier - through which large amounts of fluid are filtered from the blood with high filtration rate

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22
Q

Fluid filtered from the glomerular capillaries flows into the ____ and then into the ____

A

Glomerular capillaries - Bowmans capsule - renal tubule

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23
Q

Where is filtered fluid converted into urine

A

Renal tubule

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24
Q

Renal tubule is dividded into

A

Proximal tubule
Loop of Henle
Distal tubule
Collecting duct

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25
Q

The renal artery enters the kidney and then

A

Branches progressively

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26
Q

The venous system runs ___ to the arteriolar vessels

A

parallel

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27
Q

The _____ supplying the juxtamedullary nephron differ from those supplying the cortical nephrons

A

Vascular structures differ

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28
Q

Cortical nephrons =

A

Nephrons that have glomeruli located in the outer cortex and short loop of henle

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29
Q

Juxtamedullary nephrons =

A

Nephrons that have glomeruli located deep in the cortex and long loop of henle (20-30%)

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30
Q

Microcirculation of nephron - cortical nephrons are surrounded by

A

Extensive network of the peritubular capillaries
Enter = afferent
Leave = efferent

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31
Q

Microcirculation of nephron - cortical nephron - Renal circulation is unique because it has

A

Two capillary beds - the glomerular and peritubular capillaries

32
Q

Microcirculation of nephron - cortical nephron - The glomerular and peritubular capillaries are arranged in series and separated by the

A

efferent arteriole

33
Q

Microcirculation of nephron - Juxtamedullary nerphrons are surrounded by

A

Specialized peritubular capillaries called vasa recta

34
Q

Microcirculation of nephron - Juxtamedullary nerphron - The vasa recta extend to

A

Downward to the medulla - lying side by side with the loop of henle

35
Q

Microcirculation of nephron - Juxtamedullary nerphron - the specialized network of capillaries in the medulla plays an essential role in the formation of

A

Concentrated urine

36
Q

Basic steps in urine formation - Urine composition depends on

A

The rates at which different substances are excreted from the body

37
Q

Basic steps in urine formation -Urinary excretion is determined by

A

3 processes

1) Glomerular filtration
2) Tubular re-absorption
3) Tubular secretion

38
Q

Urine excretion - Filtration

A

Glomerular filtration

Movement of substances from the glomerular capillaries into Bowmans capsule

39
Q

Urine excretion - re absorption

A

Tubular re-absoprtion

Movement of substances from the tubular lumen to the peritubular capillary (to the blood)

40
Q

Urine excretion - secretion

A

Tubular secretion

Movement of substances from the peritubular capillary (from the blood) to the tubular lumen

41
Q

Urine excretion =

A

Filtration - re absorption + Secretion

42
Q

Renal blood flow =

A

The volume of blood delivered to the kidneys per unit time

Resting, it is about 20-25% of Cardiac output

43
Q

Blood flow through kidney serves several functions =

A

1 Delivers substrate for excretion in urine
2 Deliver O2, nutrients, and hormones to cell of nephron and return CO2 and re absorbed fluid and solutes to the circulation
3 Influence GFR
4 Modify rate of solute re absorption
5 Participate in concentration and dilution of urine

44
Q

Glomerular filtration -

A

The filtration of plasma from the glomerular capillaries into the bowmans capsule

Urine formation begins with glomerular filtration

45
Q

Filtrate is termed

A

Glomerular filtrate or ultrafiltrate

46
Q

Glomerular filtrate contains ____

Exception to this

A

all plasma constituents except plasma proteins (albumin) and cellular elements (RBCs)

Exception to this = substances (like Ca and fatty acids) that are bound to plasma proteins

47
Q

Renal blood flow vs. Renal plasma flow

A

RBF = the volume of blood delivered to the kidneys per unit of time

RPF = volume of blood plasma delivered to the kidneys per unit time

48
Q

GFR =

A

The volume of fluid filtered from the glomerular capillaries into the Bowman’s capsule per unit of time

49
Q

GFR is determined by the

A

1 Glomerular capillary filtration coefficient

2 Net filtration force (pressure)

50
Q

Is GFR a fixed rate?

A

No - but it is subject to physiological regulation - which causes a change in the net filtration forces due to neural and hormonal input to the afferent and efferent arterioles

51
Q

Net filtration force (pressure) =

A

the movement of fluid across a capillary wall is determined by the net filtration force (pressure) that is equal to the sum of the starling forces

  • Hydrostatic force (pressure)
  • Colloid osmotic force (pressure)

Note - these are the starling forces that control fluid movements across the capillary beds

52
Q

Hydrostatic Force (pressure) =

A

In the capillary, it is the force that is exerted by a fluid against the wall of capillary

53
Q

Colloid Osmotic pressure (oncotic pressure) =

A

In the capillaries, it is the pressure exerted by proteins in the plasma

54
Q

Summary of forces causing fltration by the glomerulus capillaries - Favoring filtration

A

Glomeular hydrostatic pressure

55
Q

Summary of forces causing fltration by the glomerulus capillaries - Opposing filtration

A

Glomerular colloid osmotic pressure

Bowmans capsule pressure

56
Q

Summary of forces causing fltration by the glomerulus capillaries - Net filtration pressure =

A

Glomeruluar hydrostatic pressure (-) Bowmans capsule pressure (-) glomerular oncotic pressure

57
Q

Effect of changes in resistance on GFR - VC of afferent arteriole

A

DECREASED GFR

58
Q

Effect of changes in resistance on GFR - VC of efferent arteriole

A

INCREASED GFR

59
Q

Effect of changes in resistance on GFR -VD of efferent arteriole

A

DECREASED GFR

60
Q

Effect of changes in resistance on GFR - VD of afferent arteriole

A

INCREASED GFR

61
Q

How long does it take to filter the entire plasma volume - A standard person has about 3.5 L of plasma and GFR is 125 ml/min

A

3500 ml of plasma/125 ml/min filtered = 28 minutes

62
Q

How many times a day would a standard person filter 100% of the plasma (if it takes 28 minutes to filter the entire plasma volume)

A

24 x 60 minutes / 28 minutes = 51 times

63
Q

Sodium re absorption along the nephron

A

Filtered = 100% freely
Re absorbed = 98-99%
Excreted = 1-2%

Urine = 1-2%

64
Q

Amino acid re absorption along the nephrone - how much is exccreted in urine

A

0%

65
Q

Glucose re absorption along the nephron - how much excreted in urine

A

0%

66
Q

Tubular secretion - what is secreted

A 
Organixc anions and cations
Para amino hippurate
Urea
Potassium
Proton

Urea, K, Proton = are re absorbed and secreted before to be excreted

67
Q

Organic cations and anions - endogenous and drug - Renal secretion of a substance refers to

A

Direction of flow, from the peritubular capillary (blood) into the lumen fo the nephron

68
Q

Organic cations and anions - endogenous and drug - Many of the organic compounds are

A

End product of the metabolism that circulates in the plasma or drugs

Also - many are bound to plasma proteins and are not freely filtered

69
Q

Organic cations and anions - endogenous and drug - Excretion by filtration alone eliminates only a small portion of these potentially toxic substances from the body - Secretory mechanisms are

A

powerful and remove all the organic compounds entering the kidney from the plasma

The transport mechanisms have low specificity - several organic compounds compete for the transport pathway

70
Q

Organic cations and anions secretion along the nephron

A

Filtered = not freely
Secreted - 100% from proxmila tubule
Excreted = 100%

71
Q

Potassium re absorption and secretion along the nephron

A

Filtered = freely
Re absorbed = 99%
Secreted = 1%
Excreted = 15%

72
Q

Tubular reabsorption is highly

A

Selective!

Kidney regulates the rate of tubular re absorption of solutes independently of one another

This capacity of the kidney is essential for precise control of composition and volume of urine

Selectivity of tubular re absorption is due to the characteristics of the renal tubule cells

73
Q

Re absorption of filtered fluid and solutes form the tubular lumen into the blood

A

Mvmnt from lumen of nephron into cell
Mvmnt from cell into itnerstitial fluid
Mvmnt from interstitium to the capillary

74
Q

Transcellular pathway - primary and secondary active transport

A

1 - Metabolic substrates (like glucose, amino acids and fatty acids)
2 - All of these various fuels are converted in energy ATP
3 - Electrochemical gradients such as low cell Na and negative voltage drive a whole array of transport processes

75
Q

Net re-absorptive forces - Hydrostatic and colloid osmotic forces
Favoring re absoprtion =

A

Colloid osmotic pressure in peritubular capillary

Hydrostatic pressure in the renal interstitium

76
Q

Net re-absorptive forces - Hydrostatic and colloid osmotic forces - Opposing re absorption

A

Hydrostatic pressure in peritubular capillary

Colloid osmotic pressure in renal interstitium

77
Q

Pathogenesis of edema in nephrotic syndrome - due to

A

A disturbance in the forces that normally partition fluid into the various sub compartments of extracellular fluid space
The blood volume remains contracted even though extracellular fluid volume is expanded

Glomerular injury - proteinuria - reduced colloid osmotic pressure - edema - reduced plasma volume

Original problem is at level of glomerulus

Practice Topics/PID Exam 7 (9 decks)

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