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physiology > renal physio > Flashcards

renal physio Flashcards

1
Q

what is the primary goal of the kidney

A

maintain homeostasis and renal function

- constantly changing and dynamic

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2
Q

what does the kdiney regulate exactly

A
  • water and salt balance (Na, K, Ca); balancing intake and excretion
  • remove metabolic waste, drugs, other foreign chemicals
  • gluconeogenesis
    Production of hormones
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3
Q

what hormones are made by he kidney

A

Erythropoietin
Renin
1,25-dihydroxyvitamin D

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4
Q

what is the roll of erythropoietin

A

acts in the bone marrow to stimulate synth of new erythrocytes

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5
Q

what is the roll of renin

A

Part of renin-angiotensin-aldosterone cascade to regulate blood pressure

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6
Q

what is the roll of 1,25-dihydroxyvitamine D

A

regulate calcium absorption

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7
Q

does the kidney process and see a lot of the water that the body has

A

only a small portion/compartment of the total body water

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8
Q

do changes in one compartment in the body change water presence in the other parts of the body

A

can change other compartments of the body

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9
Q

what is end stage renal disease

A

a reduced ability to elimiate nitrogenous wastes (urea) and excess nitrogen is converted to ammonium
- extra ammonium has direct effects on health
= alkalized blood

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10
Q

what are the signs and symptoms of End stage renal disease

A

Ammonia breath
Gingival enlargement
xerostomia
tooth problems (premature loss, narrowing pulp chamberes, necrosis beneath filling/crowns

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11
Q

what are the contraindication for ESRD patients

A 
Nephrotoxic drugs (tetracycline, acyclovir, aspirin, NSAIDS)
Increased susceptibility due to descruction of platelets
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12
Q

where is the kidney located

A

retroperitoneal oran

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13
Q

what is the functional unit of the kidney

A

Nephron

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14
Q

what part of the nephron does filtration

A

renal cortex

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15
Q

what part of the kidney does concentration and collection of urine

A

Renal medulla

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16
Q

how many nephrons are in the kidney

A

1.2x10^6

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17
Q

what is a nephron made of

A 
renal corpuscle (glomerulus+ capsule)
proximal (convoluted) tubule
Loop of Henle
Distal (Convoluted) Tubule
Collecting duct ( shared by multiple nephrons
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18
Q

how thick is the tubulues of the kindey

A

one cell layer

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19
Q

what are the two types of nephrons based on the location of the renal corpuscle and length of the medullary tubules

A

Superficial or cortical nephrons

Juxtamedullary nephrons

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20
Q

what is filtration

A

Solute and water pass from blood into the tubular fluid in the renal capsule (Bowman’s space)

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21
Q

where does filtration occur

A

Glomerular capillaries

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22
Q

what percent of the plasma is filtered

A

15-20%

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23
Q

what happens to the blood after it leaves the glomerular capillaries

A

Flows into peritubular capillaries (vasa recta)

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24
Q

what is secretion

A

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

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25
Q

what is reabsoprtion

A

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

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26
Q

what are the 3 renal processes to regulate blood composition

A

Filtration
Secretion
Reabsorption

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27
Q

what does the composition of tubular fluid vary with

A

The location of the tube

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28
Q

what can happen to filtered subsances

A

secreted and no reasborbed
some secreted and some reasborbed
completed reabsorbed

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29
Q

what is a renal corpuscle made of

A

glomerulus and renal capsule

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30
Q

where does filtration occur

A

glomerulus (dense capillary bed)

31
Q

what is the roll of the renal capsule

A

Collect the filtrate from the blood entering vai the afferent arterioles

32
Q

what regulates flood flow throught the glomerulus

A

Smooth msucel contraction in afferent or efferent arterioles
response of the JUxtaglomerular apparatus
SNS

33
Q

where is the juxtaglomerular apparatus

A

intersection of the macula densa and dital tubule with afferent and eferent arterioles

34
Q

what is the importance of the juxtaglomerular apparatus

A

secretes renin

35
Q

what does renin do

A

regulates systemic blood pressure and glomerular blood flow

36
Q

what drains the renal capsule

A

proximal tubule

37
Q

what does the proximal tubule do

A

reabsorb 2/3 of filtered salt and water

reabsorbed all filtered flucosa and amino acids

38
Q

where do diurectics act

A

some act in the proximal convoluted tubule
very powerful diuretics work in the loop of henle
some in distal convoluted tubule
some in collecting duct

39
Q

what are the 3 limbs of the loop of henle

A

Thin descending limb
thin ascending limb
thick ascending limb

40
Q

where does countercurrent multiplication done

A

in the loop of henle

41
Q

what is the importance of the loop of henle

A

needed to produce concentrated urine but loop itself actually produces dilute filtrate

42
Q

what drains the loop of henle

A

distal convoluted tubule

43
Q

what happens inthe distal convoluted tubules

A

Contrinued reabsorption of solute

regulate ca

44
Q

what is the action of the colecting duct

A

collect fluid from multiple nephrons

45
Q

where does the colecting duct extend

A

from cortex through the medulla

46
Q

what does the collecting duct do

A

regulates Na, K, and H2O

47
Q

what is renal clearance

A

rate of excretion of a solute through the kidney as a unit of time
- the volume of plasma from which all of a particular substance is removed to the urine

48
Q

what is the imporance of renal clearance

A

monitor renal function(glomerular filtration rate)

49
Q

what is glomerular filtration rate

A

amount of blood filtered by the kidney in unit time

50
Q

when can Glomerular filtration rate be used

A

the substance must be free filtered by glomerulus
substance is not sereted
substance is not reabsored

51
Q

what is Glomerular iltration rate in a normal kidney

A

125ml/min for females

90-140ml/min in males

52
Q

what substances are used to meaure renal cleance

A

Inulin

Creatinine

53
Q

what is inulin

A

A small polysaccharide freely filtered and not secreted orabsorbed

54
Q

what is creatinine

A

Product of muscle metabolism, freely filtered, not reabsorbed, almost no secretion

55
Q

what is the normal and unnormal creatinine level

A

less han 1+- .5mg/dl normal

greater than 10= dialysis

56
Q

what allows shit to leave th Glomerular capilaries

A

Fenestration

57
Q

what is the space between the podocytes of the capillariation

A

filtration slits

58
Q

what is not in the filtrate

A

Acellular
protein free
anything greater than 42 angustrum

59
Q

what is freely filtered

A

less than 20 angstrum
glucose
Salts
Amino acids

60
Q

how does charge affect glomerular filtration

A

Basal lamina is negative so hard to filter moderately sized, negative solute

61
Q

what causes filtration

A

pressure differences between blood in the capillaries and fluid in the capsule (starling forces)

62
Q

what are the 2 sources of pressure in the filtration

A

Hydrostatic pressure

Oncotic pressure

63
Q

what is hydrostatic pressure

A

pressure due to fluid

64
Q

what is oncotic pressure

A

pressure due to solutes(including those not dissolved

65
Q

is hydrostatic pressure greater in the capilaries or capsule

A

greater in the capillaries( increases filtration)

66
Q

is oncotic pressure greater in the capillaries greater or capsule fluid

A

greater in the capillaries (decreases filtration)

67
Q

what does net filtration pressure favor

A

filtration from blood into capule fluid

68
Q

what changes glomerular filtration rate

A

Blood flow into and out of glomerulues

Pressure gradient between capillary blood and tubular fluid

69
Q

does renal blood flow change with systemic blood pressure

A

No, remains fairly constant

70
Q

what are the methods of autoregulation of blood through the glomerulus

A

Myogenic mechanism

Tubuloglomerular feedbackk

71
Q

what is the myogenic mechanism for autoregulation of the bloodflow through the glomerulus

A

Vascular smooth muscle contracts when stretched and relaxes when not stretched
- has inverse effects on afferent and efferent arterioles

72
Q

what is the tubuloglomerular feeback mechanism for autoregulation

A

feedback from the justaglomarular apparatus adjusts afferent arteriole diameter and Glomerular filtration rate

73
Q

what is the tubuloglomerular feedback mechanism in response to increase Glomerular filtration rate

A
  1. increase in GFR
  2. increase NaCl in tubular fluid
  3. increase NaCl at macular densa
  4. increased resistance in afferent arterioles
  5. decreased GFR
74
Q

what are the extrinsic factors that regulate on renal blood flow and glomerular filtration rate

A 
Diet
Dehydration 
Hemorrhage
sympathetic nervous system
Angiotensin II
aldosterone
Natriuretic peptide

physiology (32 decks)

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