Renal Physiology 1 Flashcards
1
Q
Origin of:
* Urea
* Creatinine
* Uric Acid
* Bilirubin
A
- Urea: Amino Acids
- Creatinine: Creatine Phosphate
- Uric Acid: Nucleic Acid
- Bilirubin: Hemoglobin
2
Q
Creatinine Levels
1. Elderly Patients
2. Young Patients
A
1 < 2
Low Creatinine Levels in the elderly
3
Q
- Liver Malfunction
- Creatinine
A
Increase in 1 will Increase in 2
4
Q
- Sodium Intake
- Renal Excretion
A
Increase in 1 will increase 2
5
Q
In renal failure, there is a tendency for __ due to impairment in excretion by the kidneys
A
Hyperkalemia
Potassium is not secreted by the impaired kidneys
6
Q
- K+ Ions
- Arrhythmia
A
Increase in 1 will increase 2
7
Q
- Na+ Concentration
- Sensorium derangement in CNS
A
Increase in one will decrease 2
Hyponatremia causes derangement of sensorium in the CNS
8
Q
Long Term Regulation of BP
1. Na+ & H2O secretion
2. RAAS
RAAS - Renin Angiotensin Aldosterone System
A
1 > 2
Short term si Renin
9
Q
In regulating acid-base balance the kidneys:
* Excrete __
* Reabsorb __
A
- Excretes Acid
- Reabsorb Bicarbonate
10
Q
RBC Production
1. Hyperoxia
2. Hypoxia
A
1 < 2
11
Q
- CO2
- RBC Production
A
Increase in 1 will increase 2
12
Q
Erythropoietin Production
1. Hyperoxia
2. HYpoxia
A
1 < 2
13
Q
Erythropoietin Production
1. Non Smoker Patient
2. Smoker Patient
A
1 < 2
14
Q
Why is a smoker patient more prone to stroke?
A
Smoking = More CO2 and Less O2 (Hypoxia) = Increased RBC Production = Blood becomes more viscous = stroke
15
Q
- Kidney Diseases
- RBC Production
A
Increase in 1 will Decrease 2
16
Q
- 1,25 - dihydroxyvitamin D3
- Ca+ Reabsorption by the GIT
A
Increase in 1 will Increase 2
17
Q
Site of urine collection from each pyramid
A
Papilla
18
Q
Pathway of renal blood flow
A
Renal a => Interlobar a => Arcuate a => Interlobular a +> Afferent at => Glomerular Capillaries => Efferent at => PTC => vv
19
Q
Pressure in
1. Glomerular C
2. Peritubular C
A
1 > 2
60 > 13
20
Q
Filtration
1. Glomerular C
2. Peritubular C
A
1 > 2
21
Q
Reabsorption
1. GLomerular C
2. Peritubular C
A
1 < 2
22
Q
Hydrostatic Pressure can be regulated by the kidneys by adjusting the __
A
Resistance of the afferent and efferent glomerular arterioles
23
Q
Pathway of Urine within the nephron
A
Glomerulus (bowman’s capsule) => PCT (cortex) => Loop of Henle (Dips into Medulla) => Macula Densa => DCT => CCT => MCD => Renal Papillae => Renal Pelvis
24
Q
Length of Loops of Henle
1. Cortical Nephron
2. Juxtamedullary Nephron
A
1 < 2
25
Density of Nephrons
1. Cortical
2. Juxtamedullary
1 > 2
26
Give the blood supply of the following
* Cortical N
* Juxtamedullary N
* Cortical: Peritubular Capillaries
* Juxtamedullary: Vasa Recta
27
Part of the bladder that initiates micturition reflex
Posterior Urethra
28
Contraction of __ is a major step in emptying
Detrusor muscle
29
Principal nerve supply of the bladder
* connects w which SC segments through which plexus
Pelvic Nerves
* connects with S2 - S4 through the Sacral P
30
sensory receptors of the pelvic nerves detect the --
degree of stretch (mostly of the posterior urethra)
31
Efferent fibers of the pelvic nerves are what type of fibers
* innervate the --
Parasympathetic fibers
* innervate the detrusor m to contract the bladder for urination
32
Which nerve is inhibited to relax the External Bladder Sphincter => urination
* type of fibers and origin of this nerve
Pudendal Nerve
* Skeletal Motor Fibers from s1 - s4
33
Sympathetic nerves are received by the bladder through which nerve?
* connects with which segment of the spinal cord
* This is mainly for --
Hypogastric n
* connects with L2
* For Vasoconstriction
34
Sensory fibers that also pass through the sympathetic nerves are responsible for
Sensation of Fullness and Pain
34
Pelvic nerves (parasympathetics) innervation
* Sensory: Degree of Stretch of the Pos Urethra
* Motor: Contraction of bladder (detrusor m)
35
1. Presence of Ureteral Stone
2. Urine Output
| Same side lang
Increase in 1 will decrease 2
| if not same side na ureter and kidney C ang sagot
36
1. Presence of Ureteral Stone
2. GFR
Increase in 1 will decrease 2
37
Creatinine
1. Filtration Rate
2. Excretion Rate
1 = 2
Filtration only
38
Urea
1. Filtration Rate
2. Excretion Rate
1 = 2
39
Uric Acid
1. Filtration Rate
2. Excretion Rate
1 = 2
40
NaCl
1. Filtration Rate
2. Excretion Rate
1 > 2
Partial Reabsorption
41
Bicarbonate
1. Filtration Rate
2. Excretion Rate
1 > 2
Partial Reabsorption
42
Amino Acids
1. Reabsorption Rate
2. Excretion Rate
1 > 2
Complete Reabsorption
43
Glucose
1. Reabsorption Rate
2. Excretion Rate
1>2
Complete Reabsorption
44
Organic acids and bases
1. Reabsorption Rate
2. Excretion Rate
1 < 2
No reabsorption, just secretion and excretion
45
Foreign Substances
1. Reabsorption Rate
2. Secretion Rate
1 < 2
46
Drugs
1. Reabsorption
2. Secretion
1 < 2
47
The rate at which substances are excreted in the urine depends on which processes
* Filtration
* Secretion
* Reabsorption
48
Excess Na+
1. Reabsorption
2. Excretion
1 < 2
49
Plasma volume
3L
50
Glomerular Filtration Rate
180 L/day
51
Micturition Reflex
* Stimulus:
* Afferent:
* Efferent:
* Stimulus: Stretch of the bladder wall (pos. urethra)
* Afferent: Sacral Nerves to S2 - S4
* Efferent: PNS fibers of the Sacral Nerves
52
Micturition centers in the brain
1. Brainstem - Pons
2. Cerebral Cortec
53
Facilitative and inhibitory centers of micturition
Brainstem - Pons
54
Mainly inhibitory but can be excitatory centers of micturition
Cerebral Cortex
55
Higher Centers control micturation by: (3)
1. Partially inhibiting micturation reflex
2. Prevent micturation by tonic contraction of external us
3. Inhibit external us to initiate micturation when proper time comes
56
Inhibition of this nerve to elicit urination
Pudendal Nerve
57
Composition of Glomerular Filtrate
* Protein Free
* Devoid of Cellular Elements (RBC)
* Without Ca+ and Fatty Acids
58
Structures in the Glomerular Capillary that is richly endowed w fixed negative charges that repel the passage of plasma proteins
* These found on which specific layers of the capillary?
* Fenestrae - Endothelium
* Proteoglycan Fibrilae - Basement Membrane
* Slit Pores - Epithelial cells/Podocytes
59
1. Size of Solutes
2. Filterability of Solutes
Increase in 1 will Decrease 2
60
1. Plasma Proteins
2. Glomerular Filtration
Increase in 1 will decrease 2
61
Filterability in the Glomerular Capillary
1. Sodium
2. Myoglobin
1 > 2
62
Filterability
1. Glucose
2. Albumin
1 > 2
63
Filterability
1. Glucose
2. Inulin
1 = 2
64
Arrange the following acc to molecular size
* glucose
* water
* Albumin
* inulin
* myoglobin
* sodium
1. water
2. Sodium
3. Glucose
4. Inulin
5. Myoglobin
6. Albumin
65
Filtration of equal molecular size
1. Positive Charge
2. Negative Charge
1 > 2
66
Filtration
1. Glomerular Hydrostatic Pressure
2. Bowman's Capsule Hydrostatic Pressure
1 > 2
67
FIltration
1. Glomerular Oncotic Pressure
2. Bowman's Capusle Oncotic Pressure
1 < 2
68
1. Bowman's Hydrostatic Pressure
2. Filtration
Increase in 1 will Decrease 2
69
Compute for the net filtration pressure
Glomerular Hydrostatic: 60
Bowman's Colloid Osmotic: 0
Bowman's Hydrostatic: 18
Glomerular Colloid Osmotic: 32
Glomerular H - Bowmans H - Glomerular O + Bowman's O
60 -- 18 -- 32 + 0 = **+10 mmHg**
70
1. Kf
2. GFR
| Glomerular Capillary Filtration Coefficient = Kf
Increase in 1 will Increase 2
71
1. Density of Functional Glomerular Capillaries
2. GFR
Increase in 1 will Increase 2
| 1 increases Kf = increase in 2
72
1. Thickness of the Glomerular Capillary Membrane
2. GFR
Increase in 1 will Decrease 2
| 1 decreases Kf = decreased 2
73
1. Thickness of the Glomerular Capillary Membrane
2. Kf
Increase in 1 will Decreas 2
74
1. Hydraulic Conductivity
2. GFR
Increase in 1 will Increase 2
| decrease in 1 = low Kf = low gfr
75
1. Hydraulic Conductivity
2. GFR
Increase in 1 will Increase 2
| decrease in 1 = low Kf = low gfr
76
1. Diabetes
2. Kf and GFR
Increase in 1 will Decrease 2
77
1. Hypertension
2. GFR
Increase in 1 will Decrease 2
78
1. Kidney Stone obstruction
2. Bowman's Capsule Hydrostatic Pressure
Increase in 1 will Increase 2
79
1. Kidney Stones obstruction
2. GFR
Increase in 1 will Decrease 2
| Due to increase in bowman's capsule hydrostatic pressure
80
1. Arterial Plasma Colloid Osmotic Pressure
2. GFR
Increase in 1 will Decrease 2
| Due to increase in glomerular colloid osmotic pressure
81
1. Filtration Fraction
2. Glomerular Capillary Oncotic Pressure
Increase in 1 will Increase in 2
82
1. Filtration Fraction
2. GFR
Increase in 1 will Decrease 2
| increase in 1 will increase glomerular oncotic pressure = increase 2
83
1. Renal Plasma Flow
2. FF
Increase in 1 will decrease 2
| decreased renal plasma flow will increase ff
84
1. Renal Plasma Flow
2. Glomerular Oncotic Pressure
Increase in 1 will decrease 2
| malakas ang flow = less filtrate = low 2
85
1. Renal Plasma Flow
2. GFR
Increase in 1 will Increase 2
86
1. Arterial BP
2. GFR
Increase in 1 will Increase 2
| Increase 1 = increased glomerular hydrostatic p = high gfr
87
1. Afferent Arteriolar Resistance
2. GFR
Increase in 1 will Decrease 2
| u constrict the entrance so wala makapasok = nothing to filter
88
GFR during
1. Highly constricted efferent arteriole
2. Moderately constricted efferent arteriole
1 < 2
| 2 = increased GC hydrostatic p = increase in GFR
89
1. Highly constricted efferent arteriole
2. GC Colloid Osmotic P
Increase in 1 will increase 2
| constricted = low plasma flow = increased 2
90
1. Highly constricted efferent arteriole
2. FF
Increase in 1 will Increase 2
| constricted = low plasma flow = increased 2
91
1. Afferent Arteriole Dilation
2. Hydrostatic Pressure
3. GFR
Increase in 1 will Increase 2 and 3
92
1. Efferent Arteriole Dilation
2. Hydrostatic Pressure
3. GFR
Increase in 1 will Decrease 2 and 3
93
1. Efferent Arteriole Constriction
2. Hydrostatic Pressure
3. GFR
Increase in 1 will Increase 2 and 3
94
1. Efferent Arteriole Constriction
2. Renal Blood Flow
Increase in 1 will Decrease 2
95
1. ATP Production
2. Sodium Reabsorption
Increase in 1 will Increase 2
96
1. O2 consumption
2. Sodium Reabsorption
Increase in 1 will increase 2
ATP is needed for Na reabsorption = O2 is needed for ATP synthesis
97
1. Pressure Gradient
2. RBF
Increase in 1 will Increase 2
98
1. Total Renal Vascular Resistance
2. RBF
Increase in 1 will Decrease in 2
99
Values of Autoregulation
80 - 170 mmHg
100
Blood flow to
1. Renal Medulla
2. Renal Cortex
1 < 2
101
GFR
1. 75 mmHg
2. 180 mmHg
1 < 2
102
GFR
1. 120 mmHg
2. 180 mmHg
1 < 2
103
Structure that detects the amount of NaCl and relates it to the amount f fluid that passes through
Macula Densa
104
1. Amount of NaCl in the Macula Densa
2. Amount of Fluid present
Increase in 1 will Increase 2
105
1. Macula Densa NaCl
2. Afferent Arteriole Resistance (constriction)
Increase in 1 will Increase 2
106
1. Drop in Macula Densa NaCl
2. Afferent Arteriole Resistance (constriction)
3. Glomerular Hydrostatic P
Increase in 1 will Decrease 2 and Increase 3
107
1. Drop in Macula Densa NaCl
2. GFR
Increase in 1 will Increase 2
108
Renin Release
1. Decreased Macula Densa NaCl
2. Increased Macula Densa NaCl
1 > 2
109
1. Drop in Macula Densa NaCl
2. Efferent Arteriole Resistance
3. Glomerular Hydrostatic Pressure
4. GFR
Increase in 1 will Increase 2, 3, 4
110
1. Protein Intake
2. RBF & GFR
Increase in 1 will Increase 2
111
1. Hyperglycemia
2. Afferent Arteriole Resistance
Increase in 1 will Decrease 2
maraming glucose ir reabsorb with NaCl = low NaCl detected by Macula Densa = Dilation to increase GFR
112
1. Protein Meal/ Glucose
2. Macua Densa NaCl
Increase in 1 will Decrease 2
| reabsorbed NaCl with glucose = not sensed by MD
113
1. Heavy Metal Poisoning
2. Macula Densa NaCl
Increase in 1 will Decrease 2
we need to excrete heavy metal = less reabsorption = more NaCl sensed by MD
114
1. Heavy Metal Poisoning
2. GFR
Increase in 1 will Increase 2
kasi need sya ma excrete asapp
115
Glomerular Hydrostatic Pressure with constriction of
1. Afferent at
2. Efferent et
1 < 2
