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Applied Physiology > Renal physiology > Flashcards

Renal physiology Flashcards

1
Q

What is the difference between the male and female excretory system?

A

the males have a prostate gland

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2
Q

Kidneys

A

two bean shaped organs that produce urine

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3
Q

Urethra

A

transports urine from the bladder out of the body
-external urethral sphincter (skeletal muscle)
-Males: prostatic urethra, membranous urethra, penile urethra
-external urethral orifice

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4
Q

Ureter

A

transports urine toward the urinary bladder
-extension of the renal pelvis
-retroperitoneal
-travels posterior to the bladder and enters at the base

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5
Q

Urinary bladder
-function
-volume
-trigone
-wall
sphincters

A

temporarily stores urine
-can stretch to hold up to 700-800 mL of fluid
-fullness felt at 500 mL
-trigone– triangle made of ureters and urethral opening (common sit for infection)
-detrusor muscle: 3 layers of smooth muscle make up the wall
-internal urethral spincter

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6
Q

Where are the kidneys located

A

-retroperitoneal between T11 and L3
-right side is slightly lower
-protected by fibrous renal capsule and perirenal fat capsule

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7
Q

renal hilum

A

made up by the renal artery, renal vein and renal pelvis

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8
Q

What are the 3 layers of the kidney

A

outer fibrous renal capsule
renal cortex
inner renal medulla

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9
Q

Renal medulla
-major calyx:
-renal pelvis

A

has the renal pyramids
-3D cones leading to a mini calyx
-major calyx: where 2 of more minor calyces merge
-renal pelvis: where the major calyx empties

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10
Q

What are the functions of the kidney

A

-homeostasis of Ca++ the vitamin D synthesis
-produce erythropoietin to stimulate RBC production
(also produces thrombopoietin along with the liver)
-regulates blood volume, pressure, and solute concentration
-maintains fluid and electrolyte balance
maintain acid/base balance
removes metabolic wastes

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11
Q

Nephron

A

-functional microscopic unit of the kidney (100 of 1000 to millions in a kidney)
-two major parts:
1. renal corpuscle
2. renal tubule

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12
Q

Renal corpuscle

A

glomerulus, capsule and renal tubule

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13
Q

renal tubule:

A

proximal convoluted tubule to end of distal convoluted tubule

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14
Q

Golmeulus

A

-filtration membrane
-sits inside the capsule
-in renal cortex
-afferent arteriole delivers blood to the glomerulus
-efferent arteriole takes blood out of the corpuscle

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15
Q

Glomerular capsule

A

-bowmnas capsule
-catches whatever fluid is filtered out of the blood
-drains into the renal tubule
-filtration occurs here

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16
Q

Renal tubule:
-anatomy of tissue
-the tubules included

A

-hollow tube lined with simple epithelium
-proximal convoluted tubule (PCT): connected to glomerular capsule
-nephron loop/loop of Henle: descends into the renal pyramid
-distal convoluted tubule (DCT): ascends back into the renal cortex

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17
Q

What does the DCT sit close to?

A

afferent and efferent arterioles
-macula densa cells
-juxtaglmoerular cells
-juxtaglomeular apparatus

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18
Q

Flow of urine

A

1.Glomerular capsule: filtration of waster, water, and nutrients
2. PCT: reabsorption/secretion
3. Nephron loop
4. DCT
5.collecting duct (now considered urine)
6. minor calyx
7. major calyx
8. renal pelvis
9.ureter

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19
Q

Describe the blood flow to a nephron

A

-renal artery enters kidney
-afferent arteriole enters glomerulus
-efferent arterial leaves glomerulus
-peritubular capillaries wrap around renal tubules
-venules
-renal vein exits kidney

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20
Q

Describe vascular resistance in the nephron

A

the more proximal (closer to glomerular) has larger vascular resistance)
-renal artery has the highest
renal vein has the lowest

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21
Q

describe the make up of urine

A

-95% water
-2% urea
-2.8% salts and ions
0.2% creatine, ammonia, and uric acid

22
Q

Filtration

A

-passive process that is driven by blood pressure that moves materials from capillaries to tubules
-the greater the pressure in the afferent arterioles (increased diameter) results in more dilation
-materials filtered: nitrogenous waster (ammonia, urea, uric acid, creatinine), water, amino acids, glucose, salts

23
Q

reabsorption

A

-begins at PCT and peritubular capillaries and continues along the renal tubule
-100% of glucose, amino acids, and some mineral salts are actively transported from tubules back into the capillaries
-99% of water is reabsorbed
-remaining in urine:
~nitrogenous waster, salts, 1% of water that was filtered

24
Q

Secretion

A

-wastes that remain in the blood are removed (ie: nitrogenous wastes that were too large from filtration, excess H and K)
-movement from peritubular capillaries into tubules
-crucial for maintain pH homeostatsis (7.35-7.45 Is normal range)

25
Q

acidosis

A

below 7.35: leads to disorientation the could lead to coma

26
Q

alkalosis

A

above 7.45 – hyper excitability of PNS and spontanseous muscle contractions leading to spasms, convulsions and potentially death

27
Q

Micturition reflex

A

-stretch receptors in the bladder wall (afferent)
-when they stretch from the bladder filling they depolarize
-when it is filled it will send signals to the sacral integration center
-parasympathetic neurons tell detrusor muscles in the wall of the bladder(effector) to contract and sphincter (effect) to relax

28
Q

describe the micturition control

A

-afferent also sends information to the pons and cerebrum
-sends signals to sacral motor neurons
-either inhibits/relaxes the sphincter

29
Q

describe the neural control of micturition

A
  1. sensory neurons in the bladder wall will sense the stretch in the bladder and send information to the sacral spinal cord and to the lower thoracic and upper lumbar region of the spinal cord
  2. sympathetic fibers send information to the thoracolumbar ganglion that then send information via hypogastric nerve that inhibits relaxation of the internal urethral sphincter and prevents contraction of the wall of the bladder
  3. the first sensory nerve also sends information across the sacral spinal cord where it synapses with a somatic motor fiber of pudendal nerve to control external urethral sphincter to contract
  4. information from the pons and pontine storage center also sends information to the pudendal nerve to stop the relaxation of the external sphincter
30
Q

effects of aging on the urinary system

A

-size of kidneys and functioning nephrons decrease by 1/3 by 80 years of age
-GFR decreases (this tells us about kidney functioning)
-reserve capacity decreases (this is the ability to hold your bladder)
-drugs are cleared less effectively and remain in the system for longer
-responsiveness to ADH decreases (this causes reabsorption of water)
-men: BPH (Benign prostatic hyperplasia) where the prostate becomes harder and prevents flow
-women: incontinence due to hormonal changes and child birth stretching the pelvic floor

31
Q

Describe water in the body

A

-body is 50-75% water
-it sits in two compartments:
1. 65% in the intercellular
2. 35% sits in the extracellular fluid outside of the cells
-water retention can happen if you eat to much salt or drink too much water and your body cant get rid of it

32
Q

What happens when the blood concentration of solutes is higher than normal

A

the kidneys will put out smaller volumes of concentration urine (not as much water)

33
Q

What happens when the blood concentration of soluates is lower than normal

A

the kidneys will put out large volumes of diluted urine

34
Q

Hormones that decrease urine production

A

ADH (vasopressin)
aldosterone
-renin-angiotensin-aldosterone system

35
Q

hormones that increase urine production

A

ANP (ANH) - atrial natriuretic hormone/peptide

36
Q

ADH

A

-produced by hypothalamus and stored in the posterior pituitary
-released when blood sodium or BP decreases baroreceptors
-targets distal convoluted tubules and collecting ducts in kidney making them more permeable which allows water to move more freely and reabsorbed
-kidneys conserve water but decrease sodium concetration (same amount but more dilute)
-under negative feedback control - once Na+ levels drop in the hypothalamus stops producing ADH

37
Q

Aldosterone

A

-produced in adrenal cortex
-targets kidneys and determines if urine is concentrated or dilute
regulates active transport of Na+ and K+ and causes more sodium to be transported from the tubule of the nephron to the peritubular capillaries and more K to be secreted (Na+ and K+ always move in opposite directions)
-juxtaglomerular apparatus regulates its secretion by monitoring blood traveling through the afferent arteriole and then stimulates adrenal cortex
-negative feedback control (once K blood levels drop it inhibits release of aldosterone from AC)

38
Q

Juxtaglomerular complex

A

-moniters blood traveling through the afferent arteriol
-secretes renin when:
~blood falls
~sodium levels in blood fall
~K+ levels in blood rise
-renin starts a series of events that result in aldosterone being released

39
Q

describe the renin-angiotensin-aldosterone system

A
  1. renin is released from juxtaglomerular apparatus
  2. targets liver to convert protein to angiotensin 1
  3. ACE (angiotensin converting enzyme) produced by lungs and kidneys converts angiotensin 1 to angiotensin 2
  4. angiotensin 2 targets the adrenal cortex to secrete aldosterone
  5. aldosterone causes urine output, maintain Na++ levels in the blood and decreases K+ levels and increases BP
40
Q

direct effects of angiotensin 2

A

-causes arteries to constrict and increases BP
-decreases GFR to retain water
increases thirst

41
Q

describe effects of ADH

A

-mediates insertion of aquaporins into the nephron collecting ducts to reabsorb more water
-causes arteries to constrict to counter act the drop in BP from low blood volume

42
Q

describe the affects of aldosterone

A

causes nephron distal tubules to reabsorb Na+ in which water will follow (K+ will be excreted)

43
Q

how does medication that decreases BP affect the RAAS

A

it will disrupt it since the system tries to increase BP

44
Q

ANH

A

-atrial natriuretic hormone
-produced by cells in the right atrium when BP is too high
-increases urine production and inhibits water retension

45
Q

how does ADH increase urine production

A

-dilates afferent arterioles while constructing efferent arterioles which increase glomerular pressure and GFR (more blood in there for longer)
-inhibits the production of renin by juxtaglomerular apparatus which inhibits water and Na++ reabsorption
-inhibits ADH secretion from posterior pituitary which limits water conservation
-inhibits Na+ reabsorption in the nephron directly

46
Q

Describe negative feedback response to low effective circulating volumes

A

PICTURE

47
Q

describe negative feedback response to low effective circulating volumes

A

PICTURE

48
Q

describe the autonomic control of the kidneys
-sympathetic

A

-sympathetic neurons cause the constriction of kidney afferent arterioles during heavy exercises or acute conditions like blood loss or decrease in bp (fluid would be retained
-GFR decreases
-blood diverted from the kidneys to brain, heart, and skeletal muscle

49
Q

describe the autonomic control of the kidneys
-parasympathetic

A
50
Q

Collecting duct

A

-collecting duct: several DCT empty and then empties that into the minor calyx

Applied Physiology (15 decks)

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