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AUBF > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

The functional units of the urinary system.

A

Nephrons

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2
Q

The smallest units that are capable of performing the processes involved in urine formation

A

Nephrons

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3
Q

They number from 1 - 1.5 million per kidney (total of 2 – 3 million)

A

Nephron

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4
Q

Types of nephron according to location:

A

Cortical and Juxtamedullary Nephrons

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5
Q

This is the outer layer wherein Cortical nephrons are located

A

Cortex – outer layer

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6
Q

This is the inner layer wherein Juxtamedullary nephrons are located

A

Medulla – inner layer

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7
Q

What nephron is being described?

  • Nephrons that are localized in the renal cortex.
  • Constitute the majority of nephrons (85%).
A

Cortical Nephron

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8
Q

These are the Main functions/Primary roles of what nephron?

o Immediate reabsorption of essential
substances;
▪ Supposed to bring back everything
the body needs to circulation.
o Immediate removal of wastes

A

Cortical Nephrons

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9
Q

These are the Main functions/Primary roles of what nephron?

  • The other 15%.
  • “Have long Henle’s loops that extends deep in the
    medullary region.”
A

JUXTAMEDULLARY NEPHRONS

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10
Q

a structure that extends well below the medullary region.

A

Loop of Henle

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11
Q

Parts of a Nephron:

A

RENAL CORPUSCLE
RENAL TUBULE
VASCULAR COMPONENTS
JUXTAGLOMERULAR APPARATUS

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12
Q

Has two components – the glomerulus and the
Bowman’s capsule.

A

RENAL CORPUSCLE

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13
Q

The glomerulus is enclosed by what structure?

A

Bowman’s Capsule

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14
Q

consists of a specialized tuft of capillaries that is enclosed by the Bowman’s capsule, which forms the beginning of the renal tubule

A

GLOMERULUS

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15
Q

The product of filtration in the glomerulus is
first conveyed where?

A

Bowman’s Capsule

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16
Q

The fluid that is conveyed into the
Bowman’s capsule flows along what segments?

A

Segments of the renal tubule

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17
Q

This RENAL TUBULE functions by immediately reabsorbing
essential substances

A

Proximal Convoluted Tubule (PCT)

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18
Q

The thick and thin ASCENDING loop of Henle do NOT have major differences in function.

TRUE OR FALSE

A

FALSE

It is the DESCENDING loop of Henle that do not have major differences in function between its thick and thin loops

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19
Q

These are the two classifications of the Ascending Loop of Henle

A

Thick and Thin Ascending Loop of Henle.

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20
Q

Responsible for the final adjustments (along with the collecting duct) in sodium (DCT) and water level (collecting duct) via the reabsorption process.

A

Distal Convoluted Tubule (DCT)

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21
Q

Responsible for the final adjustments in sodium via the reabsorption process

A

Distal Convoluted Tubule (DCT)

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22
Q

Responsible for the final adjustments in water level via the reabsorption process

A

Collecting Duct

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23
Q

What part of the nephron is being described?

  • Blood vessels associated with the nephron.
  • Nephrons will not be able to carry out their reabsorptive
    and secretory functions without blood vessels.
A

VASCULAR COMPONENTS

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24
Q

Supplies oxygenated blood from a branch of the renal artery to the glomerulus or glomerular capillaries

A

Afferent arteriole

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25
Q

The largest blood vessel that supplies the kidney

A

Renal Artery

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26
Q

The left and right renal artery gets
blood from?

A

Aorta

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27
Q

Each nephron is supplied by this structure in a ratio of 1:1

A

Afferent Arteriole

Each nephron is associated with 1 Afferent Arteriole, if there are 1.5 million nephrons then there are also 1.5 million Afferent Arterioles

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28
Q

The blood that circulates in these loops of capillaries will be filtered and will eventually exit through the?

A

Efferent Arteriole

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29
Q

Carries blood from the glomerulus to the renal
tubules or renal tubular area

A

Efferent arteriole

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30
Q

Surround the renal tubules, primarily the PCT
and DCT.

A

Peritubular capillaries

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31
Q

A network of blood vessels that are adjacent to the loop of Henle. They make the reabsorptive and secretory processes taking place in the nephrons possible

A

Vasa recta

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32
Q

A structure that is composed of two types of cells:

o (1) Juxtaglomerular cells;
o (2) Macula densa cells.

A

JUXTAGLOMERULAR APPARATUS

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33
Q

Secretes RENIN when there are changes in plasma volume, blood pressure, and plasma sodium content.

A

JUXTAGLOMERULAR APPARATUS

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34
Q

represents the entirety of the functions of the kidneys of the urinary system.

A

Urine Formation

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35
Q

While urine is being formed, there is
reclamation of essential substances and
secretion of waste products, which is equally
important in the maintenance of?

A

Homeostasis

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36
Q

The three major processes involved in urine formation:

A

glomerular filtration
tubular reabsorption,
tubular secretion.

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37
Q

carries oxygenated blood from a
branch of the renal artery to the glomerulus or
glomerular capillaries.

A

Afferent Arteriole

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38
Q

The structure that first receives the filtrate coming out of the efferent arterioles

A

Bowman’s capsule

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39
Q

fluid that flows along the renal tubules from the Bowman’s capsule

A

Glomerular Filtrate

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40
Q

Fluid upon exiting the collecting ducts

A

Urine

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41
Q

glomerular filtrate and urine are the same

TRUE OR FALSE

A

FALSE

Glomerular Filtrate will first undergo compositional changes or modifications as substances are reabsorbed and secreted. It is only called URINE upon exiting the collecting duct

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42
Q

The glomerular filtrate will flow along the PROXIMAL
convoluted tubule (PCT), which is immediately
attached or continuous to the Bowman’s capsule

TRUE OR FALSE

A

TRUE

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43
Q

A process that returns filtered essential substances to
the blood

A

TUBULAR REABSORPTION

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44
Q

From the PCT down to the descending limb of the Loop
of Henle, SODIUM will be reabsorbed

TRUE OR FALSE

A

FALSE

IT IS WATER THAT IS REABSORBED

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45
Q

A significant amount of water is reabsorbed
from what loop of henle?

A

Descending Loop of Henle

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46
Q

The walls of the thin ascending Loop of Henle
are made up of what type of epithelium?

A

single layer of squamous epithelial cells

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47
Q

Epithelium of Thick walls of the loop of henle

A

Cuboidal renal tubular epithelial cells.

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48
Q

The thickness and thinness of the walls are determined by the type of cells in the epithelium

TRUE OR FALSE

A

TRUE

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49
Q

this is the primary function of the juxtamedullary nephrons; removal of water from the filtrate.

A

Renal Concentration

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50
Q

If water is removed from the filtrate, it will become DILUTED

TRUE OR FALSE

A

FALSE

IT WILL BECOME CONCENTRATED

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51
Q

When the fluid ascends through the thin and thick ascending limbs of the Loop of Henle what kind of reabsorption takes place?

A

solute reabsorption (primarily urea) takes place

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52
Q

It is a waste product of metabolism and 50% of it is filtered and brought back to circulation

A

UREA

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53
Q

In the thick ascending Loop of Henle, more WATER are reabsorbed (primarily salts).

TRUE OR FALSE

A

FALSE

more SOLUTES are absorbed

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54
Q

Selective Reabsorption of the Descending Loop

A

only water is reabsorbed.

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55
Q

Selective Reabsorption of the Ascending Loop

A

only solutes are reabsorbed

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56
Q

More sodium and bicarbonate are reabsorbed here

A

Thick ascending limb → DCT

57
Q

Sodium reabsorption in the PCT, TAL, and DCT is under the influence of?

A

Aldosterone

58
Q

not all substances which the body has to get rid of are actually filtered. The body gets rid of these substances through what back-up mechanism?

A

TUBULAR SECRETION

59
Q

Takes place in the DCT; there are also significant secretory processes taking place in the proximal convoluted tubule (PCT), which is the major site for the removal of toxic substances and waste products

A

TUBULAR SECRETION

60
Q

Secreted substances in Tubular Secretion

A

Drugs (parent drugs or metabolites, hydrogen and potassium ions).

61
Q

For many drugs and their metabolites, they circulate bound to what proteins?

A

Plasma proteins

62
Q

Spared from glomerular filtration; the complex is too large to pass through the glomerular filtration barrier

A

drugs and their metabolites

63
Q

Plasma is still concentrated; plasma osmolality is still high in what structure?

A

Collecting duct

64
Q

Water reabsorption in the collecting duct is also hormone-controlled; also under the influence of what hormone?

A

ADH (anti-diuretic hormone).

65
Q

Pathway of Urine Flow:

A

Major and minor calyces → renal pelvis → ureter → bladder → urethra.

66
Q

What is being described?

  • Filtration is dictated upon by the amount of blood
    supplied.
  • Blood supplied to the kidneys or to the nephrons.
A

RENAL BLOOD FLOW

67
Q

THE RENAL BLOOD FLOW RATE

A

Approx. 1,200 mL/min/1.73 m2 (body surface area).

▪ Greater body surface area = >1,200 mL/min.
▪ Smaller body surface area = <1,200 mL/min.

68
Q

THE RENAL PLASMA FLOW RATE

A

Approx. 600 – 700 mL/min

69
Q

Afferent arteriole gets blood from a branch of the renal artery → glomerulus → efferent arteriole → peritubular capillaries → Aorta

TRUE OR FALSE

A

FALSE

THE CORRECT ORDER IS: Renal Artery → Afferent Arteriole → glomerulus → efferent arteriole → peritubular capillaries → vasa recta

Blood from the vasa recta will then be returned to the renal vein.

70
Q

The path of Blood Flow starts with oxygenated blood and ends with deoxygenated blood.

TRUE OR FALSE

71
Q

The kidneys filter how many Liters of blood every single minute?

72
Q

is filtered by the glomeruli, which
would only amount to 600 – 700 mL/min.

73
Q

The Normal Glomerular Filtration Rate (GFR):

A

120mL/min (approx. 10% of the renal blood flow rate).

74
Q

is estimated by using clearance tests.

A

Glomerular Filtration Rate (GFR):

75
Q

are performed to evaluate the glomerular filtration rate.

A

Clearance Tests

76
Q

At the level of the Bowman’s capsule, the
filtrate is ISO-OSMOTIC with plasma

TRUE OR FALSE

A

TRUE

Iso-osmotic meaning osmolarities are almost the same.

77
Q

Glomerular Filtrate has a specific gravity of?

78
Q

Loss of renal concentrating ability of
the kidneys is consistent with?

A

glomerular nephritis, renal failure and acute tubular necrosis; which are indications of isosthenuria

79
Q

It is expected that the specific gravity
would DECREASE as a result of the
removal of water

TRUE OR FALSE

A

FALSE

It should INCREASE upon the removal of water

80
Q

Glomerular FIltrate has no significant number of cells because?

A

The glomerular filtration barrier does
not allow cells and high molecular
weight substances to pass through.

Water and low molecular
weight substances are the only
ones allowed to

81
Q

Glomerular FIltrate has no significant amount of proteins because?

A

If the cells and protein found in the
urine are a result of damage in the
glomerular filtration barrier, it is
considered clinically significant

82
Q

This is the pressure in the glomerulus that allows the
filtration of plasma, including water and low molecular
weight substances.

A

FILTRATION PRESSURE

83
Q

The Net Filtration Pressure is?

84
Q

Facilitates or makes the filtration of plasma or
blood possible as it flows along the loops of
glomerular capillaries.

A

Net Filtration Pressure

85
Q

It is a result of the opposing hydrostatic and
oncotic pressures in the glomerular capillaries
and the fluid in the Bowman’s capsule

A

Net Filtration Pressure

86
Q

Created by opposing hydrostatic and oncotic pressures
inside and outside the glomerular capillaries and
arterioles.

A

FILTRATION PRESSURE

87
Q

There is hydrostatic pressure inside the
glomerular capillaries and the afferent
arteriole, amounting to?

88
Q

This is opposed by osmotic/oncotic pressure
in the same blood vessel; contributed to by
proteins.

A

hydrostatic pressure inside the
glomerular capillaries and the afferent
arteriole

89
Q

They exert this osmotic/oncotic
pressure.

90
Q

The fluid inside the Bowman’s capsule also
exerts hydrostatic pressure amounting to?

91
Q

The osmotic/oncotic pressure exerted by proteins amount to?

92
Q

are primarily responsible for the large amount of
hydrostatic pressure in the arterioles and glomerular
capillaries.

A

The varying sizes of the afferent and efferent arterioles

93
Q

There are varying sizes of the afferent and efferent arterioles. Which arteriole is bigger?

A

Afferent arteriole

94
Q

GLOMERULAR FILTRATION BARRIER

What are its 3 layers?

A

Fenestrated endothelium (endothelial tissue/cells)
Basement membrane (basal lamina)
Podocyte Layer

95
Q

are large enough to allow the passage of water and low molecular weight substances, but are small enough to restrict the passage of cells and proteins.

96
Q

these tissues are avascular; nutrients are supplied and waste products are removed via the basement membrane.

A

Epithelial Tissue

97
Q

Middle layer of the GLOMERULAR FILTRATION BARRIER

A

Basement membrane (basal lamina)

98
Q

Outermost layer of the GLOMERULAR FILTRATION BARRIER

A

Podocyte layer

99
Q

Innermost layer of the GLOMERULAR FILTRATION BARRIER

A

Fenestrated endothelium (endothelial tissue/cells)

100
Q

this perfectly describes the GLOMERULAR FILTRATION BARRIER

A

molecular sieve

Analogous to 3 layers of filter paper or gauze

101
Q

Size Threshold (limit) of the GLOMERULAR FILTRATION BARRIER

A

70 kDa, which is the same
as 70,000 Da.

102
Q

Substances with a molecular weight of less than 70
kDa or 70,000 Da will NOT pass through

TRUE OR FALSE

A

FALSE

They are able to pass through, because they are smaller than the limit

103
Q

What structure is being described?

Negatively-charged substances are naturally repelled
by the negatively-charged basement membrane and
endothelium that make up the glomerular filtration
barrier.

A

Shield of Negativity

104
Q

Repulsion of negatively charged substances is done by the Shield of Negativity (e.g., proteins); even if they’re small enough to pass through

What protein is the best example of this?

A

Albumin: Has a molecular weight of less than 70,000 Da, but its a negatively charged protein at physiologic pH. Therefore natural repulsion takes place, because the shield is also negative.

105
Q

is not normally present in
significant amounts in urine.

106
Q

If albumin levels increase in the urine, that is indicative of damage to the integrity of the barrier, along with the disruption of the shield of negativity, allowing the
filtration of albumin and all other negatively charged particles.

What complication could this be indicative of?

A

This results to massive proteinuria, which is consistent to nephrotic syndrome.

107
Q

proteoglycans (in the basement membrane) and sialo
glycoproteins (in the endothelium), are also negatively charged like albumin

TRUE OR FALSE

108
Q

is secreted when there are alterations or
abnormalities in plasma sodium content and blood
pressure; both decrease

109
Q

Combination of changes or stimuli which is sensed by
the juxtaglomerular apparatus

A

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAAS)

110
Q

an enzyme that acts on angiotensinogen, a blood-borne substrate (naturally occurring in the blood and is produced by the liver), converting it to angiotensin I (inactive form).

111
Q

Because angiotensin I is inactive, it has to be
acted on by another enzyme produced by the
lungs, that converts angiotensin I to
angiotensin II (active form).

A

ACE (angiotensin converting enzyme)

112
Q

is capable of making adjustments in plasma sodium,
blood volume, and blood pressure.

A

Angiotensin II

113
Q

Mechanisms of Angiotensin II:

A

To stimulate vasodilation of the afferent arteriole and vasoconstriction of the efferent arteriole;

It stimulates or increases Na+ reabsorption at
the level of the proximal convoluted tubule (PCT).

Stimulates the release or secretion of
aldosterone and in turn, aldosterone increases Na+
reabsorption at the level of the DCT.

Has an effect on ADH secretion, which in turn,
stimulates water reabsorption at the level of the
collecting duct.

114
Q

Both sodium reabsorption in the DCT
(aldosterone) and water reabsorption in
the collecting duct (ADH) are hormone controlled

TRUE OR FALSE

115
Q

The collecting duct is NOT naturally permeable
to water.

TRUE OR FALSE

A

FALSE

The collecting duct is naturally permeable
to water.

116
Q

What is this type of transport?

  • Expenditure of energy.
  • Takes place at areas or segments of the renal tubule
    consisting of renal tubular epithelial cells, which have
    multiple mitochondria.
A

Active Transport

117
Q

These are reabsorbed via active transport by?

Glucose, amino acids, salts.

A

PROXIMAL CONVOLUTED
TUBULE (PCT)

118
Q

These are reabsorbed via active transport by?

Chloride

A

THICK ASCENDING LOOP
OF HENLE

119
Q

These are reabsorbed via active transport by?

Sodium

A

PCT AND DCT

120
Q

point at which tubular reabsorption
stops.

A

Renal Threshold

121
Q

substances that both have a renal
threshold.

A

Glucose and sodium

122
Q

Renal Threshold of Glucose

A

160 – 180 mg/dL.

123
Q

Renal Threshold of Sodium

A

110 – 130 mmol/L.

124
Q

Type of transport usually in areas with simple squamous epithelial cells

A

PASSIVE TRANSPORT

125
Q

These are reabsorbed via passive transport by?

Water (under the influence of ADH in the
collecting duct*)

A

Proximal Convoluted Tubule
Descending Loop of Henle
Collecting Duct

126
Q

These are reabsorbed via passive transport by?

Urea

A

Proximal Convoluted Tubule
Ascending Loop of Henle

127
Q

These are reabsorbed via passive transport by?

Sodium (aldosterone-controlled).

A

Ascending Loop of Henle

128
Q

Made possible by selective reabsorption in the Loop of
Henle that serves to maintain the osmotic gradient of
the medulla (primary role of juxtamedullary nephrons).

A

COUNTERCURRENT MECHANISM

129
Q

What reabsorption is being described?

o At the level of the DLH, only water is
reabsorbed.
o At the level of the ALH, only solutes are
reabsorbed.

A

Selective Reabsorption

130
Q

IDENTIFY THE LOOP BEING DESCRIBED

Permeable to water

A

DESCENDING LIMB

131
Q

IDENTIFY THE LOOP BEING DESCRIBED

Impermeable to water

A

ASCENDING LIMB

132
Q

IDENTIFY THE LOOP BEING DESCRIBED

Impermeable to solutes

A

DESCENDING LIMB

133
Q

IDENTIFY THE LOOP BEING DESCRIBED

Permeable to solutes

A

ASCENDING LIMB

134
Q

THE TWO IMPORTANT FUNCTIONS OF TUBULAR SECRETION:

A

(1) Removal of unfiltered substances
(2) Maintenance of electrolyte and acid-base balance.

135
Q

How is the electrolyte and acid-base balance maintained?

A

Through the secretion of hydrogen ions which bind to/react with bicarbonate, hydrogen phosphate, and ammonia.

136
Q

Disruption in this function leads to metabolic acidosis and renal tubular acidosis.

A

Maintenance of electrolyte and acid-base balance.

137
Q

is characterized by low plasma bicarbonate level; both blood and urine are acidic.

A

Metabolic acidosis

138
Q

results from either failure of hydrogen ion secretion or ammonia production by the RTE (renal tubular epithelial) cells.

A

Renal Tubular Acidosis

139
Q

Blood is acidic but the urine will be persistently alkaline

A

Renal Tubular Acidosis

AUBF (3 decks)

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