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Human Form & Function > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

why does renal physiology matter to dentistry?

A

-You will write prescriptions, the kidneys are a major excretion route for pharmaceuticals
-Local anesthetics are excreted through kidneys
-Patients with kidney failure need to be monitored closely and certain precautions should be made for them
-A lot of patients are on blood pressure medications
—–Limits of max BP you can treat pts
—–Clinic policy? 160/100

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2
Q

kidneys are a major _______ route for pharmaceuticals

A

excretion

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3
Q

local anesthetics are excreted through the …

A

kidneys

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4
Q

kidney medulla contains _____

A

pyramids

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5
Q

kidney pyramids have _____ that connect to renal pelvis

A

papilla

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6
Q

kidney pelvis drains to the _____ and then the ____

A

ureter
bladder

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7
Q

kidney nephrons are the ________

A

the functional unit of kidneys

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8
Q

how many kidney nephrons?

A

~1 million

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9
Q

what are the components of the kidney nephron?

A

renal tubule
glomerulus

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10
Q

Kidneys:
“dirty” blood goes in through the ____
“clean” blood leaves through the ____

A

arteries
veins

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11
Q

afferent vs efferent arterioles of kidneys

A

afferent = blood going into the glomerulus
efferent = blood leaving glomerulus

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12
Q

glomerular filtration creates a …

A

plasma-like filtrate of the blood

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13
Q

homeostasis

A

regulation of the volume of blood plasma, blood pressure, and pH

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14
Q

blood volume ___L

A

5 L

fluid in both plasma and RBC

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15
Q

changes in fluid will result in changes of ____

A

pressure

increase urine output can help relieve pressure

restricted urine output can maintain pressure (dehydration)

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16
Q

changes in fluid volume will start with ____

A

plasma

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17
Q

fluid in body ~__ L

A

~42 L

plasma, interstitial fluid, intercellular fluid

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18
Q

ways the body excretes fluid

A

breathing
sweat
crying
feces

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19
Q

metabolic waste products (kidneys)

A

urea
creatinine
bilirubin
uric acid

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20
Q

foreign substance waste products (kidneys)

A

drugs/medications
food additives
toxins

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21
Q

simple: how do kidneys regulate pH

A

simple: excrete or retain an acid or base

excrete or retain H+ ions (hydrogen ions)
excrete or retain HCO3- (bicarbonate)

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22
Q

kidney processes (3)

A

filtration
modification
excretion

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23
Q

blood flow of kindeys

A

Renal artery -> afferent arterioles -> glomerular capillaries -> efferent arterioles -> peritubular capillaries -> renal vein and out

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24
Q

urine flow of kineys

A

Glomerulus -> proximal tubules -> Loop of Henle -> distal tubule -> collecting duct -> renal pelvis -> ureters

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25
Q

nephrons are supplied by ____

A

glomerular capillaries (filtration occurs here)

single direction

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26
Q

peritubular capillaries: ____ & _____ occurs

A

reabsorption secretion

multi-direction

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27
Q

study

A
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28
Q

cortical nephrons compose __%

A

70%

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29
Q

juxtamedullary nephrons compose __%

A

30%

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30
Q

all nephrons are composed with the same things but they are _____

A

located in different places

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31
Q

cortical nephrons are mainly in the ___

A

cortex

with Loop of Henle in the medulla
*shorter

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32
Q

juxtamedullary nephrons span across the ___

A

medulla

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33
Q

juxtamedullary nephrons are ____
cortical nephrons are ____

(length)

A

juxtamedullary nephrons are LONG
cortical nephrons are SHORT

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34
Q

juxtamedullary nephrons have different blood supply, called

A

Vasa Recta

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35
Q

Kidneys receive ____ L of blood/min

A

~1.2 L

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36
Q

Substance is filtered but none is reabsorbed=
Substance is filtered and partially reabsorbed=
Substance is filtered and totally reabsorbed=
Substance is filtered and added back via secretion=

A

Substance is filtered but none is reabsorbed.
-creatine

Substance is filtered and partially reabsorbed.
-water (maintain homeostasis in times of dehydration)

Substance is filtered and totally reabsorbed.
-glucose (none in urine)

The substance is filtered and added back via secretion.
-hydrogen ions H+ (help with homeostasis)

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37
Q

rate of filtration equation

A
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38
Q

Hydrostatic pressure is _____ in glomerular capillaries rather than peritubular capillaries.

A

higher

creates concentration gradient

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39
Q

what will cause the contraction of mesangial cells?

A

histamine
angiotensin
norepinephrine

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40
Q

what causes the relaxation of mesangial cells?

A

dopamine for relaxation

41
Q

Glomerular filtration rate (GFR) is typically ____ L/Day

A

~180 L/Day

42
Q

how to modify GFR (Glomerular filtration rate)

A

modify the diameter of the afferent/efferent arterioles

Decreased diameter of afferent = decreased pressure in the glomerulus and decreased GFR.
Dilation is the opposite

constriction of efferent = increased resistance to leave glomerulus and increase GFR. (minor)

43
Q

Major constriction will cause blood to be trapped (with proteins) and ____ oncotic pressure and ____ GFR.

A

increases oncotic pressure
decreases GFR

44
Q

What does the sympathetic nervous system do to GFR and Renal Blood Flow (RBF)?

A

fight or flight

45
Q

angiotensin II

A

???? slide16

46
Q

Prostaglandins and NO

A

????? slide 16

47
Q

Autonomic Regulation (GFR)

A

Macula Densa (Distal Tubule)
–Detects changes in Na+
–Initiates release of renin

48
Q

study

A
49
Q

high Na levels = want filtration to be less because we want to retain water

contraction of mesangial cells
release of renin
release angiotensin

A

??? slide 16

50
Q

what detects Na+ changes?

A

Macula Densa (distal tubule)

51
Q

contraction of mesangial cells will contract the ____ and does what

A

glomerulus
slows filtration rate

52
Q

study

A
53
Q

fluid going to the proximal tubule is similar to _____

A

plasma in blood

54
Q

reabsorption is _____ and in ____ quantities

A

reabsorption is selective and in large quantities
(water/solutes)

55
Q

reabsorption depends on the osmolarity of the body which is

A

the hydration state of the body

56
Q

waste products are ___ reabsorbed while glucose and electrolytes are ____ absorbed

A

waste products = poorly absorbed
glucose/electrolytes = well absorbed

57
Q

osmolarity is high =

A

more concentrated urine

58
Q

active transport of reabsorption

A

sodium-potassium pump uses ATP and sets up a gradient

Co-transport also known as secondary active transport

59
Q

passive transport of reabsorption

A

Passive: diffusion down the concentration gradient

60
Q

____ is a large proponent to what is reabsorbed

A

Sodium

61
Q

waste products like _____ generally do not reabsorb

A

pharmaceuticals

62
Q

study

A
63
Q

proximal tubule has __% water and sodium reabsorbtoin

A

~65%

64
Q

____ is absorbed with sodium in the proximal tubule

A

chlorine

65
Q

loop of henle controls ______ of urine

A

concentrations of urine

66
Q

loop of henle is the _____ loop and more conentrated

A

longer

67
Q

two parts that make up the Renal counter-current exchange

A

thin descending aquaporins

thich ascending active transporters

*loop of henle

68
Q

at the apex of loop of henle (deep in the medulla) there are very ____ osmolarity levels

A

high

69
Q

distal tubule two cells

A

principal cells: P-reabsorb Na+ and secrete k+

intercalated cells: reabsorb k+ and hCO3- and secrete H+

70
Q

secrete means ____ to _____

A

blood to urine

71
Q

ADH regulation occurs at the

A

distal tubule
collecting duct

ADH: antidiuretic hormine (not urinating)

72
Q

high blood pressure pts will take a ____ blocker to help them urinate more

A

ADH blocker

73
Q

in the collecting duct, medullary collecting ducts are ___ permeable to urea

A

more

74
Q

collecting duct can can pump ___ into the lumen

A

H+

75
Q

excretion rate =

A

ER= (Filter rate – reabsorption) + secretion rate

76
Q

Filter =
Reabsorb =
Secrete =
Excrete =

A

Filter: What enters the kidney tube system at the beginning

Reabsorb: Out of kidney tube system back into the body

Secrete: From the body into the kidney tubes

Excrete: out of the body in general

77
Q

common electrolytes found in the body

A

Sodium
Potassium
Magnesium
Calcium
Chlorine
Organic anions
Proteins

78
Q

urea is formed in the ___

A

liver

79
Q

urea is the end product of ____ ____

A

protein metabolism

80
Q

urea maintains ______ in the medulla

A

hyperosmolarity

81
Q

urea is secreted into the very beginning of the _____ _____

A

ascending loop

82
Q

T/F: urea maintains water levels in loop of henle

A

true

83
Q

urea is passively reabsorbed from the

A

proximal tubule
collecting duct

84
Q

kidneys can create ____ (hormone)

A

erythropoietin (EPO)

85
Q

kidneys can aid the liver in ______ and retention of glucose

A

gluconeogenesis

86
Q

adrenal glands are ____ (location)

A

on top of kidneys

87
Q

adrenal glands produce … (3)

A

sex hormones

cortisol

homeostasis hormones (ie: aldosterone, vasopressin, renin, adrenaline, etc)

88
Q

kidneys have lymphatic drainage, and drains via the ____ ___

A

thoracic duct

89
Q

lymphatic trunk and ducts run near the

A

Lymphatic trunks and ducts flow following the bloodstream

90
Q

lymphatics relieves the blood steam of ___

A

toxins

91
Q

the lymphatic system has an abundance of _____ cells

A

immune cells

92
Q

kidney disease/kidney failure reasons (4)

A

Uncontrolled hypertension
diabetes
CVD
chronic medication abuse

93
Q

measure ___ in pts with kidney problems

A

Measure eGFR (filtration rate)

ability to filter waste and proteins

94
Q

stages of kidney disease (5)

A
  1. Normal function but evidence of damage
  2. Work well and sometimes hindered function
  3. Filtering is not ideal and can manifest in health problems
  4. Last stage before full kidney failure (dialysis start?)
  5. Failure (non-working) – waste builds up in blood. Need dialysis.
95
Q

common kidney problems (4)

A

kidney stones (ureter or kidney - build-up of solutes)

cancers (bladder, kidney, adrenal gland which spreads)

lupus (chronic inflammation causes kidney failure)

diabetes (high sugar levels)

96
Q

nephrotoxic medications (7)

A

NSAIDS

Diuretics

ACE inhibitors

Zoledronic Acid

Acyclovir

HIV medications

Drug abuse

97
Q

changes to dental tx in relation to Kidneys

A

amide anesthetics

codeine-based analgesics

bleeding risk

infection risk (regular prophylactic visits, more frequent post-op visits)

98
Q

Kidneys filter a lot of blood daily producing ____

A

Kidneys filter a lot of blood daily producing urine

99
Q

kidneys are essential for

A

homeostasis

Human Form & Function (40 decks)

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