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Physiology 4LE HM > Renal Physiology 2 > Flashcards

Renal Physiology 2 Flashcards

1
Q
  1. requires energy to move solute against an electrochemical or a concentration gradient.
  2. where reabsorption occurs down an electrochemical, pressure or concentration gradient.

Active Process
Passive Process

A

Active Process – requires energy to move solute against an electrochemical or a concentration gradient.

Passive Process – where reabsorption occurs down an electrochemical, pressure or concentration gradient.

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2
Q

– coupled indirectly to an energy source (e.g. ____)
– requires the hydrolysis of a direct energy source (e.g.___)

Secondary active transport
Primary active transport
Na+/K+ ATPase
ion gradient

A

Primary active transport – requires the hydrolysis of a direct energy source (e.g. Na+/K+ ATPase)

o Secondary active transport – coupled indirectly to an energy source (e.g. ion gradient)

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3
Q

All reabsorption processes are linked to the basolateral ____

o Na+/Cl- co-transport
o Na+/amino acid co-transport
o Na+/K+ ATPase
o Na+/glucose co-transport
o Na+/H+ counter-transport

Which of this transport are primary active and secondary active

A

All reabsorption processes are linked to the basolateral Na+/K+ ATPase

o Na+/Cl- co-transport (secondary active)
o Na+/amino acid co-transport (secondary active)
o Na+/K+ ATPase (primary active)
o Na+/glucose co-transport (secondary active)
o Na+/H+ counter-transport (secondary active)

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4
Q
  • is passive because the moving Na+ ion is going to draw it in order to maintain electrical neutrality
  • is passive at the PCT
  • the concentration gradient is created mainly by active Na+ reabsorption

Cl reabsorption
H2O reabsorption

A

Cl reabsorption is passive because the moving Na+ ion is going to draw it in order to maintain electrical neutrality

H2O reabsorption is passive at the PCT
- the concentration gradient is created mainly by active Na+ reabsorption

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5
Q

reabsorption is ____ ( ____ mOsm) - the body does not reabsorb more solute than water, nor does it reabsorb more water than solute

isoosmotic
hypoosmotic
hyperosmotic

100
200
300
400
500
A

the concentration gradient is created mainly by active Na+ reabsorption

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6
Q

Glucose reabsorption is through the transporters ____

A

SGLT1 and SGLT2

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7
Q
  • reabsorption is due solely to osmosis and is not subject to direct regulation
  • reabsorption can be regulated
  • E.g.: Anti-diuretic hormone (ADH)
  • E.g. reabsorption of water in the PCT

Facultative Reabsorption
Obligatory Reabsorption

A

Obligatory Reabsorption - reabsorption is due solely to osmosis and is not subject to direct regulation
- E.g. reabsorption of water in the PCT

Facultative Reabsorption – reabsorption can be regulated
E.g.: Anti-diuretic hormone (ADH)

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8
Q

occurs in the vasa recta and aids the countercurrent multiplier mechanism

renal threshold
Countercurrent Exchanger
Countercurrent Multiplier Effect

A

Countercurrent Exchanger

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9
Q

Occurs in the Loop of Henle; the overall process by which the loop of Henle, and in particular the thick ascending limb, generates the hyperosmotic medullary interstitial gradient

renal threshold
Countercurrent Exchanger
Countercurrent Multiplier Effect

A

Countercurrent Multiplier Effect

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10
Q

Purpose: increase the osmolality of the interstitial fluid and concentrate urine

renal threshold
Countercurrent Exchanger
Countercurrent Multiplier Effect

A

Countercurrent Multiplier Effect

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11
Q

The plasma concentration of substrate at which the transport maximum occurs is called the

renal threshold
Countercurrent Exchanger
Countercurrent Multiplier Effect

A

The plasma concentration of substrate at which the transport maximum occurs is called the renal threshold

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12
Q

Stimulates magnesium reabsorption in the loop of Henle
Stimulus: Plasma volume expansion/ increase in ECV
Stimuli: increase in Renin secretion
Stimuli: increased plasma osmolality & decrease in effective circulating volume (ECV)
Stimuli: increase in angiotensisn II and increase in plasma [K+]

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A 
Parathyroid Hormone
Atrial Natriuretic Peptide
Angiotensin II
Antidiuretic Hormone
Aldosterone
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13
Q

Secreted by zona glomerulosa cells of adrenal cortex
Secreted by specific cells in cardiac atria

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Aldosterone

Atrial Natriuretic Peptide

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14
Q

Site of action: thick ascending limb, distal tubule, & collecting duct
Site of action: distal tubule & collecting duct
Site of action: PCT
Site of action: collecting ducts

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Aldosterone
Antidiuretic Hormone
Angiotensin II
Atrial Natriuretic Peptide

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15
Q

Aldosterone increases activity of

Na+ channel
K+ channel
Na+/K+ ATPase

A

Aldosterone increases activity of Na+ channel, K+ channel, and Na+/K+ ATPase pump

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16
Q

– marked loss of sodium and accumulation of potassium due to adrenal destruction or malfunction
– increased sodium retention and potassium depletion due to adrenal tumors.

Increased Aldosterone
Decreased Aldosterone
Addison’s Disease
Conn’s syndrome

A

Decreased Aldosterone
Addison’s Disease – marked loss of sodium and accumulation of potassium due to adrenal destruction or malfunction

Increased Aldosterone
Conn’s syndrome – increased sodium retention and potassium depletion due to adrenal tumors.

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17
Q

increase NaCl and H2O reabsorption in the PCT

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Angiotensin II

18
Q

increases the water permeability of renal cells in the distal tubule and collecting duct, thus decreasing the volume and increasing the osmolarity of urine

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Antidiuretic Hormone

19
Q

It inhibits the reabsorption of sodium and water, w/c results to increased urinary excretion

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Atrial Natriuretic Peptide

20
Q

Increases reabsorption of calcium in distal tubules and in the loop of Henle.

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Parathyroid Hormone

21
Q

Its action helps to return blood volume back to normal

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Atrial Natriuretic Peptide

22
Q

Inhibits phosphate reabsorption by the proximal tubule

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Parathyroid Hormone

23
Q

Stimulates aldosterone secretion

Aldosterone
Angiotensin II
Antidiuretic Hormone
Atrial Natriuretic Peptide
Parathyroid Hormone
A

Angiotensin II

24
Q

Hormone Major stimulus Nephron site of action Effect on transport
Angiotensin II ↑Renin PT ↑NaCl and H2O reabsorption

Aldosterone ↑Angiotensin II,↑[K+]p TAL, DT/CD ↑NaCl and H2O reabsorption*

ANP ↑ECV CD ↓H2O and NaCl reabsorption

Urodilatin ↑ECV CD ↓H2O and NaCl reabsorption

Sympathetic nerves ↓ECV PT, TAL, DT/CD ↑NaCl and H2O reabsorption*

Dopamine ↑ECV PT ↓H2O and NaCl reabsorption

ADH ↑Posm, ↓ECV DT/CD ↑H2O reabsorption*

A

Hormone Major stimulus Nephron site of action Effect on transport
Angiotensin II ↑Renin PT ↑NaCl and H2O reabsorption
Aldosterone ↑Angiotensin II, ↑[K+]p TAL, DT/CD ↑NaCl and H2O reabsorption*
ANP ↑ECV CD ↓H2O and NaCl reabsorption
Urodilatin ↑ECV CD ↓H2O and NaCl reabsorption
Sympathetic nerves ↓ECV PT, TAL, DT/CD ↑NaCl and H2O reabsorption*
Dopamine ↑ECV PT ↓H2O and NaCl reabsorption
ADH ↑Posm, ↓ECV DT/CD ↑H2O reabsorption*

25
Q

Tubular Secretion
 Functions for the removal of ions, which are either metabolic wastes (e.g. H+ and urea) or excess electrolytes, and toxins from

A

Tubular Secretion
 Functions for the removal of ions, which are either metabolic wastes (e.g. H+ and urea) or excess electrolytes, and toxins from

26
Q

Proximal tubule
Loop of Henle
Distal convoluted tubule and collecting duct

reabsorbs by osmosis → water by simple diffusion → bicarbonate ions, urea
reabsorbs by osmosis in the descending limb → water by active transport in the ascending limb → Na, K, Cl
reabsorbs by osmosis → water
secretes → hydrogen ions, urea (if ADH is present)
secretes → urea
secretes → hydrogen ions, ammonium ions, urea, creatinine, organic anions and cations

A

Proximal tubule
reabsorbs by osmosis → water
secretes → hydrogen ions, ammonium ions, urea, creatinine, organic anions and cations

Loop of Henle
reabsorbs by osmosis in the descending limb → water by active transport in the ascending limb → Na, K, Cl
secretes → urea

Distal convoluted tubule and collecting duct
reabsorbs by osmosis → water by simple diffusion → bicarbonate ions, urea
secretes → hydrogen ions, urea (if ADH is present)

27
Q

The principal components of the medullary interstitial fluid are

H2O
K
NaCl
urea

A

NaCl

urea.

28
Q 
Resistance Vessels
Adrenal Cortex
Brain 
Posterior Pituitary 
Sympathetic Nervous System
  • Release Aldosterone, Enhances Sodium reabsorption increasing water reabsorption (because water follows Na+)
  • Vasoconstriction (increase Total Peripheral resistance)/ Increase Renal Arterial Pressure
  • Stimulates norepinephrine release and inhibits reuptake to enhance Sympathetic effects (vasoconstricton)
  • Release Vasopressin (Increases Fluid retention, Increase Fluid Volume)
  • Stimulates Thirst Center, to increase fluid volume
A

Resistance Vessels - Vasoconstriction (increase Total Peripheral resistance)/ Increase Renal Arterial Pressure
Adrenal Cortex - Release Aldosterone, Enhances Sodium reabsorption increasing water reabsorption (because water follows Na+)
Posterior Pituitary - Release Vasopressin (Increases Fluid retention, Increase Fluid Volume)
Brain - Stimulates Thirst Center, to increase fluid volume
Sympathetic Nervous System - Stimulates norepinephrine release and inhibits reuptake to enhance Sympathetic effects (vasoconstricton)

29
Q

When NaCl is elevated in the tubular fluid, renin release is

inhibited
stimulated

A

inhibited

30
Q

___ located on the JG cells respond to sympathetic nerve stimulation by releasing renin

Beta1-adrenoceptors
Alpha1-adrenoceptors
Na-K ATPase
Osmoreceptors

A

Beta1-adrenoceptors

31
Q

RAAS Pathway

When renin is released into the blood → proteolytic cleavage of angiotensinogen → angiotensin I → angiotensin-converting enzyme (ACE), cleaves angiotensin I → angiotensin II (AII)

A

When renin is released into the blood → proteolytic cleavage of angiotensinogen → angiotensin I → angiotensin-converting enzyme (ACE), cleaves angiotensin I → angiotensin II (AII)

32
Q

cells within the hypothalamus, which are sensitive to changes in osmotic pressure of the blood

Beta1-adrenoceptors
Alpha1-adrenoceptors
Na-K ATPase
Osmoreceptors

A

Osmoreceptors

33
Q

Order ther, Formation of concentrated (hyperosmotic) urine

  • ADH release by posterior pituitary
  • Increased blood osmolality
  • Increased insensible water loss or decreased water intake
  • Increased water reabsorption
  • Osmoreceptor stimulation
  • Stimulate insertion of water channels in collecting ducts (CD)
A

Formation of concentrated (hyperosmotic) urine

  1. Increased insensible water loss or decreased water intake
  2. Increased blood osmolality
  3. Osmoreceptor stimulation
  4. ADH release by posterior pituitary
  5. Stimulate insertion of water channels in collecting ducts (CD)
  6. Increased water reabsorption
34
Q

Order the, Formation of dilute (hyposmotic) urine

Decrease blood osmolality
Decreased water reabsorption at CD
Increased water intake or decrease insensible water loss
No release of ADH
No stimulation of osmoreceptor
A

Formation of dilute (hyposmotic) urine

  1. Increased water intake or decrease insensible water loss
  2. Decrease blood osmolality
  3. No stimulation of osmoreceptor
  4. No release of ADH
  5. Decreased water reabsorption at CD
35
Q

URINE VOLUME SPECIFIC GRAVITY COLOR
State of Hydration:
Decreased Water Intake
Increased Water intake

Physical Activity
Exercise
Rest

Fluid Intake
Dehydration
Overhydration

Ambient temperature
Hot
Cold

A

URINE VOLUME SPECIFIC GRAVITY COLOR
State of Hydration:
Decreased Water Intake Decreased Increased Darker yellow
Increased Water intake Increased Decreased Clear-Light yellow

Physical Activity
Exercise Decreased Increased Darker yellow
Rest Increased Decreased Clear-Light yellow

Fluid Intake
Dehydration Decreased Increased Darker yellow
Overhydration Increased Decreased Clear-Light yellow

Ambient temperature
Hot Decreased Increased Darker yellow
Cold Increased Decreased Clear-Light

36
Q

– thus regulating the filtered load of Na+ (the amount of Na+ filtered out into the tubules)
– Compensates for changes that may occur in the GFR
– Reabsorption of Na+, primarily by the PCT, is adjusted to match GFR
– Increase in the number of apical membrane NaCl symporter in the thick ascending limb of the loop of Henle
– Inc GFR = inc Na+ reabsorption by PCT, and vice versa

Glomerulotubular (G-T) balance
Ability of the loop of Henle (spec. thick ascending limb) and DT to vary Na+ reabsorptive rates
Autoregulation of GFR

A

Autoregulation of GFR – thus regulating the filtered load of Na+ (the amount of Na+ filtered out into the tubules)
o Glomerulotubular (G-T) balance
– Compensates for changes that may occur in the GFR
– Reabsorption of Na+, primarily by the PCT, is adjusted to match GFR
– Inc GFR = inc Na+ reabsorption by PCT, and vice versa
o Ability of the loop of Henle (spec. thick ascending limb) and DT to vary Na+ reabsorptive rates
– Increase in the number of apical membrane NaCl symporter in the thick ascending limb of the loop of Henle

37
Q

Positive Na+ balance:
Negative Na+ balance:

Volume contraction
Volume expansion

A

Positive Na+ balance: Volume expansion

Negative Na+ balance: Volume contraction

38
Q

Regulation of Na+ excretion when minor variations in dietary NaCl intake occur
 Small adjustments in collecting duct reabsorption are sufficient to balance intake with excretion
 Aldosterone primarily regulates Na+ reabsorption (and thus excretion too) in the CD
 Increase aldosterone, increase Na+ reabsorption by CD → decrease Na+ excretion

A

Regulation of Na+ excretion when minor variations in dietary NaCl intake occur
 Small adjustments in collecting duct reabsorption are sufficient to balance intake with excretion
 Aldosterone primarily regulates Na+ reabsorption (and thus excretion too) in the CD
 Increase aldosterone, increase Na+ reabsorption by CD → decrease Na+ excretion

39
Q

Regulation of Na+ excretion when minor variations in dietary NaCl intake occur
 Small adjustments in collecting duct reabsorption are sufficient to balance intake with excretion
 Aldosterone primarily regulates Na+ reabsorption (and thus excretion too) in the CD
 Increase aldosterone, increase Na+ reabsorption by CD → decrease Na+ excretion

A

Regulation of Na+ excretion when minor variations in dietary NaCl intake occur
 Small adjustments in collecting duct reabsorption are sufficient to balance intake with excretion
 Aldosterone primarily regulates Na+ reabsorption (and thus excretion too) in the CD
 Increase aldosterone, increase Na+ reabsorption by CD → decrease Na+ excretion

40
Q

 GFR decrease and thus a decrease in filtered load of Na+
 Increase Na+ reabsorption (decrease Na+ excretion) in the PCT
 Na+ reabsorption increases in the CD
 Increase NaCl reabsorption in the PCT

Stimulation of ADH secretion
Inhibition of ANP
Increased activity of the renal sympathetic nerves
Stimulation of the RAAS

A

Increased activity of the renal sympathetic nerves
 GFR decrease and thus a decrease in filtered load of Na+
Inhibition of ANP
 Increase Na+ reabsorption (decrease Na+ excretion) in the PCT
Stimulation of ADH secretion
 Na+ reabsorption increases in the CD
Stimulation of the RAAS
 Increase NaCl reabsorption in the PCT

Physiology 4LE HM (5 decks)

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