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Clin Med Renal > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

How do the renal arteries, segmental arteries, and interlobular arteries communicate with one another?

A

Arcuate arteries

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2
Q

What are the branches given off by the arcuate arteries?

A

Interlobular arteries

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3
Q

Where do the interlobular arteries extend into?

A

The cortex

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4
Q

What makes up the capillary network surrounding the tubule system of the nephron?

A

Interlobular arteries
Afferent arterioles
Glomerulus
Efferent arterioles

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5
Q

What are the collecting vessels of the nephron capillary system?

A

The interlobular veins

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6
Q

What makes up each nephron?

A 
Blood supply
Glomerulus
Loop of henle
Collecting tubules
Juxtaglomerular apparatus
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7
Q

Renal blood flow is ____ blood flow

A

High blood flow

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8
Q

How much of the cardiac output is pumped per minute through the kidneys?

A

1200ml/minute or 21%

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9
Q

The glomerular capillary has _____ hydrostatic pressure

A

High

60mmHg

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10
Q

The peritubular capillaries has ____ hydrostatic pressure

A

Low (13mmHg)

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11
Q

Where does filtration occur in the kidneys?

A

Glomerulus

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12
Q

Where does water reabsorption occur in the kidneys?

A

Proximal convoluted tubule
Descending loop of henle
END of distal convoluted tubule
Collecting ducts

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13
Q

Where does solute reabsorption occur in the kidneys?

A

Proximal convoluted tubule
Ascending loop of henle
Distal convoluted tubule
Collecting duct

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14
Q

Where does secretion occur in the kidneys?

A

Proximal convoluted tubule
Distal convoluted tubule
Collecting ducts

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15
Q

What makes up the renal corpuscle?

A

Glomerulus and bowman’s capsule

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16
Q

What makes up the juxtaglomerular apparatus?

A

Macula densa
Mesangial cells
Granular cells (Juxtaglomerular cells)

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17
Q

What are the four man processes of the kidney?

A

Filtration
Reabsorption
Secretion
Excretion

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18
Q
  • First step of urine formation

- Bulk transport of fluid from blood to kidney tubule

A

Filtration

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19
Q

Filtration is a result of ____ pressure

A

Hydraulic

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20
Q

What is the normal GFR?

A

125ml/min or 180L/day

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21
Q
  • Process of returning filtered material to bloodstream

- May involve transport proteins

A

Reabsorption

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22
Q

___% of what is filtered is reabsorbed

A

99

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23
Q

What is totally reabsorbed (normally) by the kidney?

A

Glucose

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24
Q
  • Material added to lumen of kidney tubule from blood
A

Secretion

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25
Q

Secretion is usually ____ transport of toxins and foreign substances

A

Active

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26
Q

Loss of fluid from body in form of urine

A

Excretion

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27
Q

Equation for amount of solute excreted

A

Amount filtered + amount secreted - amount reabsorbed

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28
Q

Blood enters the glomerulus through the ____ _____ and filters out of the ___ ___

A

Glomerular capillary

Renal corpuscle

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29
Q

What stays behind during glomerular filtration?

A

Large proteins and cells

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30
Q

What is the plasma-like fluid in the glomerulus?

A

Glomerular filtrate

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31
Q

What determines glomerular filterability?

A

Molecular weight

Charges of the molecule

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32
Q

What is the favoring force in glomerular filtration?

A

Capillary blood pressure - 60mmHg OUT

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33
Q

What are the opposing forces in glomerular filtration?

A

Blood colloid osmotic pressure 32mmHg IN

Capsule pressure - 18mmHg IN

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34
Q

What is the NET filtration pressure of the glomerulus?

A

10mmHg

This is the driving force

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35
Q

What will increase GFR?

A

Increased renal blood flow

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36
Q

What will increase GFR and cause edema?

A

Decreased plasma proteins

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37
Q

What will decrease GFR?

A

Hemmorhage

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38
Q

What 3 mechanisms regulate GFR?

A

Renal autoregulation
Neural regulation
Hormonal regulation

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39
Q

What are the 2 mechanisms that make up renal auto regulation?

A

Myogenic mechanism

Tubuloglomerular feedback

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40
Q

What innervates the afferent and efferent arterioles? This mechanisms makes up ____ regulation of GFR

A

Sympathetic nerve fibers

Neural regulation of GFR

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41
Q

Activation of the sympathetic nervous system results in??

A

VASOCONSTRICTION!!

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42
Q

What hormones contribute to GFR regulation?

A 
Angiotensin II
ANP
NO
Endothelin
Prostaglandin E2
43
Q

Angiotensin II ____ GFR because it is a vasoconstrictor

A

Reduces

44
Q

ANP ____ GFR because it increases capillary surface area available for filtration

A

Increases

45
Q

If a substance is filtered but neither reabsorbed nor secreted, then the amount present in urine is its ___ ____

A

Plasma clearance

46
Q

What are 2 agents that can be used to measure GFR?

A

Inulin

Creatinine

47
Q

Using creatinine to measure GFR is ____ accurate than inulin

A

Less

48
Q

How much of the volume that enters the glomerulus is excreted to the external environment?

A

1%

49
Q

What are the two pathways of absorption?

A

Transcellular

Paracellular

50
Q

What are some mechanisms of transport within the kidneys?

A
  1. Primary active
  2. Secondary active
  3. Pinocytosis
  4. Passive transport
51
Q

Which part of the tubule is most likely to reabsorb large molecules like proteins with pinocytosis?

A

Proximal tubule

52
Q

What occurs in the proximal tubule and thin descending segment of the loop?

A

Sodium, water, and chloride reabsorption

53
Q

What is the major vehicle for reabsorption of sodium, chloride, and water in the proximal tubule?

A

Sodium-Potassium ATPase

54
Q

In the first half of the proximal convoluted tubule, sodium is reabsorbed by co-transport along with??

A

Glucose
Amino acids
Other solutes

55
Q

In the second half of the proximal convoluted tubule, sodium is reabsorbed with??

A

Chloride ions

56
Q

What are the 3 functionally distinct segments of the loop of henle?

A

Thin descending
Thin ascending
Thick ascending

57
Q

The thin descending loop of henle is highly permeable to? Moderately permeable to?

A

Highly permeable to water

Moderately permeable to most solutes

58
Q

Which part of the loop of henle has no active reabsorption?

A

Thin descending loop

59
Q

Which segment of the loop of henle secretes hydrogen ions into the tubule?

A

Thick ascending loop

60
Q

Where is glucose reabsorbed? What is it reabsorbed with?

A

Reabsorbed with Na+ in the early portion of the proximal tubule

61
Q

The amount of glucose reabsorbed is proportionate to the ____ ______ ____

A

Plasma glucose level

62
Q

The plasma level at which glucose first appears in the urine

A

Renal threshold for glucose

63
Q

Where and how does hydrogen secretion occur?

A

Proximal tubules
Loop of henle
Early distal tubules

Secondary active transport

64
Q

Where does primary active transport begin?

A

Late distal tubules and continues through the remainder of the tubular system

65
Q

What is important for forming a maximally acidic urine?

A

Hydrogen secretion

66
Q

What allows for the excretion of excess hydrogen and the generation of new bicarbonate?

A

Ammonia buffer system

67
Q

Calcium is both filtered and reabsorbed by the kidneys but is NOT ??

A

Secreted!

68
Q

Where does PTH increase calcium reabsorption?

A

Thick ascending loop of henle and distal tubules

69
Q

PTH reduces ??

A

Urinary excretion of calcium

70
Q

Regulates permeability of the distal tubules and collecting ducts to water

A

Antidiuretic hormone

71
Q

What provides the osmotic gradient necessary for water reabsorption to occur in the kidneys?

A

High osmolarity of the renal medullary interstitial fluid

72
Q

What determines whether or not water leaves the collecting duct by osmosis?

A

ADH

73
Q

ADH makes the walls of the collecting duct more ??

A

Permeable to water

74
Q

______ in the hypothalamus detect low levels of water (high osmolarity)

A

Osmoreceptors

75
Q

If the osmoreceptors detect high osmolarity, the hypothalamus sends a signal to the ____ ____ which released ADH into the bloodstream

A

Pituitary gland

76
Q

When ADH is present, more water is _____ and less is _____

A

More water is reabsorbed

Less is secreted

77
Q

Obligatory water resorption uses?

A

Sodium and other solutes

78
Q

Water resorption is strongly influenced by ___ ___ because it follows it back to the interstitial fluid

A

Sodium reabsorption

79
Q

Occurs mostly in collecting ducts
Through the water poles (channel)
Regulated by ADH

A

Facultative (selective) water resorption

80
Q

Occurs with large amounts of poorly reabsorbed solutes such as glucose, mannitol, or urea

A

Solute diuresis or osmotic diuresis

81
Q

Osmotic diuresis results in ____ saline

A

Hypotonic

82
Q

The constant fraction of the filtered Na+ and water are reabsorbed in the proximal tubule despite variation of GFR

A

Glomerulotubular balance

83
Q

Why is glomerulotubular balance important?

A

To prevent overloading of the distal tubular segments when GFR increases

84
Q

What is the first line of defense to buffer the effect of spontaneous changes in GFR on urine output? What is the second?

A

First line = auto regulatory mechanism

Second line = glomerulotubular balance

85
Q

How do nerves from the renal plexus regulate blood pressure and distribution throughout the kidney?

A

They innervate smooth muscle of the afferent and efferent arterioles

86
Q

Sensory nerves located inside the renal pelvic wall that are activated by stretch of the renal pelvic wall

A

Renerenal reflex

87
Q

What does the renorenal reflex cause?

A

Increase in afferent renal nerve activity
Decrease in efferent renal nerve activity
Increase in urine flow rate and urinary sodium secretion

88
Q

Increases the release of substance P via activation of N-type calcium channels in the renal pelvic wall

A

PGE2

89
Q

Retention of water is controlled by ??

A

ADH

90
Q

ADH release is stimulated by ?

A

Decrease in blood volume
Decrease in blood pressure
Increase in extracellular fluid osmolarity

91
Q

Sodium balanced is controlled by ??

A

Aldosterone

92
Q

Where is aldosterone synthesized?

A

Adrenal cortex

93
Q

Where does aldosterone cause sodium resorption and K+ secretion?

A

DCT and CD

94
Q

What is the mechanism of aldosterone?

A

Stimulates the Na+K+ ATPase pump on the basolateral side of the cortical collecting tubule membrane

95
Q

What is the primary site of aldosterone action?

A

Principal cells of the cortical collecting duct

96
Q

What releases renin and what stimulates the release of renin?

A

Juxtaglomerular apparatus stimulated by fall in NaCl, extracellular fluid, or arterial BP

97
Q

Released by the atrium in response to atrial stretching due to increased blood volume

A

Atrial natriuritic peptide (ANP)

98
Q

What does ANP inhibit?

A

Inhibits Na+ and water resorption, also inhibits ADH secretion

99
Q

What does ANP promote?

A

Sodium excretion (natriuresis) and water excretion (diuresis)

100
Q

The process of emptying the urinary bladder

A

Micturition

101
Q

What two processes are involved in micturition?

A
  1. Bladder fills progressively until the tension in its wall rises above threshold level
  2. Micturition reflex occurs and empties bladder
102
Q

How does aging affect the renal system?

A
  1. Decline in number of functional nephrons
  2. Reduction of GFR
  3. Reduces sensitivity to ADH
  4. Problems with micturition reflex
103
Q

What is the myogenic reflex?

A

Type of auto regulation

Increase in blood pressure causes afferent arterioles to stretch, opening “stretch-activated channels”, which in turn opens voltage gated channels. Calcium enters the voltage gated channels and binds to the actin chain to contract myofilaments back to their normal shape

104
Q

What is tubuloglomerular feedback?

A

Type of auto regulation

Macula densa cells detect increase in Na+, creates action potential that travels to afferent arterioles and causes contraction/vasoconstriction of the afferent arteriole

Clin Med Renal (4 decks)

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