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Renal > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

What is osmolarity?

A

Concentration of osmatically active particles present in soloution

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2
Q

how can you measure the volume of a compartment using a tracer?

A

Volume = dose / concentration in sample

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3
Q

What volume of water is lost per day?

A

2.5L

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4
Q

What are the two types of water loss?

A

insensible - skin and lungs

sensible - sweat, faeces and urine

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5
Q

What is the sodium and potassium distribution in the extracellular and intracellular compartments?

A

Lots of sodium extracellular

Lots of potassium intracellular

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6
Q

What is fluid shift?

A

Movement of water between the ICF and ECF in response to osmotic gradient

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7
Q

What are the functions of the kidney?

A

Water balance

Salt balance

maintenance of plasma volume and osmolarity

acid base balance

excretion of waste

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8
Q

What is a nephron?

A

Functional unit of the kidney

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9
Q

What are the two types of nephron and the percentages of each?

A

juxtamedullary nephron - 20%

cortical nephron 80%

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10
Q

What is characteristic of a juxtamedullary nephron?

A
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11
Q

what does a juxtamedullary nephron have that a cortical nephron does not?

A

Vasa recta

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12
Q

What blood vessle enters the bowman’s capsual and what blood vessle leaves the bowan’s capsual?

A

Afferent arteriole enters

Efferent arteriole exits

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13
Q

What makes up the inner layer of the bowman’s capsual and acts like a sieve ?

A
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14
Q

What cells in the distal tubule are involved in the juxtaglomerular apparatus?

A

Macula densa

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15
Q

What is the juxtaglomerula apparatus?

A
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16
Q

What is urine?

A

Modified filtrate of the blood

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17
Q

What are the three renal processes involved in the production of urine?

A

Glomerular filtration

tubular reabsorption

Tubular secretion

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18
Q

What percentage of blood is filtered in the glomerulus?

A

20%

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19
Q

How does the nephron filter blood?

A
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20
Q

What componets make up the rate of excretion of a substance (formula)

A

rate of excretion = rate of filtration + rate of secretion - rate of reabsorption

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21
Q

What formula defines the rate of filtration of a substance?

A

Rate of filtration of (#) = concentration of (#) X glomerular filtration rate

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22
Q

How is the rate of exretion of a substance calculated?

A

Rate of excretion of (#) = concentration of (#) in urine X Urine flow rate

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23
Q

What can you deduce if the rate of filtration is greater than the rate of excretion?

A

Net reabsoption of that substance has occured

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24
Q

how do you calculate the rate of reabsorption?

A

Rate of reabsorption = rate of filtration - rate of excretion

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25
Q

What can you deduce if rate of filtration is less than rate of excreton?

A

Net secretion has occoured

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26
Q

How do you calculate the rate of secretion?

A

Rate of secretion = rate of excretion - net filtration

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27
Q

What are the filtration barriers in the glomerulous ?

A
  1. Glomerular capillary endothelium
  2. Basment membrane (plasma protein barrier)
  3. Slit processes of podocytes ( glomerular epithelium
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28
Q

What four forces make up the net filtration pressure?

A

Glomerular capillary blood pressure

Capillary oncotic pressure

Bowman’s capsule hydrostatic pressure

Bowman’s capsule oncotic pressure

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29
Q

What are the pressure values that make up the net filtraton pressure?

A

55 30 15 0

net = 10

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30
Q

Draw the glomerulor filtration pressure diagram

A
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31
Q

Define GFR?

A

GFR = filtration coefficient x net filtration pressure

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32
Q

What is the major determinant of GFR?

A

Net fitration pressure e.g glomerular capillary blood pressure

33
Q

How can glomerular filration rate be controlled?

A

the afferent arteriole can constrict reducing golerular capillary blood pressure and net filtration pressre.

Resulting in decreased GFR

conversly it can dilate causing the opposite effect

34
Q

How is afferent arteriole constriction controlled?

A

Myogenic- if it is stretched ( high bp) it constricts

Tubuloglomerular feedback- Juxtaglomerular apparatus dectects increased NaC l flowing through tuule due to high GFR. This causes afferent arterioles to constrict (some how)

35
Q

What is plasma clearance?

A

The volume of plasma completely cleared of a particular substance per minute

36
Q

What formula calculates plasma clearance?

A

Plasma clearance = rate of excretion / plasma concentration

37
Q

What substance has a clearance rate equal to the GFR?

A

Inulin

38
Q

What is the clearance of glucose (normally)?

A

0

39
Q

What is the glomerular filtration rate?

A

125ml/min

40
Q

What is the renal plasma flow rate?

A

650 ml/min

41
Q

What percentage of Cardiac output do the kidneys recieve ?

A

24%

42
Q

How much of the glomerular filtrate is reabsorbed in the proximal tubule and how much passes on to the loop of henle?

A

80ml/min is reabsorbed by the proximal tubule so 45 ml/min flows into the loop of henle

43
Q

What is reabsorbed in the proximal tubule?

A

Sugars

amino acids

phosphate

sulphate

lactate

44
Q

What are the three types of carrier mediated membrane transporters?

A

Primary active transport

Secondary active transport - carrier molecule coupled to concentration graidient

Facilitated diffusion - substance transported down its concentration gradient

45
Q

How is sodium reabsored in the proximal tubule?

A

Energy dependent Na K AtPase transporter exchanges sodium for potassium on the basolateral membrane

46
Q

How is glucose reabsorbed in the proximal tubule?

A

Coupled with sodium

47
Q

What is the renal threshold for plamsa glucose?

A

10-12 mmol/L

after which you will start to detect glucose in the urine

48
Q

What is the transport maximimum for glucose?

A

2 mmol/min

49
Q

What is the function of the loop of henle?

A

Generates a cortico-medullary solute concentration gradient enabling the formation of hypertonic urine

50
Q

What is the difference between the descening and ascending loop of henle

A

the descending limb does not reabsorbed NaCl and is highly permeable to water

Ascening limb reaborbs Na and Cl and is impermeable to water

51
Q

How is salt reabsorbed in the ascending limb of the loop of henle?

A

Using the triple co- transporter

52
Q

What ions are transported in the triple co transporter

A

Na

K

Cl

53
Q

What happens at the tripple co-transporter

A
54
Q

How does the loop of henle concentrate the urine?

A
55
Q

Give an overview of a working loop of henle?

A
56
Q

What hormones regulate the ion and water balance in the distal tuble and collecting ducts?

A

ADH

Aldosterone

Atrial natriuretic hormone

Parathyroid hormone

57
Q

What does ADH do?

A

Increase water reabsoption

58
Q

What does aldosterone do?

A

Increased Sodium reabsorption and increased hydrogen/potassium secretion

59
Q

What does atrial natriuretic hormone do ?

A

Decreases sodium reabsorption

60
Q

What does parathyroid hormone do ?

A

Increases calcium reabsorption

Decreases phsopate reabsorption

61
Q

What is the osmorality of the distal tubular fluid compared to the intersitial fluid sourrounding it ?

A

100 mosmol/l vs 300 mosmol/l

62
Q

What are the features of the late collecting duct?

A

Low ion permeability

Permeabilty to water and urea influced by ADH

63
Q

What is the plasma half life of ADH?

A

15 minutes

64
Q

How does ADH increase permeability to ADH?

A

Inserts new water channels in the luminal membrane

65
Q

What happens in the presence of lots of ADH?

A
66
Q

What happens in the presence of minimal ADH?

A
67
Q

What is the most important stimulus for ADH release?

A

Hypothalamic osmoreceptors

68
Q

What causes aldosterone to be secreted?

A

Rising [K+]

or

Falling [Na+]

69
Q

What happens to your potassium levels if you have no aldosterone ?

A

No potassium is excreted in the urine

70
Q

What produces atrial natriuretic peptide?

A

The heart

71
Q

How is ANP released?

A

ANP is released from atrial muscle cells when it is stretched

72
Q

What does ANP do?

A

Promotes excretion of sodium

73
Q

How muc volume can the bladder hold before the micturation reflex is stimulated?

A

250-400ml

74
Q

What is the reltionship between pH and [H+] conc?

A

pH = log (1/[h+])

75
Q

Where do H+ ions come from in the body?

A
  1. carbonic acid formation
  2. Inorganic acids produced during breakdown of nurients
  3. Organic acids resulting from metabolism
76
Q

What is the henderson-hasselbalch equation?

A
77
Q

When are natriuteric peptides released?

A

Releaed by the atria in response to an increase in extracellular volume ( high blood pressure)

78
Q

What do natiruteric peptides do?

A

inhibit Na/K ATPase pumps

inhibit aldosteone excretion

inhibit ADH release

Excrete salt to lower BP

79
Q
A

Renal (6 decks)

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