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Genitourinary > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

Cortical nephrons

A
  • 80-85%
  • Solute handling
  • Peritubular capillaries
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2
Q

Juxtamedullary nephrons

A
  • 15-20%
  • make Concentrated Urine
  • Peritubular Capillaries + Vasa Recta
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3
Q

Filtered freely at glomerulus:

A

Small, (+)

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4
Q

Not filtered freely at glomerulus:

A

Large
(-)
(Protein)

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5
Q

What pressure drives GFR?

A

Glomerular Capillary BP (P gc) vs. bowman’s space pressure vs. glomerular oncotic

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6
Q

Think of GFR as

A
  • # filtering nephrons by surface area

* volume plasma filtered by nephrons

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7
Q

How much plasma gets filtered?

A

20%

~140 mL per minute

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8
Q

Blood plasma ratio

A

56% plasma

44% RBCs

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9
Q

Extreme Drop in BP

Neuro regulation GFR

A
  • Sympa = afferent constricts
  • Release renin
  • Ang II constricts
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10
Q

Extreme BP rise

Neuro regulation GFR

A
  • atria stretch = ANP released
  • Mesangial cells in glomerulus relax
  • UP surface area = UP GFR
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11
Q

Vasodilators

A 
DILATE AFFERENT
UP GFR
*Prostaglandin E (PGE2) + Prostacyclin (PGI2)
*NO
*Bradykinin
*DA
*ANP + BNP (+ constrict EA)
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12
Q

Vasoconstrictors

A 
CONSTRICT AFFERENT
DOWN GFR
*Sympathetic (a1/b1)
*Ang 2 (+Efferent) = high dose
*Endothelin
*ADH

CONSTRICT EFFERENT
UP GFR
*Ang 2 = low dose
*ANP + BNP (+ dilate AA)

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13
Q

What med example need to measure GFR

A

Aminoglycosides

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14
Q

Limitations of GFR measurement

A
  • creatinine partially secreted
  • test underestimates it
  • still not balanced
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15
Q

GFR ~ P crt

A

Inverse

GFR = 1/Pcrt

GFR = Ucrt*V/Pcrt

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16
Q

Filtration fraction =

A

GFR / renal perfusion

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17
Q

Filtration - reabsoption + secretion =

A

Clearance?

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18
Q

GFR ~ RPF

A

GFR (120 mL/min)= 20% of RPF (600mL/min)

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19
Q

Filtered Load

A

Mass getting out

GFR * Plasma conc

20
Q

Filtration Fraction

A

Amount of total perfusion filtered (20%)

GFR/RPF

21
Q

Lower than normal GFR?

A

Loss of nephrons

22
Q

Collecting duct

Reabsorbs/Secretes

A

REABSORBS

  • Bicarb
  • Cl
  • Na
  • Urea
  • Water

SECRETES

  • H+
  • NH4
  • K+
23
Q

Distal Tubule

Reabsorbs/Secretes

A

REABSORBS

  • Na
  • Water
  • Bicarb
  • Cl

SECRETES
*H+, NH4, K+

24
Q

Loop of henle descending

reabsorbs

A

Water

NO SOLUTES

25
Q

Loop of Henle

Thick ascending

A

Na
Cl
NO WATER

26
Q

Thin Ascending

Reabsorbs

A
  • Na
  • Cl

NO WATER

27
Q

PCT

Reabsorbs/Secretes

A

REABSORBS

  • amino acids
  • bicarb
  • Cl
  • Glucose
  • Na
  • peptides
  • potassium
  • urea
  • water

SECRETES
*H+, Urate, NH4, Rx

28
Q

Na reabsorbed in

A
  • PCT (most) = co transpoerters (Cl)
  • TALH (Na/K/2Cl)
  • DCT (Na/Cl co)
  • CD (ENaC)(aldosterone)
29
Q

Lasix attacks

A

TALH
Na/K/Cl transporter
The Rock

Nothing excreted

30
Q

K+

A

REABSORBED

  • PCT (most) = Paracellular solvent drag
  • TALH = transcellular (Na/K/2Cl)

REABSORBED/SECRETED
*DT =
secretion (principal cells-aldosterone);
reabsorption (a-intercalated cells H/K)

15-80% excreted

31
Q

Ca2+

A

REABSORBS

  • PCT (most) = paracellular solvent drag
  • TALH = paracellular lumen positive reabsorption (K backleak)
  • DCT = Ca2+ channel (PTH)
  • CD

Almost nothing excreted

32
Q

Aldo stimulated

A

*DCT = Principal cell K channel
ENaC
Na/K ATPase

=K loss, Na reabsorbed

33
Q

Pi

A

REABSORBED

  • PCT most = Na/Pi co
  • PST = paracellular/transcellular (upreg if low Plasma Pi)
  • DT = also upreged
34
Q

Mg2+

A 
*majority NOT reabsorbed PCT
REABSORBED
*PCT = solvent drag
*TALH = solvent drag
*DCT = Mg channel
35
Q

Urea

A
  • PCT ABSORB= passively reabsorbed

* LOOP SECRETE then ABSORB from CD

36
Q

Water

A

REABSORB

  • PCT
  • tDLH
  • NO ALH
  • CD
37
Q

Sodium controls

A

Volume

Slow movement (constriction/dilate of vessels to compensate)

38
Q

Water controls

A

Osmolarity

Moves quickly, easy to regulate

39
Q

Osmoreceptors

Controlling ADH

A

Hypothal = high plasma osmolarity ->release ADH + thirst

MOST SENSITIVE TO CONTROL OSMOLALITY = PRIMARY MODE OF REGULATION

40
Q

Blood volume

controlling ADH

A

*large blood volume drop -> baroreceptors (vascular + carotid/AA) -> release ADH

LESS SENSITIVE THAN OSMORECEPTORS

41
Q

Daily loss

A

1/2 liter = lungs
1/2 liter = skin

~1.6 water needed to excrete metabolic waste

42
Q

ADH

Characteristic

A
  • short t 1/2 (10-15min)
  • Deep sleep
  • exercise
  • triggered by High Plasma Osmolarity
43
Q

Amiloride blocks

A

Na/Cl channel in DCT

44
Q

Thiazide effects

A

Increase sodium ENac Na excrete in early DCT

Late DCT = Na absorb/K excrete = LOSE K

45
Q

Diuresis

Water

A

Large water intake = inhibits ADH secretion = UP urine volume

46
Q

Osmotic diuresis

A

Ex: mannitol, excess glucose DM

CKD = less nephrons, more solute (can’t concentrate) + faster flow (can’t absorb/dilute)

47
Q

Kidney maintain homeostasis of:

A
  • blood volume (Na)
  • Body fluid tonicity/osmolality (water, ion/nutrient excretion)
  • Acid-base balance (bicarb)
  • blood pressure (hormone-vascular tone + blood volume)

Genitourinary (9 decks)

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