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Physiology Test 3 > Renal physiology > Flashcards

Renal physiology Flashcards

1
Q

what is the role of the kidneys?

A
  1. regulate water balance
  2. contribute to long term regulation of acid-base balance
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2
Q

how do the kidneys help with acid-base balance regulation?

A

excrete H+ when there is excess acid or HCO3- when there is an excess of base

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3
Q

what is the functional unit of a kidney?

A

the nephron

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4
Q

what is the entry point to the nephron from the blood?

A

Bowman’s capsule, it wraps around the vasculature

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5
Q

how does Diabete’s affect the exchange that occurs at the Bowman’s capsule?

A

it changes the structures of the basement membrane of epithelial cells in Bowman’s capsule

thickens/hardens them which makes it harder to move materials from vasculature to Bowman’s capsule

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6
Q

name some patient populations that can have issues with kidney function at Bowman’s capsule

A
  1. Diabetic
  2. hypertensive
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7
Q

what is the role of the Bowman’s capsule?

A

to act a barrier and alllow passage of some materials into the nephron and not others.

Filtration

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8
Q

what is filtrate?

A

the fluid that will eventually become urine

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9
Q

where do materials go once inside the Bowman’s capsule?

A

proximal convoluted tubule

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10
Q

where is most of the work done in the kidney?

A

the area between the glomerulus and the proximal convoluted tubule

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11
Q

what processes occur in the tubule and loops of the nephron?

A

reabsorption and secretion

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12
Q

what is reabsorption in the kidney?

A

a process that removes materials from the filtrate and brings it to the interstitial space where it will be reintegrated back into circulation

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13
Q

what is secretion in the kidney?

A

process by which materials move into the nephron for excretion

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14
Q

define Glomerular filtration rate (GFR)

A

an estimate of how much fluid is filtered from the glomerular capillareis into Bowman’s capsules per unit time

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15
Q

what would a GFR of 60 indicate?

what about 15?

A

60 = kidney disease

below 15 = stage 4 kidney disease

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16
Q

T/F: the kidney recieves a large amount of CO

A

TRUE, 20% of CO is delivered ot the kidneys in order to help maintain a constant GFR

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17
Q

how is blood flow regulated at the kidneys?

A

renal capillaries have intrinsic and extrinsic factors that affect blood flow regulations

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18
Q

what are some extrinisic factors that affect renal blood flow?

A

SNS input

decreased SNS = vasodilation and greater blood flow

increased SNS = vasoconstriction

19
Q

what are some intrinsic factors that affect renal blood flow?

A
  1. autoregulation
    • arteriolar myogenic mechanism
    • tubuloglomerular feedback mechanism
20
Q

what is the arteriolar myogenic mechanism?

A

Stretching smooth muscle causes it to contracts

remove the stretch and smooth muscle relaxes, restoring its resting length

21
Q

what is tubuloglomerular feedback mechanism?

A

tubular monitoring of filtrate flow rate and Na+ concentration

Increased osmolarity of the filtrate causes the afferent arterioles to constrict, slowing blood flow and vice versa

22
Q

how does the glomerulus regulate what it filters?

A

the epithelial walls of the capillareis in this area are fenestrated = increased permeability

23
Q

what is rhabdomyolysis?

A

severe muscle damage leading to kidney disease.

muscle breaks down and peices of muscle get into blood stream and then to the kidney but can’t pass into the Bowman’s capsule.

thus they clog pores and movement of fluid becomes compromised

24
Q

what are antigen-antibody complexes (Ag - Ab)?

A

obstruct openings in epithelial linings and prevent movement of fluid and solutes into tubules.

Ag-Ab complexes are larger than the pores

25
Q

how does tubular reabsorption occur?

A

water moves down it’s concentration gradient to be reabsorbed into the blood.

Ions move down their concentration gradients and can also be reabsorbed.

26
Q

how does Na+ move from the tubule into the interstitial space?

A

mediated transport mechanism and channels help over come the gradient from the cell to the interstitial fluid

27
Q

what gets secreted in tubular secretion?

A

molecules like H+, K+ ,creatinine, HCO3 get secreted by diffusion or mediated transport

28
Q

water follows _______

A

Na+

29
Q

where is Na+ reabsorbed?

A

in the proximal convoluted tubule (PCT)

30
Q

what is reabsorbed at the PCT?

A

Na and most of the water

31
Q

the descending loop of Henle is permeable to ________

A

water

32
Q

the ascending loop of Henle is permeable to _________

A

Na and Cl

but NOT water

33
Q

where is the last bit of water reabsorped at?

A

the distal convoluted tubule and collecting ducts

34
Q

how is does water move out of the distal convoluted tubule?

A

via aquaporin channels which are requried by ADH and inserted into the walls of the distal tubule and collecting ducts as needed

35
Q

how would you expect the urine concentration to differ between water dwelling and desert dwelling animals?

A

water dwelling = more dilute

desert dwelling = more concentrated

36
Q

what is the harm in drinking salt water?

A

too much Na+ in salt water

getting rid of that ingested Na+ would cause a loss of water

end result is amplified dehydration

37
Q

where is renin produced?

A

Kidney cells

38
Q

what prompts the kidney to release renin?

A

decreased BP,

decreased NaCl

increased sympathetic outflow in kidney

39
Q

what does Aldosterone do?

A

favors reabsorption of water and Na+

helps create osmotic gradient needed for movement

40
Q

T/F: reabsorption of glucose occurs in the kidneys?

A

TRUE

41
Q

where is glucose reabsorbed in the kidney?

A

proximal convoluted tubule

at SGLT2 transport molecules

42
Q

effect of renin angiotensin system on BP?

A

Increase BP

43
Q

how would eating salty food affect the kidney?

A

kidney wants to conserve water and get ride of excess Na+

renin angiotensin system is slowed down to get rid of Na

Water has to be lost to get rid of Na+

44
Q

effect of CHG on kidney function

A

heart is weak due to reduced cardiac contractility

body thinks there is a reduced blood volume

body trys to increase water retention to increase blood volume

kidney increases water retention = not good for these patients

Physiology Test 3 (2 decks)

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