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Physiology Block 7 > Renal Physiology Intro And Clearance > Flashcards

Renal Physiology Intro And Clearance Flashcards

1
Q

What is the in the middle of the kidney

A

Hilium

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2
Q

Where is the site of the renal artery, renal vein, and ureter entrance/exit

A

Hilum of kidney

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3
Q

What are the two parts of the kidneys

A

Cortex and medulla

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4
Q

What is the functional unit of the kidney

A

Nephron

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5
Q

What filters blood to make urine

A

Nephron

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6
Q

Where does renal artery enter the kidney

A

Hilum

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7
Q

What does the renal artery do

A

Provides blood flow to the nephrons

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8
Q

How does urine collect

A

In papilla, drains into renal pelvis, and ureter

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9
Q

How does blood drain out of the kidney

A

Through the capillaries back in renal vein

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10
Q

General renal functions

A
  • regulation of water balance
  • maintain normal electrolyte concentrations and content
  • conserve nutrients
  • excrete wastes
  • regulate CO and BP
  • control hematopoiesis
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11
Q

Water intake + metabolic water=

A

Renal excretion + GI excretion + evaporation

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12
Q

If the regulation of water balance is negative

A

Lose total body water

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13
Q

If the regulation of water balance is positive

A

Gain total body water

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14
Q

What is the minimum amount of urine needed per day

A

1/2L

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15
Q

Where are the places we lose water

A

GI, evaporation. Evaporation is the number 1 way

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16
Q

How does the kidney maintain normal electrolyte cxn and content

A

Regulate electrolyte and water excretion to control electrolyte amount AND concentration in plasma

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17
Q

What are the two different kinds of nephrons

A

Cortical (superficial)

Juxtamedullary nephron

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18
Q

Cortical (superficial) nephron

A

Superficial, short loop of henle, mostly stays out of medulla

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19
Q

Juxtamedullary nephron

A

Long loop of henle, can go down to the papilla.

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20
Q

What type of nephron has the longest loop of henle

A

Juxtamedullary nephron

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21
Q

What kind of nephron has the vasa recta

A

Juxtamedullary nephron

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22
Q

What does the vasa rectus do

A

Slow moving blood supply to make concentrated urine

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23
Q

Where is the 1st step of urine production in the kidney

A

Glomerular capillaries

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24
Q

What do the glomerular capillaries do

A

Filters plasma into nephron, makes tubular fluid

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25
Q

What are the glomerular caps fed by

A

Afferent arterioles

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26
Q

What is the glomerular caps drained by

A

Efferent arterioles

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27
Q

How does the glomerular caps control blood flow

A

Can control diamter of each arteriole

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28
Q

What is the pressure in the glomerular caps

A

Very high due to the two arterioles on either side

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29
Q

Normal caps, fed by efferent arterioles

A

Peritubular caps

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30
Q

What wraps around the nephron

A

Peritubular caps

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31
Q

What are the peritubular caps required for

A

Reabsorption and secretion

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32
Q

Filter plasma to form tubular fluid (urine). Filter load is the amount filtered in caps. Amount filtered is not always the same as excretion

A

Filtration

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33
Q

Is the amount filtered the same as the amount excreted

A

Not always

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34
Q

What is removed from the body via urine

A

Excretion

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35
Q

Remainder of tubular fluid and solutes at the end of the nephron

A

Excretion

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36
Q

What is the excretion rate of X?

A

Urine flow * [X]

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37
Q

Moves solutes/ water from tubular fluid back to blood

A

Reabsorption

Kidney taking it from peritubular fluid and putting it back into the blood

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38
Q

Moves solutes from blood into tubular fluid

A

Secretion

Kidney decides it shouldn’t be in the blood. Filters things out

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39
Q

What happens between filtration and excretion

A

Reabsorption and secretion

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40
Q

What is the hollow tube that create the tubular fluid

A

Nephron

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41
Q

What order does the nephron go in

A

Glomerulus–PCT–loop of henle–DCT–collecting duct

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42
Q

Capillary bed that filters blood to produce urine

A

Glomerulus

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43
Q

What is the first step in urine production

A

Glomerulus

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44
Q

Cup shaped entrance to nephron surrounds glomerulus that has arterioles on both sides

A

Bowmans capsule

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45
Q

What is the filtration caused by in the kidneys

A

The same as in Theo ther parts of the body

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46
Q

What is the first step in ruin production

A

Filtration

47
Q

What is the second step in urine production

A

PCT

48
Q

What is the main site of reabsorption

A

PCT

49
Q

67% of ions (Na, K, Ca) and water, all glucose and amino acid reabsorption

A

PCT

50
Q

What does the PCT have to do with secretion

A

Secretion of some metabolites and drugs

51
Q

What are most transport mechanisms dependent on

A

Na/K ATPase

52
Q

Where do carbonic anhydrase inhibitors have diuretic effects

A

PCT

53
Q

Where does reabsorption and dilution of urine occur

A

Loop of henle

54
Q

What is the 3rd step in urine production

A

Reabsorption and dilution of urine at the loop of henle

55
Q

Where is the water reabsorption and no solute movement in the loop of henle

A

Descending limb

56
Q

Where in the loop of henle do solutes get reabsorbed and no water movement

A

Ascending limb

57
Q

What sets up gradient used to alter urine concentration

A

Loop of henle

58
Q

Where is the osmolarity the highest?

A

At the bottom of the loop of henle

59
Q

Part of the juxtaglomerular apparatus that sense tubular flow and renal blood flow

A

Macula densa

60
Q

Loop diuretics

A

Furosemide (lasix) take action at the loop of henle

61
Q

What is the 4th step of urine production

A

Fine control and pH balance at the distal convoluted tubule

62
Q

Where does fine control and pH balance in urine production happen

A

Distal convoluted tubule

63
Q

Where do thiazide antidiuretics work

A

Distal convoluted tubule

64
Q

What is the 5th step in urine production

A

Collecting ducts

65
Q

Regulation of water reabsorption and final control of urine osmolality. Pulls a lot of water out to concentrate the urine

A

Collecting ducts

66
Q

How many collecting ducts per nephron

A

1 duct drains may nephrons

67
Q

Site of anti diuretic hormone function

A

Collecting ducts

68
Q

What makes the collecting ducts permeable to water only

A

Anti-diuretic hormone

69
Q

Where do potassium sparing diuretics take place

A

Collecting ducts

70
Q

Glucose is removed from the tubular fluid by active transport and returned to the blood, this is an example of what kind of renal process

A

Reabsorption

71
Q

In periods of hyperglycemia like DM, some filtered glucose is lost to the urine. This is an example of what kind of renal process

A

Excretion

72
Q

The most water reabsorption in which segment of the nephron

A

Proximal convoluted tubule

73
Q

The most Na is reabsorbed in which segment of the nephron

A

PCT

74
Q

The most unicorns is reabsorbed in whih segment of the nephron

A

PCT

75
Q

Filtration + secretion - reabsorption=

A

Excretion

76
Q

Urine flow * [urine]=

A

Excretion

77
Q

What begins everything into the kidneys

A

Renal artery

78
Q

What dies kidney only filter

A

Blood plasma

79
Q

What is Renal function

A

How much stuff was removed from the blood

80
Q

BV=

A

PV/(1-hematocrit)

Hmct is volume of blood cells

81
Q

Plasma volume is about _____ of total blood volume

A

40%ish

82
Q

Input of solute

A

Amount delivered to kidney

83
Q

Input of solute

A

RPF*(Xa)

RPF=renal plasma flow
Xa= cxn in blood plasma

84
Q

Renal output

A

Solute leaving the kidney in urine AND renal vein

85
Q

Renal output equation

A

(RPF(Xv))+(XuV)
Xv= cxn in renal vein
Xu= cxn in urine
V=urine volume

86
Q

Relationship of output and input

A

Should equal

RPF(Xa)=(RPF[Xv])+(Xu*V)

87
Q

What allows for determination of clearance of a solute

A

The fact that input=output

88
Q

As plasma moves through kidney

A

Solutes are removed from it

89
Q

Volume of plasma that has had a solute removed from it in one minute

A

Clearance

90
Q

What does clearance compare

A

Urine and plasma levels to determine amount removed

91
Q

How is clearance expressed

A

Volume/time (mls/min)

92
Q

Equation for clearance

A

CN=(Xu*V/Xa)

93
Q

What is the basis for determine renal function

A

Clearance

94
Q

What can clearance determine

A

Plasma filtered, amount of blood delivered to kidney

95
Q

Clearance of inulin

A

Glomerular filtration rate

-amount of plasma filtered by kidneys

96
Q

Clearance of PAH

A

Renal plasma flow

  • 100% filtered and 100% secreted
  • tells you how much plasma moved through kidney
97
Q

Amount of plasma that is filtered by the kidney

A

Filtration fraction

98
Q

Equation for filtration fraction

A

FF=GFR/RPF

Usually about 20%

99
Q

Tells us how much water we are excreting

A

Free water clearance

100
Q

When is free water clearance helpful

A

When we want to think about the osmolality of the ECF and if the kidneys are working correctly in trying to fix a problem

101
Q

Is plasma osmolarity were too high, what would we want

A

Excrete the minimum amount of water. Retain water to dilute ECF

102
Q

If plasma osmolarity were too low, what would we want

A

Get rid of water. Urine is diluted

103
Q

How do we calculate the renal clearance of total osmoles

A

Cosm=(Uosm*V)/Posm

104
Q

What does renal clearance of total osmoles tell us

A

Volume from which all solutes have been removed

105
Q

What would happen if osmolar clearance is 1ml/min but our urine flow was 3ml/min

A

Body needs 1ml/min of urine to remove all of the dissolved stuff, but produced 3mls/min. The extra 2mls is free water, water that has no dissolved substances

106
Q

Total clearance-Osm clearance=

A

Free water clearance

3mls/min-1ml/min=2mls/min

107
Q

If free water clearance is positive (more water cleared than solutes)

A
  • body is over hydrated, ECF osmolarity is low
  • have more water than necessary so lots of dilute urine is appropriate
  • lose free water to increase ECF osmolarity
108
Q

If the free water clearance is negative (more solute cleared than water)

A
  • body is dehydrated, ECF osmolarity is high

- have less water (more solute), so small amounts of cxn urine is appropriate

109
Q

Can you preserve water in times of no water?

A

You can’t preserve enough water to correct a hyperosmotic ECF, only slow its progression

110
Q

If Uosm»»Posm

A

You should have a negative Cwater
-appropriate when Posm is high
-need to keep water in body
Usually a low urine flow rate

111
Q

If Uosm««

A

You should have a positive C water

  • appropriate when Posm is low
  • need to lose water from body
  • usually a high urine flow rate
112
Q

Posm=335mOsm/L, Usom=156mOsm/L, Uflow=4mls/min

Is this an appropriate free water clearance

A

No
Decreases Uosm not good for preserving water
Increase Uosm needs to be higher, flow rate as low as possible

113
Q

Normal plasma osmolarity (Posm)

A

285-295

114
Q

Normal urine flow rate

A

2mls/min

Physiology Block 7 (10 decks)

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