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BioScience II > Renal Review PPT-josh > Flashcards

Renal Review PPT-josh Flashcards

1
Q

there are 2 kidneys with how many regions?

A

2

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2
Q

What are the 2 regions?

A

Cortex

Medulla

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3
Q

what is the functional unit of the kidney?

A

Nephron

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4
Q

What are 3 improtant functions of the nephron?

A

Hold filtrate

Excrete end products of metabolism

Absorb Important sunstances

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5
Q

The kidney gets what % of CO?

A

20-25%

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6
Q

how many mLs of blood does the kidney receive?

A

1100-1200 mL

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7
Q

what part of the kidney receives the most blood?

A

Cortex

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8
Q

The renal artery divides at the __1__, into several lobar arteries, they run b/t the __2__ of the medulla and turn into the __3__ then into __4__ and to the __5__.

A
  1. hilus
  2. pyramids
  3. interlobular arteries
  4. afferent arterioles
  5. glomerulus
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9
Q

Unfiiltered blood exits the kidney via what, to the venous system?

A

efferent arteriole

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10
Q

filtered blood goes where?

A

back to the body

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11
Q

waste is excreted from the kidneys as what?

A

urine

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12
Q

renal blood flow if determined by the ________ ______ ______ across the vascular bed

A

arteriovenous pressure difference

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13
Q

what is the formula to calculate renal blood flow?

A

Renal blood flow = (MAP - VP) x VR

  • MAP- mean arterial pressure
  • VP- venous pressure
  • VR- vascular resistance
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14
Q

Renal blood flow is regulated by what 2 ways?

A

intrinsic autoregulation

Neural regulation

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15
Q

Autoregulation of the kidneys is with a MAP of what?

A

75-160mmHg

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16
Q

w/ neural regulation afferent and efferent arterioles are inervated by the SNS, stimulation of which is associated w/ what? and thus should be avoided

A

vasoconstriction

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17
Q

4 main functions of the kidney?

A
  • maintenance of ECF composition
  • Maintenance of ECF volume
  • Endocrine functions
  • Regulation of Arterial BP
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18
Q

Fx of the Kidneys:

what is maintained in the maintenance of ECF composition?

A
  • Ionic composition (electrolytes)
  • Osmolality (Na+ comcentration
  • Conservation of non-ionic components (glucose, amino acids, proteins, water, vitamins)
  • Excretion of products of metabolism (urea, creatine, lactic acid, uric acid)
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19
Q

Fx of the Kidneys:

how does the kidney perform maintenance of ECF volume

A

regulation of Na+ and h2o excretion

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20
Q

Fx of the Kidneys:

what endocrine fx does the kidneys perform?

A
  • erythropoietin
  • RAAS
  • Vit D
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21
Q

What are the main structures of teh nephron? do it in order as if you were fluid going through it!

A
  • arteriole from renal artery
  • Bowman’s capsule
  • Glomerulus
  • Proximal tubule
  • Loop of henle
  • Distal tubule
  • Collecting ducts
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22
Q

What structures are in teh Cortex and what structures are in the Medulla?

A
  • Cortex
    • Renal corpuscle (bowmans capsule)
    • proximal tubule
    • Distal tubule
  • Medulla
    • Loop of henle
    • Collecting duct
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23
Q

What are the 3 steps of Urine formation and excretion

A

Glomerular filtration

Tubular reabsorption

Tubular secretion

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24
Q

Glomerular Filtration:

GFR get what % of RBF?

A

20% (125mL/min)

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25
Q

Glomerular Filtration:

the GFR is regulated by what?

A

Juxtaglomerular complex

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26
Q

Glomerular Filtration:

What 3 things can increase GFR?

A
  • Increased RBF
  • Dilation of Afferent arteriole
  • Increased resistance inefferent arteriole
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27
Q

Glomerular Filtration:

what 2 things can decrease GFR?

A
  • afferent arteriole constriction
  • Efferent arteriole dilation
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28
Q

What reabsorbs the bulk of the glomerlar filtrate?

A

Proximal tubule

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29
Q

what iare the main function of the Loop of henle?

A
  • establishes and maintains an osmotic gradient in the medulla of the kidney
  • regulation of water balance
  • Concentration/dilution of urine
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30
Q

The descending loop is highly permeable to ________ but impermeable to ______

A

Water

Solutes

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31
Q

The ascending loop is nearly impermeable to _____, but highly permeable to ___ and ____

A

water

Na+ and Cl-

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32
Q

The ECF is controlled by what hormone?

A

Aldosterone

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33
Q

ECF Volume and Osmolality:

Volume is controlled by aldosterone via ______ reabsorption

A

Sodium

34
Q

ECF Volume and Osmolality:

where is aldosterone produced?

A

Adrenal Cortex

35
Q

ECF Volume and Osmolality:

Osmolality is controlled by what?

A

ADH

36
Q

ECF Volume and Osmolality:

osmolality is controlled by ADH via ___ reabsorption

A

Water

37
Q

ECF Volume and Osmolality:

ADH is released from what?

A

the neurohypophysis (AKA posterior putuitary)

38
Q

*****

Where does aldosterone work?

A

distal tubule

39
Q

******

where does ADH work?

A

Collecting ducts

40
Q

Osmolality: ADH

explain what the body does if ADH is pressent? and also when it is absent?

A
  • ADH present
    • Collecting duct is highly permeable to H20= you get small amount of very concentrated urine
  • ADH Absent
    • Collecting duct is not pearmeable to water= you get large amounts of dilute urine
41
Q

what part of kidney os responsible for the fine tunning, makes final adjustment to urine pH and osmolality?

A

Distal tubule

42
Q

what does aldosterone reabsorb? and secrete?

A

reabsorbs- Na+

Secretes K+

43
Q

What is excreted in the proximal tubule?

A

Na+

H2O

44
Q

What is excreted in the descending loop of henle

A

H2O

45
Q

What is excreted in the ascending loop of Henle

A

Na+

Cl-

46
Q

What is excreted in the Distal Tubule

A

Na+

H2O

47
Q

what is excreted in the collecting ducts?

A

H20

48
Q

What is the basic equaltion for Acid Base balance?

A

Carbonic Anhydrase

CO2 + H2O ⇔ H2CO3 ⇔ HCO3_ + H+

49
Q

refere to acid base disturbances on own I am not going over that

A

Know your different ranges and how to determine them

50
Q

Mind the Gap:

what is the anion gap used for?

A

to differentiate b/t metabolic acidosis

51
Q

Anion Gap:

Is the difference b/t the primary measured what?

A
  • cations (Na+ and K+) and the primary measured Anions (Cl- and HCO3) in serum
52
Q

Anion Gap:

what is the equation?

A

Normal: (Na+ + K+) - (Cl- + HCO3)

or ususally done w/o K+ as

(Na+) - (Cl- + HCO3)

53
Q

Mind the Gap:

What is te normal Anion Gap

A

8-12mM

54
Q

Mind the Gap:

what does high Anion Gap Indicate?

A
  • increased non-chloride acids (H+) uses more HCO3- therby Increaseing Anion Gap
  • Normachloremia
  • Lactic Acidosis
  • DKA
55
Q

Mind the Gap:

what does normal Anion Gap Mean?

A
  • Decreased HCO3- from loss of body fluids (emesis/diarrhea), is replaced by Cl- resulting in no change to anion GAp
  • Hyperchloremia
56
Q

Diuretics:

what is a peptide hormone synthesized, stored, and secreted by teh cardiac atria

A

Atrial Natriuretic Factor

57
Q

Diuretics:

what is teh stimulis for ANF release?

A

atrial stretch, distention, or pressure

58
Q

Diuretics:

what is one of the most potent diuretics known?

A

ANF

59
Q

Diuretics:

ANF acs on the kidneys to increase urine flow and Na+ excretion, it antagonizes both the release and end organ effects of ______, ______, and ____.

A
  • renin
  • Aldosterone
  • ADH
60
Q

Loop Diuretics:

what are 2 examples of them

A

lasix

bumex

61
Q

Loop Diuretics:

how do they basically work?

A

stop reabsortion of Ions in ascending loop thus decreasing osmolality.

Increass water excretion

62
Q

Diuretics:

What are ex of thiazide diuretics work?

A

HCTZ

Zaroxoyln

63
Q

Diuretics:

what are examples of K+ sparing diuretics?

A

spironlactone

64
Q

Diuretics:

whare to thiazides work?

A

distal convoluted tubule

65
Q

Diuretics:

how do Thiazides work

A

Inhibit Na+ reabsorbtion thus decreasing water reabsortion

66
Q

Diuretics:

Where do K+ sparing diuretics work

A

i think in the collecting ducts

67
Q

Diuretics:

how do K+ sparing diuretics (spironlactone work?

A

competitively inhibits aldosterone increasing sodium excretion and promoting sodium retention

68
Q

Diuretics:

where do Carbonic-anhydrase inhibitors work?

A

Proximal tubule

69
Q

Diuretics:

what type of diuretic is impermeable to teh renal tubule and exerts osmotic force dereasing the reabsorption of water

A

Osmotic diuretics Mannitol

70
Q

Describe the RAAS! (basic don’t need to say that renin is released from the juxta…. blah blah blah)

A
  • Kidney releases renin into blood
  • Liver releases angiotensinogen
  • they meet and convert into ATI
  • ACE from the lungs then cahnges ATI into ATII
  • ATII stimulates aldonsterone secretion by the adrenal cortex
  • aldosterone stimulates Na+ and H2O reabsorption in the nephrons

(ATII also works on the neurohypophysis to release ADH and such, but the basics is above)

remember from previous slides ADH works in collecting ducts, and ALdosterone works in the distal tubule

71
Q

Blocking the actions of what can cause refractory Hypotension how?

A

Blocks the release of both aldosterone and ADH

72
Q

what are the pros of Colloid?

A
  • increased plasma volume
  • Less peripheral edema
  • Smaller volumes for resuscitation
  • Intravascular half-life 3-6 hrs
73
Q

What are the advantages of Crystalloids?

A
  • Inexpensive
  • Unse for maintenance fluid and inital resuscitation
  • restore 3rd space loss
  • Intravascular half-life 20-30 minutes
74
Q

K+ controls what with the membrane potential

A

resting membrane potential

75
Q

Ca++ controls what w/ the membrane potential

A

threshold

76
Q

Treatment of Hyperkalemia:

why give Ca++

A

move threshold away from resting membrane potential

77
Q

Treatment of Hyperkalemia:

whay give HCO3 and hyperventilate the pt?

A

decrease Concentration of H+ in the plasma (H+ from ICF to ECF, K+ back inside the cell)

78
Q

Treatment of Hyperkalemia:

why give a Beta-2 agonist (albuterol) and insulin?

A

to stimulate Na-K pump, drives K back into cells

79
Q

Treatment of Hyperkalemia:

why give dextrose?

A

to prevent hypoglycemia

80
Q

thats it for for that next is Renal patho!!!!!

A

whooooo hoooooo

BioScience II (39 decks)

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