Renal Stuff- Anatomy Physiology Whatnot

Question 1

The kidney is a _______ organ

Answer 1

Retroperitoneal

Question 2

The kidney is covered by?

Answer 2

A fibrous renal capsule covered by perinephric/ perirenal fat which is also covered by renal fascia

Question 3

What is the renal fascia cover formed by?

Answer 3

Formed by the splitting of transversalis fascia (fascia lying between inner surface of transverse abdominal muscle and parietal peritoneum)

Question 4

What level is kidney found in?

Answer 4

T12 to L3

Question 5

Difference between right and left kidney?

Answer 5

Right is slightly lower due to it being pushed down by the liver

Question 6

Left renal vein difference

Answer 6

It’s longer than the right - has to cross the aorta to reach vena cava

Question 7

Renal blood supply?

Answer 7

Renal artery - interlobar artery - arcuate artery - interlobular artery - afferent arteriole - glomerular capillary - efferent arteriole - peritubular capillary

Question 8

Where do the gonadal veins drain to?

Answer 8

Right to IVC, Left to renal vein

Question 9

Where do gonadal arteries originate from and at what level?

Answer 9

Aorta, L2

Question 10

3 sites where the ureter narrows?

Answer 10

Pelviureteric junction, pelvic brim anterior to sacroiliac joints, Vesico-ureteric junction

Question 11

How many arteries supply the adrenals?

Answer 11

3 (aorta, renal artery, inferior phrenic artery)

Question 12

3 zones of adrenal cortex of adrenal gland

Answer 12

Zona glomerulosa: produces aldosterone
Zona fasciculata : produces cortisol
Zona reticularis : produces androgens like DHEA

Question 13

What does the adrenal medulla produce?

Answer 13

Stress hormones and catecholamines eg adrenaline noradrenaline epinephrine

Question 14

Shapes of adrenal gland

Answer 14

Adrenal glands enclosed in renal fascia
Right - pyramidal
Left - oval shape

Question 15

What is glomerular filtration?

Answer 15

Passage of blood into Bowman’s space to form filtrate (GFR)
Small molecules can pass
Larger molecules restricted like albumin
The volume of fluid filtered through the glomerulus to the bowman’s space

Question 16

How much does glomerulus filter?

Answer 16

180 litres of blood per day however the renal tubes Reabsorbs 99% of that

Question 17

Functions of the kidney?

Answer 17

ACRONYM: A WET BED 
Acid base removal 
Water removal 
Erythropoietin 
Toxins removal 
BP
Electrolyte 
D - vitamin D

Question 18

How much cardiac output goes to the kidneys?

Answer 18

20%

1000ml minute - renal blood flow

Question 19

3 layers of filtration barrier

Answer 19

Fenestrated capillary endothelium
Double layer basement membrane
Foot processes of podocytes

Question 20

Normal gfr in 70kg person

Answer 20

125/ml min

Question 21

How to calculate GFR?

Answer 21

Kf(Pgc-Pbs- PiGc)
Kf filtration coefficient
Pbs hydrostatic pressure if bowman’s space
Pgc hydrostatic pressure of glomerular capillaries
PiGc - oncotic pressure if glomerular capillaries

Question 22

PCT

Answer 22

Bulk re absorption of essentials like glucose amino acids 2/3 of all filtrate reabsorbed

Question 23

Loop of Henle

Answer 23

Ascending and descending limb
Descending h20 re absorption
Ascending Na Cl K reabsorption

Question 24

DCT

Answer 24

Macula densa cells detect NaCl and activate RAAS

Fine tuning the absorption of solutes

Question 25

Collecting duct

Answer 25

2 cells
Principal cells - ADH acts here
Intercalated cells - secretes acid

Question 26

ACID-Base balance

Answer 26

Ph=-log(H+)

Normal range= 7.35-7.45

Question 27

What is base excess?

Answer 27

Quantity of acid required to return plasma pH to normal

Question 28

Standard base excess:

Answer 28

Quantity of acid required to return ECR fluid back to normal