renal system Flashcards
(28 cards)
the hilum of the left kidney is located at which vertebral level ?
L1
upper pole around 11th rib
approx 3 vertebrae in length
the adrenal glands sit immediately superior to the kidneys within a separate envelope of which fascia ?
renal fascia
anatomical relations of the right kidney
posterior-quadrates lumborum, diaphragm, poses major, transversus abdominis
anterior-hepatic flexure of colon
superior-liver-adrenal gland
from anterior to posterior, what is the correct order of the structures entering the hilum?
vein, artery, ureter
lymph from kidney drains into the
para-aortic lymph nodes
GFR=Net ultrafiltration pressure
pressure is high because…
arterioles have HIGH resistance
afferent diameter>efferent
fluids and solutes are forced out of the blood
forces involved in glomerular filtration :
-hydrostatic gradient+favours filtration
-oncotic pressure-opposes
proximal convoluted tubule-reabsorption
essential nutrients
glucose 99%
WATER 65%
relies on secondary active transport of Na+
loop of henle-reabsorption and secretion
water is reabsorbed by osmosis along the descending loop(impermeable to ions)
Na+ is actively reabsorbed along the ascending loop by Na+/K+/2Cl- cotransporters
result:smaller volume of dilute(hypotonic)filtrate leaving the LOH and entering the distal tubule
allows for extra H2) reabsorption from the collecting duct
distal tubule and collecting duct-reabsorption and secretion
under hormonal control
aldosterone binds to receptors on the distal tubule and collecting duct to promote Na+ and water reabsorption and K+ secretion
ADH binds to receptors on the collecting duct to promote water reabsorption through aquaporins
ADH
short term effector
in response to dehydration
effects:
water reabsorption from collecting duct
produces more concentrated and less volume of urine
no effect in Na+ reabsorption-so no effect in K+ secretion
aldosterone
(RAAS) is a long term response to decreased ‘body fluid volume’
effects:
-Na+ and H20 reabsorption from DCT and collecting duct
-produces urine with decreased Na+ and increased K+,decreased volume of urine
juxtaglomerular cells
modified smooth muscle cells
afferent arteriole
secrete renin
ABGs
1-check pO2
2-check pH
3-pCO2
4-HCO3-
type 1 respiratory failure
- reduced ventilation and normal perfusion=PO,bronchoconstriction
- reduced perfusion with normal ventilation=PE
pathology: V/Q mismatch
Type 2 respiratory failure
hyperaemia with hypercapnia
- increased resistance as result of air obstruction(COPD)
- reduced compliance of lung tissue/chest wall
- reduced strength of respiratory muscles
- drugs acting on respiratory centre reducing overall ventilation
vomiting
->loss of HCl in stomach
=>less H+ to bind to HCO3-
and so more free HCO3- circulating
what do the adrenal glands secrete in response to volume depletion
aldosterone-increased HCO3- reabsorption by the kidneys
->metabolic alkalosis
excess HCO3- ingestion
-can cause metabolic alkalosis
where is aldosterone produced
zona glomerulosa
where does the left gonadal vein drain into
left renal vein
what region do the kidneys originate from
pelvic
fever, pain in left loin.Dysuria and fever 3 days ago; prone to UTI. What is the most likely diagnosis?
Pyelonephritis
what is the most appropriate investigation for diagnosing a patient presenting with renal colic
CT KUB
what is the most common composition of a kidney stone
calcium oxalate
