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Foundations of Health Sciences > Renal system > Flashcards

Renal system Flashcards

1
Q

Position of kidney

A

Posterior abdnomial wall
Between T12 and L3

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2
Q

Functions of kidney

A
  • Maintenance of homeostasis
  • Formation of urine
  • Excretion of waste products and toxins
  • Regulation of electrolyte balance
  • Regulation of fluid balance
  • Regulation of acid: base balance
  • Produce renin – control blood pressure
  • Produce erythropoietin
  • Metabolism of vitamin D (convert inactive to active)
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3
Q

Whats a nephron?

A
  • Functional unit of kidney (approx. 1 million)
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4
Q

What are components of nephron?

A
  • Glomerulus
  • Bowmans capsule
  • Proximal convoluted tubule
  • Nephron loop/ loop of Henle (ascending and descending)
  • Distal convoluted tubule
  • Collecting duct
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5
Q

Whats pathway of blood through nephron?

A
  • Glomerulus
  • Bowmans capsule
  • Proximal convoluted tubule
  • Nephron loop/ loop of Henle (ascending and descending)
  • Distal convoluted tubule
  • Collecting duct
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6
Q

HWat three processes in the formation of urine?

A
  1. Glomerular – filtration
  2. Tubular – reabsorption
  3. Tubular – secretion
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7
Q

Whats the afferent arteriole?

A

Plasma in to glomerulus starting filtration
- Grancular cells on afferent arteiole release renin

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8
Q

Whats the efferebt arteriole?

A

Plasma leaves the glomerulus

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9
Q

Whats the juxta-glomerular apparatus?

A

In charge of production and release of renin
- Macular denser cells in ascending limp of loop of Henle monitor sodium concentration in filtrate
- Granular cells on afferent arteriole release renin

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10
Q

Whats renin?

A

Controlling blood pressure by amount of water we reabsorb and eliminate through aldosterone release

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11
Q

What are the stages of the filtration membrane in the kidney?

A

-selection process – in glomerulus
- three stages in filtration
1. fenestrations endothelial cells (pores)
2. filtration membrane
3. podocytes

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12
Q

What are Fenestrations endothelial cells?

A
  • First stage of filtration
  • Retaining large molecules and allowing smaller to proceed eg. proteins
  • Pores.
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13
Q

Whats the filtration membrane?

A
  • 2nd stage of filtration
  • Second filter
  • Two characteritsics – stopping big molecules (if slip through fenestration pores) and negativily charged so reject negatively charged moelcules eg. Ions
  • Allow positively charged small molecules
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14
Q

What are podocytes?

A
  • 3rd stage of filtration
  • Filter and retain large (smaller than fenestration) molecules eg. Blood cells, proteins.
  • Produces the filtrate
  • After goes on to proximal convalunted tubulae
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15
Q

What is filtration?

A
  • Movement of water and solutes from blood into filtrate under pressure
  • Rate at which kidney/nephron filters the blood is known as glomerular filtration rate
  • Filtrate passes into proximal convolted tubule containing everything in the blood except red and white blod cells, platelets and large proteins like albumin
  • Filtrate contains – glucose, amino acids, vitamins, electrolyes, nutrients, water
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16
Q

What does filtrate contain?

A

glucose, amino acids, vitamins, electrolyes, nutrients, water
no proteins - harmful

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17
Q

What is the glomerular filtration rate?

A
  • Rate at which kidney/nephron filters the blood
  • GFR = approx 125m/minute (180 literes of filtrate per day)
  • Blood pressure and hydro-static pressure mainstains GFR as well as auto-regulation
  • Reabsolption – means most of filtrate is being reabsobed
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18
Q

What actions promote filtration?

A
  • Arterial blood pressure
  • Net filtration pressure
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19
Q

What is net filtration pressure?

A
  • Sum of forces
    Out:
  • Hydro-static pressure (glomerular) in glomerular capillaries
  • Efferent arteriole narrower than afferent
    In:
  • Pressure in capsular space
  • Colloid osmotic pressure in capillaries
    Net outward force of 10mmHg
    Outward pressure – inwards pressure
    Hydro-static pressure – pressure in capulsue space – capillary pressure.
20
Q

Diameter differences in arterioles?

A
  • Efferent (out) narrower than afferent (in)
21
Q

What is auto-regulation?

A
  • Pressure is high – afferent arteriole constricts reducing pressure entering glomerulus
  • Pressure is low – efferent artertiole constricts to increase pressure in glomerulus
  • Low pressure in afferent arteriole also stimulates releasing renin (luxta glomerular apparatus)
22
Q

What are Different mechanisms involved in auto-regulation - When low blood pressure in kidney?

A
  • **Myogenic mechanism of autoreulgation **-
  • Tubulaglomerular mechanism of autoregulation -
  • ** Hormonal (renin-anglotensin-andosterone) mechanism **
  • **Neural controls **
23
Q

How is the Hormonal (renin-anglotensin-andosterone) mechanism involved in autoregulation?

A

– juxtaglomerular **release renin **
- catalysing cascade forms angiotensin
- **vasoconstricts systemic artioles **
- **increasing peripheral resistance **
- secretes aldosterone bu adrenal cortex so increased sodium absoption and water so increaisng blood volume increaisng systemic blood pressure

24
Q

How is the myogenic mechanism involved in autoregulation?

A

Afferent arterioles vasodilate (smooth muscle in walls)

25
Q

How is the tubulagomerular mechanism involved in autoregulation?

A
  • Reduced glomerulus filtration rate in ascending loop acts on **macula densa cells **of juxtraglomerulae complex of kidney releasing vasoactive chemicals causing vasodilation of afferent arterioles
26
Q

How is the neural control involved in autoregulation?

A
  • **inhibits barorecpetors **in blood vessels activating sympathetic nervous system which starts hormonal response and causes vasoconstriction of arterioles
27
Q

What is tubular reabsoption?

A
  • Return of useful substances and water from filtrate to blood
  • Selective process starting in PCT
  • Sodium actively reabsorbed from filtrate into blood
  • Loop concentrated the filtrate then dilutes it
  • Descending limb is permeable to water not salts – so water lost and gradient formed so high osmolality ending ascending
  • Ascending limp imperable to water pumps out salt
  • Water, some ions and nutrietns follor passively by osmosis, diffusion and facilitated diffusion
  • Until transport maximum is reached
  • Happens in PCT – effected by active, passive and hormonal processes (ADH and aldostrone)
28
Q

What is transport maximum?

A
  • Max amount of substance that can be reabsobed
  • If glucose exceeds this it is lost in the urine – glycosuria
29
Q

What is glycosuria?

A
  • Level of glucose exceeds the transport maxiumum its lost in the urine
30
Q

What hormones effect reabsorption in kidneys?

A
  • Aldostrone – influence reabsorption in DCT
  • ADH – affects permeability of collecting duct to water
  • Parathyroid hromone regulating calcium absorbed
31
Q

What is tubular secretion?

A
  • Active removal of unwanted substances/wastes from the blood into the filtrate
  • Occurs along tubule – potassium maining in PCT also sodium in DCT
  • Hydrogen ions, potassium, ammonium, creatinine, drugs
  • Therefroe improtant to regulate potassium and pH levels
32
Q

WHat is urine chemical composition?

A
  • 95% water
  • Urea – frim normal breakdown of amino acids
  • Sodium, potassium, phosphate, sulphate
  • Creatinine – from metabolism in muscle tissue
  • Uric acid – from metabolism of nucleic acids
33
Q

How are medications effected by urine?

A
  • They are excreted by kident so doses may be altered in renal dysfunction§
34
Q

What is osmolaity?

A
  • Number of solute particles in 1 kg of water
35
Q

What is vasa recta?

A
  • Curve/bottle point of limb of henle
  • Highly permeable to water and solutes so preseved the gradient
36
Q

Why is anti-diuretic hormones effect kidneys?

A
    • influenes the permeability of collecting duct and latter part of distal tubule
  • The aquoporin channels allow wtaer movement
  • Plasma osmolarity is detected by osmo-recetopes in hypothalamus
  • ADK secretion from posterior pituitary increases or decreases response to osmolaity
  • Increased ADH = greated reabsorption and less urine
  • Decreased ADH = less reabsortion = more urine
37
Q

What are renon-angiotensin-adosterone mechanisms?

A
  • Sodium and water movement controls blood pressure
  • Renin released in repsonse to low pressure
  • Converts angiotensinogen (inactive proetin) into angiostein 1 (active) - converted to 2 by angiotensin converting enzyme from lungs
  • Causes vasoconstriction of systemic blood vessels
  • Releases aldosterone hormone from adrenal cortex causieng reabsorption of sodium and water in renal tubules
  • Influences ADH release
38
Q

What does angiotensin 2 cause?

A
  • Causes vasoconstriction of systemic blood vessels
  • Releases aldosterone hormone from adrenal cortex causieng reabsorption of sodium and water in renal tubules
  • Influences ADH release
39
Q

What does aldosterone do?

A
  • Targets kidney tubles
  • Increasing sodium reabsoption
  • Increaisng potassium secretion
  • Restores homeostatic plasma levels of sodium and potasssium
40
Q

Whats the regulation of acid base balance?

A
  • Hydrogen ions produced in metabolism need to be eliminated as more in blood means lover pH and or OH- in blood means higher pH of blood
41
Q

What are Mechanisms to maintain acid base balance?

A
  • Buffers eg. Bicarbonate, proteins and phosphate – acting as sponse to soak up excess H and OH
  • Respiratory centre detects highened so inreases breathing rate to breath it out as carbon disoxdie
  • If falls then secreted in the kidneys into the urine as hydrogen combines with buffer and is excreted
42
Q

How is erythropoietin produced?

A
  • Produced by kidneys
  • Stimulates bone marrow to produce red blood cells – erythropoiesis
  • Stimulated by hypoxaemia
43
Q

How is calcium and phosphate regulated in vitamin D metabolism?

A
  • Main hormonal control of calcium homeostasis is released by parathyroid hormone
  • In kidkensy calsium is resbsobed and the metabolism of vitamin d into an active form (absorbed by skin from sunlight from modified cholesterol)
  • Calcium can also be reabsobed as phosphate and excreted
44
Q

What does vitamin D do in kidneys?

A
  • Active vitamin D
  • Stimulates absoption of calcium from the GIT
  • Minatains normal blood calcium levels
45
Q

What is calcium needed for in kidneys?

A
  • Strong bones and teeth
  • Normal transmission of the nerve impulse
  • Normal muscle contraction
  • Blood clotting
46
Q

What is calcium regulation?

A
  • Hypocalcemia – low blood calcium levels
  • Increase parathroid hormone
  • Increased osteoclast activity in blood so calcium and PO4 3- is released into blood
  • Increased calcium reabsorption in kidney tubule
  • Increased activation of vitamin D by kidney which increased calcium absoprtion from food in the small intestines

Foundations of Health Sciences (30 decks)

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