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AP2 > Renal System > Flashcards

Renal System Flashcards

1
Q

What is the renal system

A

Kidneys

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2
Q

What do the ureter, bladder and urethra do?

A

Store and carry urine

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3
Q

Primary function of kidneys

A

Make urine and filter waste

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4
Q

Blood sources to/from kidneys

A

Renal artery and renal vein

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5
Q

Where does renal artery branch from

A

Abdominal aorta

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6
Q

Where do renal vein drain filtered blood to

A

Abdominal vena cava

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7
Q

Outer region of the kidneys

A

Renal cortex

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8
Q

Inner region of the kidneys

A

Renal medulla

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9
Q

Area in kidneys where urine collects and is eventually drained via ureter

A

Renal pelvis

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10
Q

Groups of tubules in medulla that drain into renal pelvis

A

Renal Pyramids

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11
Q

True/false: kidneys are also endocrine producers (make hormones)

A

True

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12
Q

Hormone made by kidneys that acts on bone marrow to stimulate RBC production

A

Erythropoietin (EPO)

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13
Q

Are kidneys also metabolic organs?

A

Yes

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14
Q

What metabolic function do kidneys carry out?

A

Gluconeogenesis

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15
Q

What does the process of gluconeogenesis make glucose from?

A

Lactic acid and amino acids

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16
Q

Smallest functional unit of kidneys

A

Nephron

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17
Q

How many nephrons in each kidney

A

About 1 million

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18
Q

2 components of nephrons

A

Vascular and Tubular

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19
Q

Claw-shaped tubule that wraps around glomerulus

A

Bowman’s capsule

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20
Q

Tuft of capillaries where urine production starts

A

Glomerulus

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21
Q

Tubule that comes after Bowman’s capsule

A

Proximal

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22
Q

What tubule comes after proximal

A

Loop of Henle (descending and ascending)

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23
Q

What tubules comes after ascending

A

Distal

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24
Q

Where distal tubule goes to

A

Collecting duct

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25
Q

How many nephrons are typically attached to collecting ducts

A

8-10

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26
Q

Where are collecting ducts found?

A

Medullary pyramids

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27
Q

Where do collecting ducts drain to?

A

Renal pelvis

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28
Q

Smallest branch of renal artery that delivers blood to glomerulus

A

Afferent arterioles

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29
Q

Fluid moving from glomerulus to bowman’s capsule

A

Glomerular filtration

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30
Q

Fluid that goes from glomerular capillaries to bowman’s capsule is the same as plasma minus what?

A

Cells, proteins

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31
Q

Blood not filtered by glomerulus moves to where?

A

Efferent arterioles

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32
Q

Blood from efferent arterioles go to this mesh-like network of capillaries that surround the nephron

A

Peritubular capillaries

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33
Q

Where do peritubular capillaries drain blood to?

A

Abdominal Vena cava

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34
Q

Structure that is very important regulator of filtration

A

Juxtaglomerular apparatus

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35
Q

Where is juxtaglomerular apparatus located?

A

In distal tubule where a V is formed by afferent and efferent arterioles

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36
Q

What does juxtaglomerular apparatus measure in distal tubule?

A

BP, O2, fluid rate

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37
Q

Type of nephrons located in outer cortex

A

Superficial cortical

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38
Q

What percent of all nephrons are superficial cortical

A

80%

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39
Q

Nephrons located in inner cortex near medulla

A

Juxtamedullary

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40
Q

Percent of nephrons that are typically juxtamedullary

A

20%

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41
Q

Where are glomeruli of superficial cortical and juxtamedullary nephrons only found?

A

In the cortex

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42
Q

Superficial cortical nephrons have short loops of henle that extend to where?

A

Upper medulla

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43
Q

Juxtamedullary nephrons have long loops of henle that extend to where?

A

Deep in medulla with tip of loop next to renal pelvis

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44
Q

What kind of vessels do superficial cortical nephrons have?

A

Mesh of peritubular capillaries

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45
Q

What kind of vessels do Juxtamedullary nephrons have?

A

Single efferent loop that runs parallel to loop of henle

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46
Q

What is single efferent loop in Juxtamedullary nephrons called?

A

Vasa recta

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47
Q

What shape does vasa recta form after it leaves medulla?

A

Mesh

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48
Q

What is function of cortical nephrons?

A

Make urine

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49
Q

What is function of Juxtamedullary nephrons?

A

Concentrate urine and conserve water

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50
Q

3 processes of urine formation?

A

Glomerular filtration (GF)
Tubular reabsorption (TR)
Tubular secretion (TS)

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51
Q

How much of plasma is filtered at glomerulus?

A

20%

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52
Q

Where does the other 80% of plasma go that isn’t filtered by glomerulus

A

Efferent arterioles

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53
Q

At peritubular capillaries, what gets reabsorbed from filtered fluid?

A

Water and solutes

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54
Q

Glomerulus and bowman’s capsules together is called what?

A

Renal corpuscle

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55
Q

True/false: GF is both passive and non-selective

A

True

56
Q

Name 3 layers of glomerular membrane

A
  1. Wall of glomerular capillaries
  2. Basement membrane
  3. Inner layer of bowman’s capsule
57
Q

What are individual foot-like processes of bowman’s capsule inner layer called?

A

Podocytes

58
Q

What is the main function of the 3 layers in glomerular membrane?

A

Prevent plasma proteins and cells from passing through

59
Q

What is fluid that enters bowman’s capsule called?

A

Filtrate

60
Q

Are forces of GF active or passive?

A

Passive

61
Q

How much is glomerular capillary blood pressure?

A

55 mmHg

62
Q

Is glomerular capillary blood pressure a push or pull force?

A

Push

63
Q

How much is plasma colloid osmotic pressure?

A

30 mmHg

64
Q

How much is bowman’s capsule hydrostatic pressure

A

15 mmHg

65
Q

What force promotes GF and is most important?

A

Capillary blood pressure

66
Q

How much is net filtration pressure?

A

10 mmHg

67
Q

GF rate (GFR) is an indicator of what?

A

Number of functional nephrons and kidney health

68
Q

What is GFR?

A

Volume of fluid filtered per minute

69
Q

What 3 things does GFR depend on?

A
  1. Net filtration
  2. Surface area
  3. Permeability of membranes
70
Q

What is Filtration Coefficient (Kf)

A

Surface area x permeability

71
Q

True/false: Kf should be a constant value in a healthy person

A

True

72
Q

What is equation for GFR

A

Kf x net filtration

73
Q

Why is GFR so important?

A

It is 1st step in urine formation

74
Q

2 mechanisms of GFR

A
  1. Auto regulation
  2. Extrinsic sympathetic control
75
Q

What mechanism controls GFR most of the time?

A

Auto regulation

76
Q

How does auto regulation control GFR?

A

By preventing GFR change with normal BP changes

77
Q

What does auto regulation change when BP fluctuates to maintain a constant GFR?

A

Diameter of afferent arteriole

78
Q

What does auto regulation constrict or dilate to change afferent arteriole diameter?

A

Smooth muscle lining of vessel

79
Q

What does extrinsic sympathetic control do?

A

Alters GFR to control blood volume

80
Q

In what structure does GFR happen?

A

Juxtaglomerular Apparatus (JXA)

81
Q

What are 2 special cells in JXA?

A

Granular (afferent)
Macula densa cells (distal)

82
Q

What do macula densa cells constantly sense?

A

Fluid rate through distal tubule

83
Q

If macula densa senses fluid change, what cells get a message to release vaso dilators or constrictors?

A

Granular cells in afferent arterioles

84
Q

Can extrinsic sympathetic control override auto regulation?

A

Yes

85
Q

What is released by sympathetic nerves in extrinsic control?

A

Epi and norepinephrine

86
Q

What does epinephrine and norepinephrine attach to in afferent and efferent vessels?

A

Alpha adrenergic receptors

87
Q

Is tubular reabsorption always selective?

A

Yes

88
Q

Can tubular reabsorption (TR) be active or passive?

A

Either

89
Q

How much of H2O filtered at capsule is reabsorbed?

A

99%

90
Q

How much of glucose is reabsorbed

A

100%

91
Q

How much sodium is reabsorbed

A

99.5%

92
Q

How much of energy requirements of the kidneys is spent on Na+ reabsorption?

A

80%

93
Q

What is only area where sodium is NOT reabsorbed?

A

Descending loop

94
Q

What does sodium help reabsorb in proximal tubule?

A

Glucose
Aminos
H2O
Urea

95
Q

What does reabsorption of sodium in ascending loop help?

A

Concentrate urine
Conserve H2O

96
Q

What does sodium reabsorption in distal tubule and collecting duct regulate?

A

ECF volume and BP

97
Q

How does sodium cross lumenal membrane

A

Passive channel or cotransporter

98
Q

How does sodium leave basal membrane

A

ATP pump

99
Q

Does ATP pump at basal membrane require energy?

A

Yes

100
Q

Where in tubule does a lot happen in terms of sodium reabsorption

A

Proximal tubule

101
Q

How does sodium cross lumenal membrane in proximal tubule?

A

Co-transporters for glucose, aminos or vitamins (each has specific one)

102
Q

How do glucose, aminos, water soluble vitamins leave basal membrane

A

Passive facilitated diffusion carriers

103
Q

Where is glucose filtered?

A

Glomerulus

104
Q

What is max rate of reabsorption based on # of available transporters called?

A

Tubular maximum

105
Q

What is amount of any substance filtered by kidneys per minute called?

A

Filtered load

106
Q

What is normal plasma glucose level?

A

100mg/100ml

107
Q

What is amount of glucose filtered per minute?

A

125mg/min

108
Q

What is tubular maximum for glucose

A

375mg/min

109
Q

What is term for maximum plasma concentration reached for any organic nutrient before it will show in urine

A

Renal threshold

110
Q

What is renal threshold for glucose

A

300mg/ml

111
Q

How does sodium reabsorb in ascending loop at lumenal membrane?

A

K+ and Cl- cotransporters

112
Q

How does K and Cl cross basal membrane in ascending loop

A

Passive channel

113
Q

How does sodium cross basal membrane in ascending loop

A

ATP Pump

114
Q

What is sodium always coupled with?

A

Passive H2O reabsorption

115
Q

H20 reabsorption is always active or passive?

A

Passive

116
Q

What does H2O need for reabsorption

A

Osmotic gradient

117
Q

Where does 80% of water reabsorption take place

A

Proximal tubule

118
Q

What are 2 mechanisms of water reabsorption

A

Paracellular and trans cellular

119
Q

Where are tight junctions most leaky for water to reabsorb

A

Proximal tubule and descending loop

120
Q

How does sodium aid paracellular water reabsorption

A

Sodium pushed out along lateral wall attracts water

121
Q

T/F: Water always moves from low to high Osmolarity

A

True

122
Q

When sodium moves through a cell to interstitial space, what happens to osmolarity of interstitial space?

A

Increases

123
Q

What structures help move water through membranes

A

Aquaporins

124
Q

Aquaporins are always along basal membranes but only on lumenal in these parts

A

Proximal
Descending loop

125
Q

Only place where water is NOT reabsorbed

A

Ascending loop

126
Q

What 2 things are needed for water to reabsorb?

A
  1. Osmotic gradient
  2. Permeability (Aquaporins or leaky junctions)
127
Q

3 substances that are secreted

A

H ions
K ions
Organic cations and anions (drugs, etc)

128
Q

Where are H ions mostly secreted

A

Collecting duct and proximal tubule

129
Q

How do H ions cross basal lateral membrane

A

ATPase pump

130
Q

How do H ions cross lumenal membrane in proximal tubule

A

Sodium antiporter

131
Q

How do H ions cross lumenal membrane in collecting duct and ascending loop

A

Facilitated diffusion

132
Q

How much of filtered K is reabsorbed through passive diffusion in proximal

A

50%

133
Q

How is K secreted in distal and collecting basal membrane

A

ATP Pump

134
Q

T/F K reabsorption is unregulated but secretion is regulated

A

True

135
Q

Why is K only secreted in distal and collecting

A

Only places with passive K channels on lumenal membrane

AP2 (10 decks)

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