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Human Systems > Renal System > Flashcards

Renal System Flashcards

1
Q

What are the function of the kidney?

A
  • Process blood & rid the body of waste products of metabolism via urine
  • Required to maintain internal homeostasis of fluid
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2
Q

Explain how kidney is required to maintain internal homeostasis of fluid?

A

-Regulation of fluid, electrolytes
-Involved in calcium/vit D metabolism
-Involved in erythropoietin release

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3
Q

Where do the kidneys lie in the body?

A

Lie in a retroperitoneal position

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4
Q

What are the three 3 distinct parts of the kidney?

A

Cortex
Medulla
Pelvis

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5
Q

Which part of the kidney contains 85% of tubules (Nephrons)?

A

Cortex

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6
Q

Name the site which responsible for urine concentration and prevents excessive water loss

A

Medulla

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7
Q

What is the collection are if urine?

A

Pelvis

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8
Q

What are the features of the Blood Vessels of the Kidney?

A

-Highly vascular
-Blood delivered via Renal arteries from abdominal arteries
-Blood delivered back to IVC via renal vein

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9
Q

The basic functional unit of the kidney is the?

Cortex
Medulla
Pelvis
Nephron

A

Nephron

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10
Q

What are two types of the nephron?

A
  • Cortical nephrons - located in cortex (Shorter loop)
  • Juxtamedullary nephrons - Located on the fringe of cortex-medulla (Long loop of Henle)
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11
Q

What is renal corpuscle?

A

It consists of a glomerulus & Bowman’s capsule

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12
Q

What are Glomerulus?

A

-Network of fine - fenestrated capillaries
-Contains - single layer of endothelial cells resting on basement membrane
-Surrounded by Bowman’s capsule

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13
Q

What is Bowman’s Capsule?

A

-Structure surrounding glomerulus
-Bowman’s space → is the space within the capsule that contains the filtrate and directs this to the PCT

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14
Q

What are the two layers of Bowman’s Capsule?

A
  • Parietal (Outer) layer - Simple squamous layer
  • Visceral (Inner) layer - contains podocytes
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15
Q

What are the long branched processes of podocytes, wrap around capillaries?

A

Pedicels

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16
Q

Glomerulus + Bowman’s Capsule =?

A

Renal corpuscle

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17
Q

What forms the Filtration Barrier ?

A

Glomerular endothelium + Basement membrane + Pedicels of podocytes

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18
Q

What can pass through the filtration barrier?

A
  • Water, Glucose, Amino acids
  • Electrolytes - Na, Cl, Ca, K, P, Bicarbonate
  • Waste products - Urea, Creatinine
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19
Q

What is not Filtered in the renal corpuscle?

A
  • Cells
  • Large proteins (e.g. Hb)
  • Negatively charged proteins (e.g. Albumin)
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20
Q

Mention the filtration process

A
  1. Unfiltered blood arrives via afferent arteriole into glomerulus
  2. Blood components filtered through filtration barrier
  3. Filtered blood exits glomerulus via efferent arteriole
  4. Filtrate makes its way into PCT
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21
Q

Filtration is driven by?

A

Pressure gradient - Hydrostatic pressure

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22
Q

What is GFR ?

A

Glomerular Filtration Rate: Rate of filtration through glomerulus into Bowman’s capsule

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23
Q

Glomerular filtration is primarily driven by:

Glomerular Hydrostatic pressure
Capsular hydrostatic pressure
Glomerular osmotic pressure
Capsular osmotic pressure

A

Glomerular Hydrostatic pressure

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24
Q

GFR is counteracted by?

A

Bowman’s capsule hydrostatic pressure
Glomerular osmotic pressure

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25
Q

Mention factors that can influence the GFR

A
  • Hydrostatic pressure
  • Osmotic pressure
  • Systemic blood pressure
  • Renin-angiotensin system
  • Disease
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26
Q

What is the normal Normal healthy GFR?

A

125ml/min → 180L/day (Both kidneys)

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27
Q

How kidney damage can reduce GFR?

A
  • Results in inefficient blood clearance and waste removal
  • Waste products accumulate
28
Q
A
29
Q

What is the measurements that used to estimate GFR?

A

Serum creatinine

30
Q

Where in the kidney does filtration occur?

Renal tubule
Medulla
Renal corpuscle
Cortex

A

Renal corpuscle

31
Q

What is the primary function of our kidney’s?

Detoxify products of metabolism
Maintain internal fluid homeostasis
Produce and excrete urine
Regulate blood pressure

A

Maintain internal fluid homeostasis

32
Q

What are the components of Renal tubule?

A

PCT
Loop of Henle
DCT

33
Q

What is the function of Renal tubule?

A

Reabsorption and secretion

34
Q

What section of the nephron is the main site of reabsorption?

Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting tubule

A

Proximal convoluted tubule

35
Q

What substance is typically measured to provide an estimate of glomerular filtration rate?

Ammonia
Creatinine
Proteins
Urea

A

Creatinine

36
Q

Mention sites of sodium reabsorption?

A

-PCT → 65%
-Ascending Loop of Henle →25%
-DCT → <8% (Depending on physiological demand)

(98-99% total reabsorbed)

37
Q

What are Peritubular Capillaries - Vasa Recta?

A

Network of blood vessels surrounding the renal tubules

38
Q

What are the function of vasa recta?

A

-Provide oxygen and nutrients to the tubular cells
- Role in the reabsorption of water and solutes from the renal tubules back into the bloodstream
-Specialized capillaries that run parallel to the loop of Henle in the renal medulla.

39
Q

By what process is reabsorption Into the Peritubular Capillaries driven by?

A

Passive diffusion
50% of contents is reabsorbed this way - due to reaching equilibrium

40
Q

How water moves?

A

Facilitated by Aquaporins

41
Q

How Glucose & Amino acid transport?

A

Facilitated by sodium co-transporters

‘Hitch a ride’ with sodium

42
Q

By what process is sodium reabsorbed in the
proximal convoluted tubule?

Active diffusion
Active transport
Passive diffusion
Secondary active transport

A

Active transport

43
Q

What are the components of the Loop of Henle?

A
44
Q

What are the Specific properties of Thin Descending limb?

A
  • Aquaporins present → Freely permeable to water
  • No Na pumps
45
Q

What are the Specific properties of Thin Ascending limb?

A

No aquaporins

46
Q

What are the Specific properties of Thick Ascending limb?

A
  • No aquaporins
  • Site of active sodium transport - presence of pumps
  • Integral to mechanism of counter-current multiplication
47
Q

In the Loop of Henle, the thin descending section:

Does not contain aquaporins
Is the site of active sodium reabsorption
Is impermeable to water
Is permeable to water

A

Is permeable to water

48
Q

Where is the site of ‘fine-tuning’ of fluid volume and electrolyte regulation?

A

DCT

49
Q

What hormone is responsible in Increasing of water reabsorption?

A

Anti-diuretic hormone (ADH)

50
Q

What hormone is responsible in Increasing of Na reabsorption?

A

Aldosterone

51
Q

What hormone is responsible in promoting Na secretion?

A

Anti-Natriuretic hormone (ANH)

52
Q

What cellular response does ADH signalling have on epithelial cells lining the DCT?

-Insertion of aquaporins
-Removal of aquaporins
-Upregulation of sodium reabsorption
-Downregulation of sodium reabsorption

A

Insertion of aquaporins

53
Q

What is the primary purpose of counter current multiplication:

Sodium reabsorption
Urine concentration
Water reabsorption
Urine formation

A

Water reabsorption

54
Q

What cellular response does ADH signalling have on epithelial cells lining the distal convoluted tubule?
a.Removal of aquaporins

b.Removal of sodium pumps and channels

c.Insertion of sodium pumps and channels

d.Insertion of aquaporins

A

d.Insertion of aquaporins

55
Q

What are the Cell types of Juxta-Glomerular apparatus?

A

Macula Dense - Specialised epithelial cell (Detection of Na) - release adenosine or prostaglandins

Juxtaglomerular cells - Smooth muscle cells (adjust diameter)

Mesangial cells - Supporting cells

56
Q

Nam1 1,2,3

A

1.Macula Dense
2.Juxtaglomerular cells
3.Mesangial cells

57
Q

What is the difference between RAAS( Renin angiotensin- aldosterone system) and Renin angiotensinogen system?

A

-Renin angiotensinogen system works to restore blood pressure
-Renin angiotensin - aldosterone system works to restore blood volume whilst an increase in blood pressure is experienced

58
Q

What happens when angiotensin II bind to target receptor?

A
59
Q

What is the function Atrial natriuretic peptide (ANP)?

A

ANP - Counteracting RAAS
ANP inhibits activity of Renin activation, ADH and aldosterone to return blood pressure back to homeostatic levels

60
Q

What is CKD ?

A

Chronic Kidney Disease characterized by a lower GFR

  • Lower GFR → Increases Na reabsorption
  • Increased Na reabsorption stimulates RAAS (Mimics low systemic blood pressure conditions)
  • Inappropriate RAAS activation increases systemic blood pressure
  • Causes hypertension → promotes cardiovascular disease and further CKD
61
Q

Causes of CKD

A
62
Q

Symptoms of CKD

A
63
Q

How hypertension regulation is important in CKD patients?

A

Aids reducing severity of CKD
- Diet management 🌱
- Diuretics - furosemide
- ACE inhibitors / Angiotensin receptor blockers ARBs
- Aldosterone agonists

64
Q

What is dialysis?

A

Artificial removal of waste, solutes, water and toxins from blood.

65
Q

2 types of dialysis

A
  • Haemodialysis - diverting blood into dialysis machine
    • Requires commute to dialysis clinic
    • Only required 1-2 times a week
  • Peritoneal dialysis - uses peritoneal membrane as a filter
    • Can be performed at home
    • Regularly required

Human Systems (5 decks)

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