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
Mention factors that can influence the GFR
- Hydrostatic pressure - Osmotic pressure - Systemic blood pressure - Renin-angiotensin system - Disease
26
What is the normal Normal healthy GFR?
125ml/min → 180L/day (Both kidneys)
27
How kidney damage can reduce GFR?
- Results in inefficient blood clearance and waste removal - Waste products accumulate
28
29
What is the measurements that used to estimate GFR?
Serum creatinine
30
Where in the kidney does filtration occur? Renal tubule Medulla Renal corpuscle Cortex
Renal corpuscle
31
What is the primary function of our kidney's? Detoxify products of metabolism Maintain internal fluid homeostasis Produce and excrete urine Regulate blood pressure
Maintain internal fluid homeostasis
32
What are the components of Renal tubule?
PCT Loop of Henle DCT
33
What is the function of Renal tubule?
Reabsorption and secretion
34
What section of the nephron is the main site of reabsorption? Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting tubule
Proximal convoluted tubule
35
What substance is typically measured to provide an estimate of glomerular filtration rate? Ammonia Creatinine Proteins Urea
Creatinine
36
Mention sites of sodium reabsorption?
-PCT → 65% -Ascending Loop of Henle →25% -DCT → <8% (Depending on physiological demand) (98-99% total reabsorbed)
37
What are Peritubular Capillaries - Vasa Recta?
Network of blood vessels surrounding the renal tubules
38
What are the function of vasa recta?
-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
By what process is reabsorption Into the Peritubular Capillaries driven by?
Passive diffusion 50% of contents is reabsorbed this way - due to reaching equilibrium
40
How water moves?
Facilitated by Aquaporins
41
How Glucose & Amino acid transport?
Facilitated by sodium co-transporters ‘Hitch a ride’ with sodium
42
By what process is sodium reabsorbed in the proximal convoluted tubule? Active diffusion Active transport Passive diffusion Secondary active transport
Active transport
43
What are the components of the Loop of Henle?
44
What are the Specific properties of Thin Descending limb?
- Aquaporins present → Freely permeable to water - No Na pumps
45
What are the Specific properties of Thin Ascending limb?
No aquaporins
46
What are the Specific properties of Thick Ascending limb?
- No aquaporins - Site of active sodium transport - presence of pumps - Integral to mechanism of counter-current multiplication
47
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
Is permeable to water
48
Where is the site of ‘fine-tuning’ of fluid volume and electrolyte regulation?
DCT
49
What hormone is responsible in Increasing of water reabsorption?
Anti-diuretic hormone (ADH)
50
What hormone is responsible in Increasing of Na reabsorption?
Aldosterone
51
What hormone is responsible in promoting Na secretion?
Anti-Natriuretic hormone (ANH)
52
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
Insertion of aquaporins
53
What is the primary purpose of counter current multiplication: Sodium reabsorption Urine concentration Water reabsorption Urine formation
Water reabsorption
54
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
d.Insertion of aquaporins
55
What are the Cell types of Juxta-Glomerular apparatus?
Macula Dense - Specialised epithelial cell (Detection of Na) - release adenosine or prostaglandins Juxtaglomerular cells - Smooth muscle cells (adjust diameter) Mesangial cells - Supporting cells
56
Nam1 1,2,3
1.Macula Dense 2.Juxtaglomerular cells 3.Mesangial cells
57
What is the difference between RAAS( Renin angiotensin- aldosterone system) and Renin angiotensinogen system?
-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
What happens when angiotensin II bind to target receptor?
59
What is the function Atrial natriuretic peptide (ANP)?
ANP - Counteracting RAAS ANP inhibits activity of Renin activation, ADH and aldosterone to return blood pressure back to homeostatic levels
60
What is CKD ?
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
Causes of CKD
62
Symptoms of CKD
63
How hypertension regulation is important in CKD patients?
Aids reducing severity of CKD - Diet management 🌱 - Diuretics - furosemide - ACE inhibitors / Angiotensin receptor blockers ARBs - Aldosterone agonists
64
What is dialysis?
Artificial removal of waste, solutes, water and toxins from blood.
65
2 types of dialysis
- 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