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Physiology 1020 > Renal System > Flashcards

Renal System Flashcards

1
Q

kidney’s functions

A

regulation of extracellular fluid volume and BP
-regulation of osmolarity
-maintains ion balance and body ph
-excretion of waste
-hormone production >vitamin D, EPO
-gluconeogenesis> produce glucose from noncarb source

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2
Q

location of kidneys

A

posterior abdomen, position is retroperitoneal

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3
Q

kidneys

A

filters blood and items are excreted as urine

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4
Q

renal artery

A

BV that brings oxygenated blood to kidney

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5
Q

renal vein

A

BV brings blood out of kidneys back to heart

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6
Q

ureter

A

tube that brings urine to bladder

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7
Q

bladder

A

collects urine
increase of urine, urination will occur

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8
Q

urethrae

A

tube that removes urine, longer in males

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9
Q

kidney stones

A

form by precipitation and crystallization of increase concentration of minerals and ions
too large, get stuck in renal pelvis, ureter or urethra

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10
Q

nephron

A

functional unit of kidneys
main parts> renal corpuscle and tubule

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11
Q

renal corpuscles

A

filters blood and turns into filtrate
3 part
bowman’s capsule, glomerulus, juxtaglomerular apparatus

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12
Q

glomerulus

A

specialized leaky capillaries

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13
Q

tubule

A

tube structure made of single layer of epithelial cells

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14
Q

bowman’s capsule/renal capsule

A

outside of renal corpuscle
-where fluid filters into
-surrounds glomerulus
-cellular part made of podocytes

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15
Q

Juxtaglomerular apparatus

A

composed of late ascending limb of loop of henle then enters and exits afferent and efferent arterioles

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16
Q

macula densa cells

A

specialized cells in late ascending limb of loop of henle
detects concentration of Na and Cl in filtrate
detect how fast filtrate is flowing

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17
Q

juxtaglomerular cells

A

beside macula dense
also called granular cells
responsible for producing and releasing renin

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18
Q

types of nephrons

A

cortical 80% and juxtamedullary 20%y

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19
Q

difference between cortical and juxtamedullary nephrons

A

jux- nephron next to medulla, cort- upper cortex
jux-long loop of henle, cort-short
juz-vasa recti-help with [] urine
cort- peritubular capillaries

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20
Q

similarities between cortical and juxtamedullary nephrons

A

all nephrons in cortex, reabsorb filtrate

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21
Q

blood flow to kidneys in cortical nephrons

A

afferent arterioles > glomerulus >efferent arterioles > peritubular capillaries > venule > renal vein

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22
Q

processes of nephron

A

filtration + reabsorption + secretion and excretion

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23
Q

filtration

A

movement of fluid and solutes in blood from glomerulus to bowman’s capsule

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24
Q

reabsorption

A

movement of solutes from filtrate within tubule back into surrounding capillary bed
most is reabsorbed

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25
Q

secretion

A

solutes dissolved in blood can be added to filtrate as it travels through tubule
movement from peritubular capillary

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26
Q

excretion

A

production of urine
urine=filtrated collected in renal pelvis and collects in bladder

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27
Q

formula for excretion

A

filtration - reabsorption +secretion = excretion

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28
Q

barriers to filtration

A

size of fenestration and size of spaces between endothelial cells
-space between fibers of basal lamina
-spaces between podocytes

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29
Q

fenestrations

A

additional holes in endothelial cells
-size limits what can be filtered out of blood into bowman’s space

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30
Q

basal lamina

A

sticky tissue that connects endothelial cells to podocytes
-composed of collagen and negative charged glycoproteins
-filter plasma
0the negative charge prevents them from moving through basal lamina

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31
Q

podocyte

A

inside bowman’s capsule, specialized cells
-prevent some fluid filtration by wrapping around glomerulus
-long projections

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32
Q

bowman’s space

A

area within corpuscle where filtrate can move into from glomerulus

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33
Q

slit space

A

between podocytes
-blood can move through here
-larger items can’t pass
-limits how much volume of fluid is filtered

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34
Q

endothelial cells

A

make up capillaries
-have fenestrations

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35
Q

3 ways to analysis urine

A

visual inspection, microscopic evaluation, chemical analysis

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36
Q

visual inspection

A

colour
-brown liver
clear overhydrated vs. dark yellow dehydrated
-particles, kidney stones
-milky bacteria
frothy proteins

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37
Q

microscopic evaluation

A

sediments and or crystals, kidney stones
-bacteria
-bacteria and RBC, UTI
RBC, types of urinary tract cancers

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38
Q

chemical analysis

A

test for stuff like glucose, proteins, ketones and WBC (don’t want)

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39
Q

net filtration pressure

A

-sum of Hydrostatic pressure of glomerular capillaries
colloid osmotic pressure of glomerular capillaries
hydrostatic pressure of bowman’s capsule
colloid osmotic pressure of bowman’s capsule

-=10 mm HG

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40
Q

glomerular filtration rate

A

-quantity of fluid and solutes dissolved in water filtered into bowman’s space from glomerular caps
-influenced by BF (more, than more)
-^GFR more solutes and h2o are excreted

usually L/day

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41
Q

Hydrostatic pressure of glomerular capillaries

A

blood pushed through vessels by heart’s pumps
-as blood flows through glomerulus capillary, fluid is forced into capsule space
-this P favours filtration
-largest force that promotes filtration

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42
Q

colloid osmotic pressure of glomerular capillaries

A

-proteins in blood don’t filter into capsular space b/c size and change
-proteins generate force, drawing water to where proteins flow
-force inhibits filtration

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43
Q

hydrostatic pressure of bowman’s capsule

A

-fluid filters, it fills capsule space
-fluid movement out of tubule is slow
-the back pressure of fluid in capsule limits more fluid from filtering capsule space
-inhibits fluid filtration

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44
Q

colloid osmotic pressure of bowman’s capsule

A

-if proteins could filter in capsular space, proteins pull fluid in
-positive force that favours filtration
-usually doesn’t exist =0
-must be accounted for b/c if presence affects fluid filtration

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45
Q

NFP equation

A

[HSP glo + COP B] - [HSP B + COP glo]

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46
Q

autoregulation of GFR

A

protects kidneys from getting damaged

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47
Q

myogenic response

A

-increase blood flow in glomerulus, increase pressure, increase GFR
-myogenic response will reduce GFR
-reflexive contraction of afferent arterioles > this reduces blood flow, decrease GFR

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48
Q

tubuloglomerular feedback -high

A

-if blood pressure increases, increase the amount of fluid filtered
- when Na and Cl level in filtrate are too high or fluid flow is too high, macula dense cells release a paracrine factor that stimulate afferent arterioles (constrict) therefore decrease rate of fluid filtration

49
Q

paracine factor

A

release adenosine

50
Q

tubuloglomerular feedback- low flow

A

if low fluid flow rate or low [ ] in filtrate, macula densa cells release nitric oxide
-this causes smooth muscle to relax in afferent arteriole therefore increase GFR

51
Q

afferent arteriole constricts

A

-when they vasoconstrict, decrease blood enter glomerulus
-hydrostatic pressure would decrease
-decrease GFR

52
Q

efferent arteriole constricted

A

-when they vasoconstricted, decrease blood leaves glomerulus
-hydrostatic pressure would increase
-increase GFR

53
Q

vasoconstriction of afferent and efferent arterioles

A

caused by angiotensin II
-result is decrease GFR

54
Q

estimating the GFR

A

excretion= filtration - reabsorption + secretion

55
Q

how to measure GFR

A

-use creatinine (waste product in blood)
-why bad is increase skeletal muscle, increase creatinine produced

creatinine in urine x urine/day divide by creatinine plasma

56
Q

creatinine

A

-not perfect measurement because some creatinine is secreted in tubule
-overestimates GFR

57
Q

other methods to measure GFR

A

inulin, blood urea nitrogen, serum creatinine

58
Q

inulin

A

-plant polysaccharide
-given via intravenous, isn’t produced by kidneys
=then [ ] of inulin in blood and filtered bt kidneys
-epithelial cells of tubule don’t recognize, so inulin is not reabsorbed or secreted so 100% is excreted
-quite invasive

59
Q

blood urea nitrogen (BUN)

A

-partially reabsorbed by tubules so doesn’t show all filtration
-[ ] of urea in blood can determine if less urea is being filtered
-measures nitrogen in urea
-however high protein diet and strenuous exercise can increase urea levels in blood

60
Q

serum creatinine

A

-quick way to estimate GFR
-of serum creation levels increase in blood, can indicate kidneys are no longer filtering as much fluid
-normal values is different for different people

61
Q

converting L/day to ml/min

A

1000ml
1440 min

62
Q

GFR lower than expected

A

-with age, natural decline in renal function
-too much lower, kidneys are no longer functioning as they should

63
Q

kidney failure GFR

A

15ml/min

64
Q

normal GFR

A

180L/day or 125 ml/min

65
Q

chronic kidney disease (CKD)

A

-progressive disease can result in complete kidney failure
-damage can’t be reversed but slowed + stay
-nephrons damaged can’t heal
5 stages

66
Q

stage 1-2 of CKD

A

mild decrease in GFR, may not experience symptoms

67
Q

stage 3 of CKD

A

GFR decrease further, symptoms swelling in hands and feet b/c less blood being filtered

68
Q

stage 4 of CKD

A

last stage before kidney failure, move severe symptoms

69
Q

stage 5 of CKD

A

kidney failure > no longer functioning to support body
-dialysis or transplant

70
Q

filtered load

A

how much of each substance is filtered
-calculated using GFR
= [substance] plasma x GFR

71
Q

percentage excreted

A

= [total excreted/ filtered load ] x100

72
Q

normal excretion rate of Na

A

0.5-2.5%

73
Q

normal excretion rate of K

A

6-9%

74
Q

normal excretion rate of Mg

A

3-5%

75
Q

hypo/hypernatremia

A

hyponatremia: low Na in plasma
hypernatremia: high Na in plasma

76
Q

hypo/hyperkalemia

A

hypo: low K in plasma
hyper: high K in plasma

77
Q

hypo/hypermagnesemia

A

hypo- low Mg in plasma
hyper- high Mg in plasma

78
Q

tubule function

A

-99% of filtrate is reabsorb
-based on types of transporters in tubule epithelial cells

79
Q

proximal tubule reabsorption

A

glucose, AA, h2o, Na, K, cl
transporter type; reabsorption

80
Q

descending limb reabsorption

A

h2o, + minimal Na

81
Q

ascending limb reabsorption

A

Na, K, Cl

82
Q

distal convoluted tubule reabsorption

A

Na, K, CL, Ca

83
Q

collecting duct reabsorption

A

na and h2o

84
Q

paracellular transport

A

between epithelial cells or though cells across luminal and basolateral membrane

85
Q

transcellular transport

A

reabsorption or secretion
-uses channels or protein carriers across tubule membrane

86
Q

channels

A

small protein-lined pores that permit specific molecules them

87
Q

uniporters

A

allow movement of single molecule through membrane
-protein carriers that bind to molecules
-facilitated transport
glucose uniporter

88
Q

symporters

A

facilitated transport + secondary active transport
-permits 2 or more molecules same direction
-1 molecule must move down [] gradient
-Na/glucose symporter

89
Q

antiporters

A

-permits 2 or more molecules in different direction
-called exchangers
-1 molecules must move down [] gradient
-facilitated transport
Na/H antiporter

90
Q

primary active transporters

A

uses ATP against [] gradient
-every tubule cell has Na/k atpase

91
Q

regulation at level cellular location

A

channels and transports only function when in right location (cell membrane)
-h2o channels

92
Q

regulation at level of activity

A

protein carriers bind to specific molecules and change shape
-protein carriers can work faster by hormones
-Na/H exchanger

93
Q

regulation at level of gene expression

A

more molecules can move across membrane if more channel/ protein carriers
-make more by making copies in DNA > exporting as messager RNA in proteins

94
Q

[] in epithelial cells

A

high Na outside, high K inside
Na [] is driving force for reabsorption

95
Q

proximal tubule transport

A

reabsorbs almost everything

96
Q

Na/AA symporter location, regulated

in proximal tubule

A

-luminal
-not to hormones
-binds to protein symporter >conformation change
-Na goes down [] gradient, bring AA with it

97
Q

Na/glucose symporter location, regulated

in proximal tubule

A

luminal
-not by hormones
-Na goes down [] gradient
-Na makes protein carrier change (conformation)
-glucose doesn’t favour going in proximal tubule, Na bring it with protein carrier

in proximal tubule

98
Q

Na/H exchanger location, regulated

in proximal tubule

A

-luminal
-responsive to angiotensin 2
-Na goes down [] gradient
-antiporter of H(H in opposite direction)
-Na reabsorbed, H secreted

99
Q

Na/K ATPase location, regulated

in proximal tubule

A

basolateral
-responsive to angiotensin 2
-uses ATP to change conformation
-against [] gradient
-3 Na out, 2K in
-primary active transport
maintains low []

100
Q

aquaporin channel 1 location, responsive

in proximal tubule

A

luminal
-not by hormones
-h20 move to higher solute
-diffusion osmosis> not facilitated

100
Q

paracellular responsive

in proximal tubule

A

-h2o, K, Cl
-not by hormones
-movement between tubule cells
high to low []

100
Q

aquaporin channel 2/3 location, responsive

in proximal tubule

A

basolateral
-not by hormones
inside tubule cell to interstition space then reabsorbed in blood
-diffusion osmosis> not facilitated

101
Q

AA uniporter location, responsive

in proximal tubule

A

-basolateral
-not by hormones
-AA that were just reabsorbed into cytosol move across basolateral membrane into interstitial space by themselves
high to low []

101
Q

glucose uniporter location, responsive

in proximal tubule

A

basolateral
-not by hormones
-high to low []
-cytosol to interstitial space
-move by itself (protein carrier)

102
Q

diabetes mellitus

A

-glucose not reabsorbing in nephron
-^ urine v, glucose in urine
-more glucose will be filtered in bowman’s capsule

103
Q

glucosuria

A

-Na/glucose symporters in proximal tubule have limited capacity, so not all glucose is reabsorbed, therefore in urine
-causes less h2o in proximal tubule b/c it follows glucose
decrease h20 reabsorption, increased urine V

104
Q

osmotic diuresis

A

increase urine V due to increase levels of solute excretion

105
Q

descending loop of henle

A

-reabsorbs few substance from filtrate (mainly h2o)
-both luminal and basolateral membrane have aquaporin 1
-favourable gradient for h20 movement b/c high[] of solutes of extracellular fluid in medulla

106
Q

ascending loop of henle

A

impermeable to h2o
-paracellular transport of h20 is prevented by tight junction proteins adhering epithelial cells together
-paracellular transport of ions (Na)
NA/Cl/K symporter, Na and Cl are moving down [] gradient

107
Q

similarities between ascending loop of henle and distal convoluted tubule

A

reabsorb Na/K ATPase, luminal Na

108
Q

Differences between ascending loop of henle and distal convoluted tubule

A

Ca reabsorbed in distal convoluted tubule, paracellular transport-as

109
Q

principal cells

A

-in collecting duct
-make up majority of epithelial cells
-responsive to variety of hormones that regulate h2o and Na balance

110
Q

collecting duct cells

A

principal cells, intercalated cell A and B

111
Q

intercalated cell

A

responsive to changes in plasma pH

112
Q

aquaporin channel 2 location, regulated

in collecting duct

A

luminal
responsive to ADH

113
Q

aquaporin channel 3/4 location

in collecting duct

A

basolateral
out tubule cell

114
Q

Na channel location, regulation

in collecting duct

A

luminal
-responsive to aldosterone
-Na move high to low []

115
Q

K channel location, regulation

in collecting duct

A

luminal
-responsive to aldosterone
moving in collecting duct’s lumen

116
Q

Na/K ATPase location, regulated

in collecting duct

A

-basolateral
responsive to aldosterone
Na 3 out, 2 K in
-uses ATP

Physiology 1020 (4 decks)

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