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Foundations of Healthcare Science > Renal System > Flashcards

Renal System Flashcards

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1
Q

What is the position of the kidneys?

A

-posterior abdominal wall
-12th rib
-T12-L3

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2
Q

List some internal structures of the kidneys

A

-renal cortex
-renal medulla
-major calyx
-papilla of pyramid
-renal pelvis
-minor calyx
-ureter
-renal pyramid in renal medulla
-renal column
-fiborous capsule

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3
Q

What are the functions of the kidneys?

A

-maintenance of homeostasis formation of urine
-excretion of toxins and waste products
-regulation of electrolyte balance
-regulation of fluid balance
-regulation of acid-base balance
-produce renin
-produce erythropoietin
-metabolism of vit D inactive-active

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4
Q

Desxcribe the structure of the nephron

A

-functional unit of kidney
-consists of: Glomerulus, bowmans capsule,PCT, loop of henle,DCT,collecting duct
-glomerulus-cappilary network inside the glomerular capsule

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5
Q

What are the three main steps in the formation of urine?

A

1-glomerular filtration
2-tubular reabsorption
3-tubular secretion

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6
Q

What are some main structure and functions in the glomerulus?

A

-granular cells in afferent arteriole (release renin)

-Macula densa cells in ascending limb of loop of henle

-efferent artery-monitor Na+ conc in filtrate

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7
Q

Describe what happnes during glomerular filtration

A

1-Movement of H2O and solute from blood into filtrate under pressure

2-glomerular filtration rate

3-filtrate passing into PCT contains everything in blood but not RBC and WBC, platelets and large proteins-albumin

4-filtrate has glucose, AA, waster, vitamins,electrolytes,nutrients,H2O- plasma without proteins

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8
Q

What is GFT?

A

the rate at which the kidney/nephron filters the blood

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9
Q

Explain GFT quantitavily

A

-approx 125ml/min
-measured using
eGFR (MDRD formula) >90/min/1.73m2
-albumin>30mg/mmol
-GFR maintained in part by auto-regulation

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10
Q

What are the three main structure in the filtration membrane?

A

-fenestration pores and capillaries
-membrane-negative charge
-podocytes

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11
Q

Describe the promotion of filtration

A

-BP
-Net filtration pressure:
out:
-hydrostatic pressure in glomerular cappilaries 55mgHg
-efferent arteriole narrower than afferent

In:
pressure in capsular space (15mmHg)
-colloid osmotic pressure in cappilaries (30mmHg)
net outward force= 10mmHg

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12
Q

Whats the formula for NFP?

A

outward pressures- inward pressures

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13
Q

What is autoregulation?

A

high pressure= afferent arteriole constricts to reduce pressure entering glomerulus

low pressure= efferent arteriole contsricts to increase pressure in glomerulus
low pressure in afferent arteriole stimulates renin release

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14
Q

Describe the process of tubular reabsorption

A

1-return of useful subs to H2O from filtrate into blood
2-selective reabsorption in PCT
3-Na+ actively reabsorbed from filtrate into blood
4-H2O some ions and nutrients passively follow
5-Transport maximum

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15
Q

What is transport maximum?

A

-maximum amount of a substance that can be reabsorbed
-if glucose exceeds the TM its lost in the urine

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16
Q

Describe the reabsorption process in more detail

A

-PCT
-Reabsorption continues through tubules by active and passive means -influence hormones

-aldosterone influences reabsorption in DCT-movement of H20 and Na+ follows passively

ADH-affects permeability of collecting ducts to H20-reabsorb water or increase water loss

17
Q

Describe what happens in tubular secretion

A

1-active removal of unwanted subs from the blood into filtrate
2-occurs all along tubule
k+ mainly in PCT but also in DCT in exchange for Na+
3-H+,K+,NH4, creatine,drugs
4-important for regulating k+ (3.5-5mmol) and PH (7.35-7.45)

18
Q

Describe the urine chemical composition

A

95%-water
5%-solute

water, urea, sodium, potassium,phosphate, sulphate,creatine, uric acid

creatine-metabolism in muscle tissue
Uric acid-metabolism in nucleic acids

19
Q

describe the regulation of urine conc and volume

A

-kidneys make adjustments to maintain body fluid osmotic conc at around 300mOsm

osmolality-number of solute particles in 1kg of H2O

body fluids-expressed in milliosmols

20
Q

Describe the role of ADH within the kidney

A

-permeability of CD and latter part of DT under ADH influence

-aquaporin channels allow H2O movement

-plasma osmolality is detected by osmos receptors in hypothalamus

-ADH secretion from posterior pituatary is increased or decreased in response to osmotality
high>300mosmol low<300mosmol

21
Q

What happens if there is an increase or decrease in ADH ?

A

increase=greater reabsorption-less urine

decrease=less reabsorption-more urine

22
Q

describe the renin-angiotensin aldosterone mechanism

A

1-renin released form juxta-glomerular apparatus in respone to low pressure

2-renin converts circulating angiotensinogen (inactive protein) into angiotensin I

3-Angiotensin I is converted into angiotensin II by angiotensin converting enzyme from lungs (ACE)

23
Q

What does angiotensin II cause?

A

-vasoconstriction of systemic blood vessels
-release of aldosterone from adrenal cortex
-reabsorption of Na+ and H2O in renal tubules (DCT)
-influences ADH release

24
Q

How does the renal system regulate the acid-base balance?

A

-normal range 7.35-7.45
-H+ constantly produced as a result of metabolism-needs to be eliminated
gluocse->ATP+CO2+ H2O

-more H+ in blood the more acidic the blood PH
-more OH- in blood the more alkaline the blood PH

25
Q

Whats the acid base balance?

A

CO2+H20->H2CO3->H+ + HCO3-

Goes both ways

26
Q

How does the respiratory system maintain acid base balance?

A

-detects change in H+ conc
-if H+ increase-respiratory rate increases, excess H+ breathed out as CO2

27
Q

How do buffers e.g bicarb in blood, proteins and phosphates in cells maintain acid base balance?

A

-acts as a sponge, soaks up excess H+ or OH- ions

28
Q

Describe erythropoietin production

A

-EPO stimulates bone marrow to produce RBC (eryhtropiesis)
-HB is a principle carrier of O2 to body cells
-EPO production is stimulated by hypoxaemia

29
Q

describe the role of the kidneys in Ca2+ and Phosphate regulation in vitamin D metabolism

A

-Main homeostatic control of Ca2+ is through PTH release

-kidneys role in Ca2+ = reabsorption of Ca2+ and the metabolism of Vitamin D into an active form

-Ca2+ is reabsorbed as phosphate is excreted

30
Q

Describe the process of PO43- and Ca2+ of
Vitamin D regulation

A

1-low Ca2+-PTH released
increases the absorption of Ca2+ from kidney to GI tract
-releases Ca2+ from bones to maintain plasma Ca2+

2-kidneys convert vitamin D to active form-stimulates Ca2+ absorption from GI tract, maintains normal Ca2+ levels

31
Q

What is Ca2+ needed for?

A

-strong bones and teeth
-normal transmission of nerve impulse
-normal muscle contraction
-blood clotting

Foundations of Healthcare Science (30 decks)

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