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Physio Final > Renal System > Flashcards

Renal System Flashcards

1
Q

______ is key to maintaining Homeostasis.

A

The Kidney

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2
Q

How does the Kidney help maintain homeostasis?

A
  • Excretes wastes and drugs
  • Regulates or balances intake and excretion.
  • Gluconeogenesis
  • removal of foreign chemicals
  • Regulates salts and water
  • Production of Erythropoietin, Renin and 1,25-dihydroxyvitamin
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3
Q

_______ acts in the bone marrow to stimulate the synthesis of New erythrocytes.

A

Erythropoietin

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4
Q

_______ is helpful in regulation blood pressure.

A

Renin (via renin-angiotensin-aldosterone cascade)

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5
Q

_______ regulates calcium absorption.

A

1,25-dihydroxyvitamin D

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6
Q

________ requires Hemodialysis.

A

ESRD (End Stage Renal disease)

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7
Q

What is the main problem of ESRD?

A

Inability to get rid of nitrogenous waste (Urea) and ends up turning it in to ammonia which is toxic to humans.

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8
Q

What are the clinical manifestations of Renal disease?

A
  • Ammonia breath
  • Gingival Enlargment
  • Xerostomia
  • Tooth problems
  • Premature loss
  • Narrowing pulp chambers
  • necrosis beneath fillings or crowns.
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9
Q

What are contraindications for ESRD patients?

A

Nephrotoxic drugs such as tetracycline, acyclovir, aspirin and NSAIDS.

  • Increased susceptibility to bleeding due to destruction of platelets.
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10
Q

What is the basic structure of the kidney?

A

Renal medulla = center = portions of nephron tubule involves with concentration and collection of urine.

Renal Cortex = outer part = blood is filters in the glomeruli and filtrate passes through tubule of nephron.

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11
Q

Tubules drain to ____.

A

into renal pelvis and then into ureter

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12
Q

Ureters drain to _____.

A

Urinary bladder, and the bladder is drained by the urethra.

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13
Q

What is the functional until of the kidney?

A

The Nephron

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14
Q

Describe the structure of a nephron….

A

A cluster of capillaries and a long hollow tube with a wall that is one cell layer thick.

  • Renal Corpuscle = glomerulus + capsule
  • Proximal (Convoluted) Tubule
  • Distal convoluted tubule
  • Collecting duct (shared by several nephrons.
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15
Q

What are the 2 types of nephrons?

A
  1. Superficial or cortical nephrons
  2. Juxtamedullary nephrons
    * Differ in position of the renal corpuscle and length of the medullary tubules.
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16
Q

What are the 3 steps of the Renal process?

A
  1. Filtration = solutes pass in from the blood into the tubular fluid in the renal capsule (bowman’s space)
  2. Secretion = substances are transported from the blood in the peritubluar capillaries into the tubular fluid.

Resorption = substances are transported defrost he tubular fluid into the blood in the peritubular capillaries.

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17
Q

Where does filtration occur?

A

in the glomerular capillaries (15-20% of plasma entering the glomerulus is filtered)

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18
Q

Blood leaving the glomerular capillaries flows into _________.

A

Peritubular capillaries (Vasa recta) *See diagram

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19
Q

Where does secretion and absorption take place?

A

Throughout the length of the tubules, Thus the composition of the tubular fluid varies with tubular region.

20
Q

What happens to the tubular fluid that remains at the end of the collecting ducts?

A

it gets excreted.

21
Q

_______ is a dense capillary bed where filtration occurs.

A

Glomerulus

22
Q

_____ surrounds the glomerulus.

A

Renal capsule

23
Q

What mechanisms regulate blood flow through the glomerulus?

A
  • Smooth muscle contaction in afferent and efferent arterioles
  • Response of Juxtaglomerular apparatus = secretes the hormone renin, which regulates BP and therefore glomerular blood flow.
  • Sympathetic nervous system
24
Q

What does the Proximal convoluted tubule do?

A
  • Drains the renal capsule
  • resorbs 2/3 of filtered salt and water
  • Resorbs all filtered glucose and AAs
  • Some diuretics act here.
25
Q

What does the Loop of Henle do?

A

Site of countercurrent multiplication needed to produce concentrated urine, but the loop itself produces a dilute filtrate.
*Very powerful diuretics work here.

26
Q

What are the parts of the loop of Henle?

A

Thin descending limb
Thin ascending limb
Thick ascending limb

27
Q

What does the Distal convoluted tubule do?

A
  • Drains the loop of henle
  • regulates calcium
  • site of action for some diuretics
28
Q

What does the Collecting duct do?

A

collects fluid from multiple nephrons and extends from cortex through the medulla.

  • regulates sodium, potassium and water.
  • some diuretics act here
29
Q

_____ Represents the volume of plasma form which all of a particular substance is removed to the urine.

A

Renal clearance (EX. 100ml/min)

30
Q

Why is renal clearance clinically important?

A

It can be used to measure the globular filtration rate (GFR) based on 3 criteria:

  1. The substance must be freely filter in the glomerulus.
  2. The substance is not secreted
  3. The substance is not reabsorbed.
31
Q

What is the GFR in normal kidney?

A

125ml/min or 180L/day

32
Q

_____ and ____ are used in measure of renal clearance.

A

Insulin and creatinine

33
Q

Tell me about insulin…..

A

It is a small polysaccharide that is freely filtered indent secreted of absorbed.

34
Q

Tell me about creatine….

A

Product of muscle metabolism, freely filtered, not reabsorbed, almost no secretion.

35
Q

Creatine level above ___ require dialysis.

A

10mg/dl

36
Q

Glomerular capillary filtrate is ______ and _____.

A

Acellular and protein free.

37
Q

What molecules are freely filtered in the glomerulus?

A

Glucose, salts, and AA’s

38
Q

What determines if something is freely filtered?

A

Size = less than 20 A is freely filtered.

Charge = negatively charged molecules are not freely filtered.

39
Q

Filtration occurs due to what?

A

Pressure differences btwn the blood in the capillaries and the fluid in the capsule. Pressure comes from 2 sources:

  1. Hydrostatic pressure = due to fluid in capillaries
  2. Oncotic pressure = Due to solutes in fluid.
40
Q

Net filtration favors ________.

A

Filtration from blood into the capsule.

41
Q

What affects GFR?

A

Blood flow into and out of the Glomerulus and P gradient is critical to maintain filtration.

42
Q

Does Renal Blood flow (RBF) change much?

A

No it remains fairly constant despite changes in systemic BP. This is good because it means that GFR remains fairly constant as a result.

43
Q

What is autoregulation?

A

Intrinsic mechanisms that regulate blood flow through the glomerulus.

44
Q

What 2 mechanisms are responsible for autoregulation in the glomerulus?

A
  1. Myogenic mechanism = vascular smooth muscle tends to contract when stretched.
  2. Tubuloglomerular feedback = feedback from the JGA adjust afferent arteriole diameter and thus GFR.
45
Q

Increase in GFR = ?

A

Increase in NaCl in tubular fluid = increase in NaCl at macula dense = Increased resistance in afferent arterioles = decrease in GFR.

46
Q

What extrinsic factos regulate RBF and GFR?

A
  • diet
  • Dehydration or hemorrhage
  • Sympathetic nervous system
  • Angtiotensin II, aldosterone and natriuetic peptide.

Physio Final (3 decks)

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