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A&P II > Renal System > Flashcards

Renal System Flashcards

1
Q

Functions of Kidney

A

Remove waste
Regulate blood pH
Regulate blood pressure
Assists in formation of RBC

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2
Q

Steps in Urine Formation (3)

A
  1. Glomerular FILTRATION
  2. Tubular REABSORPTION
  3. Tubular SECRETION
    ….Water conservation (returns it to blood, minus the waste)
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3
Q

How much filtered per day?

A

48 Gallons!

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4
Q

What causes filtration in Glomerulus?

A

High glomerular blood pressure forces filtrate through capillary wall.

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5
Q

What stays in blood during filtration?

A

RBC & proteins

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6
Q

What are the filters in the renal corpuscle?

A

Podocytes

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7
Q

Large network of capillaries with large surface area?

A

Glomerulus

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8
Q

Incoming and outgoing arterioles -

A

Afferent arteriole
INCOMING, Large

Efferent arteriole
OUTGOING, small

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9
Q

Net filtration pressure

A

10mm Hg

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10
Q

Glomerular blood pressure moving into glomerulus (hint: it’s higher here)

A

60 mmHg

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11
Q

Blood osmotic pressure & glomerulus

A
  • 32 mmHg
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12
Q

Capsular Hydrostatic pressure at glomerulus

A

-18mm Hg

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13
Q

Equation showing net pressure:

A

blood pressure moving fluid in = 60mmHg
Blood osmotic - 32mmHg
Capsular hydrostatic -18mmHg

Net =
60 - 32 - 18 = 10mmHg

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14
Q

Factors that impact filtration pressure

A

Kidney Disease
Blood Pressure Drops
Stress
Kidney Stones

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15
Q

Impact of kidney disease on filtration pressure

A

glomerulus highly permeable. Plasma proteins can get out

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16
Q

Impact of blood pressure drops on filtration pressure

A

hemorrhaging
Drop in filtration pressure
very low - anuria

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17
Q

Impact of stress on filtration pressure

A

Increased sympathetic stimulation
Increased constriction of afferent arteriole
Drop in filtrate + urine volume

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18
Q

Impact of kidney stones on filtration pressure

A

Ureter blocked ->
pressure backs in in nephron, capsule
Filtration drops. Can damage

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19
Q

Causes of kidney stones

A

Dehydration
pH imbalances
Frequent UTI
Enlarged prostate

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20
Q

Glomerular Filtration Rate too high….

A

Filtrate flows too rapidly for reabsorption
Therefore:
Dehydration and electrolyte depletion

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21
Q

GFR too low

A

Everything is reabsorbed, including waste

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22
Q

How is GFR controlled?

A

By adjusting glomerular blood pressure moment to moment

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23
Q

Mechanisms for GFR control

A

Intrinsic:
Renal autoregulation

Extrinsic:
Sympathetic control
Juxtaglomerular apparatus

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24
Q

How does intrinsic renal autoregulation work

A

Nephrons self-adjust to maintain stable GFR

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25
Q

GFR

A

Glomerular Filtration Rate

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26
Q 
Myogenic mechanism (within intrinsic renal autoregulation)
What happens when blood pressure rises?
A

the afferent arteriole and it constricts to prevent increased blood flow

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27
Q

Myogenic mechanism for intrinsic renal autoregulation- what happens when blood pressure falls?

A

Afferent arteriole relaxes to allow more blood in

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28
Q

Tubuloglomerular feedback in Macula dense cells

A

Monitor changes in flow of filtrate through nephron (via NaCl concentration)

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29
Q

Tubuloglomerular feedback when GFR is high/low

A

GFR is high - MACULA DENSE releases chemicals to cause vasoconstriction of afferent arteriole to slow GFR

GFR is low - vasoconstriors are inhibited

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30
Q

Limits of autoregulation

A

has narrow upper and lower bands - arterial pressure of 90-180 mmHg

31
Q

What happens below 70 mmHg?

A

glomerular filtration and urine output cease

32
Q

Extrinsic - Sympathetic Nervous System Acivation

A

Strenuous exercise or circulatory shock

33
Q

Extrinsic- Sympathetic activation impact

A

Overrides autoregulatory mechanisms
Afferent arterioles constrict
Reduces GFR and urine output
Redirects blood to heart, brain, skeletal muscles

34
Q

Extrinsic - Juxtaglomerular Apparatus

A

Afferent arteriole - sensitive to changes in blood pressure - secretes renin

Macula densa - monitors GFR through NaCl levels - stimulates RELEASE OF RENIN

35
Q

Juxtaglomerular apparatus - response to LOW BLOOD PRESSURE AND LOW GFR

A

Release Renin - triggers increase in Blood pressure and GFR

36
Q

Renin-Angiotensin Pathway

A

Renin ->
Angiotensinogen (plasma protein) - + Renin ->
Angiotensin I

Angiotensin I + An… Converting enzyme (ACE) ->

Angiotensin II

37
Q

ACE

A

Angiotensin-Converting Enzyme (in lungs and kidneys)

38
Q

Active hormone in pathways

A

Angiotensin II

39
Q

Impacts of Angiotensin II

A
  1. Vasoconstriction
  2. Aldosterone secretion
  3. Antidiuretic Hormone secretion
  4. Increased thirst

…. Overall = INCREASED BLOOD PRESSURE

40
Q

How many gallons filtered to excreted?

A

48 gallons filtered : 1/2 gallon excreted (99% filtrate reabsorbed)

41
Q

Methods for reabsorption

A

Active transport, facilitated diffusion, diffusion, osmosis, solvent drag

42
Q

What substances are reabsorbed?

A 
Water
Salts
Urea
Glucose
Amino Acids
Vitamins
43
Q

Na+ reabsorption

A

ACTIVELY TRANSPORTED from proximal convoluted tubule, distal tuble, ascending limb

44
Q

Water reabsorption

A

80% Osmosis, mostly in proximal tubule

45
Q

Cl- reabsorption

A

Follows along electrical gradient

46
Q

Urea reabsorption

A

Concentration rises as water leaves - solvent drag

50% returned by blood

47
Q

Amino Acid reabsorption

A

Active transport from proximal tubules

48
Q

Vitamins reabsorption

A

Active transport

49
Q

Glucose reabsorption

A

Normally - active transport
(up to 220 mg/dL)

EXCESS excreted in urine

50
Q

Glucose reabsorption limit?

A

Yes. 220 mg/dL

51
Q

H20 reabsorption

A

Water will move towards SALT - Therefore tissues around nephron must be MORE SALTY

52
Q

Salt Gradient created by

A

Vasa recta, loop of henle

53
Q

Vasa Recta description, function (re: salt gradient)

A

Region of peritubular capillaries.

Recycles salt

54
Q

Loop of Henle function (re: salt gradient)

A

Pumps salt out of nephron

55
Q

Salt gradient in Cortex of kidne

A

300 mOsm

56
Q

Salt gradient in Inner medulla of kidney

A

1200 mOsm

57
Q

Salt concentration in limbs of loop of henle

A

Descending (Na+Cl = low) absorbs FROM tissues

Ascending (Na+Cl = high)
returns Solutes TO TISSUES

58
Q

Hypertonic Urine

A

Concentrated Urine

59
Q

Permeability to H20 in loop of Henle

A

Descending - freely permeable to H20

Ascending - NOT permeable (therefore Na+Cl- actively transported out)

Collecting tubule - freely permeable

60
Q

Where is Na+Cl- most concentrated in kidney?

A

Inner Medulla 1200

61
Q

Function of loop of henle

A

Water drawn out of collecting tubule and tissue is salty

Therefore allows water to be absorbed even though urine volume is low. Conserves water

62
Q

What regulates the amount of water reabsorbed from the collecting tubule?

A

ADH - antidiuretic hormone

63
Q

What secretes ADH (antidiuretic hormone)?

A

Posterior pituitary

64
Q

Impact of ADH - when present….

A 
Distal tubule AND collecting tubule become permeable to water
MORE WATER REABSORBED
Causing: hypertonic (concentrated) urine
AND 
increase blood pressure
65
Q

Impact when ADH is absent

A

Distal tubule & collecting become impermeable to water
LESS ABSORPTION

Urine is hypotonic (dilute)
Blood pressure decreases

66
Q

What stimulates ADH?

A

Dehydration, reduced blood volume, pain

67
Q

What inhibits ADH?

A

Alcohol, caffeine, ingestion of water

68
Q

What does Aldosterone regulate?

A

Na+ excretion

69
Q

Where is Aldosterone produced?

A

Adrenal cortex

70
Q

What does Aldosterone stimulate?

A

Na+ reabsorption

71
Q

Goal of aldosterone and reabsorption

A

Regulates blood pressure

72
Q

Atrial Natriuretic Peptide (ANP) - source

A

comes from heart in response to high blood pressure

73
Q

ANP - 4 actions

A

Dilates afferent, constricts efferent (GFR UP)
Inhibits Renin and aldosterone
Inhibits secretion of ADH
Inhibits NaCl reabsoprtion

74
Q

Results of ANP

A

Excretion of more salt and water in urine

REDUCED BLOOD PRESSURE AND VOLUME

A&P II (13 decks)

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