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HUBS192 EXAM > Renal system > Flashcards

Renal system Flashcards

1
Q

Between which vertebral levels do the kidneys sit?

Where are they positioned relative to the peritoneum?

A

T12-L3

Retroperitoneal

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2
Q

What passes through the hilum of the kidney?

A
  • Blood vessels (arteries + veins)
  • Lymphatics
  • Ureter
  • Nerves
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3
Q

Which liver is inferior and why?

A

Right bc of liver

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4
Q

Where are the kidneys surrounded by?

What glands sit above them?

A
  • Fat pads

- Adrenal glands

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5
Q

What are the 3 regions of the kidneys and what makes up the outer surface?

A
  • Cortex
  • Medulla
  • Pelvis
  • Surrounded by fibrous capsule
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6
Q

What is the medulla arranged into? What do they end in?

A
  • Pyramids

- Papilla

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7
Q

Urine passage through the kidneys into the ureter

A

Papilla –> minor calyx –> major calyx –> renal pelvis –> ureter

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8
Q

Blood supply to, through and from the kidneys

A

Abdominal aorta –> renal artery –> series of arteries –> afferent arteriole –> glomerular capillary –> efferent arteriole –> peritubular capillaries –> series of veins –> renal vein –> inferior vena cava

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9
Q

Nerve supply of the kidneys? Made up of?

A
  • Renal plexus

- autonomic nerves + ganglia

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10
Q

Two types of nephron + defining features

A
  1. Cortical nephron
    - 85%
    - Lie mainly in cortex
  2. Juxtamedullary nephrons
    - Extend deep into medulla
    - concentrated urine
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11
Q

Glomerulus:

  • Specialised for?
  • Endothelium?
  • Supplied + drained by?
  • Pressure?
A
  • Filtration
  • Fenestrated, simple squamous endothelium
  • arterioles
  • High pressure
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12
Q

Peritubular capillaries

  • Specialised for?
  • position?
  • Arise from?
  • Pressure?
A
  • Absorption
  • Adjacent to renal tubules
  • Aries from arterioles draining glomeruli
  • low P
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13
Q

Vasa recta

  • structure
  • associated w/
A
  • long, straight vessels (extensions of peritubular capillaries)
  • Associated w/ LoH in juxtamedullary nephrons
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14
Q

What makes up the renal corpuscle?

A

Glomerulus + bowman’s capsule

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15
Q

Structure of bowman’s capsule

A

Outer layer - simple squamous
Bowman’s space
Inner layer - podocytes

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16
Q

What facilitates filtration at the glomerular capillaries

A

Filtration slits formed by the pedicels of the podocytes

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17
Q

What is/isn’t filtered at the blood-urine barrier?

A 
Filtered (usually):
- Water and small molecules
- Na+ and K+
- Glucose
Cannot be filtered (usually):
- Proteins
- RBCs
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18
Q

Layers of the blood-urine barrier

A
  1. Fenestrated endothelium of glomerular capillary
  2. Fused basement membrane
  3. Filtration slits b/w pedicels of the podocytes
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19
Q

How does the outer cortex separate the medullary pyramids?

A

Renal columns

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20
Q

What forms a kidney lobe?

A

One medullary pyramid + all the cortex that surrounds it

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21
Q 
Specialised cells of the afferent arteriole
\+ form part of?
\+ what type of receptor
\+ detect?
\+ How do they respond to stimulus?
A
  • Juxtaglomerular cells
  • JGA
  • Mechanoreceptor
  • BP
  • Release renin, which stimulates angiotensin II formation
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22
Q

Proximal convoluted tubule (PCT)

  • What type of reabsorption
  • Surrounded by
  • Epithelium (structure + what it contains)
A
  • Bulk reabsorption
  • Peritubular capillaries
  • Cuboidal epithelial cells w/ dense microvilli on luminal membrane
  • Many mitochondria + highly folded basolateral membrane
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23
Q

Loop of Henle

  • Surrounded by?
  • Why is length important?
  • Position in kidney?
  • Structure
  • Which parts absorb what?
  • Mechanism that helps create gradient?
A
  • Vasa recta (juxtamedullary only)
  • To produce highly concentrated urine
  • Penetrates medulla
  • Descending limb: thick section = cuboidal, thin section = simple squamous; reabsorption of water
  • Ascending limb: thin = simple squamous, thick = cuboidal; reabsorption of salt
  • Counter-current system
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24
Q

Distal convoluted tube

  • What type of reabsorption?
  • Epithelium (structure + what it contains)
A
  • Fine tuning (regulated reabsorption)
  • cuboidal epithelium
  • Fewer mitochondria and few microvilli
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25
Collecting duct - What type of reabsorption? - Receives filtrate from? - Empties filtrate into? - Epithelium - Reabsorption influenced by?
- Fine tuning (regulated reabsorption) - Multiple DCTs - Papilla - Simple cuboidal (principal cells for reabsorption + intercalated cells for acid/base balance) - ADH and aldosterone
26
JGA: - Where does it lie? - Controls what? - Stabilises what?
- Between efferent and afferent arterioles - Controls GFR - Stabilises BP
27
Specialised cells of the efferent arteriole + What type of cells? + What type of receptor + Detect?
- Macula densa cells - Chemoreceptors - Detect Na+ conc. in filtrate
28
What motility pattern moves urine through ureters?
- Peristaltic waves
29
Layers of the ureter + structure
1. Mucosa - transitional epithelium, stratified 2. Muscularis - Inner longitudinal, outer circular 3. Adventitia - Outer covering of FCT - Protein plaques on inner surface (stops urine leakage)
30
How does the ureter act as a sphincter/valve?
Runs obliquely through bladder wall, thus compressed by muscles during increased bladder pressure --> prevents back flow of urine
31
3 openings of the bladder known as?
trigone
32
Male vs female bladder position
``` Male: - anterior to rectum - superior to prostate gland Female: - anterior to vagina + uterus ```
33
Layers of the bladder wall
1. Mucosa - Transitional epithelium - Allows it to expand w/out great increase in P 2. Detrusor muscle - Meshwork of oblique, longitudinal and circular muscle fibres 3. Adventitia - Connective tissue
34
Epithelia transition in urethra
1. Transitional near bladder 2. Columnar - Mucous protection from urine 3. Stratified squamous near anus
35
Female vs male urethra
``` Male: - Long - Part of repro. system - 3 sections: prostatic, membranous, spongy/penile Female: - Short - Separate from RS ```
36
Urethral sphincters - Junction of? - Composed of? - Voluntary/involuntary control
``` Internal: - Urethra and bladder - Detrusor muscle - Involuntary control (parasympathetic) External: - Where urethra passes through urogenital diaphragm - Skeletal muscle - Voluntary control ```
37
Urination steps
Bladder expands --> APs to brain --> urgency --> inner sphincter relaxes --> conscious relaxation of external sphincter --> urination
38
Places in the urinary tract which contain transitional epithelium?
Ureter, bladder, urethra
39
Composition of normal urine
- Water (95-98%) - Creatinine - Urea - H+ - Ammonia - Na+ - K+ - Drugs - Toxins
40
Composition of pathogenic urine
- Glucose - Protein - Blood - Hb - Leucocytes - Bacteria
41
Look, taste + smell of normal urine
- Clear, light or dark amber - Acidic (pH 5-7, depending on diet); NOT sweet - No smell
42
Look, taste + smell of pathogenic urine
- Golden, red, brown, blue - Sweet - Smells like fruits (diabetes, etc.) or rotten (infection)
43
Functions of the kidneys
1. Water + salt/ion homeostasis 2. Filtration 3. Reabsorption 4. Hormone production (EPO) 5. Metabolism 6. Gluconeogenesis 7. Excretion of drugs, urea, etc. 8. pH regulation
44
Rate of filtration? (GFR)
125mL/min (180L/day)
45
Rate of blood supply to the kidneys?
1-1.2L/main
46
How does DCT monitor BP
Senses how much vol. is filtered
47
How to calculate effective filtration pressure?
(glomerular hydrostatic pressure + capsular osmotic pressure) - (glomerular osmotic pressure + capsular hydrostatic pressure)
48
What is renal clearance? | + Formula
The RATE at which substances are cleared by the kidneys per unit time C = (Conc. in urine x vol. of urine) / conc. in plasma
49
What is GFR? | + Estimated how?
- VOLUME of fluid filtered per unit time | - estimated using creatinine or inulin (bc aren't reabsorbed, secreted or metabolised)
50
What is filtration fraction?
GFR / renal plasma flow | ratio b/w blood flow and filtration
51
Filtered load | - Calculation
AMOUNT of a substance filtered per minute | FL = GFR x conc. in plasma
52
Solutes which are only reabsorbed
- Glucose - Water - Na+ - Cl- - PO4- - Ca2+
53
Solutes which are only secreted
Organic cations + anions (e.g. drugs - PAH)
54
How is water transported across different parts of the nephron?
1. Paracellular - PCT - leaky epithelium (gaps b/w tight junctions are leaky) - high permeability - needs gradient 2. Transcellular - tight epithelium; tight tight junctions - low permeability - 2 barriers, involves aquaporins (APQ1 in PCT + APQ2 in CCT))
55
What percentage of sodium, water and chloride are reabsorbed in the PCT?
66%
56
How much glucose + AAs are reabsorbed in the PCT
99%
57
How much sodium, phosphate and calcium are reabsorbed in the PCT?
most
58
How much bicarbonate is reabsorbed in the PCT
80%
59
How much urea is reabsorbed in the PCT?
50%
60
Proportions of sodium reabsorbed in different parts of the nephron
PCT - 66% TAL - 25% DCT - 5% CCT - 3%
61
What is the apical transporter that allows glucose to be reabsorbed coupled to Na+?
SGLT1 or SGLT2
62
What is the basolateral transporter which allows glucose to diffuse into the interstitium? (facilitated diffusion)
GLUT1 or GLUT2
63
What membrane protein allows Na+ to maintain its coupling function?
Na+/K+ ATPase
64
How is the Hyperosmotic medullary gradient (HOMG) created?
- Salt is reabsorbed, causing the medulla interstitium to be hypERosmotic - Filtrate becomes dilute; must be reabsorbed in CD
65
What does the DCT and CD reabsorb/secrete? | - Hormonal control?
- Reabsorb remaining salt + water - Secrete K+ and H+ - Salt ions = aldosterone - Water = ADH
66
What percentage of our body weight is our total body water (TBW)?
Women - 55% | Men - 60%
67
Components of TBW
ICF = 2/3 ECF = 1/3; divided into - plasma = 1/5 - Interstitial fluid = 4/5
68
What is osmolarity
Number of ions per vol. of water
69
What is tonicity?
Effect of a solution on cells
70
Osmolarity in different parts of the nephron
PCT - isosmotic tDLH/bottom of LoH - hypertonic TAL - hypotonic CD - hypertonic
71
Relative osmolarity of ECF and ICF?
Same; tightly regulated b/w 275-295mosmol/L
72
Movement of water during - dehydration - hyperhydration
- Water lost from ECF only | - Water gained by ECF only
73
How is body osmolarity regulated?
1. Change in TBW detected by osmoreceptors in hypothalamus 2. Stimulates pituitary gland to secrete more/less ADH 3. ADH alters permeability of CD to water 4. Water retained/excreted to balance initial TBW 5. Plasma osmolarity stable 6. Cell vol. stable
74
What does ADH do?
Insert aquaporins (AQP2) into luminal membrane of CD
75
Urine composition w/ ADH
Small vol of highly concentrated urine
76
Urine composition w/out ADH
large vol. of dilute urine
77
What are the 2 water homeostasis regulation systems? What do they react to? Correct via? - What happens if not corrected?
1. Fast - Reacts to changes in osmolarity - ADH system - Problems w/ cell size + function 2. Slow - React to changes in (isosmotic) volume - Corrected via sodium retention/excretion - Problems w/ circulating vol. + BP
78
What 3 main sites detect change in ECF vol.? Via what receptors?
1. High pressure baroreceptors ("Pressure sensors") - aorta, carotid 2. Low pressure baroreceptors ("vol. sensors") - vana cava, right atrium 3. Intra-renal baroreceptors + macula densa - JGA
79
Action of low pressure baroreceptors
High vol. = release ANP/ANH | - promotes loss of sodium in urine
80
Action of intra-renal sensors
Low BP/ECF vol = alters renin secretion
81
RAAS system
1. Renin secreted by JGA 2. Renin cleaves angiotensin --> angiotensin I 3. Angiotensin I --> angiotensin II by ACE 4. Angiotensin II = vasoconstrictor and Na+ reabsorption, also stimulates aldosterone release (from adrenal gland) 5. Aldosterone = sodium reabsorption via sodium channels in DCT + CD
82
What does ANP do?
Decrease vol. by: - Incr. sodium filtration - decreased sodium reabsorption - Decreased renin secretion
83
Net urinary excretion of a substance (calculation)
Amount filtered - amount reabsorbed + amount secretion
84
How much of the cardiac output does the kidney receive?
20%
85
Approximately how much of the plasma gets filtered out? (FF)
20%
86
Which 2 intrinsic mechanisms determine the amount of blood flow in the afferent arteriole? - What happens if GFR is too high?
1. Myogenic autoregulation of the smooth muscle surrounding the afferent arteriole - incr. GFR = more vasoconstriction 2. Tubuloglomerular feedback, involving the JGA - too much salt (macula densa cells) = vasoconstriction
87
Example of extrinsic modulation
Sympathetic vasoconstrictor nerves (e.g. constrict during exercise)
88
Approximately how much of the remaining water is reabsorbed in the DCT + CD?
2-8%
89
Approximately how much of the remaining sodium is reabsorbed in the DCT + CD?
8%

HUBS192 EXAM (7 decks)

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