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SRNAanatomy > Renal System > Flashcards

Renal System Flashcards

1
Q

Primary Function–>

A

Maintain a stable internal environment for optimal cell and tissue metabolism.

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2
Q

Electrolyte homeostasis

A

Na+, K+, Ca2+, Cl-, HPO42-

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3
Q

Regulation of blood pH

A

Removes H+ from blood

maintains bicarbonate ions (HCO3-) in blood

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4
Q

Regulation of Blood Volume/Blood Pressure

A

Retention of water = increases BP

Elimination of water = decreases BP

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5
Q

Osmoregulation

A

at 300 mOsm/L

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6
Q

Hormones Produced by the Kidney

A

Calcitriol - form of Vitamin D calcium homeostasis
Erythropoietin - RBC production
Renin – Blood pressure regulation

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7
Q

Excretion of wastes

A

Ammonia & Urea (protein metabolism)
Bilirubin
Creatinine (waste product of creatine phosphate)
Uric Acid (purine metabolism – A’s & G’s of DNA)
Arthritis known as Gout excess uric acid
Drugs and toxins

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8
Q

Function 7. Performs________

A

gluconeogenesis: Synthesis of glucose from amino acids

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9
Q

Structure: Renal capsule

A

Tightly adhering capsule covers kidney

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10
Q

Structure:Adipose capsule

A

Fat capsule surrounds each kidney

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11
Q

Structure:Renal fascia

A

-Fibrous tissue attaches/suspends kidney to the posterior abdominal wall.

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12
Q

Structure:Hilum

A

Medial indentation where the renal blood vessels, nerves, lymphatic vessels, and ureter enter and exit the kidneys.

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13
Q

Structure:Renal cortex

A
  • Is the outer layer of each kidney.

- Contains all of the glomeruli, most of the proximal tubules, and some segments of the distal tubule.

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14
Q

Structure:Renal columns

A

-Extend from the cortex down between the renal pyramids.

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15
Q

Structure:Renal medulla

A
  • inner part of each kidney that contains tubules and the collecting duct.
  • Consists of regions called the pyramids.
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16
Q

Structure:Minor calyx

A
  • Receives urine from the collecting ducts through the renal papilla.
  • Apexes of the pyramids project into a cup-shaped cavity that join together to form a major calyx.
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17
Q

Structure:Major calyx

A

-Joins to form the renal pelvis.

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18
Q

Structure:Renal pelvis

A

-Joins the proximal end of the ureter

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19
Q

Parasagittal section through right Kidney

A

Posterior : protected by 11th and 12th rib; protected by adipose
Anterior: Adrenal gland/Transverse colon

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20
Q

Ureters:
Are _____ long.
Are long, intertwining ____ _______bundles.
Pass obliquely into the ____ ________of the ______
_____ ________ moves urine to the bladder.
________ compresses the_____ __________ to avoid _____ ____

A

Are 30 cm long.
Are long, intertwining smooth muscle bundles.
Pass obliquely into the posterior aspect of the bladder.
Peristaltic activity moves urine to the bladder.
Micturition compresses the lower end of the ureter to avoid urine reflux.

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21
Q

**Bladder 3 parts:

A

Detrusor muscle (wall)
Trigone
Transitional epithelium

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22
Q

*****Urethra:
Length in females/males
Which is sphincter is involuntary/voluntary
What kind of muscle in each?

A

Internal urethral sphincter - involuntary
Smooth muscle @ jct. of bladder & urethra
External urethral sphincter – voluntary
Striated skeletal muscle
Between 3 and 4 cm long in females
Between 18 and 20 cm long in males

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23
Q

**Micturition or urination (voiding):

A

• when volume exceeds 250-300 mL Stretch receptors signal spinal cord and brain

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24
Q

**Micturition center in sacral spinal cord triggers reflex:

A

• parasympathetic fibers cause detrusor muscle to contract – squeezes out urine
and
• Internal & external sphincter muscles to relax to allow flow

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25
Q

Filling initiates a desire to urinate before the reflex actually occurs

A
  • conscious control of external sphincter

* cerebral cortex can initiate micturition or delay it for a limited period of time

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26
Q

Bladder and Urethra reflex

what is required for micturition and what is it stimulated by? then what happens?

A

Reflex arc is required for micturition–>Is stimulated by
mechanoreceptors from stretching–>Bladder fullness is
sensed; impulses are sent to the sacral level of the spinal cord –>When the bladder accumulates 250 to 300 ml of urine, the bladder contracts and the internal urethral
sphincter relaxes from activation of the spinal reflex arc
(micturition reflex) –>At this time, the urge to void is felt–>In older children and adults, reflex can be inhibited or facilitated by impulses coming from brain or voluntary control of micturition

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27
Q
  1. Vasa recta
    – Is a network of capillaries for the juxtamedullary nephrons.
    – Influences osmolar concentration of the medullary extracellular fluid, which is important for the formation of a concentrated urine.
    List renal arteries to vasa recta
A
  1. Renal Arteries
  2. Segmental Arteries
  3. Interlobar arteries
  4. Arcuate arteries
  5. Interlobular arteries
  6. Afferent arterioles
  7. Glomerular capillaries
  8. Efferent arterioles
  9. Peritubular capillaries
  10. Vasa recta
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28
Q

***1. Renal arteries (role)

A

Supply blood to the kidneys.

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29
Q

**2. Segmental arteries

A

branches of the renal artery.

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30
Q

**3. Interlobar arteries

A

Travel between the pyramids.

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31
Q

***4. Arcuate arteries

A

Arch over the base of the pyramids

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32
Q

**5. Interlobular arteries.

A
  • extend through the cortex toward the periphery of the kidneys and supply the afferent glomerular arteriole
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33
Q

**6. Afferent arterioles

A

– supply glomerular capillaries.

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34
Q

**7. Glomerular capillaries

A
  • site of filtration
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35
Q

**8. Efferent arterioles

A
  • Convey blood to a second capillary bed.
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36
Q

***9. Peritubular capillaries surround the ______ and _______and _______

A
  • Surround the proximal and distal convoluted tubules and loop of Henle.
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37
Q

**10. Vasa recta

A

– Is a network of capillaries for the juxtamedullary nephrons.
– Influences osmolar concentration of the medullary extracellular fluid, which is
important for the formation of a concentrated urine.

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38
Q

*Kidneys are less

A

than 0.5% of total body mass, but receive 20-25% of

resting cardiac output

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39
Q

After peritubular capillaries

A

Interlobular veins–> Arcuate veins–> Interlobar veins–>Renal vein

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40
Q

Identify renal cortex and renal pyramid

A

renal cortex

Renal pyramid in renal medulla

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41
Q

_______per kidney – they are the functional unit of the kidney.

A

1.2 million

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42
Q

Superficial cortical nephrons:

A

Make up 85% of all nephrons, which extend

partially into the medulla.

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43
Q

Juxtamedullary nephrons

A

Lie close to and extend deep into the medulla

and are important for the process of concentrating urine; secrete renin.

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44
Q

Renal Physiology :Describe 3 major processes

A

Filtration from blood plasma into nephron
Tubular reabsorption from fluid into blood
Tubular secretion from blood into fluid

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45
Q
  1. Glomerular filtration: substances)
A

Water & small solutes in blood plasma move across the wall of the glomerular capillaries into glomerular capsule
and then renal tubules (PCT –> loop of Henle –> DCT –> Collecting duct)

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46
Q
  1. Tubular reabsorption: as ____Move along____many solutes are ________= returned to _____
A

As “filtrate” moves along tubule water and many useful solutes reabsorbed = returned to blood

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47
Q
  1. Tubular secretion:
A

“filtrate” moves along tubule other molecules (wastes, drugs, & excess ions) are secreted into fluid

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48
Q

Any solutes that remain in the fluid that drains into the renal pelvis

A

are excreted as urine

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49
Q

Excreted water (how much per day)

A

1-2 Liters per/ day

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50
Q

Distal convoluted tubule : _____ stimulate ______of ____

A

PTH stim.s reabsorption of Ca++

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51
Q

Intercalated cell

A

Regulation of pH via H+ andHCO3-

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52
Q

Principal cell

A

ADH and Aldosterone

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53
Q

Brush border villi

A

for reabsorption

Proximal convoluted tubule

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54
Q

H2O reabsorption

A

Thin descending limb of loop of Henle

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55
Q

Na+ K+ Cl- reabsorption

A

Thick descending limb of loop of Henle

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56
Q

Glomerulus within Bowman’s capsule

A

Function : Filtration

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57
Q

Proximal tubule , Function

Tonicity of fluid?

A

Reabsorption of Na+, K+, Amino acids, bicarbonate, phosphate, urea, H2O
Secretion of H+ foreign substances
-Isotonic

58
Q

Loop of henle, Function

Tonicity of fluid?

A
  • Concentration of urine (countercurrent mechanism)
  • Descending loop water reabsorption (Na+ diffuses in)
  • Ascending loop Na+ Reabsorption ( active transport, water stays in)
  • Urea secretion in thin segment
  • Isotonic,hypertonic, hypotonic.
59
Q

Distal tube , Function

Tonicity of fluid?

A

Reabsorption of Na+, H2O(ADH required) and HCO3-
Secretion of K+ , urea, H+, NH3+,some drugs.
-isotonic or hypotonic

60
Q

Collecting duct, Function

Tonicity of fluid?

A

Reabsorption of H2O(ADH required)
Reabsorption or secretion of Na+,K+, H+, NH3+
Urea reabsorption in the medulla
- Final concentration

61
Q

Tubular reabsorption:
How many L of filtrate produced? what happens to that filtrate?
Nephron must absorbed? _____% and as a result ______L of urine per day
Water and _____move ______to ______ ______

A

180 (152) Liters/day of filtrate produced – obviously most of this needs to return
Nephron must reabsorb 99% of the filtrate (as a result: 1-2 Liters of urine per day)
Water + Solutes move “Tubules to Peritubular capillaries”

62
Q

Tubular Reabsorption along the nephron
1.PCT with microvilli does most of the __________
Solutes reabsorbed by both ______and ________
______,_______, _____ and ions (__,___,___,___,____)
____% of water follows by _______

A
  1. PCT with microvilli does most of the reabsorption (remainder of nephron fine-tunes)
    – Solutes are reabsorbed by both active transport and passive diffusion
    Glucose, amino acids, urea and ions (Na+, K+, Ca2+, Cl-, bicarbonate, phosphate)
    – 65% of water follows by osmosis
63
Q
  • **Tubular Reabsorption along the nephron:

1. PCT Transporters reabsorb water and solutes

A

** 100% of Glucose, amino acids, lactic acid,
water-soluble vitamins, and other nutrients
are reabsorbed in the first half of the PCT **

64
Q

PCT: Reabsorption of Na+ produces an

A

electrical gradient that caused Cl- to follow by passive

transport

65
Q

PCT:Accumulation of NaCl outside of tubule

A

produces an osmotic gradient: Helps “pull” water out of tubule

66
Q
  1. Descending Limb of Loop of Henle:
    % of water filtered there?
    Movement of water?
    Comment on permeability of solutes
A

– 15% of the filtered water is reabsorbed in the descending limb
– High solute content of the medulla “pulls” water out
– Low permeability to solutes = little reabsorption of solutes

67
Q
  1. Ascending Limb of Loop of Henle:
    ______reclaim more ____ ____ ___and others by _____
    2 parts: _____and ______
    which one is permeable to solute and almost impermeable to water?
    Which portion is HIGHLY permeable to ___ ___ ___and significant LESS permeable to water and _______
A

Variety of transporters reclaim more Na +, Cl-, and K + ions and other ions by diffusion
– Thin, ascending segment: Is more permeable to solutes and almost impermeable to water.
– Thick portion of the ascending segment: Is highly permeable to sodium, potassium, and chloride and significantly less permeable to water and urea.

68
Q
  1. DCT:
    What percentage of water absorbed there?
    What continues there
    DCT serves as what (IMPORTANT)
A

– Moderately permeable to solutes but absorbs about 15% of water

  • reabsorption of Na+ and Cl continues
  • ****The DCT serves as the major site where parathyroid hormone stimulates reabsorption of Ca+2
69
Q
  • *By end of DCT, what happens?

5. Collecting duct contains ________ and _________cells, and what do they make?

A
  • **95 % of solutes and water have been reabsorbed **
  • Principal and Intercalated
  • final adjustments
70
Q

***Principal cells:

A

**• Targeted by 2 hormones that promote reabsorption of more water and ions
1. ADH:
increases water reabsorption (retention)
2. Aldosterone @ collecting duct:
increases reabsorption of Na+ and Cl-
Therefore water will also be reabsorbed!
Secretion of K+ (adjust for dietary intake of K+)

71
Q

*****Intercalated cells:

A

**help regulate pH of body fluids
• Proton pumps (H+ATPases)secrete protons(H+) into tubule
• Reabsorb bicarbonate ions(buffers blood pH)

72
Q 
Tubular secretion:
Transfer of material from \_\_\_\_
Occurs where?
\_\_\_\_\_\_ions to maintain \_\_\_\_
To eliminate excess \_\_\_\_\_
Drugs such as \_\_\_\_\_\_\_
A

– Transfer of materials from blood into filtrate/urine
– Occurs at various locations along the tubule
– Hydrogen ions (H+) = to maintain pH
– To eliminate excess K+, ammonia, urea, creatinine
– Drugs such as penicillin

73
Q

Major Hormone: Angiotensin II
Major Stiumuli that trigger releases?
Mechanism and site of action?
Effects

A
  • low blood volume or low blood pressure stimulates renin-induced production of angiotensin II
  • Stimulate activity of Na+/H+ antiporters in proximal tubules cells
  • Increases reabsorption of Na+, other solutes, and water which increases blood volume
74
Q

Major Hormone: Aldosterone
Major Stimuli that trigger releases? is released from where?
Mechanism and site of action?
Effects

A
  • Increased angiotensin II level and increased level of plasma K+ promote release of aldosterone by adrenal cortex
  • Enhances activity of sodium potassium pumps in basolateral membrane of principal cells in collecting duct
  • Increased secretion of K+ and Reabsorption of Na+ , Cl-increases reabsorption of water, which increases blood volume
75
Q

Normal GFR

A

120ml/min

76
Q

Major Hormone: ADH / Vasopressin
Major Stiumuli that trigger releases?
Mechanism and site of action?
Effects

A
  • Increased osmolarity of extracellular fluid or decreased blood volume promotes release of ADH from the posterior pituitary gland
    -Stimulates insertion of water channel proteins(Aquaporin-2) into the apical membrane of principal cells COLLECTING DUCT
    Effects: Increase falcultative reabsorption of water, which thus decreases blood volume
77
Q

Angiotensin II increased effect in ______greater than ______arterioles and it effect on GFR?

A

efferent> afferent and increase GFR

78
Q

Major Hormone:Atrial natriuetric peptide
Major Stimuli that trigger releases?
Mechanism and site of action?
Effects

A

Strigger:Stretching of atrial of heart stimulates secretion of ANP
MOA: suppresses reabsorption of Na+ and water in proximal tubule and collecting duct
Also inhibits secretion of aldosterone and ADH
Effects: Increases excretion of Na+ in urine (Natriuresis) ; Increases urine output (diuresis); and thus decreases blood volume

79
Q

Major Hormone:Parathyroid Hormone
Major Stimuli that trigger releases?
Mechanism and site of action?
Effects

A

Strigger: Decreased level of plasma Ca+ promotes release of PTH from parathyroid gland
MOA: stimulates the opening of Ca2+ channels in apical membranes of early distal tubule cells
Effects: Increases reabsorption of Ca2+

80
Q

Blood pressure drives_________
• Approximately ______% of renal plasma flow becomes filtrate
• average adult male rate is _____ml/min and female is_____ml/min
• ________ in males; _______ in females

A

Filtration; 20%
125 ml/min ; 105 ml/min
180 Liters/day
150 Liters/day

81
Q

Parts of the Renal Corpuscle

A 
Glomerulus 
Bowman’s (glomerular) capsule
Mesangial cells
Glomerular endothelial cells
Visceral epithelium of the Bowman capsule
82
Q

Glomerulus part of the ________and is a _______supplied by the _______ arteriole and is______by the _________ arteriole

A

Glomerulus - Set of fenestrated capillaries

• Supplied by the afferent arteriole and drained by the efferent arteriole

83
Q

Bowman’s (glomerular) capsule is a

A

• Circular space between visceral and parietal epithelium

84
Q

Mesangial cells: Supports the ______ and respond to _______ to regulate what?

A

support the glomerular capillaries and respond to ANP to regulate glomerular capillary flow.

85
Q

Glomerular endothelial cells

Synthesize (2)

A

Glomerular endothelial cells
• Synthesize nitric oxide (a vasodilator).
• Synthesize endothelin-1 (a vasocon

86
Q

Visceral epithelium of the Bowman capsule
Composed of cells called _______
are _______
Form an Elaborate network of ________ called_________ and does what ?

A

Visceral epithelium of the Bowman capsule
• Is composed of cells called podocytes.
o Are footlike processes.
o Form an elaborate network of intercellular clefts called filtration slits; modulate filtration

87
Q

Glomerular filtration membrane: what moves through the membrane and become primary urine or ____
Can blood cells enter or be filtered?
What retard filtration of anionic proteins? what does it prevent?

A
  • Water, Ions, small molecules & small proteins move through the membrane and become “primary urine” or “filtrate”.
  • Blood cells, large/medium sized proteins cannot normally be filtered
  • Negativity of the filtration membrane retard filtration of anionic proteins (prevents proteinuria)
88
Q

**JUXTAGLOMERULAR APPARATUS: Control of what occurs at this site?

A

Control of renal blood flow (RBF), glomerular filtration, and renin secretion occurs at this site.

89
Q

**Juxtaglomerular cells: located where?

A

These specialized cells are located around the afferent arteriole where the afferent arteriole enters the glomerulus.

90
Q

**Mesangial cells: are _____ _____that _______ and help regulate________and _______ ______From ______

A

specialized contractile cells that support glomerulus and help regulate glomerular blood flow; and remove macromolecules from filtration

91
Q

**Macula densa is the portion of _____ ____Tubule which contains what? located where?
FUNCTION (main) detect what?

A

o Portion of the distal convoluted tubule with specialized sodium and chloride sensing cells is located between the afferent and efferent arterioles.
*****Detect high filtrate rate in the DCT which results in a decrease of nitric oxide and vasoconstriction in the afferent arterioles.

92
Q

Blood flow through kidney from Abdominal Aorta to Inferior Vena Cava?
13 steps

ARSI-AGEPI- AIRI

A
  1. Abdominal Aorta
  2. Renal Arteries
  3. Segmental Arteries
  4. Interlobar Arteries
  5. Afferent Arterioles
  6. Glomerular Capillaries
  7. Efferent Arterioles
  8. Peritubular Capillaries
  9. InterLOBULAR Veins
  10. Arcuate veins
  11. Interlobar Vein
  12. Renal Veins
  13. Inferior Vena Cava
93
Q

Review part of the Juxtaglomerular Apparatus

A 
A – Renal corpuscle
B – Proximal tubule
C – Distal convoluted tubule
D – Juxtaglomerular apparatus
2. Bowman's capsule – parietal layer
3. Bowman's capsule – visceral layer
4. Bowman's space (urinary space)
5a. Mesangium – Intraglomerular cell
5b. Mesangium – Extraglomerular cell
6. Granular cells (Juxtaglomerular cells)
7. Macula densa
9. Afferent arteriole
10. Glomerulus Capillaries
11. Efferent arteriole
94
Q

Renal Blood flow Kidneys receive _____to _____ ml/min of blood;________ of CO).
• _____-_____ml as plasma (renal plasma flow [RPF])

A

1000 to 1200; (20-25% of CO).

600 to 700

95
Q

GFR is regulated by 3 mechanisms:

A

– autoregulatory – neural – hormonal

96
Q

Glomerular filtration rate (GFR)
• 20% of the RPF (120 to 140 ml/min) is filtered into_______
GFR is Directly related to____________ in the _________
• If mean arterial pressure decreases or vascular resistance increases, then the RBF_______

A
  • Bowman’s space
  • the perfusion pressure in the glomerular capillaries
  • decreases.
97
Q

• FF = Filtration Fraction FF = GFR/RPF

A

FF= GFR/RPF

98
Q

GFR regulation : Autoregulation
Myogenic mechanism
• If arterial pressure increases, stretch of the afferent arterioles__________
smooth muscle________ to_______ ______arteriole and perfusion

A

(pressure/stretch); increases, contracts; constrict afferent; decreases.

99
Q

GFR regulation : Autoregulation
Myogenic mechanism
• If arterial pressure declines stretch of the ______arterioles __________, smooth
muscle ________ to dilate _____ ______and perfusion_________

A

afferent arterioles decreases ; relaxes; afferent arteriole; increases.

100
Q

TUBULOGLOMERULAR feedback (sodium chloride content)
a.If sodium filtration increases, what happens to GFR?
________ _____cells stiumlates ______arteriolar ______
b. If sodium filtration decreases, what happens to GFR?

A

• If sodium filtration increases, GFR decreases.
– Macula densa cells stimulate afferent arteriolar vasoconstriction.
• If sodium filtration decreases, the opposite occurs—GFR increases.

101
Q

2 parts of autoregulation:

A

Myogenic Mechanism

Tubuloglomerular Feedback

102
Q

Second type of GFR is Neural Regulation 3 aspects

A

Sympathetic Nervous System
Exercise and change in body position
Severe hypoxia

103
Q

Second type of GFR Neural Regulation aspects 1: SNS
Sympathetic stimulation leads to what?
which _______GFR
Inhibition of sympathetic stimulation causes _______which _______GFR?

A

Sympathetic stimulation of afferent arterioles via alpha-1 (α-1) receptors
causes vasoconstriction (decreases GFR).
• Inhibition of Sympathetic nerves causes vasodilation (increases GFR).

104
Q

***Second type of GFR Neural Regulation aspects 2:

A

• Activate renal sympathetic neurons, causes mild vasoconstriction.

105
Q

***Second type of GFR Neural Regulation aspects 3:

A

Severe hypoxia: Stimulation of chemoreceptors

• Decreases RBF by means of sympathetic stimulation

106
Q

**Third Type of GFR is Hormonal Regulation
RAAS and Renin
Which arteriole does angiotensin have greater effect?

A

Renin-angiotensin-aldosterone system (RAAS)
• Increases systemic arterial pressure, and increases sodium reabsorption.

Renin: Enzyme is formed and stored in afferent arterioles of the juxtaglomerular apparatus.
• **Renin helps form angiotensin I (physiologically inactive).
• In the presence of angiotensin-converting enzyme (ACE), angiotensin I is converted to angiotensin II.

• Angiotensin II
– Stimulates the secretion of aldosterone by the adrenal cortex.
– Is a potent vasoconstrictor. (constricts both afferent & efferent arterioles in kidney; with greater affect on efferent arteriole)
– Stimulates antidiuretic hormone (ADH) secretion and thirst.

107
Q

Tubuloglomerular feedback

A

Hypovolemia–>Hypotension–> Decrease Na+ at macular densa cells of distal tubules–>Renin release from Juxtaglomerular cells

108
Q

**Natriuretic peptides

2 types; where are they secreted

A

a. Atrial natriuretic peptide (ANP) is secreted from myocardial cells in the atria.
b. Brain natriuretic peptide (BNP) is secreted from myocardial cells in the ventricles.

109
Q

ANP and BNP 4 functin

a) Inhibit _____and ______ _____by the kidney tubules
b) Inhibit secretion of ____and ______
c) Vasodilate the ______arterioles and constrict the _____arterioles
d) Increase UO, leading to decrease in ______ and ______, promote _____And _____loss

A

a) - Inhibit sodium and water reabsorption by kidney tubules.
b) Inhibit secretion of renin and aldosterone.
c) Vasodilate the afferent arterioles; constrict the efferent arterioles.
d) Increase urine output, leading to decreased blood volume and blood pressure; promote sodium and water loss.

110
Q

Regulatory Mechanisms of Glomerular
Filtration Rate (GFR)
Myogenic Mechanism
Major stimulus ? Increased ________of _______ ____in_______arteriole walls due to __________ in______
Mechanism or site of action?
those muscle _____, thereby _______ the lumen of _______
Effect on GFR?

A

MS: Increased stretching of smooth muscle fibers in afferent arteriole walls due to increase in BP
Mechanism site of action: Stretch smooth muscle fibers contract , thereby narrowing the lumen of the afferent arterioles
Effect on GFR: Decrease

111
Q

Regulatory Mechanisms of Glomerular Filtration Rate
Tubuloglomerular feedback
Major stimulus ? Mechanism or site of action? Effect on GFR?

A

Major stimulus: Rapid delivery of Na+and Cl- to the macula densa due to high systemic BP
MOA: Decrease the release of NO by the juxtaglomerular apparatus cause constriction of afferent arterioles
Effect on GFR: Decrease

112
Q

Regulatory Mechanisms of Glomerular Filtration Rate
NEURAL REGULATION
Major stimulus ? Mechanism or site of action? Effect on GFR?

A

Major Stimulus:Increase in level of activity of renal sympathetic nerves release norepinephrine
MOA: Constriction of afferent arteriole through activation of alpha 1 receptors and increased release of renin
Effect on GFR: Decrease

113
Q

Regulatory Mechanisms of Glomerular Filtration Rate
HORMONAL REGULATION: Angiotensin II
Major stimulus ? Mechanism or site of action? Effect on GFR?

A

Major stimulus –>Angiotensin II: Decrease Blood volume and BP stimulates production of angiotensin II
MOA: Constriction of both afferent and efferent arterioles
Effect on GFR: Increase

114
Q

Regulatory Mechanisms of Glomerular Filtration Rate
HORMONAL REGULATION: ATRIAL NATRIURETIC
Major stimulus ? Mechanism or site of action? Effect on GFR?

A

Major stimulus–>Stretching of the atria of the heart stimulates secretion of ANP
MOA: Relaxation of mesangial cells in glomerulus increases capillary surface area available in filtration.
Effect on GFR: Increase

115
Q

Characteristics of Normal Urine: Volume

A

1-2 Liters in 24 hours(day)

116
Q

Characteristics of Normal Urine: COLOR/ ODOR/specific gravity

A

concentrated urine is darker
Urine of diabetic has a fruity odor due to ketone bodies
pH between 4.6-8 average 6
1.001 to 1.035, the higher the concentration of solutes, THE HIGHER THE SPECIFIC GRAVITY

117
Q

Summary of abnormal urine constituent: UROBILINOGEN

A

Breakdown of bilirubin in urine(urobilinogenuria)
Trace amount of normal
Elevated may be due to hemolytic, anemia, infectious hepatitis, biliary obstruction, jaundice, cirrhosis, CHF,infectious mono

118
Q

Summary of abnormal urine constituent: ALBUMIN

A

In small amount, too large to pass through capillary fenestration
Excessive in urine- hyperalbuminuria: Increase permeability due to injury or disease, increase BP, or irritation of kidney cells, by toxins, ETHER or heavy metals

119
Q

Summary of abnormal urine constituent: GLUCOSE

A
  • Presence in urine is GLUCOSuRIA, usually indicates DM

- May be due to stress causing excessive release of epi

120
Q

Summary of abnormal urine constituent: Red Blood cells

A

The presence of RBCs in the urine: Hematuria

Cause is inflammation of urinary organs as a result of disease, irritation from kidney stones

121
Q

Summary of abnormal urine constituent: KETONE Bodies

A

High levels of ketone in the body is called ketonuria

Indicated DM, Anorexia, starvation or too little carbohydrates in the diet.

122
Q

Summary of abnormal urine constituent: CASTS

A

tiny masses of material that have becomes hard and assumed the shape of the lumen of the tubule.

123
Q

Summary of abnormal urine constituent: MICROBES

A

Specific microbes in the urinary tract.

124
Q

Clearance and GFR
What is the best estimate for the functioning of renal tissue________
Other ways are ________
• Creatinine: Provides a good estimate of GFR since only a small amount enters urine.

A

GFR
• Inulin (a fructose polysaccharide) is often used
– All inulin filtered is excreted in urine (requires constant infusion to maintain stable plasma level)

125
Q

Creatinine: Provides a __________since only a small amount enters urine.

A

good estimate of GFR

126
Q

Is a better indicator for hydration status.
• Increases in dehydration and kidney failure
Normal level

A

BUN

7-20

127
Q

Renal clearance

A
  • techniques determine how much of a substance can be cleared from the blood by the kidneys during a given unit of time.
    – Permits an indirect measure of GFR, tubular secretion, tubular reabsorption,
    and RBF.
128
Q

The process of urination

A

Micturition

129
Q

Red Blood cells in the urine

A

Hematuria

130
Q

The bladder wall muscle

A

Detrusor

131
Q

Accumulated of precipitated material in the urine that have a cylindral shape like mold of a section of tubule

A

Casts

132
Q

Precipitated material in urine

A

Crystals

133
Q

Area of bladder between the opening of the ureters and the urethra

A

Trigone

134
Q

WBC in urine

A

Pyuria

135
Q

All of the Glomeruli are located in the

A

Cortex

136
Q

Principal cells vs Intercalated cells

A

Principal: secrete K+ and reabsorb sodium and water
Intercalated: Reabsorb K+ and secreted H+ ions

137
Q

Tubular secretion vs Tubular absorption

A

secretion moves substance from the peritubular capillaries to renal tubular lumen
Reabsorption moves them from the renal tubular lumen into peritubular capillaries.

138
Q

Renal Hilum

A

Location where the renal blood vessels, nervs , lymphatics and ureter enter and exit the kidney

139
Q

The BUN level ________ when the GFR decreases

A

Increases

140
Q

How much a substance can be removed from the blood by the kidney per unit of time

A

Clearance

SRNAanatomy (25 decks)

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