Renal system Flashcards
What is the sum of all filtration rates of all functioning nephrons known as?
glomerular filtration rate
What does the leaky barrier of the filtration membrane allow and prevent from passing through?
allows water and certain solutes while preventing plasma proteins, blood cells from getting into capsular space
what are the cells of the bowman’s capsule that wrap around the glomerular capillaries?
podocytes
what are the 3 layers of the filtration membrane starting with the innermost?
fenestrations of endothelial cells, basement membrane/basal lamina, and slit membranes between pedicels
Which layer of the filtration membrane prevents blood cells from passing, but allows all other components of blood plasma through?
fenestrations of endothelial cells
Which layer of the filtration membrane prevents large proteins from passing through?
basal lamina
Which cells regulate the surface area available for filtration?
mesangial cells
Why is the filtration pressure higher in glomeruli than in any other capillaries in the body?
larger surface area, larger fenestrations, and efferent arteriole has a small diameter than afferent
What is the glomerular blood hydrostatic pressure?
pressure in glomerulus pushing outward into capsular space
How is GBHP (Glomerular blood hydrostatic pressure) different from CHP (Capsular hydrostatic pressure)?
CHP is opposite of GBHP, pressure that pushes inward on the visceral glomerular membrane
What filtration pressure is due to proteins in blood plasma and pulls solutes into the glomerulus?
BCOP (Blood colloidal osmotic pressure)
What is the formula of NFP and what does it do?
NFP=BHFP-CHP-BCOP;
Promotes filtration
NFP can still cause filtration if it is negative and lead to urine production. T or F?
F
Which pressure change leads to nephrolithiasis?
CHP increases pushing back flow into the glomerulus
What condition occurs when NFP is no longer supporting filtration?
hydronephrosis
What is the glomerular filtration rate and is it higher in males or females?
this is the amount of blood filtered through the kidney’s glomeruli into the capsular space per unit time. it is higher in males (90 - 140 mL/min)
What happens when GFR is too slow?
All filtrates may be reabsorbed and waste may not be excreted efficiently
A decreasing GFR means what to your doctor?
A progression of a chronic kidney disease
Which formula is used for estimating GFR?
Cockcroft-Gault formula
Which factors affect the calculation of GFR?
Age, Race, Weight, and Gender (GRAW)
Why is creatinine used in the calculation of GFR?
Because it is not reabsorbed after filtration and serum level should be at or near urine level
What happens to serum creatinine level when urine level is low?
It increases
Creatinine is a result of what process?
normal breakdown of muscle
The pressures that affect net filtration pressure also affect GFR. T or F?
T
GBHP is inversely related to GFR. T or F?
F
What effect does dilation of the afferent arteriole have on GBHP and GFR?
increases both
What effect does the dilation of the efferent arteriole have on the GBHP and GFR?
decreases both
what effect does the constriction of the afferent and efferent arteriole have on its resistance?
increases resistance
What are the mechanisms that regulate GFR?
renal autoregulation, neural regulation, and hormonal regulation
If the renal (kidney) autoregulation occurs due to innate actions, how does neural regulation of GFR occur?
sympathetic nervous system input
What are the hormones of the hormonal regulation of GFR?
Angiotensin II and Atrial natriuretic peptipte (ANP)
How does the kidney maintain a near constant GFR during renal autoregulation?
variable changes in resistance at afferent arteriole
Which renal autoregulation mechanism allows the transient (short) increase in GFR?
myogenic mechanism
How is the nephron integrity preserved with sudden increased blood pressure?
an initial reduction of GFR due to smooth muscle contraction of afferent arteriole
in the myogenic mechanism, an immediate increase in BP causes ___ which can cause ___?
myogenic vasoconstriction; compensatory vasodilation
What is the sole purpose of the juxtaglomerular apparatus (JGA)?
affect systemic blood pressure through autoregulation of tubuloglomerular feedback
What are the cells of juxtaglomerular apparatus (JGA)?
juxtaglomerular cells, macula densa cells, and lacis cells
What is another name for lacis cells?
extraglomerular mesangial cells
Which JGA cells are found in the walls of afferent arteriole?
juxtaglomerular cells
Which JGA cells are found in between afferent arteriole, efferent arteriole, and DCT?
lacis cells
which cells are found in the walls of the late thick ascending limb of LOH?
macula densa cells
juxtaglomerular cells are modified smooth muscle cells. T or F?
T
What are the 2 functions of the juxtaglomerular cells?
detect low blood pressure by lack of wall stretch and secrete renin to cause an increase in blood pressure
What are the 2 functions of the macula densa (specialized) cells?
detect increase in NaCL in filtrate; release locally acting ATP & adenosine causing contraction of afferent arteriole and reduction in GFR
Which JGA cell contract or relax to make small regulatory changes in response to signal from other JGA cells?
exraglomerular mesangial cells (lacis cells)
When the blood pressure and extracellular fluid volume is normal, the neural and hormonal regulation play a key role in maintaining constant GFR. T or F?
F
Blood vessels of the kidney are supplied by sympathetic nervous system fibers only. T or F?
T
The increase in sympathetic stimulation of the kidney causes ___ of the afferent arteriole.
vasoconstriction
The decrease of GFR helps to protect the ____ from rapid rise in pressure until autoregulatory compensation.
nephron
Which arteriole constricts first when GFR hormone, angiotensin II is activated?
efferent
The increase in the level of angiotensin II in the glomerular causes ____ of afferent arterioles which reduces ____?
vasoconstriction; GFR
The secretion of ANP by the atria and BNP by the brain is caused by a ____ in blood volume.
increase
How does ANP and BNP affect the afferent and efferent arteriole?
It causes dilatation of afferent and constriction of efferent
Increased secretion of ANP/BNP decreases GFR. T or F?
F
Which hormone conteracts the vasoconstricting effect of angiotensin II when BP is down?
prostaglandins
Which GFR hormonal regulator prevents renal ishemia?
prostaglandins
Which GFR hormonal regulator causes vasodilation of afferent and efferent arterioles counteracting the effect of angiotensin II?
Nitric oxide
Which GFR hormonal regulators are endothelial cell derived?
Nitric oxide and endothelin
Which GFR hormonal regulator is stimulated by angiotensin II and epinephrine to cause vasoconstriction of both afferent and efferent arterioles?
endothelin
Which vasodilator stimulates the release of NO and prostaglandins?
bradykinan
Which GFR hormonal regulator produced within kidneys causes vasoconstriction at afferent arteriole?
Adenosine
What is the function of angiotensin converting enzyme (ACE)?
converts angiotensin I to angiotensin II
Where is angiotensin converting enzyme located?
surface of endothelial cells lining afferent arteriole and glomerular capillaries
The RAAS is activated in response to ___ blood pressure.
low
RAAS is activated by the stimulation of ___ receptors found in juxtaglomerular cells.
beta 2 adrenergic
What change in luminal sodium chloride activates RAAS?
decrease in luminal NaCl
GFR is directly proportional to sodium chloride concentration. T or F?
T
Which hormones are released when RAAS is activated?
renin and angiotensinogen
If juxtaglomerular cells secrete renin, which cells secrete angiotensinogen?
hepatocytes (liver cells)
How is angiotensin 1 made after RAAS activation?
angiotensinogen reacts with renin to cleave off a 10-amino acid peptide
What happens to angiotensin-1 when it gets to the lung and kidney?
It is converted to angiotensin II by endothelial ACE
Angiontensin_II decreases ___ by causing ___ vasoconstriction of afferent arteriole and ___ vasoconstriction of efferent arteriole
GFR; major; minor
Angiotensin-II enhances __, __, & __ reabsorption in the PCT
water, sodium and chlorine ions
Angiotensin-II stimulates the adrenal cortex to release an hormone which stimulates principal cells in collecting ducts to reabsorb more sodium and chlorine ions and secrete more potassium. what is the hormone?
aldosterone
What effect does the increased reabsorption of water, sodium and chlorine ion have on blood volume and pressure?
increases
Which hormone that causes more water reabsorbtion does angiotensin-II release in the posterior pituitary gland?
ADH
Which condition is an ACE inhibitor used to treat?
hypertension
How does ACE inhibition help reduce blood pressure?
ensures that angiotensin-II does not stimulate aldosterone and ADH
What are the differences btw active and passive transport?
passive does not ATP while active requires ATP to occur; passive is from high conc. to low while active is vice versa
Glomerular filtration is an example of ___ movement
passive
Sodium/potassium pumps is an example of ___ movement
active
In addition to the efforts of the renal tubule and ducts, ____ cells makes the largest contribution to reabsorption.
proximal convoluted tubule (PCT)
Which distal cells “fine tune” the reabsorption process?
LCD; loop of henle, collecting duct and distal convoluted tubule (DCT)
By what process are small proteins and peptides reabsorbed after passing through glomerular filter?
pinocytosis
The apical membrane is the ___ side of the cell and the basolateral membrane is the ___ side of the cell.
apical; interstitial
What is the difference between tubular paracellular and transcellular reabsoption?
paracellular is btw tubule cells and transcellular is within the same tubule cell
Which tubular reabsorption method accounts for 50% of reabsorption?
paracellular reabsorption
obligatory water reabsorption is the reabsorption of water by ___ reabsorption via ___
solute; osmosis
90% of reabsorption occurs in which part of the kidney?
PCT and descending limb of the loop of henle
10% of water reabsorption is occurs by ___ water reabsorption.
facultative
Where does facultative water reabsorption occur?
late DCT and collecting ducts
Which hormone regulates facultative water reabsorption?
ADH