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eBMS2031 > RENAL SYSTEM > Flashcards

RENAL SYSTEM Flashcards

1
Q

What are the components of the renal system

A

Kidneys
ureters
bladder
urethra

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2
Q

what are the functions of the kidneys

A

regulation of water and electrolyte volume and osmolarity

regulation of blood pressure

excretion of metabolic waste products

endocrine organ secretes hormones like renin

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3
Q

what are the inner and outer regions of a kidney

A

outer = renal cortex

inner = renal medulla

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4
Q

What is the functional unit of a kidney and what are its 2 components

A

Nephron

filtration component (renal corpuscle)

renal tubules

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5
Q

Outline the anatomy of renal corpuscle

A

bundle of capillary loops called the glomerulus

sits in fluid filled bowmanns capsule

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6
Q

Outline glomerular filtration

A

movement of fluid and solutes from glomerular capillaries into bowmanns capsule

capillary hydrostatic pressure increases filtration

plasma osmotic colloidal pressure decreases filtration

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7
Q

Name the components of the renal tubules of a nephron

A

From bowmanns capsule is the:

proximal convoluted tubule
{thin descending
thin ascending 
thick ascending}(loop of henle)
distal convoluted tubule
collecting ducts
ureter
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8
Q

what parts of the renal tubules extends into the medulla of the kidney

A

the loop of henle and the collecting ducts

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9
Q

what does reabsorption from the renal tubules drain into

A

the peritubular capillaries wrapped around parts of the nephron

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10
Q

Outline tubular reabsorption

A

Reabsorption from filtrate in tubules back into peritubular capillaries.

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11
Q

What substances undergo tubular reabsorption

A

water
Na
glucose
urea

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12
Q

What are the percentages of glomerular filtration and reabsorption

A

20% filtration

19% reabsorbed
1% excreted

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13
Q

What ways can substances reabsorb through tubules

A

through tight junctions between tubular epithelial cells

through luminal membrane, through cell, through basolateral membrane

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14
Q

What passive and active processes occur in tubular reabsorption

A

passive and active transport of ATP

active Na reabsorption

water osmosis (follows Na molecules)

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15
Q

what are % of reabsorption of water and na

A

65% H2O and Na in proximal tubule

10% H2O and 30% Na in loop and distal tubule

5% H2O and Na in collecting duct

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16
Q

Why is the collecting duct special in tubular reabsorption

A

Only place where amount be reabsorbed can be modulated. Therefore this is the place that can alter H2O and Na levels in the body.

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17
Q

What is glucosuria

A

where glucose is excreted in urine

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18
Q

Outline mediated transport and its calculations

A

Reabsorption by membrane transport proteins

transport maximum reached when proteins are saturated

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19
Q

Outline tubular secretion

A

movement of solutes from peritubular capillaries to tubules. occurs for some exogenous substances like penicillin.

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20
Q

What are the three filtration/absorption functions

A

glomerular filtration

tubular reabsorption

tubular secretion

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21
Q

what are the 3 types of substances regarding their filtration and excretion

A

not filtered (e.g. large plasma proteins)

filtered and completely reabsorbed (e.g. glucose)

filtered and some reabsorbed (e.g. electrolytes)

22
Q

What is polyuria and oliguria

A

excreting >2.5L/day

<400mL/day

23
Q

what is 1 osmole

A

1 mole of solute particles

e.g. MgCl2 would be 3 osmoses

24
Q

Explain triggering ADH secretion

A

osmoreceptors in pituitary gland detect changes in osmolarity (and thus water)

In high plasma osmolarity, water will leave osmoreceptor cells, causing them to shrink which caused increased APs

Increased APs causes increased secretion of ADH from herring bodies in pituitary gland

25
Q

Explain affects of ADH

A

acts on distal tubule and collecting ducts

ADH acts on V type receptors which activates adenylate cyclase to produce cAMP. cAMP activates protein kinase which phosphorylates aquaporins.

Causes aquaporins to be inserted into membrane of tubule cells increasing water reabsorption to combat increased plasma osmolarity.

26
Q

What is diabetes insipidus

A

central =Failure of pituitary to secrete ADH.

nephrogenic = failure for kidney to respond to ADH (abnormalities in V type receptors)

Leads to excessive thirst and large H2O excretion

27
Q

treatment of diabetes insipidus

A

drink more water to combat excessive excretion

use desmopressin which mimics ADH

28
Q

Explain ADH regulation of blood volume

A

decrease in blood volume causes decreasing firing in atrial and pulmonary stretch and arterial osmoreceptors

decrease in impulses to hypothalamic osmoreceptors

large synthesis of ADH to stop water excretion and increase blood volume.g

29
Q

how much does it take to trigger a response to a change in osmolarity and blood volume

A

osmolarity = 1% from normal = small response is sufficient

blood volume = 10% from normal = large response needed

30
Q

How is thirst triggered

A

when hypothalamic osmoreceptors shrink signals to cerebral cortex causing thirst

+ decrease in saliva excretion giving a dry mouth

sensitive mechanism 1-2% change causes response

31
Q

What is oedema

A

fluid accumulation in interstitial space

32
Q

what are the 3 body fluid compartments

A

intracellular fluid

extracellular fluid made up of interstitial fluid, capillary membrane then plasma

33
Q

What is the net glomerular filtration pressure equation

A

PGC – (PBC + πGC)

π = colloidal

BC = bowmanns capsule

GC = glomerular capillaries

34
Q

What is glomerular filtration rate and how is it measured

A

volume of filtrate formed by the kidneys each minute (ml/min)

measured by renal clearance (volume of plasma cleared of a particular substance by the kidney per unit of time).

35
Q

What does natriuresis mean

A

natural excretion of Na in urine

36
Q

How does the body measure Na cocnetration

A

no direct Na receptors

indirectly measured by:

CV stretch and baroreceptors in the atria, veins, arteries

Renal sensors like intrarenal baroreceptors in macula densa

37
Q

Explain Na reabsorption due to aldosterone

A

Diffuses from peritubular capillaries into the distal tubule or collecting ducts

combines with mineralocorticoid receptor, complex then migrates to the nucleus

increases gene transcription of proteins involved in Na reabsorption

38
Q

What is aldosterone

A

Hormone secreted from the zone glomerulosa of the adrenal gland.

39
Q

What are the final results of protein transcription due to aldosterone

A

increased synthesis of Na channels in luminal membrane for more Na reabsorption

ATP synthesis to stimulate basolateral Na/K ATPase pump

K channels to secret K into the filtrate

40
Q

Differences in speed to get rid of excess Na compared to H2O

A

H2O fast due to aquaporins already being available

Na slow due to having to regulate transcription of proteins

41
Q

Outline addisons disease

A

adrenal glands don’t produce enough aldosterone

Not as much Na reabsorbed

low blood pressure, salt cravings, muscle weakness (hyperkalemia)

42
Q

Outline aldosteronism

A

adrenal glands produce too much aldosterone

too much Na reabsorbed

high blood pressure, hypernatremia, hypokalemia

43
Q

What is atrial natriuretic peptide

A

blood pressure lowering hormone secreted by atria.

decreases Na reabsorption via acting on collecting ducts

inhibits renin secretion (decreases Na reabsorption)

causes dilation of afferent and constriction of efferent renal arteriole causing increased GFR and thus Na excretion

44
Q

What is renin and what does it produce

A

produced and stored in granular cells in juxtaglomerular region of afferent renal arteriole.

renin secreted from kidneys causing the splitting of angiotensin I from angiotensinogen

ACE converts Ang I to Ang II.

45
Q

What are the 3 causes of renin to be secreted from the kidneys

A

decreased renal arterial pressure

decreased luminal Na passing the macula densa

increased renal sympathetic activity

46
Q

Outline renin secretion due to decreased renal arterial pressure

A

decrease in plasma volume, decrease stretch of juxtaglomerular cells, decrease in intracellular Ca causes renin secretion

47
Q

What is the macula densa

A

the macula densa is the thickened region of distal tubule between the afferent and efferent arterioles

48
Q

Outline renin secretion due to increased renal sympathetic activity

A

Decrease in Na causes increase in RSNA, activation of juxtaglomerular beta receptors, increases renin secretion

49
Q

What are the causes of AngII

A

increased sympathetic activation

aldosterone secretion

vasoconstriction increasing BP

ADH secretion

50
Q

What are the ultimate effects of the renin angiotensin system

A

Increased Na reabsorption.

51
Q

How do ACE inhibitors work

A

inhibits ACE enzyme, stops Ang II from working, decreases Na reabsorption and therefore decreases blood pressure. Also dilates blood vessels

Used to treat hypertension

eBMS2031 (6 decks)

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