Renal System Flashcards
Shape of kidney
Bean-shaped
Location of kidney
Retroperitoneal
What structure is located beside the kidney?
T12-L3
What kidney is slightly lower than another?
Right Kidney
Size of kidney
4 inches
Passageway where the blood vessels can enter and exit
Renal Hilum
What other renal structures exist in the renal hilum?
Renal Pelvis and Ureter
Space within the hilum
Renal Sinus
What are the two structures contained in the Renal Sinus?
Blood vessel and Renal Pelvis
Upper expanded end of the ureter
Renal Pelvis
The dark brown outer structure of the kidney
Renal Cortex
The light brown inner structure of the kidney
Renal Medulla
What composed renal medulla?
Renal Pyramid and Renal Column
“Apex” of the renal medulla
Renal Papilla
Medullary extension of renal cortex in between renal pyramids
Renal Column
Combination of 1 renal pyramid and a segment of renal cortex
Renal Lobule
Chambers through which urine passes
Renal Calyces
Collects urine from renal pyramids
Minor Calyx
Combination of minor calyces
Major Calyx
Combination of major calyces
Renal Pelvis
The functional unit of the kidney
Nephron
Movement of the fluid inside the kidney
Renal Artery to Renal Hilum to Renal Medulla to Renal Papilla = FILTRATION = Renal Calyces to Renal Pelvis to Ureter
Renal artery arises to what level of the aorta?
L2
Division of renal artery that enters the hilum of the kidney
Segmental Artery
The artery that runs toward the cortex on each side of the renal pyramid
Interlobular Artery
Artery that arch over the bases of pyramids
Arcuate Artery
Renal Blood Flow: Renal Artery
Renal Artery - Segmental A. - Lobular A. - Interlobular A - Arcuate A. - Cortical Radiate A. - Afferent Arteriole - Glomerulus
Renal Blood Flow: Renal Vein
Glomerulus - Efferent Arteriole - Peritubular Capillaries - Cortical Radiate Vein - Arcuate Vein - Interlobular Vein - Renal Vein - IVC
Combination of glomerulus and bowman’s capsule
Renal Corpuscle
Drooping of kidneys
Renal Ptosis
Drooping of kidneys below L3
Nephroptosis
Enlargement of the kidney due to back glow secondary to blockage
Hydronephrosis
Urine Flow
Nephron - Papillary Ducts - Renal Calyces - Renal Pelvis - Ureter - Urinary Bladder - Urethra
What population is more prone to urinary infection
Female (shorter urethra)
Process of urinary bladder emptying
Micturation
The nervous reflex that empties the bladder
Micturition Reflex
The stimulus of the micturition reflex
Distention
Innervation of the micturition reflex
S2-4
“Extraglomerular messengial cells”
Polkissen Cells
What kind of receptor are polkissen cells?
Baroreceptors
What enzyme is released by the kidney to regulate BP?
Renin
The segment of the nephron where most reabsorption occurs?
PCT
Chemoreceptor that is located in Early DCT
Macula Densa
What is the stimulus of Macula Densa?
Sodium-Chloride sensitive
The connective tissue that connects polkissen cells to macula densa
Lacis Cells
Macula Densa + Polkissen Cells + Lacis Cells
Juxtaglomerular Apparatus
Stimulus of JGA
Osmolarity of fluid
Carotid sinus ends signals in what area of the brain?
Vasomotor center of Medulla Oblongata
What part of the kidney does the vasomotor center send signals to?
JGA
What enzyme is released by the liver to regulate BP?
Angiotensinogen
Inhibitor of bradykinin
ACE
Most potent vasoconstrictor
AT II
Artery or Vein: Increase Pressure = Increase SBP
Vein
Artery or Vein: Increase Pressure = Increase DBP
Artery
What part of Adrenal Gland is activated in the presence of AT II?
Zona Glomerulosa
The hormone that controls sodium & water retention + potassium excretion
Aldosterone
Aldosterone activates what type of cells in the LDCT?
Principal Cells
Principal Cells: Excrete 3 sodium, Absorb 2 potassium
G1
Principal Cells: Activates potassium channels
G3
Principal Cells: Activates sodium channels
G2
ATII activates what specific part of the hypothalamus to release ADH?
Supraoptic Nucleus
Function of Intraglomerular Messengial Cells
Phagocytosis and Contractile Function
Holds basement membrane and acts like a filter
Podocytes
Fenestrated Capillaries allow how many nanometers of substances?
5-10 nm
Filtration slits allow how many nanometers of substances?
25-30 nm
Slit Diaphragm allows how many nanometers of substances?
7-9 nm
“Split Diaphragm”
Nephrin
Normal GFR Rate
125 mL/min
Urine Excretion formula
(Filtration - Reabsorption) + Secretion
Factors that influence GFR
NFR, Surface Area, Rate of Permability
NFR: Pressure pushing plasm out of capillaries into Bowman’s Capsule
Glomerular Hydrostatic Pressure
NFR: Plasma proteins that keep H20 in the blood
Colloid Osmotic Pressure
Normal GHP
55 mmHg
NFR Formula
GHP - (COP + CHP)
NFR: Extended by the actual pressure in the bowman’s capsule
Capsular Hydrostatic Pressure
Normal COP
30 mmHg
Normal CHP
15 mmHg
Autoregulator that protects nephron from being rupture
Afferent Arteriole
Two autoregulation mechanism
Myogenic Mechanism and Tubuloglomerular Feedback
Autoregulation maintains arterial pressure between what range?
80-100 mmHg
Autoregulation due to dilation of AA
Myogenic Mechanism
Release of what component facilitates depolarization in Myogenic Mechanism?
Calcium release
What is the end effect of the Myogenic Mechanism?
AA Shrinkage
What substance does the Macula Densa release to signal afferent arterioles after getting stimulate with increase tubular fluid
ATP and Adenosine
Movement of water in osmosis
Lower solute to high solute (where Na goes, H20 follows)
Number of osmotically active moles
Osmoles
Number of osmoles per liter of H20
Osmolarity
Cell Shrinking
Hypertonicity
Decrease concentration outside the cell
Hypotonicity
Number of osmoles per kilogram of H20
Osmolality
Cell Swelling
Hypotonicity
Increase concentration outside the cell
Hypertonicity
Normal osmolality in renal
290 mosm/L
How much sodium is absorbed in PCT?
65%
What substance maintains acid buffer?
Bicarbonate (HCO3)
Acid-base balance equation
H + HCO3 = H2CO3 = H + HCO3
What enzyme breakdowns carbonic acid?
Carbonic Anhydrase
Renal Regulation of Acid-Base Buffer
HCO3 reabsorption in the blood and H+ excretion
Where does H+ get excreted?
PCT
What are the two channels included in Acid-Buffer Balance?
Na + HCO3 co-transport and Na + H20 exchanged
Hyperosmolar Medullary Instertitium is produced by what mechanisms?
Counter-current multiplier and Urea Cycling
Another name of hyperosmolar medullary interstitium
Corticopapillary Gradient
Who facilitates Counter-current exchange?
Vasa Recta
Two mechanisms of urine concentration and dilation
Hyperosmolar Medullary Instertitium & Role of ADH
Is there a change of osmolality from the glomerulus to PCT?
NONE
Special channels in thick ascending LOH that helps with hyperosmolality of medullary interstitium
Na - K - 2Cl symporter
Special channels in Early DCT that helps with hyperosmolality of medullary interstitium
Na - Cl transport
Maximum osmolarity gradient in the medullary and papillary area
1200 mos/L
Area of renal tubules that is impermeable to water
Half of Thin Descending LOH, Ascending LOH, Early DCT
Who facilitates the Counter-current multiplier?
LOH
Counter-current multiplier mechanism
Descending LOH pumps out H20 and Ascending LOH pumps out Na-K-2CL out into the medullary interstitium
Area of renal tubules that is permeable to water
PCT, Half of Thin Descending LOH
Descending LOH is impermeable to what substance?
Solutes
Where is the medullary dilating segment?
Thick Ascending LOH
Ascending LOH is impermeable to what substance?
H20
Descending LOH is permeable to what substance?
H20
Where is the cortical dilating segment?
Early DCT
Ascending LOH is permeable to what substance?
Solutes
Location of Urea Recycling
Inner Medullary Collecting Ducts
Who reabsorbed urea in renal tubules to prevent overexpression of hyperosmolarity?
Thin LOH
Where can you find the diluted luminal fluid?
DCT
What mechanism maintains the hyperosmolarity by preventing rapid removal of Na-Cl?
Counter-current exchanger
Where does ADH store and released?
Posterior Pituitary Gland
What part of renal tubule ADH works?
Late DCT and CD
What stimulates the release of ADH to the renal tubule?
Dehydration (Increase plasma osmolality)
Most diluted fluid in presence of ADH
LCTD and CD
What substance produces yellow hues in urine?
Urobilin
What is the sensory stimulation of the micturition reflex?
Distention of detrusor muscle
Two parts of the micturition reflex
Storage and Emptying
What happens in the involved structure in the storage part of the micturition reflex?
EUS and IUS contraction + Detrusor relaxation
What happens in the involved structure in the emptying part of the micturition reflex?
EUS voluntary relaxed, IUS involuntary relaxed, Detrusor relaxed
Incontinence: (+) spastic baldder
Urge
Incontinence: Normal Bladder
Functional
Incontinence: Flaccid bladder
Overflow
Incontinence: Weak support of bladder and urethra
Stress
PT management with overflow incontinence
Crede Maneuver
Incontinence: MC in elderly
Urge
Incontinence: Mind and Body is not working
Functional
Incontinence: laugh or cough
Stress
Incontinence: overdistention of detrusor
Overflow
Where does the concentration of urine occur?
DCT
Urinary bladder can store how many mL of urine?
400-600 mL
Residual volume of urine after emptying
NONE or 0mL
What inhibits the secretion of ADH?
Increase blood volume
