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PSC1002- Physiology > renal system L11-13 > Flashcards

renal system L11-13 Flashcards

1
Q

juxtamedullary nephrons

A

involved in making concentrated urine

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2
Q

no. nephrons per kidney

A

1 million
~80% cortical

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3
Q

renal distribution of blood flow

A

93% cortex
7% medulla
1% papilla

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4
Q

afferent arterioles

A

feed into glomeruli

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5
Q

efferent arterioles

A

leave glomeruli and wrap around nephron

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6
Q

vascular supply to nephrons pathway

A

afferent arterioles > glomeruli> efferent arterioles > peritubular capillaries/ vasa recta> renal veins> inferior vena cava

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7
Q

kidney functions

A

homeostatic regulation of water/ ion content of blood
metabolic waste product excretion
hormone production

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8
Q

hormones produced by kidney

A

erythropoietin (RBC synthesis)
renin (sodium balance)
vit D activation
prostaglandins and kinins (renal blood flow)

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9
Q

what’s filtered at glomerular filtration?

A

all plasma constituents except proteins >67kDa
as filtration barrier filters on size/ charge

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10
Q

glomerular filtration fraction

A

~20%

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11
Q

glomerular filtration rate (GFR)

A

~180 litres/ day

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12
Q

filtration barrier layers surrounding

A

capillary lumen
filtration barrier
capillary endothelium
basement membrane
bowman’s capsule epithelium

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13
Q

pressures controlling glomerular filtration

A

hydrostatic p of blood through glomerular capillaries (~55mmHg)
colloid (30mmHg)
hydrostatic p of fluid in Bowman’s space (15mmHg)

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14
Q

colloid osmotic pressure

A

caused by proteins in blood, favouring fluid retention in capillaries

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15
Q

net glomerular filtration pressure

A

55-30-15=10mmHg

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16
Q

afferent arteriole resistance effect on blood flow to glomerulus

A

^R decreases blood flow
decrease in R ^blood flow

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17
Q

efferent arteriole resistance effect on blood flow to glomerulus

A

^R increases blood flow
decrease in R decreases blood flow

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18
Q

GFR /RBF control

A

maintained relatively constant over range of arterial pressure as a protective mechanism (autoregulation)
neural control
tubuloglomerular feedback

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19
Q

autoregulation local control mechanisms

A

myogenic response
tubuloglomerular feedback (fluid flow influences arteriole resistance/ GFR

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20
Q

why does the nephron loop back in on itself

A

so ascending limb of henle loop passes between afferent/ efferent arterioles

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21
Q

macula densa cells function

A

sense distal tubule flow/ release paracrines that affect afferent arteriole diameter

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22
Q

tubuloglomerular feedback

A

GFR/ tubule flow ^ so ^macula densa flow^ and Na+/Cl- conc sensed
paracrine factors released from macula densa (adenosine/ ATP/ nitric oxide)
afferent constricts and afferent r ^
GFR decrease

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23
Q

urine formation process

A

filtration
reabsorption
secretion (at proximal convoluted tubule)

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24
Q

amount excreted

A

amount filtered - amount reabsorbed + amount excreted

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25
reabsorption
movement of solutes/ fluid out of filtrate and into capillaries via epithelial transport mechanisms
26
epithelial transcellular transport
substances cross apical and basolateral membranes of tubule epithelial cells
27
paracellular transport pathway
substances pass through cell-cell junction between 2 adjacent cells
28
passive transport
diffusion (membrane-permeable) leak channels paracellular transport
29
active transport
membrane channels transporters co-transporters pumps carriers
30
PCT functions
reabsorption (microvilli on apical surface maximise sa) secretion interdigitations of basolateral membrane shorten distance to mitochondria for active transport
31
Na+ reabsorption at PCT-1
Passive at apical membrane (down echem gradient) co-transport w essential solutes
32
water reabsorption at PCT-1
paracellular route via osmosis
33
ion reabsorption
paracellular/ transcellular along echem gradient
34
glucose at PCT-2
co-transport at apical membrane and carrier at basolateral membrane
35
urate at PCT2
anion transporters/ paracellular/ passive/ transcellular/ secretion
36
Tm
max transport rate
37
renal threshold
plasma conc of substrate at Tm
38
diabetes mellitus
excessive glucose conc saturates carrier no. and therefore appears in urine
39
PCT secretion
peritubular capillary transfer to tubule actively isosmotic fluid leaving (300mOsm)
40
nephron osmolarity changes
descending limb ^ conc (permeable to water/ impermeabe to ions) ascending limb > hypoosmotic fluid (impermeable water)
41
H2O reabsorption in urine formation
ADH^ collecting duct permeability to water countercurrent systems maintain osmotic gradient in medullary interstitium
42
urine formation countercurrent system multiplier
enhanced by active transport of solutes maintaining osmotic gradient
43
acidosis in renal adjustment
A intercalated cells in collecting ducts excrete H+ and reabsorb HCO3-
44
alkalosis in renal adjustment
B intercalated cells in collecting duct excrete HCO3- and reabsorb H+
45
diuresis
removal of excess water from urine
46
what controls permeability in collecting duct?
vasopressin ADH reabsorption passivelycvia osmotic gradient in medullary interstitium
47
ADH cellular action
1. binds to basolateral membrane receptor 2. adenlyl cyclase stimulation > cAMP generation and protein kinase activation 3. aquaporin 2 insertion into apical membrane 4. ^ permeability
48
ADH release control
osmoreceptors
49
ADH release
produced by cells in supraopitc/ paraventricular nuclei of hypothalamus stored in vesicles in p pituitary gland
50
normal plasma osmolarity
~290mOsm
51
ADH half-life/ removal
~15 mins removed by liver and kidneys
52
physio ADH release stimuli
stress high temp exercise pain
53
alcohol effect on ADH release
inhibits
54
inappropriate ADH release stimuli
post-operative pain intracranial disease/ injury ectopic ADH production opiates MDMA/ nicotine pneumonia/ TB
55
nocturnal enuresis
delay in normal circadian rhythm of ADH development
56
MdMa effect on body
^ thirst reflex/ ADH secretion/ circulatin g volume hyponatraemia
57
diabetes insipidus
polyuria ADH secretion deficiency nephrogenic diabetes insipidus (nephrons don't respond to ADH)
58
Na+ reabsorption
free filtration at glomerulus ~67% PCT reabsorption none from henle thin ~35% from thick
59
renin-angiotensin-aldosterone axis
renin release from kidney stimulates angiotensin> angiotensin I> angiotensin II> aldosterone> ^Na+rebasorption/ extracellular fluid
60
renin release
stretch receptors in afferent arteriole sense low BP and NaCl at macula densa ^renal symp nerve stimulation
61
aldosterone cellular action
binds to cytoplasm receptors and initiates txn ^ENaC channels in apical surface ^Na+/Cl- pumps ^Na+ reabsorption (^Cl- and K+ secretion)
62
aldosterone production
steroid hormone synthesis in adrenal cortex
63
aldosterone function
stimulates angiotensin II promotes Na+ reabsorption promotion via principle cells in final third of DCT/ Cortical collecting duct ^ blood vol and decreases NaCl/water excretion
64
angiotensin II function
stimulates aldosterone release from adrenal cortex ^thirst/ vasoconstriction ^norepinephrine release from symp postganglionic fibres
65
atrial natriuretic peptide
produced by atria in response to stretch regulates plasma vol
66
nephrolithiasis symptoms
nausea renal colic sweating blood in urine
67
nephrolithiasis
renal calculi formation due to build up of ion/solute conc in filtrate in nephron loop/ distal tube/ collecting system
68
risk factors of nephrolithiasis
dehydration obesity diet
69
micturition
emptying urine from urinary bladder * up to 500ml
70
2 sphincter muscle rings
internal (smooth muscle) external (skeletal muscle controlled by somatic motor) neurones/tonic CNS stimulation maintains contraction
71
micturition process
stretch receptors fire para neurones fire and motor stop firing smooth muscle contracts/ internal sphincter passively pulled open, external sphincter relaxes

PSC1002- Physiology (8 decks)

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