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Advanced Patho UC > Structure & Function of the Renal and Urologic Systems > Flashcards

Structure & Function of the Renal and Urologic Systems Flashcards

1
Q

endocrine function of the kidneys

A

secrete renin to regulate blood pressure

secrete erythropoietin to produce new erythrocytes

secretes 1,25-dihydroxyvitamin D3: metabolism of calcium

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2
Q

the kidneys also perform _______

A

gluconeogenesis: synthesis of glucose from amino acids

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3
Q

what is the functional unit of the kidney and urine forming unit of the kidney?

A

nephron

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4
Q

3 types of nephrons

A

superficial cortical nephrons

midcortical nephrons

juxtamedullary nephrons

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5
Q

superficial cortical nephrons

A

make up 85% of all nephrons, which extend partially into the medulla

internet says: shorter, mostly in cortex of kidney, and produce “standard” urine

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6
Q

midcortical nephrons

A

have short or long loops

internet says: Midcortical nephrons with glomerulus in the mid cortex and short loops that bend in the outer medulla (10%). Other mid cortical nephrons have loops of intermediate length that bend at various points in the inner medulla

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7
Q

juxtamedullary nephrons - what process are they important for?

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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8
Q

glomerulus

A

tuft of capillaries

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9
Q

bowman glomerular capsule

A

Bowman space - space inside Bowman capsule

circular space b/w visceral and parietal epithelium

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10
Q

mesangial cells

A

secrete mesangial matrix; lie b/w and support the glomerular capillaries

SOME CONTRACT SIMILAR TO SMOOTH MUSCLE CELLS TO REGULATE GLOMERULAR CAPILLARY BLOOD FLOW

have phagocytic properties and release inflammatory cytokines and growth factors

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11
Q

parts of the renal corpuscle

A

glomerulus, Bowman glomerular capsule, mesangial cells

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12
Q

glomerular endothelial cells synthesize what? what do these things regulate?

A

synthesize nitric oxide (a vasodilator) and synthesize endothelin-1 (a vasoconstrictor)

both of which regulate glomerular blood flow

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13
Q

visceral epithelium of the Bowman capsule is composed of cells called? What do these cells do?

A

podocytes - foot-like processes

form an elaborate network of intracellular clefts called filtration slits; MODULATE FILTRATION

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14
Q

Process of filtration w/i kidneys

A

plasma filtrate from glomerulus passes through the glomerular membrane into the Bowman space to form the primary urine

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15
Q

the glomerulus is supplied by _____ and drained by ______

A

supplied by the afferent arteriole, and drained by the efferent arteriole

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16
Q

Juxtaglomerular apparatus (JGA) consists of

A

juxtaglomerular cells, macula densa

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17
Q

juxtaglomerular cells are located where and do what?

A

located around the afferent arteriole where the afferent arteriole enters the glomerulus

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

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18
Q

macula densa - what does it do and where is it located?

A

portion of the distal convoluted tubule with SPECIALIZED SODIUM AND CHLORIDE-SENSING CELLS is located b/w the afferent and efferent arterioles

from internet: The macula densa participates in the regulation of renin release from juxtaglomerular granular cells. Renin secretion depends on NaCl delivery to and reabsorption by the macula densa cells at the end of the TAL.

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19
Q

parts of renal tubules

A

proximal tubule, loop of Henle, distal tubule, collecting duct

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20
Q

proximal tubule - main thing done here?

A

lined with microvilli to increase surface area and enhance reabsorption

*tubular transport slide - ACTIVE REABSORPTION OF SODIUM (MAJORITY), secretion of hydrogen foreign substances, isotonic fluid

21
Q

loop of henle - main things?

A

transport solute and water, contributing to the hypertonic state of the renal medulla

Tubular transport slide:

  • CONCENTRATION OF URINE
  • Descending loop: WATER REABSORPTION, sodium diffuses in
  • Ascending loop: SODIUM REABSORBED (BY ACTIVE TRANSPORT), water stays in
  • Urea secretion in thin segment
22
Q

distal tubule

A

adjusts acid-base balance by excreting acid into the urine and forming new bicarbonate ions

23
Q

collecting duct

A

contains principal cells that resorb sodium and water and excrete potassium and intercalated cells that secrete hydrogen or bicarbonate and potassium

*on tubular transport slide it says collecting ducts:
reabsorption of sodium, and water only with ADH
-reabsorption or secretion of sodium, potassium, hydrogen
-Final concentration

*tubular secretion = transfer of substances from the peri-tubular capillaries to the tubular lumen (don’t think this is what secretion means in this scenario)

24
Q

bladder bag components

A

detrusor muscle and trigone

25
Q

detrusor muscle

A

smooth muscle in bladder

26
Q

trigone

A

smooth triangular area lying b/w the opening of the 2 ureters and urethra

27
Q

urethra - what does it contain and how long M vs. F?

A

internal sphincter - smooth muscle located at junction of bladder and urethra

external sphincter - striated skeletal muscle under voluntary control

b/w 3-4 cm long in females

b/w 18-20 cm long in males

28
Q

the detrusor muscle is the smooth muscle in the bladder- how does it contract?

A

contracts with parasympathetic fibers (autonomic NS)

29
Q

skeletal motor neurons in the pudental nerve (somatic) of the urethra control what?

A

external urethral sphincter

30
Q

glomerular filtration rate (GFR)

A

filtration of plasma into the Bowman space per unit of time

takes 20% of RBF (120 to 140mL/min)

31
Q

GFR directly related to what?

A

Directly related to the perfusion pressure in the glomerular capillaries

32
Q

If mean arterial pressure decreases or vascular resistance increases, then the RBF and GFR do what?

A

decrease (both RBF and GFR decrease)

33
Q

myogenic mechanism (stretch) - as systemic pressure declines, glomerular perfusion _______

A

glomerular perfusion increases

stretch on the afferent arteriolar smooth muscle decreases, and the arteriole relaxes - therefore delivering more blood to the glomerulus

34
Q

an increase in systemic pressure _______ glomerular perfusion

A

decreases

*causes the arteriole smooth muscle to contract, thereby decreasing blood flow to the glomerulus

35
Q

tubuloglomerular feedback (sodium chloride content) - when sodium filtration increases, GFR _____ and macula densa cells do what?

A

GFR decreases and macula densa cells stimulate afferent arteriolar vasoconstriction

  • when sodium filtration decreases, the opposite occurs – GFR increases
  • fluid from the blood enters the nephron by filtration
36
Q

SNS neural regulation

A

vasoconstriction occurs (diminishes GFR) regulate size of afferent and efferent arterioles, thus renal blood flow

37
Q

baroreceptor reflex neural regulation

A

vasoconstriction of afferent arterioles with activation of a1-adrenoreceptors

decreases glomerular perfusion and GFR

38
Q

exercise and change in body position - neural regulation

A

activate renal sympathetic neurons, causes mild vasoconstriction

(GFR decreases during exercise)

39
Q

severe hypoxia - neural regulation

A

stimulation of chemoreceptors - decreases RBF by means of sympathetic stimulation

40
Q

RAAS does what?

A

increases systemic arterial pressure, and increases sodium reabsorption

*renin: enzyme is formed and stored in afferent arterioles of the juxtaglomerular apparatus

41
Q

nephron filtration

A

movement of protein-free plasma across the glomerular membrane (hydrostatic pressure) - from blood to nephron is what internet said

42
Q

tubular reabsorption

A

movement of fluid and solutes from tubular lumen to the peritubular capillaries

43
Q

tubular secretion

A

transfer of substances from the peritubular capillaries to the tubular lumen

44
Q

excretion

A

elimination of a substance in the final urine

45
Q

tubular transport - proximal tubule what does it do?

A

active reabsorption of sodium (majority) and secretion of hydrogen foreign substances - isotonic fluid

46
Q

loop of henle - what does it do?

A

CONCENTRATION OF URINE

descending loop - WATER REABSORPTION, sodium diffuses in

ascending loop - SODIUM REABSORBED (BY ACTIVE TRANSPORT), water stays in

urea secretion in thin segment

47
Q

distal tubule - what does it do? type of fluid - iso, hypo, hyper?

A

reabsorption of sodium, and water only with ADH, bicarbonate

secretion of potassium, urea, hydrogen, and some drugs

isotonic or hypotonic

48
Q

collecting ducts - what do they do?

A

reabsorption of water only with ADH; reabsorption or secretion of sodium, potassium, hydrogen; final concentration

49
Q

when GFR spontaneously decreases or increases - renal tubules and, PRIMARILY THE _____, automatically adjust what?

A

primarily the proximal tubules, automatically adjust their rate of reabsorption of sodium and water to balance the change in GFR

*constant fraction of filtered sodium and water is reabsorbed from the proximal tubule

Advanced Patho UC (14 decks)

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