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Renal Phys > Study Guide > Flashcards

Study Guide Flashcards

1
Q

The limit to the rate at which a solute can be transported during active reabsorption or secretion

A

transport maximum

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2
Q

The overall transport maximum for glucose is normally about ____ mg/min- this is reached when all _____ have reached their maximal capacity to _____ glucose

A

375 mg/min
nephrons
reabsorb

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3
Q

Some substances that are PASSIVELY absorbed do NOT demonstrate a transport maximum, called _____ ; however, _____ transported substances can also exhibit characteristics- ex. Sodium reabsorption

A

gradient-time transport

actively

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4
Q

The rate of transport depends on (3)

A

Electrochemical gradient
Permeability of the membrane to substance
Time the fluid containing the substance remains in the tubule

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5
Q

Diffusion of water from an area of low solute/high water conc to an area of high solute /low water conc; water is almost always absorbed by _______ mechanism

A

osmosis

passive

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6
Q

RAISED peritubular capillary hydrostatic pressure is caused by ______ arterial pressure or ____ reabsorption rate

A

increased arterial pressure

decreased reabsorption rate

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7
Q

LOWERED peritubular capillary hydrostatic pressure is caused by ______ resistance of afferent/efferent arterioles
or _____ reabsorption rate

A

an increase in resistance of either afferent or efferent arterioles
Increase in reabsorption rate

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8
Q

ADH causes ____ water permeability

A

increase

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9
Q

Increase in osmolarity in the body causes _____ water permeability of _____ & _____

A

increase
distal tubule
collecting ducts

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10
Q

Water is reabsorbed by _____ in the ______ segment of the loop of Henle

A

osmosis

descending

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11
Q

pituitary releases ____

A

ADH

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12
Q

sodium content increases ____

A

thirst

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13
Q

phosphate’s ______ can be altered by DIET

A

transport maximum

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14
Q

Water is reabsorbed by ______ in the _____segment of the loop of Henle

A

osmosis

DESCENDING segment

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15
Q

decrease in glomerular hydrostatic P –> ___ GFR

A

DECREASE GFR

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16
Q

CONSTRICTING AFFERENT arterioles= ___Glomerular capillary hydrostatic pressure= ___GFR

opposite effect with DILATION

A

DECREASE Glomerular capillary hydrostatic pressure

DECREASE GFR

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17
Q

Constricting EFFERENT arterioles = ____ glomerular capillary hydrostatic pressure= ___GFR (slightly)

A

INCREASE glomerular capillary hydrostatic pressure

INCREASE GFR

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18
Q

Raise peritubular capillary hydrostatic pressure is caused by _____ in ARTERIAL P or ____ in REABSORPTION rate

A

increase in arterial P

decrease in reabsorption rate

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19
Q

lower peritubular capillary hydrostatic pressure is caused by ____ in _______ of afferent/efferent arterioles or _____
in REABSORPTION rate

A

increase in resistance of afferent/efferent arterioles

increase in reabsorption rate

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20
Q

______ fluid in the early part of the distal tubule, in the late part of distal tubule & collecting ducts, there is additional reabsorption of _______ - dependent upon presence of ____

A

dilute
sodium
ADH

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21
Q

repetitive reabsorption of NaCl by the THICK ASCENDING loop of Henle and continued inflow of new sodium from the proximal tubule into the loop of Henle is called _______

A

countercurrent multiplier

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22
Q

Increased blood pressure raising urinary volume excretion; WATER excretion

A

Pressure diuresis

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23
Q

The raise in SODIUM excretion that occurs with elevated blood pressure

A

Pressure natriuresis

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24
Q

The greater the concentration of _____ in the proximal tubule, the greater the ______

A

sodium

reabsorption rate

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25
Q

65% of the filtered water & sodium are reabsorbed in the _________, before reaching the loop of Henle

A

proximal tubule

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26
Q

______ segment of loop of Henle actively reabsorbs sodium, chloride and potassium

A

thick ascending

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27
Q

equation for GFR

A

GFR = RPF x FF

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28
Q

body can INCREASE GFR by (2)

A 
altering RPF (renal plasma flow)
altering FF (filtration fraction)
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29
Q

The sum of the hydrostatic and colloid osmotic forces across the glomerular membrane is called

A

(Kf) - capillary filtration coefficient

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30
Q

determinants of GFR (4)

A

hydrostatic P- glomerular capillaries
hydrostatic P- bowman’s capsule
colloid osmotic P- glomerular capillary plasma proteins
colloid osmotic P- Bowman’s capsule (not normal, should not be any proteins in the bowman’s capsule. Healthy = 0)

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31
Q

DECREASE the amount of functional glomerular capillaries (with age or disease) –> _____ SA for filtration –> ____ Kf

A

decrease SA

decrease Kf

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32
Q

INCREASE thickness of the capillary membrane (hypertension or diabetes mellitus) –> ______ permeability of capillary –> ____ Kf

A

decrease permeability

decrease Kf

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33
Q

INCREASE Bowman’s capsule P –> ___ GFR

A

decrease GFR

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34
Q

INCREASE Glomerular colloid osmotic pressure –> ___ GFR

A

decrease GFR

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35
Q

DECREASE Glomerular hydrostatic pressure –> ___ GFR

A

decrease GFR

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36
Q

most common physiological regulation of GFR is changes in __________ pressure

A

glomerular hydrostatic pressure

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37
Q

strong SYMPATHETIC activation –> _____ GFR

A

decreases

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38
Q

Epinephrine & Norepinephrine effect on GFR

A

decreases

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39
Q

Endothelin (autacoid) effect on GFR

A

decreases

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40
Q

Angiotensin II (autacoid) effect on GFR

A

maintains

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41
Q

Prostaglandins and Bradykinin (autacoids) and NITRIC OXIDE effect on GFR

A

increases

42
Q

Feedback mechanism linking sodium concentration with renal artery resistance and ensures a constant delivery of sodium chloride to the distal tubules

A

tubuloglomerular feedback

43
Q

when renal cells sense a DECREASE in sodium concentration, initiates signal to (2)

A
  • Decreases resistance to blood flow in the afferent arterioles
44
Q

The ability of the individual blood vessels in the body to resist stretching during increased arterial pressure

A

myogenic mechanism (direct effect on GFR)

45
Q

Glomerular capillary membrane has 3 layers: ___, ___ & ____

A

endothelium
basement membrane
epithelial cell layer (podocytes)

46
Q

negatively charged layer of glomerular capillary membrane

A

endothelium

47
Q

layer of glomerular capillary membrane that is meshwork of proteoglycan fibrillae & collagen; negatively charged to INHIBIT passage of proteins

A

basement membrane

48
Q

layer of glomerular capillary membrane that is NOT continuous, podocytes present on outer side, contains slit pores

A

epithelial cell layer

49
Q

the proportion of the fluid reaching the kidneys which passes into therenal tubules

A

filtration fraction

50
Q

angiotensin II _____ EFFERENT arterioles and increases ______ in PROXIMAL TUBULES (DIRECTLY stimulates)

A

constricts

reabsorption

51
Q

most reabsorption of phosphate occurs in:

A

proximal tubule

52
Q

with kidney damage, there will be impaired SODIUM ______ –> electrolyte and fluid imbalance –> _____ insufficiency (death)

There will also be ____ BP that HELPS to maintain normal _____ excretion

A

reabsorption
cardiac
increase
sodium

53
Q

proximal tubules and loop of Henle have THICK ______ cells, with high metabolic activity

A

epithelial

54
Q

distal tubule is composed of ______ cells and ____ cells

A

principal cells

intercalcated cells

55
Q

factor that shifts potassium into cell

A

alkalosis

56
Q

_____ increases potassium secretion

A

alkalosis

57
Q

pH > ____ = alkalosis

A

7.4

58
Q

When the body is in state of _______:
Tubular secretion of H+ is DECREASED
H+ is then too low for complete HCO3- reabsorption

A

alkalosis

59
Q

_____ correction of Alkalosis is to _______ ratio of HCO3- to H+ in the renal tubules

A

renal

increase

60
Q

there is a chance for _____ in “salt-sensitive” people; see a marked increase in ____ with VERY LITTLE salt

A

family inheritance

BP

61
Q

flow of urine

A

nephron > collecting ducts > renal calyces > ureters > bladder

62
Q

Excess aldosterone in the system (Conn’s syndrome) may be caused by _____

A

hypokalemia

63
Q

Factor (2) that INCREASES H+ secretion and HCO3- reabsorption

A

hypokalemia

DECREASE extracellular fluid volume

64
Q

concentration of K is low in body

A

hypokalemia

65
Q

As long as the pressure DIURESIS mechanism is working the body will be able to handle an increase in fluid and salt intake with very little _________ change

A

extracellular fluid volume change

66
Q

Decreased extracellular fluid osmolarity shifts K ______ cells

A

INTO

67
Q

Parasympathetic motor fibers innervate the _____ muscle

A

detrusor

68
Q

____ nerves innervates external bladder sphincter

A

pudendal N

69
Q

2 main buffers for H+ in tubular fluid are

A

phosphate

ammonia

70
Q

water & solutes can travel through tubular epithelium via _____ route in cell membranes or ______route btwn cells through TIGHT JUNCTIONS

A

transcellular route

paracellular route

71
Q

______ and ______ stimulate sodium-potassium ATPase pump on the basolateral side of the TUBULE MEMBRANE

A

aldosterone

angiotensin II

72
Q

_____ cells are in the late distal and collecting tubules secrete potassium for excretion

A

principal

73
Q

Increased ______ –> increased sodium and water reabsorption in the cortical collecting tubules and increased ______ excretion

A

aldosterone

potassium

74
Q

increased ____ intake stimulates ALDOSTERONE production

A

potassium

75
Q

______ stimulates active secretion of potassium of the principal cells in the late DISTAL TUBULES and collecting ducts AND increases the potassium permeability of the luminal membrane

A

aldosterone

76
Q

H+ concentration in the body is kept very ___ compared to other ions and is _____ regulated

A

low

tightly

77
Q

The buffering system in the fluids reacts within seconds to a shift in ___ concentration

A

H+

78
Q

The kidneys regulate extracellular fluid H+ concentration by 3 mechanisms:

A

Secretion of H+
Reabsorption of filtered HCO3-
Production of new HCO3-

79
Q

H+ is too low for complete HCO3- reabsorption in ______

A

alkalosis

80
Q

Tubular secretion of H+ is increased in ____

A

acidosis

81
Q

kidney blood flow IN

A

renal artery –> interlobar arteries –> arcuate arteries –> afferent arterioles –> glomerular capillaries –> efferent arterioles –> peritubular capillaries

82
Q

kidney blood flow OUT

A

peritubular capillaries –> interlobar vein –> arcuate vein –> interlobar vein –> renal vein

83
Q

renal blood flow has 2 capillary beds:

A

Glomerular capillaries

Peritubular capillaries

84
Q

when negative charge is compromised, glomerular capillary basement membrane loses it’s _________ ; ____ is filtered in URINE with a _____ appearance

A

electrical charge
albumin
frothy

85
Q

frothy urine is a sign of

A

proteinuria/albuminuria

86
Q

The total number of particles in a solution

A

osmole

87
Q

Osmoles per kilogram of water

A

osmolality

88
Q

Osmoles per liter of water

A

osmolarity

89
Q

in HYPOnatremia, abnormally high secretion of ADH is sign of

A

overhydration (over retention of water)

90
Q

HYPOnatremia may result in ____ or brain swelling

A

edema

91
Q

Presence of excess fluid in body tissues

A

edema

92
Q

____ edema: due to: hyponatremia, metabolic depression, lack of adequate nutrition

A

INTRAcellular

93
Q

_____ edema due to: fluid leakage, lymphatic failure (Lymphedema)

A

EXTRAcellular

94
Q

symptoms of nephrotic syndrome

A

1- protein in urine

2- edema

95
Q

micturition reflex leads to ______ urination

A

voluntary

96
Q

external sphincter muscle is under ____ control

A

voluntary

97
Q

in HYPERnatremia, overhydradtion is caused via ______ (and abnormally high secretions of _____

A

excess sodium chloride

aldosterone

98
Q

The transport of sodium from the tubular membrane into the interstitial fluid during reabsorption requires ____ & ____

A

energy

potassium

99
Q

glomerular filtrate does NOT contain ___ or ____

A

protein

cellular elements

100
Q

When voluntary urination is desired, the micturition reflex is excited and the _____________ signals for voluntary external urethral sphincter relaxation.

A

pudendal N

Renal Phys (4 decks)

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