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BDS1 BAMS human systems > the kidney > Flashcards

the kidney Flashcards

1
Q

what type of organs are the kidneys?

A

excretory organs

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2
Q

what is the main function of the kidneys?

A

maintain internal homeostasis of fluid
(process blood and rid the body of waste products of metabolism via urine)

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3
Q

what do the kidneys regulate?

A
  • fluid volume/concentration
  • electrolytes
    (above two involved in blood pressure regulation)
  • acid/base
  • calcium/vit D metabolism
  • erythroprotein
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4
Q

how many kidneys are there?

A

two

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5
Q

what is the function of the ureters?

A

pass urine from kidneys to bladder

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6
Q

where is urine stored before entering the urethra?

A

bladder

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7
Q

what is the function of the urethra?

A

void urine

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8
Q

where do the kidneys sit in the body?

A

behind the peritoneal cavity

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9
Q

what are the three main parts of the kidney?

A
  • cortex
  • medulla
  • pelvis
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10
Q

what is the cortex?

A
  • outer part of kidney
  • contains 85% of all kidney tubules (nephrons)
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11
Q

what is the medulla?

A
  • middle ‘triangular’ part of kidney
  • where urine is concentrated
  • prevent excess water loss
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12
Q

what is the pelvis?

A
  • inner part of kidney
  • collection area where urine is funnelled into the ureter
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13
Q

what is the kidney encased in?

A

fibrous capsule (dense irregular)

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14
Q

describe the blood vessels of the kidney

A
  • highly vascular
  • renal artery delivers blood from abdominal artery
  • receives 1/5 of cardiac output
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15
Q

what is unique about the blood vessels of the kidney?

A
  • capillaries have a glomerulus (capillary bed) located between the afferent and efferent arteries
  • these then deliver blood to a secondary capillary bed (called the peritubular vasa recta) which passes to the interlobular veins
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16
Q

what is the basic functional unit of the kidney?

A

the nephron

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17
Q

where is the site of blood filtration?

A

glomerulus capillaries

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18
Q

what are the parts of the nephron?

A

bowmens caspule
proximal convoluted tubule
loop of henle
distal convuluted tubule

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19
Q

what are the two different types of nephrons?

A

cortical and juxtamedullary

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20
Q

what is unique about the juxtamedullary nephrons?

A

very long loop of henle which goes deep into the medulla

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21
Q

what is the renal corpuscle made up of?

A

glomerulus and bowman’s capsule (filter blood)

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22
Q

what forms the renal tube?

A
  • prox convoluted tubule
  • loop of henle
  • distal convoluted tubule
  • collecting duct
    (reabsorption and secretion_
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23
Q

what is the glomerulus?

A

a network of fine capillaries composed of a single layer of epithelial cells resting on a basement membrane

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24
Q

what does fenestrated mean?

A

poreous

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25
what enables rapid filtration of blood plasma in the glomerulus?
the fenestrations
26
what is bowmans capsule?
a cuplike structure surrounding the glomerulus
27
how many layers are there in the bowmans capsule?
two: - parietal outer (simple squamous) - visceral inner (specialised epithelium called podocytes- long foot like processes) bowmans space inbetween
28
what are the long branched processes which come from the podocytes called?
pedicels (wrap around the glomerular capillaries)
29
what forms the filtration barrier?
the glomerular endothelium, basement membrane and pedicels
30
what is the function of the filtration barrier?
barrier to large positively charged proteins
31
describe the steps in blood processing
- unfiltered blood arrives at the glomerulus via the afferent arteriole - blood components filtered through the filtration barrier - filtered blood exits the glomerulus via the efferent arteriole
32
what is blood filtration facilitated by?
a pressure gradient (hydrostatic)
33
which arteriole has the thicker arteriole?
afferent
34
what does the diameter of arterioles help with?
pressure gradients
35
what is filtered in the filtration barrier?
water glucose aa urea creatinine sodium chlorine calcium phosphate bicarbonate
36
what is not filtered in the filtration barrier?
cells and large proteins eg haemoglobin negatively charged proteins eg albumin
37
what is glomerular filtration rate?
the rate at which blood is filtered through the glomerulus into bowmans capsule
38
what is filtration primarily driven by?
glomular hydrostatic pressure
39
what is filtration counteracted by?
hydrostatic pressure in the bowmans capsule and glomerular osmotic pressure
40
what are factors which can influence glomerular filtration rate?
- hydrostatic pressure - osmotic pressure - systemic bp - renin-angiotensin system - disease
41
what is the normal value for glomerular filtration rate?
125ml/min
42
what happens to GFR if the kidneys are damaged?
decreases so inefficient blood clearance and waste removal so waste accumulates in the blood
43
what are measurements used to estimate GFR?
serum creatinine and urea
44
what if glomerular filtration rate equivalent to?
kidney function (stage 1-5 of chronic kidney disease)
45
what if glomerular filtration rate equivalent to?
kidney function (stage 1-5 of chronic kidney disease)
46
what % of filtered substance is reabsorbed?
99%
47
how many litres of filtrate does a healthy individual produce each day?
180 litres/day
48
what is the function of the renal corpsule?
filtration
49
what is the function of the renal tubule?
reabsorption and secretion (conservation and fine tuning)
50
what makes up the renal tubule?
- proximal convoluted tubule - loop of henle - distal convoluted tubule
51
what is the main site of reabsorption in the kidney?
proximal convoluted tubule
52
what makes the proximal convoluted tubule ideal for reabsorption?
- very long - convoluted to max. surface area - lining epithelial cells have microvilli on apical surface
53
what is another name for the peritubular capillaries?
vasa recta
54
where does reabsorption occur from?
tubule lumen filtrate to peritubular capillary blood
55
where does secretion occur from?
peritubular capillary blood to tubule lumen filtrate
56
what is reabsorbed?
- water - glucose - amino acids - urea - sodium - chloride - calcium - phosphate - potassium - bicarbonate
57
what is the only substance not reabsorbed in the renal corpsule?
creatinine
58
what is the concentration gradient in the convoluted tubule?
high to low tubule to capillary
59
in the convoluted tubule how much filtrate remain in the tubule lumen after passive diffusion?
50%
60
how does the convoluted tubule transport the other 16% of filtrate into the capillaries after passive diffusion?
sodium potassium pump - 1 ATP moves 3 sodium out and 2 potassium in - everything else follows sodium eg water, glucose, amino acids, chloride and negative ions
61
how much sodium in reabsorbed by the sodium potassium pump?
65%
62
how much of the 180l is reabsorbed immediately by the proximal convuluted tubule?
120l
63
how much nutrient reabsorption does Na+ transport facilitate?
100%
64
where does the remaining 60l of filtrate go from the proximal convoluted tubule?
loop of henle
65
what participates in counter-current multiplication?
juxtamedllary nephrons
66
what are the different sections of the loop of henle?
- thin descending limb - thin ascending limb - think ascending limb
67
what does the thin descending limp of the loop of henle contain?
aquaporins
68
do the ascending limps of loop of henle contain aquaporins?
no therefore they are impermeble to water
69
what part of the loop of henle is permeable to water?
permeable
70
where are sodium potassium pumps present in the loop of henle?
ascending limbs, water is prevented to follow due to absence of aquaporins
71
what is sodium reabsorption done via?
NKCC2 pump on the apical membrane
72
what happens to the conc of sodium in the medulla due to the pump?
becomes more salty, which draws water out of the descending limb into the medulla
73
what happens to the water conc in the descending loop on henle?
decreases as you descend
74
what happens to the conc of the filtrate in the ascending loop of henle?
decreases as you go up
75
where does the reabsorbed water and salt from the loop of henle go?
back into the blood stream via the vasa recta
76
what helps maintain the conc gradient of the medulla?
counter current exchange in the vasa recta
77
what occurs in the distal convoluted tubule?
- fine-tuning of sodium and water reabsorption
78
what hormones regulate sodium and water reabsorption in the distal convoluted tubule?
- anti-diuretic hormone - aldosterone - atrial natriuretic hormone
79
what is the function of ADH in the distal convoluted tubule?
increases water reabsorption
79
what is the function of ADH in the distal convoluted tubule?
increases water reabsorption
80
what is the function of aldosterone in the distal convoluted tubule?
promotes Na+ reabsorption
81
what is the function of ANH in the distal convoluted tubule?
promotes Na+ secretion
82
what is the concentration of the filtrate when leaving the loop of henle?
100 mosm/l (low compared to body- 300) - therefore filtrate is hypotonic
83
why does water want move out of the distal convoluted tubule?
down concentration gradient
84
why can water not move out the distal convoluted tubule?
no aquaporins
85
how does ADH increase water reabsorption?
it signals to the epithelial cells lining the distal convoluted tubule which respond by adding aquaporins so water can leave
86
what is AVPR2?
vasopressin receptor 2 - found on tubule wall
87
how does aldosterone act?
on distal and collecting tubules - upregulates activity and insertion of sodium-potassium pumps and channels
88
what do the functions of ADH and aldosterone both lead to?
a small conc urine produced.
89
what is the function of ANP?
acts on distal and collecting tubules - counteracts ADH and aldosteone - large volume of dilute urine produced
90
how much sodium is reabsorbed in the distal convoluted tubule?
8%
91
what is the function of both ADH and aldosterone together?
Fluid reabsorption
92
What are the signals which initiate the hormones in the kidney?
Changes in blood pressure
93
What are the factors which influence glomerular filtration rate?
-glomerular hydrostatic pressure -capsular hydrostatic pressure -glomerular osmotic pressure -systemic blood pressure -renin-angiotensin-aldosterone system -disease
94
how is excretion calculated?
(filtration - reabsorption) + secretion
95
What is the juxta-glomerular apparatus?
The ball of cells which connects the distal convoluted tubule with the glomerulus which measures and responds to changes in sodium ion concentration of the filtrate
96
what are the macula dense?
- found where the distal convoluted tubule interacts with the glomerus and afferent arteriolar - small group of specialised epitheliul cells - measure and respond to changes in sodium concentration
97
what are the juxtaglomerular cells?
- modified smooth muscle cells - can adjust diameter of afferent arteriolar by vasoconstriction or vasodilation - talk directly to macula densa cells
98
what are the mesangial cells?
- extra or intro - supporting cells
99
what do the macula densa cells do when Na+ is in homeostasis ?
Don’t send any signals to the juxtaglomerular cells
100
Describe the sequence of steps which occur after an increase in blood pressure (tubuloglomerular feedback)
- increase in glomerular hydrostatic pressure - increase in glomerular filtration rate - increase in sodium ion filtrate concentration - sodium and water flow into macula densa cells which expand - this release adenosine from macula densa cells - adenosine tells the juxtaglomerular cells to vasoconstrict the afferent arteriolar - this helps protect glomerular capillaries from blood pressure fluctuations - glomerular hydrostatic pressure decreases - return to homeostasis
101
What do the macula densa cells release after a decrease in blood pressure?
prostaglandins
102
what do the juxtaglomerular cells release on affect of prostaglandins?
renin
103
describe the renin-angiotensin system’s function to restore blood pressure
- angiotensin is released into circulation by the liver - renin converts angiotensin into angiotensin 1 - angiotensin converting enzyme converts angiotensin 1 into angiotensin 2 -angiotensin 2 is a potent vasoconstriction which increases blood pressure
104
where is angiotensin produced and released?
the liver
105
what is the problem with the renin-angiotensin system?
it’s only short term as not enough blood fluid volume
106
what is the solution to the short term renin-angiotensin system?
renin angiotensin-aldosterone system
107
describe the renin angiotensin-aldosterone system
-angiotensin 2 binds target receptors o: arterioles causing constriction hypothalamus causing thirst pituitary gland causing ADH release adrenal medulla causing aldosterone release - blood volume is restored via increased fluid and salt retention
108
What does the atrial natriuretic peptide hormone counteract?
The renin antidioretic aldosterone system
109
Now does ANP counteract RAAS?
- ANP released from heart from decrepit on of increased blood pressure in baroreceptors
110
What is the anti- diuretic hormone also known as?
Vasopressin
111
What is the overall goal of hormones; anti-diuretic hormone, aldosterone and atrial naturetic peptide ?
Homeostatic regulation of blood pressure and volume
112
What happens to glomerular filtration rate as kidney disease increases?
Decreases
113
What are the consequences of chronic kidney disease?
- inadequate removal of fluid and waste products of metabolism - inappropriate activation of RAAS
114
why does kidney disease lead to activation of RAAS?
- the low glomerular filtration is mistaken as being due to low blood pressure - RAAS pathway activated inappropriately - leads to hypertension - leads to cardiovascular disease
115
What is a significant risk factor for kidney disease and cardiovascular disease?
Diabetes
116
What are causes of chronic kidney disease?
X hypertension - diabetes - high cholesterol - kidney infection - glomerulophritis - polycystic kidney disease - kidney stones - long term use of NSAIDS
117
what are symptoms of chronic kidney disease?
- hypertension - nausea - oedema in ankles hands and lungs - blood/protein in urine - amaemia - weak/painful bones
118
How can hypertension be regulated?
- diet reduced salt - anti-hypertensive treatment combinations - diuretics - ACE inhibitors / angiotensin receptor blockers - aldosterone agonists
119
What does furosemide target?
NKCC2 (sodium reabsorption )
120
What is the function of kidney dialysis?
- artificial removal of waste, solutes, water and toxins from blood
121
What are the two types of dialysis?
Haemodialysis Peritoneal dialysis
122
Describe haemodialysis?
Removing blood to cleaning blood and returning it back to the body
123
Describe peritoneal dialysis
In peritoneal cavity of abdomen (Can be done at home)

BDS1 BAMS human systems (47 decks)

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