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Science for Paramedics > The renal system > Flashcards

The renal system Flashcards

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Biology 101 flashcards
1
Q

Where are the kidneys located?

A

In the retro-peritoneal cavity extending from T12-L3

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2
Q

Which kidney is slightly higher?

A

The left

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3
Q

What is the functional unit of the kidney?

A

The nephron

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4
Q

What is the structure of the kidney?

A

8-10 conical renal medullas separated and encased by the renal cortex. All encapsulated by the renal capsule, a protective layer of adipose tissue

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5
Q

What are the renal calyces?

A

Cup like projections of the renal pelvis that collect urine, sat at the base of the renal medullas.
Grouped into minor and major

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6
Q

What is the renal pelvis?

A

A large cavity containing major and minor calyces, blood vessels, nerves and adipose tissue

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7
Q

Which parts of the nephron sit in the renal cortex?

A

The glomerulus, bowmans capsule and convoluted tubes

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8
Q

Which parts of the nephron are in the renal medulla?

A

The loops of Henle

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9
Q

What proportion of cardiac output do the kidneys receive?

A

20-25% (≈1200ml/min in adults)

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10
Q

What blood vessels supply the kidneys?

A

Renal artery
Segmental artery
Interloblar arteries
Arcuate arteries
Interlobular arteries
Afferent arterioles

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11
Q

What is the vein structure of the kidneys?

A

Interlobular veins
Arcuate veins
Interlobar veins
Segmental veins
Renal vein

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12
Q

What layers line the glomerulus side of the bowmans capsule?

A

Negatively charged basement membrane
Visceral layer of epithelial podocytes and pedicels

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13
Q

What forms the slit diaphragm of the nephrons?

A

Podocytes linked with nephrin

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14
Q

What forms the renal corpuscle?

A

The glomerulus and the bowmans capsule

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15
Q

What is filtered in the renal corpuscle?

A

Blood plasma

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16
Q

What constitutes the renal tubules?

A

Proximal convoluted tubules
Loop of Henle
Distal convoluted tubules

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17
Q

What constitutes the loop of Henle?

A

Descending and ascending limb

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18
Q

What’s the difference between cortical and juxtamedullary nephrons?

A

Cortical nephrons have a loop of Henle lying mainly within the cortex
Juxtamedullary nephrons have a loop Henle extending deep into the medulla

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19
Q

What percentage of nephrons are cortical?

A

80-85%

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20
Q

What blood vessels supply cortical nephrons?

A

Peritubular capillaries

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21
Q

What blood vessels supply juxtamedullary nephrons?

A

The vasa recta

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22
Q

What are the functions of the kidney?

A

A WET BED

Acid base balance
Water balance
Electrolyte balance
Toxin removal
Blood pressure control
Erythropoietin production
D (Vitamin D synthesis)

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23
Q

How do the kidneys regulate acid base balance?

A

Excreting hydrogen ions (H+) in the urine
Conserving bicarbonate ions (HC03-) in the blood

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24
Q

How do the kidneys regulate water balance?

A

Separately regulating loss of water and solutes in urine

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25
Q

How do the kidneys maintain electrolyte balance?

A

Regulating reabsorption of blood ionic compounds.

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26
Q

How do the kidneys excrete waste and foreign substances?

A

Excreting them in urine

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27
Q

How do the kidneys regulate blood pressure?

A

Excreting renin

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28
Q

How do the kidneys contribute to erythropoesis?

A

Excreting erythropoietin

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29
Q

Where is vitamin D metabolised?

A

Kidneys and the liver

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30
Q

What 3 processes lead to the final production of glomerular filtrate?

A

Glomerular filtration
Tubular reabsorption
Tubular secretion

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31
Q

What three pressures contribute to glomerular filtration?

A

Glomerular blood hydrostatic pressure
Capsular hydrostatic pressure
Blood colloid osmotic pressure

32
Q

What is usual glomerulus net filtration pressure?

A

10mmHg

33
Q

What is glomerular blood hydrostatic pressure?

A

The blood pressure in the glomerular capillaries ≈ 55mmHg

34
Q

What is capsular hydrostatic pressure?

A

Pressure exerted by the fluid already in the bowmans capsule and renal tubes back against filtration ≈ 15mmHg

35
Q

What is blood colloid osmotic pressure?

A

The pressure difference created due to plasma proteins being present in blood ≈30mmHg

36
Q

What is a healthy glomerular filtration rate?

A

125ml/min

37
Q

Why are substances like amino acids and glucose not usually present in urine?

A

They are usually completely reabsorbed, unless present in the blood in excessive amounts

38
Q

Which substances are not reabsorbed in the nephrons?

A

Substances that are not normal blood constituents i.e. waste

39
Q

What is tubular reabsorption?

A

Transfer of substances from the renal tubules to the peritubular capillaries

40
Q

What is tubular secretion?

A

Transfer of substances from the peritubular capillaries back to the renal tubes

41
Q

Why may certain materials not be cleared from the blood via glomerular filtration?

A

Because of the short time blood remains in the glomerulus

42
Q

Is tubular reabsorption a passive or active process?

A

Passive

43
Q

Is tubular secretion a passive or active process?

A

Both passive and active

44
Q

What are diuretics?

A

Substances that cause the kidneys to produce more urine

45
Q

What is diuresis?

A

Increased or excessive production of urine

46
Q

What is anti diuretic hormone?

A

A hormone that decreases the production of urine

47
Q

How does anti diuretic hormone work?

A

It increases the permeability of the distal convoluted tubules and collecting tubules, increasing water reabsorption

48
Q

Where is ADH secreted?

A

The posterior lobe of the pituitary gland

49
Q

What cells release renin?

A

The juxtaglomerular cells located in the kidney

50
Q

Where is angiotensin converting enzyme produced?

A

The lungs

51
Q

What does angiotensin converting enzyme do?

A

Converts angiotensin 1 to angiotensin 2

52
Q

What does angiotensin 2 do?

A

It is a generalised vasoconstrictor which increases blood pressure and stimulates the adrenal glands to release aldosterone

53
Q

What does aldosterone do?

A

Increases sodium and water reabsorption and potassium excretion

54
Q

When is atrial natriuretic peptide released?

A

In response to stretching of the atrial wall

55
Q

What is the action of atrial natriuretic peptide?

A

Dilates the afferent arteriole of the glomerulus leading to increased blood flow and filtration.
It also suppresses reabsorption of Na+ in the collecting duct and other segments of the nephron

56
Q

Where is calcitonin released?

A

The thyroid gland

57
Q

When is calcitonin released?

A

When the calcium levels in the blood rise above a set point

58
Q

What does calcitonin do?

A

Reduces blood calcium levels in the blood

59
Q

How does calcitonin work?

A

It inhibits osteoclast activity and decreases calcium re-absorption in the kidneys

60
Q

When is parathyroid hormone released?

A

When blood calcium levels fall below a set point

61
Q

How does parathyroid hormone work?

A

Stimulates release of calcium from bone tissue by enhancing osteoblast activity
Reduces secretion of calcium in the kidneys
Stimulates production of active vitamin D
Increases calcium absorption from food in the intestine through its effects on vitamin D metabolism

62
Q

What is the usual length of ureters?

A

25-30cm

63
Q

What is the usual diameter of ureters?

A

3mm

64
Q

How is backflow of urine to the kidneys prevented?

A

When the bladder fills the pressure closes the ureters

65
Q

What is the structure of the walls of the ureter?

A

An outer layer of fibrous tissue
A middle muscular layer consisting interlacing smooth muscle fibres
An inner layer of mucosa consisting of transitional epithelium

66
Q

What propels urine through the ureters?

A

Peristalsis of the smooth muscle along the ureter

67
Q

What is the average bladder capacity of the bladder?

A

700-800ml

68
Q

What is the structure of the bladder wall?

A

An outer layer of loose connective tissue containing blood and lymphatic vessels and nerves
A middle later consisting of smooth muscle and elastic tissue
An inner layer of transitional epithelium

69
Q

What controls the outflow of urine from the bladder?

A

Internal urethral sphincter

70
Q

What is the structure of the urethra wall?

A

An inner layer of mucosa with smooth muscle fibres (involuntary control) and an outer layer of striated muscle (voluntary control)

71
Q

What are the specialised epithelial cells that cover the glomerular capillaries called?

A

Podocytes

72
Q

What are pedicels?

A

Foot like projections that come off of podocytes

73
Q

What do the distal convoluted tubes drain in to?

A

Collecting ducts

74
Q

What is the path of renal urine drainage?

A

Collecting duct
Papillary duct
Minor calyx
Major calyx
Renal pelvis
Ureter
Urinary bladder

75
Q

What percentage of filtered calcium is reabsorbed?

A

Over 95%

76
Q

Atrial natriuretic peptide affects the reabsorption of which electrolyte?

A

Na+

Science for Paramedics (18 decks)

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