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Foundations of Healthcare Science > The Renal System > Flashcards

The Renal System Flashcards

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1
Q

What are the functions of the kidneys?

A

-maintenance of homeostasis and formation of urine
-excretion of waste products and toxins
-regulation of electrolyte balance
-regulation of fluid balance
-regulation of acid: base balance
-produce renin- control blood pressure
-produce erythropoietin
-metabolism of vitamin D

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2
Q

What is the nephron?

A

This is the microscopic functional unit of the kidney.

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3
Q

What does a nephron consist of?

A

-glomerulus
-bowmans (glomerular capsule)
-proximal convoluted tubule
-nephron loop (loop of henle)
-distal convoluted tubule
-collecting duct

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4
Q

What are the 3 processes for the formation of urine?

A

Filtration, reabsorption and secretion.

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5
Q

What does the efferent arteriole do?

A

Takes plasma into the glomerulus (for filtration).

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6
Q

What does the efferent arteriole do?

A

Takes the molecules that can’t be filtered back into the plasma.

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7
Q

What are the 3 stages of filtration?

A

-Pores (fenestrations)
-filtration membrane
-podocytes (more pore like)

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8
Q

What is the stage of the pores for filtration?

A

Only small molecules can fit through the pores, larger molecules are sent back into the plasma.

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9
Q

What is the stage of the filtration membrane?

A

This membrane has a negative charge so anything other molecule with a negative charge will be sent back to the plasma as repelled (such as plasma protein).

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10
Q

What is the stage of the podocytes?

A

Any molecule that is big that managed to get through the first 2 stages are caught here and sent back into the plasma.

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11
Q

Why is filtration a selective process?

A

Only want certain molecules in the urine (keep the important ones in the body)

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12
Q

Where does filtration take place?

A

The glomerulus.

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13
Q

What is the glomerular filtration rate (GFR)?

A

The rate at which the kidney/ nephron filters the blood.

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14
Q

Where does the filtrate pass through?

A

The proximal convoluted tubule.

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15
Q

What does filtrate contain?

A

Everything except red and white blood cells, platelets and large proteins (albumin).

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16
Q

How many litres of urine is produced per day?

A

180 Litres.

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17
Q

What is net filtration pressure?

A

Sum of forces of:
-out (hydrostatic pressure in glomerular capillaries, efferent arteriole narrower than afferent)
-in (pressure in capsular space, colloid osmotic pressure in capillaries)

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18
Q

What value should the net outward force be?

A

10 mmHg.

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19
Q

How to calculate net filtration pressure?

A

Outward pressures- inward pressures.

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20
Q

What happens if the value of NFP shifts from 10mmHg?

A

The glomerulus has to adapt.

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21
Q

How does the glomerulus decrease pressure to shift NFP value?

A

If pressure is higher, afferent arteriole constricts so less blood enters and therefore reduces pressure.

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22
Q

How does the glomerulus increase pressure to shift NFP value?

A

If pressure is lower, afferent arteriole can dilate and also efferent can constrict so less blood leaves the glomerulus to increase pressure.

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23
Q

What is the meaning of tubular reabsorption?

A

Return of useful substances and water from the filtrate back into the blood.

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24
Q

What are some substances that are reabsorbed?

A

Na+, water, some ions and nutrients through osmosis, diffusion and facilitated diffusion.

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25
Q

What is Transport Maximum?

A

The maximum amount of a substance that can be reabsorbed (eg if glucose exceeds its Tm, it is lost in the urine).

26
Q

Where does reabsorption occur?

A

The proximal convoluted tubule.

27
Q

What influence does aldosterone have on reabsorption?

A

Influences in distal convoluted tubule (movement of Na+ and water).

28
Q

What influence does ADH have on reabsorption?

A

ADH affects the permeability of the collecting duct to water for example (reabsorb water to increase water loss).

29
Q

What is meant by tubular secretion?

A

Active removal of unwanted substances/ wastes from the blood into the filtrate.

30
Q

Where does tubular secretion occur?

A

All along the tubule (PCT mainly for K+, also in DCT for exchange for Na+).

31
Q

Why is tubular secretion important?

A

Important for regulating K+ and pH.

32
Q

What is the chemical composition of urine?

A

Water (95%), urea, Na+, K+, phosphate and sulphate, creatinine, uric acid.

33
Q

Where does creatinine come from?

A

From metabolism in muscle tissue.

34
Q

Where does uric acid come from?

A

From metabolism of nucleic acids.

35
Q

What is osmolality?

A

Number of solute particles in 1kg of water.

36
Q

What is osmolarity?

A

Number of solute particles in 1 litre of water.

37
Q

What is the vasa recta?

A

These are small vessels that maintain plasma concentration (highly permeable to water and solutes).

38
Q

In the nephron loop, is ascending or descending side more permeable to water?

A

Descending.

38
Q

In the nephron loop, is the ascending or descending more permeable to sodium?

A

Ascending.

39
Q

What is the function of the vasa recta?

A

-preserve the gradient
-able to reabsorb water and solutes into general circulation without undoing osmotic gradient.

40
Q

What is the function of the ADH hormone in the kidneys?

A

-affects permeability of the collecting duct
-ADH secretion from posterior pituitary is increased or decreased in response to osmolality (hypothalamus detects change, stimulates pituitary gland to release ADH to increase reabsorption and decrease urine production).

41
Q

What is the ideal value of osmolality?

A

300mosmol.

42
Q

What happens with an increase in ADH?

A

There is greater reabsorption- therefore less urine.

43
Q

What happens with a decrease in ADH?

A

There is less reabsorption therefore more urine (don’t want to dilute plasma).

44
Q

Which system is involved in blood pressure control?

A

RAAS.

45
Q

What is released in result of low pressure?

A

Renin.

46
Q

What is process after the release of renin to increase blood pressure?

A

-renin converts angiotensinogen into angiotensin 1 (inactive)
-angiotensin 1 converted to angiotensin 2 by ACE.

47
Q

What does angiotensin 2 cause?

A

-vasoconstriction of blood vessels
-release of aldosterone (sodium and water retention)
-influences ADH release.

48
Q

What happens to K+ levels when Na+ levels are increased (retained)?

A

K+ levels decrease (inhibitor)- more is secreted.

49
Q

How is acid base balance regulated?

A

Depends on the amount of H+ released and present in the blood.

50
Q

How is H+ produced?

A

A result of metabolism.

51
Q

What is the pH if more H+ in blood?

A

Lower pH (more acidic).

52
Q

What is the pH if more OH- in blood?

A

Higher pH (more alkaline).

53
Q

What is the process for H+ and HCO3- being eliminated?

A

These join to form H2CO3 which dissociate to CO2 and water (breathes out).

54
Q

What are the three mechanisms to maintain acid base balance?

A

-Buffers (acts as sponge to soak up H+ or OH-)- also insulin captures H+
-Respiratory system/lungs (H+ increase, RR increases and more H+ breathed out as CO2)
-Renal system (if pH falls, H+ secreted into urine, H+ combines with buffer, excreted into urine).

55
Q

What is the function of erythropoietin?

A

This is produced by the kidneys (stimulated by hypoxaemia), stimulates bone marrow to produce RBC.
Hb principal carrier of O2 to cells of body.

56
Q

How is levels of calcium controlled?

A

Through release of parathyroid hormone (PTH).

57
Q

What happens if Ca2+ is low?

A

PTH released, increased calcium reabsorption from kidneys, releases calcium from bones to maintain plasma calcium.

58
Q

What is the function of active vitamin D?

A

The kidneys convert vitamin D to the active form, stimulates reabsorption of calcium to maintain calcium levels.

59
Q

What is calcium needed for?

A

-strong bones and teeth
-normal transmission of nerve impulse
-normal muscle contraction
-blood clotting.

Foundations of Healthcare Science (21 decks)

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