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CSC1005 - Integrated Human Physiology > The Renal System > Flashcards

The Renal System Flashcards

1
Q

In general, how many kidneys do most humans have?

A

2

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2
Q

What are the functional units of the kidney?

A

Nephrons

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3
Q

What would you expect to find in your urine?

A
  • Sodium
  • Creatinine
  • Water
  • Urea
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4
Q

What is filtration?

A

Filteration of 200 L of blood daily

-Toxins, metabilic wastes and excess ion leaves the body in urine

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5
Q

What are the major functions of the kidney?

A

Filtration, excretion and regulation

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6
Q

What is secretion?

A

Hormones and foreign substances excrete blood

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7
Q

What does the kidney regulate?

A

Water, electrolytes and acids and bases

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8
Q

How does the kidney regulate the concentration of following ion in plasma?

A

Increasing or decreasing excretion in urine

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9
Q

What ions can be excreted via the kidney?

A

Na+, K+, Ca2+, Mg2+, Cl-, HCO3-, H+, PO4-2

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10
Q

What is the endocrine function of the kidney?

A
  • Long-term regulation of blood O2 carrying capacity
  • Long-term blood pressure regulation
  • Activation of vitamin D
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11
Q

How does the kidney endocrine function allow long-term regulation of blood O2 carrying capacity?

A

RBC production by bone marrow through erythropoietin (EPO) release

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12
Q

How does the kidney endocrine function allow long-term regulation of blood pressure?

A

Controlling water excretion which controls blood volume with the help of renin

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13
Q

How does the kidney endocrine function allow activation of vitamin D?

A

Parathyroid hormone (PTH) activates 1α-hydroxylase in the proximal tubule which vitamin D3 is activated

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14
Q

What does the renal system consist of?

A
  • Diaphragm
  • Kidney
  • Ureter
  • Bladder
  • Urethra
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15
Q

Which kidney is lower than another?

A

Right kidney is lower

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16
Q

Why is the right kidney lower than the left kidney?

A

As the liver is above it

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17
Q

What is above the left kidney?

A

Spleen

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18
Q

What is on top of both kidneys?

A

Adrenal gland

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19
Q

What is the adrenal gland responsible for?

A

Production of hormones e.g aldosterone

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20
Q

What is the kidney composed of?

A

vascular system and renal parenchyma

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21
Q

What makes up the vascular system and renal parenchyma in the kidney?

A

Renal artery
Renal vein
Renal nerves

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22
Q

What is the renal artery?

A

Supplies the kidney blood

Subdivides to form afferent arteriol

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23
Q

What is the renal vein?

A

Returns blood back into circulation

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24
Q

What is the renal nerves?

A

Innervated by sympathetic nervous system

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25
Q

What does the afferent arteriole supply?

A

Blood to each and all nephrons within the kidney

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26
Q

What are the three major regions in the kidney?

A
  • Renal cortex
  • Renal medulla
  • Renal pelvis
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27
Q

What is the renal pelvis?

A

Urine collected from major and minor calyxes to be directed towards ureter then the bladder

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28
Q

What does the renal cortex contain?

A

Renal corpuscles

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29
Q

What is the renal corpuscles?

A
  • Network of capillaries surrounded by mesangial cells and encapsulated by Bowmans capsule
  • Filtrated collected and directed to proximal tubule
  • Distal tubule meets with afferent and efferent arterioles
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30
Q

What occurs in renal cortex?

A

Filtration

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31
Q

What occurs in renal medulla?

A

Concentration of urine

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32
Q

What does the nephron contain?

A
  • Afferent arteriole
  • Bowmans capsule
  • Glomerulus
  • Efferent arterioles
  • Proximal convoluted tubule
  • Peritubular capillaries
  • Distal convoluted tubule
  • Collecting duct
  • Loop of Henle
  • Vasa recta
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33
Q

What does each nephron has it own supply of?

A

Blood

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34
Q

What is the order of contents of the nephron?

A
  • Afferent arteriole
  • Bowmans capsule (Peritubular capillaries)
  • Efferent arterioles
  • Proximal convoluted tubule
  • Distal convoluted tubule
  • Loop of Henle
  • Collecting duct
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35
Q

How does the blood supply the nephron?

A
  • Blood enters through afferent arterioles
  • Subdivides into capillaries where filtration occurs
  • Come back together to form efferent arterioles
  • Further subdivided in to peritubular capillaries
  • Specialised vasa recta
  • Joins back together and takes blood back to circulation via renal vein
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36
Q

What are Bowmans capsule surrounded by?

A

Network of capillaries

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37
Q

How many nephrons are there in the kidney?

A

1,00,000

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38
Q

What are the two types of nephrons?

A

Cortical nephron

Juxtamedullary nephrons

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39
Q

What % of neurones is cortical nephron?

A

80%

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40
Q

What % of neurones is juxtamedullary nephron?

A

20%

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41
Q

What are the features of a cortical nephron?

A
  • Glomeruli located towards surface of kidney

- Penetrate very little of medulla

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42
Q

Why is glomeruli located towards surface of kidney in a cortical nephron?

A

Due to arcuate artery extending renal pyramid to external cortex

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43
Q

What are the features of juxtamedullar nephron?

A

Glomeruli located towards medulla deeply

44
Q

What is the difference from the cortex to the medulla?

A

Hypertonicity (how salty) increases from cortex to medulla

45
Q

What facilitates filtration?

A

High pressure

46
Q

What are the four fundamental mechanisms of the nephron?

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Excretion
47
Q

What is the equation for excretion?

A

Excretion = filtration - reabsorption + secretion

48
Q

Describe the filtration within renal corpuscle:

A
  • High pressure from difference of size in diameter of afferent and efferent arterioles allow passive filtration
  • Blood enters through afferent arterioles to subdivide into capillary network to leave via efferent arterial
49
Q

What are blood vessels surrounded by?

A

Podocyte and renal nerves

50
Q

What are macula densa?

A
  • Modified distal tubule cells

- Chemoreceptors

51
Q

What are juxtaglomerular cells?

A
  • Specialised smooth muscle cells
  • Renin secretion
  • Mechanoreceptors
52
Q

What is contained in the glomerus filtrate?

A

Water, glucose, amino acids and urea

53
Q

What is the filtration membrane of the glomerulus?

A
  • Capillary endothelial fenestration (prevents large proteins from entering bowman space)
  • Gel-like basement membrane (negatively charged so repels proteins)
  • Slit diaphragm
54
Q

What is the glomerular filtration rate?

A

Amount of filtrate that forms in both kidneys per minute

55
Q

What is the average glomerular filtration rate in adult females?

A

105ml/min

56
Q

What is the average glomerular filtration rate in adult males?

A

125ml/min

57
Q

How much of the cardiac out is directed towards the kidneys?

A

22%

58
Q

What is the daily volume of filtrate passing into nephrons in female?

A

150L

59
Q

What is the daily volume of filtrate passing into nephrons in male?

A

180L

60
Q

Why is it important for maintaining the glomerular filtration rate?

A
  • Precise regulation of blood fluid volumes and solute concentration
  • Excretion of waste products
61
Q

Why is glomerular filtration rate closely maintained?

A

If too high: filtrate will pass through tubules too quickly and cannot be reabsorbed
If too low: waste products are not excreted

62
Q

What could happen if glomerular filtration rate is too low?

A

Chronic renal failure

63
Q

How is glomerular filtration controlled?

A

By action of sympathetic nervous system, hormones and intrinsic mechanisms

64
Q

What volume of urine does a healthy person produce in a typical day?

A

1.5-1.8 litre

65
Q

What is filtration coefficient?

A

Surface area available for filtration

Filtration membrane permeability

66
Q

What is net filtration pressure?

A

Cumulative pressure responsible for filtrate formation

67
Q

Why is the pressure high in glomerulus ?

A
  • Arterioles have high resistance
  • Afferent diameter > efferent diameter
  • Fluids and solutes forced out of blood
68
Q

What does changes in glomerular filtration rate change?

A

Glomerular blood pressure

69
Q

What is the equation for net filtration pressure?

A

Net filtration pressure = outward pressure - inward pressure

70
Q

What happens to the glomerular filtration rate if afferent arteriole constricts?

A

Decrease in glomerular filtration rate

71
Q

What happens to the glomerular filtration rate if efferent arteriole constricts?

A

Increase in glomerular filtration rate

72
Q

What happens to the glomerular filtration rate if efferent arteriole dilation?

A

Decrease in glomerular filtration rate

73
Q

What happens to the glomerular filtration rate if afferent arteriole dilation?

A

Increase in glomerular filtration rate

74
Q

What is renal auto regulation?

A

Act locally to maintain glomerular filtration rate constant

75
Q

How does renal auto regulation work?

A
  • Myogenic

- Tubuloglomerular feedback

76
Q

What is an intrinsic controls of glomerular filtration rate?

A

Renal autoregulation

77
Q

How does myogenic regulate glomerular filtration rate?

A

Constriction/dilation of afferent article in response to changes in blood pressure

78
Q

How does tubuloglomerular feedback regulate glomerular filtration rate?

A

Contraction/dilation of afferent arteriole in response to changes in NaCl in the distal tubule (renin and adenosine)

79
Q

What are extrinsic controls of glomerular filtration rate?

A
  • Hormonal regulation

- Autonomic regulation

80
Q

When does extrinsic controls take over to maintain glomerular filtration rate?

A

If systematic blood pressure is <80 or >180

81
Q

What would happen to the glomerular filtration rate if a person suffered from severe malnutrition?

A

increase

82
Q

What happens in an increase in blood pressure?

A
  • Afferent arterioles contrics
  • Glomerular capillary blood pressure decreases
  • Net filtration pressure decreases
  • Glomerular filtration rate decreases
83
Q

What happens in a decrease in blood pressure?

A
  • Afferent arterioles dilates
  • Glomerular capillary blood pressure increases
  • Net filtration pressure increases
  • Glomerular filtration rate increases
84
Q

Where does most of water, electrolytes and nutrients filtered get reabsorbed?

A

Proximal tubule

85
Q

How much water is reabsorbed is reabsorbed in the proximal tubule?

A

65%

86
Q

What essential nutrients are reabsorbed back into the blood within the proximal tubule?

A

Water, glucose, amino acids and electrolytes

87
Q

What does reabsorption in the proximal tubule rely on?

A

Secondary active transport of Na+ across the apical membrane powered by basolateral Na+/K+ ATPase pumps

88
Q

Is the descending loop permeable or impermeable to water?

A

Permeable to water

89
Q

Is the ascending loop permeable or impermeable to water?

A

Impermeable

90
Q

How does reabsorbing occur in the loop of Henle?

A
  • Water reabsorbed by osmosis along descending loop
  • Na+ is actively reabsorbed along ascending loop by Na+/K+/2Cl-/ cotransportes (powered by basolateral Na+/K+ ATPase pumps)
  • Smaller volume of dilute filtrate leaving the loop of Henle and entering the distal tubule
91
Q

What gradient does the long loop of Henle in juxtamedullary nephrons establish in the renal medulla?

A

Vertical osmotic gradient

92
Q

Why is it important for the juxtamedullary nephrons to establish a vertical osmotic gradient?

A
  • Allows extra water reabsorption from collecting duct into salty environment of inner medulla when needed
  • Water to be conserved during states of dehydration
93
Q

What controls the vertical osmotic gradient?

A

Anti-diuretic hormone (ADH)

94
Q

How does reabsorption occur in distal tubule and collecting duct?

A
  • Aldosterone = binds to receptors on the distal tubule and collecting duct to promote Na+ and water reabsorption and K+ secretion
  • Anti-diuretic hormone = binds to receptors on the collecting duct to promote water reabsorption through aquaporins
95
Q

What happens if over hydration of water?

A
  • No water conversation required
  • No ADH released from posterior pituitary
  • Large volume of dilute urine
96
Q

What happens if dehydration of water?

A
  • Water conversation required
  • ADH release from posterior pituitary
  • Small volume of concentrated urine
97
Q

What is the role of the kidney in long-term blood pressure regulation?

A
  • Juxtaglomerular apparatus

- Tubuloglomerular feedback

98
Q

How does the juxtaglomerular apparatus help in long-term blood pressure regulation?

A
  • Monitors and responds to a fall in blood pressure and GFR

- Decrease in filtered Na+ by activating renin-angiotensin-aldosterone system (RAAS)

99
Q

How does tubuloglomerular feedback help in long-term blood pressure regulation?

A

Adjusts afferent article diameter which affects the glomerular filtration rate

100
Q

Describe the renin-angiotensin-aldosterone system (RAAS) when the blood pressure decreases:

A
  • Juxtaglomerular apparatus senses decreases
  • Renin is released from juxtaglomerular cells
  • Renin cleaves to angiotesinogen to angiotensin I
  • Converted to angiotensin II (occurs with help my angiotensin converting enzyme)
  • Promotes constriction of blood vessels
  • Acts on adrenal gland to release aldosterone (increase in Na+ and H2O reabsorption into blood from distal tubule and collecting duct –> increases blood volume
  • Blood pressure increases
101
Q

What does ADH target within the nephron?

A

Collecting duct

102
Q

What does aldosterone target within the nephron?

A

Distal tubule and collecting duct

103
Q

What does atrial natriuretic peptide target within the nephron?

A

Glomerulus, distal tubule and collecting duct

104
Q

What is the mechanism of ADH?

A

Increase insertion of aquaporins, to promote the reabsorption of water

105
Q

What is the mechanism of aldosterone?

A

Enhances activation of Na+ transports to increase reabsorption of Na+ and water
Increases secretion of K+ ion

106
Q

What is the mechanism of atrial natriuretic peptide?

A

Increases GFR by promoting vasodilation of the afferent arteriole; opposes the action of aldosterone and ADH

CSC1005 - Integrated Human Physiology (18 decks)

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