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Physio Exam 3 > Topic 1 Part B > Flashcards

Topic 1 Part B Flashcards

1
Q

Reabsorption – Proximal Tubule
__% of filtered load of sodium & water reabsorbed
-Cells of proximal tubule designed for ___ reabsorption capacity of ____ and ____

A

65% of filtered load of sodium & water reabsorbed

-Cells of proximal tubule designed for high reabsorption capacity of sodium and water

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2
Q

Reabsorption – Proximal Tubule
Little less percentage for _____
-Quantity can be __________

A

Little less percentage for chloride

-Quantity can be increased or decreased as needed

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3
Q

Proximal Tubule Cellular Ultrastructure

Contain large number of mitochondria to support

A

extensive active transport activity

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4
Q

Proximal Tubule Cellular Ultrastructure

Luminal (apical) brush border provides

A

huge surface area for rapid diffusion

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5
Q

Proximal Tubule Cellular Ultrastructure

Basolateral border contains

A

extensive number channels in between cells providing huge surface area

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6
Q

Proximal Tubule Cellular Ultrastructure
Luminal border contains extensive number of _____
-Co-transport of ______ and ______
-Counter-transport of ______ (move a large quantity of them against a small ________)

A

Luminal border contains extensive number of protein carrier molecules

  • Co-transport of amino acids and glucose
  • Counter-transport of hydrogen ions (move a large quantity of hydrogen ions against small hydrogen ion gradient
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7
Q

Proximal Tubule Cellular Ultrastructure

Basolateral border contains extensive amount of ____

A

N-K ATPase

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8
Q

Early vs. Late Proximal Reabsorption
First half of tubule:
Extensive co-transport of sodium with

A

glucose and amino acids

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9
Q

Early vs. Late Proximal Reabsorption
First half of tubule:
Sodium reabsorption carries ____, ____, ____ ions leaving _____ resulting in increasing [Cl-]
–____ mEq/L increases to _____ mEq/L

A

Sodium reabsorption carries glucose, bicarb, organic ions leaving chloride resulting in increasing [Cl-]
105 mEq/L increases to 140 mEq/L

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10
Q

Early vs. Late Proximal Reabsorption
Second half of tubule:
High chloride concentration favors _______
-Some movement may occur through specific ______

A

High chloride concentration favors chloride diffusion

-Some movement may occur through specific chloride channels

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11
Q

Early vs. Late Proximal Reabsorption
Second half of tubule:
Most ____ & _____ have been reabsorbed – ____ reabsorption drives _____ reabsorption
-_______ gradient

A

Most glucose & amino acids have been reabsorbed – sodium reabsorption drives chloride reabsorption
-Electrochemical gradient

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12
Q

Changes in Solute Concentrations

Total _____ of sodium in tubule changes but ____ does not change because ____ reabsorption matches sodium reabsorption

A

Total quantity of sodium in tubule changes but concentration does not change because water reabsorption matches sodium reabsorption

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13
Q

Changes in Solute Concentrations
Total osmolarity does not change for the same reason as sodium
-Proximal tubule _____ permeable to _____

A

Proximal tubule highly permeable to water

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14
Q

Changes in Solute Concentrations

____ & _____ concentrations decrease due to extensive ________

A

Glucose & amino acid concentrations decrease due to extensive reabsorption

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15
Q

Changes in Solute Concentrations
_____ & _____ are concentrated because they are not _______
Total amount of creatinine and urea in tubule does not ____

A

Creatinine & Urea are concentrated because they are not reabsorbed
Total amount of creatinine and urea in tubule does not change

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16
Q

Changes in Solute Concentrations

Total amount of Na+, Cl-, HCO3-, glucose, amino acids in tubule _______

A

decrease

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17
Q

Secretion of Organic Acids & Bases

Many end products of metabolism are secreted by proximal tubule (4)

A

Bile salts
Oxalate
Urate
Various catecholamines

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18
Q

Secretion of Organic Acids & Bases

Many drugs & toxins secreted (2)

A

Penicillin

Salicylates

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19
Q

Secretion of Organic Acids & Bases
Para-aminohippuric acid also secreted-
___% of PAH in renal blood flow is removed
Can be used to determine ____

A

90% of PAH in renal blood flow is removed

Can be used to determine renal blood flow

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20
Q

describe the Thin Descending & Ascending Segment of the Loop of Henle (4)

A

Thin epithelial membrane
No brush border
Few mitochondria
Minimal metabolic level

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21
Q

Thin Descending Segment of the Loop:
_____ permeable to water
_____ permeable to most solute

A

Highly permeable to water

Moderately permeable to most solute

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22
Q

Thin Descending Segment of the Loop:
Allows diffusion of water and solutes: No active ____
___% of water reabsorption occurs in the loop of Henle

A

Allows diffusion of water and solutes: No active reabsorption
20% of water reabsorption occurs in the loop of Henle

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23
Q

Thin Ascending Segment of the Loop:
_______ to water
-Part of mechanism for _______

A

impermeable to water

-Part of mechanism for concentrating urine

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24
Q

Thick Ascending Segment

____ epithelial cells with high concentration of _______- High level of _______ activity

A

Thick epithelial cells with high concentration of mitochondria- High level of metabolic activity

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25
Q

Thick Ascending Segment

Able to reabsorb (6)

A 
sodium
chloride
potassium (Approx 25% of filtered load)
calcium
bicarb
magnesium
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26
Q

Thick Ascending Segment
_______ to water
As solute reabsorb ______ concentrations drop especially since water ____ reabsorbed – Fluid very ___

A
  • Impermeable to water

- As solute reabsorb luminal solute concentrations drop especially since water NOT reabsorbed – Fluid very dilute

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27
Q

Sodium Reabsorption

Driven by _____ in ______ border of tubule cells

A

Driven by N-K ATPase in basolateral border of tubule cells

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28
Q

Sodium Reabsorption: how many transport mechanisms move sodium from tubular lumen

A

2 total
1 Na-2Cl-1K co-transport mechanism
Na-H counter-transport mechanism

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29
Q

Sodium Reabsorption
1 Na-2Cl-1K co-transport mechanism=
1. _____ means of moving sodium out of ____ into ____ cells
2. Potassium reabsorbed _____ potassium concentration gradient
3. Cl- & K+ diffuse out of cell into _______ via specific _______

A
  1. Primary means of moving sodium out of lumen into tubular cells
  2. Potassium reabsorbed AGAINST potassium concentration gradient
  3. Cl- & K+ diffuse out of cell into renal interstitial fluid via specific ion channels
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30
Q

Loop diuretics (furosemide, ethacrynic acid, bumetanide) inhibit the action of the

A

1Na-2Cl-1K co-transport mechanism

31
Q

Loop Diuretics:

Less sodium reabsorption – less water reabsorption in

A

later segments of the nephron

32
Q

Loop Diuretics:

Less sodium reabsorption – less potassium reabsorption with potential

A

loss of potassium

33
Q

Na-Cl-K co-transport mechanism is isoelectric BUT K is able to diffuse back into lumen via potassium channels creating

A

+8 mV positive charge in tubule lumen

34
Q

Electrical gradient drives diffusion of Na+, K+, Mg++ & Ca++ into the ________ via the tight junctions (paracellular diffusion)

A

renal interstitial space

35
Q

Early Distal Tubule
Macula densa forms ______
-Part of _______ complex
-Provides feedback control for ____ and_____

A

Macula densa forms first part of tubule

  • Part of juxtaglomerular complex
  • Provides feedback control for GFR and blood flow (for this nephron)
36
Q

Early Distal Tubule
Next segment is the _______
-____ reabsorption – no _____ reabsorption
-_______ segment of distal tubule

A

Next segment is the high convoluted

  • Solute reabsorption – no water reabsorption
  • Diluting segment of distal tubule
37
Q

Early Distal Tubule

___% of filtered load for sodium & chloride reabsorbed

A

5%

38
Q

Early Distal Tubule

Driven by ____ in _______ border of tubular cells

A

Driven by Na-K ATPase in basolateral border of tubular cells

39
Q

Early Distal Tubule
Na-Cl co-transport mechanism moves Na+ and Cl- _____
–Chloride _____ out of cell via ______

A

Na-Cl co-transport mechanism moves Na+ and Cl- into cell down [Na+]
–Chloride diffuses out of cell via chloride specific channels

40
Q

Early Distal Tubule
Thiazide diuretics inhibit this _______ mechanism
-Reduces sodium and chloride ______ and ultimately water reabsorption in _____segments of nephron

A

Thiazide diuretics inhibit this Na-Cl co-transport mechanism

-Reduces sodium and chloride reabsorption and ultimately water reabsorption in later segments of nephron

41
Q

Functional Characteristics – Late Distal Tubule & Cortical Collecting Tubule:
Membranes _______ to urea
-All urea entering exits to _______ to be excreted
-Some reabsorption of urea will occur in ______

A

Membranes impermeable to urea

  • All urea entering exits to collecting duct to be excreted
  • Some reabsorption of urea will occur in medullary collecting ducts
42
Q

Functional Characteristics – Late Distal Tubule & Cortical Collecting Tubule:
Sodium reabsorption controlled by various hormones but especially by

A

aldosterone

43
Q

Functional Characteristics – Late Distal Tubule & Cortical Collecting Tubule:
Potassium secretion controlled by various hormones but especially by

A

aldosterone

44
Q

Functional Characteristics – Late Distal Tubule & Cortical Collecting Tubule:

  • Able to secrete _____ ions against large concentration gradient of _____
  • Proximal tubule moves hydrogen ions against ____ gradient of _____
A
  • Able to secrete hydrogen ions against large concentration gradient (1000:1)
  • Proximal tubule moves hydrogen ions against small gradient (4 to 10:1)
45
Q

Functional Characteristics – Late Distal Tubule & Cortical Collecting Tubule:
Water permeability controlled by concentration of _____
-No ADH - no ____ permeability – excrete ____ urine
-Increased concentrations of ADH increase permeability of ____ and decrease the volume of ____and increase the ________ of the urine

A

Water permeability controlled by concentration of antidiuretic hormone (ADH, aka vasopressin)

  • No ADH - no water permeability – excrete dilute urine
  • Increased concentrations of ADH increase permeability of water and decrease the volume of urine and increase the concentration of the urine
46
Q

Late Distal Tubule & Cortical Collecting Tubule

two types of cells

A

Principal cells

Intercalated cells

47
Q

Late Distal Tubule & Cortical Collecting Tubule

principal cells=

A

Reabsorb sodium & water

Secrete potassium

48
Q

Late Distal Tubule & Cortical Collecting Tubule

intercalated cells=

A

Reabsorb potassium

Secrete hydrogen

49
Q

Principal Cell Activity

_____ in _____ borders of tubule cells drives activity

A

Na-K ATPase in basolateral

50
Q

Principal Cell Activity

Sodium follows _______ gradient – _____ through sodium specific channels

A

Sodium follows concentration gradient – diffuses through sodium specific channels

51
Q

Principal Cell Activity

Potassium follows ______ gradient out of cell into _______ via potassium specific channels

A

Potassium follows concentration gradient out of cell into tubular lumen via potassium specific channels

52
Q

Potassium Sparing Diuretics (Aldosterone antagonists):

What type of antagonist

A

Mineralocorticoid receptor

53
Q

Potassium Sparing Diuretics (Aldosterone antagonists)

Compete with aldosterone receptor sites which inhibits

A

sodium reabsorption & potassium secretion

54
Q

Potassium Sparing Diuretics (Aldosterone antagonists) drug names

A

Spironolactone & eplerenone

55
Q

Potassium Sparing Diuretics (Sodium Channel Blockers)

Inhibit entry of sodium into cell which reduces amount of

A

sodium transported by Na-K ATPase

56
Q

Potassium Sparing Diuretics (Sodium Channel Blockers)

reduces secretion of potassium as action of Na-K ATPase

A

decreases

57
Q

Potassium Sparing Diuretics (Sodium Channel Blockers):

drug names

A

Amiloride & triamterene

58
Q

Intercalated Cell Activity – Hydrogen Ions:

Secretion controlled by

A

H-ATPase transporter

59
Q

Intercalated Cell Activity – Hydrogen Ions:

Presence of carbonic anhydrase allows conversion of

A

CO2 and H2O to hydrogen ions and bicarb ions

60
Q

Intercalated Cell Activity – Hydrogen Ions:

Chloride also secreted following

A

electrochemical gradient

61
Q

Intercalated Cell Activity – Hydrogen Ions:

Bicarb reabsorbed using Cl-HCO3- counter-transport mechanism following the

A

Cl- gradient into the cell

62
Q

Intercalated Cell Activity – Hydrogen Ions:

  • _____moved freely between cell and interstitial fluid
  • ______ is also reabsorbed
A
  • CO2 moved freely between cell and interstitial fluid

- Potassium is also reabsorbed

63
Q

Meduallary Collecting Ducts:

Reabsorb ___% of filtered water and sodium

A

<10%

64
Q

Meduallary Collecting Ducts:

Determine final concentration of

A

solutes and urine concentration

65
Q

Meduallary Collecting Ducts:

Epithelial cells smooth with few

A

mitochondria

66
Q

Meduallary Collecting Ducts:

Water permeability controlled by

A

ADH

67
Q

Meduallary Collecting Ducts:

Urea is reabsorbed via specific urea transporters which moves urea into the

A

interstitial spaces thus affecting osmolarity

68
Q

Meduallary Collecting Ducts:

Secretes

A

hydrogen ions (like cortical collecting tubule)

69
Q

Solute Concentrations:

Change in solute concentration depends on rate of

A

reabsorption (secretion) versus rate of water reabsorption

70
Q

Solute Concentrations:

Y-axis: Ratio of

A

[tubular] / [plasma]

71
Q

Solute Concentrations:

Items highly concentrated are

A

not needed by body

72
Q

Solute Concentrations:

Inulin neither secreted or reabsorbed provides indication of

A

water reabsorption

73
Q

Solute Concentrations:

  • Inulin conc of 3 means that
  • Inulin conc of 125 means that
A
  • Inulin conc of 3 means that 1/3 of water remains in tubule (2/3 has been reabsorbed)
  • Inulin conc of 125 means 1/125 of water remains while 124/125 has been reabsorbed

Physio Exam 3 (6 decks)

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