Urine formation Flashcards

1
Q

What are the 3 steps of urine formation?

A
  1. Glomerular filtration
  2. Tubular reabsorption
  3. Tubular secretion
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2
Q

What is formed by glomerular filtration?

A

Primary urine

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3
Q

Is glomerular filtration selective?

A

No, everything gets filtered

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4
Q

When does the primary urine become urine?

A

After reabsorption and secretion

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5
Q

What are the 4 ways the kidneys maximize filtration?

A
  1. Large surface area
  2. Permeability
  3. Receive higher than normal blood flow
  4. Have higher than normal blood pressure that comes into the kidneys
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6
Q

How much of the plasma that enters the glomerulus is actually filtered?

A

20%

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7
Q

What are the 2 regions of the nephron?

A

Renal corpuscle and renal tubule

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8
Q

What does the renal corpuscle do?

A

Includes the glomerulus and Bowman’s capsule. Does the glomerular filtration

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9
Q

What does the renal tubule do?

A

Includes the proximal and distal tubules and the loop of Henle. Does reabsorption and secretion

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10
Q

What is the structure of the glomerulus?

A

A twisted ball of specialized capillaries that are covered by podocytes, with mesangial cells in between the capillaries

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11
Q

What are mesangial cells?

A

Loosely connected endothelial cells around the podocytes

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12
Q

What are podocytes?

A

Specialized epithelial cells that cover the outside of the capillaries, with foot processes that interact with the basement membrane and form filtration slits

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13
Q

Why are podocytes important for determining what gets filtered out of the blood during glomerular filtration?

A

The foot processes keep red blood cells and proteins inside the blood vessel, so they don’t escape

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14
Q

What are the 3 components of primary urine?

A
  1. Water
  2. Inorganic ions
  3. Small organic molecules (glucose, amino acids, urea)
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15
Q

Why is fluid driven from the glomerulus to the Bowman’s capsule?

A

Bulk flow. There is high pressure in the glomerulus and low pressure in the Bowman’s capsule

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16
Q

What are the 3 pressures that net glomerular filtration depends on?

A

Hydrostatic pressure exerted by the glomerular capillaries (60 mmHg)
Hydrostatic pressure exerted by the lumen of the Bowman’s capsule (15 mmHg)
Oncontic pressure

17
Q

Which pressure force favours the movement of fluid into the Bowman’s capsule lumen?

A

Glomerular capillary hydrostatic pressure

18
Q

Which pressure forces resist the movement of fluid into the Bowman’s capsule lumen?

A

Bowman’s capsule hydrostatic pressure and oncotic pressure

19
Q

What is oncotic pressure?

A

The colloid osmotic pressure created by the high concentration of proteins in the plasma

20
Q

What is the net filtration pressure?

A

Difference between the pressure forces that favour inwards movement (glomerular capillaries hydrostatic) and pressure forces that favour outward movement (Bowman’s capsule hydrostatic and oncotic). 60 - 30 - 15 = 15 mmHg

21
Q

Is the primary urine hypo, iso, or hyperosmotic to the blood?

22
Q

What is GFR? What is normal?

A

The glomerular filtration rate. Measures the rate of primary urine formation and is a very important indicator of kidney function. Normal GFR is 120 ml/min

23
Q

What was the way we used to measure GFR?

A

Inject the patient with inulin and then measure the amount of inulin in the patient’s urine after 24 hours

24
Q

Why was inulin a good way to directly measure GFR?

A

It isn’t reabsorbed or secreted after the Bowman’s capsule. So the amount of inulin in the urine equals GFR

25
What changes in the kidney would change the GFR?
Blood flow, blood pressure, permeability
26
How is the GFR of the entire kidney change?
Vasoconstriction or dilation of afferent or efferent blood vessels
27
How is the GFR of an individual nephron changed?
Altering the mesangial cells
28
What do we use now to measure GFR in a person?
Creatinine. Produced endogenously by muscle metabolism, so no need to inject the person. It is also not secreted or reabsorbed
29
What is plasma clearance?
The volume of plasma cleared of a specific substance over time
30
How does plasma clearance compared to GFR if a substance isn't secreted or reabsorbed?
C = GFR
31
How does plasma clearance compared to GFR if a substance is being secreted?
C > GFR
32
How does plasma clearance compared to GFR if a substance is reabsorbed?
C < GFR
33
Do the proximal tubules have controlled or uncontrolled reabsorption?
Uncontrolled
34
Do the distal tubules have controlled or uncontrolled reabsorption?
Controlled
35
How much glucose should be in the urine of a healthy person?
None, it should all be reabsorbed
36
What is the specific clearance rate?
The clearance rate of a particular substance from the plasma
37
What is the relative clearance rate?
The clearance rate of a particular substance from the plasma relative to GFR