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Therapeutics > W9 Renal Physiology > Flashcards

W9 Renal Physiology Flashcards

1
Q

Where are the kidneys located

A

one on either side of the spine located in the posterior wall of the abdominal cavity just below the rib cage

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2
Q

why is the right kidney slightly lower than the left because of the position of the liver

A

due to the position of the liver

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3
Q

what is the average weight of an adult human kidney

A

120 - 140g

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4
Q

what flows in the renal artery

A

nutrients such as

  • Na+
  • K
  • Amino acids
  • Glucose

Oxygen

Waste such as
- Urea

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5
Q

what is the vasa recta

A

the capillary networks that supply blood to the medulla

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6
Q

what are peritubular capillaries

A

tiny blood vessels in your kidneys. They deliver wastes to be secreted into urine (pee). They also reabsorb nutrients your body needs. Peritubular capillaries play an essential role in your urinary system.

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7
Q

how much of the cardiac output do the kidneys recieve

A

25%

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8
Q

how much plasma on average do the kidneys filter in a 70kg human

A

120 litres

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9
Q

Label a kidney

A

slide 1

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10
Q

what are the three main parts of the nephron

A

renal corpuscle
renal tobule
capillary network

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11
Q

label a nephron

A

label a nephron

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12
Q

where do the peritubular capillaries surround

A

they surround the proximal and distal convoluted tubules

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13
Q

what does the vasa recta surround

A

the loop of henle

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14
Q

what are the three main processes that take place in the nephron

A

ultra filtration
reabsorption
secretion

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15
Q

Where does ultra filtration take place

A

occurs in the glomerulus & bowmans capsule

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16
Q

how does ultra filtration take place

A

blood enters the glomerulus under a high pressure due to the size difference in the lumen of afferent and efferent arteriole at either end of the glomerulus

the constituents from the blood leave the glomerulus and enter the nephron which forms the filtrate.

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17
Q

what is filtration dependent on

A

filtration is determined on the size of the molecule for example small molecules such as water and have a molecular mass of up to 5000 flow freely however larger molecules such as albumin with 69,000 mw are less likely to move across

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18
Q

what is reabsorption

A

movement of constituents from the tubular fluid back into the blood to stop the constituents from being excreted.

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19
Q

what is reabsorption aided by

A

vasa recta + peritubular capillaries

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20
Q

what is transcellular and paracellular mean

A

Transcellular transport involves the transportation of solutes by a cell through a cell

Paracellular transport refers to the transfer of substances across an epithelium by passing through the intercellular space between the cells.

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21
Q

in what form of transport does reabsorption rely on

A

both paracellular + transcellular

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22
Q

what is secretion

A

movement of constituents from the blood into the tubular fluid so that they are excreted in the urine

23
Q

what is the easiest way to remember the difference between secretion and reabsorption

A

reabsorption is removing stuff from final product of urine

secretion adds to final product of the urine

24
Q

what form of transport does secretion rely upon

A

both paracellular + transcellular

25
Q

what are the 4 main roles of the kidney

A

homeostasis

produce an active form of vitamin D that promotes strong and healthy bones

control the production of red blood cells

remove drugs from the body

26
Q

how is the kidney involved in homeostasis

A

removing waste products from the body

regulating the pH of your blood and blood pressure by regulating inorganic ions

regulating water balance to maintain osmolality

releasing hormones that influence water balance and regulate blood pressure

27
Q

what is the main component of urine

A

urea

28
Q

what is contained in the urine

A

urea
uric acid
creatinine

29
Q

what is completely reabsorbed by the body

A

protein and glucose

30
Q

how much Na+ is reabsorbed

A

60-70%

31
Q

how much HCO3- is reabsorbed

A

90%

32
Q

where is Na+ and HCO3- reabsorbed

A

proximal convoluted tubule

33
Q

is the descending limb of the loop of henle impermeable to ions

A

yes

34
Q

what does the ascending limb contain

A

Na/K pumps

Na/K/Cl transporters

35
Q

what does the containment of pumps and transporters in the asscending limb mean

A

Na, Cl and K ions leave the tubular fluid via the vasa recta

36
Q

where does the reabsorption of water take place

A

tubules of the nephrons

37
Q

what are the two ways in which we can reabsorb water

A

along an osmotic gradient (passive)

by the release of hormones from the kidneys (active)

38
Q

what is the general relationship with sodium and water

A

wherever sodium goes water follows

39
Q

where is the majority of the water absorbed

A

proximal convoluted tubule as this is where 60-70% of the sodium is reabsorbed

40
Q

what hormones does the kidney release to regulate blood pressure

A

anti diuretic hormone

it is also involved in the renin angiotensin aldosterone system

41
Q

what cell is involved in the release of renin

A

juxtaglomerular cells

42
Q

when do they release renin

A

when we have a low blood pressure
sympathetic nerves
low sodium levels picked up by the mascular densa cells

43
Q

what are the mascular densa cells

A

Macula densa (MD) cells are chief cells within the kidney, playing key sensory and regulatory functions in the maintenance of body fluid, electrolyte homeostasis, and blood pressure.

44
Q

what is a chief cell

A

chief cells (zymogenic) are basophilic cells that are located in the bottom of the gland and which produce different gastric enzyme precursors

45
Q

describe the affects of rennin

A

liver produces angiotensinogen which is inactive

renin combines with this to produce angiotensin 1

endothelial cells produce angiotensin converting enzyme (ACE)

ACE combines with angiotensin 1 to produce angiotensin 2

46
Q

what does angiotensin 2 target

A

smooth muscle cells causing increased resistance in the form of vasoconstriction increasing blood pressure

kidneys as it signal them to reabsorb more Na+ and therefor more water

pituatary gland signaling for the release of anti diuretic hormone (ADH)

Adrenal gland signalling to release aldosterone

47
Q

where is ADH released from

A

pituitary gland

48
Q

what is the goal of ADH

A

reabsorption of water

49
Q

what is release of ADH triggered by

A

angiotensin 2 (Renin angiotensin aldesterone system)

osmoreceptors if there is a higher concentration of blood

low blood volume: the sympathetic nerve ending in the veins of the heart will sense this

low blood pressure: sympathetic nerve endings in the arteries of the heart will sense this

50
Q

what is a condition that can cause ADH to not work correctly

A

diabetes insipidus

  • kidneys are unable to conserve water making pale watery urine at an increased rate of urination (15-20 mins) increased thirst, always feeling dry
51
Q

what are the two types of diabetes insipidus

A

cranial diabetes insipidus

nephrogenic diabetes isnipidus

52
Q

what can cause cranial diabetes insipidus

A

brain trauma damaging hypothalamus or pituitary gland

severe head injury damaging hypothalamus or pituitary gland

complications that occur during brain or pituitary gland surgery

53
Q

what are the causes of nephrogenic diabetes insipidus

A

nephrons unable to respond to ADH

genetic

acquire from use of longterm lithium for bipolar disease or other causes such as hypercalcaemia or obstruction of the ureters

Therapeutics (50 decks)

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