Week 8 - Renal system Flashcards

1
Q

Renal system- functions

A

Filter blood: remove METABOLIC WASTE

Regulate:

  • Fluid and electrolyte balance my regulating OSMOLARITY → adjusts blood vol & pressure
  • ERYTHROPOIESIS by releasing Erythropoeitin
  • Plasma conc (Na+, K+, Cl-)
  • Acid-base balance + blood pH
  • Vital to many metabolic functions: DETOXIFYING substances in the blood, ACTIVATING VitD, making new glucose
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2
Q

Nitrogenous wastes

A

UREA:
- Proteins → amino acid → NH2 removed →NH2 forms ammonia (which is toxic), liver converts to urea

CREATINE:
- Creatine phosphate catabolism in skeletal muscle

URIC ACID:
- Nucleic acid catabolism (from recycling of RNA)

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3
Q

Excretion

A
  • RESPIRATORY: CO2
  • INTEGUMENTARY: water, inorganic salt, lactic acid, urea (via sweat)
  • DIGESTIVE: water, salts, CO2, lipids, bile pigments, cholesterol
  • URINARY: metabolic waste, toxins, drugs, hormones, salts, H+ & water
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4
Q

Kidneys - anatomy

A

Connective tissue covering:

  • PARIETAL PERITONEUM: covers anterior aspect
  • RENAL FASCIA: binds kidneys to abdominal wall
  • PERI-RENAL FAT CAPSULE: cushions kidney
  • FIBROUS CAPSULE: layer of collagen fibres; encloses kidney like cellophane wrapper, protects from trauma & infections

Blood vessels, nerves & ureter enter HILUM

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5
Q

Kidneys - internal anatomy

A
  • RENAL CORTEX: superficial layer
  • RENAL MEDULLA: inner portion consisting of RENAL PYRAMIDS separated by RENAL COLUMNS. Tip of pyramid: RENAL PAPILLA opens into MINOR CALYX
  • RENAL SINUS: cavity- houses initial segment of urine drainage system, cuplike structure
  • Minor calyces drain urine into the MAJOY CALYCES, empty into RENAL PELVIS, empty to URETER
  • KIDNEY LOVE: pyramid & overlying cortex
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6
Q

Nephrons

A

CORTICAL NEPHRONS (85%)

  • close to kidney surface
  • short nephron loops, only small proportion in medulla

JUXTAMEDLLARY NEPHRONS (15%)

  • very long nephron loops, extend deep into renal medulla
  • maintain salt gradient, helps conserve water by concentrating urinw
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7
Q

Renal tubule - anatomy

A

PROXIMAL CONVOLUTED TUBULE (PCT)
- longest, more coiled, simple cuboidal w/ microvilli

NEPHRON LOOP (LOOP OF HENLE)

  • descending & ascending limbs
  • thick segment (simple cuboidal) initial part of descending limb & part or all of ascending. active transport- salt
  • thin segment (simple squamous) → very water permeable

DISTAL CONVOLUTED TUBULE (DCT)

  • nephron loop returns to cortex, shorter, less convoluted
  • cuboidal, smooth surface w/ minimal microvilli
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8
Q

Blood supply - kidneys

A

Renal artery divides into segmental arteries that give rise to:

  • interlobar arteries : up renal column betw. pyramids
  • arcuate arteries - over pyramids
  • interlobar (or radiate) arteries → up to cortex
  • branch into afferent arterioles → each suppying one nephron
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9
Q

Neural regulation - kidneys

A
  • renal nerves enter the hilum
  • follow branches of renal arterioles and innervate the afferent & efferent arterioles
  • kidneys receive SYMPATHETIC info from renal plexus w/ little/ no input from PARASYMPATHETIC div
  • the sympathetic NS will trigger vasoconstriction & reduce renal blood flow, reducing urine output
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10
Q

Tubular reabsorption

A
  • nephrons perform after filtration: to MODIFY the filtrate as it flows through tubules
  • nephron is able to reabsorb MAJORITY of filtered water & solutes from proximal tubule & loop
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11
Q

Tubular secretion

A
  • process where stubstances are added into filtrate from peritubular capillaries for excretion from body
  • helps maintain ELETROLYTE & ACID-BASE HOMEOSTASIS, REMOVES TOXINS from blood that did not enter tubular fluid by filtration
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12
Q

Glomerular filtration

A

Process of nephrons → selectively filter blood (by size)

FENESTRATED ENDOTHELIUM
- 70-700 nanometre pores - exclude blood cells
BASAL LAMINA (basement membrane) ECM gel
FENESTRATION SLITS (visceral layer)

Forces that drive fluid movement:

  • HYDROSTATIC PRESSURE (BP): force on capillary walls
  • COLLOID OSMOTIC PRESSURE → created by proteins

interaction vetween these two pressures determines NET FILTRATION PRESSURE and direction that water will flow

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13
Q

Autoregulation GFR - Tubuloglomerular Feedback

A

Glomerulus receives feedback on status of downstream tubular fluid

  • juxtaglomerular apparatus afferent arterioles makes contact w/ ascending limb loop of henle
  • tubule comes to contact w/ afferent & efferent arterioles @ vascular poles of renal corpuscle
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14
Q

Autoregulation GFR- myogenic mechanism

A

Reult of inherent tendency for arterioles to contract/ dialate in response to changes in BP

  • inc. arterial BP stretches the different arteriole which stimulates muscle cells to contract
  • when BP falls, afferent arteriole relaxes & allows blood flow
  • filtration remains stable
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15
Q

Juxtaglomerular apparatus

A

Juxtaglomerular cells: found in afferent arteriole → act as mechanoreceptors
- able to secrete renin when there is a drop in GFR which regulates systemic BP via RAAS

Macula Densa Cells: found in distal tubule → acts as chemoreceptors

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16
Q

tubuloglomerular feedback

A
  1. High GFR
  2. high rate of flow of filtrate through the nephron
  3. when flow of filtrate is too fast, decreased reabsorption of ions in tubules
  4. increase osmolarity (NaCl) in filtrate passing through Distal Tubule
  5. detected by macula densa cells of distal tubule. → release vasoconstrictor
  6. afferent arteriole constricts, decreasing blood flow through glomerulus
  7. GFR returns to normal
  8. Filtration flow rate decreases
17
Q

Renin-angiotensin-aldosterone system (RAAS)

A
  • complex system that maintains systemic BP primarily and GFR secondarily
  • resonds to combination of three conditions: stimulation by sympathetic nervous system, low glomerular hydrostatic pressure, and stimulation from macula densa
18
Q

Atrial Natriuetic peptide (ANP)

A
  • hormone released by heart cells in ATRIA in resonse to increasing fluid vol
  • lowers blood vol & BP to reduce workload of the heart
19
Q

Central neural regulation of GFR

A

involves SYMPATHETIC DIV of ANS and hormone → ANOREPINEPHRINE
- inc sympathetic activity causes constriction of afferent arterioles
→inc systemic BP
- low levels of sympathetic stimulation trigger JG cells to release renin
- high levels of sympathetic stimulation leads to high levels of angriotensis-II; constricts both afferent and efferent arterioles, decreasing GFR to minimise fluid loss, preserve blood vol and maintain BP

20
Q

endocrine regulation of tubular absorption - Antidiuretic hormone (ADH)

A
  • released by post, part of pituitary gland

- increases water reabsorption in collecting ducts

21
Q

endocrine regulation of tubular absorption - aldosterone

A
  • secreted by adrenal glands
  • acts on collecting ducts and distal convoluted tubules
  • Na+ reabsorption water flows
  • decreases K+ levels
22
Q

endocrine regulation of tubular absorption - Parathyroid hormone

A
  • secreted by the parathyroid glands
  • acts on distal convoluted tubule
  • increases Ca2+ reabsorption
23
Q

Counter-current mechanism

A

ADH increases water reabsorption in LOH, DCT, & CD

  • water re-enters the tissue fluid and blood stream
  • decreases urine vol

recaptures NaCl and returns it to renal medulla

Descending limb

  • reabsorbs water but not salt
  • concentrates tubular fluid

ascending limb

  • reabsorbs Na+, K+ and Cl-
  • maintains high osmolarity of renal medulla
  • impermeable to water
  • tubular fluid becomes hypotonic