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1
Q

BLOOD FILTRATION: location and function

A

Location: glomerulus

Remove waste products from blood

2
Q

REABSORPTION: location and function

A

Location: nephron

Recover nutrients, ions, H2O

3
Q

SECRETION: location and function

A

Location: nephron

Assists filtration by removing waste products directly from blood

4
Q

ACTIVATION: Vitamin D

A
  • Dehydrocholesterol → vitamin D3 by ultraviolet (UV) light @skin
  • Vitamin D3 → calcitriol @kidney
5
Q

Location where Calcitriol ↑Ca++ deposition

A

@bone

6
Q

Location where Calcitriol ↑Ca++ reabsorption

A

@kidneys

7
Q

Location where Calcitriol ↑Ca++ absorption

A

@small intestines

8
Q

ENZYME RELEASE: Renin

location what does renin converts to

A
  • Location: kidneys

- Renin converts Angiotensinogen → Angiotensin I → Angiotensin II

9
Q

Function of Angiotensin II

A
  • vasoconstricts (↑blood pressure)

- Causes aldosterone (hormone) release (adrenal cortex) which stimulates DCT to reabsorb salt, H2O follows the salt

10
Q

AUTOREGULATORY LIPID RELEASE: Prostaglandins

location and function

A
  • Location: kidneys

- Prostaglandins: vasodilate (↓blood pressure)

11
Q

H+ SECRETION:

A
  • Eliminates excess hydrogen ions

- Controls acid/base (pH) balance

12
Q

HCO3– REABSORPTION:

A
  • Recovers bicarbonate ions

- Controls acid/base (pH) balance

13
Q

HORMONE RELEASE: Erythropoietin (EPO) (location and function)

A

Location: kidneys

EPO ↑RBC production (bone marrow)

14
Q

Function of Renal Artery:

A

Transports ↑O2 blood from aorta → kidney (filtration)

15
Q

Function of Renal Vein:

A

Transports filtered ↓O2 blood from kidney → inferior vena cava

16
Q

Function of Renal Column:

A
  • Area between renal pyramids (medulla)

- Site for blood vessel passage to the cortex

17
Q

Function of Nephron:

A
  • Kidney FUNCTIONAL UNIT

- Filtration, reabsorption, & secretion

18
Q

Function of Capsule:

A
  • Thick outer membrane

- Surround & protect

19
Q

Function of Cortex:

A
  • Outer layer
  • Contains most of the nephron
  • Filtration, reabsorption & secretion
20
Q

Function of Medulla:

A
  • Inner layer
  • Nephron structures not located in cortex
  • Salt, water & urea reabsorption
21
Q

Function of Renal Pyramids:

A
  • Triangle-shape

- Loops of Henle, collecting ducts, & counter-current multiplier system (concentrates salt & saves water)

22
Q

Function of Renal Papilla:

A
  • Renal pyramid apex

- Releases urine → minor calyx

23
Q

Function of Minor Calyx:

A
  • Collecting sac surrounding papilla

- Transports urine from papilla → major calyx

24
Q

Function of Major Calyx:

A
  • Collecting sac

- Transport urine from minor calyces → pelvis

25
Q

Function of Renal Pelvis

A

Collects urine from major calyces → ureter

26
Q

Function of Ureter

A

Transport urine from renal pelvis → bladder

27
Q

Function of Urinary bladder:

A
  • Stores urine from ureter

- Releases urine → urethra

28
Q

Function of Urethra:

A

Releases urine → outside

29
Q

Function of Afferent Arteriole:

A

Transports arterial blood → glomerulus (filtration)

30
Q

Function of Efferent Arteriole:

A

Transports filtered blood from glomerulus → peritubular capillaries & vasa recta → renal venous system

31
Q

Function of Glomerulus:

A
  • Blood filtration
  • Nonspecific filter
  • Removes both useful & non-useful materials into filtrate
32
Q

Function of Bowman’s Capsule:

A
  • Sac that encloses glomerulus

- Transfers filtrate from glomerulus → Proximal Convoluted Tubule (PCT)

33
Q

Function of Proximal Convoluted Tubule (PCT):

A
  • Reabsorbs most of the useful substances in the filtrate: Na+ (65%), H2O (65%), HCO3– (90%), Cl– (50%), glucose (100%)
  • Primary site for secretion of toxins, wastes & hydrogen ions (H+)
34
Q

Function of Descending Limb of the Loop of Henle (DLLH):

A
  • Counter-current multiplier system
  • Permeable to H2O
  • Impermeable to solutes (salts)
  • Receives filtrate from the PCT; allows H2O to be reabsorbed; sends “salty” filtrate to ALLH; “Saves water & passes salt”
35
Q

Ascending Limb of the Loop of Henle (ALLH):

A
  • Counter-current multiplier system
  • Impermeable to H2O
  • Permeable to salts
  • Actively transports (reabsorbs) salts (NaCl) into the interstitial fluid of the medulla; “Saves salt & passes water”
  • Filtrate becomes dilute; interstitial fluid of medulla becomes hyperosmotic (salty)
36
Q

Function of Distal Convoluted Tubule (DCT):

A
  • Receives dilute fluid from ALLH

- If Aldosterone (hormone) is present, sodium is reabsorbed, (Cl– & H2O follow Na+); Potassium (K+) is se

37
Q

Function Collecting Duct:

A
  • Receives fluid from DCT
  • If antidiuretic hormone (ADH) is present, collecting duct becomes porous to water
  • Collecting duct H2O moves (osmosis) to the “salty” (hyperosmotic) medulla
38
Q

Where is the LAST CHANCE to save water?

A

The collecting duct

39
Q

Function of Peritubular Capillaries:

A

Transport reabsorbed materials from PCT & DCT → renal veins

40
Q

Function of Vasa recta:

A
  • Blood vessels of the peritubular capillary network

- Surround descending & ascending loops of Henle

41
Q

Filtration Structures of Glomerulus:

A

-Filtration site
Screen-like:
-Fenestrated glomerular capillaries (podocytes w/ pedicels)
-Allows passage of H2O & solutes smaller than plasma proteins

42
Q

Net filtration pressure of blood hydrostatic pressure (BHP)

A

60 mm Hg (out)

43
Q

Net filtration of colloid osmotic pressure (COP)

A

-32 mm Hg (in)

44
Q

Net filtration of capsular pressure (CP)

A

-18 mm Hg (in)

45
Q

Total net filtration pressure (NFP)

A

10 mm Hg

46
Q

What does the Juxtaglomerular Apparatus (JGA) contain?

A
  • Macula densa cells (DCT)

- Granular cells (afferent arteriole)

47
Q

Function of Juxtaglomerular Apparatus (JGA)

A

maintain blood pressure

48
Q

What does Granular cells detect and release?

A

detect ↓pressure; release renin

49
Q

What does Renin convert?

A

Renin converts angiotensinogen → angiotensin I → angiotensin II

50
Q

What does Macula dense monitors?

A

blood salt

51
Q

What does macula dense do when high blood salt content occurs?

A
  • macula densa inhibits granular cells
  • Inhibits renin release, which
  • Inhibits Angiotensin II (causing vasodilation & ↓blood pressure)
  • Aldosterone inhibited (↓blood volume & ↓blood pressure)
52
Q

Summary of Granular cells

A

↑Blood volume & ↑BP

53
Q

Summary of Macula Densa

A

(inhibit granular cells)

↓Blood volume & ↓BP

54
Q

Ascending limb of loop of Henle (ALLH): (counter-current mechanism)

A
  • Reabsorbs salt (active transport) → interstitial tissue of the medulla
  • Makes medulla hyperosmotic (salty)
55
Q

What leaves Ascending limb of loop of Henle (ALLH) during counter-current mechanism

A

Salt (NaCl)

56
Q

Osmolarity of Ascending limb of loop of Henle (ALLH) fluids

A

Osmolality of ALLH fluid decreases from 1200 to 100 milliosmoles/L (mOsm/L)

  • ALLH is impermeable to H2O
  • Remove salt from filtrate
  • Accumulate salt in medulla
57
Q

Accumulated salt in medulla is used to “draw-out” water (osmosis) from:

A

1) DLLH (H2O permeable, salt impermeable)

2) Collecting duct

58
Q

Is DLLH permeable to H20?

A
  • DLLH is H2O permeable & loses H2O to the medullary interstitial tissue
  • H2O is reabsorbed by medullary blood vessels
  • Osmolality of DLLH fluid changes from 300 to 1200 mOsm/L
  • Saves H2O
59
Q

Where does ALLH transfer salt into?

A
  • ALLH actively transfers salt into medulla

- Medullary salts attract H2O out of DLLH

60
Q

Hyperosmotic (salty) medulla

A
  • Hyperosmotic (salty) medulla will also “pull-out” H2O from the collecting duct if ADH (hormone) is present
  • H2O moves out of collecting duct (urea follows)
  • Urea contributes to ↑osmolality of the medulla
61
Q

What makes ADH?

A

Hypothalamus

62
Q

Where is ADH stored and causes?

A
  • ADH stored in posterior pituitary & released (if dehydration)
  • ADH causes collecting duct “pores” to open
  • H2O moves from collecting duct → medulla
63
Q

As H2O leaves the collecting duct:

A
  • Collecting duct fluid becomes more concentrated (↑osmolality of collecting duct fluid 100 to 1200 mOsm/L)
  • If ADH is not present, H2O is lost in dilute collecting duct fluid (100 mOsm/L)
64
Q

Vasa recta is permeable to:

A

salts and water

65
Q

How does vasa recta vessels flow?

A
  • flow counter-current to loop of Henle fluid (counter-current exchange)
  • Blood flowing through vasa recta absorbs H2O (not salts)
  • Vasa recta return H2O back to body & leave salts (maintain hyperosmotic medulla)
66
Q

Equation of excretion and why does the difference mean?

A
  • Excretion = Filtration – Reabsorption

- Difference between filtration & reabsorption determines how much of a substance kidneys eliminate per unit of time

67
Q

Filtration: 16 grams of NaCl per day Reabsorption: 14 grams of NaCl per day
WHAT IS THE EXCRETION?

A
Excretion: 2 grams of NaCl per day
Amount Excreted = 
       Amount Filtered – Amount Reabsorbed
      2g NaCl/day    =   
           16g NaCl/day  –  14g NaCl/day
68
Q

_______________ = 100g of glucose – 100g of glucose

Find the missing value

A

0.0g

69
Q

100g of glucose = _____________ – 300g of glucose

Find the missing value

A

400g

70
Q

200g of glucose = 400g of glucose – _____________

Find the missing value

A

200g

71
Q

Renal Plasma Clearance Rate (RPCR) definition

A

amount of plasma cleared of a substance per minute

72
Q

Kidneys conduct clearance through:

A
  • Filtration
  • Reabsorption
  • Secretion
73
Q

How does filtration affect clearance?

A
  • Filtration directly affects clearance

- ↑Filtration → ↑material removed from blood plasma

74
Q

How does reabsorption affect clearance

A
  • Reabsorption indirectly affects clearance

- ↑Reabsorption → ↓material removed from blood plasma

75
Q

How does secretion affect clearance

A
  • Secretion directly affects clearance

- ↑Secretion → ↑material removed from blood plasma

76
Q

C = (V x U) ÷ P

What does the C mean?

A

C = clearance rate (mL/min)

77
Q

C = (V x U) ÷ P

What does the V mean?

A

V = urine production rate (mL/min)

78
Q

C = (V x U) ÷ P

What does the U mean?

A

U = substance conc. in urine (mg/mL)

79
Q

C = (V x U) ÷ P

What does the P mean?

A

P = substance conc. in plasma (mg/mL)

80
Q

After a dose of inulin, urine has 30 mg/mL & plasma has 0.5 mg/mL of inulin (urine production rate (V) is 2.0 mL/min)
What is inulin clearance rate?
C = (V x U) ÷ P

A

120 mL/min of inulin

120 mL/min = (2 mL/min x 30 mg/mL) ÷ 0.5 mg/mL

81
Q

Renal calculi (kidney stones) cause and effect:

A
  • Cause: crystallization of calcium (Ca++), magnesium (Mg++), uric acid salts
  • Precipitate w/in renal pelvis
  • Calculi become large & travel down the ureter
  • Effect: intense pain radiates from lower back to anterior abdominal wall (same side as renal calculus)
82
Q

Cystitis (bladder infection) cause and effect:

A
  • Cause: bacteria from anal region, sexually transmitted disease (STD), & chemicals
  • Effect: inflammation, pain, fever, ↑urination
83
Q

Glomerulonephritis (Bright’s Disease) cause and effect

A
  • Cause: abnormal immune response (autoimmune)
  • Inflammation of glomeruli
  • Streptococcal antibody complexes
  • Effect: abnormal filtration, renal failure
84
Q

Incontinence cause and effect:

A
  • Cause: old age, emotions (laughing), pregnancy, nerve damage, stress, excessive coughing
  • Effect: loss of voluntary micturition
85
Q

Gout (Gouty Arthritis) cause and effect:

A
  • Cause: uric acid crystals in the soft tissues of joints (base of great toe)
  • ↑Uric acid intake
  • ↓Uric acid excretion (genetic)
  • Effect: bone ends fuse & immobilize the joint
  • **Note: humans, apes, dalmatians lack enzyme uricase (breaks down uric acid)
86
Q

Gouty Arthritis Treatment

A
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Glucocorticoids (cortisol)
  • Avoid foods rich in organ tissue (liver, kidney, etc.)
  • Recommendation: avoid processed meats, & organ meats rich in nucleic acids (purines)
87
Q

Hemodialysis uses a ________ to transfer a patient’s blood plasma through a _____________ tube (permeable to selected substances)

A

machine, semi-permeable

88
Q

Dialysis machine contains a dialysis fluid that produces a ________ gradient (↑ to ↓)

A

diffusion

89
Q

Gradient allows abnormal substances to diffuse from blood plasma (produces a “________” effect)

A

cleansing

90
Q

Def of dialysis

A

process to artificially remove metabolic wastes from blood plasma

91
Q

What does dialysis therapy compensate for renal failure lead to?

A
  • ↑Nitrogenous wastes (urea & ammonia)
  • Ion imbalances
  • pH imbalances
  • Breathing imbalances
  • Convulsions
  • Coma
  • Death
92
Q

Key Aspects of dialysis therapy

A
  • Blood is transferred from an artery (arm)
  • Blood returns to a vein
  • Blood is heparinized (prevent clotting)
  • Dialysis sessions 3 times/week
  • Each session = 4-8hrs
  • Can lead to thrombosis (blood clots), infection & death of tissue (necrosis) around a shunt (access site in arm)