Term
| Name 3 reasons why you might have increased capillary pressure. |
|
Definition
1. Excessive kidney retention of salt and water
2. High venous pressure and venous constriction
3. Decreased arteriolar resistance |
|
|
Term
| Name 3 reasons why you might have decreased plasma proteins. |
|
Definition
1. Loss of proteins in urine (nephrotic syndrome)
2. Loss of protein for denuded skin areas
3. Failure to produce proteins |
|
|
Term
| Name 2 reasons why you might have excess kidney retention of salt and water. |
|
Definition
1. Acute or chronic kidney failure
2. Mineralocorticoid excess |
|
|
Term
| Name 3 reaons you might have High Venous Pressure and Venous Constriction. |
|
Definition
1. Heart Failure
2. Venous Obstruction
3. Failure of venous pumps |
|
|
Term
| Give 3 reasons why there might be failure of venous pumps. |
|
Definition
1. Paralysis of muscles
2. Immobilization of parts of the body
3. Failure of venous valves |
|
|
Term
| Give 3 reasons why you might have decreased arteriolar resistance. |
|
Definition
1. Excessive body heat
2. Insufficient of SNS
3. Vasodilator drugs |
|
|
Term
| Name 2 reasons for loss of protein for denuded skin araes. |
|
Definition
|
|
Term
| Name 2 reasons you might have a failure to produce proteins. |
|
Definition
1. Liver Disease (cirrhosis)
2. Serious protein or caloric malnutrition |
|
|
Term
| Name 6 causes for increased capillary permeability |
|
Definition
1.Burns
2. Prolonged Ischemia
3. Vitamin Deficiency (Vit C)
4. Bacterial Infections
5. Toxins
6. Immune reactions that cause release of histamine or other immune products |
|
|
Term
| What 4 things might lead to a blockage of lymph return? |
|
Definition
1. Cancer
2. Infections
3. Surgery
4. Congenital absence or abnormality of lymphatic vessels |
|
|
Term
| Increased Na+ does what to water? |
|
Definition
|
|
Term
| Increase Na+ = Increase H20 retention = __BV and __P |
|
Definition
|
|
Term
| Functions to excrete metabolic wastes, foreign chemicals, drugs and hormone metabolites. |
|
Definition
|
|
Term
| Urea, H+, Bicarbonate, Na+, K+ and Cl- are all what? |
|
Definition
|
|
Term
| Functions to regulate water and electrolyte balance, as well as body fluid osmolality and electrolyte concentrations. |
|
Definition
|
|
Term
| Functions to regulate acid-base balances and arterial pressures. |
|
Definition
|
|
Term
| Functions to regulate erythrocyte production and secretion, metabolism, and excretion of hormones. |
|
Definition
|
|
Term
| Controls the formation of angiotensin and influences BP and sodium balance. |
|
Definition
|
|
Term
| Influences calcium balance. |
|
Definition
|
|
Term
| Does the kidneys function for gluconeogenesis? |
|
Definition
|
|
Term
| What is the main function of the kidneys? |
|
Definition
| Provide long term control of blood regulation |
|
|
Term
| Name 4 causes of extracellular edema |
|
Definition
1. Increased capillary pressure
2. Decreased plasma proteins
3. Increased capillary permeability
4. Blockage of lymph return |
|
|
Term
| Walk thru the Renal Blood Supply - Afferent Circulation. |
|
Definition
| Renal Artery - Segmental Arteries - Interlobar Arteries - Arcuate Arteries - Interlobular Arteries - Afferent Arterioles - Renal Corpuscles (glomerulus, bowman's capsule) |
|
|
Term
| Walk thru the Renal Blood Supply - Efferent Circulation. |
|
Definition
| Glomerulus - Efferent Arterioles - Peritubular Capillaries / Vasa Recta - Arcuate Vein - Interlobar Veins - Renal Vein |
|
|
Term
| What arterioles are coming into the capillary bed and which ones are coming out of? |
|
Definition
Afferent (coming in)
Efferent (coming out) |
|
|
Term
| These capillaries are located in the renal cortex and surround the tubules of the nephron. |
|
Definition
|
|
Term
| Depending on the location of the nephron, what circulation might be different? |
|
Definition
|
|
Term
| The functional unit of the kidney that produces a filtrate. |
|
Definition
|
|
Term
| Each nephron contains what? |
|
Definition
|
|
Term
| A network of glomerular capillaries through which large amounts of fluid are filtered from the blood. |
|
Definition
|
|
Term
| The glomerulus is supplied with blood from the _ _. |
|
Definition
|
|
Term
| Blood from the glomerulus exits through the __ __ |
|
Definition
|
|
Term
| Fluid is filtered from the blood and collected where? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| The 1st point of filtration into the renal system. |
|
Definition
|
|
Term
| A cup-like sac at the beginning of the tubular component of a nephron in the mammalian kidney that performs the first step in the filtration of blood to form urine. |
|
Definition
|
|
Term
| Fluids from blood in the glomerulus are collected where? |
|
Definition
|
|
Term
| Once fluid from the blood in the glomerulus is collected in bowman's capsule it is further processed along the nephron to form what? |
|
Definition
|
|
Term
| The process in which fluids from blood in glomerulus are collected in bowmans capsule and further processed along the nephron to form urine. |
|
Definition
|
|
Term
| What are the 3 layers of Bowman's Capsule? |
|
Definition
Parietal Layer
Bowman's Space
Visceral Layer |
|
|
Term
| A single layer of simple squamous epithelium. Does not function in filtration. |
|
Definition
|
|
Term
| Found between the visceral and parietal layers, into which the filtrate enters after passing through the podocytes' filtration slits. |
|
Definition
| Bowman's Space (urinary space)(capsular space) |
|
|
Term
| Lies just above the thickened glomerular basement membrane and is made of podocytes. |
|
Definition
|
|
Term
| What lies beneath the visceral layer of bowman's capsule? |
|
Definition
|
|
Term
| Long tubes in which fluid is converted into urine on its way to the pelvis of the kidney |
|
Definition
|
|
Term
| A group of specialized cells that are constantly monitoring Na+ concentration in the tubule. |
|
Definition
|
|
Term
| All distal convoluted tubules feed into what? |
|
Definition
|
|
Term
| Bowman's capsule drains into what? |
|
Definition
| Proximal Convoluted Tubule |
|
|
Term
| The proximal convoluted tubule gives rise to what? |
|
Definition
|
|
Term
| Comprised of a descending limb from the proximal convoluted and an ascending limb. |
|
Definition
|
|
Term
| A patch of cells at the end of the loop of henle as it becomes the distal tubule that runs between the efferent and afferent arterioles |
|
Definition
|
|
Term
| When activated, this sends signals to the juxtaglomerular cells |
|
Definition
|
|
Term
| Found in the afferent arteriole and form the juxtaglomerular apparatus (JGA) |
|
Definition
|
|
Term
| Secretes into the bloodstream in response to Na+ |
|
Definition
|
|
Term
| Receives filtrate from the loop of henle |
|
Definition
|
|
Term
| Name the 2 collecting duct systems |
|
Definition
|
|
Term
| The distal convoluted tubules drain into what? |
|
Definition
|
|
Term
| The collecting duct systems coalesce into what? |
|
Definition
|
|
Term
| Made up of several hundred large medullary collecting ducts |
|
Definition
|
|
Term
| Do cortical and juxtamedullary nephrons have the same function? |
|
Definition
|
|
Term
| Make up the majority of nephrons |
|
Definition
|
|
Term
| Where are cortical nephrons located? |
|
Definition
|
|
Term
| With cortical nephrons, do the loops of henle extend deep into the medulla? |
|
Definition
|
|
Term
| What percentage of nephrons are juxtamedullary? |
|
Definition
|
|
Term
| Where are juxtamedullary nephrons located? |
|
Definition
| On border of cortex and medulla |
|
|
Term
| With juxtamedullary nephrons, do the loops of henle extend deep into the medulla? |
|
Definition
|
|
Term
| The rate at which substances are exreted in the urine represents the sum of 3 renal processes. |
|
Definition
|
|
Term
| Name the 3 renal processes that lead to the formation of urine. |
|
Definition
Glomerular Filtration
Tubular Reabsorption
Tubular Secretion |
|
|
Term
| Urine formation begins with the filtration of large amounts of fluid thru the __ __ into Bowman's Capsule. |
|
Definition
|
|
Term
| Relatively impermeable to proteins, so the glomerular filtrate is essentially protein free and devoid of cellular elements (RBC, etc.) |
|
Definition
|
|
Term
| Does the glomerular capillary membrane serve as a barrier? |
|
Definition
|
|
Term
| Composed of the fenestrated epithelium of the glomerular capillaries, the fused basal lamina of the endothelial cells and podocytes, and the filtration slits of the podocytes. |
|
Definition
| Glomerular capillary membrane |
|
|
Term
| The basal lamina of the filtration barrier is composed of what 3 layers? |
|
Definition
1. Lamina Rara Externa (adjacent to the podocyte processes)
2. Lamina Rara Interna (adjacent to endothelial cells)
3. Lamina Densa (a darker central zone of the basal lamina that consists of a network of type IV collagen and laminin, which act as a selective macromolecular filter) |
|
|
Term
| Name 5 small molecules that can pass freely into bowman's space |
|
Definition
water
glucose
salt
amino acids
urea |
|
|
Term
| Name 3 things that are too large to freely pass into bowman's space |
|
Definition
|
|
Term
| Prevents the passage of large and/or negatively charged proteins (such as albumin) |
|
Definition
| Glomerular Capillary Membrane |
|
|
Term
| Concentration of other solutes in the filtrate is similar to the concentration in the __. The exception is that protein-bound substances(Ca and fatty acids) are not freely filtered. |
|
Definition
| Plasma (salts and organic molecules) |
|
|
Term
| Determined by pressures and permeability to substances across the membranes |
|
Definition
| GFR (Glomerular Filtration Rate) |
|
|
Term
| Almost always a positive pressure (out of capillaries and into bowman's) |
|
Definition
|
|
Term
| The balance of hydrostatic and colloid osmotic forces acting across the membrane |
|
Definition
| Net Filtration Pressure (same as GFR) |
|
|
Term
| Normally the net filtration pressure is __ which initiates the formation of urine by forcing protein-free filtrate out of the glomerulus and into bowman's space. |
|
Definition
|
|
Term
| Hydrostatic pressure inside the glomerular capillaries __ filtration. |
|
Definition
|
|
Term
| Hydrostatic pressure in bowman's capsule outside the capillaries __ filtration. |
|
Definition
|
|
Term
| Colloid osmotic pressure exerted the glomerular capillary plasma proteins __ filtration. |
|
Definition
| (pi)g = opposes filtration |
|
|
Term
| Colloid osmotic pressure of the exerted by the proteins in bowman's capsule __ filtration. |
|
Definition
| (pi)p = promotes filtration |
|
|
Term
| Dependent on the permeability of the membrane and the surface area of the capillaries |
|
Definition
| Capillary Filtration Coefficient |
|
|
Term
| Are there proteins in bowman's space? |
|
Definition
| No they are in the capillaries |
|
|
Term
| Would you expect the oncotic pressure to be higher or lower in the capillaries than bowman's space? |
|
Definition
|
|
Term
| What does promote filtration mean? |
|
Definition
|
|
Term
| What does oppose filtration mean? |
|
Definition
|
|
Term
| __ capillaries have a much higher rate of filtration than most other capillaries in the body |
|
Definition
|
|
Term
| The total GFR for both kidneys is about __ml/min (20% of all renal plasma flow) |
|
Definition
|
|
Term
| Increased volume does what to hydrostatic pressure? |
|
Definition
|
|
Term
| Name 2 reasons for an increased GFR |
|
Definition
1. Increased glomerular capillary filtration coefficient
2. Increased glomerular capillary hydrostatic pressure |
|
|
Term
| There is usually more pressure in capilarries than bowman's, but the net filtration is __ of capillaries and __ bowmans |
|
Definition
|
|
Term
| Is increased glomerular capillary filtration coefficient usually a factor in regulating day-to-day filtration? |
|
Definition
|
|
Term
| What could cause an increased glomerular capillary filtration coefficient? |
|
Definition
| Pathologies such as chronic hypertension and diabetes mellitus gradually reduce Kf by increasing the thickness of the capillary basement membrane, and eventually by damaging the capillaries so severely that there is a loss of capillary function |
|
|
Term
| What is normal glomerular capillary hydrostatic pressure? |
|
Definition
|
|
Term
| Changes of this pressure serve as the primary means for physiological regulation of GFR |
|
Definition
| Glomerular capillary hydrostatic pressure |
|
|
Term
| Glomerular capillary hydrostatic pressure is determined by what 3 variables? |
|
Definition
1. Arterial Pressure
2. Afferent arteriolar resistance
3. Efferent arteriolar resistance |
|
|
Term
| Name 2 things that afferent arteriolar resistance can do. |
|
Definition
1. Dilation increases GFR
2. Constriction decreases GFR |
|
|
Term
| Name 2 things that efferent arteriolar resistance can do. |
|
Definition
1. At moderate levels of efferent constriction, there is a slight elevation of GFR.
2. With severe constriction, there is a decrease in GFR because colloid pressure rises above capillary hydrostatic pressure |
|
|
Term
| Name 6 ways in which you can have a decrease in GFR |
|
Definition
1. Constriction of afferent arteriolar resistance
2. Severe constriction of efferent arteriolar resisance
3. Increased bowman's capsule hydrostatic pressure
4. Increased glomerular capillary colloid osmotic pressure
5. Decrease in Kf
6. Decrease in Pg |
|
|
Term
| Is Bowman's capsule hydrostatic pressure a primary determinant of GFR? |
|
Definition
|
|
Term
| Why might bowman's capsule hydrostatic pressure reduce GFR? |
|
Definition
| Conditions such as an obstruction of urinary tract (kidney stones) can cause the pressure to rise and reduce GFR |
|
|
Term
| This pressure is usually higher than the afferent colloid pressure because of the filtration fraction that enters bowman's capsule (fluid leaving the plasma concentrates the proteins in the plasma) |
|
Definition
| Glomerular capillary colloid osmotic pressure |
|
|
Term
| Increase in the filtration fraction will lead to higher colloid osmotic pressue in the glomerular capillaries and __ GFR |
|
Definition
|
|
Term
| Increase in the arterial colloid pressure will __ GFR |
|
Definition
|
|
Term
| A decrease in renal blood flow or increase in plasma proteins can __ glomerular capillary colloid osmotic pressure |
|
Definition
|
|
Term
| Name 3 things that might lead to a decrease in Kf |
|
Definition
Renal Disease
Diabetes Mellitus
Hypertension |
|
|
Term
| 3 things that lead to a decrease in Pg |
|
Definition
1. Due to decreased arterial pressure
2. Decreased angiotensin II
3. Increase SNS activity, vasocontrictor hormones |
|
|
Term
| GFR and renal blood flow are controlled by neural and hormonal inputs. Name Then. |
|
Definition
1. Sympathetics
2. Hormonal and autacoid control of renal circulation
- NorEpi
- Epi
- Endothelin
- Angiotensin II
- NO |
|
|
Term
| Primarily causes vasoconstriction and causes direct activation of the juxtaglomerular cells. |
|
Definition
|
|
Term
| A highly selective process that moves substances across the epithelial tubular lumen into the rental interstitial fluids and then across the peritubular capillary membrane back into the blood. |
|
Definition
|
|
Term
| Some substances are almost completely reabsorbed from the tubules (name 2) so the urinary excretion rate of those substances is essentially zero. |
|
Definition
|
|
Term
| H20 and Na+ intake and outake is normally ___ |
|
Definition
|
|
Term
| Tubular Reabsorption is regulated by what 2 processes? |
|
Definition
1. Diffusion
2. Active/Mediated Transport |
|
|
Term
| How is tubular reabsorption regulated by diffusion? |
|
Definition
| Several substances diffuse from areas of higher to lower concentrations. The concentration gradients are often created because of the diffusion of water in and out of the tubular lumens. |
|
|
Term
| How is tubular reabsorption regulated by active/mediated transport? |
|
Definition
| Utilizes an energy source and/or cotransporter to move substances across cell membrane |
|
|
Term
| About __% of the filtered load of Na and H20 and Cl are reabsorbed by the proximal tubules before the filtrate reaches the loop of Henle |
|
Definition
|
|
Term
| Important for secretions of organic acids and bases (primarily metabolic waste products) |
|
Definition
|
|
Term
| Are the proximal tubules very permeable to water? |
|
Definition
|
|
Term
| Name the 3 segments of the loop of henle |
|
Definition
Thin Descending Segment
Thin Ascending Segment
Thick Ascending Segment |
|
|
Term
| This segment of the loop of henle is highly permeable to water and moderately permeable to most solutes (including urea and sodium) |
|
Definition
|
|
Term
| The primary function of this segment is to allow simple diffusion of substances thru its walls. About 20% of filtered water is reabsorbed here. |
|
Definition
|
|
Term
| This segment of the loop of henle is virtually impermeable to water. It serves to concentrate the urine. |
|
Definition
|
|
Term
| This segment of the loop of henle is impermeable to water. It has a thick wall of epithelial cells that have high metabolic activity and are capable of active reabsorption of sodium, chloride, and potassium. |
|
Definition
|
|
Term
| About 25% of filtered load of Na, K, and Cl are reabsorbed here. Also capable of reabsorbing Ca, bicarb, and Mg |
|
Definition
|
|
Term
| Name the 2 segments of the distal tubules |
|
Definition
1. early segment
2. late segement/cortical collecting ducts |
|
|
Term
| Avidly reabsorbs most ions, including Na, K, and Cl. Virtually impermeable to water and urea. Known as the diluting segment. |
|
Definition
| Early Segment of Distal Tubules |
|
|
Term
| Almost completely impereable to urea. Permeability to water depends on ADH levels. |
|
Definition
| Late segment of distal tubules |
|
|
Term
| If ADH levels are low, is the later segment permeable or impermeable to water? |
|
Definition
|
|
Term
| If ADH levels are high, is the later segment permeable or impermeable to water? |
|
Definition
|
|
Term
| The late segment of the distal tubules have 2 types of cells |
|
Definition
Principle cells
Intercalated discs |
|
|
Term
| These cells reabsorb Na and H20, and secrete K |
|
Definition
|
|
Term
| These cells reabsorb K and bicarb and secrete H |
|
Definition
|
|
Term
| The final site for processing the urine. ADH levels control permeability to water. It's permeable to urea, and capable of secreting H+ |
|
Definition
| Medullary Collecting Ducts |
|
|
Term
| The ejection of urine from the bladder |
|
Definition
|
|
Term
| In tubular secretion, substances such as H ion, K, and organic anions move from the peritubular capillaries into the __ __ |
|
Definition
|
|
Term
| Tubular Secretion can be regulated by what 2 processes. |
|
Definition
Diffusion
Active/Mediated Transport |
|
|
Term
| This hormone provides long term regulation of Na+ levels. It acts slowly because it induces changes in gene expression and protein synthesis. |
|
Definition
|
|
Term
| This hormone stimulates the Na/K ATPase pump. It increases Na and H20 reabsorption, and stimulates K secretion |
|
Definition
|
|
Term
| What hormone is stimulated by the renin-angiotensin system? |
|
Definition
|
|
Term
| Low total body Na leads to __ plasma volume |
|
Definition
| Low (retaining too much H20) |
|
|
Term
| Low plasma volume leads to __ cardiovascular pressures |
|
Definition
|
|
Term
| Initiate short-term, acute relfexes that influence arterioles and tubules |
|
Definition
|
|
Term
| What is an example of a substance that should never be found in the urine? |
|
Definition
|
|
Term
| What is the main reason that glucose might be found in the urine? |
|
Definition
| Destruction of tubular wall. Something has degraded the integrity of the tubular membrane. |
|
|
Term
| What should never be at an elevated level in the blood? |
|
Definition
|
|
Term
| Why might you have elevated creatinine in the blood? |
|
Definition
| It is not being filtered. Such as problems with bowman's space |
|
|
Term
| Name 4 types of things that regulate normal tubular reabsorption |
|
Definition
1. Glomerulotubular Balance
2. Peritubular Capillary and Renal Interstitial Fluid Forces
3. Effect of arterial pressure on urine output
4. Hormonal control of tubular reabsorption |
|
|
Term
| What is filtered must be in balance with what is reabsorbed. |
|
Definition
|
|
Term
| This pressure pushes fluid out |
|
Definition
|
|
Term
| This pressure brings fluid in |
|
Definition
|
|
Term
| Can you find hydrostatic and oncotic pressures in the peritubular capillary and in the renal interstital fluid? |
|
Definition
|
|
Term
| What is normal glomerular oncotic pressure? |
|
Definition
| 0 because protein does not get filtered into bowman's space |
|
|
Term
| If you have increased blood volume, then you will have __ atrial pressure, __ pressure in afferent tubules, __ filtration and __ reabsorption |
|
Definition
|
|
Term
| Where is the primary action site of aldosterone? |
|
Definition
| In principle cells collecting tubule and duct |
|
|
Term
| Where is the primary action site of Angiotensin II? |
|
Definition
| Proximal tubule, thick ascending loop of henle, distal and collecting tubule |
|
|
Term
| This hormone stimulates the secretion of aldosterone |
|
Definition
|
|
Term
| This hormone stimulates the Na/K ATPase pump |
|
Definition
|
|
Term
| This hormone increases Na and H20 reabsorption and stimulates K secretion |
|
Definition
|
|
Term
| Increase Na+ diet = __ Aldosterone Production |
|
Definition
|
|
Term
| A decrease in Na in diet will do what to aldosterone production? |
|
Definition
|
|
Term
| Increase in K+ = __ aldosterone production and ___ secretion of K+ |
|
Definition
|
|
Term
| A potent vasoconstrictor of efferent arterioles and peripheral arterioles (TPR and arterial pressue) |
|
Definition
|
|
Term
| Does angiotensin II directly stimulate the Na/K ATPase pump? |
|
Definition
|
|
Term
| This hormone increases Na and H20 reabsorption and H+ secretion |
|
Definition
|
|
Term
| Where is the primary site of action for ADH hormone? |
|
Definition
| Distal/collecting tubule and duct |
|
|
Term
| What does the ADH hormone do? |
|
Definition
| Increase water reabsorption |
|
|
Term
| This hormone is released from the posterior pituitary gland and is stimulated by increased osmolarity of body fluids above normal. |
|
Definition
|
|
Term
| Increased concentration of solutes ; decreased fluids |
|
Definition
|
|
Term
| Increases the permeability of distal tubules and collecting ducts to water and permits water reabsorption. |
|
Definition
|
|
Term
| When there is an excess of water in the body and ECF osmolarity is reduced, secretion of ADH __ which causes urine to be ___ |
|
Definition
|
|
Term
| This hormone determines to an extent whether the kidneys excrete diluted or concentrated urine. |
|
Definition
|
|
Term
| Where is the primary site of action for ANP? |
|
Definition
| Distal tubule / collecting tubule and duct |
|
|
Term
| What hormone directly inhibits the secretion of aldosterone? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Increase Na excretions = __ BV |
|
Definition
|
|
Term
| Where is the primary site of action for PTH? |
|
Definition
| Proximal tubule, thick ascending loop of henle, and distal tubule |
|
|
Term
| This hormone increases calcium reabsorption and decreases phosphate reabsorption |
|
Definition
|
|
Term
| What does sympathetic innervation do to sodium reabsorption? |
|
Definition
|
|
Term
What do the following letter stand for?
C, U, P, V. |
|
Definition
Clearance
Urine concentration
Plasma concentration
Urine Flow Rate |
|
|
Term
| A substance found in plasma that does not undergo any reabsorption or secretion, it is 100% filtered. |
|
Definition
|
|
Term
| The volume of plasma from which a substance is completely removed (cleared) per unit time |
|
Definition
| Renal Clearance of a substance |
|
|
Term
| What can renal clearance of a substance be a good measure of? |
|
Definition
|
|
Term
| What is the equaton for renal clearance? |
|
Definition
|
|
Term
| If C>GFR, then that substance must undergo what? |
|
Definition
|
|
Term
|
Definition
|
|
