Term
| The kidney is arranged in bundles of... |
|
Definition
|
|
Term
|
Definition
| 1 Glomerulus = 1 set of renal tubules |
|
|
Term
| There are how many nephrons per kidney? |
|
Definition
|
|
Term
| The glomeruli lie in the 1. , and the renal tubules 2. . |
|
Definition
1. Cortex
2. Loop down below them |
|
|
Term
| Each bundle of renal tubules is arranged in a... |
|
Definition
|
|
Term
| The tips of the tubule loops form the apex of the pyramid called the... |
|
Definition
|
|
Term
| What is the medullary pyramid? |
|
Definition
| A bundle of renule tubules arranged. |
|
|
Term
|
Definition
| the tips of the tubule loops forming the apex of the pyramid |
|
|
Term
| What collects at each papilla? |
|
Definition
|
|
Term
| Once urine collects at the papilla, where does it go? |
|
Definition
| Empties into the calyx -> the renal pelvis -> the ureter -> the bladder |
|
|
Term
| The kidney is very 1. , with the lowest salt in the 2. and the highest at the 3. . |
|
Definition
1. salty
2. cortex
3. papilla |
|
|
Term
| Look at the picture on page 31 |
|
Definition
|
|
Term
| How does blood go through the kidneys? |
|
Definition
| Afferent Arteriole -> Glomerulus -> Efferent Arteriole -> Peritubular Capillaries -> interlobular veins -> renal vein |
|
|
Term
| The glomerulus has what type of pressure, is what type of capillary, and what is the pressure in mm Hg? |
|
Definition
1. High
2. Fenestrated
3. 30 mm Hg |
|
|
Term
| What are the peritubular capillaries? |
|
Definition
| Vasa Recta; normal capillaries; pressure = 5-10 mm Hg |
|
|
Term
| What are the renal tubular components of the nephron? |
|
Definition
| Bowman's capsule -> Proximal tubule -> proximal tubule -> Loop of Henle -> Distal Tubule -> Collecting Duct -> Renal pelvis -> Ureter -> Bladder |
|
|
Term
| What two components of the renal tubule are impermeable to water? |
|
Definition
1. The ascending loop of henle
2. Distal Tubule |
|
|
Term
| The collecting tubule is impermable to water unless... |
|
Definition
| stimulated by antidiuretic hormone ADH |
|
|
Term
| What is ADH also known as? |
|
Definition
|
|
Term
| Know the figure on page 32 |
|
Definition
|
|
Term
| Know the two pictures on page 33 |
|
Definition
|
|
Term
| Where is the macula densa cells located and what are they a source of? |
|
Definition
| The distal tubule, erythropoietin |
|
|
Term
| Where is the juxtaglomerular apparatus located? What is is a source of? |
|
Definition
1. Afferent arteriole
2. Renin |
|
|
Term
| What supports the glomerular capillaries? |
|
Definition
|
|
Term
| What are contained in the proximal tubule? |
|
Definition
|
|
Term
| What are a specialization for absorption and/or transport? |
|
Definition
|
|
Term
| The upper, apical, border is sealed round by... |
|
Definition
|
|
Term
| 1. basal processes of cells interlock with each other. |
|
Definition
|
|
Term
| 1. of plasma through 2. under high pressure (3. ) moved fluid (4. ) from plasma into 5. . |
|
Definition
1. Filtration
2. Fenestrated glomerular capillaries
3. 30 mm Hg
4. filtrate
5. renal tubules |
|
|
Term
| What is the glomerular filtration rate, GFR? |
|
Definition
|
|
Term
| What is the renal plasma flow? |
|
Definition
| 1680 ml plasma through the kidney/min |
|
|
Term
| What is the filtered fraction? |
|
Definition
|
|
Term
| What is the average urine excretion? |
|
Definition
| 1-2 L/day (0.5-1.0 % of GFR per day) |
|
|
Term
| Filtration is sensitive to 1. by the 2. . A 3. % drop in glomerulus pressure = 4. . |
|
Definition
1. vasoconstriction
2. sympathetic nervous system
3. 50%
4. no filtration |
|
|
Term
| Materials which are filtered from the plasma through glomeruli into the filtrate are smaller than.... |
|
Definition
|
|
Term
| What are some examples of the materials that are filtered from the plasma through glomeruli into the filtrate? |
|
Definition
H2O
ions
glucose
amino acids
small proteins (< 12,000 MW or < 120 amino acids)
urea, bile pigments, creatinine (from creatine) |
|
|
Term
| Materials no normally filtered from the plasma through glomeruli are: |
|
Definition
| Large plasma proteins (albumin, transferrin, clotting proteins, etc) |
|
|
Term
| Why aren't Fe3+ ions and other trace metals and many hormones filtered and lost? |
|
Definition
| These are carried on large plasma ptroteins (like transferrin for iron) and therefore not filtered. |
|
|
Term
| Reabsorption by renal tubule cells causes dissolved material to move out of the 1. and return to 2. . This results in 3. of reabsorbed water and solutes. |
|
Definition
1. filtrate
2. circulation
3. conservation |
|
|
Term
| Describe the path that reabsorbed materials take? |
|
Definition
| Lumen of renal tubule -> 1 layer of tubule cell -> intersitital space outside tubule -> into vasa recta capillaries or lymphatic vessels -> circulation -> heart |
|
|
Term
| Most reabsorption is by what? |
|
Definition
|
|
Term
| What are some reabsorbed materials? |
|
Definition
- H2O
- Na+ (sodium) ion
- Ca2+ (calcium) ion
- PO43- (phosphate) ion
- HCO3- (bicarbonate) ion
- Glucose
- Amino Acids
- Nucleic Acids
|
|
|
Term
| Of the previously listed reabsorbed materials, which are reabsorbed by active transport? |
|
Definition
- Na+ (sodium) ion
- Ca2+ (calcium) ion
- PO43- (phosphate) ion
- HCO3- (bicarbonate) ion
- Glucose
- Amino Acids
- Nucleic Acids
|
|
|
Term
|
Definition
|
|
Term
| Secretion by renal tubule cells moves material from the 1. around tubules back into the 2. , resulting in excretion of secreted solute. |
|
Definition
1. intersitial space
2. filtrate |
|
|
Term
| Describe the path that secreted materials take: |
|
Definition
| Vasa recta capillaries -> interstitial space around tubules -> tubule cells -> *active transport-> lumen of renal tubule |
|
|
Term
|
Definition
|
|
Term
| What are some important secreted materials? |
|
Definition
- H+(hydrogen ion) (linked to Na+ion)
- K+ (potassium ion) (linked to Na+ion)
- some drugs
|
|
|
Term
| Non-reabsorption for exretion of filtered materials are... |
|
Definition
| filtered from plasma, but are not actively reabsorbed. Therefore they are excreted |
|
|
Term
| What are some materials that are non-reabsorped? |
|
Definition
Urea (from protein, DNA, RNA breakdown)
Creatinine (byproduct of creatine from muscle metabolism)
Bile pigments (from hemoglobin)
Many drugs (steriods)
Many homone metabolites (sex steroids and others) |
|
|
Term
| What does clearance measure? |
|
Definition
| How well the kidney removes (excretes) a particular substance from the plamsa in a given time. Expressed in ml/min |
|
|
Term
| Clearance of substance "x" = |
|
Definition
amount of "x" appearing in the urine/min
concentration of "x" in the plasma |
|
|
Term
What is the clearance of inulin? Relate this to GFR...
|
|
Definition
| 125 ml/min = GFR; inulin is a syntehtic carbohydrate which is completely filtered and not reabsorbed |
|
|
Term
| What is the clearance of creatine? Relate this to the GFR.. |
|
Definition
| 120 ml/min (efficient removal; nearly = GFR). Creatinine, a natural metaboline, is used as a substitute for inulin as as a measure of kidney function. |
|
|
Term
| What is the clearance of glucose? |
|
Definition
| 0ml/min (ALL of glucose is normally completely reabsorbed, therefor NO glucose in the urine, therefore, clearance =0) |
|
|
Term
| What is the clearance of urea? |
|
Definition
| 60ml/min (urea is not removed as efficiently as reatinine; it is partially reabsorbed) |
|
|
Term
| The control of electrolyte (ion) balance is due to the reabsorption of... |
|
Definition
Na+
HCO3-
Cl-
Ca2+
Mg2+
PO43- |
|
|
Term
| The control of electrolyte (ion) balance is due the secretion of these: |
|
Definition
|
|
Term
| What are the major functions of the kidney? |
|
Definition
1. Control of electrolyte (ion) balance
2. Control of water balance
3. Long-term control of blood pressure by controlling blood volume (water retention na+ and k+ balance)
4. Control of blood pH (acidity)
5. Waste removal (urea, bile pigments)
6. Source of erythropoietin (in macula densa cells)
7. Activation of vitamin D, required for calcium transport |
|
|
Term
| How do the kindeys control electrolyte balance? |
|
Definition
| Kidney tubules tend to conserve Na+, Ca2+, HCO3- and PO43- and exrete K+ and H+ ions |
|
|
Term
| The kidney's conservation of Na+ is also key to... |
|
Definition
|
|
Term
| The kidney is 1. ; there are 2. 3. gradients surrounding renal tubules, with the saltiest environment toward the tips of the 4. , the 5. . |
|
Definition
1. salty
2. Na+
3. Cl-
4. Medullary pyramid
5. papillae |
|
|
Term
| What does the hormone aldosterone do and how does it do this? Where is it from? |
|
Definition
| conserves Na+ by increasing active reabsorption of Na+. From the adrenal gland |
|
|
Term
| What is the counter-current multiplier? |
|
Definition
| not fully understood, generates the sodium-ion gradients in the kidney: creates the low salt (NaCl) in the cortex, highest salt in the papillae |
|
|
Term
| What are the three ways that the kidneys control water balance? |
|
Definition
1. Salt Gradient in the kidney outside the tubules
2. Water-impermeable ascending loop of henle and distal tubule
3. Collecting duct |
|
|
Term
| Water moves out of the tubules as it moves down 1. and 2. . Since water in filtrate moves into and out of tubules by 3. (4. ). "Saltiness" controlled by 5. from 6. . |
|
Definition
1. proximal tubules
2. descending loop of henle
3. osmosis
4. 70-80% fo filtered water is reabsorbed here
5. aldosterone
6. adrenal gland |
|
|
Term
| Because of the water-impermeable ascending loop of henle and distal tubule... |
|
Definition
| filtrate water is trapped inside |
|
|
Term
| Trapped water moves down the duct toward the 1. . Amount of trapped water that is returned to the circulation is controlled by the 2. from nerve cells in the brain. |
|
Definition
1. Papilla
2. Anti-diuretic hormone |
|
|
Term
| If the hormone ADH is not present... |
|
Definition
| The collecting duct remains impermeable to water and the trapped water inside is excreted as urine |
|
|
Term
| If the hormone ADH is present... |
|
Definition
| the collecting duct becomes permeable to water and water leaves collecting duct and returns to circulation (only 1.0-0.5% of original filtrate water is lost as urine) |
|
|
Term
| The release of ADH from the brain is 1. by alcohol. |
|
Definition
|
|
Term
| Look at the chart on page 37 |
|
Definition
|
|
Term
| 1. controls amount of water conserved. Therefore the more 2. conserved, the more 3. is conserved leading to and 4. and 5. . |
|
Definition
1. Salt gradient
2. Na+ ion
3. Water
4. Increased Blood Volume
5. Increased Blood Pressure |
|
|
Term
| Adrenal Gland Hormone 1. (a 2. ) increases 3. leading to a 4. , leading to 5. , 6. , and 7. . |
|
Definition
1. aldosterone
2. steroid hormone
3. Na+ retention
4. Steeper salt gradient
5. Increased blood volume
6. Increased blood pressure |
|
|
Term
| The brain hormone, 1. , directly affects the amount of 2. . Therefore, the more ADH the 3. . This leads to 4. , leading to 5. . ADH levels are 6. by 7. in the brain that stimulate ADH release when 8. . |
|
Definition
1. ADH
2. Water conserved
3. More water is conserved
4. Increased blood volume
5. Increased blood pressure
6. increased
7. osmoreceptor nerves
8. plasma concentration increases |
|
|
Term
| Look at the picture on page 38 |
|
Definition
|
|
Term
| Anti-Diuretic Hormone is a 1. with a molecular weight of 2. . It is synthesized in 3. of 4. in the brain, then transported down the nerve's axon to its terminals which are in the 5. . |
|
Definition
1.10-amino acid peptide
2. 1000
3. cell bodies
4. neurosecretory nerves
5. posterior pituitary gland |
|
|
Term
| ADH is stored in the 1. which are synapsed to capillaries in the 2. . They are stimulated to fire an action potential when blood volume is 3. (due to 4. or 5. ), causing the release of ADH into the capillaries of the pituitary. |
|
Definition
1. axon terminals
2. pituitary
3. low
4. blood loss
5. dehydration |
|
|
Term
| The blood carried the ADH to the 1. where it has its water -2. effect on the 3. and 4. of all the nephrons. 5. inhibits the electrical activity of these nerves. |
|
Definition
1. kidney
2.-conserving
3.distal
4. collecting tubules
5. Alcohol |
|
|
Term
| Diuretics promote 1. , excess urine production. Anti-diuretic hormone.... |
|
Definition
1. Diuresis
decreases urine production |
|
|
Term
| Cells of the 1. secrete an enzyme, 2. , which begins an enzyme cascade to produce 3. , an 4. , and powerful stimulator of 5. , 6. , and 7. . |
|
Definition
1. Juxtaglomerular apparatus
2. Renin
3. Angiotensin II
4. 8-amino acid peptide
5. aldosterone release
6. thirst
7. hypertension |
|
|
Term
| Look at and memorize the control of aldosterone secretion on page 39 |
|
Definition
|
|
Term
|
Definition
| The effect of the hormone abolishes the stimulus for its release |
|
|
Term
| Diuretics induce 1. ; are used to 2. . Examples of these are 3. , 4. and 5. . |
|
Definition
1. diuresis
2. decrease blood volume
3. caffeine
4. lasix
5. Alcohol |
|
|
Term
| How does caffeine induce diuresis? |
|
Definition
| Increases the GFR leading to greater water filtration, leading to the urine volume increases |
|
|
Term
| How does lasix induce diuresis? |
|
Definition
| decreased Na+ ion retention elading to decreased water retention, leading to an increase in urine volume, leading to a decrease in blood volume. |
|
|
Term
| What family of drugs does lasix belong to? |
|
Definition
| Furosemide family; prescription drug |
|
|
Term
| How does Alcohol act as a diuretic? |
|
Definition
| inhibits ADH secretion from the pituitary gland, leading to decreased water reabsorption from collecting tubules, leading to an increase in volume |
|
|
Term
| How do the kidney and lungs control blood acidity? |
|
Definition
|
|
Term
| The pH of the arterial blood is... |
|
Definition
7.4 +/- 0.1
H+= 10 to the power of -7.5 M |
|
|
Term
| pH is the inverse log of the H+ concentration |
|
Definition
|
|
Term
| pH is maintained within these narrow limits by the 1. and 2. . |
|
Definition
|
|
Term
| The lungs control 1. levels in the blood by controlling blood 2. . |
|
Definition
1. carbonic acid H2CO3
2. PCO2 |
|
|
Term
| The kidneys control 1. levels by 2. of 3. . |
|
Definition
1. HCO3- (bicarbonate ion)
2. Active reabsorption
3. HCO3- |
|
|
Term
| To maintain a pH of 7.40, the ration of bicarbonate ion to carbonic acid must be... |
|
Definition
| 20 to 1 ( the Henderson- Hasselbach equation |
|
|
Term
|
Definition
|
|
Term
| In the body, the 1. control the level of 2. . |
|
Definition
1. kidneys
2. bicarbonate ion |
|
|
Term
| How do the kidneys control the level of HCO3- in the body? |
|
Definition
| Increased active reabsorption of HCO3- ion in the kidney lead to the level of blood HCP3- increases, leads to the blood acidity descreasing (or pH rising) |
|
|
Term
| In the body, the lungs control the level of ... |
|
Definition
|
|
Term
| How do the lungs control the level of H2CO3 in the body? |
|
Definition
| Increased respiration leads to lower blood CO2, leadingn to lower blood H2CO3-, leading to lower blood acidity (or raised blood pH) |
|
|
Term
| Look at the diagram on page 41 |
|
Definition
|
|
Term
|
Definition
| Blood acidity greater than normal (pH < 7.4) |
|
|
Term
|
Definition
| Blood acidity less than normal (pH < 7.4) |
|
|
Term
| What is respiratory acidosis or alkalosis? |
|
Definition
| abnormal acidity level caused by problem in the pulmonary system |
|
|
Term
| What is metabolic acidosis or alkalosis? |
|
Definition
| abnormal acidity level caused by something other than the pulmonary system (for example, malfunctions of the kidney, abnormal metabolism of diabetes, sudden loss of body acids or base) |
|
|
Term
| Give an example of Respiratory Acidosis. |
|
Definition
| Pneumonia (poor excretion of CO2) -> high PCO2 -> high carbonic acid -> high acidity |
|
|
Term
| Explain how the kidneys would compensate for respiratory acidosis |
|
Definition
| Retain more HCO3- ion to return ratio to 20 parts to 1 part |
|
|
Term
| Explain how the respiratory system would compensate for respiratory acidosis |
|
Definition
| None, it's the source of the problem |
|
|
Term
| Give and example of respiratory alkalosis. |
|
Definition
| Hyperventilation (excessive loss of CO2 from the lungs) -> low pCO2 -> low carbonic acid -> low acidity |
|
|
Term
| How would the kidneys compensate for respiratory alkalosis? |
|
Definition
| retain less HCO3- ion and return ratio to 20 to 1 |
|
|
Term
| How would the respiratory system compensate for respiratory alkalosis? |
|
Definition
| None, it is the source of the problem |
|
|
Term
| Give an example of metabolic acidosis. |
|
Definition
| Severe diarrhea (as in the disease Cholera) -> loss of HCO3- ion and Na+ from small intestines -> low blood HCO3 -> high blood acidity |
|
|
Term
| How would the kidneys compensate to metabolic acidosis? |
|
Definition
| Retain more HCO3- ion to return ratio to 20/1 |
|
|
Term
| How would the Pulmonary system compensate to metabolic acidosis? |
|
Definition
| increases rate of respiration-> increased loss of CO2 from lungs -> lower pCO2 -> lower carbonic acid -> lower acidity |
|
|
Term
| Give an example of metabolic alkalosis. |
|
Definition
| Severe Vomiting -> loss of stomach acid -> low blood carbonic acid -> low blood acidity |
|
|
Term
| How would the kidneys compensate for metabolic alkalosis? |
|
Definition
| retain less HCO3- to return the ion ratio to 20/1 |
|
|
Term
| How would the pulmonary system compensate for metabolic alkalosis? |
|
Definition
| Chemoreceptor cells -> decreases rate of respiration -> decreased loss of CO2 from lungs -> higher pCO2 -> higher carbonic acid -> higher acidity |
|
|
Term
| How do the kidneys remove metabolic wastes? |
|
Definition
| Urea, Creatinine, solubilized steroids and solubilized bile pigments (bilirubin) are filtered, but not reabsorbed |
|
|
Term
| Where do the kidneys produce erythoropoietin? |
|
Definition
|
|
Term
| How do the kidneys activate vitamin D for calcium absorpion? |
|
Definition
| kidney glomerular 1-hydroxylase enzyme required for final stage of 1,25 dihydroxy vitamin D3 synthesis (adds an -OH group to the #1 position of the vitamin D rings |
|
|
Term
|
Definition
| inflammation of the renal tubule system (proximal tubule, Loop of Henle etc) |
|
|
Term
| What is glomerulonephritis? |
|
Definition
| inflammation of the glomeruli |
|
|
Term
| What is polycystic kidney diease? |
|
Definition
| replacement of functioning nephrons with scar tissue |
|
|
Term
| What is diabetic nephropathy? |
|
Definition
| occlusion of the glomerular arterioles, probably the most common cause of all kidney disorders |
|
|
Term
|
Definition
| kidneys fail gradually, and may reach a completely non-functioning state |
|
|
Term
| When kidneys reach a completely non-functioning state, it is called 1. and requires 2. and/or 3. to maintain life. |
|
Definition
1. end-stage renal disease (ESRD)
2. hemodialysis
3. kidney transplantation |
|
|
Term
| Inflammation of the renal tubule system (proximal tube, Loop of Henle...) |
|
Definition
|
|
Term
| Inflammation of the glomeruli |
|
Definition
|
|
Term
| Replacement of functioning nephrons with scar tissue |
|
Definition
| polycystic kidney disease |
|
|
Term
| Occlusion of glomerular arterioles; probably the most common of all kidney diseases |
|
Definition
|
|
Term
| What are the special circulatory accesses called that are used to take patients blood out? |
|
Definition
|
|
Term
| Blood is pumped through tubing by 1. into 2. . |
|
Definition
1. peristaltic pumps
2. hollow-fiber dialyzer cartridge |
|
|
Term
| Microscopic hollow fibers are semi-permeable to dissolved substances smaller than... |
|
Definition
|
|
Term
| Osmosis and diffusion are used to adjust levels of 1. , 2. ,3. , and 4. . Artificial 5. , containing proper levels of 6. and 7. , passes over dialysis fibers in opposite direction to blood. |
|
Definition
1. Water
2. Electrolytes
3. Waste Products
4. Nutrients
5. Dialyser solution
6. electrolytes
7. sero-levels of waste products |
|
|
Term
| What kind of pressure can be used to pull large amounts of water out of the blood? |
|
Definition
|
|
Term
| How often in hemodialysis performed? |
|
Definition
|
|
Term
| What are the advantages to hemodialysis? |
|
Definition
| Rapid removal of excess water load (possible cause of congestive heart failure); fine adjustment of electrolytes |
|
|
Term
| What are the disadvantages of hemodialysis? |
|
Definition
| Rapid loss of fluid and rapid readjustment of electrolytes, pH, waste products can lead to dizziness, disorientation; must be done in a clinic |
|
|
Term
| What is the other type of dialysis? |
|
Definition
| Continous ambulatory peritoneal dialysis |
|
|
Term
| 1. lining abdomen used as a natural dialyzer. Rich capillary bed acts as a semi-permeable exchanger with artificial dialysate solution infused into the belly |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the advantages of CAPD |
|
Definition
| Gentler change in body chemistry & blood volume; can be done at home; between changes, patient can perfomr any normal activities; more physiological, less restrictive diet |
|
|
Term
| What are the disadvantage of CAPD |
|
Definition
| Slower process than hemodialysis; risk of peritoneal infection (peritionitis) |
|
|
