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Renal system
Craft, J., Gordon, C., & Tiziani, A. (2011). Understanding pathophysiology. NSW: Elsevier
64
Nursing
Undergraduate 2
08/26/2014

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Cards

Term
function of bladder
Definition
temporarily stores urine produced from the kineys
Term
ureters function
Definition
permits urine flow from kidneys to bladder
Term
urethra
Definition
transports urine from bladder to exteriour of body
Term
two functions of kidneys
Definition
urine production and maintaining homeostasis
Term
location of kidneys
Definition
posterior abdominal wall, ouside the peritoneal cavity. Each kidney lies on either side of the vetebral column, extending from the 12th thoracic vetebrae to the 3rd lumbar vetebrae.
Term
hilium
Definition
cleft in the middle of the concave surface of the kindeys. It is the area where blood vessels, nerves and joining tubes to the bladders are connect to the kidneys
Term
renal capsule
Definition
layer of fibrous connective tissue that encapsulates each kidney. It is embedded in a mass of fat
Term
cortex
Definition
outer layer of kidney
Term
medulla location and structures
Definition
forms the inner layer of kidneys. Consist of regions called pyramids. renal column between each pyramid divides each pyramid. The papillae are the inward projection of the pyramids. Pyramids extends into the renal pelvis .
Term
function of renal pelvis
Definition
connects to ureters to allow urine to flow to bladder
Term
major and minor calyces functions
Definition
chambers recieving urine. Also, form entry of renal pelvis
Term
two layers of the glomuruler capsule and types of cells they consist of
Definition

-visceral (inner layer): specialised epithelial cells called podocytes

-parietal (outer layer): simple squamous epithelial cells

Term
podocyte function
Definition
specialised cells in visceral layer of glomeruler capsule. Allow th movement of fluids from capillaries and into the capsule
Term
name two major nephrons and their location
Definition

-juxtamedullary: lie close to and extend deep into the medulla

-cortical: makes up ~85% of nephrons. Located in  cortex and extend only partially to the medulla

Term
importance of juxtamedullary nephrons
Definition
important for kidney production of concentrated urine
Term
amount of blood needed for kidneys
Definition
25% of CO, or 1000-1200mL blood/min
Term
location of juxtaglomeruler apparatus
Definition
Located around the afferent arteriole, where it enters the renal corpuscule
Term
two parts of juxtaglomeruler apparatus and their function
Definition

 

1) Juxtaglomeruler cells: specialised cell that release a hormone called renin. They detect BP within the kidneys, contain granules that secrete renin when stimulated.

2) macula densa: detect sodium levels within the distal tubules

Term
Two factors the juxtaglomeruler apparatus controls
Definition
Important in sensing the properties of fluid flowing though the region (at entry of arteriole). the apparatus controls BP and glomerular filtration rate
Term
processes of urine formation
Definition

glomerular filtration

glomeruler reabsorption 

glomeruler secretion

Term
how do fluids and solute move across the glomerular filtration membrane
Definition
fluids and solutes are forced across the GF membrane by hydrostatic pressure
Term
What should not cross the glomeruler filtration membrane
Definition
protein
Term
compare glomeruler filtration to other capillaries
Definition
membrane of glomeruler filtration is freely permeable to water and relatively impermeable to large compounds (like other capillary membranes). The glomerulus has a higher pressure than other capillaries and have structures called fenestrations. This makes the glomerulus more effiecient in filtering at a faster rate than other capillaries
Term
the major force in the capillaries in the glomeruler capsule
Definition

-hydrostatic pressure: major force for moving water and solutes across the filtration membrane and into the glomeruler capsule

 

Term
the 2 opposing the filtration effects of the glomeruler hydrostatic pressure
Definition

-hydostatic pressure in glomeruler space

-oncotic pressure of the glomeruler capillary blood

Term
hydrostatic pressure (glomeruler)
Definition
pressure moving water and solutes from the glomerulus into the glomeruler capsule
Term
5 processes in which tubular reabsorption can take place
Definition
simple diffusion, facilitated diffusion, osmosis, active transport and co-transport
Term
describe pressure in the peritubular capillaries
Definition
pressure in the peritubular should be low, so that filtrate may be reabsorbed from the tubules
Term
describe process of glucose reabsorption
Definition
glucose reabsorption is via co-transportation. Specific protein carriers return filtered glucose back into the bloodstream.
Term
How may co-transportation be limited in reabsorption
Definition
there are only a limited amount of of protein carriers avaliable
Term
describe relationship of tubule length and effeciency in water conservation
Definition
longer loop=greater the ability to concentrate urine
Term
Main role of the proximal convoluted tubule
Definition
To reabsorb sodium by active transport using the active sodium-potassium- ATP pump. This allows for other electrolytes and water to move from the PCT and into the peritubular capillaries to be brought back into the bloodstream.
Term
Describe co-transportation with sodium and electrolytes in the PCT
Definition
movement of Na by the Na-K-ATP pump to be absorbed, also allows other electrolytes (K, Cl, Ca and phosphate) to be reabsorbed
Term
Describe movement of water in PCT (2)
Definition

The Na-K-ATP pump generates osmotic force, which allows water to passively diffuse out of the PCT and into the peritubular capillaries. 

Also, water transportation is enhanced by elevated oncotic pressure of blood in the peritubular capillaries

Term
Compare the ascending and descending arms of the loop of Henle (3)
Definition

(Compare: permeability, which substances transported and form of transportation) 

 

-Descending arm: highly permeable to water, no active transport capabilities, water moves out via osmosis

-Ascending arm: non-permeable to water, allows Na to move out using active and passive transports

Term
Describe filtrate when it enters the distal convoluted tubule
Definition
the majority of water and electrolyte reabsorption have already occured.
Term
Funtion of DCT
Definition
Work with the collecting duct, under hormonal control to adjust solute concentration
Term
Describe permeability in the DCT, what hormone controls the permeability
Definition
Is unpermeabile to water. However the end of the DCT and collecting duct are permeable to water as controled by the hormone, antidiuretic hormone (ADH)
Term
How does ADH control reabsorption at the end of the DCT/collecting duct
Definition
Presence of ADH, water is reabsorbed from the filtrate to increase blood volume
Term
What happens to Na in the DCT
Definition
reabsobed in later segment of the DCT/collecting duct. This is under the influence of aldosterone
Term
What can be secreted in the later segment of the DCT/collecting duct and how
Definition
K may be secreted in the latter segment/ collecting ducts. This is controled by aldosterone and other fators related to regulating potassium levels in the body
Term
What does aldosterone control in the latter segment of the DCT and collecting duct
Definition
controls Na reabsorption and K secretion
Term
3 types of urine concentration
Definition
hypotonic, isotonic and hypertonic
Term
How is ADH released (from detecting internal changes)
Definition
Osmoreceptors in the hypothalamus senses changes in blood osmolity. When there is an increase in blood osmolity, ADH is released by from the posterior pituitary gland.
Term
What other (external) factors can cause the release of ADH
Definition
surgery, pain, exercise and heat exposure
Term
Function of ADH
Definition
Acts to preserve water content. ADH increases water permeability in the last segment of the DCT and collecting duct. Therefore, more water is diffused out of the tubule and returns to the systemic circulation. Urine becomes more concentrated
Term
ADH does not effect which electrolyte
Definition
Na
Term
Describe processes in which angiotension II is produced
Definition
a decrease in BP or decrease in plasma volume -> stimulates the juxtaglomeruler apparatus to release -> renin enzyme to act on plasma protein angiotensionogen (produced in liver) -> interaction changes angiotensionogen to angiotension I -> Angiotension converting enzyme (ACE, found in the capillary of lungs in lungs) converts angiotension I -> angiotension II
Term
where is ACE found
Definition
in the capillaries of the lungs
Term
what is renin and where is it found
Definition
Renin is an enzyme, which is formed and arterioles of the juxtaglomeruler apparatus
Term
Three effects of angiotension II and their processes
Definition

- stimulate hypothalamus to release anti-diuretic hormone -> increasing water absorption -> decrease urine output

 

-stimulate adrenal cortex to release aldosterone -> acts on DCT and collecting ducts -> inc. Na reabsorption -> water follows -> inc. blood volume and dec. urine output

 

-causes vasocontriction -> inc. BP -> inc blood volume -> dec. urine output

Term
urea
Definition
by-product of protein metabolism in the liver. Excreted in kidneys
Term
2 factors influencing urea levels in blood rise
Definition

1) urea concentration increases as glomeruler fitration drops.  

2) Altered protein intake and protein catabolism

 

 

Term
3 conditions thar elevated urea levels in blood can indicate
Definition
dehydration, acute or chronic renal failure
Term
what is creatinine and why to measure
Definition
by-product of uscle metabolism. Released into the body at a relatively constant rate. Creatinine clearance is a good indicator to renal function
Term
describe normal process of micturition (micturition reflex)
Definition
stretch in bladder muscles, when full -> mechanoreceptors respond to stretch -> stimulates nerve impulses -> travel to sacral level of spinal cord -> action potential of parasympathetic fibres of the autonomic nervous system causes detrusor muscles of bladder to contract -> simultaneously (with detrusor movement) the internal urethral sphinter relaxes -> individual feels urge to void
Term
what may inhibit the relaxation of the external urethral sphinter
Definition
higher brain centres
Term
pons role in micturition
Definition
controls the micturition reflex
Term
location of bladder (in females and males)
Definition

in the pelvic cavity, behind the symphysis pubis. 

females: anterior to vagina and uterus

males: anterior to rectum

Term
neurons in spinal cord
Definition
spinal reflex: co-ordinates the signals of the micturation process
Term
describe conscious desire to urinate
Definition
when mechanoreceptors signal to sacral area (PNS), signals are also sent to the pons and cerebrum. Allowing individual to have conscious control over urination
Term
consciously inhibit urination
Definition
brain sends signal via efferent pathways to spinal cord and micturation reflex is inhibited
Term
intrinsic control of renal system (2)
Definition
-renal autoregulation: keep blood flow and glomerular filtration rate constant
-macula dense cells (distal convoluted tubules) of juxtaglomerular apparatus assist by sensing Na levels
Term
extrinsic control of renal system (2)
Definition
1) sympathetic nervous system
2) hormonal control
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