Kidney I

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What makes up the extracellular fluid?

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Philosophy

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1

What makes up the extracellular fluid?

Blood plasma

Interstitial fluid

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2

What are the functions of the kidneys?

  1. reg of extracellular fluid volume

  2. reg of extracellular fluid osmolarity

  3. reg of blood pressure

  4. maintain ion concentration

  5. reg pH

  6. excrete wastes

  7. production of hormones

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3

What hormone is released by the kidney?

Erythropoietin

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4

What is the normal pH?

7.4

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5

What is the normal osmolality?

280mosm

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6

What are the key ions in the kidney?

HCO3-, Na+ , K+ and Cl-

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7

What are the metabolic products that are excreted by the kidneys?

Creatinine and urea

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8

What is the medulla composed of?

8-15 renal pyramids

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9

What is in the renal pyramids?

Multiple nephrons

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10

What is transported in the nephrons to the renal pelvis?

Urine

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11

What’s the centre of the kidney called?

Calyx

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12

What is the function of the kidney?

Filter

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13

Where does filtrate travel into?

Tubules

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14

What happens in the tubules?

Reabsorbtion

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15

What happens to the remainder of the filtrate that wasn’t reabsorbed into the bloodstream in the tubules?

Passes into the renal pelvis and excreted

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16

What is the glomerulus?

Capillary bed

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17

What are the two types of nephrones?

Cortical nephrons

Juxtamedullary nephrons

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18

Where do the glomeri of the cortical nephrons originate?

Outer cortex

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19

Where do the loops of henle of the cortical nephrons descend to?

The outer medulla

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20

What’s “higher up“ cortical or juxtamedullary nephrons?

Cortical

The latter are “deeper” and posses a much longer loop of henle

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21

Where do the loops of henle of the juxtamedullary nephrons descend to ?>

The inner medulla

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22

What are the four functions of the nephrons?

Filtration

Absorbtion

Secretion

Excretion

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23

How much blood does the kidney receive?

25% of cardiac output

1L/min

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24

Where is arterial blood directed to in the kidneys?

From renal arteries to INTERLOBAR AND ARCUATE arteries to afferent arterioles

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25

How does the blood return from the kidneys?

Via arcuate veins, interlobar veins into renal vein

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26

Where is blood from afferent arteriole directed to?

Glomelular capillary

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27

Where is blood from the glomerular capullaries directed to?

efferent arteioles

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28

Where is blood from efferent arterioles directed to?

Peritubular capillaries

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29

What the function of the glomerus?

Filtration

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30

What’s the function of the peritubular capillaries?

Absorbtion

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31

What are the glomerular capillaries surrounded by?

A rigid Bowman’s capsule

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32

What kind of capillaries are in the glomerulus?

Fenestrated capillaries

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33

What do fenestations allow to pass into the capsule?f

Dissolved solutes

NOT CELLS or PLATELETS

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34

What does plasma pass through during glomerular filtration?

  1. fenestrations

  2. glomerular basement membranes

  3. inner layer of bowmans capsule

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35

What cells make up the inner layer of the bowmans capsule?

Podocytes

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36

What structures extend out of the podocytes to wrap around the capillaries?

Pedicels/ foot processes

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37

What are the spaces between pedicles of the podocytes?

Slit diaphrams that solutes have to pass between

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38

What is the filtrate composed of?

Plasma and small amounts of proteins= albumin

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39

Why isn’t Ca filtrated?

They are bound to larger proteins

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40

Why are’t fatty acids filtered through?

They are lipophillic hence they need to bind to transported proteins which are far too large to be filtered through

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41

What’s proteinuria?

Protein is filtered through into urine

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42

What is proteinuria caused by?

Damage to slit diaphrams?

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43

How are podocytes charged?

Negative charge

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44

Why won’t albumin filter through?

They are negatively charged and are repelled by the neg charged podocytes and capillary walls

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45

What the glomerular filtration rate?

vol of filtrate produced/ min

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46

What’s the average GFR?

115ml/min females

180L/day

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47

What’s the total blood volume?

5.5L

this means total blood volume is filtered every 40 mins?

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48

What forces allow filtration in the glomerulus?

glomerular hydrostatic pressure - bowmans capsule pressure - glomerular oncotic pressure

→ opposed by plasma oncotic pressure

→ opposed by bowman’s capsule pressure

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49

What’s the net filtration pressure in mm of mercury?

10mmHg

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50

What’s oncotic pressure?

More proteins in bloodstream

Promotes water into bloodstream

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51

Why is there no absorbtion in the glomerus?

Pressure difference

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52

What’s haematocrit?

The red blood cells in blood

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53

how much % of plasma is filtered through the glomerular capillaries?

20%

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54

How is the GFR regulated?

intrinsically and extrinsically

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55

What increases GFR?

autonomic nervous system if Na+ levels rise too high

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56

what will a haemorrhage do to GFR?

reduced to retain blood volume

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57

What is changed to control GFR?

resistance to afferent and efferent arterioles

→ hydrostatic pressure changes

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58

What happens in the peritubular capillaries?

Absorbtion (low pressure)

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59

What happens to GFR if afferenent arterioles are dilated?

increased

larger diameter= more GFR

larger diamter=less resistance= higher pressure = more filtrated

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60

What happens if the diameter of the efferent arterioles is decreased?

Vaconstriction= build up of blood on the side of the glomerus= more pressure= higher GFR

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61

what happens to the glomerular hudrostatic pressure of effereent arterioles are constricted>

increased

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62

What happens if the efferent arterioles are REEAAALLY contracted?

less renal flow= large increaase in plasma oncotic pressure (that opposes filtration) = less GFR

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63

What’s the glomerular hydrostatic pressure?

Pressure in the capsule fluid that drives the outward filtration

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64

What does GFR stand for?

Glomerular filtration rate

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65

What is the filtrtion freaction?

GFR/ renal plasma flow

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66

Whats the renal plasma flow?

600ml/mon

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67

How is the glomerular filtration rate controlled?

intrinsically and extrisincally

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68

How will a haemorrhage impact GFR?

fall in GFR`

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69

What happens if Na+ conc rises to the GFR?

Increases

More stuff exctreted

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70

Does mean arterial pressure affect GFR?

No, as the kidney autoregulates itself.

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71

What’s the myogenic response?

increase in blood pressure= constriction of afferent arterioles

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72

What happens to the afferent arterioles if MAP falls?

dilation= more blood coming to glomerus despite sluggish trickling in due to low pressure

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73

What apparatus controls the intrinsic renal autoregulation?

Juxtaglomerular

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74

What cells are in the juxtaglomerular apparatus?

Macula Densa

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75

What does the macula densa detect?

NaCl

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76

What happens due to increased levels of NaCl?

Release of ATP by macula dense

constriction of afferent arteriole

less GFR

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77

What division of the nervous system regultes nephrons and renal blood vessels?

Sympathetic only

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78

What NT is released by the renal sympathetic nerves?

Noradrenline

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79

What does noradrenaline cause?

Constriction of afferent arterioles

→ reduced GFR

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80

What happens to urine output due to Noradrenaline?

Decreased

this prevents loss of blood

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81

How is GFR measured?

by the renal clearance of any substance

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82

what’s the equation for the renal clearance?

Cs * Ps = Us *V

clearance rate

plasma conc.

urine conc.

urine flow rate

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83

What’s the urinary extretion rate in terms of GFR and secretion rate and reabsorbtion rate?

Urinary excretion rate= GFR + secretion rate- reabsorbtion rate

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84

In what conditions is GFR= renal clearance?

  • the substance measured isn’t reabsorbed or secreted at the tubules

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85

What waste product is used to measure GFR?

Creatinine

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86

If the substance is filtered and partially reabsorbed, what is the relationship between GFR and renal plasma clearance?

Renal plasma clearance < GFR

  • gets rid of that substance better in the glomerus than the plasma because it comes back

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87

If the substance is filtered and then secreted, what is the relationship between GFR and renal plasma clearance?

Renal plasma clearance > GFR

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