Renal (1 + 2) + Reproductive System

What are the primary functions of the renal system?

Volume of blood plasma (affects BP), wastes, electrolytes, pH, and secrete erythyropoietin

What protects the kidneys?

Ribs, surrounded by fat perirenal for protection, and a fibrous capsule is thick, strong, and protective

The sensory exam identifies:

Urine color, urine odor, and urine clarity/cloudiness

The dipstick identifies:

Specific gravity (density), pH, glucose, blood, WBCs, ketones, bilirubin/urobilinogen, protein, and other ion

The microscopic lab exam identifies:

Casts/Crystals (kidney stones), WBC/RBC count, parasites, yeast, and bacteria

What are the various structures of the nephron in order?

Bones/Capsule → PCT (Proximal Convolted Tubule) → Nephron Loop → Descending → Ascending → Distal Convolted Tubule (DCT) → Collecting Tubule → Collecting Duct

What do juxtaglomurular cells do?

Secretes renin, specifically converts Angiotensiogen → Angiotensin I, as ACE lowers BP → Antiotensin II (Increases BP + causes aldosterone to secrete K+ → Na+/H2O reabsorbption)

What do macula densa cells do?

Detect NaCl content and decreases GFR via afferent arteriole vasoconstriction

What do mesangial cells do?

Provide structural support and filter out debris in glomerulus

Know the conversions and locations of agents to get Angiotensin 2 produced.

The enzyme renin converts the pro-enzyme angiotensin I; the lung-derived enzyme ACE converts angiotensin I into active angiotensin II

What determines net filtration pressure?

NFP=OP + HP , Osmotic forces increases w/larger and charged particles, Hydrostatic forces increase w/greater blood flow/pressure

What creates the gradient in the countercurrent multiplier system? 

Salt (NaCl) is actively pumped into the interstitial fluid from the thick segment of the limb

• Descending Loop=permeable to H2O

• Ascending Lopp=immpermeable

• Deeper=increased conc. Of fluid in tube

The more salt the ascending limb removes, the saltier the fluid entering it will be (due to loss of water in descending limb)

What are urinary buffers?

1. Nephrons cannot produce urine with a pH below 4.5

2. To increase H+ secretion, urine must be buffered:

   • Phosphates and ammonia (NH3) buffer the urine

   • Phosphates enter via filtration

   • Ammonia comes from deamination of amino acids

Know the relative amounts and compartments of body water.

Intracellular flud (ICF) - fluid within cells (abt ⅔)

extracellular fluid (ECF) - ???

1. Interstitial fluid part between cells (4/5th of ECF)

2. Blood plasma second part of ECF (1/5 th of the ECF)

Know which ions are primarily intracellular vs extracellular. 

Intracellular - K ( potassium), HPO4 2- (phosphate), Mg 2+ (magnesium), protein 

Extracelular - Na+, Cl-, HCO3- 

What controls our thirst? 

Osmoreceptors in the hypothalamus detect DCR in water levels in blood > renin-angiotensin-aldosterone is activated by JGA apparatus by the SNS which detects low BP from baroreceptors > Angiotensin II - vasoconstriction - stimulating aldosterone release and decor GFR, along w/ increasing thirst

What does ADH and Aldosterone do, what cell does it effect to do that?

ADH: produced in the hypothalamus and released by pituitary gland, causes kidneys to retain water → more reabsorption → increases water out of tubule into the bloodstream by the cells of the collecting tubules (aquaporins), increase BP

Aldosterone: released by the adrenal gland, facilitates reabsorption of Na+ and water, raises BP, cells in the DCT and collecting ducts of the kidneys

How are males vs females determined?

TDF: determines male structures

IMF - only stopping female structures