Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
115 Cards in this Set
- Front
- Back
aldosterone
|
hormone synthesized and released by the adrenal cortex; causes the kidneys to reabsorb sodium
|
|
ADH - antidiuretic hormone
|
hormone secreted by the posterior pituitary gland; causes the kidneys to reabsorb more water; aka vasopressin
|
|
anuria
|
O < 50 mL / 24 hours
|
|
bacteriuria
|
bacterial count higher than 100,000 colonies/mL
|
|
creatinine
|
endogenous waste product of muscle energy metabolism
|
|
dysuria
|
painful or difficult urination
|
|
frequency
|
voiding more frequently than every 3hours
|
|
glomerulus
|
tuft of capillaries forming part of the nephron through which filtration occurs
|
|
GFR - glomerular filtration rate
|
volume of plasma filtered at the glomerulus into the kidney tubules each minute; normal rate is approximately 120mL/min
|
|
hematuria
|
RBC in the urine
|
|
micturition
|
urination or voiding
|
|
nephron
|
structural and functional unit of the kidney responsible for urine formation
|
|
nocturia
|
awakening at night to urinate
|
|
oliguria
|
O < 400 mL/24h
|
|
proteinuria
|
protein in the urine
|
|
pyuria
|
WBC in the urine
|
|
renal clearance
|
volume of plasma that the kidneys can clear of a specific solute (eg creatinine); expressed in mL/min
|
|
renal glycosuria
|
recurring or persistent excretion of glucose in the urine
|
|
specific gravity
|
reflects the weight of particles dissolved in the urine; expression of the degree of concentration of the urine
|
|
tubular reabsorption
|
movement of a substance from the kidney tubule into the blood in the peritubular capillaries or vasa recta
|
|
tubular secretion
|
movement of a substance from the blood in the peritubular capillaries or vasa recta into the kidney tubule
|
|
urea nitrogen
|
nitrogenous end product of protein metabolism
|
|
urinary incontinence
|
involuntary loss of urine
|
|
The primary function of the renal and urinary systems is to...
|
maintain the body's state of homeostasis by carefully a. regulating fluid and electrolytes, b. removing wastes, and c. providing hormones that are involed in RBC production, bone metabolism, and hypertension.
|
|
Location of the kidneys
|
retroperitoneally on the posterior wall of the abndomen from the T12 to L3.
|
|
Which kidney is higher? Why?
|
the left kidney is higher. because the liver is on the right
|
|
How much of total CO do the kidneys receive each minute?
|
20-25%
|
|
How many times per hour does all of the body's blood circulate through the kidneys?
|
approximately 12 times per hour
|
|
When does renal replacement therapy need to be considered? When the total number of functioning nephrons is less than....?
|
when the total number of functioning nephrons is 20% less than normal
|
|
general info about the cortical nephrons...
|
-80-85% of nephrons
-located in the outermost part of the cortex |
|
general info about the juxtamedullary nephrons
|
-15-20% of nephrons
-located deeper in the cortex -have longer loops of Henle that are surrounded by long capillary loops (the vasa recta) that dip into the medulla of the kidney |
|
the length of the tubular component of the nephron is directly r/t?
|
its ability to concentrate urine
|
|
2 basic components of nephrons
|
-the glomerulus (the capillary network)
-the attached tubule |
|
each kidney has about how many nephrons?
|
about 1 million
|
|
2 forms of nephrons?
|
cortical and juxtamedullary
|
|
3 filtering layers of the glomerular membrane
|
1. the capillary endothelium
2. the baement membrane 3. the epithelium |
|
what cells is the macula densa made of and what is it's location?
|
the distal tubular cels located in the area where the afferent and efferent arteriole respectively enter and leave the glomerulus.
|
|
composition of the juxtaglomerular apparatus
|
the macula densa plus the adjacent afferent arteriole
|
|
function of the juxtaglomerular apparatus
|
renin production
|
|
what is the site of the renin production?
|
the juxtaglomeruar apparatus JGA
|
|
the urothelium of the ureters prevent?
|
reabsorbtion of urine
|
|
capacity of the adult bladder
|
300-500 mL
|
|
the healthy human body is composed of approximately what % of water?
|
60%
|
|
3 step process of urine formation
|
1. glomerular filtration
2. tubular reabsorption 3. tubular secretion |
|
what 2 things are normally filtered and then reabsorbed so that neither is excreted?
|
1. amino acids
2. glucose |
|
when does renal glycosuria occur?
|
if the amout of glucose in the blood and glomerular filtrate exceedds the amount that the ubules are able to reabsorb
|
|
what is the most common clinical expression of a blood glucose level exceeding the kidney's reaborption capacity?
|
-diabetes
-also common in pregnancy |
|
what are 2 examples of low-molecular-weigh proteins that are usually not found in the urine but may periodically be excreted in small amounts?
|
1. globulins
2. albumin |
|
normal blood flow through the kidneys per minute
|
1200 mL/ min
|
|
normal percent of filtrate produced from blood passing through the glomeruli AND
how much a day does this amount to? |
20%, amounting to 180 L/ day
|
|
how much of the filtrate is reabsorbed?
|
99%
|
|
how much of the filtrate is actually excreted as urine?
|
1%, or 1000-1500 mL
|
|
although reabsorption occurs along the entire tubule, where does is mostly occur
|
the proximal tubule
|
|
where does filtrate become concentrated?
|
in the distal tubule and collecting ducts, under hormonal influence
|
|
where is ADH secreted?
|
the posterior pituitary gland
|
|
ADH is secreted why?
|
in response to change in blood osmolality. ie if blood osmolality increases (more solutes in blood than in surrounding tissues)
|
|
as water intake increases, ADH secretion...
|
is suppressed
|
|
decreased ADH secretion leads to...
|
diuresis
|
|
increased ADH secretion leads to...
|
increased blood volume or HTN
|
|
what does a fixed specific gravity (about 1.010) or a fixed osmolality (about 300 mOsm/L) indicate?
|
-early sign of kidney disease
-indicates an inability to concentrate and dilute the urine |
|
osmolaRity refers to...
|
the ratio of solute to water
|
|
osmolaLity refers to...
|
the number os osmoles dissoloved per kilogram of solution.
|
|
what is the normal osmolality of the filtrate in the glomerular capillary and the blood?
|
275-300 mOsm / kg
|
|
what is the normal intake and output of fluids?
|
intake of oral liquids - 1300 mL
intake through food - 1000 mL output through skin and lungs (insensible loss) - 900 mL output through sweat - 50 mL output through feces - 200 mL |
|
what is a reliable means of determining overall fluid status?
|
daily weight measurements
|
|
w regards to fluid status, a weight change of as little as 1 lb could suggest an overall fluid gain or loss of ....
|
500 mL
|
|
normally, the volume of electrolytes excreted per day is equal to....
|
the amount ingested
|
|
what is the most plentiful extracellular ion?
|
sodium
|
|
what is the only cation to exert significant osmotic pressure?
|
sodium
|
|
if more sodium is excreted than ingested, what results?
|
dehydration
|
|
if more sodium is ingested than secreted, what results?
|
fluid retention
|
|
what hormone regulated sodium volume excretion?
|
aldosterone
|
|
where is aldosterone synthesized and released?
|
the adrenal cortex
|
|
as aldosterone in the blood is increased, what happens to sodium
|
less sodium is excreted in the urine / aka the body hold on to more sodium
|
|
when is the RAA syste actived?
|
when pressure in the renal arterioles fall below normal levels, as occurs with
-shock -dehydration -or decreased sodium choride deliery to the tubules |
|
activation of the RAA system increases...
|
water retention and expanision of the intravascular fluid volume, thereby maintaining enough pressure within the glomerulus to ensure adequate filtration
|
|
what is the most abundant intracellular ion?
|
potassium
|
|
what percent of daily ingested potassium (K) is excreted by the kidneys
|
90% of the total daily potassium intake
|
|
what factors influence potassium loss
|
-aldosterone release
-acid-base balance -amount of dietary potassium intake -flow rate of the filtrate in the distal tubule |
|
aldosterone release does what pertaining to sodium and potassium
|
-increases blood Na level
-decreases blood K level |
|
what is the most threatening effect of renal failure
|
retention of potassium
|
|
in what 2 ways do the kidneys help maintain acid-base balance?
|
1. reabsorption and return to the body's circulation any bicarbonate from the urinary filtrate
2. excretion of acid in the urine |
|
to replace any lost bicarb not reabsorbed, new bicarbonate is generated by the
|
renal tubular cells
|
|
the body's acid production is the result of ...
|
catabolism of proteins, which produces acid compounds, in particular phosphoric and sulfuric acids, which cannot be eliminated by the lungs. so, they must be excreted in the urine
|
|
how does the kidney get rid of acid other than directly as free acid?
|
excess acids are bound to chemical uffers (phosphate ions and ammonia) so that they can be excreted in the urine
|
|
what are 2 important chemical buffers that bind to excess acid in the tubular filtrate?
|
-phosphate ions
-ammonia (NH3) ions |
|
phosphate is present in the
|
glomerular filtrate
|
|
phosphate is produced by
|
the renal tubules and secretes into the tubular fluid
|
|
when ammonia is buffered with acid, it becomes
|
NH4, ammonium
|
|
through the buffering process, the kidney is able to ...
|
excrete large quantities of acid in a bound form, without further lowering the pH of the urine
|
|
what specialized cells in the kidney constantly monitor BP?
|
the vasa recta
|
|
What happens when the vasa recta detects a decrease in BP?
|
specialized juxtaglomeruluar cells near the afferent arteriole, distal tube, and efferent arteriole secrete RENIN
|
|
what is the most potent vasocontrictor?
|
antiotensin II
|
|
renin, and therefore angiotensin II, production, causes BP to...
|
increase
|
|
when the pituitary glands detects poor perfusion or increase serum osmolality, what happens
|
stimulation of the adrenal cortex to secrete aldosterone, leading to an increase in BP
|
|
when the vasa recta recognizes an increase in BP,
|
renin production stops
|
|
what is one of the primary causes of HTN
|
failure of the feedback system of the vasa recta
|
|
what is the primary test of renal clearance used to evaluate how well the kidney performs it's excretory function
|
a 24-hour collection of urine to wh
|
|
what can effect renal clearance?
|
-how quickly the substance is filtered across the glomerulus
-how much of the substance is secreted into the tubules |
|
what renal clearance measure is particularly important?
|
creatinine clearance
|
|
what is creatinine
|
an endogenous waste product of skeletal muscle that is filtered at the glomerulus, passed through the tubules with minimal change, and excreted in the urine
|
|
what is a good measure of GFR?
|
creatinine clearance
|
|
what is creatinine clearance a good measure of?
|
1. renal clearance
2. GFR |
|
as renal function declines, what happens to creatinine clearance?
|
as renal function declines, creatinine clearance decreases
|
|
why would the kidneys excrete EPO?
|
when they sense a decrease in the oxygen tension in the renal blood flow
|
|
what is the effect of EPO release from the kidneys?
|
stimulation of the bone marrow to produce RBCs, therby increasin the amount of hemoglobin available to carry oxygen
|
|
what is the kidney responsible for r/t vitamin D?
|
the final conversion of inactive vitamin D to its active form, calciferol
|
|
vitamin D is necessary for
|
maintaining normal calcium balance in the body
|
|
what do the kidneys do r/t prostaglandins?
|
the kidney produce prostaglandin E and prostacyclin
|
|
what are the effects of the PGs produced by the kidneys
|
-vasodilation
-important in maintaining renal blood flow |
|
what is the waste products of metabolism that must be excreted by the kidneys?
|
urea, creatinine, phoshates, sulfates, and uric acids
|
|
what is the major waste product of protein metabolism?
|
urea
|
|
how much urea must be excreted?
|
all of the urea produced daily, about 25-30 g
|
|
uric acid is a waste produce of
|
purine metabolism
|
|
what is the primary mechanism in the body of excreting drug metabolites?
|
the kidneys
|