543 Renal Physiology

Front 1

ECF

Back 1

Na+

Cl- HCO3-

Front 2

ICF

Back 2

K+, Mg+

Anions: Proteins, Oranic Phosphates

Front 3

PHA (Paraminohaburic Acid)

Back 3

used to measure excretion (Filtration + secretion)

not naturally produced

Front 4

Measure Total Body Water

Back 4

D2O

THO

Antipyrine

Front 5

What happens - need to Pee

Back 5

Detrusor stretched
--> micturition center reduces sympathetic & increases parasymapthetic (S2-4)

--> (S2-4) --> Ach
--> Ach activates Muscarinic receptors
--> Detrusor muscle contracted
--> internal sphincter relaxed

Front 6

Measure ECF

Back 6

can't pass through membrane

Mannitol

Inulin

Sulfate

Front 7

What happens - Don't need to Pee

Back 7

L1-3 NorEpi
-->Beta 2 receptors Detrusor muscle Relaxed
--> Alpha receptor internal sphincter contracted

Front 8

Measure ICF

Back 8

Total Body Water minus ECF

*measure ECF 1st

Front 9

hormones in the kidney

Back 9

Rennin
Erythropoietin
Vitamin D (1-25-Dihydroxycolicalciferon)

Front 10

Measure Plasma

Back 10

RadioIodinated Serum Albumin

Evan's Blue

Front 11

where is the majority of Na reabsorbed

Back 11

Proximal Tubule

Front 12

This type of transport is how early proximal convoluted tubule gets solutes from lumen into cell

Back 12

secondary active transport w/Na moving down gradient made by Na/K ATPase pump on basolateral membrane

Front 13

where is Cl- reabsorbed

Back 13

late proximal convoluted tubule (-4mV to +4mV)

thick ascending limb

Distal Tubule

Collecting duct

Front 14

how is water absorbed in proximal convoluted tubule

Back 14

Isosmotic Absorption

Front 15

Glomerulotubular balance

Back 15

major regulator mech of proximal tubule
prevents Na loss from body
balance btw filtration & reabsorption in proximal tube

Volume contraction will have lower hydrostatic pressure in Peritubular capillar facilitating reabsorption

Volume expansion will have higher pressure in peritubular capillary that will inhibit reabsorption

Front 16

areas of kidney impremeable to water

Back 16

Thin ascending limb
Thick ascending limb
Early Distal Convoluted Tubule

Front 17

Counter Current Multiplication Mech

Back 17

Thin descending limb has solutes move into renal tubule & water leaves renal tubule -

this helps reabsorbe solutes in thin ascending limb

Establishes Osmolarity gradient (maintained by vasa rector)

Front 18

Na Transporter in Thick Ascending limb

Back 18

Na-Cl-K co transporter

Front 19

What drugs work at Thick Ascending Limb

Back 19

Loop Diuretics: Furosemide, Bumetanide, Etharcrynic Acid

Block Cl- binding & stop action of Na/K/Cl Co-Transporter

Front 20

Early Distal Convoluted Tubule (Cortical Diluting Segment)

Back 20

reabsorb using Na/Cl Co-Transporter

Thiazide Diuretics:

Impermeable to water

Front 21

Late Distal Convoluted Tubule

Back 21

Na reabsorbed through channels via secondary active transport

K+ sparing Diuretics: Spironolactone, Amiloride,Triamterene

Aldosterone

ADH

Front 22

Thiazide Diuretics

Back 22

--> blocks Cl ions from binding Na/Cl symport in Early Distal Convoluted Tubule

Cholorothiazide
Hydrochlorothiazide
Metolazone

Front 23

K+ Sparing Diuretics

Back 23

Late Distal Convoluted Tubule
prevents Expression of Na channel (Less Na reabsorbed & K secreted)

Spironolactone
Amiloride
Triamterene

Front 24

Aldosterone in kidney

Back 24

increases Na reabsorption in Late Distal Convoluted Tubule

Front 25

ADH

Back 25

increases aquaporin in Late distal convoluted tubule

Front 26

ADH & Aldosteron increase b/c

Back 26

drop in BP

Front 27

K+ is usually found higher

Back 27

inside the cell

Front 28

Hyperkalemia

Back 28

too much K+ in blood

Front 29

causes Hyperkalemia

Back 29

correction of Acidemia

Cell Lysis

Renal Failure + Exercise

Beta2 Antagonist: Propranolol

Alpha agonists

Front 30

causes Hypokalemia

Back 30

too much insulin

correction of Alkalemia

Beta2 agonists: Albuterol

alpha antagonists

Front 31

albuterol

Back 31

Beta-2 agonists

excess = hypokalemia

Front 32

Propranolol

Back 32

Beta 2 antagoinist

excess = hyperkalemia

Front 33

internal K balance

Back 33

cellular K+ balance

Front 34

External K+ balance

Back 34

systemic K+ balanace

Front 35

K+ is reabsorbed

Back 35

mostly Proximal Convoluted Tubule
Thin Ascending Limb
Distal Convoluted

Front 36

What is the 'PARASYMPATHETIC' response on 'BLOOD VESSELS' (ARTERIOLES)

(BOTH SKELETAL/OTHER BODY ARTERIOLES)

Back 36

NONE

NO EFFECT

Front 37

Measure Interstitial Fluid

Back 37

ECF minus Plasma

Front 38

How to use markers for fluid measurement

Back 38

(injected - excreted) / Compartment concentration

Front 39

High Renal Clearance

Back 39

PAH (Para-AminoHippuric Acid)

highest clearance rate

Front 40

reflects filtration rate

Back 40

Inulin

Creatinine

BUN (Blood Urine Nitrogen)

Front 41

Sympathetic stimulation of renal arterioles

Back 41

norepinephrine

constricts Afferent & Efferent Arterioles

Blood Volume decreases, hemorrhage

Front 42

Angiotensin II

Back 42

from adrenal gland when BP drops

systemic vassoconstriction

Efferent more than afferent

Front 43

Prostaglandin (E2 & I2)

Back 43

in resoponce to low body fluid

vassodilation

prevents renal failure

Front 44

Auto regulation mech of renal blood flow

Back 44

Myogenic Mech

Tubuloglomerular Feedback

60-200 mmHg can control, short term

Front 45

Myogenic Mech

Back 45

renal arterioles stretch
--> activates Ca channels

--> depolarize

--> contraction/constriction of arterioles

Front 46

Tubuloglomerular Feedback

Back 46

high renal arteriole pressure

--> increased filtration

--> Macula Densa (Distal Convoluted Tube) sense high filter flow
--> constrict afferent arteriole

Front 47

transporter in late proximal convoluted tubule

Back 47

Na+/H+ exchange

Cl-/Formate exchange

Na+ & Cl- btw cells

Positive Lumen