543 Sabs Renal Physio 2012 Edition

Front 1

Superficial cortical nephron

Back 1

Glomerulus in outer cortex

shorter loop of Henle

Front 2

Juxtamedullary Nephrons

Back 2

larger & longer loop of Henle

Filters faster

Reabsorbs more water

Vasa Recta

Front 3

Peritubular Capillary Network

Back 3

efferent arteriol --> around loop of Henle

Front 4

Vasa Recta

Back 4

capillary -Juxtamedullary nephron

follows loop of Henle

Front 5

Total Body Water

Back 5

50-70% of body weight

Measured: D2O, THO, antipyrine

Front 6

Inter Cellular Fluid

Back 6

40% of body weight

2/3 of total body water

Measured: (TBW - ECF)

Front 7

Extra Cellular Fluid

Back 7

1/3 body weight

Measured: Inulin, Mannitol, Sulfate

Front 8

Diarrhea

Back 8

Iso-Osmotic Volume Contraction

loose water & solute in same proportion

Front 9

Water Deprivation

Back 9

Hyper-Osmotic Volume Contraction

loose more water than solute

increased protein, osmolarity ECF (pulls from ICF)

unchanged Hematocrit,

Front 10

Adrenal Insufficiency

Back 10

Hypo-Osmotic Volume Contraction

trigger is decreased osmolarity

increased hematocrite, RBC, plasma pro

Front 11

Intravenous Fluids

Back 11

Iso-Osmotic Volume Expansion

Front 12

High NaCl intake

Back 12

Hyper-Osmotic Volume Expansion

reduced hematocrite & RBC volume

Front 13

Syndrome of Inappropriate ADH (SIADH)

Back 13

Hypo-Osmotic Volume Expansion

Increased ADH

Unchanged hematocrit

Reduced RBC concentration, protein

Front 14

clearance equation

Back 14

= (Urine concentration * flow rate ) / Plasma Concentration

Front 15

Intra Cellular Fluid: Ions

Back 15

cations: K, Mg

Anions: Proteins

Front 16

Extra Cellular Fluid: ions

Back 16

Cations: Na

Anions: Cl, HCO3

Front 17

reflects glomerulus filtration rate

Back 17

Inulin: filtered NOT secreted

Front 18

Highest Renal clearance rate

Back 18

PAH (Para AminoHippuric acid)

filtered & secreted

Front 19

Clearance ratio

Back 19

clearance of X/Clearance of Inulin

= 1- then same as filtration rate

< 1 --> then reabsorbed
>1 --> then secreted

Front 20

Renal Bl flow: Sympathetic stimulation

Back 20

constriction of Afferent & Efferent arterioles

Hemorrhage

Front 21

Renal Bl flow: Angiotensin II

Back 21

constricts Efferent more than Afferent

Renin released b/c
Juxtaglomerular cells by sympathetic innervation,
decline Osmotic concentration of filtrate @ macula densa

Front 22

Renal Bl Flow: Prostaglandin

Back 22

vasodilation

Front 23

Myogenic Mech

Back 23

sm muscles of arterioles

stretch --> Activate Ca++ channels
--> contraction Sm Muscles

reduce pressure gradient

Front 24

Tubuoglomerular feedback

Back 24

glomerulus & renal tuvule

if too much flow macula densa senses & causes constriction of afferent arteriole --> reduce filtration

Front 25

Macula Densa

Back 25

Distal Convoluted tubule

near afferent arteriole

Front 26

Autoregulation renal Bl flow

Back 26

Myogenic Mech

Tubuloglomerular Feedback

60 - 200 mm Hg
momentary changes

Front 27

Myogenic Mech

Back 27

Autoregulation renal Bl flow

sm muscle arteriole stretch

--> activates Ca++ --> constriction

Front 28

Tubuloglomerular Feedback

Back 28

Autoregulation renal Bl flow

increased filtrate along tubule --> Macula Densa
--> signals constriction of afferent arteriol

Front 29

Juxtaglomerular apparatus

Back 29

macula densa & afferent arteriole

Front 30

Muscles of piss

Back 30

Detrusor = Bladder

Internal sphincter

External sphincter - voluntary

Front 31

Filling bladder

Back 31

Detrusor - Beta2 receptor- Norepiephrine

Internal Sphincter - Alpha1 - Nor Epinephrine

Front 32

Empty bladder

Back 32

Muscarinic receptors & Ach

Detrusor & Internal Sphincter

Front 33

where is most Na reabsorbed

Back 33

Proximal Convoluted Tubule - 67%

Thick Ascending limb - 25%

Distal convoluted Tubule - 5%

Front 34

Na with most (67%) co-transport mech (EARLY)

Back 34

Early Proximal Convoluted Tubule

Front 35

Na with most (67%) Na+ /H+ Anti-Port (LATE)

Back 35

Late Proximal Convoluted Tubule

Front 36

Proximal Convoluted Tubule

Back 36

Early - Na co-transporters
Late - Na/H Anti-Port

IsoOsmotic Absorption
Glomerulotubular balance

Front 37

Glomerulotubular Balance

Back 37

Proximal Convoluted Tubule
balance btw filtration & reabsorption

more filtration --> higher oncotic pressure & more reabsorption

Front 38

Counter Current Multi Mech

Back 38

Thin limbs

Thin Ascending impermeable to Water

Vasa Rector

Maintain Gradient

Front 39

25% Na reabsorbed

Back 39

Thick Ascending

Co -Transport Na, 2 Cl-, K

Front 40

loop diuretics

Back 40

Furosemide, Bumetanide, Etharcrynic Acid

blocks Cl of Na/2Cl/K cotransporter in Thick Ascending Limb

Front 41

Early Distal Convoluted Tubule (Cortical Diluting Segment)

Back 41

Thiazide Diuretics

Co Transporter Na/Cl

Front 42

Thiazide Diuretics

Back 42

Early Distal Convoluted Tubule

blocks binding of Cl- to Na/Cl co transporter

Cholorothiazide, Hydrochlorothiazide

Front 43

Late Distal Convoluted Tubule

Back 43

secondary Active Transport of Na

K sparing Diuretics
Lumen = Na & K channels

Basolateral = Na/K anti port (pumping Na from cell to interstitial (Blood)

Front 44

K sparing Diuretics

Back 44

Late Distal Convoluted Tubule

blocks Na channel

Spironolactone, amilride, triamterene

Front 45

Beta Agonists & K+

Back 45

albuterol

Hypokalemia

Front 46

Beta Antagonists

Back 46

Hyperkalemia

Propranolol

Front 47

Alkalosis & K+

Back 47

H+/K+ antiport

moves K+ out of cells & H+ in

Front 48

Most K+ reabsorbed

Back 48

67% Proximal Convoluted Tubule

20 Thick Ascending limb

Alpha cells of Distal Convoluted Tubule

Front 49

Aldosterone

Back 49

K+ Secretion

Na reabsorption

Front 50

Acidosis & K+

Back 50

H+ moves into Principal Cells, Decreased K Secretion

Front 51

these increase secretion of K

Back 51

Loop & Thiazide diuretics

Sulfates in filtrate

Front 52

Phosphate reabsorption

Back 52

70% proximal convoluted

15% straight tubules

Front 53

Phosphate proximal convoluted

Back 53

Na/Phosphate co transport

Inhibited by PTH via AC --> urine with high PTH & cAMP

Front 54

Pseudohypoparathyrodism

Back 54

problem w/PTH signal

excess PTH not secreting Phosphate

Front 55

PTH & Ca++

Back 55

increases plasma Ca++

Front 56

Diuretics & Ca++

Back 56

Loop blocks Ca++ reabsorption

Thiazide increases Ca++ reabsorption

Front 57

Diuretic that promotes Ca++ reabsorption

Back 57

Thiazide

Front 58

use this for hypercalciuria

Back 58

Thiazide

Front 59

Mg+ reabsorption

Back 59

60% thick ascending limb

blocked by Loop Diretics

Front 60

ADH mech

Back 60

Principle cells

G protein --> AC --> cAMP --> PKA

causes made water channels to implant

Front 61

Counter Curent Multiplication

Back 61

Establishes corticopapillary osmotic gradient

Front 62

Countercurrent Exchange Mech

Back 62

maintains Corticopapillary Osmotic Gradient

Vasa recta

Front 63

Vasa Recta

Back 63

part of peritubular capillary network

associated w/ Juxtamedullary network

Countercurrent Exchange Mech