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204 Cards in this Set
- Front
- Back
Every cell produces which wastes that are excreted by the Urinary System? |
- Excess water - Salts - Urea |
|
Urea |
Toxic compound that is produced when amino acids are used for energy |
|
_______ can be toxic if they buildup and cause acidosis (too much acid) |
Hydrogen Ions |
|
4 Functions of the kidneys |
- Regulate ionic composition - Regulation of blood pH, volume, pressure, osmolarity, glucose level - Produces hormones (calcitrol & erythropoietin) - Excretes wastes & foreign substances (nitrogenous wastes, bilirubin, creatinine, uric acid, certain drugs and environmental toxins) |
|
6 things in the blood that kidneys regulate |
- Blood ionic composition (K+, Na+, Cl-, HPO4) - Blood pH - Blood volume - Blood pressure - Blood osmolarity - Blood glucose level |
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Which 2 hormones does the kidney produce? |
Calcitol Erythropoietin |
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6 things that the kidneys excrete |
- Nitrogenous wastes - bilirubin - creatinine - uric acid - certain drugs - environmental toxins |
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When blood enters the kidney through the renal artery it is _______ and _______ |
Dirty Oxygenated |
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When blood leaves the kidney through the renal vein it is _______ and _______ |
Clean Deoxygenated |
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Renal nerves originate mostly from the _________. These nerves pass through the _________ and enter the kidney with the renal arteries. These are sympathetic nerves; most are _______. |
Celiac gangion (sympathetic NS) Renal plexus Vasomotor |
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What are the functional units of the kidneys? |
Nephrons |
|
4 functions of nephron |
- Filter blood - remove substances from blood that are not needed - Form urine - Return useful substances to blood |
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The __________ is a capillary network in the cortex; capillaries here are _____ times more leaky |
Glomerulus 50 |
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The ____________ has two layers. The parietal layer is made of ____________ epithelium. The visceral layer is __________. |
Glomerular (Bowman's) Capsule Simple squamous Podocytes |
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The proximal convoluted tubule is made of __________ with ________. |
Simple cuboidal epithelium Brush border |
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The loop of Henle is in the _______ and the descending and ascending limbs have thick portions made of ______ and thin portions made of ________ |
Medulla Simple Cuboidal Simple Squamous |
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The distal convoluted tubule is made of ________ |
Simple cuboidal |
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The collecting duct is made of ________ and contains _________ and _________ |
Simple cuboidal Principal Intercalated cells |
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What are the to types of nephrons? |
Cortical Nephrons Juxtamedullary Nephrons |
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Which are the most prevalent type of nephrons? |
Cortical (85%) |
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Which nephrons are mainly in the cortex and outer medulla? |
Cortical |
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Which nephrons are have short loops of henle? |
Cortical |
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Which nephrons do NOT concentrate urine? |
Cortical |
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Which nephrons have long loops of henle? |
Juxtamedullary |
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Which nephrons are deep in the medulla? |
Juxtamedullary |
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Which nephrons can excrete very dilute or very concentrated urine? |
Juxtamedullary |
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What is the area called where the distal convoluted tubule interacts with cells of the afferent arteriole? |
Juxtaglomerular Apparatus (JGA) |
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What are the two parts of the Juxtaglomerular Apparatus? |
Macula Densa Juxtaglomerular cells |
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_________ are modified cells from ascending LOH-DCT junction. They monitor _______ and will hold onto them if BP is _____. |
Macula Densa Na+ and Cl- Too low |
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_________ are modified smooth muscle cells from afferent arteriole (and sometimes efferent). They secrete renin if ________. |
Juxtaglomerular Cells BP drops |
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What hormone is released by the kidneys and used to increase blood pressure? |
Renin |
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What are the 3 main steps to urine formation? |
1. Glomerular Filtration 2. Tubular Reabsorption 3. Tubular Secretion |
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Which step of urine formation occurs in the renal corpuscle? |
1. Glomerular Filtration |
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Which step of urine formation occurs all along the renal tubule? |
2. Tubular reabsorption |
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Which step of urine formation includes water and plasma solutes passing into glomerular capillaries and on to the renal tubule (PCT)? |
1. Glomerular Filtration |
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Which step of urine formation is when most filtered water and useful solutes are reabsorbed by the cells of the tubule and are returned to the bloodstream? |
2. Tubular Reabsorption |
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Which step of urine formation is when wastes, drugs, and excess ions are added to the fluid as it passes along distal convoluted tubule? |
3. Tubular Secretion |
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Which step of urine formation is when all solutes that remain in the fluid are passed on to the renal pelvis and are excreted in urine? |
3. Tubular Secretion |
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Which 6 substances are filtered in the glomerulus and passed on to the bowman's capsule? |
- H2O - Urea - Uric Acid - Glucose - Amino Acids - Salts |
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Describe glomerular filtration (3) |
- Process of filtration in glomerulus - Anything small enough to fit through pores, goes into bowman's capsule and then proximal convoluted tubule. - If it is too big, it goes out through efferent arteriole |
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Describe Tubular Reabsorption (2) |
- Materials that we can use are reclaimed and put back into blood stream. - Glucose, Amino Acids, some of the salts |
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Describe Tubular Secretion (3) |
- Mostly in DCT - Final chance to get rid of substances that were too big to filter out before. - Drugs, Creatinine, H+ |
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Fluid that enters the bowman's capsule is called ________. |
Glomerular Filtrate |
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More than _____ of fluid (glomerular filtrate) that enters the capsular space returns to blood stream during _________. Only 1-2 Liters are excreted as ______> |
99% Tubular Reabsorption Urine |
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The filtration membrane (fenestrated capillaries & podocytes) prevent filtration of _______, _______ and _______. |
Plasma proteins Blood cells Platelets |
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Which pressure promotes filtration? |
Glomerular Blood Hydrostatic Pressure (GBHP) |
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Which 2 pressures oppose filtration? |
Capsular Hydrostatic Pressure (CHP) Blood Colloid Osmotic Pressure (BCOP) |
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Which pressure is always highest? |
Glomerular Blood Hydrostatic Pressure (GBHP) |
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What is the formula for Net Filtration Pressure (NFP)? |
GBHP - CHP - BCOP = NFP 55 mm/Hg - 15 mm/Hg - 30 mm/Hg = 10mm/Hg |
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Damage to kidney or blockage will effect ______. |
Net filtration pressure (won't filter properly, will raise BP, etc) |
|
7 Contents of Glomerular Filtrate |
- Water - Glucose - Amino Acids - Tiny Plasma Proteins - Ammonia - Urea - Ions |
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Tubular reabsorption returns useful substances from _____ into _______. |
From: tubule fluid Into: bloodstream |
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_______ and ________ both involve active and passive processes in the tubule epithelial cells. |
Tubular Reabsorption Tubular Secretion |
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Tubular Secretion transfers material from ______ and _______ into ________. |
From: blood & tubule cells Into: tubule fluid |
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5 examples of materials from blood that are added to tubule fluid (for excretion) during tubular secretion) |
- H+ - K+ - Ammonium ions (NH4+) - Creatinine - Drugs (penicillin) |
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What are 4 types of hormonal regulation that effect the kidneys? |
- ADH (vasopressin) - Angiotension II - Aldosterone - ANP (atrial natriuretic peptide) |
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_______ is secreted from posterior pituitary to stimulate constriction of arteries and adjust the permeability of the ________ |
ADH (vasopressin) Collecting Duct |
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More water is reabsorbed and a smaller volume of concentrated urine is produced when _____ is present. |
ADH (vasopressin) |
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_______ is released in response to a decrease in BP or blood volume. |
Angiotension II |
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Angiotension II causes constriction of both afferent and efferent arterioles; ______ blood flow to the glomerulus; _______ GFR to _________ BP and Blood volume. |
Decreases Decreases Increase |
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Angiotensinogen becomes Angiotension I in response to _______. Angiotension I becomes Angiontension II in response to ______. |
Renin ACE |
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________ is produced and released by the adrenal cortex. |
Aldosterone |
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Aldosterone increases blood volume by reabsorbing more ______, _______, and _______, and by excreting less ______. |
Na+ Cl- Water Urine |
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ANP (atrial natriuretic peptide) is produced by the atria of the heart to inhibit _________ and _____. |
Aldosterone ADH |
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ANP decreases blood volume by reabsorbing less ______; increase in ______, and excreting more _____. |
Na+ GFR Urine |
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Formation of concentrated urine occurs in the presence of ADH when water intake is _____ or _____ is high. |
Low Water loss |
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Formation of concentrated urine depends on an _______ of solutes (Na+, Cl-, and Urea) in the ________ of renal medulla |
osmotic gradient interstitial fluid |
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Osmotic gradient of solutes is maintained by these two things: |
1. Permeability and reabsorption of the Loops of Henle & Collecting Duct 2. Countercurrent mechanism in descending and ascending limbs of Loop of Henle |
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_________ carry tubular fluid in opposite directions. |
Descending and Ascending limbs of the loop of Henle |
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The limbs of the loop of henle carry urine on direction, while the _____ carries blood the other direction. This is called the ______. |
Vasa Recta Countercurrent flow |
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Descending Limb (LOH) (4) |
- Permeable to water - Impermeable to solutes, except urea - More solutes in interstitial fluid outside tubule, so water moves out (into medulla). - Fluid in tubule becomes more concentrated as loop descends. |
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Ascending Limb (LOH) (3) |
- Impermeable to water - Permeable to Na+ and Cl- which move out of tubule and into medulla. - Fluid in tubule becomes less concentrated as loop ascends (because of loss of solutes, NOT more water). |
|
Distal Convoluted Tubule (4) |
- Impermeable to Urea - Permeable to water (in presence of ADH) - Water leaves tubule and moves into cortex - Tubule fluid becomes more concentrated again |
|
Collecting Duct (5) |
- Permeable to water - Water & Urea leave collecting duct and are reabsorbed into medulla (then vasa recta) - Tubular fluid becomes more concentrated as it moves down collecting duct - Medulla concentration = collecting duct concentration. - Concentrated urine is excreted. |
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_______ cells are present in the collecting duct and are targets for _____ and ______. |
Principal ADH Aldosterone |
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____, _____, and _____ move into blood as it moves down descending portion of Vasa Recta causing the osmolarity of the blood to ________ |
Na+ Cl- Urea increase |
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As the blood flows up the ascending portion of the Vasa Recta, the loss of _____ and ______ occurs and the osmolarity of the blood _____ |
Ions Urea Decreases |
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The _____ and _____ diffuse from the blood into the interstitial fluid, contributing to the __________ in the interstitial fluid of the renal medulla. |
Ions Urea High Urea Concentration |
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Cold temperature, caffeine and alcohol _____ urine and _______ urine output |
Dilute Increase |
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When water loss is high (heavy sweating, vomiting, diarrhea), a small volume of _______ is excreted. |
Concentrated urine |
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What is the normal pH of urine? Is is slightly basic or slightly acidic? |
4.6 - 8.0 (6.0 average) Slightly acidic |
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Normal urine is yellow or amber in color, transparent, mildly aromatic and contains these 9 things: |
- Electrolytes - Urea - Creatinine - Uric Acid - Urobilinogen - Fatty Acids - Pigments - Enzymes - Hormones |
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What 8 things can cause the normal properties of urine to vary? |
- Diet - Medications - Diseases - Fluid intake - Blood pressure - Body Temperature - Age - General health |
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What 8 substances should not be found in urine and indicate abnormality? |
- RBC - WBC - Microbes - Bacteria - Glucose - Protein - Blood nitrogen - Plasma Creatinine |
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What abnormality in urine would indicate kidney stones? |
RBCs |
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What abnormality in urine would indicate a urinary infection? |
WBCs |
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What abnormality in urine would indicate a yeast or E.coli infection? |
Yeast or E.coli Microbes |
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What abnormality in urine would indicate diabetes? |
Glucose |
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What abnormality in urine would indicate severe anemia? |
Protein |
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What abnormality in urine would indicate renal disease or obstruction? |
Blood Nitrogen |
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What abnormality in urine would indicate poor renal function? |
Plasma Creatinine |
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The urinary bladder is a hollow organ surrounded by the _______ muscle. It has ______ epithelium and the ______ triangle. |
Detrusor Transitional Trigone |
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The shape of the bladder depends on _____. The average capacity is ______. |
Fullness 750mL |
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The _____ is smaller in the female because of the uterus. The ____ urethra is smaller at only ____ inches. |
Bladder Female 1.5 |
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The _____ urethra is ____ inches and is shared with the reproductive system |
Male 6-8 |
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The ______ urethral sphincter is smooth muscle and involuntarily controlled by the autonomic nervous system. The ______ urethral sphincter is skeletal muscle and is under voluntary control. |
Internal External |
|
Trigone |
Triangular area between the three openings into the bladder (two ureters and one urethra) |
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In males, the _______ urethra contains the internal sphincter and the ______ urethra contains the external sphincter. |
Prostatic Membranous |
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Which ion is the most abundant extracellular cation? |
Na+ |
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Which ion is the most abundant intracellular cation? |
K+ |
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Which ion the most abundant mineral in the body? |
Ca2+ |
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Which ion is the most abundant extracellular anion? |
Cl- |
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Which ion moves through voltage gate during depolarization in neurons and muscles? |
Na+ |
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Which ion moves through voltage gate during repolarization in neurons and muscles? |
K+ |
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Which ions are involved in maintaining RMP? |
Na+ K+ Cl- |
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Which ion buffers H+ to maintian pH? |
K+ |
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Which ion signals NT release from synaptic end bulbs? |
Ca2+ |
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Which ions are involved in chloride shift to maintain electrical neutrality? |
Cl- HCO3- |
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Which ion moves into RBC during chloride shift? |
Cl- |
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Which ion moves out of RBC during chloride shift? |
HCO3- |
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Which ion is produced by intercalated cells in the collecting duct? |
HCO3- (bicarbonate) |
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Which ion is reabsorbed back into blood in DCT? |
HCO3- (bicarbonate) |
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Which 4 ions effect acid/base balance? |
K+ Cl- HCO3- (bicarbonate) HPO4 2- (phosphate) |
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Which ion is an important buffer in urine? does it act as week base or weak acid? |
HPO4 2- (phosphate) Acts as weak base and accepts H+ |
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Which ion is especially important for maintaining acid/balance base? |
HCO3- (bicarbonate) |
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Where is HPO4 2- (phosphate) found (7)? |
- Phospholipids - Cell membrane - DNA/RNA - ATP - Some proteins - Carbs - Lipids |
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Which hormone(s) regulate Na+? |
Aldosterone - Inc reabsorption of Na+ and water into blood ADH - Inc BP ANP - Vasodilator, lowers BP |
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Which hormone(s) regulate K+? |
Aldosterone - secreted by principal cells of DCT/CD |
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Which hormone(s) regulate Ca2+? |
PTH - Chief cells of parathyroid to stimulate osteoclasts to Inc level of Ca2+ and activate calcitriol |
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Which ion passively follows Na+? |
Cl- |
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Which hormone(s) regulate HPO4 2- (phosphate)? |
PTH - Chief cells of parathyroid to stimulate osteoclasts to breakdown bone and put HPO4 2- in blood and inhibit reabsorption so more HPO4 2- can be excreted in urine. |
|
What is an imbalance of Na+ called? |
Hypo or Hypernatremia |
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What is an imbalance of K+ called? |
Hypo or Hyperkalemia |
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What is an imbalance of Ca2+ called? |
Hypo or Hypercalcemia |
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What is an imbalance of Cl- called? |
Hypo or Hyperchloremia |
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What is an imbalance of HCO3- (bicarbonate) called? |
Metabolic Acidosis (too low) Metabolic Alkalosis (too high) |
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What is an imbalance of PHO4 2- (phosphate) called? |
Hypo or Hyperphosphatemia |
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What type of problems can occur when there is an imbalance of Na+? |
Can effect action potential & muscle contraction |
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What type of problems can occur when there is an imbalance of K+? |
too low - trauma/starvation too high - can effect heart |
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What type of problems can occur when there is an imbalance of Ca2+? |
Problems with bones or nerve & muscle contraction |
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What type of problems can occur when there is an imbalance of Cl-? |
Acid/Base balance problems |
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What type of problems can occur when there is an imbalance of HCO3- |
Acid/Base balance problems |
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What are the 2 Extracellular cations? |
Na+ Ca2+ |
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What are the 2 Intracellular cations? |
K+ Mg2+ |
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Which ion is the cofactor for many enzymes and is involved in neuromuscular activity and cardiac synaptic transmission? |
Mg2+ |
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What hormone regulates Mg2+? |
PTH |
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What do electrolytes dissociate into? |
Ions |
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What type of problem would happen if there is an imbalance of Mg2+? |
Heart rhythm problems |
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pH: What is the normal range? What is it called if it is too high? What is it called if it is too low? |
7.35 - 7.45 Too High = Alkalosis Too Low = Acidosis |
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HCO3: What is the normal range? What is it called if it is too high? What is it called if it is too low? |
22-26 mEq/l Too High = Metabolic Alkalosis Too Low = Metabolic Acidosis |
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Pco2: What is the normal range? What is it called if it is too high? What is it called if it is too low? |
35-45 mmHg Too High = Respiratory Alkalosis Too Low = Respiratory Acidosis |
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What are the 4 classes of lipoproteins? |
1. Chylomicrons --- trans dietary lipids 2. Very low density lipoproteins (VLDLs) --- transport triglycerides from liver to adipose 3. Low density lipoproteins (LDLs) --- transport cholesterol for use --- excess = plaque on artery 4. High density lipoproteins (HDLs) --- transport cholesterol for elimination |
|
Lipolysis is the process where the enzyme lipase breaks down triglycerides into what? |
Glycerol & Fatty Acids |
|
What inhibits lipolysis? |
insulin |
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What are the two ways to make triglycerides (lipogenesis)? |
Amino Acids --> Acelyl CoA --> Fatty Acids (+ glycerol) = Triglycerides Glucose --> Glyceraldehyde 3 Phosphate --> Glycerol (+ fatty acids) = Triglycerides (process stimulated by insulin) |
|
Does the body store amino acids? |
No |
|
What promotes the uptake of amino acids? |
Insulin & Insulin-like growth factors |
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What stimulates the breakdown (catabolism) of proteins into amino acids? |
Cortisol |
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Do all amino acids enter the krebs cycle in the same place? |
No, they enter in different places |
|
Which 3 molecules play a pivotal role in metabolism? |
- Glucose-6-phosphate - Pyruvic Acid - Acetyl coA |
|
What 3 things can be broken down to make ATP? |
Carbohydrates - preferred method Triglycerides Proteins (Amino Acids) |
|
What are the 4 parts of metabolism? |
Glycolysis Transition Krebs (citric acid) Cycle Electron Transport Chain |
|
Where does glycolysis take place? |
Cytoplasm |
|
Where does Krebs Cycle take place? |
Mitochondria |
|
Where does Electron Transport Chain take place? |
Mitochondria inner membrane (cristae) |
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Which is the only part of metabolism that is anerobic? |
Glycolysis |
|
What is the breakdown of glucose called? |
Glycolysis |
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What happens at the end of glcolysis if no oxygen is present? |
Pyruvic acid is converted into lactic acid |
|
What is the metabolic pathway that results in the generation of glucose from certain non-carbohydrate carbon substrates called? |
Gluconeogenesis (GNG) |
|
What is produced as a result of the Glycolysis stage? |
- 2 NADH - 2 net ATP - 2 Pyruvic Acid (goes to next) |
|
What is produced as a result of the Transition stage? |
- gives off CO2 & H+ - 2 NADH - Acetyl CoA (goes to next) |
|
What is produced as a result of the Krebs Cycle stage? |
- gives off CO2 & H+ - 6 NADH - 2 FADH2 - 2 ATP |
|
What is produced as a result of the Krebs Cycle stage? |
- Buildup of H+ (used to phosphorolate ADP into ATP) - O2 is final electron acceptor - Produces Water - 32 ATP |
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How many ATP are made from 1 molecule of glucose in aerobic cellular respiration? |
36 ATP |
|
How many ATP are made in the mitochondria? |
34 ATP (2 in Krebs + 32 in ETC) |
|
How many ATP produced in transition stage? |
0 |
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What enters the Krebs Cycle to produce citric acid? |
Acetyl coA |
|
Which stage of metabolism is a circular series of reactions? |
Krebs Cycle |
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Which stage of metabolism is slow to start? |
Glycolysis |
|
What is combined in the transition stage to produce Acetyl CoA? |
Pyruvic Acid + CoA |
|
Fluid balance is maintained by what 3 things? |
1. Hormones (JGA, RAA, ADH) 2. Thirst centers (in hypothalamus) 3. Metabolic reactions (like ETC) |
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Acid-Base Balance is maintained by what 3 things? |
1. Buffer systems 2. Ventilation 3. Kidneys |
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How do buffer systems maintain acid-base balance? |
They convert strong acids into weak acids |
|
How does ventilation maintain acid-base balance? |
It removes H2CO3 (carbonic acid) by exhaling CO2 |
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How do Kidneys maintain acid-base balance? |
By excreting H+ in the urine (excretion in urine is only way to remove H+ from body) |
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What is the most important buffer in intracellular fluid (cytosol) and extracellular fluid (blood plasma)? |
Protein Buffer System |
|
______ are polymers of amino acids |
Proteins |
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Amino acids have ______, ______, _______, and ______, all bonded to a central carbon atom |
Amine Group Carboxyl Group Hydrogen atom R Group |
|
_______ of an amino acid acts like a base because it ______ H+ (protons) |
Amine group accepts |
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______ of an amino acid acts like an acid because it _______ H+ (protons) |
Carboxyl group donates |
|
What are examples of 2 proteins that are part of the protein buffer system? |
- Hemoglobin (regulates pH) - Albumin (regulates osmotic pressure) |
|
How does hemoglobin act as part of the protein buffer system? |
It is the protein in RBC that contains the amino acids histidine and cysteine which regulates the pH of the blood |
|
How does albumin act as part of the protein buffer system? |
It is the large, abundant protein in the blood plasma that also helps to maintain blood osmotic pressure. |
|
What are 3 examples of buffer systems that maintain the acid-base balance? |
- Protein buffer system - Carbonic acid buffer system - Phosphate buffer system |
|
How does carbonic acid buffer system work (3)? |
- H2CO3 (Carbonic acid) acts like weak acid and donates H+ to become bicarbonate - HCO3- (Bicarbonate) acts as weak base and accepts H+ to become carbonic acid - CO2 is exhaled to get rid of toxic H2CO3 |
|
Which buffer systems are both intracellular and extracellular? |
Protein buffer system Carbonic acid buffer system |
|
What does H2CO3 (carbonic acid) act like in carbonic acid buffer system? |
Acts like a weak acid and donates H+ to become Bicarbonate (HCO3) |
|
What does HCO3- (bicarbonate) act like in carbonic acid buffer system? |
Acts like a weak base and accepts H+ to become carbonic acid (H2CO3) |
|
What effect does increased ventilation have on pH? |
Increased ventilation --> More CO2 exhaled --> Less H+ --> higher pH (basic) |
|
What effect does decreased ventilation have on pH? |
Decreased ventilation --> Less CO2 exhaled --> More H+ --> Lower pH (acidic) |
|
How does the phosphate buffer system work (3)? |
- Acts as intracellular (cytosol) buffer in urine - H2PO4- acts as weak acid, donates H+ - HPO4- acts as weak base, accepts H+ |
|
Which buffer system is only used in urine? |
Phosphate buffer system |
|
What are the 2 clinical signs of metabolic acidosis? |
low pH (acidic) HCO3- too low |
|
What are the 2 clinical signs of respiratory acidosis? |
low pH (acidic) pCO2 too high |
|
What are the 2 clinical signs of metabolic alkalosis? |
high pH (basic) HCO3- too high |
|
What are the 2 clinical signs of respiratory alkalosis? |
high pH (basic) pCO2 too low |
|
3 causes of metabolic acidosis |
- ketoacidosis - decreased blood flow to kidneys (from MI) - loss of HCO3- |
|
3 causes of respiratory acidosis |
- hypoventilation - obstructed airway - decreased breathing rate |
|
4 causes of metabolic alkalosis |
- vomiting - Diarrhea - dehydration - excess loss of acids |
|
2 causes of respiratory alkalosis |
- Hyperventilation - Anxiety |
|
What are 2 treatments for metabolic acidosis? |
- IV of sodium bicarb - Hyperventilation |
|
What are 2 treatments for respiratory acidosis? |
- Inc exhalation of CO2 - Inc excretion of H+ via urine |
|
What are 2 treatments for metabolic alkalosis? |
- Inc fluids and electrolytes - Hypoventilation to slow loss of CO2 |
|
What are 2 treatments for Respiratory alkalosis? |
- Increase CO2 by breathing in paper bag - Excrete more HCO3- |