Chapter 14 Kidneys Etc

Front 1

____ - paired organs
Anything they secrete goes to the ____
A sac that holds the urine.

Back 1

kidneys
bladder

Front 2

Approx ____ per kidney

Back 2

1 million nephrons

Front 3

____ is the functional filtering unit of the kidney
Basically a ____, capillary network associated with each ____
Has the ability to reabsorb back into the blood very quickly

Back 3

nephron
tube
nephron

Front 4

____ lead into a collecting duct, every collecting duct in the kidney receives ____ from 5-10 ____.

Back 4

Nephrons
filtrate
nephrons

Front 5

____, Similar to the adrenal gland - ____, and ____ area

Back 5

nephron
outer cortex
inner medullary

Front 6

____ - ball of capillaries at the beginning of the nephron, has an afferent and efferent arteriole

Back 6

Glomerulus

Front 7

blood flows through the ____ and enters the ____.

Back 7

glomerulus
nephron

Front 8

Glomerulus sits in ____ and ____ leads into the nephron.

Back 8

bowmans capsule
bowmans capsule

Front 9

Capillary has ____, glomerular capillaries are much more ____ than other capillaries,
this allows many more things to enter bowmans capsule and enter the nephron:

Back 9

filtration slits
permeable
ions, (hydrogen,potassium)
water
small peptides (2-3 amino acids)

Front 10

Cannot get through fenestrated capillaries:

Back 10

larger proteins
individual amino acids,
glucose,
Cells cannot get through - RBC, WBC, platelets

Front 11

filtration order:

Back 11

1. Bowmans capsule (glomerulus is inside)
2. Proximal tubule
3. Descending limb of the loop of henle
4. Ascending limb of the loop of henle
5. Distal Tubule
6. Collecting Duct

Front 12

Each nephron has this ____ associated with it.

Along the tubule, tremendous amount of reabsorption taking place to ____ the water, ion etc back into the bloodstream.

Back 12

peritubular network
reabsorption
recoup

Front 13

____ - group of specialized cells in the ____ portion of the nephron.
In contact with the ____ of the nephron, it is a ____ mechanism, it allows the front portion of the nephron to know what is going in the back portion of the nephron - (going to fast or slow, too much or little sodium going through)

Back 13

JGA (juxtaglomerular apparatus)
back (distal)
entrance
feedback

Front 14

JGA can send a signal to arteriole to ____ or ____ to adjust blood flow into the nephron.

Back 14

vasodialate
vasoconstrict

Front 15

____ - main function to transport salt, sodium, but not much else

Back 15

Ascending limb

Front 16

____ can transport a lot of water, can reabsorb a lot of water.
Cant transport other stuff, main function to reabsorb water.

Back 16

Descending limb

Front 17

____ - site of most of the reabsorption.
list of being reabsorbed:

Back 17

proximal tubule
All the glucose (pass and get dumped)
amino acids/peptides (ditto)
70% of the sodium and water, taken up either as a cotransport mechanism w/ amino acids, cotransport mechanism w/ glucose or by itself, and the water follows it (by osmosis)

Front 18

Once ____ leaves the collecting duct, cant change it, this is what we dump as the ____.

Back 18

filtrate
urine

Front 19

____ - can also be under the control of certain drugs, another area where we can change transport capabilities.

Back 19

Collecting duct

Front 20

____ - very susceptible to certain drugs
(____ etc to monitor kidney function)
First place in the ____ to really change transport capabilities depending on that persons needs (dehydrated vs super hydrated want to change urine output) and here is where to change it
Also do a lot of ____ here.

Back 20

Distal tubule
antidiuretics
nephron
secreting

Front 21

The outer layer of the kidney is the ____; it is the site of ____ as well as the ____.

Back 21

renal cortex
glomerular filtration
convoluted tubules

Front 22

The inner part of the kidney is the ____; this is the location of the ____, and the drainage of the ____ into the renal pelvis and ureter.

Back 22

renal medulla
longer loops of Henle
collecting ducts

Front 23

Kidney Parts-

Back 23

Outer (renal) cortex
Inner (renal) medullary area

Front 24

____ - part of the process of getting that urine in larger and larger tubules then to the renal pelvis (center of the kidney) and then one ureter per kidney that empties to the urinary bladder

Back 24

Collecting ducts

Front 25

This ____ -
Allows us to conserve as much water as possible
The longer the loop, (deeper it goes into the medullary region) the more water conservation I can have!

Back 25

loop of henle

Front 26

The front portion of the ____ is always in the cortex region.

Back 26

nephron (glomerulus)
cortex

Front 27

____ - associated with the wrapping around the kidneys

Back 27

Peritubular capillary

Front 28

____ - a group of cells associated with the distal tuble, basically epithelial cells, in contact with the filtrate in the center of the tubule/lumen contents so they are able to monitor flow rate and sodium content

Back 28

Macula densa

Front 29

____ - responsible for synthesizing, storing and secreting renin

Back 29

Juxtaglomerular cells - (granular cells)

Front 30

____ - receive information from the macula densa cells in the form of chemical signals and they are going to if any vaso contstriction/dialation is necessary and they can send a signal to the efferent or afferent arteriole

Back 30

Mesangial cells - (extraglomerular mesangial cells)

Front 31

The intersection of the ____ in the distal tubule with the afferent and efferent arterioles forms the ____, which secretes the ____ known as renin in to the blood in the afferent arteriole.

Back 31

macula densa
juxtaglomerular apparatus
endocrine signal

Front 32

____ - it is transported from the lumen, back into the peritubular capillary.

Back 32

Reabsorbed

Front 33

____ - anything that is transported across the peritubular capillary and into the nephron.

Back 33

Secretion

Front 34

Anything that makes it into the nephron from the arteriole (via glomerulus) is ____.

Back 34

Filtered

Front 35

Normal functioning kidney always be a ____.

Back 35

net positive filtration pressure

Front 36

Hydrostatic pressure favors pushing into ____
Proteins in blood favor ____
Hydrostatic pressure in ____ pushing back (not as much) towards the ____

Back 36

nephron
reabsorption
nephron
glomerulus

Front 37

Constrict blood entering (traffic jam at the beginning) will ____.
Because of narrowed area/stuff leading into the nephron

Back 37

decrease GFR

Front 38

To ____, constrict arteriole leading out of the nephron (backing up traffic) increases the pressure and ____

Back 38

increase GFR
increases GFR

Front 39

Can dilate arteriole leading out of the nephron (like opening up extra lanes) will shoot through a little faster and will ____, due to decreased amount of time blood is at entrance to the nephron.

Back 39

decrease GFR

Front 40

Dilate at the beginning, lose traffic lanes, increased pressure and ____.

Back 40

increase GFR

Front 41

Under normal circumstances no glucose in urine
If we start dumping ____ on a normal occurrence, we can ____ the kidneys.

Back 41

glucose
damage

Front 42

We reabsorb the vast majority of everything that enters the ____.

Most of the time water is following sodium by ____, reabsorb ____ and water is following.

Back 42

reabsorb
nephron

osmosis
sodium

Front 43

____ - part of the luman that faces the urine, or what is being filtered (inside)
Lined with the epithelial cells, lots of transport here

Back 43

Tubular lumen

Front 44

____, reabsorb from the lumen across the epithelial cells and into the capillary. ____ is the opposite.

Back 44

Peritubular capillary
Secretion

Front 45

Epithelial cells joined to each other with ____.

Back 45

tight junctions

Front 46

Occasionally more ____ in the blood than we can ____, at that point we have hit the ____, literally run out of glucose transporters

At this point any more glucose becomes this filtered load that has to be ____ (nowhere else to go)

Back 46

glucose
reabsorb
transport maximum
excreted

Front 47

Couple of mechanisms to determing renal function -

Looking at ____, a sugar that we cannot digest/break down
So if you inject it into someone, small enough to get into the nephron, cannot transport it and cannot break it down (no reabsorption, no secretion)
Just ____ of this solute.
Can estimate ___ based on the clearance rate of ___ downside is that it can damage the kidney (rare to give people inulin)

Back 47

filtration rate of inulin
filtering
GFR
Inulin

Front 48

____, how much blood of a substance can I clear per minute (how much blood can I take all the Inulin out of per minute)

Back 48

glomerular filtration rate, GFR

Front 49

GFR of a healthy adult male = ____ per minute
Adult female, = ____ per minute

Back 49

120 mL
110 mL

Front 50

GFR = ____

Back 50

concentration of a particular substance in the Urine times the volume of urine per unit time divided by the concentration of that substance in the plasma
[U]*V / [P]

Front 51

GFR is measured in ___

Back 51

mL/minute (volume per unit time)

Front 52

Infants - babies less then 1 year old = ____ per minute
Danger - can get ____ more quickly, cant clear ____ out of their body as quickly/efficiently.

Back 52

20 mL
dehydrated
toxins

Front 53

____ are going to dump that urine into the bladder, normally will stay closed, two ____ that will keep it from leaking.

Back 53

ureters
sphincters

Front 54

____ (closest to the urine) - composed of smooth muscle so invuluntary

Back 54

Internal sphincter

Front 55

____ (closest to the environment) - composed of skeletal muscle ie voluntary, as the bladder fills relaxed internal sphincter more pressure on the external sphincter and signals
ES will not relax unless we let it...

Back 55

External sphincter

Front 56

As the bladder fills with urine it will put more and more pressure on that ____, as the pressure increases, more likely to relax

Back 56

internal sphincter

Front 57

____ - depending on how you came upon this condition will often give you a 3rd kidney - will just put it in the gastrointestinal cavity- can recover quite fast (stomach surgery is much faster than back surgery)

Can last 10-20 years

Back 57

Kidney transplant

Front 58

____ - can be done at home, same thing clearing blood of waste product, and done in
Peritoneal cavity
Put fluid in peritoneal cavity and will draw the stuff out, have to replace every 8 hours


Not a good long term solution

Back 58

Peritoneal dialysis

Front 59

____ - hooked up to a machine, and cleaned up (through a filter)

Back 59

Hemodialysis

Front 60

____ - kidneys cant get rid of waste and all the other functions of the kidney too!
Regulate pH, electrolyte balance!
Rise in levels of creatinine, muscle breakdown levels
Can get by chronic high BP (athero..)
Could have chronic , Kidney ischemia - not receiving enough oxygen to nourish its tissues (similar to heart ), Overuse of Nsaids - ibuprofen

Back 60

Acute renal failure

Front 61

____ - a disorder, sometimes temporary, sometimes permanent - due to immune cells attacking the glomerulin membranes, filtration slits are larger and more things can get through the pores into the nephron - and enter the urine,
First is larger and larger peptides/proteins entering the urine
First have an increase in urine output, the proteins act as a solute and draw more water

Pulling proteins out of the blood abnormally will decrease the plasma colloid (inside the blood) osmotic pressure, and will have more fluid in the interstitial fluid (edema!)

Sometimes can recover, sometimes cant --

Back 61

Glomerulonephritis

Front 62

Think of ____ as a colander.

Back 62

bowmans capsule

Front 63

____ - could be sick and threw up lots of stomach acid, could be a kidney issue, for whatever reason my pH is high h+ is low or bicarb is high (took alkaline drugs) main fix is respiratory

Back 63

Metabolic Alkalosis

Front 64

____ - blew off too much co2, hyperventilation - can compensate via a renal mechanism, can decrease bicarb reabsorption, can decrease hydrogen ion secretion

Back 64

Respiratory Alkalosis

Front 65

____ problem the fix is via kidneys.
If ____ issue the fix is respiratory/ventilation.

Back 65

Respiratory
metabolic

Front 66

____ = they have a low pH, lower than normal (normal = 7.4)

Back 66

Acidosis

Front 67

____ - due to some problem with your metabolism or kidney disfunction (NOT a breathing problem) - means one or more of these mechanisms to get rid of hydrogen is not working,

Back 67

Metabolic acidosis

Front 68

____ - a person has a low pH, due to a respiratory problem, typically not able to blow off the extra co2 - emphysema, maybe hypoventilating, the more c02 I am holding the more acidic I become

Back 68

Respiratory acidosis

Front 69

The compensatory mechanism to cure ____ - is through the kidneys, they will excrete as much ____ as they can - will use all those previous mechanisms and can even convert certain amino acids pull the ammonia group off and bind with the H+ and excrete it.
Wont help with co2 levels but will correct the pH of their blood

Back 69

RA
hydrogen ions

Front 70

Often can correct ___ by blowing off extra Co2 - can correct it via respiratory, these ppl tend to have lower than normal ____ values but at lease have corrected pH blood values

Back 70

MA
co2

Front 71

Can also bind ____ ions in the lumen to ____ and form ammonium ions ____ -- another method of trapping ____ ions in the urine/ acidifying the urine/getting rid of ____ ions/control the pH of the blood.

Back 71

hydrogen
NH3
NH4+
hydrogen
hydrogen

Front 72

The h ions can be pumped into the lumen, so I can get rid of extra ____ ions in the urine, so not there to acidify the blood.

____ the urine helps control bacterial formation/colonization, helps prevent uti's.

Back 72

hydrogen
acidifying

Front 73

In the tubular epithelial cells, cells lining the ____ - play a role in the acid base balance, some of the ____ they are reabsorbing will help convert ____ to ____, will transport ____ back into the peritubular capillary to maintain pH level

Back 73

nephron
water
CO2
bicarb
bicarb

Front 74

"Body makes choices" must maintain volume and pressure to get stuff to the tissues - getting rid of ____ is not that great… If ____ is used long term to help maintain ____ will have low ____ levels

Back 74

potassium
aldosterone
volume
potassium

Front 75

If I need to conserve volume and ____ is being secreted, ____ will help with ____ reabsorption and water will follow -
____ helps with the secretion of ____ (get rid of it)

Back 75

aldosterone
aldosterone
sodium
aldosterone
potassium

Front 76

severe loss of water -

Back 76

Have to decrease GFR, decrease urine output
Have to increase sodium reabsorption
Have to use a combination of Aldosterone, Vasopressen and Angiotensin II to keep BP up!

Front 77

No channels = ____
w/ ADH = ____

Back 77

more urine secretion
more water channels

Front 78

Collecting duct, vasopressin/adh working - will help to ____ (more ____ channels present)
Water is being pulled into the ____ towards the higher concentration of ____ in the ____.

Back 78

reabsorb water
water
vasa recta
solutes
vasa recta

Front 79

Term ____ - water channel

CD = ____

Back 79

aquaporin
collecting duct

Front 80

Regulate volume/urine output

____ = increase urine output
____ volume = decrease urine output (but more concentrated)

Back 80

High volume
Low volume

Front 81

Decreased plasma volume -
Low plasma volume = low blood pressure
Release ____, land on the collecting ducts
That will trigger the 2nd messenger system and incorporate more ____ on the collecting duct and have more ____.

Back 81

ADH/Vasopressin
collecting channels
water reabsorption

Front 82

Increased GFR = ____

Back 82

increased urine output

Front 83

Increased volume, increase ____
(remember ____ helps me get rid of the volume)
Inhibits ____ levels, which inhibits ____ and ____ reabsorption
Also helps with afferent dilation and efferent constriction - which will increase ____- which increases urine output.

Back 83

ANP
ANP
aldosterone
sodium
water
GFR

Front 84

Proximal tubule reabsorbs ____ - does not change concentration much, appropriate amount of ____ is being pulled out to match ____ being pulled out.

Back 84

iso-osmotically
water
solutes

Front 85

____ and ____ have hormonal control/can adjust ____ based on the bodies needs.

Back 85

distal tubule
collecting duct
transport capabilities

Front 86

Remember if pumping 180L of fluid a day have to ____ the vast majority of it!

Back 86

conserve

Front 87

Vasa recta travelling in an ____.

Back 87

anti parallel direction

Front 88

The purpose of the ____ - Main function is to retain water/as much as the fluid as can be conserved

Back 88

counter-current multiplier system

Front 89

Always maintaining a ____ between the two ____ , so I can always draw out more salt and water.

Back 89

concentration gradient
(l o h and v r)

Front 90

On the descending side water is always going to be pulled from the ____ into the ____ (down its concentration gradient/trying to dilute out the higher sale levels)

On the ascending side water is going to go down its concentration gradient, trying to dilute out higher concentrations of ____, and much of the time to ensure the maintenance of higher concentration of solutes, the ____ are active.

Back 90

nephron
vasa recta
solutes
sodium-chloride-potassium pumps

Front 91

The part of the capillary that travels anti-parallel to the loop of henle is called the ____.

The ____ has a very important role in reabsorbing water.

Back 91

vasa recta
vasa recta

Front 92

____ - trying to conserve water
(we are land animals and always slightly dehydrated)

Back 92

Distal tubules

Front 93

____ has the ability to reabsorb additional water

Back 93

Collecting duct

Front 94

The way ____ works on the CD, ____ lands on hormone receptors on the CD and it will trigger a second messenger system (just like a protein hormone would do) and eventually that 2nd ms will trigger the production and incorporation of additional ____ into the collecting duct (Always Digging Holes).

Back 94

ADH
ADH/vasopressin
water channels

Front 95

____ -
Descending limb down to the medullary region then the ascending limb
Descending - primarily water reabsorption to the interstitial fluid and then to the peritubular capillaries
Ascending limb (back to the cortex) responsible for resorbing salt
It does this by both passive and active transport, at the ascending limb both active and passive transport of NaCl, depending wher eyou are in that ascending limb

Back 95

Loop of henle