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170 Cards in this Set
- Front
- Back
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What are the components of the urinary system?
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kidneys, ureters, urinary bladder, and urethra
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List the six functions of the kidney
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Waste removal
formation of calcitriol production and release of erythropoietin regulation of ion levels and acid-base balance regulation of blood pressure potential to engage in gluconeogenesis |
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What is the function of calcitriol?
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increases the absorption of calcium from the small intestine to increase blood calcium concentration
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What triggers the secretion of erythropoietin?
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Low blood oxygen levels detected by the kidneys.
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What ions do the kidneys regulate
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Inorganic ions such as Na+, K+, Ca2+, and PO4(3-)
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What two ions do the kidneys regulate in order to maintain acid-base balance?
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H+ ions and HCO3- ions
(hydrogen and bicarbonate ions) |
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Which enzyme is released by the kidneys to produce angiotensin II?
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renin
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What enzyme released by the kidneys that ultimately results in an increase in blood pressure?
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renin
Part of the renin-antiontensiogen system or renin-angiotensink system |
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What is gluconeogenesis?
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the production of glucose from non-carbohydrate sources
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When do the kidneys participate in gluconeogenesis?
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during times of extreme starvation
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What is renal agenesis?
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the failure of a kidney to developWhat is a pelvic kidney?
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what is a pelvic kidney
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when a developing kidney fails to migrate from the pelvic cavity to the abdominal cavity.
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Where the blood vessels, nerves, and ureter connect to the kidney
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hilum
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The _____ (right/left) kidney is 2cm inferior to the other.
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Right
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Why is the right kidney 2cm lower than the left kidney?
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to accomodate the large size of the liver
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The kidneys are located in the _______ space
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retroperitoneal
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Only the ______ part of the kidney is covered with parietal peritoneum?
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anterior
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The inferior movement of the kidney within the abdominal cavity is called _____
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renal ptosis
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List the 4 layers of tissue that surround and support the kidneys, from innermost to outermost.
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fibrous capsule, perinephric fat, renal fascia, and paranephric fat
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Pneumonic for the 4 layers of tissue that surround and support the kidneys:
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four people read papers
fibrous capsule perinephric fat renal fascia paranephric fat |
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The two distinct regions of the kidney are:
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renal medulla, renal cortex
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How many renal pyramids does the typical adult kidney have?
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8-15
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Where the renal pyramids meet the renal cortex:
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corticomedullary junction
or corticomedullary border |
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the tip of the renal pyramids is called the
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renal papilla
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This space serves as the urine drainage area of the kidney
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renal sinus
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What are the three subdivisions of the renal sinus?
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major calices, minor calices, and renal pelvis
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The _____ merges at the medial edge of the kidney with the ureter
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the renal pelvis
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Each kidney is innervated by the ______ nervous system through the ______ _______
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autonomic;
renal plexus |
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The functional anatomy of the kidneys includes:
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nephrons, collecting tubules, collecting ducts, and their associated structures
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The microscopic, functional filtration unit of the kidney
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The nephron
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Nephrons consist of two major structures:
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renal corpuscle and renal tubule
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Is the renal corpuscle housed in the renal medulla or renal cortex?
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cortex
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What two structures make up the renal corpuscle?
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glomerulus and glomerular capsule
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What is the glomerulus?
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thick tangle of capillary loops called the glomerular capillaries
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Blood enters the glomerulus by the ______ and exits by the _____.
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afferent arteriole; efferent arteriole
(hint: Exit:Efferent) |
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What is the other name for the glomerular capsule?
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Bowman's capsule
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What are the two opposing poles of the renal corpuscle?
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vascular pole (afferent/efferent arterioles) and tubular pole (origination of the renal tubule)
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What are the three parts of the renal tubule?
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proximal convoluted tubule, nephron loop, distal convoluted tubule
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Does the renal tubule lie in the renal cortex or medulla?
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All but the nephron loop resides in the renal cortex. The nephron loop extends into the renal medulla.
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The first region of the renal tubule:
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proximal convoluted tubule
(PCT) |
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What kind of epithelium is the PCT composed of?
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simple cuboidal
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What feature of the PCT markedly increases its surface area, and therefore its reabsorption capacity?
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apical microvilli on the simple cuboidal epithelial cells
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What is the other name for the nephron loop?
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Loop of Henle
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What is the other name for the Loop of Henle?
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Nephron loop
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What are the two limbs of the Loop of Henle?
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descending limb and ascending limb
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The thin segments of each limb of the Loop of Henle are lined by ______ _____ epithelium
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simple squamous
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What kind of epithelium lines the thick segment of each limb of the Loop of Henle?
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simple cuboidal
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Where does the distal convoluted tubule end?
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Collecting tubule
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What are the differences between the simple cuboidal epithelium of the PCT and the DCT?
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DCT are smaller cells with shorter and more sparse microvilli
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Why does the DCT appear clear and not fuzzy when viewed under a microscope?
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It has short and sparse microvilli
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What is excretion?
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The separation of body wastes from body fluids
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The separation of body wastes from body fluids:
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excretion
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What other systems besides urinary participate in excretion?
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Respiratory system, digestion, integumentary system
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what does the renal system excrete?
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metabolic wastes
hormones salts drugs |
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Functions of the kidney
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1 - regulate the volume and composition of extracellular fluid
2 - Ridding the body of metabolic waste 3 - Ridding the body of chemicals 4 - Long term blood pressure control 5 - Production of erythropoietin 6 - Vitamin D metabolism (produces the active form of VD) 7 - Gluconeogenesis (only under starvation conditions) 8 - pH regulation |
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Urea is the end product of _____ ______
Uric acid is the end product of _____ ______ Creatinine is the end product of _____ ______ |
nitrogen metabolism;
nucleotide metabolism; creatine metabolism |
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What is the active form of vitamin D?
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125 dihydroxyvitamin D cholicalciferol
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Pneumonic for kidney functions:
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Very finely educated doctors get paid big money
Volume foreign chemicals EPO Vitamin D gluconeogenesis pH Blood Pressure maintenance Metabolic Waste |
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The functional unit of the kidney
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nephron
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path of urine in the kidney:
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from nephron to minor calix to major calix to pelvis, to ureter
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How many nephrons are there per kidney?
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~1.3 million
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Tuft of capillaries:
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glomerulus
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the capsule around the glomerulus and the glomerular capsule
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renal corpuscle
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This is where fluid is pressed out of the blood and results in filtrate
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renal corpuscle
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Fluid is pressed out of the glomerulus and across the _____ _______ to enter into the ________
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visceral layer; glomerular space
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What are the two poles of the renal corpuscle?
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renal and vascular poles
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When stretched out, the tubule is ______ in length
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50-55mm in length
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The tubule is made up of how many layers of epithelium? what do they lie on
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single, basement membrane
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What kind of junctions are present between the simple epithelial cells of the renal tubule?
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Tight
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Why are there tight junctions along the tubule?
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To prevent leakage and maintain control
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The straight portion of the PCT is called ____ and the other is ______
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Pars recta
Pars convolucta |
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The _____ surface of the PCT simple cuboidal cells has the brush border
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luminal surface
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Why do PCT simple cuboidal cells have so many mitochondria?
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To facilitate active transport
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~___% of the Loop of Henles dips into the medulla and are called _____
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~15%
Juxta medullary loops |
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~___% of the Loop of Henles do not dip into the medulla and are called _____
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~85%
cortico loops |
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Nephrons dump into the _______
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collecting ducts
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What kind of cells are present in the collecting duct?
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Principal cells (vast majority)
Intercalated cells (Type A and Type B) |
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What does intercalated mean?
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sprinkled in amongst the principal
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Principal cells are sensitive to what two hormones?
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ADH and aldosterone
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Intercalated cells are essential for _____
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acid-base balance
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What do type A intercalated cells do?
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Remove acid
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What do type B intercalated cells do?
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Remove base
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What is another name for Type B intercalated cells?
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flipped A
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What is the macula dense?
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A section of the DCT or the ascending loop of Henle
subpart of juxtaglomerular apparatus |
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Modified smooth muscle cells of the afferent arteriole are called _____
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granular cells of afferent arteriole
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What do granular cells of the afferent arteriole secrete?
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Renin
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What cells secrete renin
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granular cells of the afferent arteriole
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What kind of receptors are the granular cells of the afferent arteriole?
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mechanoreceptors
detect blood pressure |
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Macula densa cells that are part of the juxtaglomerular apparatus are what kind of receptor?
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chemoreceptors
monitor sodium chloride levels |
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What are extraglomerular mesangial cells?
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They function in paracrine signaling
Have gap junctions between them Phagocytic activity Communication ability between granular and macula densa cells |
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Are extraglomerular cells part of the JGA?
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Some people say yes, others say no
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What is an arcuate artery?
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it's an arc
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Vasa recta are capillaries associated with what?
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loop of Henle
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What is glomerular filtrate?
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The fluid that is pressed out from the glomerulus into the PCT
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We only use the word filtrate at the _____ ____ and use tubular filtrate when we are along the _____ ______, ______, and ________
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early PCT;
latter PCT, loop of Henle, and DCT |
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When is tubular filtrate called urine?
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At the collecting duct
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Voiding the bladder is called _____
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micturition
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when is the term urination used?
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for the formation of urine
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when urine is produced, there are 3 processes involved:
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1 - filtration
2 - reabsorption 3 - secretion |
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Reabsorption takes something from where to where?
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From the tubule into the blood
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Filtration means what?
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You're going to filter something out of the blood and into somewhere else
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Secretion is from where to where?
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blood to tubule
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Filtration under pressure is called
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ultra filtration
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Regarding filtration, how many layers must filtrate pass?
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3 layers:
1 -Capillary endothelium 2 - basement membrane (meshwork of glycoproteins and mucopolysaccharides) This is negatively charged 3 - visceral surface of bowman's capsule |
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What kind of capillaries are present at the renal corpuscle?
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Fenestrated capillaries
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The ______ surface of the Bowman's Capsule is made up of highly specialized cells called _____?
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Podocytes
foot like |
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What is the net filtration pressure at the renal corpuscle?
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10 mmHg
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What are the pressures at the renal corpuscle?
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Hydrostatic pressure out (glomerular) = 60 mmHg
Osmotic pressure in = 32 mmHg Hydrostatic pressure (capsule) in = 18mmHg Net filtration pressure = 10mmHg |
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If someone has low blood pressure, why can't they filter blood?
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Not enough pressure differential to get the net filtration pressure, the blood won't be cleansed.
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If someone has high blood pressure, what happens to urine formation?
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Increase urine formation
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This is the driving force that pushes water and some dissolved solutes out of the glomerulus and into the capsular space of the renal corpuscle
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glomerular hydrostatic blood pressure
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The _____ arteriole has a larger internal diameter than the ______ arteriole
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afferent; efferent
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Why are renal corpuscles so vulnerable to damage?
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higher blood pressure
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What two pressures opposed glomerular hydrostatic blood pressure?
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Blood colloid osmotic pressure
capsular hydrostatic pressure |
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What does GFR stand for?
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Glomerular filtration rate
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The rate at which the volume of filtrate is formed is called:
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Glomerular filtration rate
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Define GFR
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The rate at which the volume of filtrate is formed
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What units is GFR expressed?
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volume per unit time
usually 1 minute |
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The _____ directly influences GFR
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Net filtration pressure
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What are three things GFR depends on?
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NFR, surface area, permeability
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What is Kf?
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filtration coefficient
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Kf is proportional to _____ and _____
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permeability and surface area
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What is the number for Kf?
What is the NFP at the renal corpuscles? |
12.5 ml/minute mmHg
10 mmHg GFR = 125 ml/min |
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These cells are involved in contraction and decrease the lumen into the renal corpuscle, affecting the Kf value
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extra glomerular mesangial cells
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How do we calculate 180L of filtrate formation per day?
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125 ml/min x 1440 min/day = 180,000 mL or 180L
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What are two processes involved in intrinsic control of GFR?
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changing the luminal diameter of the afferent arteriole and altering the surface area of the filtration membrane
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Between ___ and ____ mmHg the kidney maintains GFR
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180 - 180 mmHg
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What are the two ways renal autoregulation functions?
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myogenic mechanism and tubuloglomerular feedback mechanism
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Smooth muscle _____ in response to stretch
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contracts
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If there is an increase in systemic bp, the kidney will ______ at the afferent arteriole. What is the effect of this and why does it happen.
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constrict
lower GFR prevents damage to the renal corpuscle |
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If bp is low, how does the lumen of the afferent arteriole react?
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relaxes, resulting in vasodilation
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What is the basis of the tubuloglomerular feedback mechanism?
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detection of NaCl
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What cells function in the tubuloglomerular feedback mechanism?
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macula densa cells
they have chemoreceptors |
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What is the tubuloglomerular feedback mechanism?
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monitors filtrate flow and osmolarity
feeds back to the glomerulus monitored at the macula densa cells of the juxtaglomerular apparatus |
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When you are at rest, the kidney is not getting sympathetic stimulation and the afferent arterioles are _______
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dilated
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Sympathetic stimulation to the kidney (constricts/dilates) the afferent arterioles?
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Constricts, therefore decreases GFR
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What hormone is released by the kidney under sympathetic stimulation?
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Renin
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What issues arise from GFR being too high?
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loss of ions due to lack of reabsorption
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What issues arise from GFR being too low?
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too much reabsorption, wastes are not removed
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Is renin an enzyme or a hormone?
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both
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What is the plasma precursor on which renin acts?
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angiotensinogen
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What is ACE?
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angiotensin converting enzyme
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Where is ACE?
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In the endothelium of the lungs
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Angiotensin II is one of the most ______ known
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vasoconstrictors
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What is the effect of angiotensin II at the kidney?
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vasoconstriction at the afferent arteriole and contraction of the mesangial tissue, which decreases surface area, which decreases Kf, and decreases GFR
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What is natruim?
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salt
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What is ANP
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Atrial natiuretic peptide
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When is ANP released?
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When blood pressure is too high and the stretch receptors in the atria detect an increase in pressure. ANP is released and causes vasodilation of the afferent arteriole, increasing GFR.
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What percent of filtrate is reabsorbed?
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~65%
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The (afferent/efferent) arteriole gives off the peritubular capillaries?
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Efferent
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White drives everything in the PCT?
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Na+
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_____ is an osmotic diuretic. What does this mean?
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glucose
Water follows it |
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Why does glucose attract water? Why does this matter at the level of the PCT?
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It has a lot of OH groups
It matters because if glucose can't be reabsorbed due to the saturation of Na+/glucose symporters, water will also not be reabsorbed because it will stay in the tubule with the glucose where it is attracted to the OH groups of the glucose. |
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With regard to glucose reabsorption at the level of the PCT, an uncontrolled diabetic will micturate (more/less). Why?
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More
Because they have saturated the Na+/glucose symporters and no more glucose can be reabsorbed, so it will remain in the tubule to be excreted. Since water is attracted to the OH groups of the glucose, it will also fail to be reabsorbed and will be excreted. End result, the diabetic pees a lot. Polyurea = pee a lot. Polydypsea = drink a lot because they're thirsty. Want to eat a lot because they are not |
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Describe asymmetrical epithelial cells
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the luminal border and the basolateral membranes of the epithelial cells can be different polarities
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At the tubules, from blood to tubule is _____, from tubule to blood is _____.
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secretion, reabsorption.
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_____% of filtrate is reabsorbed at the PCT
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65-85%
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What kind of water reabsorption is at the PCT?
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obligatory
tied to the movement of solute |
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What kind of water reabsorption is at the DCT/collecting duct?
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facultative
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At the PCT, how does sodium move into the tubular cell?
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Facilitated diffusion
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How does sodium move across the basolateral membrane of the PCT tubular cells?
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Na+/K+ pump
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Explain how the facilitated diffusion and the Na+/K+ pump of the luminal border and the basolateral border of the tubular cells are interdependent.
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Facilitated diffusion is going to be maintained because we are constantly pumping glucose back out of the tubular cell at the basolateral border with Na+/K+ pumps. The decrease in glucose concentrations within the tubular cell causes more glucose to move down its concentration gradient at the luminal border and replenishes the glucose in the cell.
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Why does it make sense that the tubular cells are able to pump so much?
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Lots of mitochondria
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At the PCT, Na+/K+ are pumped into the tubular cell by the _____
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Na+/K+ ATPase
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At the PCT, active Na+ transport creates concentration gradients that drive:
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1 - downhill movement of Na+ at the luminal membrane
2 - reabsorption of organic nutrients at the LM 3 - Reabsorption of water by osmosis, which in turn allows the solvents to move down their concentration gradient to be reabsorbed 4 - K+ movement 5 - Chloride movement because of electrical gradient |
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Water pores are called
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aquaporins
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At the loop of Henle, _____% of potassium if reabsorbed, _____% of sodium, ____ % Chloride, _____% H2O
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10-30% K+
20% Na+ 35% Cl 10-15% H2O |
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Water movement is/is not strictly tied to solute movement at the Loop of Henle
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Is not
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What is the osmolarity of the blood?
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300 milliosmolds
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Four facts about the Loop of Henle
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1 - Actively resorbs sodium in the ALH (K+ and Cl- will follow)
2 - Water permeability is low in ALH 3 - With salt movement, interstitium becomes concentrated 4 - HIgh water permeability in the descending Loop of Henle |
