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158 Cards in this Set
- Front
- Back
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Which pressure must exceed all others in Filtration Pressure?
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Grlomerular blood hydrostatic pressure must exceed osmotic pressure of the blood and hydrostatic pressure of the filtrate
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How do you determine filtration pressure?
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NFP = GBHP - CHP - BCOP
NFP: Net Filtration Pressure GBHP: Glomerular blood hydrostatic pressure CHP: Capsular hydrostatic pressure BCOP: Blood colloid osmotic pressure |
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What would increasing the hydrostatic pressure of the filtrate do to the GFR
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Decrease it
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What would increasing osmotic pressure of blood do to the filtration? What would decreasing do?
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Increase = decrease filtration
Decrease = increase filtration |
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What would dilating the afferent arterioles do to the GFR?
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Increase GFR
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What would constricting the efferent arterioles do to the GFR?
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Increase GFR
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How would you determine the renal clearance (amount excreted)?
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Amt excreted = amt filtered + amt secreted - amt reabsorbed
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Where can substances be reabsorb?
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In the nephron (proximal tube, loop of henle, distal tube)
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Where do substances secrete?
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Proximal tube and Distal tube
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Where is most of the sodium reabsorbed
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Ascending limb
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At what expense does reabsorbing sodium cause?
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Losing potassium ions
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Where is most of the water reclaimed?
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Descending loop of henle
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Which tubes (renal) exhibits variable permeability
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Distal tube and collecting duct
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Where does aldosterone act? What does it increase reabsorption of?
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-Distal tube
-Sodium |
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Where is most of the urea reabsorbed? Actively or passively, why?
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-Connecting ducts and medulla
-Passively b/c most membranes cant block urea, goes from high conc. to low conc. |
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Is reabsorbing sodium active or passive?
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Active
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Is reabsorbing glucose active or passive?
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Passive (by facilitated diffusion)
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What does glucose and amino acids usually symport with?
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Sodium
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If the cortex was damaged, which part of the nephron would damaged?
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Bowman's capsule, proximal tube, and distal tube
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If the medulla was damaged, what would also be damaged?
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Loop of henle and collecting ducts
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The Micturition reflexes are controlled by what nervous system?
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Autonomic Nervous System
-Parasympathetic = rest and repose |
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What makes up urine composed of?
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Urobilinogen
Urobilin Hematoporphyrin |
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What color is urine? What causes the coloration?
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Yellow or amber
coloration due to urochrome |
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What is the normal specific gravity
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1.010 to 1.030
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How do you determine the amount of urinary solids
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(last 2 digits of specific gravity) x (long's coefficient: 2.66)
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Is it normal to find protein in urine?
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No
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Is it normal to find blood cells in urine?
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No
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Where does ADH act?
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Primarily collecting ducts
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What does ADH help reabsorb? How?
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Water because it increases the numbers of aquaporins
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What would be 2 good substances, that is not native to the body, to use to measure GFR
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Creatinine and Inulin
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What is the normal GFR per day? Per minute? Why would women have a lower normal GFR?
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180L/day
125mL/min -Due to less body mass |
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Can reabsorption involve cotransport?
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Yes, like symports
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Is reabsorption active? passive? facilitated?
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Yes to all
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What is the normal volume of urine produced? What is the minimal loss of urine?
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-1500mL, normally ranging from 800-2300mL
-300mL |
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What is the primary drive for filtration?
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Pressure
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Is filtration selective?
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No, it is bulk transport
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Where is most of the reabsorption going to take place? What enhances its ability to reabsorb?
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Proximal convoluted tubules
-Microvilli powered by mitochondria |
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What reinforces the capillaries and the glomerulus
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Podocytes
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In order to filter what does it have to go through?
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Go through the fenestration, to the podocyte slits, and then into the capsular space
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What 2 things make up the Juxtaglomerular apparatus
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Macula densa and juxtaglomerular cell
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Where do you find the macula densa
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Distal tube
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How does the macula densa communicate with the juxtaglomerular cells
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Paracrine
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What does the juxtaglomerular cells generally sense (respond to in the blood)
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Pressure
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What do the macula densa cells respond to?
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Osmolarity
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Where can the urine be most concentrated on the filtrate? Why?
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Hairpin turn on the loop of henle because it is more hypertonic
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Where do you find the kidneys? What holds them in position?
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-Retroperitoneal, not peritoneal cavity
-Pericapsular fat |
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How does the urine get from the kidney to the bladder?
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Ureter
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What is unique about the epithelium in the ureter? Why is it unique?
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Transitional epithelium
-compressible in order to hold more fluids |
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Where are the 2 places you would find transitional epithelium?
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Bladder
Ureter |
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What allows the bladder to increase in size dramatically?
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Rugae
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What is the one area of the urinary bladder where the surface is smooth
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Trigone
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What is the name of the smooth muscle that forms the wall of the bladder
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Detrusor muscle
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Blood flows from the renal artery to where?
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Renal artery > segmental > interlobars > arcuates > interlobular > afferent arterioles > glomerulus > efferent arterioles > peritubular capillaries (vas recta) (then back)
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What is the outer most layer of the kidney? What is after that layer?
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Capsule > cortex > medulla > pelvis
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What is the attachment at the pelvis of the kidney called?
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Hilus (hilum)
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What is the one ion that the kidney does not regulate? Why?
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-Hydroxyls because the kidney can regulate hydrogen
-If hydrogen is reclaimed = hydroxl conc is high; if not reclaimed = hydroxl conc is diluted |
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How is the kidney involved in maintaining blood pressure?
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By the release of renin hormone and erythropoietin
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Is the kidney involved in maintaining blood pH?
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Yes
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Is the kidney involved in maintaining toxic compounds in the body due to the break down of protein?
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Yes
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Is the kidney involved in maintaining the amount of blood protein? Why
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No, blood proteins are formed by the liver, they kidney does not excrete blood protein
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Can the kidney compensate for poor respiration?
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Yes
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How does the sympathetic nervous system affect GFR
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Vasoconstriction of afferent arterioles to the glomerulus = sympathetic would cause less GFR
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Where is most of the filtrate reabsorbed
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Proximal convoluted tubules
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What is the function of the collecting system in the kidney?
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Designed to adjust urine
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Should glucose be in the urine?
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No
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What has been exceeded if there is glucose in the urine?
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exceeded threshold max for glucose = exceeded number of symporters available
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If given just aldosterone, but deprived of ADH, how would it affect the filtrate?
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Less sodium in filtrate and not reabsorb equal amount of corresponding water because tubes are not porous enough
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What is the entire purpose of the counter current multiplication system (give an example)
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Allows changes in osmolarity of the filtrate (ie. to keep increased conc of solute at the bottom of the loop of henle and descending limb. Highly concentrated because of water loss)
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What picks up most of the filtered material from the proximal convoluted tube?
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Peritubular capillaries
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What is the functional unit of the kidney?
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Nephron
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What is the average pH of urine?
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around 6
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What is the pH of the urine normally buffered by?
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Phosphates
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Which kidney tubes branched borders? Why?
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Proximal, needed for increased surface area to enhance reabsorption
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What percent of the plasma is filtered by the kidney with every cardiac output
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20-25%
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Describe how breathing would be through a straw 1 feet under water
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Breaths will be faster and deeper (need to create greater pressure gradient to pull air in over increased resistance due to longer pipe)
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What do you call the air that doesnt reach the alveoli
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Anatomical dead air
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How do you figure out the dead air?
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Pulmonary ventilation minus alveolar ventilation
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What is another name for pulmonary ventilation?
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Minute respiratory volume which is approximately 7500mL (respiration rate x tidal volume)
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What is the term given to the reduced ability to transport oxygen? What could it be due to?
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Anemia
-Due to erythropenia, dietary deficiency, loss of blood, cells are abnormal like sickle cells, lack of hemoglobin |
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What would a decline in pH do to the ability of hemoglobin to bind to oxygen? Rise in pH?
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Decline in pH = decreases it
Rise in pH = increases it |
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If the body and blood temperature raised, what would happen to the ability of blood to carry oxygen
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It is reduced
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In the chloride shift, what is being traded for chloride?
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Bicarbonate for chlorides
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How is oxygen transported in the blood?
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Bound to hemoglobin
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How is CO2 transported in the blood
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Bicarbonate ion
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The chemoreceptors in the vascular system are responding to what three things
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Oxygen (responded to least)
CO2 (can cross blood brain barrier) Hydrogen (receptors in medulla oblongata) |
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Describe what happens after CO2 binds with water once it crosses the blood brain barrier and enters CSF
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Becomes carbonic acid > becomes bicarbonate and hydrogen > hydrogen bind to receptors on the medulla affecting respiration rate (increase in hydrogen = increase in respiration rate)
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Breathing is controlled by what center?
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Primary respiratory center
-2 main areas pons & medulla -Pons: Pneumotaxic & Apneustic -Medulla: Inspiratory & Expiratory |
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What is the second most common way to carry CO2 in the blood?
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Bound to hemoglobin
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What is designed to prevent over inflating or deflating of the lung?
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Hering–Breuer reflex
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What is the term for no oxygen in the blood
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Anoxemia
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What is the term for high CO2 level in the blood
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Hypercapnia
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Lung disorders are classified by what 2 groups? (give examples for each)
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Obstructive (ie. asthma)
Restrictive (ie. fibrotic lung) |
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As you get older, what volume in the lung increases? Why
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Residual because the lung is becoming less complaint
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What happens to the breathing rate if you rebreathe into a bag? What about threading a needle?
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Bag: Increases
Needle: Decreases |
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Most gases are moving from the alveoli into the blood down what?
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Pressure gradient as bulk transport
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The movement of blood to tissue is done by what?
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Concentration gradient (can be done by pressure gradient as well)
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23-DPG forms to stabilize the hemoglobin as it releases what?
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Oxygen
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High levels of CO2 will cause hemoglobin to lose its affinity for oxygen and oxygen is now released to the tissue is commonly described as what effect?
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Bohr effect
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In the lung, there is high level of oxygen that tends to drive out CO2 directly and indirectly, this is describe as who's effect?
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Haldane effect
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What gas is the primary regulator for breathing
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CO2
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Where would u expect to find most of your CO2, Hydrogen, oxygen receptors in the vascular system
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Aortic arch and carotid sinus
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What happens to the oxygen level with rapid shallow breathing
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Decrease because shallow breathing fails to reach alveoli = reduce surface area for gas exchange
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Why is emphysema often regarded as an obstructive disorder after a period of time
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Airways start collapsing on themselves
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What does pleurisy do to the interpleural space?
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Pleurisy adds fluids to the interpleural space causes difficulty to breath
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If the right lung is pieced and collapses, why does the left lung not collapse?
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it is in a different sealed cavity
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The pleural space should be what, in terms of pressure relative to the pulmonary pressure
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Lower (3-4mmHg)
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Describe inspiratory capacity
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Inspiratory reserve + tidal volume
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Describe vital capacity
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Inspiratory reserve + tidal + expiratory reserve
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What happens if you make the vascular bed smaller?
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More resistance and increases pressure (bigger the bed = lower the pressure)
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If you lack surfactants now, you will go into an acute respiratory distress syndrome because what will happen in the lung?
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Alveoli may collapse because surface tension is going up
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If a baby is born prematurely, they are in an acute respiratory distress because they havent formed what?
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Surfactants
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What cells produce surfactants
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Type 2
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Cystic fibrosis is what type of disorder?
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Autosomal recessive disorder
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What escalator is unable to dislodge a thick mucoidal secretion?
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Cilia which normally removes particles from the lung
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If the diaphragm contracts, what will happen to the intrapleural pressure?
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Decrease
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What muscles are involved in inspiration? expiration?
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Inspire: External intercostal
Expire: Internal intercostal |
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Is inspiration active or passive?
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Active
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Is expiration active or passive?
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Passive due to elastic recoil
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Who describes the fact that if the diameter of the alveoli increases, the surface tension will diminish
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Laplace
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Who describes the pressure of a gas as part of the total overall pressure of all the gases combined
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Dalton
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Who describe the solubility of the gases
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Henry
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Which of the laws relate volume of the gas to pressure
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Boyle
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Who relates the volume of the gas to temperature
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Charles
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Who relates the volume of the gas to temperature
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Diameter of airway, elasticity/compliance of lung
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Why does air come into the lung in the first place
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Because of the difference in air pressure (negative pressure for inhalation)
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What do you call the bifurcation of the trachea into the 2 primary bronchi
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Carina
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How many secondary bronchi are there
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5 (3 on right 2 on left)
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What is the serous membrane around the lung
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pleural membrane
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What is the difference structurally between a bronchus and a bronchiole
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Bronchiole dont have cartilage (they maintain their diameter with smooth muscle)
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Can a bronchus dilate or constrict?
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Yes, but not to the same degree as a bronchiole
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What is the difference between terminal bronchiole and a respiratory bronchioles
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-Terminal = dead air (no exchange)
-Respiratory is the beginning of the airway where gas exchange is possible between the air in the bronchiole and the blood vessels around it |
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Can you lose fluid through respiratory system
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Yes (insensible loss)
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What is the partial pressure in the lung? Distal tissue?
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Lung: 100-105
Distal: 40 |
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What is the partial pressure of CO2 in the distal tissues?
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45
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What is the partial pressure of CO2 by the time it gets to the alveolus
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40
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What is the name of the instrument that has a drum that floated on water and is used to measure the volume of air inspired and expired by the lungs
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Spirometer
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What is the Volume that you could never exhale
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residual (1200)
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What is the usual total lung capacity for a 70kg 21 year old male? female?
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6000
female: 6000 x .75 |
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When you filter your blood, do you also filter out RBC? Proteins?
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No to both, filtrate is highly refined (ultra-filtrate)
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The odor is normally pleasant at first, why doesnt it remain so?
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Due to bacteria. urine becomes cloudy and becomes alkaline. Odor is due to ammonification
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How did you test for reduced sugar
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Benedicts
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How did you test for proteins
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Biurets, acids, nitric acids
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What did you use to test for ketones
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urine added to acetone powder
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What did you use to test for calcium
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Sulkowitch's reagent
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What did you use to test for phosphate (color of ppt)
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Nitric acid and ammonium molybdate
-Heated, ppt = yellow |
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What is the term for the decrease of urine production as you age?
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oliguria = skant urine
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What did you use to measure specific gravity
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Urometer
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What is the term for when urine has sugar in it
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glucosuria
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What is the term for when there is blood in the urine
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Hematuria
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Where were the breathing sounds best heard
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Triangle of oscutation, on the back under the scapular between the midscapular line and vertebral spine where there was least amount of muscle
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Which sounds could you hear all the time, vesicular or bronchiole? Why
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Bronchiole because vesicular would mean the air would have to reach the aveoli. (Bronchi brings air into lungs)
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Why do we want gases that pass from the lung into the blood to go to RBCs rather than stay in the plasma
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Because of hemoglobin
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What else does the RBC have that really favors transport of CO2
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Carbonic anhydrase
-accelerate formation of carbonic acid that then becomes bicarbonate |
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Place these in order of solubility in the plasma, oxygen, nitrogen, or CO2
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CO2 > oxygen > nitrogen
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What is the buffer for urinary and blood plasma
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Urinary (phosphate/phosphoric acid)
Blood plasma (bicarbonate/carbonic acid) |
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The interpleural space must have what kind of pressure
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Negative
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When you stand up vs lying down, which would have a larger vital capacity
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Standing up bc lying down has weight of chest pressing down = less capacity
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What is the term for if you had a high pH in your blood plasma
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alkalemia
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