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113 Cards in this Set

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What is the order of blood vessels to and within the kidney from the aorta to the vena cava?
1. Abdominal aorta to Renal artery

2. Renal artery to Renal vasculature

3. Renal vasculature to Renal vein

4. Renal vein to Inferior Vena Cava

5. (Inferior Vena Cava to Right heart)

A.A.
R.A
RVas.
RV
IVC
6. Normally, an individual will have only one

A. inferior vena cava
B. ureter
C. renal artery
D. renal vein
E. kidney
A. inferior vena cava
7. The cells of the proximal tubule
A. are always impermeable to Na+
B. secrete renin
C. are always permeable to water
D. are modified smooth muscle cells
E. are relatively thin and flat, with few mitochondria
C. are always permeable to water
9. Fluid in the tubular segment with the macula densa will flow next and immediately into which tubular segment:
A. cortical collecting duct
B. distal convoluted tubule
C. thin descending limb of Henle’s loop
D. thin ascending limb of Henle’s loop
E. proximal convoluted tubule
9. B The path of fluid flow is from the thick ascending limb of Henle’s loop, to the region of the macula densa, and then to the distal convoluted tubule.
10. Fluid in the major calyx will flow next and immediately into the
A. ureter
B. medullary collecting duct
C. thick ascending loop of Henle
D. cortical collecting duct
E. renal pelvis
10. E
11. The passage of negatively charged molecules from the plasma to the urinary space is blocked primarily by which component of the glomerular filter
A. fenestrations of the endothelium
B. molecular composition of the basal lamina
C. slit between pedicels
D. molecular composition of the slit diaphragm
11. B
12. Glucose is reabsorbed from the tubular fluid in which segment of the nephron?
A. Bowman’s capsule
B. proximal tubule
C. descending thin loop of Henle
D. collecting tubule
E. macula densa
12. B
13. Vasopressin (ADH / antidiuretic hormone) regulates _________ in the ________ cells
A. water channels proximal tubule
B. Na+ channels juxtaglomerular cells
C. water channels collecting duct
D. Na+ channels distal convoluted tubule
13. C. vasopressin (or ADH) stimulates the cell to insert water channels (aquaporins) into the apical membrane of the collecting duct cell.
14. Select the answer below which lists renal blood vessels in their correct sequence (blood vessels which
immediately follow)
A. arcuate artery -> arcuate vein
B. cortical peritubular capillary -> interlobar vein
C. afferent arteriole
-> glomerular capillary
D. vasa recta -> interlobular vein
E. renal vein -> arcuate vein
14. C

Arcuate artery --> interlobular artery
Cortical peritubular capillary -> interlobular vein
Vasa recta --> arcuate vein
Renal vein -> inf. vena cava
15. Tubular cells with a high density of mitochondria, but no apical microvilli, are those that line the
A. thin descending limb of Henle’s loop
B. thick ascending limb of Henle
C. proximal tubule
D. cortical collecting duct
E. medullary collecting duct
15. B
(also the distal convoluted tubule)
16. A feature common to all of the epithelial cells of the tubular segments located both the cortex and the medulla is
A. the presence of extensive apical microvilli
B. the proximity to segments of the peritubular capillaries
C. a relatively thin (squamous) shape
D. the presence of high density of mitochondria near the apical cell membrane
E. the presence of podocytes
16. B. Cells lining the different tubular segments vary quite a bit in size, function, and specialization, but they are all close to the peritubular capillaries (remember that in the medulla, the peritubular capillaries are the vasa recta).
17. For the renal transport process of REABSORPTION, number the correct sequence of structures a substance would pass through starting in the proximal convoluted tubule (PCT) lumen. Assume the substance is not metabolized by the PCT epithelial cell or endothelial cell and the substance follows a transcellular and not paracellular route.

order (1=1st, 9=last) structure or fluid space

plasma ultrafiltrate in proximal tubule lumen

plasma found in peritubular capillary adjacent to PCT epithelial cell

luminal-side plasma membrane endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

intracellular fluid of PCT epithelial cell

intracellular fluid endothelial cell of peritubular capillary adjacent to
PCT epithelial cell

interstitial-side plasma membrane of endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

interstitial fluid

basolateral plasma membrane of PCT epithelial cell
apical plasma membrane of PCT epithelial cell
17.
1. plasma ultrafiltrate in proximal tubule lumen

2. apical plasma membrane of PCT epithelial cell

3. intracellular fluid of PCT epithelial cell

4. basolateral plasma membrane of PCT epithelial cell

5. interstitial fluid

6. interstitial-side plasma membrane of endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

7. intracellular fluid endothelial cell of peritubular capillary adjacent to
PCT epithelial cell

8. luminal-side plasma membrane endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

9. plasma found in peritubular capillary adjacent to PCT epithelial cell
18. During the process of filtration, solutes pass through a series of structures. Which of the following lists a pair of structures that immediately follow each other in this process, and in the order given
A. glomerular capillary plasma, Bowman’s space
B. Bowman’s space, podocyte slit
C. basement membrane, podocyte slit
D. endothelial fenestration, glomerular capillary plasma
E. basement membrane, endothelial fenestration
18. C
Filtration proceeds from the capillary plasma -> endothelial fenestration
-> basement membrane -> podocyte slit -> fluid of Bowman’s space
Urine flow:
formation, modification, and disposal
Formed by filtration in the kidney, and modified by renal tubules
-> ureter -> bladder -> urethra
What are the 2 Regions of the kidney?
Cortex : outer region

Medulla, medullary pyramid: inner region
Tip of the pyramid= papilla
The cortex of the kidney does what?
All filteration and most of the re-absorption
The medulla of the kidney does what?
H20/Na+ adjustment
What is the path of urine leaving the kidneys?
minor calyx (“cup”) --> major calyx --> renal pelvis -->
ureter --> bladder
Urine is formed in the ______; modified in the ____ & _____; Exits at the ______, and enters ________
Urine is formed in the cortex; modified in the cortex and
medulla; Exits at the papilla, and enters excretory regions:minor calyx (“cup”) --> major calyx --> renal pelvis -->
ureter --> bladder
Describe Urine flow process
Formed by filtration in the kidney, and modified by renal tubules
-> ureter -> bladder -> urethra
Functional unit of the kidney includes?
renal corpuscle (where filtration occurs (initial formation of urine))
and elongated tubules (where urine is modified)
All nephrons have ________ within the cortex
Corpuscle
What are the two types of nephrons in the kidneys?
Cortical nephron: most of the tubule is also within the cortex

Juxtamedullay nephron: corpuscle is near cortical-medullary
boundary;
Most of the Juxtamedullay nephron tubule extends into?
the medullary pyramid
All nephrons participate in formation of ___________, and all contribute to _________________, but only the _____________________
participate in the concentration of urine.
- ultrafiltrate
- the urine outflow
- juxtamedullary nephrons
Where does the initial formation of urine occur?
Renal corpuscle
What are the subdivisions of a nephron?
Renal corpuscle
Proximal tubule
Loop of Henle (TDL, THINA, TALH)
Juxtaglomerular apparatus
Distal convoluted tubule
Cortical collecting duct
What are the components/functions of the renal corpuscle?
• Glomerular capillaries tuft of capillaries. This is the blood that will be filtered

• Bowman’s capsule: hollow capsule surrounding capillaries, ends in the proximal tubule.

• Ultrafiltrate: fluid and small molecules exit glomerular capillaries, and enter the fluid of Bowman’s capsule
What are the components/functions of the proximal tubule?
reabsorbs water and other molecules from the
ultrafiltrate, secretes other molecules into the ultrafiltrate

Convoluted initial portion
straight (thick descending loop of Henle)

Most re-absorption takes place here
What are the components/functions of the Loop of Henle?
involved in the mechanism of concentrating urine, to
appropriately adjust Na+ excretion to Na+ and water balance.

Contains:
• Thin descending limb of Henle’s loop
• ascending thin limb of Henle’s loop
• Thick ascending limb of Henle’s loop
Collecting ducts are found in both _______ & ________.
cortex and medulla
Juxtaglomerular apparatus is a ____________ point in the nephron
Regulation
What are the components/functions of the Distal convoluted tubule?
part of the mechanism for Na+ balance
What are the components/functions of the cortical collecting duct?
several tubules flow into a single collecting duct
What are the components/functions of the medullary collecting duct?
Ducts flow into larger ducts of the tubules and ducts

participate in Na+/K+/water balance and acid/base balance.

found in both cortex and medulla
Ultrafiltrate of the renal corpuscle is so named because
it contains no proteins
What is the 4 basic renal processes?
Some of the plasma is filtered

Some of the filtered plasma (“ultrafiltrate”) is reabsorbed

Some of the solutes in the non-filtered plasma is secreted

The remaining fluid and solutes of the ultrafiltrate are excreted in the urine
Components and circulation of the formation of the ultrafiltrate
takes place in renal corpuscle:

involves Glomerular capillaries and Bowman’s capsule:

Has Portal circulation: (unusual)
afferent arteriole - > glomerular capillaries -> efferent arteriole
what arteriole of the renal corpuscle controls the resistance?
afferent arteriole
what arteriole of the renal corpuscle controls the resistance for both blood in and out?
efferent arteriole
describe Glomerular capillaries
tufts of interconnected capillaries
describe Bowman’s capsule
cup formed around the (glomerular) capillary network
what is Bowman’s space:
fluid interior of the Bowman’s capsule
Fluid & solutes entering Bowman’s space from the capillary must pass through?
1-Capillary endothelium – fenestrated

2-Basement membrane – extracellular material, negatively
charged

3-epithelial layer of Bowman’s capsule=Podocytes
describe Podocytes?
have cytoplasmic extensions / foot processes
spaces between adjacent foot processes form slits,
covered by a diaphragm
What are Mesangial cells?
These cells provide physical support for the glomerular
capillaries, and help “clean” the basal lamina.
Disease processes affecting the mesangial cells affect?
the ability to maintain the basal lamina, and change the composition of the ultrafiltrate
Ultrafiltrate consists of?
fluid, and particles that can pass between the slits of the podocyte process, and can also pass through the basal lamina of the endothelium and podocytes:
The type of material that can enter the ultrafiltrate depends on?
both size, and charge
Most non-protein nutrients can easily enter the ultrafiltrate, and must be?
reabsorbed (transported back into the blood) by the nephron. In addition, many waste products have additional mechanism (secretion ) to enter the urine.
Most proteins ____ ______ from the blood into the ultrafiltrate (albumin is at the upper end of the
permitted size).
cannot pass
The appearance of significant amounts of albumen or other proteins in the ultrafiltrate is usually a sign of?
renal disease.
A leaky filter is very common in?
Diabetic patients
Tubules (collecting tubules) are lined by ___________, resting on _____________?
a single layer of epithelium

a basement Membrane
Epithelial cells are linked by?
tight junctions, which can be tight or “leaky”
Epithelial cells are polarized, with ?
an apical (towards lumen) domain & a basolateral (towards interstitium)domain
Epithelial cells with more ATP-requiring process have more ___________, and these are located near _______________ (i.e. basolaterally, or apically, depending on the location of the transporter)
mitochondria

the ATP requiring transporters
In collecting tubules, Size matters. Why?
flat (squamous) cells have more passive processes than do large cuboidal or columnar cells
All tubule cells are close to?
a capillary
Permeability to ______ & ______varies along the tubule
water and/or NA+
What is in the Proximal tubule?
Large cells specialized for absorption:

Extensive apical (lumen facing) microvilli
pinocytotic vesicles;
The Proximal tubule is always permeable to ______ because _____.
water and Na+

apical water channels and Na+ transporters
The Proximal tubule contains what kind of folds?
Basolateral folds
High density of mitochondria are found in the Proximal tubule, especially along?
basolateral folds
Proximal tubule cells reabsorb __% of the glucose, __% of the water and salt and ___% of A. Acids
100%
70%
100%
Thin loop of Henle is comprised of that type of cells?
thin, squamous(flat)cells;
Epithelial cells can increase membrane surface area (and number of transporters) apically with?
microvilli, and basolaterally with basolateral membrane folds
Thin descending segment of the loop of Henle is always highly permeable to ______, less permeable to ___ & ___
water
urea and salt
Thin ascending segment of the loop of Henle is always impermeable to _____, but permeable to ___.
water
NaCl
- involves Na+/K+ ATPase
Movement of salt but not water in the Thin loop of Henle allows……………, and is key to the formation of __________.
the interstitium to become hyperosmotic
concentrated urine
Thick ascending limb of Henle is comprised of that type of cells, folds, and microvilli?
Cuboidal cells, basolateral folds (surface area) but very few microvilli;
Thick ascending limb of Henle has what type of mitochondria?
basolateral mitochondria (ATP)
involves Na+/K+ Atpase
Thick ascending limb of Henle Transports ions from……………, but is impermeable to ____.
(for reabsorption)
the lumen to the interstitium

water
Macula densa is part of the ………… and is specialized for __________.
juxtaglomerular appartus

monitoring osmolarity of filtrate
Distal convoluted tubule cells are similar in morphology to those of the?
TALH.
Distal convoluted tubule is impermeable to _____ and permeability to _____.
water
NA+
Distal convoluted tubule permeability to NA+ is stimulated by?
aldosterone
The collecting duct is comprised of what type of cells?
Cells are cuboidal in cortical collecting tubules and early ducts, and columnar in later ducts
(closer to the calyx)

(in other words, the height of the cell increases towards the distal region of the ducts).
The collecting duct cells have no _____ & ________ and fewer __________ than
proximal or distal tubule cells.
Microvilli & basolateral folds

mitochondria
What are the two cell types:
Principle cells and Intercalated cells
Facts about Principal cells
have water channels, AQP-2, that are regulated by the
hormone Vasopressin (antidiuretic hormone or ADH.)
Principal cells are regulated by?
aldosterone (increases with aldosterone)
Facts about Intercalated cells
participate in H+ and HCO3- balance
reabsorb K+.
These are found more in the initial, cortical regions than in the distal, medullary regions.
Juxtaglomerular cells (JG cells) are and secrete?
Modified smooth muscle cells of the afferent arteriole.

Secrete renin. (Renin catalyzes the conversion of angiotensinogen to antiotensin I, which is in turn converted to angiotensin II in the lung. Angiotensin II stimulates aldosterone secretion)
Renin catalyzes the conversion of …………. to ………….., which is in turn converted to …….. in the lung. Angiotensin II stimulates ……….
angiotensinogen to antiotensin I
angiotensin II
aldosterone secretion
Angiotensin II stimulates?
aldosterone secretion
When rennin increases, angiotension 2 increases which is important for?
Blood Pressure
Relationship to systems regulating ECF volume and blood pressure: Systematic response

? Plasma volume ? sympathetic nerve outflow ? renin ? angiotensin 2 & aldosterone
Decrease Plasma volume; Increase sympathetic nerve outflow; Increase renin; Increase angiotensin 2 & aldosterone
Relationship to systems regulating ECF volume and blood pressure: Local response

? Arterial pressure ? stretch of muscle in afferent arteriole ? renin ? angiotensin 2 & Aldosterone
Decrease Arterial pressure; Decrease stretch of muscle in afferent arteriole; Increase renin; Increase angiotensin 2 & aldosterone
Relationship to systems regulating ECF volume and blood pressure: Local response

? Flow rate of fluid in the tubule ? NaCa delivery to macula densa ? rennin
Decreased Flow rate of fluid in the tubule; Decrease NaCa delivery to macula densa; Increase rennin
The Macula densa is?
Modified cells of the distal tubule.
The cells of the Macula densa are ____ & _____ and in contact with _______ .
tall and narrow (“densa”),
the JG cells
Macula densa cells sense the osmolarity of …………… in ………..
the tubular fluid in the distal tubule.
Macula densa cells sense the osmolarity of the tubular fluid in the distal tubule

A high load of NaCl ? signal (probably ATP) ? JG cells, and inhibits ?
A high load of NaCl sends a signal (probably ATP) to the JG cells, and inhibits renin secretion
Macula densa afferent Arial smooth muscle provides?
tubuloglomerular feedback
Blood enters in the ________ from the __________.
renal artery
Abdominal aorta
What are 3 arteries of the kidneys?
interlobar arteries (in between the medullary pyramids)

arcuate arteries (along the border between cortex and medulla)

interlobular arteries
There are no anastomoses in the kidneys which means?
the loss of blood supply is not compensated, so that cell death occurs if any artery is blocked (this is not the case in most organs)
There is no direct arterial supply to what part of the kidney?
the medulla
Capillary system in the kidney is unusual. What is the path of blood flow from Interlobular artery to efferent arteriole.
Interlobular artery ~> afferent arteriole ~> glomerular capillary ~> efferent arteriole
How many sets of arterioles does the kidney have?
Two. Afferent and efferent arterioles
Where does where filtration occur in the kidneys?
glomerular capillaries
How can afferent and efferent arterioles can be regulated
independently?
portal circulation
Blood in the efferent arterioles heads to?
second set of capillaries called the peritubular capillaries in the cortex
The peritubular capillaries surround ?
The tubules
What is the blood path from the Peritubular capillaries of the cortex to the inferior vena cava?
Peritubular capillaries ~> interlobular vein, ~> arcuate vein ~> interlobar vein ~> renal vein ~> inferior vena cava
In the medulla , these peritubular capillaries are called the _________ , which are adjacent to, and parallel to ………………………..
vasa recta

the long loops of Henle and the collecting tubules
Blood in the vasa recta flows down to …………, then back up to ………………, and empties into the ………….
the tip (papilla) of the pyramid

the junction between cortex and medulla

arcuate veins
What is the blood path from the Peritubular capillaries (Vasa Recta) of the medulla to the inferior vena cava?
Vasa Recta ~> the tip (papilla) of the pyramid ~> the junction between cortex and medulla ~>
arcuate veins ~> interlobar vein ~> renal vein ~> inferior vena cava
Modification of the ultrafiltrate involves ………………….. into the capillaries
reabsorption and/or secretion
Peritubular capillaries are essential for?
reabsorption and/or secretion of most solutes
Vasa recta is essential for?
Na, urea and water transport involved in concentrating urine.
With ultrafiltration, changing the charge can change the?
permeability of a molecule