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105 Cards in this Set

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The kidneys filter how much blood daily?
1700 liters
How much urine do the kidneys produce daily?
1.5 liters
Which kidney sits slightly lower in the body?
the right kidney
The renal artery and vein enter and exit at what point?
the hilus
Is there colateral circulation to the kidneys?
no, the renal artery is the only source of blood supply to the kidneys
The nephron is supplied by what 2 capillary networks?
the glomerulus and the peritubular capillary network
A unique, high-pressure capillary filtration system located between the afferent and the efferent arterioles
the glomerulus
A low-pressure reabsorptive system that originates from the efferent arteriole
the peritubular capillary network
Fluid and particles from the blood are filtered through the capillary membrane into a fluid-filled space in bowman's capsule called what?
Bowman's space
The fluid filtered through the glomerulus is called what?
filtrate
The majority of nephrons are what type?
Cortical nephrons
These have a short, thick loops of Henle and penetrate only a short distance into the medulla.
Cortical nephrons
These originate deeper in the cortex and have longer, thinner loops of Henle that penetrate the entire length of the medulla.
Juxtamedullary nephrons
Which nephrons are largely concerned with urine concentration?
juxtamedullary nephrons
What is normal GFR?
125 ml/minute
What is approximate capillary filtration pressure?
60 mm Hg
How does constriction of efferent arterioles affect GFR and glomerular pressure?
it increases both GFR and glomerular pressure
How does constriction of affernet arterioles affect renal blood flow, GFR and filtration pressure?
it decreases all 3
With strong sympathetic stimulation urine output can fall to almost zero. True or False?
True
Renal tubular cells have 2 surfaces through which substances must pass.
the luminal membrane and the basolateral membrane
Most of the energy consumed by the kidney is used for what?
active sodium transport mechanisms
What 2 things are passively absorbed in the kidney?
water and urea
65% of reabsorptive and secretory processes that occur in the tubular system occur where?
proximal tubule
Glucose, amino acids, lactate, and water-soluble vitamins are completely resorbed. True or False
true
Sodium, potassium chloride ad bicarbonate are ___% resorbed.
65-80%
the maximum amount of a substance that can be reabsorbed per unit of time is defined as what?
transport maximum
the plasma level at which the substance appears in the urine is defined as what?
renal threshold
What are the 3 segments of the loop of henle?
the thin descending segment, the thin ascending segment, the thick ascending segment
Fluid entering the loop of henle is iso-osmotic, hypo-osmotic or hyper-osmotic?
enters as iso-osmotic and then becomes hypo-osmotic
The descending limb is permeable to what?
Highly permeable to water; Moderately permeable to urea, sodium and other ions
The ascending limb is impermeable to what?
water
Which segment of the loop of henle requires energy?
the thick segment
The thick segment contains what type of cotransport system?
Sodium/Potassium/Chloride
Approximately what percent of the filtered sodium, potassium and chloride is reabsorbed in the thick loop of henle?
20-25%
The countercurrent mechanism controls what in the loop of henle?
water and solute mvmt so that water is kept out of the peritubular area and sodium and urea are retained
Calcium and magnesium are reabsorbed where?
the thick ascending loop
Distal convoluted tubule is permeable to water. True or False
False, it is impermeable to water
Calcium is actively reabsorbed where?
distal convoluted tubule
Aldosterone affects the reabsorption of what?
sodium and potassium
Where is the major site for regulation of potassium excretion by the kidney?
late distal tubule and cortical collecting tubule
Principal cells do what?
reabsorb sodium and water from filtrate, secrete potassium into filtrate, separate channels for sodium and potassium; no cotransport mechanism
What do intercalated cells do?
reabsorb potassium ions from filtrate and secrete hydrogen ions into filtrate
This is where the urine becomes highly: concentrated, diluted, alkaline or acidic
medullary collecting duct
ADH has its effects where?
medullary collecting duct
How does ADH concentrate urine?
by returning water to circulation
What determines the permeability of collecting ducts to water?
concentration of ADH
What happens without ADH?
dilute urine is formed
What are the types of diuretics?
loop, thiazide, potassium sparing
Diuretics do what in the body?
increase urine production
What percent of sodium is resorbed in the loop of henle?
25-30%
What percent of sodium is resorbed in the distal convoluted tubule?
10%
Late distal and cortical collecting tubule resorb what percent of sodium?
2-5%
Where do loop diuretics exert their effects?
the thick ascending loop of henle
What are some negative effects of loop diuretics?
increase uric acid retention, impair glucose tolerance, hypovolemia
Where do thiazide exert their effects?
precent the reabsorption of NaCl in the distal convoluted tubule
Where do aldosterone antagonists exert their effects?
reduce sodium reabsorption and increase potassium secretion in the late distal tubule and cortical collecting tubule site regulated by Aldosterone
Aldosterone antagonists interfere with secretion of hydrogen which can cause what?
metabolic acidosis
kidneys receive what percent of cardiac output?
20-25%
What are some vasoconstrictors?
angiotensin II, ADH, Endothelins
What are some vasodilators?
Dopamine, Nitric Oxide, Prostaglandins
Which cells produce renin?
juxtamedullary cells
A high protein diet can cause what?
increase renal blood flow 20-30%
What are the effects of high blood glucose levels?
uncontrolled DM causes elevated renal blood flow and GFR
This substance can be a quick estimate of GFR?
inulin
Renal clearance is determined by what?
1. the ability of the substance to be filtered in the glomeruli
2. the capacity of the renal tubules to reabsorb or secrete the substance
The elimination of sodium and potassium is regulated by what?
GFR, Aldosterone, Atrial Natriuretic Peptide
Aldosterone is secreted where?
adrenal gland
This is released from atrial muscle cells when the atria are stretched.
Atrial Natriuretic Peptide
What does ANP do?
1. vasodilation of the afferent and efferent arterioles resulting in increased renal blood flow and GFR
2. inhibits aldosterone secretion by the adrenal gland
3. inhibits ADH release from pituitary
How do the kidneys regulate pH?
by conserving base bicarbonate and eliminating hydrogen ions
All hydrogen ion elimination from the body is through the kidneys. True or False
True
What are the 3 major urine buffers?
bicarbonate, phosphate, ammonia
A product of purine metabolism.
Uric Acid
High levels of this can cause gout or kidney stones.
Uric Acid
This is an end product of protein metabolism.
Urea
What is the normal daily production of urea?
25-30 g
Normal BUN is in what range?
8-25 mg/dl
_______ is an enzyme that is synthesized and stored in the juxtaglomerular cells.
Renin
Renin is released in response to what 3 things?
1. decrease in renal blood flow
2. change in composition of the distal tubular fluid
3. sympathetic nervous system stimulation
____________ is a polypeptide hormone that regulates the differentiation of red blood cells in the bone marrow.
erythropoietin
Where is EPO formed?
the kidneys
Synthesis of EPO is stimulated by what?
tissue hypoxia
Activation of vitamin D occurs where?
the kidneys
What is the action of vitamin D?
It increases calcium absorption from the GI tract and helps regulate calcium deposition in bone
What are the 3 functions of the kidneys?
1. filter the blood
2. selectively reabsorb substances needed to maintain proper body fluids
3. excrete metabolic wastes
Why should a freshly voided urine specimen be examined within 1 hour?
red blood cells lyse, casts disintegrate, bacteria multiply
What is the normal range for creatinine?
0.6-2.1 mg/dl
What is normal creatinine clearance?
115-125 ml/minute
Where is EPO formed?
the kidneys
Where is EPO formed?
the kidneys
What is the best test for renal sufficiency?
creatinine
Where is EPO formed?
the kidneys
Synthesis of EPO is stimulated by what?
tissue hypoxia
_____ is formed in the liver as a byproduct of protein metabolism.
Urea
Synthesis of EPO is stimulated by what?
tissue hypoxia
Synthesis of EPO is stimulated by what?
tissue hypoxia
Activation of vitamin D occurs where?
the kidneys
Activation of vitamin D occurs where?
the kidneys
Activation of vitamin D occurs where?
the kidneys
What is the action of vitamin D?
It increases calcium absorption from the GI tract and helps regulate calcium deposition in bone
What is the action of vitamin D?
It increases calcium absorption from the GI tract and helps regulate calcium deposition in bone
What is the action of vitamin D?
It increases calcium absorption from the GI tract and helps regulate calcium deposition in bone
What are the 3 functions of the kidneys?
1. filter the blood
2. selectively reabsorb substances needed to maintain proper body fluids
3. excrete metabolic wastes
Why should a freshly voided urine specimen be examined within 1 hour?
red blood cells lyse, casts disintegrate, bacteria multiply
What is the normal range for creatinine?
0.6-2.1 mg/dl