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34 Cards in this Set

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renin-producing granular cells do what? where are they located?
sense pressure, reduce store and release rennin

in afferent arteriole
macula densa
salt sensor of the nephron
extraglomeular mesangial cells
can contract or relax dependent on endogenous substances

Contraction of these cells may restrict flow through some of the capillary loops, thus effectively reducing the area available for filtration (thus a decrease in Kf) and thus a decrease in GFR
what is GFR and normal?
The volume of filtrate formed per unit time
Don’t forget the units…VOLUME/TIME

norm = 180L/Day
Rate of filtration =?
Kf x NFP

Kf= hydraulic permeability X surface area (thi sis the filtration coefficient)

NFP= Net filtration pressure
NFP =
net filtration pressure

(PGC-PBC-OncoticGC)

PGC= glomerular capillary hydrostatic pressure

PBC= Bowman's capsule hydrostatic pressure

PieGC= Glomeruluar capillary oncotic pressure
if you relax the glomeruluar mesangial cells, what will this do to Kf?
this increases Kf

so according to Kf x NFR= GFR

this increases the GFR
FINISH TABLE 2-2
SLIDE 11

have to know it
if you increase the afferent arteriole resistant, what does it do to PGC? what does this mean for GFR?
decrease PGC

decrease GFR
if you increase the efferent arteriole resistant, what does it do to PGC? what does this mean for GFR?
increase PGC

increase GFR
if you decreases renal plasma flow what happens to GFR?
When the flow is slow you will get a rapid increase in oncotic GC…this can mean that you stop filtration b/c the oncontic GC opposes filtration

according to Kf x NFP

you will decrease GFR
Filtration factor=
GFR/RPF
Filtration factor is greater at low or high plasma flow?
LOW

FF=GFR/RPF
if you increase afferent arteriole resistance, what does this do to RBF?
decrease
if you increase efferent arteriole resistance, what does this do to RBF?
decrease
if you increase afferent AND efferent arteriole resistance, what does this do to RBF?
decrease
how is it possible to constrict the efferent arteroile and cause increase GFR and decrease RBF?
when you vasoconstrict you will increase GFR up to a certain point, yet as RBF starts to decrease, you will reach a threshold where you will not have enough RBF to cause an increase in GFR...
With SNS stimulation (and angiotensin II), BOTH afferent and efferent resistances _____ and RBF _____
increase

decrease
when you have an increase in RAAS after volume depletion the combined effect will do what to GFR?
it will be maintained

even though you decrease RBF

this was on a test before..worth knowing that when you have volume depletion and you activate RAAS that GFR will be maintained
You give a person a drug that dilates the afferent arteriole and constricts the efferent arteriole by the same amounts.

What effect will this have on GFR, RBF, and FF?
GFR= increase

RBF= no change

FF= increase

in spite of the fact that you have that PGC effect to increase GFR, FF is increasing oncotic pressure (you are leaving proteins left behind in the capillary), this will blunt the effect GFR
Your patient has entered the ER after a motorcycle accident. His blood pressure is very low and he is tachycardic. You believe he has lost a great deal of blood volume.

What will happen to RAAS?

What about FF?
RAAS will increase

FF will increase after RAAS
Your patient has renal artery stenosis. What effect will the stenosis have on RAAS and subsequently on GFR?
increase RAAS

maintain GFR

angiotension works right where you have that threshold of constricting the efferent arteriole that sets RBF and PGC about equal...
what is they myogenic response and where does it occur?
increase in BP that would increase the RBF, you get a vasoconstriction to maintain RBF to maintain GFR

this also works in the reverse for low BP

THIS HAPPENS AT THE AFFERENT ARTERIOLE****

note this only blunts the effect
effects of RAAS/SNS on RBF and GFR
RAAS system: Ang II constricts afferent and efferent arterioles (efferent more than afferent)
SNS: constricts both afferent and efferent arterioles
Net effect: decrease in RPF w/ only a little or no change in GFR
what does ADH do to RBF and GFR?
does vasoconstrict, but normally RBF and GFR remain constant
what does ANP do to GFR and RBF?
afferent dilation, thus causes increases in both GFR and RBF; also inhibits the secretion of renin
low dose dopamine does what
causes low dose vasodilation
generally protective against excessive vasoconstriction like the excess you might see with lots of SNS and ANG II...this describes?
Prostaglandins
If you have an increase in renal arterial pressure, what does this do to GFR?
this increases PGC

in the equation GFR= Kf (PGC-PBC-OncoticGC)

so increase GFR
what does decreasing afferent arteriolar resistance do to GFR?
this increases PGC

in the equation GFR= Kf (PGC-PBC-OncoticGC)

so increase GFR
what does efferent constriction do to GFR?
this increases PGC

in the equation GFR= Kf (PGC-PBC-OncoticGC)

so increase GFR
if you have obstruction of a tubule or increased intratubular pressure, what does this do to GFR?
this increases PBC

in the equation GFR= Kf (PGC-PBC-OncoticGC)

so decrease GFR
if you have an increase in systemic-plasma oncotic pressure what will this do to GFR?
this increases OncoticGC

in the equation GFR= Kf (PGC-PBC-OncoticGC)

so decrease GFR
decrease in renal plasma flow will do what to GFR?
this causes an increase rise of oncotic GC

so in the equation GFR= Kf (PGC-PBC-OncoticGC)

so decrease GFR