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56 Cards in this Set
- Front
- Back
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What are 5 functions of the kidney?
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-Regulate pH
-Regulate hematopoesis -Regulate Vit D metabolism -Regulate BP -Filter blood |
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What step of Vit D synthesis occurs in the kidney?
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Converts 25-OH Vit D3 to 1-25 (OH)2 Vit D3
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What comprises the corpuscle of a nephron?
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-Glomerulus
-Bowman's capsule |
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Does the nephron include the glomerulus? The collecting duct?
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Includes the glomerulus NOT the collecting duct
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What germ layer does the nephron come from? The collecting duct?
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Nephron - intermediate mesoderm
Collecting duct - ureteric bud from mesonephric duct (Recall that mesonephric/Wolffian duct persists as the vas deferens but regresses in the female) |
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What type of neurons have long loops of Henle?
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Juxtamedullary nephrons
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What are the 3 functions of the nephron?
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Filter
Reabsorb Actively secrete |
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What 2 hormones are required for K+ uptake into the cells to prevent life threatening hyperkalemia?
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-Insulin
-Aldosterone |
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What is the function of the endocytotic vesicles in the proximal convoluted tubule?
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Recapture whatever proteins are able to escape out into the primary urine.
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Where does most water and sodium reabsorption occur?
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Proximal convoluted tubule
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What part of the tubular system has the greatest control over reabsorption? What kind of control is this?
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-Distal tubule and collecting ducts
-Hormonal control |
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Where does sodium transport occur across the basolateral membrane? What type of transport is this?
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-All segments of tubular system
-Primary active via Na/K pump |
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What is the name of the peritubular capillaries that run along the Loop of Henle?
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Vasa recta
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What feature of juxtamedullary nephrons allow them to concentrate urine more efficiently?
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They transport urea in addition to pumping Na+
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What is the purpose of renal autoregulation:
1- Regulation of renal blood flow 2- Maintainance of adequate GFR |
2- Maintainance of an adequate GFR
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Myogenic or tubulo-glomerular feedback:
"P=QR" |
Myogenic, smooth muscle contracts in response to stretch. Increased pressure in afferent arteriole causes vasoconstriction (increases resistance) so flow stays the same.
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Myogenic or tubuloglomerular feedback:
"Distal tubule makes contact with macula densa. Macula densa senses the concentration of NaCl. Macula densa stimulates juxtaglomerular cells to release renin. Renin converts angiotensin II. This causes constriction of the efferent arterioles and vasoDILATION of afferent arterioles. Too low NaCl means too low GFR. |
Tubulo-glomerular feedback mechanism.
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Is the distal tubule a major player in determining the osmolality of the excreted urine.
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No, 65% of filtrate is reabsorbed in the proximal tubule regardless of whether the excreted urine will be hyper/hypo-osmolar.
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What is the primary player in setting up the outer medullary gradient?
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Sodium, responsible for 600-700 out of the full 1200
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What is the main function of the Loop of Henle?
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Set up the concentration gradient.
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What is described below:
"Sodium is pumped out of the ascending limb (impermeable to water) and water moves from the descending limb to balance the osmolality of the interstitial spaces." |
Countercurrent multiplication
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Sodium and water cannot build up without limit in the institial space from all the sodium pumped out of the thick ascending limb. Therefore the blood leaving that area must be hypertonic. Why must medullary blood flow be relatively slow?
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The medullary blood flow must remove the accumulated sodium and water as fast as it is reabsorbed once the concentration gradient reaches a steady state. The blood flow must be low, however, to prevent the blood flow from washing out all of the sodium and water and ruining the concentration gradient. This is further assisted by the vasa recta behaving as countercurrent exchangers... MTF...
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What is the driving force behind the concentration of urea in the inner medulla of the kidney?
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-The active pumping of NaCl
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Which urea transporter is increased with ADH? Which sodium transport is sensitive to ADH?
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-UT-A1
-AQP2 |
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What is the osmolality of primary urine leaving the proximal convoluted tubule?
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ALWAYS Isotonic, about 300 mOsm
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What is the osmolality of primary urine entering the distal tubule?
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ALWAYS Hypotonic, about 100 mOsm
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Is more volatile or non-volitile acid produced in the body normally?
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More volatile acid. 13,000-20,000mMol/day vs 40-80mMol/day
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What 2 hormones are required for K+ to be taken up into the cell after a meal?
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-Insulin
-Aldosterone |
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What happens to K+ thorughout the renal system?
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-Freely filtered
-Reabsorbed in proximal convoluted tubule and loop of Henle (NKCC in thick ascending limb) -Aldosterone dependent secretion in the cortical collecting duct (major regulatory step) |
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What channel is used to secrete K+ from the collecting duct? How is this controlled?
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-ROMK channels.
-Aldosterone causes the basolateral Na/K pump to work faster, pumping more K into the principal cells of the collecting duct. Then they flow down their concentration gradient through the ROMK channels and into the urine. |
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What two things causes aldosterone to be released?
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-Angiontensin II (triggered by drop in plasma volume)
-High levels of K sensed by the zona glomerulosa |
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What ion is unusual in that it is reabsorbed paracellularly, going through channels in the tight junctions between cells? It also is (unusually) mostly reabsorbed in the thick ascending limb.
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Magnesium
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What is CHiklasdjf
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laskdjfjk
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What muscles are used in normal inspiration? In respiratory distress?
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-Diaphragm and external intercostals
-Scalenes and sternocleidomastoids |
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What muscles are used in normal exhalation? In respiratory distress?
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-Abdominals, internal intercostals
-Pecs minor, rhomboids |
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How do you tell bronchioles from bronchus?
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Bronchioles have no cartilage
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How do you tell bronchus from trachea?
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If you see alveoli, ya got bronchi!
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What does it mean that hemoglobin is fully saturated about 1/3 of the way through the capillary pathway?
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There is lots of reserve capacity for oxygenation to increase during exercise!
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How do the lungs match ventilation and perfusion?
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When PO2 drops in an alveolus, the blood vessels supplying that capillary bed constrict, cutting off blood flow to that area.
-Therefore perfusion is matched with ventilation. |
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Where do you find carbonic anhydrase (CA)?
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In the RBC
-Facilitates the formation of carbonic acid from H2O and CO2 |
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What are the 3 ways that CO2 can be carried through the blood?
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-Dissolved
-As carbamino compounds (Hb) -As bicarb |
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What is the difference between Type I and Type II respiratory failure?
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The level of CO2. Type II has increased CO2 levels.
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What is the main nucleus for inspiratory control? Where is it located?
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The dorsal regulatory group in the medulla.
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What is the main nucleus for expiratory control? Where is it located?
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The ventral regulatory group in the medulla.
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Describe the pontine control mechanism of breathing.
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The pontine apneustic center (lower pons) stimulates inspiration. Its actions are controlled by 1) pulmonary stretch receptors and 2) inhibitory signals from the pontine pneumotaxic center (upper pons).
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What nuclei has the cell bodies for the phrenic nerve and intercostal nerves?
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Dorsal regulatory group and ventral regulatory group
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Where is the central pattern generator for respiration located?
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In the medulla (dorsal and ventral regulatory group)
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What is the difference between hyperventilation and hyperpnea and tachypnea?
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Hyperpnea is the body's normal response to exercise. Hyperventilation is increased breathing ABOVE normal with loss of CO2. Tachypnea is ust an increase in breathing rate.
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For central chemoreceptors, what do they respond to MOST strongly?
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-Change in [H+] in the CSF (H+ can't cross BBB!)
-Changes in CO2 in the blood affects both central chemoreceptors and the [H+] of the CSF. |
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Where are the peripheral receptors for breathing?
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-Airway receptors (monitor airway temperature
-Pumonary receptors (slow receptors in smooth muscle, rapidly adapting receptors in epithelium, J cells near pulmonary capillaries -Chest wall receptors in intercostals and (limited) diaphragm. |
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Where are the peripheral receptors for breathing?
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-Airway receptors (monitor airway temperature
-Pumonary receptors (slow receptors in smooth muscle, rapidly adapting receptors in epithelium, J cells near pulmonary capillaries -Chest wall receptors in intercostals and (limited) diaphragm. |
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What are the peripheral chemoreceptors MOST sensitive to?
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Fall in O2
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Where are the peripheral chemoreceptors located?
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Aortic arch and carotid bodies
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What condition might you expect in a high anion gap acidosis?
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Metabolic acidosis
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Is most oxygen carried dissolved in plasma or attached to hemoglobin?
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Hemoglobin! 97% (Plasms 3%)
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What is the difference between a pulse ox and a co-oximeter?
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-Pulse ox has 2 freq
-Co-oximeter has 4 and can see carbon monoxide and met-hemoglobin |
