The Giant Renal Phys Flashcard Game

Front 1

What is located within the Cortex of the kidney?

Back 1

Proximal and Distal convoluted tubules

(Page 2 Lec 1)

Front 2

What is located within he Medulla of the kidney?

Back 2

Renal pyramids, Renal papillae, Minor/Major calyces

(Page 2 Lec 1)

Front 3

Unfiltered blood flows into the kidney via _____, whereas filtered blood flows out of the kidneys via veins and into the _________.

Back 3

Arteries (from Aorta), into the Caudal vena cava

(Page 3 Lec 1)

Front 4

Describe the flow of blood of the kidneys starting from the Renal artery.

Back 4

Renal artery --> Segmental artery --> Interlobar artery --> Arcuate artery --> Interlobular artery --> Afferent arteriole --> Glomerular capillaries --> Efferent arteriole.

(Page 4, Lec 1)

Front 5

Describe the flow of blood out of the kidneys starting at the Efferent arteriole.

Back 5

Efferent arteriole --> Peritubular capillaries --> Vasa recta --> Interlobular vein --> Arcuate vein --> Interlobar vein --> Renal vein

(Page 5 Lec 1)

Front 6

What is the tonicity inside the kidney in the Cortex? In the Medulla?

Back 6

Cortex is Isotonic
Medulla is hypertonic

(Page 7 Lec 1)

Front 7

Which species have a multipyramidal kidney? A unipyramidal?

Back 7

Multipyramidal: Humans, Pigs, Cows

Unipyramidal: Horses, Sheep, Dogs, Cats, Camelids, Rodents

Birds: Have mammalian and reptilian systems

(Page 8 Lec 1)

Front 8

What is the pathway of filtrate through the nephron?

Back 8

Glomerulus/Bowman's Capsule --> Proximal convoluted tubule --> Loop of Henle --> Distal convoluted tubule --> Collecting ducts --> Renal pelvis

(Page 9 Lec 1)

Front 9

What parts of the nephron lie within the cortex? The outer medulla? The inner medulla?

Back 9

Cortex: Glomerulus/Bowman's capsule, JGA, Convoluted tubules

Outer medulla: Thick ascending limb, Outer medullary collecting ducts

Inner medulla: Thin limbs, Henle's loop, Inner medullary collecting ducts

(Page 10 Lec 1)

Front 10

What are the two main classes of nephrons? Which species has each?

Back 10

Long loop (Larger glomeruli and convoluted tubules) and Short loop (smaller glomeruli and convoluted tubules) nephrons.

Short loop: Humans!
Long loop: Cats, Dogs, Rabbits

(Page 12 Lec 1)

Front 11

What percentage of solutes and proteins does the kidney retain?

Back 11

Greater than 99% of all solutes and proteins.

(Page 13 Lec 1)

Front 12

The vascular system is critical for kidney function. What are three things that the set up of the vascular system in the kidney allow the kidney to do?

Back 12

Reabsorb solutes
Reabsorb water
Maintain a tonic gradient

(Page 15 Lec 1)

Front 13

What is filtered in the glomerulus? What is not?

Back 13

Filtered: Fluid, ions, low-molecular weight proteins

Not-filtered: Blood cells, medium-high molecular weight proteins

(Page 19 Lec 1)

Front 14

What are the three layers of the filtration barrier in the glomerulus?

Back 14

Capillary endothelium (Contain fenestrae)

Basement membrane (3 layers)

Visceral epithelium (contain podocytes)

(Page 21 and 22 Lec 1)

Front 15

What are the three layers of the basement membrane of the glomerulus? What materials is it made from?

Back 15

Made from acellular glycoproteins (collagen, laminin, fibronectin, proteoglycans)

Layers: Lamina rara interna, Lamina densa, Lamina rara externa

(Page 23 Lec 1)

Front 16

What are the podocytes made up of that form the filtration barrier of the glomerulus?

Back 16

Primary and secondary foot processes

Epithelial slit diaphragm

(Page 24 Lec 1)

Front 17

What type of cell surrounds the glomerular capillaries?

Back 17

Mesangial cells

(Page 25 Lec 1)

Front 18

When would protenuria occur?

Back 18

When the selectivity of the filtration barrier in the glomerulus is lost and allows larger proteins to be filtered (in various glomerular pathologies).

(Page 26 Lec 1)

Front 19

Of the following, which most easily gets through the basement membrane of the glomerulus? Cations, Neutral ions, or Anions.

Back 19

Cations (Followed by neutral, then anions last)

(Page 27 Lec 1)

Front 20

What is GFR? What pressures is it dependent on?

Back 20

GFR= Glomerular Filtration Rate (mL/min/kg)

Pressures: Glomerular hydrostatic <---> Blood osmotic + Capsular hydrostatic.

(Page 28 Lec 1)

Front 21

What are the four Starling's forces at work in Glomerular filtration?

Back 21

Hydrostatic pressure of plasma
Oncotic pressure of filtrate (negligible)
Hydrostatic pressure of filtrate
Oncotic pressure of plasma

(Page 29 Lec 1)

Front 22

In the equation GFR = Pf x Kf, what is Kf?

Back 22

Kf= the product of the permeability of the glomerular capillary and the surface area available for filtration. (Variable because both of these can be changed)

(Page 31 Lec 1)

Front 23

How do changes in blood flow to the kidney affect GFR?

Back 23

Increased flow: Prevents rise in oncotic pressure and so increases filtration rate.

Decreased flow: Increases oncotic capillary pressure and decreases filtration rate.

(Page 34 Lec 1)

Front 24

How do changes in mesangial cell contractions and relaxation change GFR?

Back 24

They alter the surface area part of Kf in the equation GFR= Pf x Kf

(Page 2 Lec 2)

Front 25

Name some substances that contract Mesangial cells.

Back 25

Endothelins
Angiotensin II
Vasopressin/ADH
Norepinephrine
Platelet-activating factor
Platelet-derived growth factor
Thomboxane A2
PGF2
Leukotrienes C and D
Histamine

(Page 3 Lec 2)

Front 26

Name some substances that relax mesangial cells.

Back 26

ANP (Atrial-naturitic peptide)
Dopamine
PGE2
Cyclic AMP

(Page 3 Lec 2)

Front 27

What is the myogenic reflex?

Back 27

Stretching of the arterioles from increased Renal Blood flow leads to contraction in the vessels. (This limited how much flow gets through)

(Page 6 Lec 2)

Front 28

What is tubuloglomerular feedback?

Back 28

Chemoreceptors in macula densa cells in the JGA sense changes:

Hypernatremia (and so decrease renin secretion)
Contraction of afferent arteriole (and this decrease GFR)
Contraction of mesangial cells (and thus decrease GFR)

(Page 7 Lec 2)

Front 29

What is the major player in the alteration of systemic blood pressure when it comes to filtering blood in the kidneys?

Back 29

The renin-angiotensin-aldosterone system

(Page 8 Lec 2)

Front 30

Uh-oh, the homeostatic loop is back...

What is it?

Back 30

STIMULUS -- input --> SENSORY STRUCTURE ---> COMPARATOR WITH PRESET REFERENCE VALUE --error signal --> EFFECTOR ORGAN -- output (-) --> STIMULUS

(Page 12 Lec 2)

Front 31

What are some quantitative measures used by the nephron to respond to qualitative stimuli?

Back 31

Secretion of vasoconstrictors/vasodilators

Enzymatic regulation

Both rapid and long term effects can occur dependent on the stimulus

(Page 13 Lec 2)

Front 32

What happens when the JGA sense a drop in renal BP?

Back 32

Renin is produced -->
Stimulates transformation of Angiotensin to Angiotensin II -->
AII --> Vasoconstricts, Stimulates aldosterone secretion, increases Na+ reabsorption and K+ excretion.

(Page 14 Lec 2)

Front 33

Describe the substances that are within the renin-angiontensin-aldosterone cascade.

Back 33

Renin --> converts angiotensinogen to Angiotensin

ACE (Angiotensin converting enzyme) --> converts An to AnII

AnII --> acts on glomerulosa cells to secrete aldosterone.

(Page 15 Lec 2)

Front 34

Chapell loves his diagrams..

What are some of the pleiotropic effects of Angiotensin II?

Back 34

Increase sympathetic activity.
Increase tubular NaCl reabsorption and K+ excretion with H2O retention
Increase Aldosterone secretion in the adrenal gland cortex.
Increase Arteriolar vasoconstriction and raise BP.
Increase pituitary gland secretion of ADH to retain water in the collecting ducts.

(Page 17 Lec 2)

Front 35

What do the V1R receptors do when exposed to ADH/Vasopressin?

Back 35

V1a in liver and vascular epithelium: Increase glycogenolysis, increase intracellular Ca2+ concentrations and PG, Increase BP with vasoconstriction, increase blood glucose slightly.

V1b in anterior pituitary: Syngerize with CRH to increase ACTH.

(Both receptors are coupled with G proteins)

(Page 20 Lec 2)

Front 36

What doe V2R receptors do when exposed to ADH/Vasopressin?

Back 36

V2R in renal ducts: Antidiuresis, increase cAMP/PKA, fuse to aquaporin-2 channels in cell membranes to increase water reabsorption.

(Receptor is also coupled with a G protein)

(Page 21 Lec 2)

Front 37

What are the layers of the adrenal cortex? What is made in each? Where specifically is aldosterone made in it?

Back 37

Layers: GFR (NOT glomerular filtartion rate ;) ) -- Zona glomerulosa, fasciculata, reticularis.

Glomerulosa: makes Mineralcorticoids (AND ALDOSTERONE)
Fasciculata: makes Glucocorticoids
Reticularis: makes Androgens

(Slide is wrong in PPT. Page 25 Lec 2)

Front 38

How does aldosterone inhibit natriuersis?

Back 38

Stimulates Na+ reabsorption via increased expression of the Na/K pump.

(Page 27 Lec 2)

Front 39

How is Bradykinin related to renin? What does Bradykinin do?

Back 39

Kallikrein --> kinin --> converts prorenin to renin and creates bradykinin as well.

Bradykinin: smooth muscle relaxation, vasodilation, PG production, prevents hypertension.

(Page 28 Lec 2)

Front 40

What are the three main factors that determine the urine composition?

Back 40

The amount of substance filtered.
The amount of substance reabsorbed.
The amount of substance secreted.

(Page 30 Lec 2)

Front 41

Why is inulin an ideal substance for determining GFR?

Back 41

No endogenous inulin is made--> it must be injected into the body.
It is freely filtered by the glomerulus.
None of it is reabsorbed.
None is secreted by the body.
The rate of removal, therefore, is directly related to the glomerular filtration.

(Page 31 Lec 2)

Front 42

How is the clearance rate of GFR determined?

Back 42

GFR clearance = clearance of substance = (urine concentration of substance times volume of urine) divided by the plasma concentration of the substance.

(Page 32 Lec 2)

Front 43

Instead of inulin, what substance is most often used in clinical assessment of GFR?

Back 43

Creatinine

(Though animals except dogs? do secrete about 10% of the measured amount in GFR)

(Page 33 Lec 2)

Front 44

What is renal azotemia?

Back 44

It is a high amount of protein-like nitrogen containing substances in the blood such as creatinine, urea.

(Looked it up for my own knowledge)

Front 45

What is PAH?

Back 45

PAH= para-aminohuppuric acid.

It is another substance used to measure renal blood flow.

(Page 45 Lec 2)

Front 46

What is the equation for determining RBF?

Back 46

RBF = RPF/1-hematocrit(PCV)

RPF= renal plasma flow.

(Page 46 Lec 2)

Front 47

True or False:

With kidney failure, natriuresis is increased.

Back 47

True!

Fractional excretion increases 10-fold with a large decrease in GFR

(Page 47 Lec 2)

Front 48

What are some things that can lead to problems with filtration in the glomerulus?

Back 48

Diabetes- thickens basement membrane.

Glomerulosclerosis-scarring of glomerulus from diabetes, affects filtration.

(Pages 48-50 Lec 2)