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Physiology- Renal
Structure and Function of Kidney (T Pierce)
39
Medical
Post-Graduate
03/30/2009

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Cards

Term
Define specific gravity
Definition
  • weight of a volume of a solution divided by the weight of an equal volume of water
Term

Equation for van Hoff's law

Definition

Π = nCσRT

Term

define oncotic pressure

Definition
pressure generated by large molecules such as protein in solution (Plasma = 28 mmHg, 1.4 mOsm/kg)
Term
% of body weight that is H2O
Definition
  • 60% (40% is intracellular and 20% is extracellular)
    • of 20%, 1/4 is plasma and 3/4 is intersitial fluid

 

Term
Major ions, organic molecules in ECF
Definition
  • sodium
  • chloride
  • bicarbonate
Term
Describe the Gibbs-Donnan effect
Definition
phenomenon of the plamsa having a slightly higher sodium concentration and slightly lower chloride concentration than the blood or intersitial fluid due to the negative charge on proteins in plasma
Term
Major ions, organic molecules of ICF
Definition
  • potassium
  • magnesium
  • proteins
  • organic phosphates (ATP, ADP, AMP)
Term
Normal osmolarity of body fluids
Definition
290 mOsm/L
Term
Equation for plasma osmolarity
Definition

Plasma Osm = 2 x Na in plasma + glucose conc./18 + BUN/2.8

 

*Na in meq/L

*glucose, BUN in mg/dL

Term
Effect of iso-osmotic volume contraction (ex: diarrhea, vomitting, burn) on ECF, ICF, EC Osm., hematocrit, plasma protein conc.
Definition
  • ECF volume ↓
  • ICF volume ↔
  • EC Osmolarity ↔
  • hematocrit ↑
  • plamsa protein conc. ↑
Term
Effect of hyperosmotic volume contraction (ex: sweat, fever, diabetes insipidus)
Definition
  • ECF volume ↓
  • ICF volume ↓
  • EC Osmolarity ↑
  • hematocrit ↔
  • plamsa protein conc. ↑
Term
Effect of hypo-osmotic volume contraction (ex: adrenal insufficiency)
Definition
  • ECF volume ↓
  • ICF volume ↑
  • EC Osmolarity ↓
  • hematocrit ↑
  • plasma protein conc. ↑
Term

Efect of isosmotic volume expansion (ex: infusion of isotonic NaCl)

Definition
  • ECF volume ↑
  • ICF volume ↔
  • EC Osmolarity ↔
  • hematocrit ↓
  • plasma protein conc. ↓
Term
Effect of hyperosmotic volume expansion (ex: high NaCl intake)
Definition
  • ECF volume ↑
  • ICF volume ↓
  • EC Osmolarity ↑
  • hematocrit ↓
  • plasma protein conc. ↓
Term
Effect of hyposmotic volume expansion (ex: SIADH)
Definition
  • ECF volume ↑
  • ICF volume ↑
  • EC Osmolarity ↓
  • hematocrit ↔
  • plasma protein conc. ↓
Term

Path of urine in the nephron

Definition
  1. glomerular capillaries
  2. Bowman's space
  3. PCT
  4. thin decending limb
  5. thin ascending loop or Henle
  6. thick ascending loop of Henle
  7. macula densa
  8. DCT
  9. cortical collecting duct
  10. outer medullary collecting duct
  11. inner medulary collecting duct
Term
Parts of nephron found in cortex
Definition

PCT

DCT

cortical collecting duct

Term
Parts of nephron found in the medulla
Definition

loop of Henle

outer medullary CD

inner medullary CD

Term
two types of nephrons
Definition

juxtamedullary (25%)

cortical (75%)

Term
Order of branching of renal artery
Definition
  1. interlobar A's
  2. arcuate A's
  3. interlobular A's
  4. afferent arterioles
  5. glomerular capillaries (high hydrostatic P)
  6. efferent arterioles
    1. peritubular arteries (main reabsorption site- low hydrostatic P)
    2. vasa recta
Term
Effect of increased sympathetic activity on renal blood flow
Definition
  1. leads to increase of Angiotensin II
  2. constricts afferent arteriole (can constrict both, but mainly afferent)
    1. decrease P at glomerular capillaries
    2. decrease renal blood flow
    3. decrease GFR
Term
Effect of decrease Ang II on renal blood flow
Definition
  1. constrict efferent arteriole
    1. increase P at glomerular capillaries
    2. decrease RBF
    3. increase GFR (make more filtrate)
Term
Effect of clamping Afferent and efferent arterioles on each other
Definition
  • if clamp afferent, decrease bp at efferent
  • if clamp efferent, increase bp at afferent
Term
Substances that mainly cause vasodilation of afferent arteriole
Definition
  • PGE2 (increase renin)
  • PGI (increase renin)
  • dopamine
  • nitric oxide
Term
Composition of JG apparatus
Definition

macula densa

mesangial cells

granular cells

Term
Function of mesangial cells
Definition
  • secrete mesangial matrix
  • phagocytic
  • secrete cytokines, PG's
Term
Function of macula densa
Definition
sense chloride content in filtrate
Term
Function of graular cells in JG apparatus
Definition
secrete renin
Term

Describe innervation of JG apparatus

Definition
  • beta 1 receptors stimulate release of renin from granular cells
  • no parasympathetic innervation
Term
Sympathetic receptors in afferent arteriole
Definition
alpha 1 adrenergic receptors
Term
Layers of filtration barrier within glomerular capillary wall
Definition
  • endothelium (permeable to water, dissolved solutes)
  • basement membrane (collagen, glycoproteins)
    • lamina rara interna
    • lamina densa
    • lamina rara externa
  • epithelium
Term
Explain how proteins are preventing from entering Bowman's space
Definition
  • the epithelium consists of podocytes, which are negatively charged (repels proteins negative charge, but not the small ions like chloride and bicarbonate)
    • allows more positive charged solutes
  • lamina rara interna and externa have negative charged glycoproteins as well
  • also, btw each podocyte is a filtration slit
  • slight bridged by filtration slit diaphragm made up of proteins
Term
Role of epithelial cells in the function of different parts of the nephron
Definition
  • those that are permeable to water contain aquaporins
  • contain nonmotile cilium which protrude into tubule fluid and functions as mechanosensor and chemosensor
  • linked to calcium signaling in cells
Term

Places in nephorn where water permeable

Definition
  • PCT
  • thin descending loop
  • collecting duct when ADH present
Term
Parts of nephron that are water impermeable
Definition
  • thin ascending loop
  • thick ascending loop
  • DCT
  • collecting duct w/ ADH
Term
Parts of kidney that receive sympathetic innervation
Definition
  • smooth muscle of major branches of:
    • renal artery
    • afferent and efferent arterioles
  • granular cells of JG apparatus

These nerve fibers release both Norepi, dopamine.

Term
Explain the pheonomenon of autoregulation of RBF
Definition
  • btw pressures of 80-200 mmHg, renal blood flow will not change
  • this is indep. of ANS
  • two hypothesis
    • myogenic hypotheis- smooth musc. in afferent A. constrict when stretched due to activation of calcium channels
    • tubuloglomerular feedback
Term
Describe mechanism of action of TG feedback
Definition
  1. increase GFR, RBF
  2. increase delivery of solute to JG apparatus sensed by macula densa (via Na/2Cl/K co-transport)
  3. increase release of adenosine
  4. increase resistance in afferent arteriole (vasoconstriction)
  5. decrease GFR, RBF
Term

Describe where most of the blood in the RBF tends to go in the kidney

Definition
kidney's cortex has the greatest volume of blood, and it will progressively decrase as we go into the kidney's center
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