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Renal Phys 2 and 3

WVSOM -- Renal Physiology -- Lectures 2 and 3

How do you calculate the amount of a substance secreted in urine? amount filtered – amount reabsorbed + amount secreted
What are the 3 layers of the filtration membrane? capillary endothelium of glemerular capillaries, glomerular basement membrane and layer of epithelial podocytes
What factors effect the physical solute characteristics on filtration? Molecular size, electrical charge and shape
What if a solute is protein bound? it can’t get thru
How does molecular size affect filtration? low molecular weight and small effective radius make it easier for it to get thru
How does electrical charge affect filtration? Postive charge are filtered to a great extent (a positive attitude is a good thing to havce…!!!! )
What negative charge molecules go thru despite the negative charge? chloride and bicarb
How does shape affect filtration? rigid and globular solutes have low filterability, deformable molecules of the same size will go thru much easier!
What determines GFR? rate and net filtration pressure (NFP)
What is the equation for net filtration pressure? Pgc + ∏bc - Pbc - ∏gc
What is the equation for Rate of filtration? Kf X NFP
Calculate NFP when Pgc = 50, ∏gc=25, Pbc=10? 15 L/min
How does hydraulic pressure in the capillary change along the length and why? very little because there is lots of cross-sectinal ara and small resistance to flow
How does osmotic pressure change along the capillary? increases because as more fluid is filtered out of the capillary it leaves proteins behind.
What causes an increase in Kf? glomular surface area
What happens to GFR with an increase in Kf? increased GFR
What happens to GFR with increased Pgc? increase in GFR
What causes an increase in Pgc? renal arterial pressure, afferent arteriolar dilation and efferent constriction.
What does an increase in the osmotic pressure of the glomular capillaries result in? decreased GFR
What happens to RBF if afferent arteriolar resistance is increased? decrease in RBF and decrease in Pgc
What happens when there is in increase in efferent arteriolar resistance? increase in Pgc and decrease in RBF
What happens if there is an increase in afferent resistance and an increase in efferent resistance? Pgc stays the same but there is a decrease in RBF
What is RBF? renal blood flow
What is the equation for flow? change in pressure divided by resistance
If RBF goes up what happens to GFR? GFR increases
If RBF goes down what happens to GFR? GFR decreases
What is the equation for filtration fraction? GFR/RPF
Why is Filtration fraction greater at low flows than at higher flows? because GFR saturates at high plasma flows.
What will cause changes in GFR independent of effects on Pgc? arteriolar resistance
What will constriction of only the afferent arteriole do to GFR? decrease
What happens to GFR with only constriction of the efferent arteriole? GFR increases because rising capillary pressure dominates
What does SNS and angiotensin II stimulation do to afferent and efferent resistances? resistances increase and RBF decreases
What does Ang II have more effect on… efferent or afferent? efferent
Where do peritublar capillaries come emerge from? efferent arteriole
What surrounds tubules? peritubular capillaries
How do starling forces affect peritubluar capillaries? blood in the PCs have a high oncotic pressure due to proteins not being filtered yet has a low hydrostatic pressure do to the resistance of the efferent arteriole. This will FAVOR reabsorption
What happens with volume expansion? afferents and efferents vasodilate, there is a decrease in SNS and RAAS and the FF goes down because RBF is up drastically and more blood enters the peritubular capillaries.
What are the two process of autoregulation? mygenic response and tubuloglomerular feedback
What does autoregulation do? keeps RBF and GFR from varying too widely. The macula densa will release paracrines which will bring things back into equilibrium.
What is the RAAS system? Ang II constricts afferent and efferent artioles (mostly efferent)
What does SNS stimulation do? constricts both afferent and efferent arterioles
How does ADH affect the peritubular capillaries? vasoconstricts but normally total RBF and GFR remain constant
What does ANP do to arteriols? vasodilates the afferent and efferent arterioles causing an increase in RBF and GRF. Will also inhibit secretion of rennin
What does Dopamine do to arterioles? cause vasodilation
What do prostaglandinds do to the kidneys? protects agains excessive vasoconstriction. Help maintain RBF and GFR whenthere is high sympathetic outflow and lots of RAAS
Your patient has a primary glerular disease that decreases the surface area available for filtration. What effect will this have on GFR and what will be the autoregularotyr response to it? GFR will decrease. Paracrines will then be released from the macula densa due to a decreased NaCl that will vasodilate the arterioles causes in an increased GFR, Pgc and RBF
You give a person a drug that constricts the afferent arteriole and dilates the efferent arteriole by the same amounts. What effect will this have on GFR, RBF and FF? Decrease in GF, Increase in RBF and then that will result in a decrease in FF
Your patient has entered the ER after a motorcycle accident. His BP is very low and he is tachycardic. You believe he has lost a great deal of blood volume. What is the reflex response to hypotension in respect to RAAS and what will happen to FF? RAAS will increase because ang II is a vasoconstrictor to compenstate for the hypovolemia. FF will go up because AngII works better on efferent than afferent so thre will be a large decrease in RBF but an increase in GFR
Created by: tjamrose



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