Physiology Unit 4 - Renal - Fofi
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| show | regulation of body fluid osmolality, volume; excretion of H20 & NaCl regulated w/ cardiovascular, endocrine, & CNS
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| Regulation of electrolyte balance | show 🗑
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| show | kidneys work in concert with lungs to regulate the pH in narrow limits of buffers within body fluids
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| Excretion of metabolic products and foreign substances | show 🗑
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| Renin | show 🗑
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| Prostaglandins/kinins-braykinin | show 🗑
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| show | stimulates RBC formation by bone marrow
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| show | nephron
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| show | production of filtrate, reabsorption of organic nutrients, reabsorption of water and ions, secretion of waste products into tubular fluid
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| Types of nephrons | show 🗑
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| show | 85% of all nephrons; located in cortex
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| Juxtamedullary nephrons | show 🗑
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| Blood supply to kidnesy | show 🗑
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| Glomerular filtration | show 🗑
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| Filtrate | show 🗑
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| Glomerular filtration barrier | show 🗑
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| What drives filtration? | show 🗑
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| Glomerulus is more efficient than other capillary beds…why? | show 🗑
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| show | not filtered and are used to maintain oncotic (colloid osmotic) pressure of the blood
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| Net filtration pressure (NFP) | show 🗑
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| Glomerular filtration rate (GFR) | show 🗑
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| GFR too high | show 🗑
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| GFR too low | show 🗑
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| Control of GFR | show 🗑
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| Autoregulation of GFR | show 🗑
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| show | autoregulation of GFR; arterial pressure rises, afferent arteriole stretches, vascular smooth muscles contract, arteriole resistance offsets pressure increase; RBF & hence GFR remain constant
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| show | autoregulation of GFR; feedback loop of flow rate (increased NaCL) sensing mechanism in macula dena of juxtaglomerular apparatus; increased GFR & RBF triggers release of vasoactive signals; constricts afferent arteriole leading to decreased GFR & RBF
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| Juxtaglomerular apparatus | show 🗑
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| show | tall, closely packed distal tubule cells; lie adjacent to JG cells; function as chemoreceptors or osmoreceptors
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| show | renal blood vessels are maximally dilated, autoregulation systems prevail
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| show | Norepi released by sympathetic NS; Epi released by adrenal medulla; afferent arterioles constrict, filtration inhibited; drop in filtration pressure stimulates JGA to release renin and erythropoietin
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| Renin-angiontensin mechanism | show 🗑
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| Angiotensin II | show 🗑
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| Prostaglandins | show 🗑
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| show | vasodilator produced by vascular endothelium
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| Adenosine | show 🗑
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| show | mesangial cells have contractile properties, influence capillary filtration by closing some of the capillaries; effects surface area; podocytes change size of filtration slits
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| Process of urine formation | show 🗑
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| show | amount excreted in urine = amount filtered through glomeruli into renal proximal tubule minus amount reabsorbed into capillaries plus amount secreted into tubules
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| Reabsorption and secretion | show 🗑
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| Transport maximum (Tm) | show 🗑
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| Sodium reabsorption | show 🗑
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| show | Na linked secondary active transport; key site is proximal convoluted tubule (PCT); reabsorption of glucose, ions, amino acids
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| show | substances that lack carriers, are not lipid soluble, too large to pass through membrane pores; urea, creatinine, uric acid most important
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| Tubular secretion | show 🗑
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| PCT reabsorption & secretion | show 🗑
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| show | performs final adjustment of urine; active absorption of Na and Cl; secretion of K and H based on blood pH; water regulated by ADH/vasopressin; Na and K regulated by aldosterone
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| Atrial natriuretic peptide activity (ANP)—reduces Na | show 🗑
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| show | acting on medullary ducts to inhibit Na reabsorption; antagonistic to aldosterone & angiotensin II; promotes Na and H20 excretion in urine by kidney; indirectly stimulates increase in GFR reducing H20 reabsorption
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| show | released by posterior pituitary when osmoreceptors detect increase in plasma osmolality; dehydration or excess salt intake produces thirst sensation; stimulates H20 reabsorption from urine
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| show | regulated by controlling water and sodium reabsorption; precise control allowed via facultative water reabsorption
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| Osmolality | show 🗑
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| Countercurrent mechanism | show 🗑
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| show | vasa recta prevents loss of medullary osmotic gradient—equilibrates w/ interstitial fluid; maintains osmotic gradient, delivers blood
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| show | relatively impermeable to solutes; highly permeable to water
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| Ascending loop of Henle | show 🗑
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| show | permeable to urea
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| Countercurrent multiplier and exchange | show 🗑
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| show | ADH inhibits diuresis; equalizes osmolarity of filtrate, interstitial fluid; presence of ADH99% filtrate water reabsorbed; ADH is signal to produce concentrated urine; kidney ability to respond depends on high medullary osmotic gradient
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| show | ADH dependent water reabsorption
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| show | diluted in ascending loop if ADH not secreted; created by allowing filtrate to continue into renal pelvis; collecting ducts remain impermeable to water—no further water reabsorption occurs; Na and selected ions removed via active/passive mechanisms
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| ADH mechanism action | show 🗑
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| show | volume of plasma that is cleared of a particular substance in a given time; =UV/P; U = conc mg/ml of certain substance in urine; v = flow rate of urine (ml/min); P = conc of same substance in plasma
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| Renal clearance tests | show 🗑
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| Creatinine clearance | show 🗑
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| Glomerular filtration | show 🗑
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| Inulin | show 🗑
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| PAH | show 🗑
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| Excretion | show 🗑
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| show | color and transparency; yellow due to urocrhome; concentrated = deep yellow; drugs, vitamin supplements, diet, can change color of urine; cloudy urine may indicate UTI
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| show | slightly acidic (pH 6); diet can alter pH
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| show | ranges from 1.001 to 1.035; dependent on solute concentration
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| show | 95% water, 5% solutes; Nitrogenous wastes include urea, uric acid, & creatinine; Other normal solutes--Na, K, phosphate, and sulfate ions, Ca, Mg, and HCO3 ions; Abnormally high concentrations of urinary constituents may indicate pathology
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| show | from kidneys, urine flows down ureters to bladder (peristalsis); fills bladder; contraction of detrusor muscle empties bladder; greater volumes stretch bladder walls—initiate micturition reflex
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| show | spinal reflex; Psymp stimulation causes bladder to contract; internal sphincter opens, external sphincter relaxes due to inhibition
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