Podcast
Questions and Answers
A patient is experiencing diuresis. An increase in which of the following substances is the MOST likely explanation?
A patient is experiencing diuresis. An increase in which of the following substances is the MOST likely explanation?
- Atrial natriuretic peptide (correct)
- Renin
- Antidiuretic hormone
- Aldosterone
A nurse suspects that a patient with female genitalia who suffered a CVA is not able to empty the bladder completely when urinating. Which test does the nurse anticipate will be ordered to assess this?
A nurse suspects that a patient with female genitalia who suffered a CVA is not able to empty the bladder completely when urinating. Which test does the nurse anticipate will be ordered to assess this?
- Cystometry
- Postvoid residual urine (correct)
- Uroflowmetry
- Video urodynamics
Which of the following is the MOST significant reason why children have a narrow margin for fluid and electrolyte balance compared to adults?
Which of the following is the MOST significant reason why children have a narrow margin for fluid and electrolyte balance compared to adults?
- Increased number of nephrons
- Increased thirst response
- Higher GFR relative to body size
- Decreased concentrating ability (correct)
An elderly patient is prescribed a medication primarily cleared by the kidneys. What age-related renal change presents the GREATEST risk for medication toxicity in this patient?
An elderly patient is prescribed a medication primarily cleared by the kidneys. What age-related renal change presents the GREATEST risk for medication toxicity in this patient?
Which sequence accurately describes the flow of filtrate through the nephron?
Which sequence accurately describes the flow of filtrate through the nephron?
What is the primary function of the glomerulus?
What is the primary function of the glomerulus?
A physician is evaluating a patient with possible kidney dysfunction. They want a measurement that provides the BEST estimate of the glomerular filtration rate. Which substance would be MOST appropriate to measure for clearance?
A physician is evaluating a patient with possible kidney dysfunction. They want a measurement that provides the BEST estimate of the glomerular filtration rate. Which substance would be MOST appropriate to measure for clearance?
Which component of the glomerular filtration membrane contains podocytes?
Which component of the glomerular filtration membrane contains podocytes?
What is the role of mesangial cells within the renal corpuscle?
What is the role of mesangial cells within the renal corpuscle?
Which cells within the juxtaglomerular apparatus are responsible for sensing sodium levels in the distal tubule?
Which cells within the juxtaglomerular apparatus are responsible for sensing sodium levels in the distal tubule?
The efferent arteriole carries blood:
The efferent arteriole carries blood:
Which of the following structures is not located within the renal cortex?
Which of the following structures is not located within the renal cortex?
If the afferent arteriole constricts, what direct effect does this have on glomerular filtration rate (GFR)?
If the afferent arteriole constricts, what direct effect does this have on glomerular filtration rate (GFR)?
The peristaltic activity of the ureters, combined with their oblique passage through the bladder wall, primarily serves to:
The peristaltic activity of the ureters, combined with their oblique passage through the bladder wall, primarily serves to:
Which structure is characterized by intertwining smooth muscle bundles and is responsible for transporting urine from the kidneys to the bladder?
Which structure is characterized by intertwining smooth muscle bundles and is responsible for transporting urine from the kidneys to the bladder?
How does sympathetic nervous system activity primarily influence renal blood flow?
How does sympathetic nervous system activity primarily influence renal blood flow?
The kidney's ability to maintain a relatively constant glomerular filtration rate (GFR) despite fluctuations in blood pressure is primarily due to:
The kidney's ability to maintain a relatively constant glomerular filtration rate (GFR) despite fluctuations in blood pressure is primarily due to:
What is the primary mechanism by which the proximal convoluted tubule (PCT) contributes to overall nephron function?
What is the primary mechanism by which the proximal convoluted tubule (PCT) contributes to overall nephron function?
Which of the following correctly describes the relationship between the length of the loop of Henle and the concentration gradient in the kidney?
Which of the following correctly describes the relationship between the length of the loop of Henle and the concentration gradient in the kidney?
How does antidiuretic hormone (ADH) contribute to the regulation of fluid balance in the body?
How does antidiuretic hormone (ADH) contribute to the regulation of fluid balance in the body?
Which of the following hormones directly stimulates red blood cell production in response to decreased oxygen levels in the kidney?
Which of the following hormones directly stimulates red blood cell production in response to decreased oxygen levels in the kidney?
What is the primary function of natriuretic peptides, such as atrial natriuretic peptide (ANP), in the kidneys?
What is the primary function of natriuretic peptides, such as atrial natriuretic peptide (ANP), in the kidneys?
A patient's lab results show a significantly decreased glomerular filtration rate (GFR). Which of the following factors would directly contribute to this finding?
A patient's lab results show a significantly decreased glomerular filtration rate (GFR). Which of the following factors would directly contribute to this finding?
A patient with a history of heart failure is prescribed a medication that inhibits the action of aldosterone. What direct effect would the nurse anticipate observing, based on an understanding of aldosterone's function in the kidneys?
A patient with a history of heart failure is prescribed a medication that inhibits the action of aldosterone. What direct effect would the nurse anticipate observing, based on an understanding of aldosterone's function in the kidneys?
A researcher is evaluating the effectiveness of a new drug designed to increase glomerular filtration rate (GFR). Which of the following methods would provide the MOST accurate and direct measure of the drug's impact on GFR?
A researcher is evaluating the effectiveness of a new drug designed to increase glomerular filtration rate (GFR). Which of the following methods would provide the MOST accurate and direct measure of the drug's impact on GFR?
An elderly patient is admitted with dehydration and a urinary tract infection. Given the understanding of age-related changes in renal function, which intervention is MOST important for the nurse to implement?
An elderly patient is admitted with dehydration and a urinary tract infection. Given the understanding of age-related changes in renal function, which intervention is MOST important for the nurse to implement?
A child is diagnosed with a condition affecting their ability to concentrate urine effectively. Which physiological consequence is the MOST likely to develop as a result of this condition?
A child is diagnosed with a condition affecting their ability to concentrate urine effectively. Which physiological consequence is the MOST likely to develop as a result of this condition?
A patient with suspected urinary retention following a surgical procedure is ordered to have a postvoid residual (PVR) measurement. Which action by the nurse is MOST appropriate when performing this assessment?
A patient with suspected urinary retention following a surgical procedure is ordered to have a postvoid residual (PVR) measurement. Which action by the nurse is MOST appropriate when performing this assessment?
Which of the following structures is located between the inner capillary endothelium and the outer capillary epithelium of the glomerular filtration membrane?
Which of the following structures is located between the inner capillary endothelium and the outer capillary epithelium of the glomerular filtration membrane?
What is the correct order of blood flow through the following vessels in the kidney?
What is the correct order of blood flow through the following vessels in the kidney?
If a patient has damage to their macula densa cells, what specific function of the nephron would be most directly impaired?
If a patient has damage to their macula densa cells, what specific function of the nephron would be most directly impaired?
Considering their location and function, damage to the principal cells of the collecting duct would most directly impair:
Considering their location and function, damage to the principal cells of the collecting duct would most directly impair:
A drug that selectively constricts the efferent arteriole would be expected to directly cause which of the following?
A drug that selectively constricts the efferent arteriole would be expected to directly cause which of the following?
Which of the following best describes the relative locations of cortical and juxtamedullary nephrons within the kidney?
Which of the following best describes the relative locations of cortical and juxtamedullary nephrons within the kidney?
How does the unique arrangement of the vasa recta in the medulla contribute to the kidney's function?
How does the unique arrangement of the vasa recta in the medulla contribute to the kidney's function?
A researcher is studying the composition of filtrate as it moves through the nephron. Where would they expect to find filtrate with the highest concentration of glucose under normal physiological conditions?
A researcher is studying the composition of filtrate as it moves through the nephron. Where would they expect to find filtrate with the highest concentration of glucose under normal physiological conditions?
What is the functional significance of the ureters passing obliquely through the posterior aspect of the bladder?
What is the functional significance of the ureters passing obliquely through the posterior aspect of the bladder?
How does the sympathetic nervous system primarily influence renal blood flow?
How does the sympathetic nervous system primarily influence renal blood flow?
What is the INITIAL effect of afferent arteriole constriction on glomerular filtration rate (GFR)?
What is the INITIAL effect of afferent arteriole constriction on glomerular filtration rate (GFR)?
Which of the following BEST describes the role of the countercurrent exchange system in the nephron?
Which of the following BEST describes the role of the countercurrent exchange system in the nephron?
What is the primary mechanism by which the proximal convoluted tubule (PCT) contributes to nephron function?
What is the primary mechanism by which the proximal convoluted tubule (PCT) contributes to nephron function?
A patient's kidneys are releasing erythropoietin. What is the MOST probable cause?
A patient's kidneys are releasing erythropoietin. What is the MOST probable cause?
What is the primary effect of Atrial Natriuretic Peptide (ANP) on kidney function?
What is the primary effect of Atrial Natriuretic Peptide (ANP) on kidney function?
Which of the following describes the glomerular filtration membrane's permeability characteristics?
Which of the following describes the glomerular filtration membrane's permeability characteristics?
How does antidiuretic hormone (ADH) influence urine production?
How does antidiuretic hormone (ADH) influence urine production?
A drug that inhibits aldosterone MOST likely has which of the following effects on kidney function?
A drug that inhibits aldosterone MOST likely has which of the following effects on kidney function?
Flashcards
Renal Cortex
Renal Cortex
Outer layer of the kidney.
Renal Medulla
Renal Medulla
Inner portion of the kidney, containing renal pyramids.
Renal Pelvis
Renal Pelvis
Collects urine from the nephrons.
Nephron
Nephron
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Glomerulus
Glomerulus
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Bowman Capsule
Bowman Capsule
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Macula Densa
Macula Densa
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Juxtaglomerular Cells
Juxtaglomerular Cells
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Ureters
Ureters
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Detrusor Muscle
Detrusor Muscle
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Trigone
Trigone
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Internal and External Sphincters
Internal and External Sphincters
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Renal Blood Flow
Renal Blood Flow
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Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR)
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Autoregulation (kidneys)
Autoregulation (kidneys)
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Tubular transport
Tubular transport
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Countercurrent Exchange System
Countercurrent Exchange System
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Antidiuretic Hormone (ADH)
Antidiuretic Hormone (ADH)
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Atrial Natriuretic Peptide (ANP)
Atrial Natriuretic Peptide (ANP)
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Renal Clearance
Renal Clearance
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Postvoid Residual (PVR)
Postvoid Residual (PVR)
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Pediatric Renal Function
Pediatric Renal Function
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Retroperitoneal Kidneys
Retroperitoneal Kidneys
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Renal Capsule
Renal Capsule
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Renal Fascia
Renal Fascia
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Kidney Hilum
Kidney Hilum
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Sympathetic Fibers (Kidney)
Sympathetic Fibers (Kidney)
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Renin-Angiotensin-Aldosterone System (RAAS)
Renin-Angiotensin-Aldosterone System (RAAS)
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Natriuretic Peptides
Natriuretic Peptides
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Nephron Function
Nephron Function
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Net Filtration Pressure
Net Filtration Pressure
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Glomerulotubular Balance
Glomerulotubular Balance
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Countercurrent Exchange
Countercurrent Exchange
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Uroflowmetry
Uroflowmetry
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Aging & Renal Function
Aging & Renal Function
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Study Notes
Structures of the Kidney
- The kidneys are retroperitoneal in location.
- The kidney consists of a renal capsule, renal fascia, and hilum.
- The cortex is the outer kidney region.
- The medulla is the inner kidney region.
- Pyramids are located in the medulla.
- Minor and major calyces collect urine.
- The renal pelvis directs urine toward the ureter.
- A lobe is the functional kidney unit with a pyramid and cortex.
Nephron
- Each kidney contains 1.2 million nephrons.
- Nephron types include cortical, midcortical, and juxtamedullary.
- The nephron is the kidney's functional unit.
- The renal corpuscle consists of the glomerulus, Bowman capsule, and mesangial cells.
- Bowman's space (capsule) surrounds the glomerulus.
- The glomerular filtration membrane consists of inner capillary endothelium, a middle basement membrane, and outer capillary epithelium with podocytes and filtration slits.
- Filtrate forms primary urine as it passes through glomerular filtration membrane layers.
- The juxtaglomerular apparatus contains juxtaglomerular cells that release renin.
- The macula densa senses sodium levels.
- Renal tubules are the proximal convoluted tubule, the Loop of Henle, the distal convoluted tubule, and collecting duct.
- Principal and intercalated cells are also part of the renal tubules.
Blood Vessels
- Renal arteries supply the kidneys with blood.
- Interlobar arteries branch into afferent arteries.
- Arcuate arteries branch from interlobar arteries.
- Glomerular capillaries include afferent and efferent arterioles.
- Peritubular and vasa recta capillaries surround the tubules.
- Renal Veins drain the blood flow
Urinary Structures
- Ureters are 30 cm long and contain intertwining smooth muscle.
- Ureters pass obliquely through the posterior bladder aspect.
- Peristaltic activity moves urine.
- Bladder contraction during micturition prevents urine reflux via ureter compression.
- The bladder contains the detrusor muscle and the trigone.
- The urethra features internal and external sphincters.
- Female urethras are 3 to 4 cm long.
- Male urethras are 18 to 20 cm long.
Renal Blood Flow
- The kidneys receive 1000-1200 mL of blood per minute.
- Glomerular filtration rate (GFR) is the plasma filtration rate per time unit.
- Autoregulation involves tubuloglomerular feedback.
- Sympathetic fibers regulate afferent and efferent arteriole size, thus affecting renal blood flow.
- There is no significant parasympathetic regulation of renal blood flow.
- Renalase regulates blood flow.
- Hormonal regulation involves the renin-angiotensin-aldosterone system and natriuretic peptides like urodilantin.
Nephron Function
- Nephrons filter plasma, reabsorb, and secrete.
- Tubular reabsorption and secretion are processes that form protein-free fluid filtrate.
- Fluid volume, electrolytes, and pH are maintained by filtrate regulation.
- Glomerular filtration is permeable to water but not to large molecules.
- Net filtration pressure depends on glomerular capillary oncotic and hydrostatic pressure.
- The filtration rate is 180 L per day.
- Tubular transport:
- Active sodium reabsorption occurs in the proximal convoluted tubule.
- Glomerulotubular balance adjusts sodium and water reabsorption.
- Concentration and dilution of urine by the countercurrent exchange system.
- Uromodulin is produced in the Loop of Henle and distal tubule
Concentration and Dilution of Urine
- Concentrated urine is produced through the countercurrent exchange system.
- Fluid flows in opposite directions through parallel tubes.
- Fluid moves up and down the parallel limbs of the loop of Henle.
- A longer loop yields a greater concentration gradient.
Hormones and Renal Function
- Antidiuretic hormone (ADH) regulates water balance.
- Aldosterone regulates sodium and potassium balance.
- Natriuretic peptides include atrial natriuretic peptide, B-type natriuretic peptide, C-type natriuretic peptide, and urodilantin.
- Diuretics increase urine output
- Vitamin D promotes calcium and phosphate absorption.
- Erythropoietin stimulates RBC production in response to decreased oxygen.
Tests of Renal Function
- Clearance and renal blood flow can be measured.
- Glomerular filtration rate can be tested via inulin, cystatin C, and creatinine.
- Blood tests analyze plasma creatinine concentration and blood urea nitrogen (BUN).
- Urinalysis is used.
- Urodynamic tests include cystometry, uroflowmetry, postvoid residual volume measurement, electromyography, and video urodynamics.
- Direct visualization tests include cystoscopy and ureteroscopy.
Pediatric Renal Function
- Infants have a decreased ability to remove excess water and solutes and concentrate urine.
- Infants have a narrow margin for fluid and electrolyte balance.
- Infants have an increased risk of medication toxicity.
Aging and Renal Function
- There is a decrease in renal blood flow and GFR in older adults.
- Sodium and water balance is altered with age.
- The number of nephrons decreases due to renal vascular and perfusion changes.
- The response to acid-base changes is delayed in older adults.
- They have an increased risk of medication toxicity
- Alterations to thirst and water intake occur in older adults.
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Description
Explore the kidney's anatomy, including the cortex, medulla, and renal pyramids. Understand the nephron's role as the functional unit, its types, and the glomerular filtration membrane. Learn about urine collection and the path it takes through the kidney.
