Kidney (Urinary) System I
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Questions and Answers

What primarily drives the filtration process in the kidneys?

  • Osmotic pressure of the blood
  • Concentration gradients in the nephron
  • Electrochemical gradients of ions
  • Hydrostatic pressure of the blood (correct)

What is the normal Glomerular Filtration Rate (GFR) in adults?

  • 125 ml/min (correct)
  • 180 ml/min
  • 100 ml/min
  • 150 ml/min

Which of the following substances is not typically filtered through the glomerulus?

  • Blood cells (correct)
  • Ions
  • Glucose
  • Urea

Which process is primarily responsible for increasing the concentration of urea in the urine?

<p>Secretion from the blood (A)</p> Signup and view all the answers

What percentage of water is typically reabsorbed in the nephron?

<p>99% (A)</p> Signup and view all the answers

Why is the kidney considered one of the most metabolically active organs in the body?

<p>Reabsorption and secretion processes consume energy. (D)</p> Signup and view all the answers

What can be inferred about renal failure based on the content provided?

<p>Urea and creatinine levels increase in the blood. (B)</p> Signup and view all the answers

What is the main function of tubular secretion?

<p>To excrete waste and regulate blood composition. (B)</p> Signup and view all the answers

What is the filtration fraction in a healthy individual?

<p>0.20 or 20% (A)</p> Signup and view all the answers

Which structure contributes to the high permeability of the glomerular capillary membrane?

<p>Fenestrae in the endothelium (D)</p> Signup and view all the answers

Which of the following is NOT a contributing factor to the net filtration pressure?

<p>Arterial blood pressure (A)</p> Signup and view all the answers

What happens to glomerular filtration rate (GFR) with an increase in renal plasma flow?

<p>GFR increases due to greater filtration surface area (A)</p> Signup and view all the answers

Which pressure opposes filtration in the glomerulus?

<p>Hydrostatic pressure in Bowman’s capsule (B)</p> Signup and view all the answers

What is the typical effect of urinary tract stones on GFR?

<p>They raise Bowman’s capsule pressure, reducing GFR (D)</p> Signup and view all the answers

What role does the basal lamina play in the glomerular filtration process?

<p>It provides a meshwork of glycoproteins with negative charges (B)</p> Signup and view all the answers

Which cellular component forms filtration slits along the capillary wall?

<p>Podocytes (D)</p> Signup and view all the answers

What action does angiotensin II have on the systemic arterioles?

<p>It causes constriction. (A)</p> Signup and view all the answers

Which substance does renin convert angiotensinogen into?

<p>Angiotensin I (D)</p> Signup and view all the answers

What role does aldosterone play in the body?

<p>It promotes sodium and water absorption. (B)</p> Signup and view all the answers

How does myogenic autoregulation affect renal blood flow?

<p>It prevents excessive increases in RBF and GFR. (A)</p> Signup and view all the answers

Which mechanism is responsible for converting angiotensin I to angiotensin II?

<p>ACE (Angiotensin Converting Enzyme) (C)</p> Signup and view all the answers

What effect does a high protein intake have on renal function?

<p>It increases renal blood flow and GFR. (C)</p> Signup and view all the answers

What is the outcome of the renin-angiotensin-aldosterone mechanism in response to low blood pressure?

<p>Vasoconstriction and increased blood volume. (B)</p> Signup and view all the answers

How can ACE inhibitors affect blood pressure?

<p>By blocking the conversion of angiotensin I to angiotensin II. (C)</p> Signup and view all the answers

What percentage of cardiac output do the kidneys receive?

<p>25% (B)</p> Signup and view all the answers

What is the primary role of the glomerular capillary bed?

<p>Fluid filtration (B)</p> Signup and view all the answers

Which capillary network has a high hydrostatic pressure?

<p>Glomerular capillary bed (C)</p> Signup and view all the answers

What is the pressure in the peritubular capillaries?

<p>13 mmHg (A)</p> Signup and view all the answers

Which arteriole has relatively high resistance compared to the glomerular capillary bed?

<p>Efferent arteriole (A)</p> Signup and view all the answers

What is the primary function of the vasa recta in the kidney?

<p>Filtration and reabsorption (C)</p> Signup and view all the answers

What mechanism allows the kidneys to maintain consistent blood flow despite blood pressure changes?

<p>Autoregulation (C)</p> Signup and view all the answers

What happens to blood pressure in the glomerular capillaries compared to the peritubular capillaries?

<p>It is higher in glomerular capillaries. (C)</p> Signup and view all the answers

What characteristic must a substance have to effectively measure the Glomerular Filtration Rate (GFR)?

<p>It should be freely filtered and neither reabsorbed nor secreted (C)</p> Signup and view all the answers

Why is inulin used for measuring GFR?

<p>It must be given by intravenous infusion to maintain a constant plasma level (C)</p> Signup and view all the answers

What is the formula for calculating GFR using inulin clearance?

<p>C inulin = U inulin × V / P inulin (D)</p> Signup and view all the answers

What value represents the average GFR in a normal-sized adult?

<p>125 mL/min (B)</p> Signup and view all the answers

What is a significant limitation of using creatinine clearance to assess GFR?

<p>A small amount of creatinine is secreted by the renal tubules (B)</p> Signup and view all the answers

How much plasma does the kidneys filter approximately per day?

<p>180 liters (B)</p> Signup and view all the answers

What percentage of the filtrate is normally reabsorbed by the kidneys?

<p>99% or more (C)</p> Signup and view all the answers

How often does the whole plasma volume get filtered by the kidneys each day?

<p>60 times (C)</p> Signup and view all the answers

What is the primary mechanism that maintains relatively constant renal blood flow and glomerular filtration rate despite changes in arterial blood pressure?

<p>Autoregulation (A)</p> Signup and view all the answers

Which of the following best describes the function of macula densa cells?

<p>Sense tubular fluid flow and composition (D)</p> Signup and view all the answers

When do juxtaglomerular cells typically secrete renin?

<p>When blood pressure is decreased (B)</p> Signup and view all the answers

What happens to GFR when arterial pressure changes between 75 mmHg and 160 mmHg?

<p>GFR remains relatively constant (B)</p> Signup and view all the answers

What type of cells are the juxtaglomerular cells classified as?

<p>Modified muscle cells (C)</p> Signup and view all the answers

Which factor does NOT stimulate the secretion of renin from juxtaglomerular cells?

<p>Increased blood pressure (B)</p> Signup and view all the answers

The juxtaglomerular apparatus is primarily associated with which part of the nephron?

<p>Distal convoluted tubule (B)</p> Signup and view all the answers

Which statement about the renal autoregulation mechanisms is accurate?

<p>They can function independently of external hormonal influence. (B)</p> Signup and view all the answers

Flashcards

What drives glomerular filtration?

The hydrostatic pressure of blood in the glomerulus forces fluid and small molecules into Bowman's capsule.

What is filtered in the glomerulus?

Water, small molecules like ions and glucose, are filtered; blood cells and large molecules (like proteins) are not.

What's the normal glomerular filtration rate (GFR)?

The normal GFR is 125 ml/min, which means 125 milliliters of plasma are filtered each minute by both kidneys.

What happens to most of the filtered fluid (filtrate)?

Most of the filtrate is reabsorbed back into the blood as it travels through the nephron.

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Why is it important for glucose and bicarbonate to be reabsorbed?

These substances are essential for the body's function and are almost completely reabsorbed into the blood.

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What happens to waste products like urea and creatinine?

Waste products are excreted in the urine because they aren't reabsorbed.

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What are the functions of tubular secretion?

Tubular secretion moves substances from the blood into the nephron tubule, helping to regulate the blood composition.

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Why are the kidneys metabolically active?

Reabsorption and secretion require energy, making the kidneys one of the most metabolically active organs in the body.

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Renal Blood Flow

The amount of blood that flows through the kidneys per minute. It's surprisingly high considering the kidney's size, around 1200 ml/min.

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Glomerular Capillaries

Tiny blood vessels within the kidney responsible for filtering blood. They are unique because they are fed by an afferent arteriole and drained by an efferent arteriole.

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Afferent Arteriole

The blood vessel that brings blood to the glomerulus.

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Efferent Arteriole

The blood vessel that carries blood away from the glomerulus.

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High Hydrostatic Pressure in Glomerulus

The glomerular capillaries experience a higher pressure than other capillaries due to the narrower diameter of the efferent arteriole compared to the afferent arteriole.

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Peritubular Capillaries

A network of capillaries that surrounds the renal tubules, responsible for reabsorbing water and solutes back into the bloodstream.

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Vasa Recta

Loop-shaped blood vessels found only in juxtamedullary nephrons. They help to create and maintain the concentration gradient in the renal medulla.

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Renal Autoregulation

The ability of the kidneys to maintain a constant blood flow despite changes in blood pressure.

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Autoregulation of GFR & RBF

The ability of the kidneys to maintain a relatively constant GFR and RBF despite changes in arterial blood pressure.

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Tubuloglomerular Feedback Mechanism

A feedback system within the kidney that helps regulate GFR by sensing changes in tubular fluid flow and composition.

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Juxtaglomerular Complex

A specialized structure near the glomerulus of the nephron that plays a role in autoregulation and renin secretion.

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Macula Densa Cells

Specialized epithelial cells located at the beginning of the distal tubule that sense tubular fluid flow and composition.

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Juxtaglomerular Cells

Modified muscle cells in the wall of the afferent arteriole that secrete renin and erythropoietin.

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Renin

An enzyme secreted by juxtaglomerular cells that converts angiotensinogen to angiotensin I, triggering the renin-angiotensin-aldosterone system (RAAS).

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Erythropoietin

A hormone produced by juxtaglomerular cells that stimulates red blood cell production in the bone marrow.

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Conditions that stimulate renin secretion

A decrease in blood pressure, a reduction in extracellular fluid volume, and increased sympathetic activity.

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Filtration Fraction

The ratio of Glomerular Filtration Rate (GFR) to Renal Plasma Flow (RPF), typically around 20%.

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Glomerular Filtration Membrane Permeability

The glomerular membrane's ability to filter substances is high due to its unique structure, including fenestrated endothelium, podocytes, and a negatively charged basal lamina.

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Fenestrated Endothelium

The inner layer of the glomerular membrane has pores called fenestrae, measuring 70-90 nm in diameter, allowing efficient filtration.

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Podocyte Filtration Slits

The outer layer of the glomerular membrane has podocytes, cells with foot-like processes that interdigitate, forming filtration slits.

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Basal Lamina of Glomerular Membrane

A meshwork of glycoproteins between the endothelium and podocytes, with a strong negative charge, making the membrane selective.

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Net Filtration Pressure

The balance of forces that drive or oppose filtration in the glomerulus, including hydrostatic pressure and colloid osmotic pressure.

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Flow-Limited Filtration

An increase in renal plasma flow increases filtration and GFR due to a shift in equilibrium towards the efferent arteriole, expanding the filtration surface area.

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Bowman's Capsule Pressure Impact

Changes in Bowman's capsule pressure don't typically regulate GFR, but blockages can raise pressure and damage the kidney.

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GFR Measurement Criteria

A substance used to measure GFR must be freely filtered by the kidneys, neither reabsorbed nor secreted by the renal tubules, non-toxic, and not metabolized by the body.

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Inulin: GFR Measurement

Inulin, a polymer of fructose, meets all the criteria for measuring GFR. It is freely filtered, not reabsorbed or secreted, non-toxic, and not metabolized by the body.

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GFR Calculation

GFR is calculated using the clearance of inulin, which is the volume of plasma cleared of inulin per unit time.

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GFR Equation

GFR = (U inulin * V) / P inulin where: U inulin = inulin concentration in urine, V = urine flow rate, P inulin = plasma concentration of inulin.

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Creatinine Clearance

Creatinine, a byproduct of muscle metabolism, can also be used to assess GFR, although it's not as accurate as inulin due to a small amount of tubular secretion.

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GFR Normal Value

The average GFR in a healthy adult is approximately 125 mL/minute, translating to 180 L/day.

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Filtrate Reabsorption

Out of the 180 L of filtrate produced daily, only 1-2 L is excreted as urine, indicating that 99% of the filtrate is reabsorbed.

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Kidney Filtration Cycle

The entire blood volume (approximately 3 liters) is filtered by the kidneys about 60 times per day.

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What is renin?

Renin is an enzyme produced by the kidneys that helps regulate blood pressure. It converts angiotensinogen into angiotensin I.

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What is angiotensinogen?

Angiotensinogen is a protein produced by the liver that serves as a precursor to angiotensin I and then angiotensin II.

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What is angiotensin II?

Angiotensin II is a potent vasoconstrictor that causes blood vessels to narrow, leading to an increase in blood pressure. It also stimulates the adrenal cortex to release aldosterone.

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What is the role of aldosterone?

Aldosterone is a hormone produced by the adrenal cortex that increases sodium and water reabsorption in the kidneys, leading to increased blood volume and blood pressure.

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How does renin-angiotensin-aldosterone (RAA) system affect blood pressure?

The RAA system works to increase blood pressure by a series of steps: renin converts angiotensinogen to angiotensin I, which is then converted to angiotensin II. Angiotensin II constricts blood vessels and stimulates aldosterone release, which increases blood volume.

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What is myogenic autoregulation?

Myogenic autoregulation is the intrinsic ability of blood vessels to resist stretching and maintain blood flow. When blood pressure increases, the vessels contract to prevent over-distention.

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How does high protein intake affect RBF and GFR?

High protein intake increases renal blood flow (RBF) and glomerular filtration rate (GFR) because the kidneys need to filter out the extra waste products from protein breakdown.

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How does high blood glucose affect RBF and GFR?

High blood glucose (hyperglycemia) also increases RBF and GFR as the kidneys attempt to filter out excess sugar from the blood.

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Study Notes

Kidney (Urinary) System I

  • Kidneys are paired organs, weighing approximately 150 grams each, comprising 0.2% of body weight.
  • Renal system units include cortex, medulla (renal pyramids), calyces, renal pelvises, ureters, bladder, and urethra.
  • Urine flows from calyces to renal pelvises, then ureters, bladder, and finally exits via the urethra.
  • The urinary bladder is under both voluntary and autonomic control.

Kidney Anatomy

  • Diagram shows kidney anatomy: renal cortex, renal medulla, renal papilla, renal pyramids, renal columns, major calyx, minor calyx, fibrous capsule.
  • The diagram also shows the renal artery, renal vein, and ureter.
  • The kidneys receive a significant blood supply (~25% of cardiac output).

Metabolic Waste Products

  • Urea from protein breakdown
  • Uric acid from nucleic acid breakdown
  • Creatinine from muscle creatine breakdown
  • Bilirubin from hemoglobin breakdown are excreted in urine.

Kidney Function

  • Regulates extracellular fluid (ECF) volume and composition by balancing intake and output of water and electrolytes (Na+, K+, HCO3-).
  • A major role in regulating arterial blood pressure
  • Removes waste products like urea, creatinine, and uric acid.
  • Eliminates toxins such as drugs and food additives.
  • Maintains acid-base balance (pH regulation) with the respiratory system.
  • Produces hormones like erythropoietin, renin, and calcitriol.

Nephron

  • Nephron is the functional unit of the kidney.
  • Two types of nephrons:
    • Cortical nephrons: 86% of total nephrons, primary role in sodium absorption.
    • Juxtamedullary nephrons: 14% of total nephrons, crucial for increasing concentration of medullary interstitial fluid.

Glomerulus

  • Tuft of capillaries connected to afferent and efferent arterioles.
  • Bowman's capsule surrounds the glomerulus.
  • Inner (visceral) layer of Bowman's capsule covers glomerular capillaries, outer (parietal) layer makes up Bowman's capsule.
  • Space between visceral and parietal layer is termed Bowman's space.
  • High filtration takes place due to single endothelial cells attached to a basement membrane and high porous membrane of the capillary bed.

Renal Tubule

  • Three parts:
    • Proximal convoluted tubule
    • Loop of Henle (thin descending, thin ascending, and thick ascending limb).
    • Distal convoluted tubule
  • Open into initial arched cortical collecting ducts and then into the medullary collecting ducts.

Glomerular Filtration Rate (GFR)

  • Volume of plasma filtered by the glomeruli per unit time.
  • High GFR levels:
    • ~ 125 ml/min, 7.5 L/hr, and 180 L/day.
  • Substances such as inulin and creatinine are used for GFR measurement.
  • Normally, nearly 99% of the filtered fluid is reabsorbed.

Factors Affecting GFR

  • Glomerular capillary membrane: Specialized structure: capillary endothelium, Bowman's capsule made of podocytes.
  • Size of the capillary bed: Effective filtration surface area.
  • Net filtration pressure: Sum of hydrostatic and colloid osmotic forces (favoring/opposing filtration).

Physiologic Control of GFR & RBF

  • The sympathetic nervous system directly influences both afferent and efferent arterioles.
  • Hormones and autacoids (e.g., norepinephrine, epinephrine, endothelin, angiotensin II, nitric oxide, prostaglandins) affect GFR and renal circulation.
  • Autoregulation of GFR and RBF:
    • Myogenic autoregulation: Intrinsic feature of vascular smooth muscles.
    • Tubuloglomerular feedback: Feedback mechanisms within the kidneys.

Tubuloglomerular Feedback Mechanism

  • Juxtaglomerular apparatus (specialized structure near the glomerulus):
    • Macula densa cells: Monitor tubular fluid flow and composition.
    • Juxtaglomerular cells: Secrete renin, and erythropoietin.
  • These components in the autoregulatory mechanism modulate GFR.

Secretion and Functions of Renin

  • Secreted by juxtaglomerular cells in response to low blood pressure, reduced extracellular fluid volume or sympathetic activity.
  • Converts angiotensinogen to angiotensin I.
  • Angiotensin I converts to angiotensin II by angiotensin-converting enzyme (ACE).
  • Angiotensin II is a potent vasoconstrictor.
  • Ultimately, renal blood flow (RBF) and glomerular filtration rate (GFR) are regulated by this pathway.

Renin-Angiotensin-Aldosterone Mechanism

  • Low blood pressure triggers the secretion of renin.
  • Renin activates a cascade converting angiotensinogen to angiotensin II and aldosterone.
  • Angiotensin II causes vasoconstriction and stimulates aldosterone release.
  • Aldosterone increases sodium reabsorption, ultimately increasing blood volume and blood pressure.

Myogenic Autoregulation

  • Intrinsic feature of vascular smooth muscles that resist stretching during increased arterial wall tension.
  • The vascular smooth muscles contract to resist stretching, thereby maintaining consistent RBF and GFR.

High Protein Intake and Increased Blood Glucose

  • High protein intake moderately increases RBF and GFR.
  • High blood glucose levels in uncontrolled diabetes also increase RBF and GFR.

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Description

This quiz covers the anatomy and functions of the kidney and urinary system. It includes details about kidney structure, urine flow, and metabolic waste products. Test your understanding of renal physiology and the intricate workings of the urinary system.

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