Physio IV Arbeitsdokument PDF

Physio IV Arbeitsdokument Bitte markieren Sie Fragen, bei denen Sie sich nicht zu 100% sicher sind, mit Gelb, und die, bei denen Sie sich sicher sind, ebenfalls mit Gelb. How much blood do kidneys receive per minute? - 10 ml - 50 ml - 100 ml - 500 ml...

Physio IV Arbeitsdokument Bitte markieren Sie Fragen, bei denen Sie sich nicht zu 100% sicher sind, mit Gelb, und die, bei denen Sie sich sicher sind, ebenfalls mit Gelb. How much blood do kidneys receive per minute? - 10 ml - 50 ml - 100 ml - 500 ml i - 1000 ml IV Drag and drop the renal blood vessels in the right order according the blood flow direction Correct order (not all may appear in the question): - Abdominal aorta - Renal artery - Interlobar artery - Arcuate artery - Interlobular artery - Afferent arteriole - Glomerular capillaries / Primary glomerular capillary network - Efferent arteriole - Secondary (peritubular) capillary network / Peritubular capillaries - Interlobular veins - Arcuate vein Not relevant answers: - Afferent venule - Efferent capillaries From which blood vessels does efferent arteriole begin? - Interlobar artery - Afferent arteriole - Efferent venules - Peritubilar capillaries - Interlobular artery - Arcuate artery - Renal artery - Glomerular capillaries Which of these reflex arches shows the most precisely the mechanism of the bladder wall contraction regulation during the micturition reflex?  - A - B - C - D - E Which of these reflex arches show the most precisely the mechanism of external sphincter tonus regulation during the micturation reflex (blue-excitatory), red-inhbitory neurons)? - B - A - C - D What is correct about the renal glucose reabsorption threshold? - It is about 5.55 mmol/l - It is about 3.33 mmol/l - It is about 11 mmol/l - There is no glucose in the secondary urine if its concentration is below the threshold / There is no substance in the secondary urine if its concentration is below the threshold - At it facilitated diffusion of glucose through the basolateral membrane stops (apical surface) - At it facilitated diffusion of glucose stops (No, apical surface is affected not basolateral) - At it apical membrane transporters are saturated - It indicates concentration of glucose in blood at which the reabsorption of it in the renal tubules begins (correct answer would be ends, not begins) - It indicates concentration of glucose in blood at which the secretion of it in renal tubules begin - It is the concentration of substance from which its reabsorption begins - It indicates concentration of substance in blood at which substance cannot be completely reabsorbed What is correct about the renal reabsoprtion threshold? - There is no substance in the secondary urine if its concentration is below the threshold - It is the concentration of substance from which its reabsorption begins (correct answer would be ends, not begins - For sodium ions it is 135 mmol/l (not mentioned in lecture) - It indicates concentration of substance in blood at which substance cannot be completely reabsorbed - For glucose it is about 5.55 mmol/l (Correct answer: 11 mmol/l) What values you have to determine from the person to find out the renal blood flow? / Which of these parameters would be of use for the renal plasma flow - Creatinine concentration in urine - Para aminohippuric acid concentration in blood - Hydrostatic pressure in the glomerular capillaries - Inulin concentration in blood - Minute diuresis - amount of urine excreted per minute - Hematocrit index Also: - Urine flow rate/minute - Renal plasma flow What from these values could be used to determine the renal blood flow? - Creatinine concentration in blood - Colloid-osmotic pressure in blood - Para aminohippuric acid concentration in urine - Minute diuresis - amount of urine excreted per minute - Hematocrit index Which method can we use for the renal blood flow determination? - Inulin clearance - Glucose clearance - Creatinine clearance - Para aminohippuric acid clearance - Calculation from the renal blood flow and hematocrit index Which substances can we use for the renal plasma flow determination? - Inulin - Creatinine - Glucose - Para aminohippuric acid - Should calculate from the renal blood flow and hemtocrit index (a method or a value NOT a substance) What from mentioned substances can be in the primary urine for the healthy adult person? / Which substances can be filtered into the primary urine in the healthy adult person? - Albumins - Water - Potassium ions - Amino acids - Calcium ions - Creatinine - Sodium ions - Glucose - Creatinine - Blood platelets / Platelets - Leukocytes - Proteins with the molecular weight of 85 kDa What can lead to increase of the renal blood flow? // Which of these factors can lead to increased renal blood flow? - Stretch of the muscle cells in the renal artery - Activation of the sympathetic nervous system - Epinephrine acting on alpha 1 receptor - Acetylcholine acting on M2 receptor - B natriuretic peptide - Nitric Oxide - Vasopressin - Low Na+ and Cl- concentration in the distal convoluted tubule /// Decrease of Na and Cl concentration in the distal convoluted tubule What can lead to decrease of the renal blood flow? - High Na+ and Cl- concentration in the distal convoluted tubule - B natriuretic peptide - Epinephrine  - Activation of the parasympathetic nervous system - Vasopressin Match the nephron parts with the respective reabsorption intensity - Proximal convoluted tubule → 65% - Loop of Henle → 25% - Distal convoluted tubule → 5% - Collecting duct → 4% - Bowman’s Capsule / Anything else → 0% If filtration intensity is low: Na concentration in the distal convoluted tubule decreases. Macula densa secretes Prostaglandins E2 / Kinins Juxtaglomerular cells increase secretion of renin Afferent arteriole dilates. Efferent arteriole constricts. If filtration intensity is high: Na concentration in the distal convoluted tubule increases. Macula densa secretes Adensine / ATP. Juxtaglomerular cells decrease secretion of renin Afferent arteriole constricts. Efferent arteriole dilates. What factors can decrease filtration of substances in kidneys? - Greater colloid osmotic pressure in glomerular capillaries - Lower colloid osmotic pressure in glomerular capillaries - Greater hydrostatic pressure in glomerular capillaries - Larger substance molecular weight - Lower filtration pressure - Negative charge of the substances - Lower substance molecular weight - Greater hydrostatic pressure in peritubular capillaries (increases filtration due to greater pressure) - Positive charge of the substances - Lower hydrostatic pressure in peritubular capillaries (only important for reabsoprtion, not filtration) Which of these transporters are located on the apical surface of the tubular epithelial cell? - GLUT (Glucose transport protein for facilitated diffusion) - Na/K pump - H+ pump - Na/glucose symport - K+ channels Also: - Na/H+ antiport  - K+/H+ pump - Na+ channels - H2O aquaporins Which of these transporters are located on the basolateral surface of the tubular epithelial cell? - Na/K pump - Na/amino acid symport - GLUT (Glucose transport protein for facilitated diffusion) - K+ channels - K+/H+ pump Also: - Na+/HCO3 antiport - Cl-/HCO3 antiport - Cl- channels - H2O aquaporins What is the effect of these regulatory mechanisms on the diameter of the afferent arteriole diameter in kidneys? - Nitric oxide → Increases - Vasopressin → Decreases - Atrial natriuretic peptide → Increases - Parasympathetic nervous system → Does not affect - Epinephrine → Decreases Drag and drop properties to the side of capillary network they characterize (soe properties that do not belong to any should be left our) Peritubular capillaries: - There gas exchange takes place - There reabsorption takes place  - Made from efferent arteriole - Fives oxygen to renal cells - From these substances can be secreted into urine - Lower blood pressure Glomerular capillaries: - Made from afferent arteriole - From there primary urine is produced - Enclosed into the Bowman’s capsule Left out: - Receives venous blood What is correct about the renal filtration? - Decreased plasma protein amount stimulates it - Its intensity is about 100 ml/min - It happens from the peritubular capillaries into the Bowman’s capsule - Filtration membrane stimulates negative ion filtration - Higher capsular pressure inhibits it Which of these substances can constrict renal arterioles (afferent or efferent)? - Dopamine - Angiotensin II - Adenosine - Nitric oxide - Eåinephrine through beta 2 receptors How much bood of cardiac output do kidneys receive? - 30% - 15% - 20% - 10% Myogenic regulation of renal blood flow is based on - Stretch of the smooth muscle cells in the blood vessels - Local hormonal regulation - Stretch of the nephron tubules - Neural regulation Which properties are necessary for a substances used for the determination of glomerular filtration rate? (about renal clearance test) - Is not reabsorbed - Is not secreted - Is not toxic - Is not metabolized in organism - Is not filtered Calculate the effective filtration pressure in the nephron according given data - Hydrostatic pressure in glomerular capillaries 58 mmHg - Hydrostatic pressure in peritubular capillaries 28 mmHg - Colloid-osmotic pressure in glomeular capillaries 23 mmHg - Hydrostatic pressure in Bowman’s capsule 19 mmHg Effective filtration pressure: 16 mmHg (58-(23+19)) Calculate the effective filtration pressure in the nephron according given data - Hydrostatic pressure in glomerular capillaries 55 mmHg - Hydrostatic pressure in peritubular capillaries 25 mmHg - Colloid-osmotic pressure in glomeular capillaries 25 mmHg - Hydrostatic pressure in Bownman’s capsule 15 mmHg Effective filtration pressure: 20 mmHg (55-(25+15)) Calculate the effective filtration pressure in the nephron according given data - Hydrostatic pressure in glomerular capillaries 69 mmHg - Hydrostatic pressure in peritubular capillaries 25 mmHg - Colloid-osmotic pressure in glomeular capillaries 30 mmHg - Hydrostatic pressure in Bownman’s capsule 13 mmHg Effective filtration pressure: 26 mmHg (69-(30+13)) What factors can increase filtration of substances in kidneys? - Greater filtration pressure - Negative charge of the substances - Larger surface area of the filtration membrane - Greater substance molecular weight - Greater permeability of the filtration membrane How much of the ultrafiltrate is reabsorbed in nephrons? - 59% - 99% - 79% - 89% What will happen if stretch receptors in the bladder activate? - Sympathetic nervous system stimulates contraction of bladder wall - Parasympathetic nervous system activation leads to relaxation of internal sphincter - Motor neuron in the spinal cord innervating external sphincter will activate - External sphincter of the bladder relaxes (not until a certain point) - Impulses will be sent to the pontine micturation centre Which of these factors can decrease the renal blood flow? - Increase of Na+ concentration in the distal convoluted tubule - Stimulation of the parasympathetic nerve fibers - Epinephrine acting on alpha 1 receptor - Vasopressin release - Dilation of the renal artery What is correct about the glomerular filtration? - Positively charged ions are filtered better than negatively - The filtered fluid contains protein concentration similar to blood plasma - Higher blood pressure in glomerular capillaries stimulates it - Filtration intensity can be determined with the PAH clearance - Normally it is about 1.5 liters in 24 hours (125 ml/min, 180 L/24 hours) Renin secretion is stimulated by: - Decreased calcium levels - Decreased potassium levels in the blood (increased) - Increased blood pressure - Decreased sodium levels in the blood - ANP Drag and drop components of the renin-angiotensin-aldosterone system (some might be left out and some boxes can be left empty)! Primary urine is blood plasma with substances with high molecular weight! - True - False (high molecular weight substances can’t filter through) What is normal glucose level in blood? - 7.8-11.1 mmol/l - 5.55-7.8 mmol/l - 3.33-5.55 mol/l - 3.33-5.55 mmol/l - Above 11 mol/l Match the pressure values to the correct pressure in Glomerular filtration:  - Hydrostatic pressure in glomerular capillaries → 50-70 mmHg - Colloid-osmotic pressure in glomerular capillaries → 20-30 mmHg - Capsular pressure → 10-20 mmHg What does macula densa cells detect? - Changes in Na+, Cl-, K+ concentration - Changes in Na+, Cl- concentrations - Changes in Ca2+ concentration - Changes in renin-angitensin II concentration Place in the correct order: - Macula densa stimulate juxtaglomerular cells → 2 - Renine binds with angiotensinogen → 4 - Low BP → 1 - Angiotensin I is produced → 5 - AG I in lung epithelium gets converted to AG II → 6 - Release of renin → 3 What is renal clearance? - Volume of plasma that is completely cleared of substance by kidneys per unit of time - Volume of plasma that is partially cleared of substance by kidneys per unit of time Which ion changes does macula densa cells detect? - Ca++ - Na+ - Cl- - K+ Where is renin synthesized? - Juxtaglomerular cells - Leidig cells - Macula densa cels - Bowmans capsule What is the reabsoprtion threshold for glucose? - 12 mmol/l - 13 mmol/l - 14 mmol/l - 11 mmol/l Which are the key factors for urine formation in the kidney? - Secretion - Reabsorption - Correct answer not mentioned - Filtration - Absorption How much is filtration intensity in kidneys?  - 180 l/24 h - 120 l/24h - 10 l/24 h - 1 l/24 h - 275 l/24 h In kidneys 85% of filtered glucose is reabsorbed in the proximal convoluted tubule - True - False In glomerular filtration the filtrate pressure is determined by - Hydrostatic pressure in glomerular capillaries - Partial pressure of oxygen in blood - Hydrostatic pressure in peritubular capillaries - Capsular pressure - Osmotic-colloid pressure in glomerular capillaries - Osmotic- collid pressure in peritubular capillaries What is the normal hydrostatic pressure in glomerular capillaries? - 50-70 mmHg - 20-30 mmHg - 10-20 mmHg