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Functions of the kidneys?

  • Filtering of blood--recovery of nutrients and water; removal of metabolic wastes, excess electrolytes and toxins.

  • Water and electrolyte balance

  • Acid-base balance

  • Production of renin

  • Production of EPO

  • Production of calcitriol

Connective tissue coverings of the kidneys that hold the kidneys in place?

  • Adipose capsule

  • Renal fascia

Blood supply of the kidney:
A) Aorta to afferent arteriole
B) Efferent arteriole to inferior vena cava

  • A) Aorta → renal artery → segmental artery → lobar artery → interlobar artery → arcuate artery → interlobular artery → afferent arteriole

  • B) Efferent arteriole → peritublar capillary → interlobular vein → arcuate vein → interlobar vein → renal vein

Relative to the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery, where do the renal arteries come off the abdominal aorta?

  • Inferior to superior mesenteric artery, superior to inferior mesenteric

The tubes that drain urine from the kidneys to the urinary bladder?

  • Ureters

The tube that drains urine from the urinary bladder to the outside?

  • Urethra

Are any parts of the urinary system intraperitoneal?

  • No

Anatomical relationships of urinary bladder in relation to the bony pelvis and to other abdominopelvic viscera, accounting for differences in male and female:

  • Male: Posterior to pubis, anterior to rectum, superior to prostate

  • Female: Posterior to pubis, anterior to uterus and vagina

Percentage of cardiac output that goes to the kidneys:

  • 20-25%

What is the hilus of the kidney and what structures enter and leave it?

  • The hilus is the entrance to the kidney

  • Structures entering and leaving the hilus:

  • renal artery, renal vein, lymphatic vessels, sympathetic nerves (The renal pelvis is at the hilus)

The difference between minor calyces and major calyces:

  • Former continous with the latter

  • no physical separation

Differences between the:
A) Renal hilus
B) Renal sinus
C) Renal pelvis

  • A) the enterance of the kidney

  • B) the indention in the medial aspect of the kidney

  • C) formed at the confluence of major calyces; the ureter begins at the renal pelvis

Why is the right kidney positioned lower than the left kidney?

  • To accommodate the liver

Abdominal viscera in close proximity to the right kidney:

  • Duodenum, (head of)  pancreas, liver, gallbladder, right colon

Abdominal viscera in close proximity to the left kidney:

  • Stomach, spleen, (tail of) pancreas, jejunum, left colon

Nerve supply of the kidneys:

  • Sympathetic division of ANS

  • Role of parasympathetic, if any, unclear

Parts of the nephron:

  • Renal corpuscle (consisting of glomerulus, glomerular capsule and the subcapsular space)

  • proximal convoluted tubule

  • loop of Henle

  • distal convoluted tubule

Two types of nephrons based on location within the kidney:

  • Cortical

  • Juxtamedullary

The comparative percentages relative to the total of the two types of nephrons:

  • Cortical ~ 85%

  • Juxtamedullary ~ 15%

The specific name of the capillary network that filters blood in the renal corpuscle:

  • Glomerulus

The part of the nephron where filtration of the blood occurs:

  • Renal corpuscle

Afferent arterioles are terminal branches of these arteries:

  • Interlobular arteries

What is unique about the vascular arrangement of the glomerululus of the kidney (no other organ has a capillary arrangement like it)?

  • The glomerular capillary network is both fed by and drained by an arteriole.

In round numbers, how many nephrons does each kidney have?

  • About 1.2 million

Reabsorption of glomerular filtrate occurs primarily in this part of the nephron:

  • Proximal convoluted tubule

In the nephron the loop of Henle starts where and ends where?

  • Starts at end of PCT

  • Ends at beginning of DCT

The nephron ends at the distal end of the:

  • DCT

The last part of the nephron connects to what?

  • Collecting duct

What two substances do the granular cells of the afferent arterioles secrete?

  • Renin

  • Erythropoietin

What is GFR (glomerular filteration rate)?

  • The volume of filrate the kidneys prduce per minute

How is the JGA (juxtaglomerular apparatus) related to red blood cell formation?

  • Granular cells of afferent arterioles release erythropoietin in response to ↓ O2 concentration in blood.

  • Occurs in states of decreased BP and blood flow

What is the difference between secretion and excretion?

  • Secretion: passage of material formed by a cell to its exterior

  • Excretion: elimination of substances from the body

With respect to its composition, what is the glomerular filtrate like?
  • Most like plasma, without the plasma protiens
What would happen if normal glomerular hydrostatic pressure (above) were reduced by 20%?
  • In the above case, NFP would be 0
What are some conditions or events that can resist glomerular filtration?
  • Hypotension, inflammation in the kidney, ureteral obstruction, renal trauma
What organinc substances are notably absent from glomerular filtrate normally?
  • Plasma protiens (smaller proteins that are filtered are reabsorbed in PCT)
The volume of the filtrate produced by the glomerulus normally average about how much per minute?
  • 125 ml/minute
The glomeruli generate about 180 liters of filtrate per day. About how much of this is actually excreted as urine, assuming all parts of nephrons and collecting ducts are functioning at maximum? 
  • About 0.5-1.0% (0.9-1.8 L/day(24hrs)
If blood pressure drops, what happens in the afferent arteriole and what happens in the efferent arteriole to keep the glomerular filteration rate up?
  • Afferent arteriole dilates
  • Efferent arteriole constricts
Does glomerular filtration by itself remove all undesirable products from the blood, if not what other process is inovled to get rid of undesirable substances?
 
  • No
  • Secretion
What is tubular fluid?
  • Fluid in renal tubules that has been filtered in the glomeruli
Is tubular fluid the same thing as urine?
  • No, not until it has been fully processed in the tubules
 
What is peritublar fluid?
  • Fluid that has moved out of tubules but is not (yet) in capillaries
Is peritubular fluid the same thing as interstitial fluid?
  • Yes
Does the kidney have mechanisms that actively reaborb and actively secrete water?
  • No
  • Water moves by a specialized diffusion process called osmosis, a passive process
The two general ways ions and molecules are moved across renal tubular cell membranes:
  • Diffusion along concentration or electrochemical gradients or by active transport (against concentration and electrochemical gradients)
Define osmosis:

  • Movement of water molecules from an area of higher water molecule concetration to an area of lower water molecule concentration

  • Ma also be stated: Movement of water molecules from an area of lower solute concentration to an area of higher solute concentration

Where in the nephron are most of the filtered water and most of the organic nutrients reabsorbed?
  • PCT
What is the purpose of the microvilli in the epithelium of the PCT (proximal convoluted tubule)?
  • Increased surface area for absorption
In the loop of Henle, the permeability of the descending limb to water and to solutes:
  • Permeable to water
  • Not to solutes
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