Flashcards in Renal Anatomy Deck (26)
The fetus is compressed and unable to urinate in utero.
Develop pulmonary hypoplasia, oligohydramnios, twisted face and skin and extremity defects with in utero kidney failure.
Inferior poles of both kidneys fuse as they ascend from the pelvis during fetal developement.
they are trapped under the INFERIOR MESENTARIC ARTERY.
Why is the left kidney preferred during donor transplantations?
It has a longer renal vein.
Describe the course of the ureters
pass under the uterine artery and under ductus deferens or uterine artery
"Water under the bridge"
What is the 60-40-20 rule/
60 percent total body water
40 percent intracellular fluid
20 percent extracellular fluid
What substance is used to measure extracellular volume?
What makes up the layers of the glomerular filtration barrier?
Fenestrated capillary endothelium
Fused basement membrane (negatively charged lossed in nephrotic syndrome)
Epithelial layer of podicyte foot processes.
Urine concentration x Urine flow rate / Plasma oncentration
What substance is used to measure effective renal plasma flow?
PAH (para-aminohippuric acid)
Used because it is both filtered and secreted in the proximal collectine tubule.
Results in near 100% excretion of all PAH entering the kidney.
Which substance is best used to determine GFR?
Not perfect as some creatinine is secreted.
At which plasma glucose level will glucosuria begin?
at 200 mg/dL
at 375 all transporters will be fully saturated.
How are amino acids reabsorbed by the kidney?
Sodium dependent transporters in the PCT reabsorb amino acids.
In hartnup disease, there is a deficiency in the tryptophan transporters and thus you cannot convert tryptophan to niacin. Results in pallegra.
What naturally produced hormone regulates the sodium/ H+ pump in the proximal convuluted tubule?
Angiotensin II it also promotes HCO3- reabsorption.
Acetazolamide counteracts the effects.
What occurs in the thin descending loop of henle?
Passive water reabsorption
Known as the concentrating segment making urine hypertonic.
What occurs in the thick ascending loop of henle?
indirect magnesium and cacium reabsorption through positive lumen potential generated by potassium backleak.
Impermiable to water here!!!!
What occurs at the early distal convuluted tubule?
Reabsorption of sodium, chloride.
Makes the urine most dilute.
Which segment of the kidney responds to PTH to cause reabsorption of calcium?
The early distal convuluted tubule.
How do thiazides work?
Block the sodium/chloride channel in the early distal convuluted tubule.
What occurs at the collecting tubule?
Reabsorbs sodium in exchange for secreting potassium and hydrogen.
Which cells in the collecting duct does ADH interact with?
Principal cells via V2 receptor to increase aquaporin placement.
Which cells in the collecting duct does aldosterone act on?
Alpha intercalated cells which serve to increase potassium conductance and ENAC channels leading to potassium loss and sodium absorption.
FABulous Glittering LiquidS
Renal tubular defects in order of glomerular distance.
Fanconi syndrome - PCT
Barter Syndrome - Thick ascending
Gitelman syndrome - DCT
Liddle syndrome - Collecting tubule
Syndrome of apparent mineralcorticoid excess - Collecting tubule.
Generalized reabsorption disorder in PCT increased excretion of all amino acids, glucosee, HCO3- and PO4-.
Lead poisoning and wilsons disease can lead to this.
Thick ascending limb Na/K+/Cl pump not working corrctly
Leads to hypokalemia and metabolic alkalosis with hypercalciuria.
Loss of NaCL absorption in the DCT.