Renal Tutorial ppt

Renal Tutorial ppt - PEGGY CHEN & JOYCE LAM...

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Unformatted text preview: PEGGY CHEN & JOYCE LAM Renal Tutorial Figure 14.02 Glomerulus (glomerular capillaries) Bowmans space in Bowmans capsule Proximal convoluted tubule Proximal straight tubule Descending thin limb of Henles loop Ascending thin limb of Henles loop Thick ascending limb of Henles loop (containing macula densa at end) Distal convoluted tubule Cortical collecting duct Medullary collecting duct Renal pelvis Renal corpuscle Renal tubule Proximal tubule Loop of Henle Distal convoluted tubule Collecting duct system Amount Amount Amount Amount excreted = filtered + secreted - Formation of urine Figure 14.08 Forces involved in filtration (oncotic pressure) Concept of clearance Clearance: the volume of plasma from which that substance is completely removed (cleared) by the kidneys per unit time . Clearance of S (Cs) = Mass of S excreted per unit time Plasma concentration of S (Ps) Mass of S excreted per unit time = Urine concentration of S (Us) x Urine volume per unit time (V) Cs = UsV Ps GFR ? Urine volume = 2.4 L/day Inulin concentration in the urine = 300 mg/L Amount of inulin excreted in the urine = 2.4 L/day x 300 mg/L =720 mg/day C IN = 720 mg/day 4 mg/L = 180 L/day GFR = C IN = 180 L/day Plasma concentration of sodium is NOT a marker for total body sodium. P Na only reflects the relative relationship of total body Na and water. Attention!! Renal regulation of sodium-control by GFR Na + and H 2 O loss due to diarrhea Plasma volume Venous pressure Venous return Atrial pressure Ventricular end-diastolic vol Stroke volume Cardiac output Arterial blood pressure Activity of renal sympathetic nerves Reflexes mediated by venous, atrial and arterial baroreceptors Constriction of a.a. Net GF pressure GFR Direct effect Na + and H 2 O excreted Kidneys Vanders, 10th ed. Fig. 14-18, page 547. (9th ed. Fig. 14-17 page 535) Regulation of renin secretion by extracellular fluid volume (important mechanisms for Na balance) Vanders 10th ed. Fig. 14-20, page 549 (9th ed. Fig. 14-19 page 537) Plasma volume Activity of renal sympathetic nerve Arterial pressure (direct effect of less stretch) GFR, which causes flow to macula densa NaCl delivery to macula densa Renal juxtaglomerular cells Renin secretion Plasma renin Plasma angiotensin II Adrenal cortex Aldosterone secretion Plasma aldosterone CCD Sodium and H 2 O reabsorption Sodium and H 2 O excretion Aldosterone does NOT stimulate H 2 O reabsorption directly in the CCD. Action of ANP Vasa recta:...
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Renal Tutorial ppt - PEGGY CHEN & JOYCE LAM...

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