Renal LOs

Renal LOs - Introduction to Renal Function 1. Major fxns of...

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Introduction to Renal Function 1. Major fxns of kidney a. Regulation of water/electrolyte balance i. SS: input=output ii. Regulation of acid-base balance 1. Regulates bicarb excretion, synthesizes new bicarb b. Excretion of metabolic waste Metabolic waste Source Urea Protein Uric acid Nucleic acids Creatinine (Cr) Muscle creatine Misc pigments Heme c. Excretion of hormones, drugs, their metabolites i. Metabolites of steroids hormones, glucuronide conjugates of drugs, unchanged drugs d. Regulation of arterial BP (long-term) e. Regulation of RBC production i. Erythropoietin from kidneys (secreted in hypoxia) f. Regulation of vitamin D production i. Vitamin D3 25-hydroxy vitamin D3 via liver 1,25 dihydroxy vit D3 via kidney (active form: calcitrol) g. Gluconeogenesis i. Glucose from non CHO sources 2. Kidney has major role in homeostasis, involved in many (-) feedback loops 3. Identify renal cortex, renal medulla, medullary pyramids, renal calyces, renal pelvis, ureter, hilum 1
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4. Nephron=basic fxnal unit of kidney 5. Distinguish between superficial cortical, midcortical, and juxtamedullary nephrons based on location of glomerulus and length of LOH a. Juxtamedullary (15%): glomerulus very close to medulla, long-looped tubular portion b. Midcortical c. Superficial cortical: glomerulus at top of cortex, short-looped tubular portion 6. Describe blood vessels from renal artery to vein a. Renal artery segmental a interlobar a (between pyramids) arcuate a (parallel to surface of cortex) cortical radial a (blood to individual nephrons) afferent arteriole glomerular caps efferent arteriole 2 nd capillary bed cortical radial vein arcuate vein interlobar v segmental v renal v 7. Kidneys have unique vascular bed, w/ 2 capillary networks in series 8. Identify afferent/efferent arterioles, glomerular caps, mesangial cells, bowman’s capsule, juxtaglomerular apparatus 2
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9. Describe 3 layers of filtration barrier a. Capillary endothelium b. Basement membrane c. Epi cells of bowman’s capsule (podocytes: interdigitating foot processes, imp for filtering different sized particles in blood) 10.Filtration in glom caps, like in other caps, described by starling eqn 11.Define/list typical values for RBF, RPF, GFR, FF a. GFR= 120-125 ml/min (180 L/day) (from 600x0.2) b. RPF=600ml/min c. RBF 12.Describe in sequence tubular segments of nephron a. PT i. Proximal convoluted tubule (PCT) – cortex ii. Proximal straight tubule (pars recta) – into medulla b. LH i. Thin descending limb (thin DL) ii. Thin ascending limb (thin AL) 1. JM nephrons only! 3
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iii. Thick ascending limb (thick AL) iv. Ends at macula densa c. Distal nephron (DN) i. Distal convoluted tubule (DCT) ii. Connecting tubule iii. Collecting duct (CD) – collects TF from many nephrons 1. Cortical CD 2. Outer medullary CD (aka papillary CD) 3. Inner medullary CD (papillary CD) d. Juxtaglomerular apparatus i. Macula densa (end of thick AL) 1. Cells monitor TF, send signal to glomerulus to adjust glom filtration
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This note was uploaded on 09/14/2011 for the course PHARM rs taught by Professor Staff during the Spring '11 term at UCSD.

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Renal LOs - Introduction to Renal Function 1. Major fxns of...

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