Renal Physiology & Anesthesia

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Blood flow into the glomerular capillary is provided by a single ___ Arteriole?

Afferent

Glomerular filtration pressure is normally what % of MAP?

60%

What percentage of plasma is filtered as blood passes through?

20%

Glomerular filtration pressure is opposed by both plasma ____ pressure & renal ____ Pressure.

plasma oncotic & Renal interstitial pressure

Glomerular capillaries are ____ Proportional to efferent arteriolar tone & ____ proportional to afferent arteriolar tone.

Directly Inversely

What is the major function of the proximal tubule?

Na+reabsorption

What does the proximal tubule secrete?

Organic anions,organic cations,ammonia production

Explain the countercurrent multiplier?

Descending limb/thin ascending limb is permeable to Na+, CL-, H20, & Urea.

Thick ascending limb is permeable to H20, urea, actively reabsorbs Na+/CL- generating an osmotic gradient.

Major site of PTH/Vit D mediated Ca+ absorption?

Distal tubule

Explain what is involved in the cortical portion of the collecting tubule?

Principle Cells (P cells) secrete K+, participate in aldosterone mediated Na+ reabsorption.

Intercalated cells (I cells) Acid base regulation

Explain the medullary portion of the collecting tubule?

Site of action of ADH
Dehydration = ADH secreation
Responsible for acidifying urine (contains more I cells than P cells)

What does the juxtaglomerular apparatus do?

Secretion of renin

What are juxtaglomerular cells innervated by?

These cells are innervated by the SNS

What does renin do when it is released by the kidney into the blood stream?

Renin released into the bloodstream acts on angiotensinogen to form angiotensin I. Conversion of ACE in lungs to form angiotensin II. Angiotnesin II plays a major role in BP regulation/aldosterone secretion.

Kidneys are the ONLY organs for which ____ consumption is determined by blood flow.

o2

Combined blood flow in both kidneys is ____% of total CO?

20-25%

____% of RBF goes to cortical neprhons.

80%

Renal cortex has ____ blood flow, extracting little O2.

high

Renal medulla has low blood flow, high ____metabolic activity.

metabolic

How many ML/min is RBF?

1200 mL/min

Normal values for men/woman GFR?

Men 120 mL/min
Women 95 mL/min

What is a practical measurement of GFR?

Creatinine Clearance

GFR is dependent on tones of afferent/efferent arterioles. T or F?

True

Afferent arteriolar tone appears to maintain GFR constant over a wide range of BPs? T or F?

True

Where does auto regulation of RBF normally occur at?

MAP 80-180

Blood flow is generally decreased at MAP <___?

70 mm Hg

RBF/GFR kept constant by afferent arteriolar vasoconstriction/vasodilation.

Just an important fact to know

GFR ceases when MAP is <40-50 mm HG

Another slide to memorize

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