P215 Spring 2018: Renal Physiology Chapter 18: pp , Chapter 19: pp ,

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1 P215 Spring 2018: Renal Physiology Chapter 18: pp , Chapter 19: pp , I. Main Components of the Renal System 1. kidneys 2. ureters 3. urinary bladder 4. urethra 4 Major Functions II. KIDNEY Basic structure 1. Renal cortex 2. Renal medulla 3. Minor Calyx Major Calyx Renal Pelvis 4. Ureter

2 III. Nephron Anatomy The nephron is the basic functional unit of the kidney. There are about 1 million nephrons per kidney. Major Structures: A. Afferent arteriole B. Glomerulus C. Glomerular Capsule D. Efferent arteriole

3 III. Nephron Anatomy (cont.) Major Structures: (cont.) E. Nephron Tubules 5 major sections of the nephron tubule: 1. Proximal Convoluted Tubule (PCT) 2. Descending Limb of the Loop of Henle 3. Ascending Limb of the Loop of Henle 4. Distal Convoluted Tubule (DCT) 5. Collecting Duct

4 III. Nephron Anatomy (cont.) Major Structures: (cont.) F. Peritubular Capillaries Put it all together, and it looks like this: IV. Nephron Function Three main processes: a) filtration, b) reabsorption, c) secretion A. Filtration = mechanism: result:

5 IV. Nephron Function (cont.) A. Filtration (cont.) Glomerular filtration rate (GFR) = total volume of fluid filtered from the plasma per minute. About % of the plasma that enters the glomerulus is filtered into the nephron tubules. On average, of filtrate are produced per minute, or per day! Autoregulation of GFR: Goal: Why? What would happen to GFR if arterial blood pressure rises and no corrections are made? How will GFR be controlled intrinsically (i.e. autoregulated) if blood pressure rises?

6 IV. Nephron Function (cont.) B. Reabsorption = mechanism: result: C. Secretion = mechanism: result: The Big Picture of Nephron Function In the end, MANY things will be filtered just because they re small. MANY things that were filtered will need to be reabsorbed because we need them. Additionally, some things that weren t initially filtered (or too much was reabsorbed) will be secreted into the nephron for various reasons.

7 V. REGULATION OF SOME EXTRACELLULAR FLUID COMPONENTS 1) REGULATION OF GLUCOSE. Filtration: Reabsorption: where? how? why? Secretion: Final net result: Question? Why is the condition glycosuria (glucose in urine) observed in untreated diabetes mellitus?

8 V. REGULATION OF SOME EXTRACELLULAR FLUID COMPONENTS (cont.) Clinical Application: Potassium Potassium is found in highest concentration in fluid. What role does potassium play in the body? What would happen if high [K + ] was found in fluid? 2) REGULATION OF POTASSIUM (K + ) Filtration: Reabsorption: where? how? why? Secretion: Final net result:

9 V. REGULATION OF SOME EXTRACELLULAR FLUID COMPONENTS (cont.) 3) REGULATION OF SODIUM (Na + ) AND WATER (H 2 O) a) filtration in glomerular capsule (GC) b) reabsorption in the proximal convoluted tubule (PCT) how? net result: Important question: If water is allowed to freely follow sodium, then what is happening to the osmotic gradient between the tubular fluid and the blood plasma? c) reabsorption in the loop of Henle NET RESULT through the Loop of Henle =

10 V. REGULATION OF SOME EXTRACELLULAR FLUID COMPONENTS (cont.) 3) REGULATION OF SODIUM (Na + ) AND WATER (H 2 O) (cont.) d) reabsorption in the distal convoluted tubule Effect of Dietary Sodium on reabsorption NET RESULT after DCT = e) reabsorption in the collecting duct Without ADH WITH ADH FINAL RESULT after CD =

11 VI. ACID-BASE BALANCE Role of the Distal Convoluted Tubule Metabolic Disorders Metabolic Acidosis = potential causes: Metabolic Alkalosis = potential causes: VII. EFFECT OF HORMONES Hormones play an important role in the regulation of by monitoring three major fluid characteristics: a. b. c.

12 VII. EFFECT OF HORMONES (cont.) Two main hormones are going to do the job of maintaining these three characteristics within normal levels: 1. Antidiuretic Hormone (ADH) (a.k.a. vasopressin or VPN) Released when is low and is high. Mechanism: Effect: Clinical Questions: In diabetes insipidus, ADH is either not produced or ineffective. What are the symptoms and treatments? In the Syndrome of Inappropriate ADH (SIADH), too much ADH is produced. What are the symptoms and treatments?

13 VII. EFFECT OF HORMONES (cont.) 2. Aldosterone Indirectly released when is low. Anatomy: juxtaglomerular apparatus (JGA) macula densa granular cells Mechanism of aldosterone secretion: Effect of aldosterone secretion:

14 VIII. Urine Transport and Release 1. ureters a. conduct urine from kidneys to bladder b. utilize peristaltic contractions 2. bladder a. storage of urine b. distensible organ with smooth muscle walls 3. urethra a. conveys urine to outside 4. sphincters - contraction prevents urine flow; relaxation allows urine flow a. internal: smooth muscle sphincter b. external: skeletal muscle sphincter 5. micturition (urination) a. distension of bladder with urine ( ml) b. stimulates bladder stretch receptors c. sensory input to spinal cord d. autonomic motor control: reflex contraction of bladder smooth muscle relaxation of internal sphincter e. voluntary relaxation of external sphincter f. urine flows and contents of bladder lost from body

15 PRACTICE WORKSHEET FOR GLUCOSE, POTASSIUM, SODIUM, WATER & ph REGULATION

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