Renal Physiology Study Guide
- List the major functions of the kidneys
- Describe the basic anatomical features of the kidney, especially the nephron
- Describe the vascular supply to the kidney
- Discuss the structural adaptations of the renal corpuscle that influence glomerular filtration
- Know the forces that determine rate of glomerular filtration
- Be able to calculate net filtration pressure
- Describe the 2 processes which may produce autoregulation of kidney blood flow
- Discuss how constriction of the afferent or efferent arteriole will affect glomerular filtration rate and blood flow
- List examples of vasoconstrictors and a vasodilator in the kidney circulation
- Define the terms reabsorption and secretion as they apply to the nephron
- Know the basic mechanisms of reabsorption of Na+, K+, glucose, and water in the proximal tubule
- Describe how organic acids and bases are secreted in the proximal tubule
- Discuss why glucose may appear in the urine
- Contrast the behavior of substances filtered, reabsorbed, and secreted in terms of their concentrations at the end of the proximal tubule
- Describe permeability characteristics and mechanisms of reabsorption for epithelial cells in the loop of Henle
- Describe mechanisms of Na+ reabsorption and K+ secretion or reabsorption in the distal convoluted tubule and collecting duct
- List and discuss the mechanisms of action of diuretics working in the loop of Henle, distal convoluted tubule, and collecting duct
- Discuss the mechanism of action of aldosterone on tubular epithelial cells
- Quantitate percentage of Na+, K+, and H2O reabsorbed by the end of the proximal tubule and at the end of the thick ascending limb of the loop of Henle
- Know typical percentages of filtered Na+ and H2O excreted as urine
- Decribe the characteristics of the loop of Henle that cause high NaCl concentration in interstitial fluid of the inner medulla
- Discuss the role of ADH in production of urine with high versus low solute concentration
- Discuss the role of ADH in excretion of high versus low urine volume
- Discuss the mechanisms of ADH action
- Know how concentrated or diluted (in mOsm) urine can become
- What is diabetes insipidus
- Undestand the concept of clearance and be able to calculate GFR and renal plasma flow based on clearance of particular solutes
- Explain how plasma creatinine levels can be used to see if GFR is normal, and be able to make such a calculation
- Locate osmoreceptors in the brain and describe the circumstances of their activation
- Know how stimulation or suppression of osmoreceptors results in increased or decreased urine flow and increased or decreased urine osmolarity
- Desribe receptors relevant to the sensation of thirst and desribe how this can influence plamsa osmolarity
- Describe how regulation of the amount of Na+ in ECF affects interstitial fluid and vascular volume
- List and describe sensory signals to the kidney which help regulate vascular volume
- Describe the pathways by which kidney readjusts ECF volume by changing GFR
- Describe the renin-angiotensin system
- Describe the pathways by which aldosterone release is regulated to adjust Na+ reabsorption
- Explain the role of ADH in regulating extracellular volume
- Describe when and by what pathway atrial natriuritic factor (ANF) regulates Na+ reabsorption
- Be able describe the relevant pathways that compensate for increases or decreases in plasma volume
- Describe the general distribution of Ca++ in the body
- Explain the circumstances of parathyroid hormone release and the systems affected to influence plasma levels of Ca++ and phosphate
- Know the cells responsible for mineralization and reabsorption of bone
- Know the basic pathway necessary to produce active vitamin D (1,25[OH}2D3)
- Describe how Ca++ is reabsorbed in the nephron and list percentages reabsorbed
- Describe the effects of increasing or decreasing plasma HCO3- on plasma H+ ion concentrations
- Discuss 3 pathways for reabsorption of HCO3- in the nephron: which of these pathways produce new HCO3- for the plasma? Which of these pathways will result in excretion of H+ ion.
- Based on the TBL, discuss respiratory compensation for metabolic acidosis and renal compensation for respiratory acidosis.
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