anatomy and physiology of the kidney. true/false: the kidneys are outside the peritoneal cavity true...
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Anatomy and physiology of the kidney
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• True/false: the kidneys are outside the peritoneal cavity True
• The kidneys sit at __ to __ vertebral levelT12 to L3
• Why is the right kidney lower that the left?
The liver push on the right kidney
• In relation to the vertebral level, describe where are the hila.
Left hilum is at the upper border of L1 and the right hilum
is at the lower border
• Give the order of structure in the hilum from the frontVein, artery, ureter
• Where do the renal arteries come from and at what vertebra level?
From abdominal aorta at L2
• Where do the renal veins come from?Inferior vena cava
• What level does the sympathetic supply to the kidneys come from? T12 and L1
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A. Ureter
B. Renal pelvis
C. Renal vein
D. Renal artery
E. Major calyx
F. Renal capsule
G. Renal pyramid
H. Medulla
I. Minor calyx
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A
B
C
D
A. Interlobular artery and vein
B. Interlobar artery and vein
C. Renal artery and vein
D. Arcuate artery and vein (at the corticomedullary junction)
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Afferent arteryGlomerulusEfferent artery
Interlobular artery
Interlobular veinPeritubular capillary network
Collecting duct
Vasa recta
9. What is the difference between cortical nephron and juxtamedullary nephron and why is this important?
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Function of The Kidney
Regulation of water & electrolyte, volume & osmolarity • Sodium, chloride, potassium, calcium, phosphate, magnesium
Regulation of acid-base balance
• Hydrogen ions (pH)
Excretion of metabolic waste products and foreign chemicals• Nitrogen
Removal of foreign chemicals from blood
• drugs, pesticides and food additives
Secretion of hormones:• renin = controls the formation of angiotensin • erythropoietin = stimulates red blood cell production• 1,25-dihydroxy vitamin D3
Glucogenesis = conversion of amino acids to glucose
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Filtration
Reabsorption
Secretion
Excretion
How the nephron works
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How does each of these structures work?
• High capacity for active & passive reabsorption• 65% H2O & Na+; 50% Cl-; 90%
HCO3-; >90% K+, Nearly all glucose, lactose, amino acid
• Apical cell surface has a border of microvilli
• Na+/K+-ATPase located in basolateral cell membrane
Proximal convoluted tubule
• Highly permeable to water and H2O reabsorbed
• No active Na+ reabsorption
Descending loop of Henle
• Impermeable to water• Reabsorbs 25% of filtered Nacl & K+,
Ca2+ ,HCO3-
• Creates a hypotonic condition in the tubule compared to the interstitial space
Ascending loop of
Henle
• Reabsorption regulated by hormones• Na+ reabsorbtion depends on
aldosterone• H2O reabsorbtion depends on ADH
Distal convoluted tubule
• Macula densa – monitors the content of DCT
• Juxtaglomerular cells in afferent arteriole synthesise renin which converts angiotensinogen to angiotensin I
Macula densa and
juxtaglomerular apparatus