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BIOC34H3 Lecture Notes - Lecture 4: Arteriole, Renal Function, Diuresis

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violetskunk939
4 Jan 2018
School
UTSC
Department
Biological Sciences
Course
BIOC34H3
Professor
Stephen Reid

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Document Summary

The effects of arteriole radius on glomerular filtration. Solute gradients and their impact on urine concentration. Diuresis is a term for increased urine flow. When adh secretion is decreased, water reabsorption in the kidneys decrease, and its excretion will increase, which increases urine production. Without adh, the tubule becomes impermeable to water and leads to the formation of dilute urine resulting in a higher urine volume than normal. The concentration of the electrolytes in the blood will then increase, and that would usually signal adh to be released, but the presence of alcohol prevents that from happening: use the following values to calculate glomerular filtration rate. Gfr = urine conc*urine flow / plasma connc. = (1. 01 mg/ml * 1. 15 ml/min) / 0. 012 mg/ml. = 96. 8 ml/min: a patient goes to the doctor complaining about excessive thirst, frequent urination and weight loss. She gets up several times during the night to urinate.

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Related Questions

1. Which of the following vessels, if stimulated to vasoconstrict, would cause increased filtration in the glomerular capillaries?
(a) Afferent arteriole​(c) Efferent arteriole
(b) Vasa recta​(d) Peritubular capillaries
2. Which of the following CORRECTLY describes the flow of filtrate through the renal tubule?
(a) Glomerulus à Distal convoluted tubule à Ascending limb of nephron loop à Descending limb of nephron loop à Proximal convoluted tubule à Collecting duct
(b) Glomerulus à Proximal convoluted tubule à Descending limb of nephron loop à Ascending limb of nephron loop à Distal convoluted tubule à Collecting duct
(c) Glomerulus à Proximal convoluted tubule à Ascending limb of nephron loop à Descending limb of nephron loop à Distal convoluted tubule à Collecting duct
(d) Glomerulus à Distal convoluted tubule à Descending limb of nephron loop à Ascending limb of nephron loop à Proximal convoluted tubule à Collecting duct
3. Tubular ______________ occurs when certain substances (i.e. ions, drugs) are removed from the bloodstream and placed back into the renal tubule.
(a) Elimination​(c) Secretion
(b) Reabsorption​(d) Filtration
4. Which of the following is TRUE about the reabsorption process in the proximal convoluted tubule?
(a) Na + ions are actively transported out of the tubule and into the peritubular capillaries
(b) Negatively charged ions (e.g. chloride) are transported out of the tubule in response to the movement of sodium
(c) Water is reabsorbed into the peritubular capillaries because of the increased osmotic pressure
(d) All of the above
5. Which of the following statements is FALSE about the glomerulus and the processes that occur there?
(a) Capsular hydrostatic pressure refers to the pressure of fluid pressing on the capsule and opposes filtration
(b) Net filtration pressure in the glomerulus is the difference between forces favoring filtration and forces opposing filtration
(c) Blood from the afferent arteriole is filtered by size when it enters the glomerulus because of the many fenestrae
(d) Vasoconstriction of the efferent arteriole lowers glomerular filtration rate
6. The descending limb of the nephron loop is impermeable to water while the ascending limb of the nephron is permeable to water.
(a) True​(b) False
7. Which of the following vessels takes blood out of the renal corpuscle and returns it to the bloodstream?
(a) Peritubular capillary system​(c) Vasa recta
(b) Efferent arteriole​(d) Afferent arteriole
8. Under the influence of ADH, the ___________________ and the _________________ become permeable to water and water is reabsorbed.
(a) Proximal convoluted tubule, Nephron loop
(b) Distal convoluted tubule, Nephron loop
(c) Proximal convoluted tubule, Collecting duct
(d) Distal convoluted tubule, Collecting duct
9. What is the name of the region inside the bladder bounded by the two uretal openings and the urethra?
(a) Trigone​(c) Mucous layer
(b) Detrusor muscle​(d) Transitional epithelium
10. During the accumulation of urine, the bladder distends, allowing stretch receptors in the transitional epithelium to be stimulated.
(a) True​(b) False

Case-3: Patient History

P.W. is 23 years old. He was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency department. P.W.’s vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output, and fluid resuscitation is initiated while his wounds are cleaned and sutured. The urine output is averaging 15 ml/hr, with a high urine osmolality and low urine sodium.

What type of renal failure is P.W. likely developing? (select all that apply)

Intrarenal acute renal failure
Prerenal acute renal failure
Postrenal acute renal failure

Chronic renal failure

Based on your answer for the previous question, what is the best therapy for preventing this from occurring? (select all that apply)

Adequate extracellular volume replacement with blood or isotonic fluids to ensure adequate circulating blood volume and perfusion pressure to the kidney is essential.
Antibiotic therapy should be administered immediately.
Restriction of fluid intake to prevent increase in circulating blood volume and perfusion pressure to the kidney is essential.
Dialysis should be initiated immediately.

In addition to urine output, what laboratory data should be monitored to assess changes in P.W.’s renal function? (select all that apply)

Serum BUN, creatinine, and potassium should be monitored. A decrease indicates decreased renal function.
Creatinine clearance can be measured to more accurately assess glomerular filtration rate.
Serum BUN, creatinine, and potassium should be monitored. An increase indicates decreased renal function.

Serum sodium may be useful in determining the correct IV fluid composition to administer.

If P.W.’s renal function does not return to normal, but continues to be diminished, what renal disorder might develop? (select all that apply)

He may progress to acute tubular necrosis.
He may develop renal calculi.
He may develop pyelonephritis
He may develop nephrotic syndrome

1. Which of the following would increase glomerular filtration rate? (More than one answer may be correct)

Increased blood pressure

Increased solute concentration in the bowman capsule

Increased solute concentration in the blood

Decreased ADH

2. Explain the concept of a countercurrent multiplier system and how it works in the kidneys. What is the importance of this system to the function of the kidneys?

3. Many drugs prescribed to treat high blood pressure actually act on the kidneys. Why would this be a good target?

4. Explain one mechanism by which such drugs could work.