THREE BASIC RENALPROCESSES    Glomerular Filtration: Filtering of blood    into tubule forming the primitive urine    Tubu...
BASIC RENAL PROCESSES                                             Efferent ArterioleAfferent    GlomerulusArteriole       ...
Glomerular Filtration    First step in urine formation    180 liters/day filtered    Entire plasma volume filtered 65    t...
Forces Involved inGlomerular Filtration   Glomerular Capillary   Blood Pressure                    +              55   Pla...
Tubular Reabsorption    Water: 99% reabsorbed    Sodium: 99.5% reabsorbed    Urea: 50% reabsobed    Phenol: 0% reabsorbed0...
Tubular Reabsorption    By passive diffusion    By primary active transport: Sodium    By secondary active transport: Suga...
Tubular Reabsorption is a Function of theEpithelial Cells Making up the TubuleLumen              Cells                    ...
Sodium Reabsorption            PUMP: Na/K ATPase                                               SodiumLumen                ...
Rennin-Angiotensin-Aldosterone System    Stimulates Sodium Reabsorption in distal    and collecting tubules    Naturetic p...
Rennin-Angiotensin- Aldosterone System        Fall in NaCl, extracellular fluid volume, arterial blood pressure           ...
DIURETICS    ACE Inhibitors (Angiotensin Converting    Enzyme): Cause loss of salt---> water    follows    Atrial Natureti...
Glucose and Amino Acids are reabsorbed bysecondary active transport    They are actively transported across the    apical ...
GLUCOSE REABSORPTION HAS ATUBULAR MAXIMUMGlucose                              Filtered           ExcretedReabsorbedmg/min ...
Tubular Secretion    Protons (acid/base balance)    Potassium    Organic ions03/20/13           www.freelivedoctor.com
Potassium Secretion            PUMP: Na/K ATPase                                               SodiumLumen                ...
DUAL CONTROL OFALDOSTERONE SECRETION                                                           Fall in sodium             ...
Reabsorption in ProximalTubule (Summary)    Glucose and Amino Acids    67% of Filtered Sodium    Other Electrolytes    65%...
Secretion in ProximalTubule (Summary)    Variable Proton secretion for acid/base    regulation    Organic Ion secretion03/...
Reabsorption in DistalTubule (Summary)    Variable Sodium controlled by    Aldosterone    Chloride follows passively    Va...
Secretion in Distal Tubule(Summary)    Variable Proton for acid/base regulation    Variable Potassium controlled by    ald...
Collecting Duct (Summary)    Variable water reabsorption controlled by    vasopressin    Variable Proton secretion for aci...
REGULATION OF URINECONCENTRATION    Medullary countercurrent system    Vasopressin03/20/13          www.freelivedoctor.com
Medullary countercurrentsystem    Osmotic gradient established by long    loops of Henle    Descending limb    Ascending l...
Descending limb    Highly permeable to water    No active sodium transport03/20/13          www.freelivedoctor.com
Ascending limb    Actively pumps sodium out of tubule to    surrounding interstitial fluid    Impermeable to water03/20/13...
COUNTERCURRENT MAKESTHE OSMOTIC GRADIENT           From                                         To Distal                 ...
THE OSMOTIC GRADIENT CONCENTRATESTHE URINE WHEN VASOPRESSIN (ANTIDIURETIC HORMONE [ADH]) IS PRESENT    Interstitial Fluid ...
WHEN VASOPRESSIN (ANTI DIURETICHORMONE [ADH]) IS ABSENT A DILUTEURINE IS PRODUCE    Interstitial Fluid                    ...
Renal Failure    Acute: Sudden onset, rapid reduction in    urine output - usually reversible    Chronic: Progressive, not...
THE URINARY BLADDERSTORES THE URINE    Gravity and peristaltic contractions propel    the urine along the ureter    Parasy...
Reflex and VoluntaryControl of Micturition    Bladder filling                   Stretch receptors in    reflexively contra...
Upcoming SlideShare
Loading in …5
×

Basicprocessesofkidney 100408015158-phpapp01

448 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
448
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
5
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Basicprocessesofkidney 100408015158-phpapp01

  1. 1. THREE BASIC RENALPROCESSES Glomerular Filtration: Filtering of blood into tubule forming the primitive urine Tubular Reabsorption: Absorption of substances needed by body from tubule to blood Tubular Secretion: Secretion of substances to be eliminated from the body into the tubule from the blood03/20/13 www.freelivedoctor.com
  2. 2. BASIC RENAL PROCESSES Efferent ArterioleAfferent GlomerulusArteriole GF Kidney TR Tubule Peritubular Capillary TA Urine Excreted03/20/13 www.freelivedoctor.com
  3. 3. Glomerular Filtration First step in urine formation 180 liters/day filtered Entire plasma volume filtered 65 times/day Proteins not filtered03/20/13 www.freelivedoctor.com
  4. 4. Forces Involved inGlomerular Filtration Glomerular Capillary Blood Pressure + 55 Plasma Colloid - Osmotic Pressure 30 Bowman’s Capsule - Hydrostatic Pressure 15 Net Filtration Pressure + 1003/20/13 www.freelivedoctor.com
  5. 5. Tubular Reabsorption Water: 99% reabsorbed Sodium: 99.5% reabsorbed Urea: 50% reabsobed Phenol: 0% reabsorbed03/20/13 www.freelivedoctor.com
  6. 6. Tubular Reabsorption By passive diffusion By primary active transport: Sodium By secondary active transport: Sugars and Amino Acids03/20/13 www.freelivedoctor.com
  7. 7. Tubular Reabsorption is a Function of theEpithelial Cells Making up the TubuleLumen Cells Plasma03/20/13 www.freelivedoctor.com
  8. 8. Sodium Reabsorption PUMP: Na/K ATPase SodiumLumen CellsPotassium Plasma Chloride Water03/20/13 www.freelivedoctor.com
  9. 9. Rennin-Angiotensin-Aldosterone System Stimulates Sodium Reabsorption in distal and collecting tubules Naturetic peptide inhibits In absence of Aldosterone, 20mg of sodium/day may be excreted Aldosterone can cause 99.5% retention03/20/13 www.freelivedoctor.com
  10. 10. Rennin-Angiotensin- Aldosterone System Fall in NaCl, extracellular fluid volume, arterial blood pressure Adrenal Helps Juxtaglomerular Correct Apparatus CortexLiver Renin Lungs + Converting EnzymeAngiotensin Angiotensin Angiotensin Aldosterone Increased Sodium Reabsorption 03/20/13 www.freelivedoctor.com
  11. 11. DIURETICS ACE Inhibitors (Angiotensin Converting Enzyme): Cause loss of salt---> water follows Atrial Naturetic Peptide (ANP) also inhibits sodium reabsorption Osmotic diuretics: Are not reabsorbed03/20/13 www.freelivedoctor.com
  12. 12. Glucose and Amino Acids are reabsorbed bysecondary active transport They are actively transported across the apical cell membranes of the epithelial cells Their active transport depends on the sodium gradient across this membrane All other steps are passive03/20/13 www.freelivedoctor.com
  13. 13. GLUCOSE REABSORPTION HAS ATUBULAR MAXIMUMGlucose Filtered ExcretedReabsorbedmg/min Reabsorbed Renal threshold (300mg/100 ml)03/20/13 Plasma www.freelivedoctor.comof Glucose Concentration
  14. 14. Tubular Secretion Protons (acid/base balance) Potassium Organic ions03/20/13 www.freelivedoctor.com
  15. 15. Potassium Secretion PUMP: Na/K ATPase SodiumLumen CellsPotassium Plasma Chloride Water03/20/13 www.freelivedoctor.com
  16. 16. DUAL CONTROL OFALDOSTERONE SECRETION Fall in sodium Increased Plasma ECF Volume Potassium Blood Pressure Increased Aldosterone secretion Increased Tubular Increased Tubular Potassium Secretion Sodium ReabsorptionIncreased Urinary Fall in UrinaryPotassium Secretion Sodium Excretion03/20/13 www.freelivedoctor.com
  17. 17. Reabsorption in ProximalTubule (Summary) Glucose and Amino Acids 67% of Filtered Sodium Other Electrolytes 65% of Filtered Water 50% of Filtered Urea All Filtered Potassium03/20/13 www.freelivedoctor.com
  18. 18. Secretion in ProximalTubule (Summary) Variable Proton secretion for acid/base regulation Organic Ion secretion03/20/13 www.freelivedoctor.com
  19. 19. Reabsorption in DistalTubule (Summary) Variable Sodium controlled by Aldosterone Chloride follows passively Variable water controlled by vasopressin03/20/13 www.freelivedoctor.com
  20. 20. Secretion in Distal Tubule(Summary) Variable Proton for acid/base regulation Variable Potassium controlled by aldosterone03/20/13 www.freelivedoctor.com
  21. 21. Collecting Duct (Summary) Variable water reabsorption controlled by vasopressin Variable Proton secretion for acid/base balance03/20/13 www.freelivedoctor.com
  22. 22. REGULATION OF URINECONCENTRATION Medullary countercurrent system Vasopressin03/20/13 www.freelivedoctor.com
  23. 23. Medullary countercurrentsystem Osmotic gradient established by long loops of Henle Descending limb Ascending limb03/20/13 www.freelivedoctor.com
  24. 24. Descending limb Highly permeable to water No active sodium transport03/20/13 www.freelivedoctor.com
  25. 25. Ascending limb Actively pumps sodium out of tubule to surrounding interstitial fluid Impermeable to water03/20/13 www.freelivedoctor.com
  26. 26. COUNTERCURRENT MAKESTHE OSMOTIC GRADIENT From To Distal Cortex Proximal 300 300 100 Tubule Tubule 450 250 Medulla 450 600 600 400 Active 750 550 750 Sodium Transport 900 900 700 1050 1050 850 Passive 1200 1200 1000 Water Transport 1200 1200 1000 Long Loop of Henle03/20/13 www.freelivedoctor.com
  27. 27. THE OSMOTIC GRADIENT CONCENTRATESTHE URINE WHEN VASOPRESSIN (ANTIDIURETIC HORMONE [ADH]) IS PRESENT Interstitial Fluid From Distal Cortex 300 300 Tubule 400 Medulla 450 Collecting 550 600 Duct 750 700 900 850 1050 1000 Pores 1100 1200 Open 1200 1200 Passive Water Flow03/20/13 www.freelivedoctor.com
  28. 28. WHEN VASOPRESSIN (ANTI DIURETICHORMONE [ADH]) IS ABSENT A DILUTEURINE IS PRODUCE Interstitial Fluid From Distal Cortex 300 100 Tubule 100 Medulla 450 Collecting 100 600 Duct 750 100 900 100 1050 100 Pores 100 1200 Closed 1200 100 No Water Flow Out of Duct03/20/13 www.freelivedoctor.com
  29. 29. Renal Failure Acute: Sudden onset, rapid reduction in urine output - usually reversible Chronic: Progressive, not reversible Up to 75% function can be lost before it is noticeable03/20/13 www.freelivedoctor.com
  30. 30. THE URINARY BLADDERSTORES THE URINE Gravity and peristaltic contractions propel the urine along the ureter Parasympathetic stimulation contracts the bladder and micturition results if the sphincters (internal and external urethral sphincters) relax The external sphincter is under voluntary control03/20/13 www.freelivedoctor.com
  31. 31. Reflex and VoluntaryControl of Micturition Bladder filling Stretch receptors in reflexively contracts bladder send the bladder inhibitory impulses to Internal Sphincter external sphincter mechanically opens Voluntary signals from cortex can override the reflex or allow it to take place03/20/13 www.freelivedoctor.com

×