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• Renal Anatomy
• Renal Blood Flow
• Renal Physiology
• Urine formation
– Glomerular Filtration
– Tubular Reabsorption
– T...
Renal Anatomy
kidney
What is the average weight of the kidney?
115-170 g
What is its average size?
11 cm in length, 6 cm in width, 3 cm ...
kidney
Cortex
• Renal corpuscles
• Proximal tubules
• Distal tubules
Medulla
• Loop of Henle
• Vasa recta
• Collecting
tubules
2 ...
What is the functional unit of the kidney?
of the kidney?
NEPHRON
Renal Blood Flow
3a
2
1
3b
Renal Blood Flow
1 2
3a
4a
3b
5b
7b
4b
5a
6a
6b
8b
Renal Physiology
MAJOR FUNCTIONS
The Body’s Filters: removing toxins &
metabolic waste products
• Ultrafiltration
• Endocr...
ultrafiltration
ultrafiltration
Of the renal blood flow, how much is filtered
by the glomerulus?
125 mL/min
How many liters of blood is fi...
ultrafiltration
The kidneys possess extraordinary
mechanisms to reabsorb water while
removing metabolic waste by-products
...
Endocrine function
1. Erythropoietin
2. Active form of vitamin D (1,25-
dihydroxy vitamin D3)
3. renin
Osmolarity regulation
ADH – synthesized in the hypothalamus &
released in the posterior pituitary in
response to an increa...
↓BP ↓PLASMA VOL ↑OSMOLARITY
↓venous pressure ↓venous return ↓ atrial pressure
↑ ADH secretion
↑ tubular permeability to wa...
Volume Regulation
Regulation of ECF volume thru the
• Renin-Angiotensin-Aldosterone (RAA)
pathway
• Atrial Natriuretic Fac...
↓BP ↓PLASMA VOL ↓Na
↑ Renal symp nerves ↓ renal arterial pressure
↑ renin secretion (into afferent arteriole)
↑ plasma ang...
Volume Regulation
Atrial Natriuretic Factor (ANF)
• Secreted by the cells in the atria of the
heart to inhibit Na+ reabsor...
Acid Base Regulation
Acid Base Regulation
• To excrete X’s alkali:
– Na2HPO4
– NaHCO3
• To excrete X’s acid:
– NH4Cl
– (NH4)2SO4
– NaH2PO4
What is the first step in urine formation?
GLOMERULAR FILTRATION
Glomerular Filtration
The filtration of a solute that is not
reabsorbed or secreted
Unit: mL/min
Affected by: hydrostatic ...
Glomerular Filtration
Substances retained:
• Blood cells
• Serum proteins
• Substances filtered:
• Water
• Smaller molecul...
Glomerular Filtration
• Approximately 20% of the volume of plasma
that passes through the glomerular tuft is
caught in Bow...
What barriers are there to
the passage of the filtrate?
• Endothelium (glomerular capillary)
• Basement membrane
– Lamina ...
Glomerular Filtration
Glomerular Filtration
• To pass through the filtration barrier:
– <4 nm in size
– Threshold
Glomerular Filtration
Tubular Reabsorption
• The movement of substances (by active or
passive transport)
– from the tubular ultrafiltrate into t...
Tubular Reabsorption
Substances reabsorbed by active transport:
• Glucose, Amino acids, Salts (PCT)
• Chloride (LOH)
• Sod...
Tubular Reabsorption
Substances reabsorbed by passive
transport:
• Water (all nephron parts except ascending
limb)
• Urea ...
Tubular Secretion
• The movement of substances (by active or
passive transport)
– from the peritubular blood or the inters...
Tubular Secretion
• Substances incompletely metabolized
– E.g. thiamine
• Substances not metabolized at all
– E.g. radiopa...
SUMMARY
• Close your notes...
•Glomerulus
FILTRATION: water (ADH not required)., Na+, Glucose, K+,
Cl-, Urea, Urate, Uric Acid, Proteins, Amino acids,
B...
•Proximal Tubule
SECRETION: Creatinine, Hydrogen, PAH
•Loop of Henle
Hypertonic filtrate
REABSORPTION: Water, Na+, Cl-, U...
 Collecting Duct
Hypertonic or Hypotonic filtrate
REABSORPTION: Water (ADH required), Na+, Cl-, Urate,
Urea, CO2
SECRETI...
Cm5 renal function
Cm5 renal function
Cm5 renal function
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Cm5 renal function

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Transcript of "Cm5 renal function"

  1. 1. • Renal Anatomy • Renal Blood Flow • Renal Physiology • Urine formation – Glomerular Filtration – Tubular Reabsorption – Tubular Secretion
  2. 2. Renal Anatomy
  3. 3. kidney What is the average weight of the kidney? 115-170 g What is its average size? 11 cm in length, 6 cm in width, 3 cm thick What is the rate of blood flow into the kidney via the renal artery? 600 mL/min
  4. 4. kidney
  5. 5. Cortex • Renal corpuscles • Proximal tubules • Distal tubules Medulla • Loop of Henle • Vasa recta • Collecting tubules 2 regions of the kidney
  6. 6. What is the functional unit of the kidney? of the kidney? NEPHRON
  7. 7. Renal Blood Flow 3a 2 1 3b
  8. 8. Renal Blood Flow
  9. 9. 1 2 3a 4a 3b 5b 7b 4b 5a 6a 6b 8b
  10. 10. Renal Physiology MAJOR FUNCTIONS The Body’s Filters: removing toxins & metabolic waste products • Ultrafiltration • Endocrine function • Osmolarity regulation • Volume regulation • Acid-base regulation
  11. 11. ultrafiltration
  12. 12. ultrafiltration Of the renal blood flow, how much is filtered by the glomerulus? 125 mL/min How many liters of blood is filtered by the kidney each day? 180 liters How much urine is produced per day? 1.5 liters
  13. 13. ultrafiltration The kidneys possess extraordinary mechanisms to reabsorb water while removing metabolic waste by-products and toxins. How is kidney function measured? GFR Glomerular Filtration Rate
  14. 14. Endocrine function 1. Erythropoietin 2. Active form of vitamin D (1,25- dihydroxy vitamin D3) 3. renin
  15. 15. Osmolarity regulation ADH – synthesized in the hypothalamus & released in the posterior pituitary in response to an increase in osmolarity as sensed by osmoreceptors in the anterior hypothalamus
  16. 16. ↓BP ↓PLASMA VOL ↑OSMOLARITY ↓venous pressure ↓venous return ↓ atrial pressure ↑ ADH secretion ↑ tubular permeability to water ↑ water reabsorption ↓ water excretion ↓ urine volume ↑ urine osmolarity
  17. 17. Volume Regulation Regulation of ECF volume thru the • Renin-Angiotensin-Aldosterone (RAA) pathway • Atrial Natriuretic Factor (ANF)
  18. 18. ↓BP ↓PLASMA VOL ↓Na ↑ Renal symp nerves ↓ renal arterial pressure ↑ renin secretion (into afferent arteriole) ↑ plasma angiotensin (from adrenal cortex) ↑ aldosterone secretion ↑ tubular Na reabsorption ↓ Na excretion ↓ arterial pressure ANF
  19. 19. Volume Regulation Atrial Natriuretic Factor (ANF) • Secreted by the cells in the atria of the heart to inhibit Na+ reabsorption in the kidneys • Inhibits secretion of aldosterone which stimulates Na+ reabsorption
  20. 20. Acid Base Regulation
  21. 21. Acid Base Regulation • To excrete X’s alkali: – Na2HPO4 – NaHCO3 • To excrete X’s acid: – NH4Cl – (NH4)2SO4 – NaH2PO4
  22. 22. What is the first step in urine formation? GLOMERULAR FILTRATION
  23. 23. Glomerular Filtration The filtration of a solute that is not reabsorbed or secreted Unit: mL/min Affected by: hydrostatic & oncotic pressure, Renin-angiotensin-aldosterone system, structure
  24. 24. Glomerular Filtration Substances retained: • Blood cells • Serum proteins • Substances filtered: • Water • Smaller molecules (MW: <70,000) – Ions – Amino acids – Glucose – Urea – Creatinine – Uric acid – ammonia
  25. 25. Glomerular Filtration • Approximately 20% of the volume of plasma that passes through the glomerular tuft is caught in Bowman’s space and is called the glomerular filtrate. • At this point, the filtrate is iso-osmotic with plasma and is called an ultrafiltrate. (sp. gr. 1.010 +/-0.002 ; pH 7.4)
  26. 26. What barriers are there to the passage of the filtrate? • Endothelium (glomerular capillary) • Basement membrane – Lamina rara interna – Lamina densa – Lamina rara externa • Podocytes (visceral layer)
  27. 27. Glomerular Filtration
  28. 28. Glomerular Filtration • To pass through the filtration barrier: – <4 nm in size – Threshold
  29. 29. Glomerular Filtration
  30. 30. Tubular Reabsorption • The movement of substances (by active or passive transport) – from the tubular ultrafiltrate into the peritubular blood or the interstitium by the renal tubular cells.
  31. 31. Tubular Reabsorption Substances reabsorbed by active transport: • Glucose, Amino acids, Salts (PCT) • Chloride (LOH) • Sodium (DCT)
  32. 32. Tubular Reabsorption Substances reabsorbed by passive transport: • Water (all nephron parts except ascending limb) • Urea (PCT, ascending limb) • Sodium (ascending limb)
  33. 33. Tubular Secretion • The movement of substances (by active or passive transport) – from the peritubular blood or the interstitium into the tubular ultrafiltrate by the renal tubular cells • To secrete substances the kidney is unable to eliminate via ultrafiltration
  34. 34. Tubular Secretion • Substances incompletely metabolized – E.g. thiamine • Substances not metabolized at all – E.g. radiopaque contrast media / mannitol • Substances not normally present – Certain drugs
  35. 35. SUMMARY • Close your notes...
  36. 36. •Glomerulus FILTRATION: water (ADH not required)., Na+, Glucose, K+, Cl-, Urea, Urate, Uric Acid, Proteins, Amino acids, Bicarbonates, Creatinine, Phosphate, Inulin, PAH REABSORPTION: -- SECRETION: -- •Proximal Tubule Isotonic filtrate FILTRATION: -- REABSORPTION: Water (ADH not required), Na+, Glucose, K+, Cl-, Urea, Urate, Uric Acid, Proteins, Amino acids, CO2
  37. 37. •Proximal Tubule SECRETION: Creatinine, Hydrogen, PAH •Loop of Henle Hypertonic filtrate REABSORPTION: Water, Na+, Cl-, Urate, Urea, CO2 SECRETION: -- •Distal Tubules Area of dehydration (where ADH acts) Iso or hypotonic filtrate; most common area of cast form’n REABSORPTION: Water (ADH required), Na+, Cl-, Urate, Urea, CO2 SECRETION: K+, Uric Acid, H+
  38. 38.  Collecting Duct Hypertonic or Hypotonic filtrate REABSORPTION: Water (ADH required), Na+, Cl-, Urate, Urea, CO2 SECRETION: K+, H+
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