The basics of autoregulation of Gloemrular filtration rate. This ppt deals with basic renal physiology, tubuloglomerular feedback, myogenic reflex, juxtaglomerular apparatus and renin angiotensin aldosterone system in brief. P.S.- The ppt has animations so kindly view in slide/presentation mode
Renal blood flow (The Guyton and Hall physiology)Maryam Fida
In an average 70-kilogram man, the combined blood flow through both kidneys is about 1100 ml/min, or about 22 per cent of the cardiac output. Two kidneys makes about 0.4 % of total body weight but receive very high blood flow as compared with other body organ. The purpose of additional blood flow is to supply sufficient plasma for high rates of GF which is essential for regulating body fluid volumes & solute concentrations.
Characteristics of the renal blood flow:
1, High blood flow. 1100 ml/min, or 22 percent of the cardiac output. 94% to the cortex.
2, Two capillary beds
High hydrostatic pressure in glomerular capillary (about 60 mmHg) and low hydrostatic pressure in peritubular capillaries (about 13 mmHg)
Blood flow to renal medulla is supplied by vasa recta.
Blood flow in vasa recta of medulla is very low as compared to blood flow in cortex.
Blood flow in renal medulla is 1-2 % of total renal blood flow.
Vasa recta are important to form concentrated urine.
The basics of autoregulation of Gloemrular filtration rate. This ppt deals with basic renal physiology, tubuloglomerular feedback, myogenic reflex, juxtaglomerular apparatus and renin angiotensin aldosterone system in brief. P.S.- The ppt has animations so kindly view in slide/presentation mode
Renal blood flow (The Guyton and Hall physiology)Maryam Fida
In an average 70-kilogram man, the combined blood flow through both kidneys is about 1100 ml/min, or about 22 per cent of the cardiac output. Two kidneys makes about 0.4 % of total body weight but receive very high blood flow as compared with other body organ. The purpose of additional blood flow is to supply sufficient plasma for high rates of GF which is essential for regulating body fluid volumes & solute concentrations.
Characteristics of the renal blood flow:
1, High blood flow. 1100 ml/min, or 22 percent of the cardiac output. 94% to the cortex.
2, Two capillary beds
High hydrostatic pressure in glomerular capillary (about 60 mmHg) and low hydrostatic pressure in peritubular capillaries (about 13 mmHg)
Blood flow to renal medulla is supplied by vasa recta.
Blood flow in vasa recta of medulla is very low as compared to blood flow in cortex.
Blood flow in renal medulla is 1-2 % of total renal blood flow.
Vasa recta are important to form concentrated urine.
I am a medical student. I have one friend who is persuing his MBBS degree in Taishan Medical UNiversity. I got these notes from him.
These notes are by Dr. Bikesh, He is a famous lecturer of TMU.
These notes have helped me a lot and i also watch his lecture videos , which are great; highly simple and huge content.
I am uploading with Renal physiology. If you want some other topics i would upload for you.
"Let the Knowledge be spread" Dr. Bikesh
I am a medical student. I have one friend who is persuing his MBBS degree in Taishan Medical UNiversity. I got these notes from him.
These notes are by Dr. Bikesh, He is a famous lecturer of TMU.
These notes have helped me a lot and i also watch his lecture videos , which are great; highly simple and huge content.
I am uploading with Renal physiology. If you want some other topics i would upload for you.
"Let the Knowledge be spread" Dr. Bikesh
EVENTS OF URINE FORMATION (The Guyton and Hall physiology)Maryam Fida
FILTRATION.
REABSORPTION
SECRETION
FILTRATION is the function of the glomerulus.
Reabsorption and secretion are the functions of tubular portion of nephron.
It is the first process of urine formation.
DEFINITION
“ The process by which the blood that passes through glomerular capillaries is filtered Formed by three layers.
Glomerular capillary membrane.
Basement membrane
visceral layer of Bowman’s capsule.
Glomerular Filtration Rate (GFR)
“The rate at which plasma is filtered into Bowman's capsule.
The units of filtration are a volume filtered per unit time, e.g. ml/min or liters/day.
Normal Value is 125ml/min or 180 liters/day.
99% of filtrate is reabsorbed, 1 to 2 L is excreted as urine.
Glomerular Filtration rate and its determinants.pptxDr.Nusrat Tariq
The first step in urine formation is filtration of large
amounts of fluid through the glomerular capillaries into
Bowman’s capsule—almost 180 L/day. Most of this filtrate is reabsorbed, leaving only about 1 liter of fluid to be
excreted each day, although the renal fluid excretion rate
is highly variable, depending on fluid intake. The high rate
of glomerular filtration depends on a high rate of kidney
blood flow, as well as the special properties of the glomerular capillary membranes.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Thrombotic Microangiopathy (TMA) in Adults and Acute Kidney Injury - Dr. GawadNephroTube - Dr.Gawad
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- English version of this lecture is available at:
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Infection-related Glomerulonephritis (KDIGO 2021 Guidelines) - Dr. GawadNephroTube - Dr.Gawad
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Insights from the FIGARO-DKD and FIDELIO-DKD trials - Dr. GawadNephroTube - Dr.Gawad
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Diabetes Mellitus Management in CKD (Clinical Tips) - Dr. GawadNephroTube - Dr.Gawad
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Renal Physiology (II) - Glomerular Structure & Filtration - Dr. Gawad
1. 1
RENAL PHYSIOLOGY
(II)
m
GLOMERULAR
STRUCTURE & FILTRATION
Mohammed Abdel Gawad
2. OBJECTIVES
2
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
3. OBJECTIVES
3
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
6. OBJECTIVES
6
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
7. Formation of URINE in 3 steps
7
Tubular Tubular
Reabsorption Secretion
Glomerular Excretion
Filtration
10. OBJECTIVES
10
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
14. GLOMERULAR BASEMENT MEMBRANE
STRUCTURE
14
Formed of:
Collagen type IV
Triple helix: 3 α-peptide chains with globular non collagenous
domain (NC1)
Abnormalities:
Mutation in α-peptide chains → no proper helix → hereditary nephritis
Antibodies against NC1 in kidney → anti GBM disease
Antibodies against NC1 in kidney & lung → Goodpastuer Syndrome
15. OBJECTIVES
15
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
16. 16
Glomerular Filtrate & GFR
Glomerular filtrate:
fluid that filters through the glomeruli into
Bowman's capsule
= plasma – (plasma proteins, plasma
proteins binbed substances & substances
with a MW > 70.000).
Glomerular Filtration Rate (GFR):
- definition: The quantity of glomerular
filtrate formed in all nephrons of both
kidneys / min.
- normal value: 125ml/min. 180 Liters/day.
18. OBJECTIVES
18
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
19. Movement of water:
Starling’s Forces & Membrane Permeability
19
The amount of water in each body compartment is
dependent on:
1- osmotic pressure
2- hydrostatic pressure
+ Membrane characteristics
26. Membrane Factors
Membrane permeability (s) is clinically relevant in disorders which
disrupt membrane integrity (e.g., sepsis).
Permeability of a membrane ranges from zero, completely
permeable, to one, completely impermeable.
32. GFR & Filtration Coefficient (Kf)
32
Glomerular Filtration Rate:
- definition: The quantity of glomerular filtrate formed in all nephrons of
both kidneys / min.
For the 10 mmHg
- normal value: 125ml/min. 180 Liters/day.
Filtration coefficient (Kf):
It is the GFR for both kidneys per mmHg of filtration pressure.
Normally = 12.5 For 1 mmHg
GFR = 12.5 X 10 = 125 ml/min
33. OBJECTIVES
33
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
34. Autoregulation of GFR
34
Under normal conditions (MAP= 80-
180mmHg) renal autoregulation maintains
a nearly constant glomerular filtration rate
A- Myogenic mechanism:
Laplace law:
Vessel wall tension
α Distending pressure X radius of the vessel.
When arterial pressure rises →
afferent arteriole stretches → vascular
smooth muscles contract → arteriole
resistance offsets pressure increase →
RBF (& hence GFR) remain constant &
vise versa
37. Autoregulation of GFR
37
B- Tubuloglomerular feed back mechanism
Juxtaglomerular Apparatus or Complex:
is a specialized region of a nephron where the afferent arteriole and Distal Convoluted
Tubule (DCT) come in direct contact with each other. Juxtaglomeruar Apparatus (JGA)
consists of:
1) Juxtaglomerular cells (modified smooth muscle cells) of afferent
arteriole including renin containing (synthesizes and stores renin) and sympathetically
innervated granulated cells which function as mechanoreceptors to sense blood
pressure.
2) Macula densa cells (Na+ sensors) of Distal Convoluted Tubule (DCT) which
function as chemoreceptors to sense changes in the solute concentration and flow rate
of filtrate.
40. Autoregulation of GFR
40
B- Tubuloglomerular feed back mechanism
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41. OBJECTIVES
41
Be sure that you know what is NEPHRON
Be sure that you know RENAL CIRCULATION
Formation of URINE Steps (General Aspect)
Glomerular Filtration Barrier
Glomerular Filtrate & GFR (definitions)
Starling’s Forces & Membrane Permeability
Dynamics of Glomerular Filtration
Glomerular Filtrate & Kf (definitions)
Autoregulation of GFR
Factors affecting GFR
42. Factors Affecting GFR
1. Renal Blood Flow :
42
- increase blood flow
through the nephrons →
elevates the glomerular
pressure → increases
the glomerular filtration
rate.
44. Factors Affecting GFR
2. Diameter of glomerular blood vessels:
44
i- mild constriction → increases the
glomerular pressure → increases the
Eff. Art. filtration rate.
constriction
ii- severe or moderate constriction →
decreases the glomerular flow rate →
decreases the filtration rate, because the
plasma will remain for a longer period of
time in the glomerulus → extra large
amounts of plasma will filter out →
increases the plasma colloid osmotic
pressure → paradoxical decrease in
GFR occurs despite the increase in
glomeular pressure.
45. Factors Affecting GFR
3. Factors affecting Net Filtration Pressure:
45
I. Arterial blood pressure:
-a rise in the systemic blood pressure →
an auto-regulatory mechanism (automatic
afferent arteriolar constriction) →
prevents the rise in the glomerular
pressure
II. Colloid osmotic pressure:
-Hypoproteinaemia will increase the
filtration rate.
III. Post renal obstruction makes back
pressure and increases the Bowman’s
capsule hydrostatic pressure which leads to
decreasing GFR.
46. Factors Affecting GFR
4. Factors affecting filtration coefficient (Kf):
46
I. Permeability of Glomerular capillaries
(hydrolic conductivity):
- Increase permeability of glomerular capillaries →
increases the GFR.
- Normally the permeability of the glomerular
capillaries and Bowman's capsule is absent for
substances of molecular weight higher than 70,000.
- MW:
Albumin: 70,000
Globulin: 165,000
Fibrinogen: 200,000
Hb:68,000
II- Surface area of the membrane:
if decrease, it will decrease GFR
e.g.
Chronic pyelonephritis
Chronic GN
47. The Concept Of Plasma
47
Clearance
Inulin clearance
Creatinine clearance
PAH clearance
48. 48
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