The document is a lecture on renal physiology and urine formation by Dr. Ayub Abdulcadir Sheikh. It contains 14 pages covering the following topics:
- An introduction to the urinary system and nephron anatomy.
- Nerve supply and mechanism of micturition.
- Glomerular filtration rate and the glomerular filtration barrier.
- Tubular reabsorption and secretion mechanisms along different parts of the nephron.
- Formation of dilute and concentrated urine depending on water content and ADH levels.
- Acidification of urine through intercalated cell function.
- Control of extracellular fluid osmolarity and electrolyte
# Diluting & Concentrating of urine. plus Acidification of Urine.
# what will happen if body water increased or decreased the role of collecting and distal convulated tube.
# Diluting & Concentrating of urine. plus Acidification of Urine.
# what will happen if body water increased or decreased the role of collecting and distal convulated tube.
# Tubular reabsorption along part's of nephron.
# Tubular reabsorption is the most important because it's selective.
# Every cells in the nephron has a special charecteristic and mechanism of reabsorption.
# a breif detail about the anatomical and physiological of kidney.
# micturation reflex (the role of sympathetic, parasympathetic, and somatic nerves).
# the process of urine formation "filtration, reabsorption, secretion, and excretion".
KIDNEY IS A VITAL ORGAN IN HUMAN BEINGS. EVERY HUMAN HAS A PAIR OF KIDNEYS WHICH HELP TO EXCRETE OUT WASTE PRODUCTS FROM THE BODY IN THE FORM OF URINE...
URINE IS FORMED IN KIDNEY BY THREE STEPS WHICH ARE
(1) FILTRATION.
(2) ABSORPTION
(3) SECRETION
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
Loop of Henle with its complex anatomy and even more complicated physiology has long remained an enigma to researchers all around the world. Here we discuss about the functional anatomy and the transport characteristics of Loop of Henle.
- Introduction
- Normal anatomy of kidney
- Nephron
- Juxtaglomerular apparatus
- Clearance
- tubular function
- Regulation of water and ion reabsorption
- Types of water reabsorption
- Mechanism of urine concentration and dilution
- Countercurrent mechanism
# Tubular reabsorption along part's of nephron.
# Tubular reabsorption is the most important because it's selective.
# Every cells in the nephron has a special charecteristic and mechanism of reabsorption.
# a breif detail about the anatomical and physiological of kidney.
# micturation reflex (the role of sympathetic, parasympathetic, and somatic nerves).
# the process of urine formation "filtration, reabsorption, secretion, and excretion".
KIDNEY IS A VITAL ORGAN IN HUMAN BEINGS. EVERY HUMAN HAS A PAIR OF KIDNEYS WHICH HELP TO EXCRETE OUT WASTE PRODUCTS FROM THE BODY IN THE FORM OF URINE...
URINE IS FORMED IN KIDNEY BY THREE STEPS WHICH ARE
(1) FILTRATION.
(2) ABSORPTION
(3) SECRETION
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
Loop of Henle with its complex anatomy and even more complicated physiology has long remained an enigma to researchers all around the world. Here we discuss about the functional anatomy and the transport characteristics of Loop of Henle.
- Introduction
- Normal anatomy of kidney
- Nephron
- Juxtaglomerular apparatus
- Clearance
- tubular function
- Regulation of water and ion reabsorption
- Types of water reabsorption
- Mechanism of urine concentration and dilution
- Countercurrent mechanism
AnswerKidneys are the functional units of renal system of rom uri.pdfaquacareser
Answer:
Kidneys are the functional units of renal system of rom urine and it is essential to maintain
homeostasis. Blood is going to enter into the kidney through renal arteries followed by entry of
afferent arterioles into the \"glomerulus of nephrons\" & leave the filtrate (according to
concentration gradient) finally exists as efferent arteriole
Kidneys are the major organs of urinary system. The filtration of blood takes place in the kidneys
through the nephrons. Two ureters carry the urine from the kidneys to the urinary bladder. From
the bladder, urine is excreted out through the urethra. Relatable analogy is presence of \"similar
ureters\" and two bean shaped kidenys with nephrons
The different stages in glomerular filtration or urine formation are.
Filtration: The movement of water and solutes from the plasma into the renal tubules is known as
filtration. The major driving force of the filtration is hydrostatic pressure in the glomerulus
capillaries.
Blood passes through the capillaries in the glomerulus, due to the hydrostatic pressure in the
Bowman’s capsule, plasma is filtered into the Bowman\'s capsule except blood proteins (this is
called ultra-filtration). This filtrate is called glomerular filtrate. Hydrostatic pressure is the
pressure exerted by the filtrate in Bowman\'s capsule (15 mm Hg).
Absorption (or reabsorption):
It is the movement of water and solutes from the renal tubule into the plasma. The process of
absorption mostly occurs in the proximal tubules (approximately 70% of the filtrate is
reabsorbed from the proximal tubules). The process of reabsorption is driven by hydrostatic and
oncotic pressure, which is strictly under hormonal regulation.
Oncotic pressure is the pressure exerted by the blood proteins, which draws water in to the
circulation.
Secretion:
Tubular reabsorption of water and other substances back to the blood occur while the glomerular
filtrate passes through the tubular portion of nephron. About 99% of water and electrolytes are
reabsorbed during this process by both active and passive reabsorption process. During tubular
secretion, substances pass from the blood into renal tubules.
Excretion:
Urine from the renal tubules enter into the collecting duct à Papillary duct à Calyx à Renal pelvis
à Ureters à Urinary bladder à Urethra (excreted out of the body.).
Normal glomerular filtration rate in the Bowman’s capsule is from 90 to 120 ml / min/1.73 m2.
Usually older people do have a bit lower normal GFR levels as it is naturally reduce with age.
Given GFR is 35mL/min/1.73 m2 (moderate decrease), it tells about the patient’s kidney
function that “a sign of chronic kidney disease” because of diabetes, high blood pressure
followed by glomerulonephritis. It is better control blood pressure by hormonal release.
The three stages of urine formation are 1. Filtration; 2. Tubular reabsorption & secretion; 3.
Water conservation
Glomerular filtration (GFR):
The formation of urine includes
1. Glomerular filtration
.
AnswerKidneys are the functional units of renal system of rom uri.pdfaquapariwar
Answer:
Kidneys are the functional units of renal system of rom urine and it is essential to maintain
homeostasis. Blood is going to enter into the kidney through renal arteries followed by entry of
afferent arterioles into the \"glomerulus of nephrons\" & leave the filtrate (according to
concentration gradient) finally exists as efferent arteriole
Kidneys are the major organs of urinary system. The filtration of blood takes place in the kidneys
through the nephrons. Two ureters carry the urine from the kidneys to the urinary bladder. From
the bladder, urine is excreted out through the urethra. Relatable analogy is presence of \"similar
ureters\" and two bean shaped kidenys with nephrons
The different stages in glomerular filtration or urine formation are.
Filtration: The movement of water and solutes from the plasma into the renal tubules is known as
filtration. The major driving force of the filtration is hydrostatic pressure in the glomerulus
capillaries.
Blood passes through the capillaries in the glomerulus, due to the hydrostatic pressure in the
Bowman’s capsule, plasma is filtered into the Bowman\'s capsule except blood proteins (this is
called ultra-filtration). This filtrate is called glomerular filtrate. Hydrostatic pressure is the
pressure exerted by the filtrate in Bowman\'s capsule (15 mm Hg).
Absorption (or reabsorption):
It is the movement of water and solutes from the renal tubule into the plasma. The process of
absorption mostly occurs in the proximal tubules (approximately 70% of the filtrate is
reabsorbed from the proximal tubules). The process of reabsorption is driven by hydrostatic and
oncotic pressure, which is strictly under hormonal regulation.
Oncotic pressure is the pressure exerted by the blood proteins, which draws water in to the
circulation.
Secretion:
Tubular reabsorption of water and other substances back to the blood occur while the glomerular
filtrate passes through the tubular portion of nephron. About 99% of water and electrolytes are
reabsorbed during this process by both active and passive reabsorption process. During tubular
secretion, substances pass from the blood into renal tubules.
Excretion:
Urine from the renal tubules enter into the collecting duct à Papillary duct à Calyx à Renal pelvis
à Ureters à Urinary bladder à Urethra (excreted out of the body.).
Normal glomerular filtration rate in the Bowman’s capsule is from 90 to 120 ml / min/1.73 m2.
Usually older people do have a bit lower normal GFR levels as it is naturally reduce with age.
Given GFR is 35mL/min/1.73 m2 (moderate decrease), it tells about the patient’s kidney
function that “a sign of chronic kidney disease” because of diabetes, high blood pressure
followed by glomerulonephritis. It is better control blood pressure by hormonal release.
The three stages of urine formation are 1. Filtration; 2. Tubular reabsorption & secretion; 3.
Water conservation
Glomerular filtration (GFR):
The formation of urine includes
1. Glomerular filtration
.
1 . EXCRETION
Waste product removal e.g. nitrogenous – uric acid (mammals urea , fish ammonia)
Kidneys – secrete uric acid (product of protein metabolism)
Gastro-intestinal tract secretions e.g. bile
No sweat glands
Salt glands (water birds)
Water loss – lungs
2. URINARY SYSTEM
• Major organs are the kidneys, the ureter and the cloaca.
• No urinary bladder in bird.
3 . ANATOMICAL STRUCTURE OF KIDNEY
Avian kidneys are paired fitted closely the bony depression on the dorsal wall of the pelvis . Each kidney is divided into three lobes.
4 .
5 . NEPHRON
Two kinds of nephrons.
1. Reptilian nephron
2. Mammalian nephron
• 6 .
• 7. DIFFERENCE BETWEEN AVIAN AND MAMMALIAN KIDNEY
8. RENAL PORTAL SYSTEM
Uric acid is formed in the liver as well as the kidneys of the birds from ammonia, which is the most toxic protein metabolic by product .
9. GLOMERULAR FILTRATION
Fluid pressure forces water and dissolved substances from glomerular blood to Bowman’s capsule .
Filtration averages 125 ml/min form two kidneys.
10 . TUBULAR REABSORPTION
Return of the useful substances from the filtrate to the blood capillaries or interstitial fluid.
11 . COUNTER CURRENT MECHANISM
This mechanism works in the loop of henle to increase water reabsorbed from the descending limb as a result of salt reabsorbed from the ascending limb .
12 . POST RENAL URINE MODIFICATION
After the presentation of urine to cloaca their might be retrograde flow or backward flow of urine into the colon.
In the colon reabsorption of excessive amount of water as well as sodium ion takes place.
13 . HORMONES RESPONSIBLE FOR URINE FORMATION
Arginine vasotocin ,Angiotensin ׀׀ ,Aldosterone ,ANP (arterial natriuretic peptide)
Aldosterone is responsible for the reabsorption of sodium and excretion of potassium in the filtrate.
Common medication used for anesthesia, there action; dosage; adverse effect; duration of action.
They Include {inhalation + Induction + Muscle relaxant + Anticholinergic + Analgesic + Resuscitation}
in this presentation lecture we gone take a hypo and hyper thyrodism that affect the human cell because both situation may increase or decrease the basal metabolic rate.
When the pituitary Gland it' s function is increased whether the cause are?
Both anterior and Posterior gland secretions are increased the most causes are ADENOMAS
in this presentation you will be learn the different drug form that all medical health workers prescribing the medication.
the medical student should have a good knowledge and keep in mind these drug forms based on medical administration the drugs are classified into invasive (injection and transdermal implantation) and non invasive (oral, inhalers, suppository)
Medical equipment and tools are crucial to saving a person's life or performing any procedure.
i presented here the most and commonly equipment used by medical student to improve their skills
This note paper is short notes of general physiology for medical students who which to understand the concept of the physiology, physiology is the mother of medicine.
A summary of skeletal muscle contraction and relaxationAyub Abdi
it consist for 4 pages and cover all the steps that occur during muscle contraction and relaxation, I does not take a time just 5 minute is enough to read. I hope it's interesting.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Dr: Ayub Abdulcadir Sheikh:
Postgraduate MBBS, at University of Somalia.
Resident physician at Sureya Medical Center.
A lecturer physiology at Frontier University.
Dedication:
To all my family especially may parents (Allah may bless you), also my student
in frontier university.
3. TABLE OF CONTENTS
1. Introduction to Urinary system ………………………......……………..……….……. 1
2. Nerve Supply of Urinary Bladder & Sphincter + Micturition ………..….…….…… 2
3. Glomerular Filtration Rate ……………………………………………………….....… 3
4. Tubular Reabsorption & Secretion ……………………………….……….……… 4 – 7
5. Formation of Dilute and Concentrated Urine …….….………………………...…..… 8
6. Acidification of Urine ……………………………………………………….….…….. 11
7. Control of Extracellular Fluid Osmolarity & Regulation of Electrolytes …… 12 – 14
4. Page | 1
The Kidneys: are 2 pairs of cone shaped structure.
The Function of Renal system:
1. Excretion of metabolic waste products and foreign chemicals.
2. Regulation of water and electrolyte balances
3. Regulation of bodyfluid osmolality and electrolyte concentrations.
4. Regulation of arterial pressure.
5. Regulation of acid-base balance.
6. Regulation oferythrocyte production.
7. Secretion, metabolism, and excretion of hormones
Gluconeogenesis.
Nephron:
A) The functional and structural
of the kidney.
B) Types of nephron:
Cortical nephron.
Juxtamedullary nephron.
C) Parts of nephron:
Renal corpuscle.
Renal tubules.
The renal circulation:
1- The glomerular Capillaries (High hydrostatic pressure = about 60
mm Hg, causes rapid fluid filtration).
2- The peritubular capillaries (lower hydrostatic pressure = about 13
mm Hg) permits rapid fluid reabsorption).
5. Page | 2
NERVE SUPPLY TO URINARY
BLADDER AND SPHINCTERS::
1. Sympathetic (Hypogastric) nerve - (Nerve of
Filling).
2. Parasympathetic (pelvic) nerve - (Nerve of
Empyting).
3. Somatic (Pudendal) nerve.
Micturition: is the process by which the urinary
bladder empties when it becomes filled.
Mechanism Action of micturation (Uniration):
1. Increased extracellular fluid volume causes the kidney to excrete the water.
2. Then sympathetic nerve fiber causes relaxation of detrusor muscle of urinary bladder & constricts
the internal sphincter.
3. This leads the urine to flow a drop by drop until the bladder is fully filled with urine.
4. The pressure inside the bladder increased.
5. Firing the stretch receptor (parasympathetic sensory) in the bladder and generation of impulses.
6. Transmission of impulses to the spinal cord then to the brain.
7. The responses will stimulate both the parasympathetic motor to the bladder and somatic nerve
leads.
8. To contraction the detrusor muscle and relaxation of internal sphincter + relaxation of external
sphincter.
9. Now the urine will outside the body.
URINE FORMATION RESULTS FROM
6. Page | 3
Glomerular filtration rate: Amount of plasma
filtered by glomerular capillaries into Bowman’s
capsule per minute.
Normal GFR—125 mL/min (range 90–140mL/min)
or 180 L/day.
A high GFR is that it allows the kidneys to rapidly remove
waste products from the body that depend mainly on
glomerular filtration for their excretion.
The high rate of glomerular filtration depends on:
1- A high rate of kidney blood flow.
2- The special properties of the glomerular capillary
membranes.
• Filtration fraction: is the fraction (portion) of the
renal plasma, which becomes the filtrate.
Glomerular filtration
barrier or GLOMERULAR
CAPILLARY MEMBRANE:
1. Endothelium of the
capillary.
2. Basement membrane.
3. Epithelial cells of
podocytes.
Negatively charged large molecules are filtered less.
Positively charged molecules are filtered much more.
Small molecular weights are more filtered.
Autoregulation: is the intrinsic ability of an
organ to regulate its own bloodflow.
Two mechanisms are involved in renal
autoregulation:
1. Myogenic response.
2. Tubuloglomerular feedback.
Myogenic autoregulation:
1. Increased arterial blood pressure &increased GFR then
2. Vascular wall stretch causes
3. More calcium will enter vascular smooth muscle cell and
contraction.
4. Decreased blood flow& decreased GFR.
7. Page | 4
Tubular reabsorption is highly selective.
Glomerular filtration is non-selective.
Tubular reabsorption plays a much
more important role than tubular
secretion.
Pathways of tubular reabsorption:
1. Transcellular route.
2. Paracellular route.
3. Ultrafiltration(bulk flow).
Factors that causes substance transportation:
1. Primary Active Transport: (Energy is ATP) example
“Na-KATPase, H ATPase, Ca ATPase.
2. Secondary Active Transport: ( Energy is concentration
gradient) example “Na-Glucose symport.
3. Pinocytosis: (Active transport) example “Reabsorption
of protein”.
4. Transport Maximum: a limit to the rate at which the
solute can be transported.
5. Gradient-time transport: time that the fluid containing
the substance remains within the tubule & its
electrochemical gradient.
Secondary Active Secretion
into the Tubules.
Example: (sodium-hydrogen
exchanger)
8. Page | 5
REABSORPTION AND SECRETION ALONG DIFFERENT
PARTS OF THE NEPHRON:
Proximal Convoluted Tube:
Substance that reabsorbed:
Nutrients (Gkucose, Amino Acids).
Electrolytes (Na, K, Ca, Cl, Po, Hco3).
Water.
Urea & Uric Acid.
Substances that secreted:
1. Bile salts,Oxalates, Urate, Para-
aminohippuric acids.
2. Drugs.
3. Toxins.
Loop of Henle:
Thin descending segment.
Thin ascending segment.
Thick ascending segment.
Thin descending segment:
Substances that reabsorbed:
1. Highly reabsorbed water.
2. Moderate reabsorption of Na &
urea.
Thin ascending segment:
Low reabsorption of water &
Solutes.
Thick ascending segment:
Water does reabsorb this segment.
Substances that reabsorbed:
Highly and active reabsorption of Na, Cl, K, Ca,
Mg, Hco3.
Has 4 mechanism for reabsorption of
substances:
A. Na-K ATPase.
B. 1Na, 2Cl, 1K cotransporter – X “Loop
diuretics”.
C. Na-H counter transporter.
D. Paracellular reabsorption of cations (Mg,
Ca, Na, K).
Substances that secreted:
H ions by Na-H conter transporter.
9. Page | 6
Distal Convoluted Tube:
2 portion:
1. Macula densa (Tubuloglomerular
feedback).
2. Highly convoluted tube.
Types of convoluted tube:
A. Early distal convoluted tube.
B. Late distal convoluted tube.
Collecting Tube:
Has 2 portion:
Cortical collecting tube.
Medullary collecting tube.
Cortical collecting duct.
Cortical collecting and distal convoluted
has 2 cells:
Principle cells:
Reabsorption of Na and water from the
lumen – Na channel blockers.
Secretion of K ions into the lumen –
Aldesterone antagonists.
Intercalated cells:
Have 2 cells that regulate acid-base
balance.
Type A:
Secretion of H ions by “H ATPase, H-K
ATPase” and Reabsorption of HCO3.
Type B:
Secretion of HCO3 by “Cl-HCO3
exchanger”.
Medullary collecting ducts:
Substances that reabsorbed:
1. Reabsorption of Na, Cl, Urea.
2. Reabsorption of water caused by
ADH.
3. Reabsorption of HCO3.
Substances that secreted:
1. H ions against concentration
gradient.
11. Page | 8
Osmolarity of glomerular filtrate is same
as that of plasma and it is 300 mOsm/L.
Dilute Urine = 50 – 90 mOsm/L.
Concentrated Urine = 1,200 mOsm/L.
Osmolarity of urine depends upon two factors:
1. Water content in the body.
2. Antidiuretic hormone (ADH).
Formation of Dilute Urine:
Increased body water causes (increased
ECF volume).
1. The osmolarity of fluid in proximal CT is
300 mOsm/L.
2. As fluid descends more its osmolarity
increased step by step due to more water
reabsorbed).
3. Now the fluid in the loop of henle is mush
concentrated up to 1,200 mOsm/L due to
more water reabsorbed.
4. As fluid ascends its osmolarity decreased
up to 100 mOsm/L in the distal CT, it’s
due to more of reabsorption NaCl and
other electrolytes.
5. In the absence of ADH hormone there is
active excretion of water and
reabsorption of additional NaCl.
6. Now the fluid osmolarity is 50-60
mOsm/L.
Formation of Concentrated Urine:
Decreased body water causes (decreased
ECF volume).
1. The osmolarity of fluid in proximal CT is 300
mOsm/L.
2. As fluid descends more its osmolarity
increased step by step due to more water
reabsorbed).
3. Now the fluid in the loop of henle is mush
concentrated up to 1,200 mOsm/L due to
more water reabsorbed.
4. As fluid ascends its osmolarity decreased up
to 100 mOsm/L in the distal CT, it’s due to
more of reabsorption NaCl and other
electrolytes.
5. In the presence of ADH hormone there is
active reabsorption of water and excretion
of NaCl.
6. Now the fluid osmolarity is 1200
mOsm/L.
7.
FACTORS THAT CAUSES FORMATION OF
CONCENTRATED URINE:
A) Development and maintenance of medullary
gradient by countercurrent system.
Countercurrent system is subdivided into:
Countercurrent multiplier formed by loop of
Henle.
1. Active reabsorption of sodium chloride.
2. Reabsorption of sodium from collecting duct.
3. Recirculation of urea.
Countercurrent exchanger formed by vasa
recta.
B) Secretion of ADH.
15. Page | 12
Control of Extracellular Fluid Osmolarity, and
Regulation of Electrolytes:
Regulation ofextracellular fluid osmolarity and sodium
concentration are closely linked.
Two primary systems are especially involved in regulating the
concentration of sodium and osmolarity of extracellular fluid:
1. The osmoreceptor-ADH system.
2. The thirst mechanism.