Renal&pulmonary_physiology.csv

regulation of water & electrolyte balance; regulation of arterial blood pressure; maintenance of acid/base balance & excretion of metabolic waste; excretion of foreign substances; regulation of red blood cell production; regulation of the active form of vitamin D

cortex; medulla; minor calyx; major calyx; renal pelvis

filtration - barrier between inside and outside world; allows small molecules & water through to filtrate while preventing exit of red blood cells & proteins from the blood

reabsorption; most water and salt absorption takes place here

creation of concentration gradient in kidney medulla

fine-tuning of absorption/secretion

glomerulus (cortex) -> proximal convoluted tubule (cortex) -> proximal straight tubule (outer medulla) -> thin descending loop of Henle (outer medulla) -> thin ascending LOH (inner medulla) -> thick ascending LOH (outer medulla) -> juxtoglomerular apparatus (cortex) -> distal convoluted tubule (cortex/outer medulla) -> connecting segment (cortex) -> cortical collecting duct -> medullary connecting duct

peritubular capillaries (proximal tubule); vasa recta (lie parallel to loop of Henle)

endothelial; mesangial; podocyte

fenestrated; line the capillaries of the glomerulus; comprise first layer of filtration (very broad; allows entry of many substances)

found in the central part of the glomerulus between capilary loops; produce negatively charged basement membrane (2nd layer of filtration -> charge filtration)

"comprise 3rd and most selective layer of filtration; have processes (""fingers"") that extend into basement membrane; thin processes called slit diaphrams bridge gaps between ""fingers"""

hydrostatic & plasma oncotic & capsular hydrostatic pressure and resistance (flow = pressure difference/resistance); afferent arteriole slightly larger than efferent arteriole -> increased pressure

the amount of blood filtered from the capillary into the glomerular capsule; is directly proportional to net filtration pressure (GFR = Kf * NFP)

by 3 mechanisms: autoregulation (mediated by vascular smooth muscle tone of arterioles) & autonomic regulation from the CNS -> regulation of blood flow & tubuloglomerular feedback -> regulation of blood flow or mesangial cell size

antidiuretic hormone (vasopressin); released by the pituitary gland; overall - concentrates urine; increases water permeability of cells in the collecting duct; enhances urea transport to the interstitium; increases sodium uptake in the thick ascending loop of Henle

mineral corticoid; responsible for salt and water reabsorption; secreted by the adrenal glands; decreases plasma sodium and increases plasma potassium/ACTH/angiotensin II; when bound to receptor -> translocation to nucleus of collecting duct cell -> action as a transcription factor

receptor found in cells of the collecting duct; ADH binding activates a cascade that causes translocation to the membrane; permeable to water

can interact with other steroid hormones; enzyme 11-beta-HSD decreases affinity of other steroids to the receptor

the process of sodium excretion; leads to increased water excretion; regulates blood pressure and volume

the process of water excretion; regulates blood pressure and volume

smooth muscle cells found in the afferent arterioles of the glomerulus; act as baroreceptors; synthesize and secrete renin

portion of the thick ascending limb in close contact with the glomerulus; acts as a sodium sensor; influences renin production to regulate blood pressure

baroreceptors in the CNS assess blood pressure and act via the renal sympathetic nerve to affect renin production

enzyme produced by granular cells in response to low blood pressure; act on angiotensinogen to convert angiotensin I to angiotensin II

increases blood volume by acting directly on arteriolar/vascular smooth muscles to increase cardiac output & increasing sympathetic CNS activity & stimulating the pituitary to release ADH & stimulating the release of aldosterone

contains less solute than surrounding fluid (less osmotic pressure)

contains more solute than surrounding fluid (more osmotic pressure)

includes trachea & bronchi & bronchioles; involved in warming & humidifying air; protects airway through actions of cilia and mucous; no respiratory exchange takes place

includes respiratory bronchioles & alveoli; involved in gas exchange

dead space = volume of air that does not contribute CO2 to expired air; can calculate using Bohr equation (knowing volume of exhaled air and partial pressure of CO2 in alveoli)

total lung capacity; can be determined using helium dilution of exhaled air

tidal volume (amount inhaled/exhaled in a normal breath); use spirometer

vital capacity (amount of air one is able to expel in a full forceful breath); use spirometer

functional residual capacity (volume left in the lungs after a normal breath); can be determined using helium dilution of exhaled air

residual volume (volume left in the lungs after a forceful exhalation); can be determined using helium dilution of exhaled air

increased alveolar ventilation -> increased O2; decreased V -> decreased O2

increased alveolar ventilation -> decreased CO2; decreased AV -> increased CO2

quiet breathing: inspiration - external intercostals contract & raise ribs; diaphragm contracts and lowers. Forceful breathing: inspiration - sternocloidomastoids as well; expiration - internal intercostals & abdominal muscles

keeps alveoli from collapsing

pressure = (2*surface area)/r

increases lung compliance by decreasing surface tension of fluid

decreases the surface tension of fluid in order to decrease pressure on the alveoli/decrease resistance

compliance work against elastic tissues & surface tension of the lung

tissue-against-tissue sliding; air through airways

the partial pressure of a hypothetical gas phase with which the liquid would be in an equilibrium state

affinity drops under increased temperature & increased acidity & increased partial pressure of CO2 & increased levels of 2 3 diphosphoglycerate (increases during anaerobic glycolysis) - anything requiring release of O2 from hemoglobin

combined with hemoglobin & dissolved

dissolved in blood; combined with protein as carbamino compounds; combined with water to form bicarbonate ions (90%)

average output of CO2 divided by the average intake of O2; under normal conditions is about 80%

pH = 6.1 +(log[HCO3])/(0.03 x pCO2)

metabolic acidosis = HCO3- levels are too low; alkalosis = HCO3- levels are too high

respiratory acidosis = CO2 levles are too high; alkalosis = CO2 levels are too low

most bicarbonate is reabsorbed in the proximal tubule; bicarbonate can be regenerated in the Type A intercalated cells of the collecting duct

Type A intercalated cells of the proximal tubule involved in secretion of hydrogen ions (bicarbonate reabsorbed -> interstitium and H+ -> lumen); bicarbonate regenerated using phosphate or ammonia as proton acceptors

Type B intercalated cells of the proximal tubule involved in secretion of base (release bicarbonate -> lumen and H+ -> interstitium via H+/K+ pump)

contributes about 50% of interstitial osmolarity at tip

in healthy people - shunts 1-2% blood from the right to the left ventricle without making contact with alveolar air; teratology of Fallot is an inappropriate R-to-L shunt (results in right-left septal defect & right ventricle -> aorta defect & stenosis of pulmonary artery & hypertrophied right ventricle)

max=25; min=8; average = 15

max=120; min=75

much lower resistance to blood flow in pulmonary vs. systemic blood vessels

mechanism to reduce resistance in the pulmonary capillaries in order to deal with increases in cardiac output; recruitment = allowing blood to flow through more (normally bypassed) capillaries; distension = increasing radius of capillaries

zone I = alveolar pressure greater than arterial and venous (pathological); zone II = alveolar pressure is less than arterial but greater than venous (blood flows in pulses) - top of heart; zone III = alveolar pressure lower than arterial and venous (blood flow continuous) - most of heart

perfusion & ventilation = greater @ bottom of lung due to gravity; pressure = higher; alveoli = smaller

central chemoreceptors = in brainstem; peripheral chemoreceptors = in aortic arch and @ bifurcation of carotid artery

central - detect CO2 via pH changes in CSF; peripheral - detect O2 & CO2 & pH (carotid receptors only)

pons/medulla = vasomotor region

slowly adapting stretch receptors in large & small airways (respond to lung inflation -> prevention of overinflation); rapidly adapting receptors in airways (respond to mechanical/chemical irritation ->cough/bronchoconstriction); J-receptors in alveolar walls (respond to pulmonary embolism/vascular congestion -> tachypnea & dyspnea)

the difference between the transpulmonary pressure vs. volume curve for inhalation and exhalation (volume is less for a given pressure durng inhalation vs. exhalation)

rapid shallow breathing

sensation of shortness of breath