1 The main purpose of the kidneys is ALWAYS to regulate what? The blood.

2 Define renal fraction. The percentage of blood flow that passes through the kidney each minute.
3 What is NORMAL renal fraction? Average is 21 percent.
4 What makes up the filtration membrane? Podocytes and capillary walls. (Whatever separates the
blood from the filtrate.)
5 Whats the purpose of podocytes? They reduce capillary permeability, so we dont lose proteins.
6 Define filtration fraction. Percentage of the plasma in the renal fraction that becomes filtrate.
7 What is NORMAL filtration fraction? Around 20 percent.
8 (2 point question, because he described it two ways!) Define Net Filtration Pressure. The amount of
force I am pushing with in order to get a solution through its filtration membrane. The net difference
between forces out and forces in at the glomerular capillaries.
9 (5 point question!) What are the three forces at work in Net Filtration Pressure? Where is each force
working? Glomerular hydrostatic pressure, which is the force of the blood moving out of the glomerulus;
glomerular osmotic pressure, which is the pulling pressure trying to keep fluid inside the glomerulus;
and capsular hydrostatic pressure, which is the pressure of the filtrate within the Bowmans capsule,
pushing back upon the glomerulus.
10 What is the only reason filtrate moves? Because Im making more filtrate at the filtration membrane.
11 Define glomerular filtration rate. The volume of filtrate produced per minute. (rate of filtration
formation.)
12 What is average GFR? 125 ml/minute, or 180 L/day.
13 What does GFR determine? It determines the rate at which filtrate travels through the nephron.
14 How do we regulate GFR? GFR depends on NFP. If you raise NFP, you also raise GFR.
15 What happens if GFR is too high? Filtrate zips through the nephron and I wont have time to reabsorb
everything I need to.
16 What happens if GFR is too slow? I can reabsorb things I didnt need or want.
17 Changes in what will alter NFP and therefore GFR? Glomerular hydrostatic pressure or glomerular
osmotic pressure.
18 Whats the normal percentage by which flow rate can change? +/- 30 percent.
19 (5 point question!) What if you hemorrhage? BP drops, so NFP drops, so GFR drops. So filtrate moves
slower, and I reabsorb more water. Urine volume would decrease and concentration would increase. A
few waste products would be reabsorbed, but no big deal.
20 Whats the basic difference between intrinsic & extrinsic controls? Extrinsic controls consider the
needs of the body and can override the intrinsic controls. Intrinsic controls regulate the kidney without
regard to the rest of the body.

21 Whats the myogenic mechanism? What does it do? Its part of the intrinsic controls. If systemic BP
increases, this mechanism reduces the diameter of afferent arterioles to resist that higher pressure.
22 Whats the OTHER Intrinsic control? What does it do? The tubuloglomerular feedback mechanism.
Macula densa cells of the JGA sample filtrate @ top of the loop of Henle for sodium chloride
concentration.
23 If the macula densa cells find too much sodium, what do we know about the flow rate? It was too
fast. We didnt have enough time to reabsorb all the NaCl.
24 (5-point question!) Once macula densa cells know whats up with the NaCl level, how do they adjust
to compensate for it? If flow was too fast and we need to constrict the afferent arterioles, theyll release
ATP. If flow was too slow and we need to dilate the afferent arterioles, theyll back off ATP release.
25 When do extrinsic controls take over in the kidneys? When we need to override the intrinsic controls;
F/F, hemorrhage, etc.
26 (4 points) What happens when extrinsic controls take over? Sympathetic stimulation contricts
arterioles, (esp. skin, digestive organs and kidneys); Epi & norepi constrict afferent arterioles @ kidneys;
low BP in glomeruli initiates the renin-angiotensin mechanism.
27 When is it the priority of the kidney to regulate the concentration and volume of urine? NEVER!!!!
28 Osmoreceptors in the where respond to what? Hypothalamus, osmolarity.
29 Whats the name for the way we maintain a hypertonic ISF @ the kidney? The countercurrent
multiplier and exchanger.
30 How do we control urine output? By reabsorbing water from our filtrate.
31 Whats different about the blood vessels that surround the loop of Henle? They do not pick up the
sodium and chloride we reabsorbed. They just feed the cells of the loop of Henle.
32 What is diuresis? Urine production.
33 How do we adjust diuresis? By adjusting reabsorption of electrolytes and water from filtrate in the
DCT and the collecting tubule. Most changes are made by ADH and aldosterone.
34 What are the two types of diuretics? Those that inhibit reabsorption of sodium and chloride, and
therefore water, and those that act as osmotics.
35 What are the three chemical buffer systems? Protein, bicarb and phosphate.
36 What are the three ways we adjust pH? Chemical buffers, respiratory adjustment and renal
adjustments.
37 Where is the phosphate buffer system most influential? In the ICF inside cells, and in urine.
38 What do chemical buffers do to pH? They minimize its effect. pH still changes, just less dramatically.
39 What exactly is happening to free hydrogen when were blowing off CO2? Free hydrogen
disappears as it recombines with bicarb.

40 What do kidneys usually do with free hydrogen? Secrete it.

41 When sodium is reabsorbed, what is secreted? Either hydrogen or potassium.
42 What is secreted into filtrate to buffer free hydrogen? Ammonia (NH3).
43 If your patients urine pH is less than 6, what do you know must have recently been true about him?
Must have been in acidosis.
44 What is the normal pH range for urine? 6-7, with extremes of 4.5-8
45 If you are hyperkalemic, where is the potassium too high? Outside the cell.
46 What two tissues are especially sensitive to potassium levels? Cardiac muscle and the brain.
47 What happens in the brain when potassium is low? Seizures can happen.
48 What happens to the heart if potassium is high OR low? You can have weak contractions and
arrhythmias.
Whats the major effect of acidosis? Depression of CNS.
Whats the major effect of alkalosis? Hyperexcitablity of the CNS.
What does ABG stand for? Arterial blood gases.
Whats normal range for Pco2?