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Anatomy of The Kidney, GFR and RBF
Anatomy of The Kidney, GFR and RBF
Learning Objectives
Know the basic anatomy of the kidney and nephron.
Know how urine is transported to the bladder and
the process of micturition.
Understand the relationship between filtration,
reabsorption, secretion and excretion.
Understand the determinates of the glomerular
filtration rate (GFR).
Know how afferent and efferent arteriolar
resistances influence GFR and RBF.
Know how the juxtamedullary complex
autoregulates GFR and RBF.
Renal Anatomy
Nephron Anatomy
Transport of
Urine from
Kidney to
Bladder
Stretching of the renal
calyces induces peristaltic
contractions that spread
down the ureter and force
urine into the bladder.
The ureter is constricted
at the entrance to the
bladder due to the basal
tone of the detrusor
muscle. The constriction
prevents backflow of urine.
Peristaltic contractions in
the ureter are enhanced
by parasympathetic
stimulation and inhibited
by sympathetic
stimulation.
Micturition
Micturition is the process of emptying
the urinary bladder.
- As the bladder fills, stretch receptors
initiate the micturition reflex. This
causes contraction of the bladder,
whose strength progressively increases.
- Once the micturition reflex is stronger
than the voluntary control of the
external sphincter, urination occurs.
Innervation and
Anatomy of the
Urinary Bladder
Pelvic Nerves
Sensory nerves detect the
degree of stretch in the
bladder wall.
Parasympathetic motor
nerves then cause
contraction of the bladder.
Somatic nerves
(pedendal) that control the
voluntary skeletal muscle
of the external sphincter.
Sympathetic nerves
stimulate the bladder neck
and external sphincter
during filling (contraction).
This is inhibited during
micturition.
Micturition Reflex
Voluntary Urination
Contract abdominal muscles to
increase pressure in bladder.
This excites the micturition reflex and
inhibits the external sphincter.
Renal Handling
of Some
Substances
A. Waste products
such as creatine.
B. Many
electrolytes.
C. Nutritional
substances, such
as glucose and
amino acids.
D. Organic acids
and bases, some
foreign
compounds and
some drugs.
Purpose of Reabsorption
Why filter, then reabsorb?
- Control
- High filtration rate makes it easy to
remove waste products.
- Reabsorption allows control of the
bodys electrolyte balance.
Glomerular
Capillary
Membrane
Similar to fluid
flow at other
capillaries except,
that the pores are
larger.
Negative charge
on the 3 layers of
the capillary wall
keep negatively
charged albumin
from being
filtered.
Determinants of GFR
As we discussed with other capillaries:
- Glomerular hydrostatic pressure (PG).
- Bowmans capsule hydrostatic pressure (P B).
- Glomerular colloid osmotic pressure (PGC).
- Bowmans capsule colloid osmotic pressure (PBC).
In addition,
- Glomerular capillary filtration coefficient (K f).
- Kf is the product of the hydraulic conductivity and
the surface area.
Capillary Filtration
Coefficient
Kf is the product of the hydraulic
conductivity and the surface area.
- Hydraulic conductivity is the ease at
which H2O flows through.
Glomerular Capillary
Osmotic Pressure
PG changes during flow
through glomerular
capillary.
PG is increased by
increasing filtration
fraction and arterial
osmotic pressure.
Filtration fraction is
GFR/renal plasma flow.
Increased renal plasma
flow decreases the
filtration fraction. This
causes a slower rise in
the PG.
With a constant PG, an
increase of BF into the
glomerulus tends to
increase GFR and viceversa.
Anatomy Reminder
Autoregulation
There is a feedback mechanism that
ensures a constant delivery of NaCl
to the distal tubule.
This feedback mechanism, called
tubuloglomerular feedback, is
mediated by the macula densa in the
juxtaglomerular complex.
Juxtaglomerular Complex