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physical characteristics of the kidneys: - - wrapped in fat capsule - bean shaped - laterally convex - medial indentation 3 major processes that result in urine formation - - glomerular formation - tubular reabsorption - tubular secretion according to the myogenic regulation of GFR, an increase in BP = AAs stretch and an increase in GFR is countered by: - vasoconstriction of AA to bring GFR back down to normal Because of various endocrinological issues, your patient has been struggling with his weight for years. Though he has undergone countless lifestyle changes, including diet and exercise, he cannot seem to loose enough weight to drop out of the "morbidly obese" range. As such, he decided to undergo bariatic (stomach bypass) surgery. In preparing him for surgery, you inform him he will have to take oral forms of vit B12 to prevent pernicious anemia. Why is this? - in order to absorb vit B12 in the small intestine, intrinsic factor is needed. with stomach bypass surgery, the stomach is "bypassed" so intrinsic factor secretion from the parietal cells does not enter into the small intestine. Thus, vit B12 can not be absorbed in the small intestine and there would be a decrease in RBC production, thus causing pernicious anemia. extrinsic: hormonal - - decrease in BP and decrease in blood flow to kidneys - renin-angiotensin-aldosterone system - salt deficit - decrease blood vol - decrease blood pressure extrinsic: neural - - sympathetic nervous system- very low BP - shunt blood from kidney - SNS releases epi and norepi - vasoconstriction increases BP - constriction AA= decreased GFR and increase blood vol and BP - negative feedback of pressure glomerular filtration rate (GFR) (2 types) - - intrinsic - myogenic - tubuloglomerular feedback - extrinsic - neural - hormonal glucose is reabsorbed from the nephron lumen into the nephron cell via: - cotransport (symport) with sodium importance of intrinsic factor and B12 in RBC formation? - - intrinsic factor is necessary for B12 absorption in small intestine - vit B12 is needed for RBC - without vit B12 = vit B12 deficiency = pernicious anemia in order to micturate, the following must happen (3): - - contraction of the internal urethral sphincter - contraction of the external urethral sphincter - relaxation of the detrusor muscle intrinsic: myogenic - - increased BP causes afferent arterioles to stretch= glomerulus works faster - this causes AAs to vasoconstrict= GFR to decreaseIntrinsic: Tubuloglomerular Feedback - - GFR increases, NaCl increases bc not enough time to reabsorb - macula densa cells release vasoconstrictor chemicals= AAs constricts - this decreases GFR - negative feedback - GFR decreases, NaCl decreases bc a lot of time for reabsorption - AAs vasodilates