《基础医学各论II》课件：泌尿系统生理学1.pdfVIP

Kidney Physiology Liang Huawei, Ph.D. E-mail: liang.huawei@ Overview – Functions of the Kidney Regulation of body fluid osmolality Production of hormones: Erythropoietin, Kinins and Renin, Prostaglandins ，1,25- dihydroxycholecalciferol Regulation of electrolyte and water Excretion of waste products Regulation of acid and base Structure of the Kidney Nephron Renal corpuscle - Glomerulus - Bowman’s capsule Renal tubular system Proximal convoluted tubule Loop of Henle - Decending limb - Ascending thin limb - Ascending thick limb Distal convoluted tubule Collecting duct system Types of the Nephron Cortical nephron 皮质肾单位 Juxtamedullary nephron 近髓肾单位 Differences between the Nephrons Size Number in A.A / E.A Renin percentage in diameter production Cortical nephron small 80 to 90 2:1 yes Juxtamed.. nephron big 10 to 20 1:1 or 1:1+ no Juxtaglomerular Apparatus 近球小体 Juxtaglomerular cells 近球细胞 Renin-producing granular cells Macula densa 致密斑 Extraglomerular mesangial cells (Mesangial cell) 间质细胞 Blood Supply of the Kidney 肾脏的血液供应 1200 ml/min, 20 % of the cardiac output Cortex: 94 % Outer medulla: 5-6 % Inner medulla: 1 % Autoregulation of Renal Blood Flow 肾脏血液供应的自身调节 Range of regulation BP: 80 ~ 170 mmHg Mechanisms Myogenic mechanism Flow dependent mechanism (Tubuloglomerular feedback) Myogenic mechanism 肌源学说 Arterial blood pressure ↑ → contraction of the vascular smooth muscle → constriction of the blood vessel →the blood flow relatively constant Tubuloglomerular feedback