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An elderly female patient has had osteoporosis, DM II, hypertension. She…

- - - - Relative position of nephron in cortex
      - Length of loop
    - - Oriented with renal corpuscles near peripheral cortex
      - Have short nephron loop, just penetrating medulla
      - Bulk residing within cortex
      - 85% of nephrons
    - - Renal corpuscles adjacent to corticomedullary junction
      - Long nephron loop extending into medulla
      - Play important role in kidneys ability to produce concentrated urine
  - - - Blood entering by afferent arteriole
      - Exit by efferent arteriole
    - - Has internal permeable visceral layer
        
        Directly overlies glomerular capillaries
      - External impermeable parietal layer
        
        Composed of simple squamous epithelium
      - Capsular spaces between the 2 layers
        
        Receives filtrate, modified to form urine
  - - - Originates at tubular pole of renal corpuscle
      - Lined by simple cuboidal epithelium
      - Has microvilli increasing surface area and reabsorption capacity
    - - Connect at a "hairpin turn" within the medulla
      - Ling changes from simple cuboidal epithelium to simple squamous then back to simple cuboidal
    - - Originates in renal cortex at end of descending limb
      - Extended to collecting duct
      - Lined by simple cuboidal epithelium with microvilli
- - - - Consists of renal corpus and renal tubule
    - - Nephron drainage: each nephron drains into collecting ducts
        
        Ducts project medially towards renal papilla
        
        Ducts fuse together and deliver urine into minor calyces
      - Specialized cells in collecting ducts
        
        Principal cells
        
        Responsive to aldosterone and antidiuretic hormones
        
        Responsible for maintaining body's water and sodium balance
        
        Intercalated cells (types A & B)
        
        Both specialized epithelial cells
        
        Help regulate urine pH and blood pH
- - - - Filtration: in glomerular capillaries
        
        Some water and solutes entering capsular space of renal corpuscle
        
        Separated fluid termed filtrate
      - Tubular reabsorption: return of components from within tubular fluid to blood within peritubular capillaries and vasa recta
        
        Moved by diffusion, osmosis, and active transport
        
        All vitale solutes and most water reabsorbed
        
        Excess solutes, waste products, some water remaining in tubular fluid
      - Tubular secretion: movement of solute from blood to tubular fluid
        
        Usually by active transport
        
        Materials moved selectively into tubules to be excreted
  - - - Some substances reabsorbed from tubular fluid back into blood
      - Some substances not originally filtered in glomerulus become components of urine through tubular secretion
    - - Nutrient absorption
        
        Some substances 100% absorbed
        
        Nutrients normally reabsorbed inPCT
    - - Sodium reabsorption
        
        Majority reabsorbed in PCT
        
        Reabsorption is regulated by hormones, aldosterone and ANP
      - Water reabsorption
        
        180 L filtered daily; all but 1.5 L reabsorbed
        
        65% reabsorbed in PCT, 10% in nephron loop
- - - - Glucose acts as osmotic diuretic
  - - - Heart must work harder; myocardium enlarges, weakens, and becomes flabby
      - Also accelerates atherosclerosis