Qu'est-ce qu'un corpuscule rénal ?

C'est une structure rénale composée de deux éléments : le glomérule et la capsule de Bowman.

À quoi servent les pores de fenestration ?

Ils permettent le passage de petites molécules, d'eau, d'électrolytes à travers les capillaires tout en bloquant les éléments formés comme les globules rouges et blancs.

Quelle est la fonction de la membrane basale glomérulaire ?

Elle agit comme un filtre supplémentaire en repoussant les protéines chargées négativement.

Comment les podocytes contribuent-ils à la filtration ?

Ils forment des fentes de filtration qui permettent uniquement le passage des particules très petites.

Qu'est-ce que la pression hydrostatique glomérulaire ?

C'est la force qui pousse le plasma hors des capillaires glomérulaires vers l'espace de Bowman.

Quel est l'effet de la pression sanguine sur le GFR ?

Une pression artérielle élevée augmente la pression hydrostatique glomérulaire, augmentant ainsi le GFR.

Pourquoi les protéines plasmatiques ne passent-elles pas dans l'urine ?

Elles sont repoussées par la charge négative de la membrane basale glomérulaire et des protéines des fentes de filtration.

Renal | Glomerular Filtration

00:43:09

https://www.youtube.com/watch?v=SVqSqPOcahY

概要

TLDRDans cette vidéo, on aborde en détail le processus de filtration glomérulaire, pièce essentielle du fonctionnement rénal. Le corpuscule rénal est introduit comme une structure constituée du glomérule et de la capsule de Bowman. Le glomérule, un ensemble de capillaires fenestrés, filtre le sang en permettant le passage de petites molécules, d'eau, et d'électrolytes, tandis que les éléments formés comme les cellules sanguines sont retenus. La membrane basale glomérulaire et les podocytes (cellules avec des pieds) forment une barrière à trois niveaux qui empêche le passage de grandes molécules chargées négativement comme les protéines plasmatiques, grâce à des pores spécifiques et des charges électriques. Les pressions hydrostatiques et osmotiques à l'intérieur du glomérule régulent le taux de filtration glomérulaire (GFR), qui est normalement d'environ 125 ml/min. Différents facteurs, y compris la pression sanguine et les propriétés des membranes de filtration, influencent le taux de filtration glomérulaire.

収穫

🧬 La filtration glomérulaire est un processus crucial dans la fonction rénale.
🏗️ Le corpuscule rénal comprend le glomérule et la capsule de Bowman.
🩸 Les capillaires du glomérule sont fenestrés, filtrant le sang efficacement.
🔬 La membrane basale glomérulaire empêche les protéines chargées négativement de passer.
🐾 Les podocytes contribuent en formant des fentes de filtration.
📊 Le taux de filtration glomérulaire normal est de 125 ml/min.
⬆️ Une pression artérielle élevée peut augmenter le taux de filtration.
⚖️ Les pressions glomérulaires régulent la filtration.
🔄 La filtration glomérulaire est influencée par des facteurs pathologiques.
🩺 Une bonne compréhension de ce processus est essentielle pour diagnostiquer des maladies rénales.

タイムライン

00:00:00 - 00:05:00
Dans cette vidéo, nous abordons la filtration glomérulaire, en commençant par la structure du corpuscule rénal, qui comprend le glomérule et la capsule de Bowman. Le glomérule est fait de capillaires fenêtrés, laissant passer certains éléments du plasma sanguin tout en bloquant les éléments formés comme les globules rouges et blancs. Nous discutons aussi de l'artériole afférente et efférente, qui alimentent et drainent le glomérule respectivement.
00:05:00 - 00:10:00
Les capillaires glomérulaires possèdent des pores fins, permettant le passage de petites molécules comme les protéines et électrolytes. Un élément clé est la membrane basale glomérulaire qui repousse les protéines chargées négativement. La membrane contient trois couches, dont la lamina densa constituée de collagène de type IV, jouant un rôle crucial dans la filtration.
00:10:00 - 00:15:00
La membrane basale résiste au passage des grandes molécules négativement chargées grâce à la charge négative des glycosaminoglycanes. Les molécules positives passent plus aisément la barrière. Les protéines plasmatiques comme l'albumine sont généralement repoussées. On examine comment cette membrane influence la filtration glomérulaire.
00:15:00 - 00:20:00
Les cellules podocytes de la capsule de Bowman forment des filtres supplémentaires appelés fentes de filtration, contrôlées par la protéine néphrine. Cela limite le passage des molécules de plus de 7-9 nm. Cela protège également contre la perte excessive de protéines, en constituant une barrière sélective.
00:20:00 - 00:25:00
Les cellules mésangiales jouent un rôle de soutien dans la structure glomérulaire et aident à phagocyter les macromolécules coincées. Elles ont aussi une activité contractile, régulant le flux sanguin et contribuant à la sécrétion de rénine qui affecte la pression artérielle.
00:25:00 - 00:30:00
La pression nette de filtration dépend des pressions glomérulaires hydrostatiques et colloïdale osmotiques. La PNF influence directement le taux de filtration glomérulaire (TFG), qui est d'environ 125 ml/min en conditions normales. Différents facteurs comme la tension artérielle systémique modifient ces pressions, affectant le TFG.
00:30:00 - 00:35:00
La surface et la perméabilité du glomérule affectent le TFG. Une plus grande surface filtrante et une plus haute perméabilité augmentent le TFG. Les conditions comme la néphropathie diabétique peuvent réduire la surface, diminuant le TFG. Le coefficient de filtration (KF) est crucial ici.
00:35:00 - 00:43:09
Les pressions comme la pression hydrostatique et la pression colloïde osmotique influencent fortement la filtration. Des scénarios cliniques comme l'hypertension ou les calculs rénaux peuvent augmenter ou diminuer ces pressions et altérer la filtration, impactant significativement la fonction rénale globale.

よくある質問

Qu'est-ce qu'un corpuscule rénal ?
C'est une structure rénale composée de deux éléments : le glomérule et la capsule de Bowman.
Quels types de capillaires sont trouvés dans le glomérule ?
Les capillaires fenestrés.
À quoi servent les pores de fenestration ?
Ils permettent le passage de petites molécules, d'eau, d'électrolytes à travers les capillaires tout en bloquant les éléments formés comme les globules rouges et blancs.
Quelle est la fonction de la membrane basale glomérulaire ?
Elle agit comme un filtre supplémentaire en repoussant les protéines chargées négativement.
Comment les podocytes contribuent-ils à la filtration ?
Ils forment des fentes de filtration qui permettent uniquement le passage des particules très petites.
Qu'est-ce que la pression hydrostatique glomérulaire ?
C'est la force qui pousse le plasma hors des capillaires glomérulaires vers l'espace de Bowman.
Qu'est-ce que le taux de filtration glomérulaire (GFR) normal ?
Environ 125 ml/min.
Quel est l'effet de la pression sanguine sur le GFR ?
Une pression artérielle élevée augmente la pression hydrostatique glomérulaire, augmentant ainsi le GFR.
Pourquoi les protéines plasmatiques ne passent-elles pas dans l'urine ?
Elles sont repoussées par la charge négative de la membrane basale glomérulaire et des protéines des fentes de filtration.

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00:00:08
all right ninine ND in this video we're
00:00:09
going to specifically start talking
00:00:10
about glamar filtration all right before
00:00:13
we do that before we even get into glara
00:00:14
filteration we have to look at the
00:00:16
structure of something specific what is
00:00:18
that structure that we have to talk
00:00:19
about we have to talk about what's
00:00:20
called a renal cor pusle okay so first
00:00:23
off what is Arenal cor pusle let's
00:00:25
actually Define what
00:00:26
Arenal Corpus
00:00:31
is so Roc cor pel is two things okay the
00:00:35
first thing is actually the
00:00:38
glomerulus okay which is capillaries
00:00:40
which is a TFT of capillaries the other
00:00:44
thing is the
00:00:47
Bowman's
00:00:49
capsule or sometimes they even call it
00:00:51
the glomular capsule we're just going to
00:00:53
call the Bowman's capsule okay so two
00:00:56
components of the renal cor pusle again
00:00:58
what are those two components of the
00:00:59
Reno Cor pule the two components of the
00:01:01
renal cor pusle is specifically the
00:01:05
Glarus which is the tough de capillaries
00:01:08
and the Bowman's
00:01:09
capsule let's first talk about the
00:01:12
glomerulus and the filtration membrane
00:01:14
which is a part of it and then we'll
00:01:16
talk about the Bowman's capsule okay so
00:01:18
let's first focus on the Glarus so if
00:01:20
you notice here this right here is the
00:01:21
Glarus because this is the TFT of
00:01:23
capillaries right here so a Glarus is
00:01:25
like a tuft of capillaries and here's
00:01:27
what's interesting if you notice let's
00:01:29
say that this is the vessel coming into
00:01:31
the Glarus so this is feeding into the
00:01:34
Glarus when it goes into the Glarus it's
00:01:37
actually called aparent
00:01:41
arterial okay so if there's a vessel
00:01:43
that's feeding in the glus it's called
00:01:44
the aparent arterial and again this is
00:01:46
the glus right here right here is their
00:01:48
Glarus okay so we'll put that right
00:01:50
above it this is our
00:01:53
glus which is our TFT of capillaries oh
00:01:56
what type of capillaries is there within
00:01:58
the Glarus that's really really
00:01:59
important you know it's type of
00:02:00
capillaries are here in the Glarus
00:02:02
they're actually called
00:02:06
finr
00:02:08
capillaries you know what finist strated
00:02:10
capillaries means okay so let's say I
00:02:12
take one of these endothelial
00:02:14
cells and I zoom in on them so let's say
00:02:17
here's an endothelial
00:02:19
cell okay here's the nucleus of the
00:02:21
endothelial cell in this endothelial
00:02:24
cell it has little holes look at this
00:02:27
you see this little hole right there
00:02:29
little Channel basically that's a
00:02:32
finestra there's another one over here
00:02:34
too they have them all around these
00:02:36
things there's hundreds upon hundreds
00:02:39
maybe even thousands of these little
00:02:41
finestra pores on this endothelial cell
00:02:46
now these finestra pores what are they
00:02:48
for let me explain to you what they're
00:02:50
for well first off how big are these
00:02:52
little things you know these little
00:02:53
things right here these finra are
00:02:55
approximately about 50 to 100 nanometers
00:02:58
in diameter that's really really
00:03:00
freaking small so about how much 50 to
00:03:03
100
00:03:05
nanometers in
00:03:07
diameter so really what can actually
00:03:10
filter through this okay you know within
00:03:11
the blood you have your plasma which is
00:03:14
consisting of a lot of water and
00:03:15
different types of solute molecules
00:03:17
right and then also you have formed
00:03:19
elements like your white blood cells
00:03:20
your red blood cells your
00:03:22
plets any type of formed elements cannot
00:03:26
fit through these finestra okay so any
00:03:29
type of form form Med elements cannot
00:03:32
fit through these actual fitration pores
00:03:35
so formed elements are again what what
00:03:36
are those components of formed elements
00:03:38
red blood cells white blood cells
00:03:40
platelets none of those can get in okay
00:03:43
what can pass through the different
00:03:45
components of the plasma so you know
00:03:47
like small
00:03:49
proteins small proteins can pass through
00:03:52
this what else can pass through this
00:03:55
water what else can pass through this
00:03:58
electrolytes like sodium and potassium
00:04:01
and calcium and chloride and a whole
00:04:03
bunch of other different types of
00:04:04
molecules a lot of different things okay
00:04:07
and even
00:04:09
nutrients waste products all different
00:04:11
types of molecules can pass through
00:04:14
these actual finestra pores okay so
00:04:17
these fitration pores are basically
00:04:19
riddled against all these little
00:04:20
endothelial cells within the Glarus
00:04:22
that's one important Point okay what is
00:04:25
this structure draining the glomerulus
00:04:28
here's a really really interesting watch
00:04:30
this usually it's a vein right or a
00:04:33
venil this is actually called the
00:04:36
eant arterial this is one of the only
00:04:39
examples in the
00:04:41
body in which a capillary bed is being
00:04:44
fed by an arterial and then drained by
00:04:47
an arterial okay so we have aeren
00:04:50
arterial feeding the Glarus we have an
00:04:52
eeper arterial draining the Glarus and
00:04:54
the Glarus is again fristrated
00:04:56
capillaries what does it mean to be
00:04:57
fitrated it's these little pores
00:05:00
in the endothelial cell right that are
00:05:02
about 50 to 100 nanm in diameter and
00:05:05
what do they allow for things for it to
00:05:06
pass through electrolytes nutrients
00:05:09
small proteins water molecules and even
00:05:11
maybe some large molecular weight
00:05:13
proteins that are less than 100
00:05:15
nanometers in diameter because if
00:05:17
they're less than 100 nanometers in
00:05:18
diameter they can pass through the
00:05:20
actual fitration pores so let's even say
00:05:23
not only small proteins but like we'll
00:05:24
say
00:05:26
moderate size
00:05:28
proteins and again any proteins or any
00:05:31
molecules that are about less than 100
00:05:34
nanm in diameter can fit through these
00:05:35
fitration pores
00:05:38
now look at this little nice blue baby
00:05:42
blue thing we have right here you see
00:05:45
this blue membrane right here this is
00:05:47
one of the most critical parts of the
00:05:49
actual Glarus okay one of the most
00:05:52
important points of the Glarus you know
00:05:54
what this thing is actually called this
00:05:56
blue membrane structure let's actually
00:05:57
show it over here this blue membrane
00:05:59
structure right here that we that I'm
00:06:00
kind of showing here that I'm zooming in
00:06:02
on right here this is actually called
00:06:04
the glomular basement membrane so again
00:06:07
what is it called the
00:06:09
glomular
00:06:12
basement membrane now some of you might
00:06:15
be thinking okay it's just a basement
00:06:16
membrane what what significance does
00:06:18
that have oh my goodness so much
00:06:21
significance okay this glar basement
00:06:24
membrane is extremely interesting
00:06:26
because if I were to let's say I
00:06:27
actually zoomed in on even more let's
00:06:28
say I even zoomed in the layer even more
00:06:30
you know the GL base memory is actually
00:06:32
three sub layers look at this let's say
00:06:35
I zoom in on it for a second so here's
00:06:37
the glomular basement membrane in the
00:06:40
glomular basement membrane there's three
00:06:42
layers let's say here in I make a black
00:06:44
layer right there a real real thick
00:06:47
black
00:06:48
layer this thick black layer is actually
00:06:51
going to be
00:06:53
specifically consisting of type four
00:06:57
collagen so what is this layer right
00:06:59
here consisting of it's specifically
00:07:02
consisting of type four
00:07:06
collagen and laminins these different
00:07:09
types of proteins okay so one is
00:07:12
actually going to be type four collagen
00:07:14
and if you notice it's really dense you
00:07:16
know what they call this actual layer
00:07:17
they call this the
00:07:20
lamina
00:07:22
denza okay so one layer right smack dab
00:07:25
in the middle which is consisting of
00:07:26
type four collagen and laminins is
00:07:28
called the lamin den
00:07:30
then let's say that this is the
00:07:32
endothelial
00:07:34
side and what do I mean by
00:07:37
endothelial side I mean that here's your
00:07:40
endothelial cells this part of the
00:07:42
membrane closest to the endothelial
00:07:44
cells is this side then you have these
00:07:46
black cells which I'm going to talk
00:07:47
about called the poyes that's going to
00:07:49
be on this side so the poite I'm going
00:07:52
to put pooy
00:07:55
layer okay on this side here towards the
00:07:59
endothelial cells it's a thinner like
00:08:02
tissue okay it's a thinner layer this
00:08:05
layer right here is actually made up of
00:08:08
specific types of molecules like
00:08:11
proteoglycans okay or
00:08:13
glycosaminoglycans
00:08:14
particularly Hein
00:08:17
sulfate and guess what else you're going
00:08:19
to find on the other side the same thing
00:08:23
Hein sulfate these different types of
00:08:26
glycos amino glycans now here's the next
00:08:29
part that's really interesting Hein
00:08:31
sulfate is extremely negatively charged
00:08:34
okay so it's very very negatively
00:08:36
charged so if I were to show that here
00:08:38
let's say I show it here in Orange on
00:08:40
this side what are you going to have a
00:08:41
lot of negative charges what would you
00:08:44
have on this side a lot of negative
00:08:46
charges that's important I'm going to
00:08:48
talk about that why that is now if I
00:08:50
were to be particular this side is
00:08:52
closest to the endothelial cell we call
00:08:54
this side
00:08:56
lamina Rara
00:09:00
interna and then we call this side so
00:09:03
that's laminar rare interna the one
00:09:04
towards the endothelial lining the one
00:09:06
on the opposite s towards the pooy
00:09:08
lining is actually called the
00:09:10
lamina
00:09:12
Rara
00:09:14
externa okay so the GLA basement
00:09:16
membrane is actually three different
00:09:18
sublayers one in the middle is actually
00:09:20
the lamino denza with type four collagen
00:09:22
and laminins lamin arera interna and
00:09:24
lamin arera externa are consisting of
00:09:26
Hein sulfate okay so a different type of
00:09:28
glycos amino can which has a lot of
00:09:30
negative charges on it why is this
00:09:33
important
00:09:35
okay you know inside of our blood we
00:09:38
have these things called plasma proteins
00:09:41
let's say I represent a plasma protein
00:09:43
here as like
00:09:45
albumin you know what abuin charge is
00:09:48
inside of the blood generally or most
00:09:50
plasma proteins it's negatively
00:09:55
charged let's say I draw another plasma
00:09:57
protein just for the heck of it I put in
00:09:59
here here uh let's say I put in here um
00:10:02
specifically different types of
00:10:04
imunoglobulin so I'm going to put i g
00:10:07
and we'll just be for the heck of it put
00:10:09
IG
00:10:11
immunoglobulins these are also
00:10:14
negatively charged I could even put
00:10:15
fibrinogen or different types of trans
00:10:17
other type of transport proteins the
00:10:19
whole point is proteins inside of our
00:10:21
actual plasma are negatively charged
00:10:23
what's the charge on this glomular
00:10:24
basement membrane negative charge so
00:10:28
it's very very negatively charge now if
00:10:30
you know a little bit about biology you
00:10:31
know that same charges repel one another
00:10:35
so for example if I have albumin I
00:10:38
represent albumin here as this circle
00:10:40
and then all around him I have negative
00:10:42
charges if he tries to come through this
00:10:44
membrane or any type of molecule that's
00:10:45
negatively charged tries to come through
00:10:47
that membrane what's going to happen to
00:10:48
it it's going to repel it so can I get
00:10:51
through this actual glomular basement
00:10:53
membrane no that's good at helping to
00:10:56
act act as a good filter so now it's
00:10:59
acting as a very good filter so any type
00:11:02
of negatively charged particles that
00:11:04
actually try to move through the
00:11:05
glomular basement membrane is repelled
00:11:08
but if you know again about biology what
00:11:11
actually is going to want to come to the
00:11:14
negative charge positively charged
00:11:16
particles right so anything that's
00:11:17
positively charged is going to want to
00:11:19
come to the negative charges so any type
00:11:22
of positive positively charge particles
00:11:24
that we might
00:11:25
have with inside of the plasma is going
00:11:28
to want to what
00:11:29
pass through
00:11:32
here what are positively charged
00:11:34
molecules usually different types of
00:11:36
electrolytes like sodium and potassium
00:11:39
and calcium and
00:11:41
magnesium so that's really really
00:11:43
interesting any type of positively
00:11:44
charged substances are going to pass
00:11:45
through the glomular basement membrane
00:11:47
easily anything that's neutral it's
00:11:49
going to be a little bit harder than
00:11:51
positively charged species to pass
00:11:52
through but it can still pass through
00:11:55
any negatively charged species or
00:11:57
different types of molecules are going
00:11:58
to be repelled and prevented from
00:12:01
entering into this actual glarin uh
00:12:03
capsule here okay so if it's big enough
00:12:08
like large molecular weight proteins or
00:12:10
large different solute molecules and
00:12:11
they move through the fenestration pores
00:12:14
usually protein molecules are negatively
00:12:15
charged so they'll be repelled by the
00:12:17
glomular basement membrane so we have
00:12:19
two barriers so far part of this
00:12:21
filtration membrane so now we've
00:12:23
developed what our Glarus is really made
00:12:24
up of so let's actually write those two
00:12:26
things out what are the two components
00:12:28
one is actually the specifically the
00:12:33
endothelial lining which is what finist
00:12:37
strated guys remember that with the
00:12:38
finestra pores which are approximately
00:12:40
about 50 to 100 nanm in diameter which
00:12:43
allow for certain things to pass through
00:12:45
what's the other component of the Glarus
00:12:47
the other component of the Glarus is the
00:12:50
I'm just going to put glomular basement
00:12:52
membrane GBM right and this is important
00:12:56
because he has negatively charged
00:12:58
surface which repels negatively charged
00:13:01
particles so if you think about it like
00:13:02
this negatively charged particles are
00:13:04
repelled positively charged particles
00:13:06
move through any neutral charge will
00:13:09
also move through but not as readily as
00:13:11
positively charged particles okay those
00:13:13
are the two components of the glomerulus
00:13:15
now what about the Bowman's capsule okay
00:13:18
for the Bowman's
00:13:20
capsule there's actually two different
00:13:24
components one one is actually the
00:13:27
parietal
00:13:31
and the other one is the visceral layer
00:13:34
but specifically these are your phocytes
00:13:37
okay so now let's look at this okay so
00:13:41
we talked about the Finish rate of
00:13:42
capillary and ath helium we talked about
00:13:43
the GL basement membrane now we're going
00:13:45
to talk about the visceral layer of the
00:13:47
Bowman's capsule specifically the poyes
00:13:50
these poyes you know what poto actually
00:13:52
means foot so it's foot cells so if you
00:13:53
see at the end part it has these little
00:13:55
little different foot processes okay
00:13:58
these have in between the poyes so let's
00:14:01
say here's a pooy so let's say this is
00:14:02
pooy
00:14:04
one and this is poite 2 poite 3 poite
00:14:08
four poite 5 in between poite 1 and two
00:14:13
there is a specific type of protein
00:14:18
molecule look at this you see this it's
00:14:21
kind of like inter connecting here so
00:14:23
here's another one here's another one
00:14:25
interconnecting here's another one
00:14:26
between four and three interconnecting
00:14:30
and here's one between four and five
00:14:32
interconnecting you see what these
00:14:34
little orange molecules are that are
00:14:35
interconnecting our
00:14:36
poyes this is actually called a very
00:14:39
important protein I wouldn't be
00:14:40
mentioning if it's not this molecule
00:14:41
right here is actually this orange
00:14:42
molecule is called
00:14:45
nephrine now nephrine is important
00:14:48
because there is certain types of uh
00:14:50
conditions in glarin nefritis where you
00:14:52
can actually have mutations within this
00:14:53
nephrine protein why is that significant
00:14:56
because you know nephrine is really
00:14:58
really important for being able to
00:15:00
control what's actually making it
00:15:02
through what what so far would they have
00:15:03
to go through to get to this point
00:15:05
they'd have to go through the finra
00:15:07
pores they'd have to make it through the
00:15:08
negatively charged glomular basement
00:15:10
membrane and then they have to get
00:15:12
between these little things here what's
00:15:14
this space right here called
00:15:16
between the Poo sites here called what's
00:15:18
that space there called that space
00:15:21
between the Poo sites is actually called
00:15:23
the
00:15:26
filtration
00:15:27
slit and a filtration slit is
00:15:31
approximately 25 to 30 nanometers in
00:15:35
diameter so now if it's made it through
00:15:38
the fenestration pores if it's made it
00:15:40
through the negatively charged glomular
00:15:41
basement membrane and if it's less than
00:15:43
25 nanometers approximately 25 to 30
00:15:46
nmet in diameter it'll make it through
00:15:48
but then guess what this nephrine
00:15:50
proteins only allow for molecules
00:15:54
anything that's actually 7 to 9
00:15:56
nanometers in diameter or less to pass
00:16:00
through okay nephrine is this protein
00:16:03
molecule and he's actually forming this
00:16:06
structure around so this space is the
00:16:07
filtration slit but nephrine is kind of
00:16:09
like a thin protein structure that's
00:16:11
spanning that filtration slit and
00:16:13
because it's spanning the filtration
00:16:15
slit they call
00:16:17
this the
00:16:20
slit
00:16:23
diaphragm okay so it's called the slit
00:16:26
diaphragm and the Slit diaphragm is
00:16:28
composed osed of nephrine and nephrine
00:16:30
is only allowing for molecules that are
00:16:32
less than 7 to9 nanm to be able to pass
00:16:35
through this area okay then what do we
00:16:40
have on the outside edges here we have
00:16:42
the parietal layer of the Bowman's
00:16:44
capsule so it's continuous with the
00:16:46
visceral layer of Bowman's capsule so
00:16:49
the poyes cling to the capillaries and
00:16:51
it goes continuous with the prior layer
00:16:54
of the bonus capsule to make a nice
00:16:56
space so that anything that's filtering
00:16:57
out isn't just lost it's collected into
00:17:00
this nice little Bowman space here okay
00:17:03
so what are the two components of the
00:17:04
Bowman's capsule ready the pooy layer
00:17:07
and has spaces in between the poyes
00:17:10
which are called filtration slits and
00:17:12
they're approximately 25 to 30
00:17:13
nanometers in diameter and then has this
00:17:16
protein molecule that are in between the
00:17:18
phocytes linked together right and
00:17:21
nephrine is the component of it it's
00:17:23
it's making the slit diaphragm which is
00:17:25
only allowing for molecules that are
00:17:27
about less than 7 to 9 Nan to make it
00:17:29
through this area okay so now let's go
00:17:32
ahead and just kind of recap what can
00:17:34
actually move through here because we
00:17:35
kind of got a basis comp basic component
00:17:37
of everything that's making up this Reno
00:17:39
cor pusle let's cover what can make it
00:17:41
through now okay so we can have plasma
00:17:44
proteins let's just represent a as
00:17:46
albumin IGG antibodies as another
00:17:48
different type of protein let's
00:17:50
represent our electrolytes like sodium
00:17:53
uh potassium chloride what else would
00:17:56
you have you'd have calcium you'd have
00:17:58
magnesium magesium you can have
00:18:00
bicarbonate tons of different molecules
00:18:02
different types of actual uh electrolyte
00:18:04
molecules right what else would you have
00:18:06
over here you'd have
00:18:08
glucose you'd have amino acids you'd
00:18:11
have different types of lipids you'd
00:18:13
have
00:18:14
Ura uh different types of waste products
00:18:16
right like uh even
00:18:18
creatinine or creatinine which is a
00:18:20
breakdown product of the muscle skeletal
00:18:22
muscles from phosphate you'd have
00:18:24
vitamins tons of different molecules in
00:18:26
here right and what's one of the more
00:18:28
important ones that we should definitely
00:18:30
mention water all these are different
00:18:33
molecules which are running through our
00:18:34
plasma right and this isn't even all of
00:18:36
them we could even have other things in
00:18:37
there but again basic component is that
00:18:39
you have electrolytes flowing through
00:18:41
the plasma you have different types of
00:18:42
nutrient sources and waste products
00:18:44
flowing through the plasma you have
00:18:45
water which is making up like 93% of the
00:18:48
plasma and you have different types of
00:18:49
plasma proteins okay albumin fibrinogen
00:18:53
I could even put in there I could put in
00:18:54
an F for fibrinogen if I needed to okay
00:18:57
so there's fibrinogen and fibrin would
00:18:59
also have negatively charged particles
00:19:01
on it right different types of amino
00:19:03
acids that make it negatively charged
00:19:05
now out of these things what did I tell
00:19:07
you can actually fit through the
00:19:08
fenestration pores anything that's
00:19:10
actually less than 50 to 100 nmet in
00:19:13
diameter can pass right through so most
00:19:15
of these substances can actually pass
00:19:17
through but what did I tell you the
00:19:19
glomular basement membrane has on it
00:19:21
negatively charged particles so anything
00:19:24
that's negatively charged like these
00:19:25
actual what any of these plasma proteins
00:19:29
are repelled this is repelled and this
00:19:32
is repelled from what the glomular
00:19:34
basement membrane what else did I tell
00:19:36
you about the glamar basement membrane
00:19:38
any type of positively charged particles
00:19:40
are going to move through faster and
00:19:42
easier than negatively charged particles
00:19:44
so if you had to compare here bicarbon
00:19:46
it would be a little bit harder to
00:19:47
filter right as compared to sodium
00:19:50
potassium calcium magnesium and chloride
00:19:52
would be harder to filter as compared to
00:19:54
potassium but nonetheless these
00:19:56
substances are filtered
00:19:59
so what would be filtered out here you
00:20:01
would have it would actually move
00:20:03
through the finestra pores through the
00:20:05
glomular basement membrane and these
00:20:07
particles as long as they're less than
00:20:09
what at least 25 to 30 nmet in diameter
00:20:13
as well as if they're less than 7 to 9
00:20:15
nanometers in diameter what's going to
00:20:16
come out here you're going to have
00:20:18
bicarb you're going to have sodium
00:20:20
you're going to have pottassium
00:20:22
chloride calcium magnesium water's even
00:20:26
going to be out here what else would be
00:20:28
out here
00:20:29
glucose amino acids lipids
00:20:34
Ura creatinine all these different types
00:20:36
of molecules are being filtered out look
00:20:40
at all of these
00:20:41
things all of these are being filtered
00:20:43
out and again what do they want running
00:20:44
through as a quick
00:20:46
recap running through the fitration
00:20:48
pores as long as they're uh less than 50
00:20:50
to 100 nmet in diameter anything that's
00:20:52
negatively charged is repelled by the
00:20:53
glomular basement membrane they pass
00:20:56
through the filtration slits which is
00:20:57
about 25 to 30 nanm in diameter then
00:21:00
there's the nephrine which is making up
00:21:01
that slit diaphragm and as long as any
00:21:04
particle is less than 7 to9 nanm in
00:21:06
diameter it'll get freely filtered and
00:21:09
what are those molecules that are most
00:21:11
commonly freely filtered they are
00:21:14
glucose amino acids lipids Ura
00:21:18
creatinine different types of
00:21:19
electrolytes even lactic acid and
00:21:22
vitamins different types of molecules
00:21:24
are filtered out and then where will
00:21:25
they
00:21:26
go they'll move out here into the actual
00:21:30
what proximal convoluted tubal now one
00:21:33
more thing before we go into these
00:21:35
pressures
00:21:37
okay let's say by some Chance some type
00:21:40
of Macro Molecule gets through the
00:21:42
fenestration pores gets through this
00:21:45
actual glomular basement membrane and
00:21:47
gets hung up in this filtration slit by
00:21:50
the slit diaphragm what are we going to
00:21:52
do with that it's just let's say it's
00:21:54
actually dangling let's say here it is
00:21:55
let's say somehow albumin is just
00:21:58
freaking dangling from this thing okay
00:22:00
like a monkey look what happens you see
00:22:03
these cells right here these little like
00:22:05
piranha looking cells they're getting
00:22:06
ready to freck something up you know
00:22:08
what these cells are called they're
00:22:10
called mangial cells so what are these
00:22:11
cells here called these little piranha
00:22:14
looking
00:22:15
cells they're called mangial
00:22:19
cells now mangial
00:22:22
cells are very very important to the
00:22:24
glamar
00:22:25
structure right because they have a
00:22:27
couple different properties one one is
00:22:29
they'll actually phagocytose any type of
00:22:31
molecules that get hung up in that
00:22:33
actual slit diaphragm which is composed
00:22:35
of nephrine so that that guy right there
00:22:37
he's going to come over and he's going
00:22:39
to phagocytose any macromolecules that
00:22:41
get stuck and hung up in that slit
00:22:43
diaphragm you know what else he can do
00:22:46
he also has contractile activity so he
00:22:48
can contract contract what he can
00:22:51
contract and control the amount of blood
00:22:52
flow that's coming in through the aarin
00:22:54
arterial and into the glara capillar
00:22:56
we'll discuss that all also he has Gap
00:22:59
Junctions Gap Junctions that connect him
00:23:02
to these cells from other cells which
00:23:04
are called the macula Denis cells what
00:23:06
are these cells here called these little
00:23:09
Violet or maroon cells they're called JG
00:23:13
cells specifically
00:23:16
juxa glomular
00:23:18
cells if you remember these these are
00:23:21
the ones that are producing renin and
00:23:24
renin was important for our blood
00:23:26
pressure right so they're actually
00:23:27
Barrel receptors so pressure receptors
00:23:29
they pick up different types of changes
00:23:31
in pressure when the pressure is low
00:23:33
they'll secrete renin and if you
00:23:34
remember renin was important for being
00:23:36
able to maintain our blood
00:23:38
pressure okay and he can get signals
00:23:41
from who pretend here was that mangial
00:23:44
cell the mangial cell has little Gap
00:23:48
Junctions that connect him to these
00:23:51
actual JG cells and he can allow for
00:23:54
different types of positively charged
00:23:56
ions to come over here and stimulate him
00:23:58
to release random we'll talk about that
00:24:00
in the TU below glomular feedback
00:24:02
mechanism Okay so we've covered a lot
00:24:05
about the actual glomerulus and the
00:24:07
Bowman's capsule and everything it can
00:24:09
filter what allows for it to filter I
00:24:11
think we've done pretty good on this now
00:24:13
let's come over here and let's cover all
00:24:15
the pressures that are involved in this
00:24:17
what's actually allowing for this net
00:24:18
filtration so what did I say net
00:24:21
filtration so what are we going to talk
00:24:23
about now we need to talk about the net
00:24:25
filtration but you know nothing likes to
00:24:26
move on its own it has to get a little
00:24:28
bit of a push so you have to apply some
00:24:30
pressure okay what is that called then
00:24:32
we're going to talk about net filtration
00:24:35
pressure because you know when we're
00:24:37
talking about things that are being
00:24:38
filtered it happens over a given period
00:24:41
of time when something is being filtered
00:24:43
over a given period of time and where is
00:24:45
it occurring it's occurring in the
00:24:47
glomerulus so there's what's called a
00:24:50
glomular
00:24:52
filtration rate so there's a glara
00:24:55
filtration rate and generally we we
00:24:58
describe Des rbe this is the amount of
00:25:00
fluid that's actually being you know
00:25:02
plasma volume that's actually being
00:25:04
filtered out of the Glarus and into the
00:25:05
Bowman's capsule for every 1 minute so
00:25:08
we refer to this as the volume of plasma
00:25:12
that's being filtered from the Glarus
00:25:14
for every one minute on average that's
00:25:16
about
00:25:17
125 milliliters per minute now some of
00:25:21
you might be like where the freck did
00:25:22
that come from let me explain to
00:25:25
you every about every 1
00:25:30
minute okay there is approximately
00:25:34
1,200 milliliters of plasma flowing
00:25:37
through the glara so for every 1 minute
00:25:40
1,200 milliliters is flowing through
00:25:43
this area now out of that 1,200
00:25:49
milliliters only
00:25:52
625 milliliters per minute are going to
00:25:56
be used in this filtration process so
00:25:58
1,00 milliliters per minute are passing
00:26:00
through here but out of that 1200
00:26:02
milliliters 625 are being used in the
00:26:05
filtration process the remaining amount
00:26:08
is passing by so now what's actually
00:26:10
leaving then so 1 12200 is coming in 625
00:26:14
is being going to be using this
00:26:15
filtration process but 575
00:26:19
milliliters per minute is actually going
00:26:21
to be leaving out now here's what's the
00:26:23
interesting part out of that
00:26:25
625 milliliters per minute that you're
00:26:27
actually going to be coming out of this
00:26:30
here's what's
00:26:31
crazy only 20% of it is actually going
00:26:35
to be filtered okay so 1,200 Millers is
00:26:38
passing through here 625 Millers we're
00:26:40
going to use for this filtration process
00:26:42
but out of that 625 Ms we're only going
00:26:44
to really filter 20% of it how what is
00:26:47
20% of
00:26:49
625 that is actually 125 milliliters per
00:26:54
minute okay that's where we get that
00:26:56
glara filtration rate
00:26:58
okay now that we've done that we know
00:27:02
specifically how we get the glal
00:27:03
filtration rate but now we got to talk
00:27:05
about factors that are affecting the
00:27:07
glome filtration weight what's actually
00:27:09
affecting the glome filtration rate so
00:27:11
in other words what can increase it what
00:27:13
can decrease it so on and so forth okay
00:27:16
so the first part of it is the net
00:27:18
filtration
00:27:19
pressure now net filtration pressure is
00:27:22
consisting
00:27:24
of the forces that are trying to push
00:27:27
things out so
00:27:31
pressures trying to push things so I'm
00:27:33
going to put pressures uh forcing
00:27:37
out okay so let's take a look at those
00:27:41
pressures but then it's also dependent
00:27:44
upon the difference of the pressures
00:27:45
forcing things out
00:27:47
minus the
00:27:50
pressures pulling things in so
00:27:55
pressures pulling
00:27:59
in okay let's look at these two
00:28:02
different components here because glal
00:28:04
filtration rate is dependent upon this
00:28:06
and something else that we'll talk about
00:28:07
in a
00:28:08
second okay so look at this first
00:28:11
pressure this first pressure here is
00:28:14
actually going to be called
00:28:16
glomular
00:28:18
hydrostatic
00:28:19
pressure now glomular hydrostatic
00:28:22
pressure is actually trying to push
00:28:26
things out
00:28:29
out of this
00:28:32
capillary okay so he's trying to push
00:28:35
things out of the
00:28:37
capillary that's what glomular
00:28:39
hydrostatic pressure is now generally as
00:28:42
blood is flowing through here okay so
00:28:45
let's say blood is flowing through the
00:28:46
AER arterial right because this is the
00:28:48
aarant arterial and this is the eer
00:28:51
arterial when the blood is flowing
00:28:53
through here the glomular hydrostatic
00:28:55
pressure is defined as the pressure
00:28:57
that's trying to p push the plasma
00:28:59
components out of the capillary and into
00:29:02
this actual Bowman space so that's what
00:29:06
glomular hydrostatic pressure is it's
00:29:08
defined as the actual forces that are
00:29:09
trying to push the plasma the a specific
00:29:12
volume of the plasma out of the Glam uh
00:29:15
glomular capillaries into the Bowman
00:29:17
space this number on average is about
00:29:21
55 millimeters of mercury okay that's
00:29:26
the average glamar hydrostatic pressure
00:29:29
now there's another pressure there's a
00:29:32
pressure that's exerted by specific
00:29:34
types of plasma proteins like alumin
00:29:37
albumin is trying to be able to keep
00:29:41
things into the blood he doesn't want
00:29:44
things to leave the blood okay so this
00:29:48
is actually going to be a specific
00:29:49
pressure and this pressure we're going
00:29:51
to call colloid
00:29:54
osmotic
00:29:56
pressure and colloid osmotic pressure is
00:29:59
exerted by plasma proteins that are
00:30:01
being able to try to keep the water into
00:30:04
the bloodstream so where is the arrow
00:30:06
pointing it's trying to keep the actual
00:30:08
water it prevent the water from leaving
00:30:10
out into the space so keep it into the
00:30:12
blood this colloid osmotic pressure is
00:30:15
on average okay on average about
00:30:19
specifically 30 millimet of mercury so
00:30:22
about 30 millimeters of
00:30:26
mercury okay
00:30:28
so 30 millim of mercury for the colloid
00:30:30
osmotic pressure and that's exerted by
00:30:33
who
00:30:34
albumin now there's one
00:30:36
more as fluid is being filtered out here
00:30:40
right think about it like a funnel so
00:30:42
here's the fluid and it's trying to
00:30:44
filter down into this little funnel
00:30:46
right there as the fluid is trying to
00:30:48
filter in through this area what happens
00:30:51
if you try to pour a lot of fluid into a
00:30:53
funnel at once what happens it overflows
00:30:55
right same thing is happening here you
00:30:58
start trying to push fluid out into this
00:31:00
actual Bowman's capsule there's a narrow
00:31:02
filtering process here so some of the
00:31:04
fluid can start backing up and backing
00:31:06
up and backing up and exert a pressure
00:31:08
that wants to push things back into the
00:31:11
actual capillary what is this pressure
00:31:13
called that's trying to push
00:31:16
things back
00:31:18
into this capillary bed this right here
00:31:22
is
00:31:23
called capsular
00:31:26
hydrostatic pressure this is called
00:31:30
capsular hydrostatic pressure so the
00:31:33
capsular hydrostatic pressure is the
00:31:35
pressure that's being exerted by the
00:31:37
actual pressured built up within the
00:31:39
Bowman's capsule and as it's trying to
00:31:40
drain there's a back pressure that tries
00:31:42
to push fluid back into the actual glome
00:31:45
capillaries and this on average is
00:31:49
approximately 15 millimeters of
00:31:53
mercury okay so now we have all of our
00:31:57
our J B basically all these pressures
00:31:58
that are pushing things out and all the
00:32:00
pressures that are trying to pull or
00:32:02
push things in technically there is one
00:32:04
more pressure that I could mention here
00:32:06
and it's it's zero though so it's not
00:32:09
not really necessary to mention it but
00:32:11
and the reason why is there's a pressure
00:32:13
that you can can technically consider
00:32:14
out here and then let's say there's
00:32:16
there's a pressure trying to pull things
00:32:18
into this
00:32:21
actual Bowman's capsule that pressure
00:32:24
would technically be called the capsular
00:32:26
osmotic pressure pressure but what do we
00:32:30
say as long as the filtration membrane
00:32:32
is nice and actual kept intact and and
00:32:34
it's not going to have any type of uh
00:32:36
fluctuations in its activity there
00:32:38
shouldn't be any type of plasma proteins
00:32:40
out in this area so if there's no plasma
00:32:42
proteins into this area can there really
00:32:44
be any osmotic pressure out here no so
00:32:46
normally the colloid osmotic pressure in
00:32:48
this area is zero millimeters of mercury
00:32:51
that's why we don't even really consider
00:32:53
this one into the equation okay so now
00:32:55
let's come over here and let's look and
00:32:56
see what we got now
00:32:58
so if we take the pressures trying to
00:33:00
force things out or even if you
00:33:01
technically think about it the cism
00:33:03
modic pressure trying to pull things out
00:33:05
what is the pressures Associated here so
00:33:07
technically we could say the first
00:33:09
pressure is the glomular hydrostatic
00:33:11
pressure plus the capsular osmotic
00:33:14
pressure technically right what was the
00:33:16
glomular hydrostatic pressure it was
00:33:19
approximately 55 millim of mercury and
00:33:24
then what was the CID osmotic pressure
00:33:25
it was
00:33:26
approximately 0 millim of Brey right
00:33:29
assuming normal activity what were the
00:33:32
pressures that were trying to pull
00:33:34
things in it was the colloid osmotic
00:33:38
pressure right and that was actually
00:33:40
trying to pull things in via the albumin
00:33:43
then there was actually going to be the
00:33:45
back pressure of the capsule trying to
00:33:47
push things in which is called the
00:33:48
capsular hydrostatic pressure what's the
00:33:51
CID osmotic pressure on average is about
00:33:53
30 millim of mercury plus the capsular
00:33:56
hydrostatic pressure which is about 15
00:33:59
mm of mercury if you do 55 minus
00:34:04
approximately 45 what's your net
00:34:06
filtration
00:34:08
pressure 10 millime of
00:34:12
mercury okay now from this we can derive
00:34:15
a specific concept that due to these
00:34:18
pressures any fluctuations in your net
00:34:20
filtration pressure directly affects
00:34:22
your glal filtration rate so in other
00:34:25
words your net filtration pressure is
00:34:28
directly proportional to your glomular
00:34:30
filtration rate so in other words any
00:34:32
increase in net filtration
00:34:34
pressure increases your GFR any decrease
00:34:37
in net filtration pressure decreases
00:34:40
your GFR wow you developed a heck of a
00:34:42
concept there right okay so there's two
00:34:44
components here that are affecting this
00:34:46
one is the surface area of the
00:34:51
Glarus okay so surface area of the
00:34:53
glomerulus that's one thing the other
00:34:57
thing that going to determine this is
00:34:58
also going to be specifically the
00:35:02
permeability so the
00:35:07
permeability of
00:35:11
glomerulus okay so let's say I take two
00:35:14
different types of gla one like
00:35:17
this right so there's the apan arterial
00:35:19
that's actually taking the blood in
00:35:21
here's the eant arterial let's draw
00:35:24
another one
00:35:25
though okay now look at this puppy
00:35:29
whoa aeren arterial eiren arterial
00:35:33
what's the difference that you notice
00:35:34
between these two this one has a very
00:35:36
small surface area so he has a very
00:35:38
small surface area there's not much
00:35:40
surface area to act upon to filter so
00:35:43
this will have a lower glomular
00:35:45
filtration rate right because it has a
00:35:48
smaller surface area but if you have a
00:35:50
large surface area you have much more
00:35:52
surface area for filtration so this
00:35:55
would result in a greater glomular
00:35:57
filtration rate that should be almost
00:36:00
intuitive right that should make
00:36:02
complete sense smaller the surface area
00:36:04
the smaller the GFR the greater the
00:36:06
surface area the greater the GFR simple
00:36:08
as that what could change the surface
00:36:11
area certain types of conditions could
00:36:13
actually make it a little thicker you
00:36:14
know there's actually a condition you've
00:36:16
probably heard of it called diabetes but
00:36:18
specifically it's called diabetic
00:36:23
nephropathy and with di diabetic
00:36:25
nephropathy there's actually protein and
00:36:27
actual specific deposits in this actual
00:36:29
Glarus that make it thicker and as you
00:36:30
make it thicker it actually decreases
00:36:32
the surface area which could affect the
00:36:34
glara filtration rate but I'm just
00:36:35
giving you a clinical correlation to
00:36:37
surface area and how important it is for
00:36:39
GL filtration rate okay so I say I take
00:36:42
two different types of glami here let's
00:36:44
say I take this one same surface area
00:36:46
for both of them so look here's another
00:36:48
one same surface area for this guy also
00:36:51
but look at the difference here watch
00:36:53
this let's say that this one only has
00:36:56
one
00:36:59
two three channels here to filter things
00:37:02
out okay three channels while this one
00:37:05
over here has
00:37:07
one
00:37:09
2
00:37:11
3
00:37:12
4 five five channels on the same surface
00:37:17
area what's going to happen to this
00:37:18
guy's filtration rate this one will have
00:37:21
a greater glara fitration rate right
00:37:23
because he has a lot more permeability
00:37:26
this one will have a low glara
00:37:28
filtration rate because he has less
00:37:30
permeability what kind of diseases could
00:37:32
affect this you ever heard of glara
00:37:34
nefritis so there's a condition called
00:37:38
glomerulo
00:37:40
nefritis and whenever there's damage to
00:37:42
the Glarus it actually can affect the
00:37:44
basement membrane and make the basement
00:37:46
membrane very very uh it can actually
00:37:48
destroy the basement membrane and make
00:37:49
it very porous what happen to the GL
00:37:51
filtration uh rate if the actual glome
00:37:54
basement membrane was affected in very
00:37:56
poor you would have a higher glal
00:37:58
filtration rate and you would Lo lose a
00:37:59
lot of proteins into the urine okay okay
00:38:01
so now as an overall concept here if I
00:38:05
were to take surface
00:38:08
area and
00:38:10
permeability of the actual capillaries
00:38:13
and combine them together this actually
00:38:15
gives me a specific term this term is
00:38:17
called
00:38:19
KF and KF stands for
00:38:23
filtration coefficient
00:38:28
okay so now I can actually derive one
00:38:30
last formula that we need here we can
00:38:32
say that glara filtration rate
00:38:34
technically is equal to the net
00:38:36
filtration pressure times the filtration
00:38:40
coefficient because before we said that
00:38:42
net filtration pressure is directly
00:38:44
proportional to GFR increase in NFP
00:38:47
increases GFR filtration coefficient is
00:38:50
dependent upon surface area and
00:38:51
permeability of the Glarus any
00:38:53
fluctuations in the filtration
00:38:55
coefficient also directly affect the
00:38:58
glome infiltration rate one last thing
00:39:00
here
00:39:02
guys let's apply a clinical correlation
00:39:05
to these actual net filtration pressure
00:39:07
because I think that's it's significant
00:39:08
okay so let's say that I take these
00:39:10
three different pressures here the the
00:39:11
most important ones the glamar
00:39:12
hydrostatic
00:39:15
pressure the uh colloid osmotic pressure
00:39:19
here and then the capsular hydrostatic
00:39:22
pressure what could be certain
00:39:24
situations that could affect these
00:39:26
things well I told before that glomular
00:39:28
hydrostatic pressure is directly
00:39:30
dependent upon your systemic blood
00:39:32
pressure so if your BP is really high if
00:39:36
your systemic blood pressure is high
00:39:37
what happens to your your glomular
00:39:39
hydrostatic pressure it increases your
00:39:42
glomular hydrostatic pressure what
00:39:45
happens if your BP goes down so what
00:39:47
happens if you're having hypotension
00:39:48
your glomular hydrostatic pressure goes
00:39:52
down it's that simple okay so glomular
00:39:55
hydrostatic pressure is directly
00:39:56
dependent upon your systemic blood
00:39:58
pressure an increase in blood pressure
00:40:00
increases the GL hydrostatic pressure
00:40:02
whereas a decrease decreases the GL
00:40:04
hydrostatic pressure what about colloid
00:40:07
osmotic
00:40:08
pressure let's say that you actually
00:40:10
have too many different types of
00:40:12
proteins in the blood like there's a
00:40:14
condition called multiple
00:40:16
[Music]
00:40:18
Myoma where you have too many different
00:40:20
types of proteins in the blood if that
00:40:23
happens what happens to the amount of
00:40:25
proteins in the blood they go up if the
00:40:27
amount amount of proteins in the blood
00:40:28
go up you start holding on to more water
00:40:29
in the blood if you hold on to a lot of
00:40:32
water what happens the colloid osmotic
00:40:34
pressure is going to increase right so
00:40:35
this increases colloid osmotic pressure
00:40:38
what happens if you have hypoproteinemia
00:40:41
so low proteins in the blood so this
00:40:44
could be due to maybe someone who's
00:40:45
Gluten Sensitive and they decide to like
00:40:47
Take and Eat house a pizza and what
00:40:49
happens they don't feel good and they
00:40:50
have the Hershey squirts right so they
00:40:51
start losing a lot of substances right
00:40:55
or maybe they have some type of actual
00:40:56
disease maybe like they've infected by
00:40:58
the Giardia and they lose a lot of
00:41:00
proteins into their actual feces right
00:41:02
so what happens then you lose proteins
00:41:04
if you lose proteins can you hold on to
00:41:07
as much water inside of the bloodstream
00:41:08
no so what happens to your CID cosmotic
00:41:11
pressure if you lose
00:41:13
proteins this decreases colloid osmotic
00:41:16
pressure and then what happens then you
00:41:18
start losing fluids a lot more than
00:41:21
normal into the actual Bowman
00:41:26
space okay what about capsular
00:41:29
hydrostatic pressure well let's say that
00:41:31
you get like a freaking massive kidney
00:41:33
stone stuck in your nefron Loop or
00:41:35
something like that right so you get
00:41:37
what's called a ren calculi that's
00:41:38
greater than 5 millimeters in diameter
00:41:40
and it gets stuck so a
00:41:42
renal culi right so just a kidney stone
00:41:47
greater than 5 millimeters in diameter
00:41:49
so greater than 5 millimeters in
00:41:51
diameter and it gets stuck in one of the
00:41:54
actual nefron Loops let's say here's
00:41:55
your nefron Loop
00:41:57
and here's your actual Bowman's capsule
00:41:59
if you have a stone stuck there what's
00:42:01
going to happen to the pressure it's
00:42:04
going to start backing up and it's going
00:42:05
to start increasing and trying to push
00:42:07
things back into the Glarus so what
00:42:08
would that do to your capsular
00:42:09
hydrostatic pressure if you had like a
00:42:11
kidney stone it's going to increase your
00:42:14
capsular hydrostatic pressure there's
00:42:16
other conditions too like renalis when
00:42:19
uh the individuals are really really
00:42:20
emaciated they don't they lose a lot of
00:42:22
weight rapid weight loss their kidneys
00:42:24
drop and it Kinks up and fluid flows
00:42:26
back into their kid it's called
00:42:28
hydrosis that also can cause this
00:42:30
problem too so not only can Roc culi do
00:42:33
this but also
00:42:36
Hydro nephrosis due to renal
00:42:41
Tois okay this can also
00:42:45
increase capsular hydrostatic pressure
00:42:48
and then what would be the result of an
00:42:49
increase in capsular hydrostatic
00:42:50
pressure you would have more fluid being
00:42:52
pushed back into the glami and not as
00:42:55
much net filtration
00:42:57
all right Ninja nerds we covered a lot
00:42:59
in this video about GLA filtration thank
00:43:01
you guys for sticking with us and
00:43:02
watching this we really appreciate it I
00:43:04
hope you guys enjoyed it I hope it all
00:43:06
made sense until next time Ninja nerds

タグ

filtration glomérulaire
corpuscule rénal
glomérule
capsule de Bowman
capillaires fenestrés
membrane basale glomérulaire
podocytes
pression hydrostatique
taux de filtration glomérulaire