Function of Nephron in Kidney - Regulation of GFR - Renal System Physiology

today we are going to discuss about how a nephron works right how in the kidney urine is formed is that right all of you know that kidney basically has special types of tubes which are called nephrons right and these tubes are involved in formation of urine and in one kidney how many nephrons are there yes mr. Abbas in one kidney how many nephrons are there yeah 1 million and in about one to 1.2 million right in 1 kiloton it means in both kidneys you have two to 2.4 millions nephrons and every nephron has a Gulu marvelous which is a filtering unit which is a filtration unit our main discussion today will be about the structure and function of glomerulus what is Goomer has Goomer Ellis is mainly the filtration unit for a nephron as you know we have about 2.4 million nephrons in both kidneys it means we should have about 2.4 millions glimmer lie in the both kidneys together but here I will concentrate on the concept of one nephron and one governor Ellis first first we will see what is the structure of a glomerulus and then we will see how Wilmer lass functions as a filtration unit and what are the factors which alter the filtration through the glomerulus structure right let us come to the Ovilus structure first right what is groom Ellis let's suppose here I draw the afferent arteriole what is this this is efferent arteriole which is bringing the blood to filtration direct right efferent arteriole is bringing the efferent arteriole is bringing the blood to the glomerulus now what really happens that this efferent arteriole will break down and to multiple similar areas it will break down into multiple cappella is let's suppose this is one capillary network this is another capillary network and here there is let's pose right and let's suppose here is one more capillary network and this is like this now these all capillaries they rejoin each other and make what if front arteriole what is it different arteriole so what we really see that there is there is afferent arteriole which is bringing the blood and efferent arteriole break down into bunch of capillaries it break down into bunch of Hilary's right and these anastomosing channels of triple rays is that right these nasta Mosin channels of capillaries are called yes they are called glomerular capillary tuft glomerular capillary tuft right again this is afferent arteriole this is different arteriole efferent arteriole breakdown I have shown just three loops of capillaries but actually it break down many many loops of capillaries and these capillaries are a master motion channels and these channels eventually unite together and make which arteriole different arteriole so we can say and this bunch of capillary together is called gloomy ruler capella tuft what we call it this whole bunch of capella is called glomerular capillary tuft now this criminal capillary tuft is surrounded by or invested by our group of cells double layer of cells let's suppose this is a very special group of cells these are epithelial cells these are very specialized epithelial cells right and these epithelial cells which have some foot processes and these foot processes are called photosites what are these called these cells are called epithelial cells are called photosites and these have foot processes and these cells right these are called visceral epithelial cells which sells visceral epithelial cells visceral epithelial cells and then they are connected with parietal epithelial cells what is this they are connected with yes another type of cells and these cells are called these cells are called displays parietal epithelial cells and then these cells join together to next group of cells which are making vows amell convoluted tubules right this is these are the cells of proximal convoluted tubules possible convoluted tubules will study in later right now what you really see that this is a loop of capillaries and anastomosing capillary channels and these anastomosing capillary channels are called goomar capillary tuft and this group of people is invested by a double layer of epithelium they are covered by double layer of epithelium one layer of epithelium is this which is called epithelial cells visceral epithelial cells and other layer is this and this layer is called not visceral this is called parietal epithelial cells right and whole this structure whole this structure is called glomerulus hole this structure is called glomerulus cool America Marla's consists on what structures it consists of groomer ruler capillary tuft and which is invested by or in which covered by double layer of epithelial health right this double layer of epithelial cell make a capsule and this capsule is called Bowman's capsule what is it called Bowman's Bowman's capsule another important point which I want to mention that there are special type of cells in between these capillaries and these cells are called I will just highlight this couple is a little more now what do you really see this is a bunch of capillaries now all these people raised on one side they are having epithelial cells right other side they are having special type of these cells and these blue cells are called mesangial cells what are the name of these cells these are called yes please machine jail cells and residual cells also produce lot of connective tissue they also produce lot of connective tissue and I can show you that connective tissue and blue lines and this connective tissue right with them including the Machine gel cell and this connective tissue together right this is the connective tissue right and along with mesangial cells right now all this structure this blue cells the angel cell with the practive tissue in which capillaries are in passing through right all this structure is called missing geom what is the name of the structure whole the structure and file just please miss engine now you should know when someone talked about blue color Morales you should know what has glue Morales pull Morales is a yes group of an Astra moseying Kepler is present in the kidney invested by double layer of epithelial cells making bomb in capsule and capillaries are embedded within mesangium and whole guru Morales is functionally the filtration unit of the nephron whole guru merliss is functionally a filtration unit of the nephron where filtration occurs right now I will go into detail of every part and one thing which is very important that between this the basement membrane of this capillary right and between this capillary endothelial lining and this epithelial lining here is a basement membrane what is that basement membrane on one side of this basement membrane there are endothelial cells of the capillaries on other side of the basement membrane there are epithelial cells of the epithelial cells or the bowman capsule right this black is what this is basement membrane and basement membrane is made of connective tissue on one side it has endothelial cells of the capillaries on other side basement membrane is having which cells visceral epithelial cells am i clear now in the next diagram to further explain the whole structure into detail let's suppose I will take this much area and enlarge it I will just draw next diagram basement membrane on one side capillary and within geom other side epithelial cells I will magnify this area and then we will discuss this structure into detail again whole GU neural capably bed is fed by the afferent arteriole other side there is drained by the different attitude and because these capabilities are unusually placed between two arterioles most of other copales in the body have arteriole on one side and on other side they have been you'll but these capabilities are unusual couple is glomerular capillaries that on there fed by the arterioles as well as they are drained into arteriole due to that reason these capably bunches very high pressure system this is this is a very high pressure capillary system because they are having arterioles which is feeding it as well as arteriole in which they drain they do not drain into you'll directly they drain into another art you is the right of course then this afferent arteriole will if you really want to know this infinite arterial will eventually again break up into what capella is efferent arteriole will again break up into capillaries and these people is are these capillaries are near the proximal and distal convoluted tubules so this triple is are called peri tubular cattle-raiser right these peritubular capillaries eventually drain into winds through which blood will go back out of kidney now we were discussing about that blood is coming to kidney and eventually it comes into afferent arteriole efferent arteriole breakdown into which is glomerular capillaries which are high pressure comparisons are concerned with filtration right and then blood is collected from the lunar localities into efferent arteriole afferent arteriole again break down into another group of capillaries which will drain eventually into venous system of the kidney to take the blood out of the kidneys right now I am going to enlarge this area you know glomerular basement membrane on one side into the capillary site other side is Bowman's side so I will enlarge this area and show you exactly what is the structure and function there let's suppose that here is goo Marlar basement membrane right on other side here should be what is this blood flowing side that is capillary side and to make it simple blood is coming from yes blood is coming from this direction so which arteriole is this one afferent arteriole this is one of the capillary and it is draining eventually into yes what is this afferent arteriole right here we can produce a little dip to represent the cells over here and what is the what are these cells yes messenger cells and there is some angel connective tissue present over here right now this is our glue modular basement membrane and here are the cells what were these cells visceral are epithelial visceral epithelial our visceral epithelial our bridal epithelial yeah visceral epithelia right and here is your Bowman's capsule space here is of course what are these cells [Music] yeah the right all epithelial cells right now and yes it is draining into which type of cells what is this possible convoluted tubular this is their brush border now first of all I will talk in detail about endothelial cells endothelial cells which line the glue marrow coupled is a very special type of endothelial cells what is the very special thing about them the ND of endothelial cells which are present over here they have thousands of the holes within the cell they have thousands of the hold or perforations within the south right so here are your endothelial cells this is another individual cell and still here we have one more endothelial cells of course they are present on other side as well right Dida of course because this is a couple rate is lined by endothelial cells but what is the very special thing about these endothelial cells these endothelial cells have holes they have holes and the thousands of such holes right and such endothelial cells which have holes and perforations within the cell structure we see that these cells are fenestrated these cells that finis created that is why this capillary is this group of capillaries are called fenestrated capillaries what kind of people is are these these are called glomerular glomerular capillaries are called what type of ripple is fenneis created capella is what is meant by the fenestrations fenestrations are the whole present within the endothelial cells lining the glomerular capillaries now what is the size of these holes these holes which are present over they are right these fenestrations are holes which are present in these cells right their size is approximately 7,200 meter what is the size of this hole this hole is seventy two hundred nano meter right because this this whole layer has to act as a filtration system we should know that filtered material has to pass through these fenestrations so what is the size of fenestrations every fenestration is somewhere between seventy two hundred nanometers and every endothelial cell has thousands of fenestrations due to that reason right you can say these are perforated endothelial cells what are these cells these are unusual perforated endothelial cells of course these four perforations are fenestrations enhance the filtration process right and every size is somewhere between 70 to hundred nanometer per fenestration is that right now this was a speciality of what thing endothelial cell then when you look at the glomerular basement membrane under the electron microscope you find that a central area is very very dense and this central area of the glomerular basement membrane which has on one side endothelial cell and other side it has what type of cells epithelial visceral epithelial cells so this central area which looks very dense under the electron microscope this is called lamina densa what what is this called justplease lamina densa is that right and on both sides of this the basement membrane looks less dense or we say that this one membrane in the central area is strongly electron dense but on endothelial side and on epital side basement membrane is relatively electron Lucent what is it it is electron Lucent mean that under the electron microscope it looks less dense it shows some loose ends see is that right it is not as dense as it in the center and due to this reason this is you can say less dense area and so we call it lamina rera this was lemonade densa both sides of lamina densa there is lamina yes please rera and this laminar era it is towards a catalyst and this is called the laminar era which is towards the capillary this is called lamina rera interna and dharna and this laminar era which is towards the Bauman capsule or epithelial cells this is called lamina rera externa externa so what we can say under the electron microscope the glomerular basement membrane right which is having endothelial cells on one side and epithelial cells on other side this will be our lab basement membrane has centrally watson lamina densa and on one side to the endothelial side it is having lamina Brera and Tarna and to the epithelial side it is having lamina rera externa is that right now let us go into bit detail off this structure the house ele glomerular basement membrane is made right actually goomar basement membrane structure is primarily mean of collagen type for collagen type for now this collagen right which male the Supra structure and basic network of modular basement membrane this collagen molecule consists of triple helix of alpha these are three peptide chains right these are called alpha peptide chains different type of alpha peptide chains they are making a triple helix and this triple helical structure is basically making what is the structure this is making collagen type four and this collagen type four is making the base millions of collagen type four molecules are making the basic network structure of the glomerular basement membrane and this is very important to understand this part of these caps peptide chains this part of the peptide chain is called globular globular non collagenous non collagenous component this is called globular non-college anus component of the peptide right or we call globular non collagenous domain this globular non collagen has domain of the collagen type for this green in some patient right there are there is formation of antibodies against this structure right there is formation of antibodies against the structure and these are twenty bodies which react here right with the collagen which component of collagen globular globular non collagenous component of collagen type four in some patients there is formation of our twenty bodies against this structure right and these auto antibodies may damage the glomerular basement membrane and there may be hematuria and proteinuria right and this is called this whole situation is called and tea GBM GBM is glomerular basement membrane and t GBM antibodies these antibodies are called NT GBM anti-bodies how are we simply call it NT GBM glomerular nephritis NT GBM glomerular nephritis another important point which is really worth mentioning here is that similar antigens the present an alveolar basement membrane also similar antigens are present n alveolar basement membrane also so some patient may make antibodies which will react not only against the glomerular basement membrane in the kidney right antibodies will react not only against ax and GBM but they will also react against the alveolar basement membrane under these circumstances in these patients where our 20 bodies are coming out and attacking the kidney as well as attacking the lungs so this will produce hematuria here immature iya here and this will produce damage to this and that will bring him up disease here I mop dices here right so when patient has hematuria and hemoptysis due to autoimmune disease in which there are antibodies directed against GBM as well as against ABM ABM is alveolar basement membrane GBM is gulmira basement membrane when both are destroyed by the immune process patient develops immature iya as well as hemoptysis do you think it's a good situation a bad situation yeah bad but I do not know why they call it good posture syndrome rather than calling bad posture syndrome they call it good have you heard of it okay good pastures syndrome we will discuss in detail when we will discuss the pathology of the good pastures syndrome ja that is why because sometimes these antibodies involve only kidney then we say there is NT GBM glomerulonephritis but if these antibodies damage the kidney as well as lungs and patient clinically comes with immature iya as well as hemoptysis we see patient is suffering with Goods posture syndrome in which there is no good for the patient is it right anyway so this was something important there type for collagen is involved in the what is this gurupada basement membrane how do you remember that which collagen is making which component type one collagen is making which a structure in the body yes Shirin will tell tell me this at least we should know what type one collagen is doing where type two collagen is involved in the body where type three is involved where type 4 is involved type 1 ok should I tell you a trick to help to remember it yeah type 1 okay tell me what I have written here bone what is this so bone has type 1 : yeah it's so simple in the spelling it is written that bone has which K which collagen type 1 collagen okay tell me I am going to write here something and you see what is wrong here do you think these are the right spellings of cartilage what I have written cartilage because cartilage has type 2 : is that right cartilage as type 2 collagen type 3 collagen is at many places so no need to remember right but tie for four sometimes you should do some poetry a little poetry here for under the under the floor how do you spell the floor develop are for under the floor in type 4 collagen is under the floor what is it under the floor basement so basement membranes wherever they are present in the body there which collagen type 4 type 4 is under the floor for under the floor what is that under the floor basement membrane basements so it is al Beulah basement or it is guru mother basement or any other basement both for the basements a corrective tissue basement membrane connective tissue that is having which collagen type for collagen is it difficult now so what do you think type 1 is present where and bone and type 2 is president car to ledge and 3 is present at many places and 4 under the floor and what is under the floor basement so 4 is present in the basement membranes another thing one thing we have talked about that these were which component yes plays non non global norm collagenous globular globular norm collagenous component or type for collagen against which antibodies will be formed if involve only kidney we call it NT GBM Goulburn nephritis and if involve the kidney as well as lungs we call it goods posture syndrome another important point which is related here is the sometimes there are mutations and due to those mutations these alpha chains which are supposed to make a good triple helix they are mutant if someone inherits defective genes and due to some defective genes he makes these alpha chains abnormal do you think the triple helix will be strong or weak it will be weak and this type of situation will result in two abnormally weak what lamellar basement membrane and these patient Vallabh in early life hematuria and gloom earlier injury right and this is called hereditary nephritis that is called hereditary nephritis if you have mutations here and if these are mutant then naturally mutations of these alpha chains they can now mutant chains cannot make the proper triple helix and that will end up in - yes harakiri nephritis right then another very important thing now you know that throughout this structure right type for collagen is present within the glomerular basement membrane right now another thing which I want to tell you which is very very important that this type for collagen is making the Supra structure within the glomerular basement membrane and over this there is deposition of many many negatively charged molecules right what are those molecules which make the glomerular membrane very much electronegative right those molecules are like polyanionic pulley in ionic column in many anionic mean negative charges pulley and ionic proteoglycans there are lot off yes what are these here pulley and INEC what are these pulley and ionic proteoglycans and what is the charge of them they are electro negative these molecules are negatively charged the pulley and I napoleonic mean that proteoglycans have multiple negative charges so this supra structure is loaded with lot of negatively charged molecules in which there are pulley and ionic proteoglycans moreover there are lemon UNS there fibronectin they are intact in you are not supposed to remember all of them if you just remember this type for collagen and lot of deposition of negatively charged molecule on them so Goomer all a basement membrane will become electro positive or electro negative it will be rank'd or negative so normally your whole bloomer of basement membrane is electro negative at the top even there are special type of negatively charged molecules present not only in the glomerular basement membrane but negatively charged molecules are also present on endothelial cells as well as epithelial cells and those negatively charged molecules are as a group called CLO glyco proteins right these are special glycoproteins which are present on the endothelial cells and make the layer electro positive or electro negative they make it electronegative and they are present on epithelial cell as well and epithelial cell surface also become electro negative so what we really see that there is electro negativity within the glomerular basement membrane there is also lateral negativity yes present on the endothelial cell and there is also lateral negativity present on epithelial cells this is a fright which means the whole filtration membrane is electro positive neutral or electro negative electrode negative this is what you have to remember all your life as long as you are dealing the patient who have kidneys so all over gloom earlier different membranes are electro negative their over line and your endo cells are negatively charged and you can say that epithelial cells are also negatively charged these are proteoglycans and Gulbarga basal membrane which make it negatively charged just CLO glycoproteins also which are present on endothelial cells and epithelial cells they also make it negatively charged [Music] these this negative charge is due to that protein if you really want to see it okay I make it this beautiful what is this protein CLO glycoprotein and what are these charges negative so the millions of molecules like this present here as well as here so hold this tri layer this is a triple layer for filtration what are the three layers one layer of and ocsl second layer of blue murder basement membrane third layer of visceral epithelial cells so all full all the layers are negatively child is their fright once you have understood this then another point about these epithelial cells it is very important to know that these epithelial cells when they are healthy they are having foot processes and with the tips of foot processes these cells are attached with the what is this blue Merlot basement membrane right and these cells right they are having finger-like processes and these finger-like processes not only help these cells to hold with the glomerular basement membrane these finger-like processes interdigitate for one cell to the next cell let me tell you an example let's suppose this is one epithelial cell this is the second epithelial cell right now this is one epithelial cell this is second epithelial cell right and let's suppose I should give me some paper okay give me this five six paper just hurry up you can come here come come here okay give me two paper I know you are very paper sensitive okay yes now look this paper is what this is glue marvel basement membrane this is glomerular basement membrane under it what has this applied what is this my hand under it this hand no no this is not women's capsule Bowman's even it it is part of the Bowman's capsule but what is this visceral cell and what is this this is another visceral cell both cells interdigitate come here just take the basal membrane up let us really meet the concept how this look this paper is the basement membrane take the basement membrane up yes do not take it away bus just take it little up right now what is this above is the basal membrane under it this is one epithelial cell this is the second epithelial cell right now just take it away now you see these cells are having finger-like processes one cell has lot of finger-like processes other cell also has lot of injured like processes with the tips of the finger these cells are held with the basement membrane and these finger-like processes are interdigitating you see here interdigitating and in between the inter digitated you find there are longitudinal slits you see the slits are not between one finger and for example this is one finger this is the photo sites from one cell digitation this is from other cell and there is one filtration slit here there is another filtration slits here these slits which are present in between the interdigitating foot processes of epithelial cells these slits are called filtration slits I should have a very clear concept that on this side what is this what are this fenestrations and here there are space between two interdigitating area what is this area filtration sled what is this filtration slits and what you have to see what was the size of this point fenestration was 70 to 100 nano meter and this filtration sled what is the size of it 20 to 30 nano meter it means the size barrier for example this is something which want to pass through this area down right there to barrier size barrier is here because fenestrations are larger but filtration sleeves are narrow these are seventy-two hundred extra nanometer filtration sleeves are twenty to thirty so they act either distal size barrier molecules which are smaller they can pass through it but larger molecules will not be able to pass through this is that right another point which we have to remember is that these epithelial cells right with their foot processes number one you have to remember these are visceral epithelial cells and this is criteria epithelial cell piety or epithelial cells do not have foot processes but visceral epithelial cell have foot processes visceral epithelial cells are applied against the glomerular basement membrane they are applied against the vole burger basement membrane and interdigitating processes or foot processes of different epithelial cells interdigitate with each other and in between the interdigitate ins there are filtration slits it means basically fluid will filter to this area to this area to this area to this area and through that to move laterally and then to come from here or it will directly filter from here is that right so fluid and substantial move through frustrated people is then they will move through the network of type for collagen right through global oh this will membrane and then fluid will move through a filtration filtrating material moves from filtration slits let me recap that anything which is filtered from glomerular capillaries to the Bowman's space right it moves through three layers it has to pass through endothelial layer it has to pass through connective tissue layer of goomar a basement membrane it has to pass through the layer of this roulette with Hiddleston here to facilitate the filtration what is present over here fenestrations here there is loose supra structure of collagen type for having some proteoglycan molecule than some more molecules with that and here there are filtration slits right any question here now very recent concept is that these filtration slits are having filtration diaphragm they are having a very thin diaphragm here and this is called which diaphragm filtration diaphragm right it's very thin now this filtration diaphragm is made of special type of protein and that protein is called nephron that protein is called nephron in renal pathology we will study that sometimes in some patients nephron is either mutant or against the nephron antibodies are formed and when nephron is damaged filtration diaphragms are destroyed and Goomer system start filtering out pathological amount of proteins proteins urea may start that we will discuss later in googler pathology again so what we really see that from here anything which has to be filtered right it has to be large sized molecular weight or small size small size because larger molecules not move they have seen as you keep on increasing the molecular weight of a substance right the chances of that substance to filter are getting more or less they are becoming less the classical example is dextran dextran molecules can be dextran molecules can be synthesized with different sizes and with different yes and with different charges they have synthesized the dextran molecule with positive charges with neutral charges of course no charges and with the negative charges then they did the experiment that when they infuse intravenously the past dextran molecule of very small ties the freely filter when they increase the sizes keep on increasing the size filtration will become less due to this reason they say that this glomerular filtration barrier is a size barrier it is a size barrier because filtration depend on the size of the molecule to be filtered smaller molecule like glucose or - Earth's the freely filter but plasma proteins which are larger molecule they cannot filter is that right secondly they did another experiment that first they filtered they injected the person with the dextran molecule which could freely filter right then they made those molecules electro positive the filtration will increase or decrease if molecules to be filtered right if molecules to be filtered are having just right right sides to be filtered and at the top they are electro positive it means a cationic molecule they will be repelled for the membrane or they will be facilitated in filtration they will be facilitated because membrane is negatively charged so any molecule which come here and which is positively charged will be attracted and move through that so they have seen that if there are three group of dextran molecules these are three groups of dextran molecule and all these have same molecular weight all three of them have same size and but one group is charged with positive charges other is neutral and third is synthesized and loaded it with negative charges right this is the first group of dextran this is second group of dextran neutral destron this is K tiny dextran this is neutral dextran and this is an ionic dextran what do you think out of this which will best filter eggs excellent you have given right answer the best filtration will be seen for K tiny dextrins and which will be the worst filtered in ionic it means that filtration not only depend on the size but also depends on the charge number one smaller size molecule will filter more larger sized molecules will filter less number two that cationic molecules will filter more and in any molecules will be filtering less it means that anything which has to filter through this that finds two type of barrier one is the size barrier another is charge barrier that is why we say that glomerular capillaries act as size and charge barrier system for the filtration now let me give you very classical example which you have to remember actually you know plus there are RBC SW PCs and platelets present over here RBC is a very large what is the size of RBC's seven to eight micron what is the size of one of on average WBC yes plays it is twelve to fourteen micron right and what is the size of platelet what is the size of platelet 1 to 2 micron all these right okay this is the platelet all these platelet RBC and WBC they are so large that in a healthy glomerular capillary system none of them can filter it means when blood is passing through this filtration juror in a healthy system RBC's WBC's of platelets cannot filter due to the very large size they are prevented from filtration due to their size barrier system emmaclaire then plasma freely made most of the things which are present in plasma the freely filter but in a healthy glomerular membrane system filtration system plasma proteins do not filter why what our plasma proteins their arguments they are globulin and there are fibrinogen humans are the smallest plasma proteins globulin are larger and fibrinogen of very large is that right actually they have seen the size of the albumin size of the albumin molecule is just right to be filtered that is just right that it can just plug and move through the fenestrations as well as by for collagen as well as through filtration slits I am talking about which plasma protein albumin globulin and fibrinogen are really too large to be filtered but normally it is seen in a healthy person even albumin which can which can easily pass due to its size still it does not filter what could be the reason for that yeah that albumin is negatively charged all plasma proteins at body pH plasma proteins are negatively charged and albumin is also negatively charged because albumin is an egg charge so in spite of the fact that the size of the women is just enough to pass through this barrier but still normally albumin does not filter in any significant amount practically we can say it does not filter at all through the healthy global appellate system because it is negatively charged and negative charges of endothelial cells the murder basement membrane and epithelial cells they repel you can say albumin molecules and don't allow the albumin to be filtered now this information is very important why because there is a disease called minimal change gloom are low patchy have you heard of it will study again in detail in pathology minimal change glue Neru low patty why we call it minimal change in this disease there is very little alteration in the goomar lie rather and under light microscope in this disease you don't see any change in the goomar lie under electron microscope you just find that in this disease these cells are little bit disrupted and there are little bit swollen and lost their fourth processes so there is minimal change or almost they do not find any significant change in gruber lie but in this change there is very heavy protein Judea lot of women is leaking into urine lot of Libya - leaking into surance doctors are always thinking what is happening endothelial cells look normal good Merle or basal membrane under the microscope look normal and under light microscope even epithelial cells also look normal they show some abnormalities under electron microscope so doctors are always wondering when this filtration system looks normal under light microscope why so much albumin is leaking down now the Tenno that actually in this disease some cytokines are produced in the body and those cytokines are inflammatory product they neutralize the negative charges on this membrane that is the only change what really happens minimal change will Merlin nephritis Orgrimmar block patty right there are some immunological products in the body which neutralize the negative charges of the governor filtration system and because these endothelial cells or gbn GBM strands of goon velu peaceful membrane and epithelial cells they are no more electronegative so they do not repel the albumin due to charge and as I told you albumin size is just the right size to pass through this different size barriers so because electro negativity of filtration membrane is lost so if amusement is no more repelled due to its charge and albumin freely filters and patient develops heavy albumin Sharia patient develops heavy albumin Judea so I hope this is clear how this membrane is made and how there's such a size and charge barrier right then few words about mesangial cells mesangial cells are active players they are not just cells silly like Sleeping Dogs they're functional cells and some disease processes they start behaving in a pathological fashion and produce troubles for us that is why we should know about the missing gel cell residual cells have special properties number one their contractile cells they can contract and if they can contract and they are present around the capillaries it means they can have some influence on gulbarga filtration right and you will be surprised to know that means angels sell their receptors for angiotensin ii so enjoy attention to can act on the news angel cell and through that to some extent it can influence the filtration so number one ms angel cell can contract number two miss angel cell can forego Saito's they act as Figgis it excels so that if there are some antigen-antibody complexes here these cells can engulf them right number three means angel cell can proliferate also later on when we will discuss the glomerular diseases we will find that in some globular diseases miss angel cell too much proliferate and of course if the proliferate too much and produce extra amount of connective tissue then of course they will compress for Capelli's and will marrow filtration will be disrupted emmaclaire so these cells can contract these cells can figure Saito's these cells can proliferate and these cells can deposit museum including collagen and and in the end angel cells if they are irritated due to some disease processes then these angel cell can produce many biologically active product right which can enhance the inflammation within the goomar line this is it right but these things we will discuss in detail in renal pathology in glomerular diseases right now having said all of this about the goomar structure right do you have any question about the glomerulus structure right after the break then we will discuss about the glomerular function that how the filtration other through bloomer lie what are the factors which alter the and affect the goomar filtration rate GFR right that will discuss in the next session

Channel: Dr. Najeeb Lectures

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Keywords: nephrology, filtration, glomerulus, renal, kidney, nephron, kidney (anatomical structure), bowman's capsule, physiology, renal function, dr najeeb lectures, armando, handwritten tutorials, anatomy and physiology, function, structure, metabolism, anatomy, anatomy (field of study), efferent, pee, arteriole, reabsorption, urethra, pressure, biology, filtrate, medical school, urinary system, medical, glomerular filtration, renal physiology, urine formation, loop of henle, bladder, gfr, nursing school, usmle

Id: H6vLAG_0Trs

Length: 57min 43sec (3463 seconds)

Published: Wed Dec 14 2016