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Renal > 2.1: Physiology 6 > Flashcards

2.1: Physiology 6 Flashcards

1
Q

Fluid entering the loop of henle from the proximal tubule is:

  • Hypo-osmotic?
  • Iso-osmotic?
  • Hyper-osmotic?

Give the value?

A

Fluid entering the loop of henle from the proximal tubule is ISO-OSMOTIC

(salt and water are absorbed in the same concentrations)

300mosmol/l

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2
Q

Fluid entering the distal tubule from the loop of henle is - Hypo-osmotic? - Iso-osmotic? - Hyper-osmotic? Give the osmolarity?

A

Fluid entering the distal tubule from the loop of henle is HYPO-OSMOTIC

100mosmol/l

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3
Q

What is the osmolarity of the interstital fluid (of the renal cortex) that surronds the distal convuluted tubule?

A

300mosmol/l

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4
Q

Where does the tubular filtrate go after the distal convoluted tubule?

A

Empties into the collecting duct

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5
Q

Describe the interstitial fluid surronding the collecting duct?

A

Increasing concentration as it passes down into the medulla

Goes from 300mosmol/l to 1200mosmol/l

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6
Q

All tubules empty into…?

A

Cortical Collecting Ducts

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7
Q

What percentage of ions are reabsorbed before they reach the distal tubule?

A

95%

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8
Q

The residual load of ions that reaches the distal tubule is:

A) Very important?

B) Insignificant?

A

The residual loads of ion that reaches the distal tubule is very important for salt balance

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9
Q

Fluid and NaCL regulation are mainly affected by…?

A

Fluid and NaCl regulation are mainly affected by hormones

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10
Q

The distal tubule and the collecting duct are a major site for the regulation of water and ion balance.

True or False?

A

True - the distal tubule and collecting duct are important in regulation of water and ion balance

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11
Q

Name the hormones involved in water and ion balance regulation?

A
  • ADH (Anti-Diuretic Hormone, also known as Vasopressin)

Aldosterone

Atrial Natriuretic Hormone

Parathryoid Hormone

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12
Q

Function of ADH?

A

Increases water reabsorption

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13
Q

Function of Aldosterone?

A

Increase Na+ reabsorption

Increased hydrogen and potassium secretion

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14
Q

Function of Atrial Natriuretic Hormone?

A

Decreased Na+ reabsorption

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15
Q

Function of Parathyroid hormone?

A

Increased Calcium Reabsorption

Decreased phosphate reabsorption

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16
Q

Describe the permeability of the distal tubule to water and urea?

A

The distal tubule has a very low permeability to urea and water

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17
Q

What are the two segments of the distal tubule?

A

Early

Late

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18
Q

Describe the early distal tubule?

Describe the late distal tubule?

A

EALRY - where early reabsoprtion of sodium and calcium occurs

LATE - Calcium Reabsorption, Sodium Reabsorption, Potassium Reabsorption, Hydrogen Secretion

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19
Q

What are the two parts of the collecting duct?

A

Early

Late

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20
Q

Describe the early collecting duct?

Describe the late collecting duct?

A

Early collecting duct is similar to late distal tubule - Sodium, Chloride, Potassium reabsorption and hydrogen secretion

Late collecting duct has a low ion permeability. Its permeability to water and urea is increased by ADH

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21
Q

Where is ADH produced?

Where is ADH stores?

A

Hypothalamus

Posterior Pituitary

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22
Q

Describe the affect of ADH on the permeability of the collecting duct?

A

Increases permeability of the luminal membrane to water by inserting new water channels called Aquaporins

23
Q

Describe what happens in the presence of high ADH?

Describe what happens in the presence of low ADH?

A

High ADH = High water permeability, hypertonic urine

Low ADH = Low water permeability, hypotonic urine

24
Q

Describe the urine produced when ADH is maximal?
Explain why?

A

Small, concentrated amount of urine

Tubular fluid equilibrates with interstitial fluid (water moves out)

25
Q

Describe the urine produced when ADH is minimal?

Why?

A

Large Volume of Dilute Urine

Collecting duct is impermeable to water so no reabsorption occurs

26
Q

Describe the effect of increasing ADH on:

  • Urine osmolarity?
  • Urine volume?
A

Increasing ADH causes increased urine osmolarity (blue line)

Increasing ADh causes decreased urine output (green line)

27
Q

What are the main receptors in thirst and ADH secretion?

What are the minor receptors in thirst and ADH secretion?

A

Hypothalmic Osmoreceptors

Left Atrial Volume Receptors (only important in large changes in plasma volume/arterial pressure)

28
Q

Describe the effect of water deficit on blood pressure?

What is done to compensate this?

A

Water deficit causes decreased blood pressure

This is detected by left atrial volume receptors

Increased ADH is released to compensate for this

29
Q

What is Diabetes Insipidus?

A

This is is a form of diabetes characterised by excessive thirst and a large amount of dilute urine being produced

30
Q

What are the types of Diabetes Insipidus?

A

Central = Caused by lack of ADH

Nephrogenic = Lack of sensitivities of the kidneys to ADH

31
Q

Treatment for Diabetes Insipidus?

A

ADH Replacement

32
Q

What are the most important stimulus for ADH release (receptors)?

Second set of receptors?

A

Hypothalamic Osmoreceptors

Left Atrium Stretch (Volume) Receptors

33
Q

Decreased atrial pressure leads to:

A) Increased

B) Decreased

ADH release?

A

Decreased atrial pressure leads increased ADH release

34
Q

Matching:

  • Nicotine
  • Alcohol

A. Inhibits ADH

B. Stimulates ADH

A

Nicotine stimulates ADH release

Alcohol inhibits ADH release

35
Q

What is the tubular flow rate at the distal tubule and collecting duct:

  • Maximal ADH?
  • Minimal ADH?
A

Maximum = 0.2ml/min

Minimum: 20ml/min

36
Q

Where is Adolesterone secreted from?

A

Adrenal Cortex

37
Q

When is adolsterone secreted?

A

If potassium rises or sodium falls (in blood)

Activation of the renin-angiotensin system

38
Q

Function of Aldosterone?

A

Increases sodium reabsorption

Increases potassium secretion

39
Q

90% of potassium is reabsorbed where?

Where is the other 10% absorbed?

A

Early regions of nephron (proximal tubule)

When there is no adolsterone present, the other 10% is reabsorbed in the distal tubule

40
Q

Describe the effect of:

  • Increased plasma potassium
  • Decreased sodium potassium

On the adrenal cortex?

A

Increasing plasma potassium directly stimulates the adrenal cortex to secrete Aldosterone

Decreased plasma sodium indirectly causes aldosterone secretion through the juxtaglomerular apparatus

41
Q

What are three things the Renin-Angiotensin-Aldosterone system tries to correct?

A
  • Decreased sodium
  • Decreased ECF volume
  • Decreased arterial pressure
42
Q

Describe the renin-angiotensin-adolsterone system?

A

Liver produces angiotensin

Renin from kidneys converts this to angiotensin 1

Angiotensin converting enzyme from lungs converts angiotensin 1 to angiotensin 2

Angiotensin stimulates:

  • ADH
  • Thirst
  • Vasoconstriction
  • Adrenal Cortex to produce aldosterone
43
Q

Where is renin released from?

*SPECIFIC*

A

Granular Cells cells in Juxtaglomerular apparatus

44
Q

What causes release of renin from granular cells of juxtaglomerular apparatus?

A
  • Reduced pressure in afferent arteriole
  • Macula Densa sensing decreased NaCl in distal tubule
  • Increased sympathetic activity due to reduced arterial blood pressure
45
Q

Aldosterone increases Na+ reabsoprtion in the ….. and ….

Fill in the blanks?

A

Aldosterone increases Na+ reabsorption in the distal tubule and collecting tubule

46
Q

Describe the fluid retention in heart failure (in relation to Renin-Angiotensin-Aldosterone system)

Treatment?

A
  • Heart failing
  • CO and BP drop
  • RAA system activated
  • Fluid and electrolytes retained
  • Causes heart to fail further

Low salt diet, loop diuretics, ACE Inhibitors

47
Q

Where is ANP (Atrial Natriuretic Hormone) produced?

Where is it stored?

When is it released?

A

ANP is produced in the heart

It is stored in the atrial muscle cells

It is released when these cells are mechanically stretched due to an increase in circulatiing plasma volume

48
Q

Function of ANP?

Affect of ANP on plasma volume?

A

Promotes excretion of Na+ and diuresis (increased urine production)

This decreases plasma volume

Also exerts an effect on the cardiovascular system to lower BP

49
Q

What does ANP help correct?

A

Increased Na+

Increased ECF volume

Increased Arterial BP

50
Q

What happens when ANP is increased (detailed)?

A
  • Decreased sodium reabsorption (it is excreted)
  • Inhibition of Renin-Angiotensin-Aldosterone
  • Vasodilation (causing increased GFR)
  • Decreased sympathetic activity leading to decreased arterial BP
51
Q

What is the process of urination called? (Bladder Emptying)

What controls this process?

A

Micturition

Controlled by the micturition reflex (involuntary bladder control) and voluntary control (tightening of external sphincter)

52
Q

Describe the steps in bladder emptying?

A

Bladder fills

Stimulates stretch response

Stimulates parasympathetic response

Bladder contracts

Internal urethral sphincter opens (males)

Urination

Can be overriden by cerebal cortex controlling motor neuron. (VOLUNTARY) When motor neuron is stimulated, external urethral sphincter doesn’t open

53
Q

Describe the steps that cause increased Aldosterone?

A
54
Q
A

Renal (34 decks)

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