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A&P II > Chapter 19 > Flashcards

Chapter 19 Flashcards

1
Q

To maintain homeostasis, what comes in the body
must eventually be

A

used or excreted

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2
Q

Input + production =

A

utilization + output

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3
Q

Factors Affecting the Plasma Composition

A
  • Kidneys regulate solute and water content, which also
    determines volume
  • Regulate acid-base balance
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4
Q

Composition is also affected by exchange between what compartments of body

A

Cells
* Connective tissue
* Gastrointestinal tract
* Sweating
* Respiration

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5
Q

figure 19.1

A
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6
Q

Balance

A
  • Solutes and water enter and exit plasma
    at the same rate
  • Quantity stays the same
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7
Q

Positive balance

A
  • Solute or water enters plasma faster than it exits
  • Quantity increases
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8
Q

Negative balance

A
  • Solute or water exits plasma faster than it enters
  • Quantity decreases
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9
Q

Cells in late distal tubules and collecting ducts that
regulate balance

A
  • Principal cells (Water
    and Electrolytes)
  • Intercalated cells (Acid-base balance)
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10
Q

Water intake + metabolically produced =

A

water output +
water used

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11
Q

water Intake

A
  • Gastrointestinal tract
  • Metabolism
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12
Q

Water output

A
  • Insensible loss
  • Sweating
  • Gastrointestinal tract
  • Kidneys
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13
Q

Normovolemia

A

normal blood volume

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14
Q

Hypervolemia

A

high blood volume due
to positive water balance

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15
Q

Hypovolemia

A

low blood volume due
to negative water balance

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16
Q

Osmosis

A
  • Water diffuses down the concentration gradient
  • Water reabsorption follows solute reabsorption
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17
Q

Water moves from area of ___ solute concentration to
area of ___ solute concentration

A

low ; high

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18
Q

kidney’s role in osmolarity

A

Kidneys compensate for changes in osmolarity of
extracellular fluid by regulating water reabsorption

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19
Q

Water reabsorption is a ____ process

A

passive

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20
Q

Proximal tubules

A

70% of filtered water is reabsorbed
* Not regulated

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21
Q

Distal tubules and collecting ducts

A

Most remaining water is reabsorbed
* Regulated by ADH (vasopressin)

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22
Q

Water reabsorption follows

A

solute reabsorption

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23
Q

What is the primary solute

A

sodium

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24
Q

Na+ is ____ transported across the _____
membrane

A

actively ; basolateral

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25
Q

figure 19.5

A
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26
Q

Osmolarity of interstitial fluid of renal medulla
varies with?

A
  • depth
  • Lower osmolarity near cortex
  • Greater osmolarity near renal pelvis
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27
Q

Osmotic gradient is established by the

A

countercurrent
multiplier

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28
Q

Ascending limb (loop of henle)

A

Impermeable to water
* Active transport of Na+, Cl–, and K+

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29
Q

Descending limb (loop of henle)

A

Permeable to water
* No transport of Na+, Cl–, or K+

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30
Q

Fluid in descending limb

A
  • osmolarity increases as it descends
  • Osmolarity = interstitial fluid
  • Osmolarity > descending limb
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31
Q

Fluid in ascending limb

A

osmolarity decreases as it ascends
* Osmolarity < interstitial fluid
* Osmolarity < descending limb

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32
Q

Role of urea in the medullary osmotic gradient

A
  • Generated by liver
  • Nitrogen elimination
  • Extremely water soluble
  • Requires urea transporters: UTA, UTB, and UTC
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33
Q

Role of the vasa recta

A

capillaries prevents the
diffusion of water and solutes from dissipating the medullary osmotic gradient

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34
Q

Descending limb of vasa recta

A

As it descends, water leaves capillaries by osmosis and solutes enter by diffusion

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35
Q

Ascending limb of vasa recta

A

Water moves into plasma and solutes move into interstitial fluid
* Osmolarity is higher due to the lack of urea transporters

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36
Q

Water permeability dependent on what water channels

A

Aquaporin-3
Aquaporin-2

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37
Q

Aquaporin-2

A

present in apical membrane only when ADH present in blood

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38
Q

Aquaporin-3

A

present in basolateral membrane always

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39
Q

When membrane of late distal tubule and collecting duct is impermeable to water what happens

A

Water cannot leave the tubules
* No water reabsorption
* More water is excreted in urine

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40
Q

ADH stimulates the insertion of water channels
_____ into ___ membrane

A

aquaporin-2 ; apical

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41
Q

Maximum amount of water reabsorbed depends on ___ of ____

A

length ; loop of Henle

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42
Q

Obligatory water loss

A

Minimum volume of water that must be excreted in the
urine per day

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43
Q

Effects of ADH on water reabsorption

A
  • ADH regulates permeability of late distal tubules and
    collecting ducts
  • Urine osmolarity range: 100–1400 mOsm
  • Aquaporin-2 varied by ADH
  • Antidiuretic
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44
Q

Regulation of ADH secretion

A

Released from terminals in the posterior pituitary from
cell bodies originating in the hypothalamus
* Osmoreceptors in the organum vasculosum of laminae
terminalis (OVLT) sense osmolarity
* OVLT is not surrounded by the blood-brain barrier
* ADH is also affected by baroreceptors detecting blood
volume and pressure
* increase baroreceptor activity = increase ADH secretion

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45
Q

Figure 19.13

A
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46
Q

Hypernatremia

A

high plasma sodium

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47
Q

Hyponatremia

A

low plasma sodium

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48
Q

Sodium

A

primary solute in ECF

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49
Q

Why is sodium needed?

A
  • Critical for normal osmotic pressure
  • Critical to function of excitable cells
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50
Q

Where is Na reabsorbed?

A

Reabsorbed (70%) in proximal tubules, distal tubules, and
collecting ducts

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51
Q

Where is Na reabsorption regulated?

A
  • Reabsorption regulated by aldosterone and ANP
  • Reabsorption regulated at principal cells of distal tubules and
    collecting ducts
52
Q

Is reabsorption of Na passive or active?

A

active

53
Q

What drives Na reabsorption?

A

Na+/K+ pump on basolateral membrane

54
Q

Know figure 19.14

A
55
Q

What are the effects of aldosterone?

A

Increases sodium reabsorption
* Steroid hormone secreted from adrenal cortex

56
Q

Function of aldosterone

A
  • Acts on principal cells of distal tubules and
    collecting ducts
  • Increases number of Na+/K+ pumps on basolateral
    membrane
  • Increases number of open Na+ and K+ channels on
    apical membrane
57
Q

Granular cells of juxtaglomerular apparatus secrete what?

A

Renin-angiotensin-aldosterone system (RAAS)

58
Q

Angiotensinogen is converted by___ into _____

A

renin ; angiotensin I

59
Q

Liver secretes?

A

angiotensinogen

60
Q

Angiotensin II stimulates?

A

aldosterone production

61
Q

Angiotensin I is converted by ___ into angiotensin II

A

ACE; angiotensin II

62
Q

Capillary walls contain ______, especially in lungs

A

angiotensin-converting enzyme (ACE)

63
Q

Know figure 19.16

A
64
Q

Know figure 19.17

A
65
Q

Atrial Natriuretic Peptide

A

Secreted by atrial cells in response to distension
of atrial wall

66
Q

Atrial Natriuretic Peptide increases?

A

GFR
* Dilation of afferent arteriole
* Constriction of efferent arteriole

67
Q

Atrial Natriuretic Peptide decreases?

A

Na+ reabsorption by closing Na+
channels in apical membrane

68
Q

Overall effect of Atrial Natriuretic Peptide

A

increased Na+ excretion

69
Q

Hyperkalemia

A

high plasma potassium

70
Q

Hypokalemia

A

low plasma potassium

71
Q

Potassium is crucial to function of _____

A

excitable cells

72
Q

Renal Handling of Potassium Ions in the glomerulus

A

freely filtered

73
Q

Renal Handling of Potassium Ions in the proximal tubules

A

reabsorbed

74
Q

Renal Handling of Potassium Ions in the Distal tubules and collecting ducts

A

reabsorbed and
secreted

75
Q

Aldosterone regulates

A

principal cells

76
Q

K+ in plasma directly stimulates

A

aldosterone release

77
Q

As K+ increases, more ____ is released

A

aldosterone

78
Q

Hypercalcemia

A

high plasma calcium

79
Q

Hypocalcemia

A

low plasma calcium

80
Q

Calcium balance is critical for?

A
  • Triggers exocytosis
  • Triggers secretion
  • Triggers muscle contraction
  • Increases contractility of cardiac and smooth muscle
81
Q

Know figure 19.21

A
82
Q

Blood calcium

A
  • Bound to carrier proteins
  • Free in plasma
  • Free calcium: freely filtered at glomerulus
83
Q

Parathyroid hormone (PTH)

A

released from parathyroid
glands

84
Q

Stimulus for the release of PTH

A

decreased Ca2+ in plasma

85
Q

Functions of PTH

A
  • Increases Ca2+ reabsorption by kidneys
  • Stimulates activation of 1,25-dihydroxycholecalciferol in kidneys
  • Stimulates resorption of bone
  • Stimulates small increase in calcium absorption
86
Q

Overall effect of PTH

A

increased blood calcium

87
Q

1,25-dihydroxycholecalciferol

A

steroid hormone
derived from vitamin D3

88
Q

Calcitonin is secreted from?

A

C cells of thyroid gland

89
Q

What triggers the release of calcitonin?

A

high plasma [Ca2+]

90
Q

Actions of calcitonin at target cells

A
  • Increases bone formation
  • Decreases calcium reabsorption by kidneys
91
Q

Normal pH of arterial blood

A

7.35–7.45

92
Q

pH < 7.35 =

A

acidosis

93
Q

pH > 7.45 =

A

alkalosis

94
Q

Complications with acid-base disturbance

A
  • Conformation change in protein structure
  • Changes in excitability of neurons
  • Changes in potassium balance
  • Cardiac arrhythmias
    Vasodilation
95
Q

Normal PCO2 arterial blood =

A

40 mm Hg

96
Q

Sources of CO2

A

metabolism

97
Q

Output of Co2

A

through respiratory system

98
Q

Increased plasma [CO2] →

A

respiratory acidosis

99
Q

Decreased plasma [CO2] →

A

respiratory alkalosis

100
Q

What causes acidosis?

A
  • High-protein diet
  • High-fat diet
  • Heavy exercise
  • Severe diarrhea (loss of bicarbonate)
  • Renal dysfunction
101
Q

Metabolic alkalosis causes

A
  • Excessive vomiting (loss of hydrogen ions)
  • Consumption of alkaline products (baking soda)
  • Renal dysfunction
102
Q

Three lines of defense against Acid-Base Disturbances

A
  • Buffering of hydrogen ions
  • Respiratory compensation
  • Renal compensation
103
Q

Most important ECF buffer=

A

bicarbonate

104
Q

ICF buffers

A

proteins and phosphates

105
Q

Increased ventilation →

A

decreased CO2

106
Q

Decreased ventilation →

A

increased CO2

107
Q

Renal compensation

A
  • Regulates excretion of hydrogen ions and bicarbonate in urine
  • Regulates synthesis of new bicarbonate in renal tubules
108
Q

Effects of increased acidity

A
  • Increased secretion of hydrogen ions
  • Increased reabsorption of bicarbonate
  • Increased synthesis of new bicarbonate
109
Q

Renal handling of hydrogen and bicarbonate ions in the Proximal tubule

A

Bicarbonate reabsorption coupled to hydrogen ion secretion

110
Q

Renal handling of hydrogen and bicarbonate ions in the Distal tubule and collecting duct

A

Secretion of hydrogen ions coupled to synthesis of new bicarbonate ions

111
Q

Compensation for Acid-Base Disturbances: PH

A

7.4, [HCO3–]/[CO2] = 20:1

112
Q

Compensation for Acid-Base Disturbances: ACIDOSIS

A

[HCO3–]/[CO2] < 20:1

113
Q

Compensation for Acid-Base Disturbances: ALKALOSIS

A

[HCO3–]/[CO2] > 20:1

114
Q

Kidneys regulate?

A

HCO3–

115
Q

Lungs regulate

A

CO2

116
Q

Cause of Respiratory acidosis

A

hypoventilation

117
Q

Increased CO2 →

A

increased H+

118
Q

Compensation of Respiratory acidosis

A
  • renal
  • Increased H+ secretion
  • Increased HCO3– reabsorption
119
Q

Cause of Respiratory alkalosis

A

hyperventilation

120
Q

Decreased CO2 →

A

decreased H+

121
Q

Compensation of Respiratory alkalosis

A
  • renal
  • Decreased H+ secretion
  • Decreased HCO3– reabsorption
122
Q

Metabolic acidosis
Cause

A

increased H+ independent of CO2

123
Q

Metabolic acidosis compensation

A
  • respiratory and renal
  • Increased H+ secretion
  • Increased HCO3– reabsorption
  • Increased synthesis of new bicarbonate
124
Q

Metabolic alkalosis
Cause

A

decreased H+ independent of CO2

125
Q

Respiratory compensation

A

Decreased ventilation → increased CO2

126
Q

Renal compensation

A
  • Decreased H+ secretion
  • Decreased HCO3– reabsorption
  • Decreased synthesis of new bicarbonate
127
Q

figure 19.29

A

A&P II (8 decks)

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