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Human physiology PT > Chapter 19- EXAM 3 > Flashcards

Chapter 19- EXAM 3 Flashcards

1
Q

how does the renal body fluid system work

A

Using blood volume to control Blood Pressure

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2
Q

what helps control the long term pressure control

A

renal body fluid system

–as extracellular fluid volume increases arterial pressure increases.

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3
Q

what does an increase in arterial pressure cause the kidneys to lose

A

kidneys to lose Na and water which returns extracellular fluid volume to normal

– look at slide 2 flow chart

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4
Q

what is pressure diuresis

A

The effect of pressure to increase water excretion

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5
Q

what is pressure natriuresis

A

The effect of pressure to increase Na excretion

– Look at slide 4

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6
Q

what are major determinants of long-term arterial pressure control

A

Renal Fucntion

Salt and water intake

** It is impossible to change the long-term mean arterial pressure level to a new value without changing Renal Function Curve and/or Salt & Water intake

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7
Q

where is the equilibrium point

A

where intake and output curves intersect

– look at the slide 5

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8
Q

what kind of gain does the renal body fluid feed back system has an ?

A

infinite gain

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9
Q

do changes in the TPR affect long term atrial pressure levels

A

no

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10
Q

what curve must be altered to have to have long term changes in arterial pressure

A

one must alter the renal fx curve to have long term changes

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11
Q

what is another things that would change leads to arterial pressure

A

changing renal vascular resistance will lead to long term changes in arterial pressure

–Look at slide 6

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12
Q

what happens when Na intake is increased

A

Na stimulates drinking, increased Na concentration stimulates thirst and ADH secretion

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13
Q

what do changes in Na intake lead to

A

leads to changes in extracellular fluid volume (ECFV)

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14
Q

ECFV is determined by

A

the balance of Na intake and output

–Look at slide 7

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15
Q

what are the 2 sequential stages of Volume-loading hypertension

A

1 first

  • — increased Q form increased fluid volume
  • —- produces the HTN

2 second
—– HTN continues with high blood pressure and high total peripheral resistance but Q returns to near normal

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16
Q

when does increased TPR occur

A

after hypertension has developed so it is secondary to the hypertension rather than being the cause

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17
Q

what is the final stage of Volume-loading hypertension

A
  1. Hypertension
  2. Marked increase in total peripheral resistance
  3. Almost complete return of the extracellular fluid volume, blood volume, and cardiac output back to normal
18
Q

look at this slide

A

9

19
Q

where is renin synthexsized and is stored in

A

Renin is synthesized and stored in modified smooth muscle cells in afferent arterioles of the kidney

20
Q

why is renin released

A

Renin is released in response to a fall in pressure

21
Q

what does renin acts on

A

Renin acts on a substance called angiotensinogen to form a peptide called angiotensin I.

22
Q

what is AI converted into

A

AI is converted to AII by a converting enzyme located in the endothelial cells in the pulmonary circulation

23
Q

Look at slides

A

10, 11, 12, 13, 14

24
Q

what are some action of the renin angiotensin system

A
  • vasoconstriction
  • na retention by direct and indirect acts on the kidney
  • shifts in renal function curve to the right
25
Q

what is the Na retention by direct acts

A

Direct actions on the tubular cells to increase tubular reabsorption of sodium and water

26
Q

what is Na retention by indirect acts

A

Indirect by stimulating release of Aldosterone by adrenal glands

27
Q

what is renin angiotenssin system important in maintaining

A

maintaining a normal Art Pressure during changes in Na intake

28
Q

what happens to reniin level as Na intake is increased

A

it will fall to near 0

29
Q

what happens to reniin level as Na intake is decreased

A

levels increased significantly

30
Q

what does the renin angiotenssin system cause the renal fx curve to look like

A

RAS causes the Na loading renal function curve to be steep

31
Q

who gets primary hypertension

A

90% of hypertensive patients

    • mild form of hypertension, slow progression
    • cause is unknown but most likely related to weight gain
    • 2/3 of essential hypertensives are overweight
32
Q

what are some other types of hypertension caused by volume loading and vasoconstriction

A
  • Renal Artery Stenosis
  • Chronic renal disease
  • Primary hyperaldosteronism
  • Sleep Apnea
  • Pheochromocytoma
  • Preeclampsia
  • Aortic Coarctation
33
Q

what does renal artery disease cause

renal artery stenosis

A

renal artery disease can cause of narrowing of the vessel lumen (stenosis).

34
Q

what does the reduced lumen diameter in the renal artery do

(renal artery stenosis)

A

increases reduces the pressure at the afferent arteriole in the kidney.

35
Q

what does Reduced renal perfusion stimulate renin release by the kidney do
(renal artery stenosis)

A

This increases circulating angiotensin II(ANGII) and aldosterone.

36
Q

what do angiotensin II(ANGII) and aldosterone do in the blood
(renal artery stenosis)

A

These hormones increase blood volume by enhancing renal reabsorption of sodium and water. Increased ANGII also causes systemic vasoconstriction.

37
Q

what is the net effect of these renal mechanisms

renal artery stenosis

A

The net effect of these renal mechanisms is an increase in systemic vascular resistance and an increase in cardiac output (transient)

38
Q

what can cause damage nephrons in the kidney

chronic renal disease

A

a number of pathologic processes (e.g., diabetic nephropathy, glomerulonephritis) can damage nephrons in the kidney.

39
Q

what happens when there is damage to the nephrons of the kidneys
(chronic renal disease)

A

When this occurs, the kidney cannot excrete normal amounts of sodium which leads to sodium and water retention, increased blood volume, Renal disease may also result in increased release of renin leading to a renin-dependent form of hypertension.

40
Q

what can the elevation in arterial pressure secondary to renal disease can be viewed as what
(chronic renal disease)

A

The elevation in arterial pressure secondary to renal disease can be viewed as an attempt by the kidney to increase renal perfusion and restore glomerular filtration.

41
Q

what can catecholamine secreting tumors cause

Pheochromocytoma

A

Catecholamine secreting tumors in the adrenal medulla can lead to very high levels of circulating epinephrine and norepinephrine.

42
Q

LOOK/ Read slide

A

19- as there is a lot of stuff about (Pheochromocytoma)

Human physiology PT (12 decks)

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