Chapter 28: Urine Concentration And Dilution Flashcards

0
Q

Excretion of excess water is done how?

A

Excretion of diluted urine

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1
Q

Action of vasopressin

A

Increases water permeability of distal tubules and collecting ducts

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2
Q

Osmolarity of glomerular filtrate in the proximal tubule

A

Isosmotic to plasma

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3
Q

Tonicity of filtrate as it passes down the descending limb of the loop of Henle

A

Hypertonic

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4
Q

Segment of tubular system which is impermeable to water even with the presence of ADH, which dilutes the tubular fluid

A

Ascending Loop of Henle

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5
Q

Osmolarity of tubular fluid as it leaves the early distal tubule

A

Hyposmotic

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6
Q

Minimal volume of urine that must be excreted

A

Obligatory urine volume

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7
Q

Maximal urine concentration of the human kidney

A

1200 mOsm/L

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8
Q

Weight of solutes in a given volume of urine

A

Urine specific gravity (1.002-1.028)

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9
Q

Requirement s for excreting concentrated urine

A
  1. High levels of ADH

2. Hyperosmotic renal medullary interstitial fluid

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10
Q

Mechanism responsible for concentrating the renal medullary interstitial fluid

A

Countercurrent mechanism

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11
Q

The most important cause of of the high medullary osmolarity is active transport of sodium and co-transport of K, Cl and other ions from what tubular segment?

A

Thick ascending limb of the loop of Henle

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12
Q

Limit of the concentration gradient between tubular fluid and interstitial fluid

A

200 mOsm/L

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13
Q

Refers to the repetitive reabsorption of NaCl by the thick ascending loop of Henle and continued inflow of new NaCl from the proximal tubule into the loop of Henle

A

Countercurrent multiplier

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14
Q

Substance that contributes 40-50% of the osmolarity of the renal medullary interstitium when the kidney is forming a maximally concentrated urine

A

Urea

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15
Q

Tubular segment which are impermeable to urea

A

Thick ascending limb of the loop of Henle up to cortical collecting duct

16
Q

Transport of urea from the inner medullary collecting ducts to the renal interstitial fluid occurs through which mechanism?

A

Facilitated diffusion utilizing urea transporters (UT-A1 and UT-A3)

17
Q

Secretion of urea in the thin loops of Henle is facilitated by which transporter

A

UT-A2

18
Q

Give two special features of the renal medullary blood flow that contribute to the preservation of the high solute concentrations

A
  • low medullary blood flow (<5% of renal blood flow)

- vasa recta serve as countercurrent exchangers

19
Q

The vasa recta do not create the medullary hyperosmolarity, but they do prevent it from being dissipated. True / False

A

True

20
Q

Effect of increased medullary blood flow to urine concentrating ability

A

Reduced urine concentrating ability due to washing out of some of the solutes from renal medulla

21
Q

NaCl is one of the principal solutes that contribute to the hyperosmolarity of the medullary interstitium. However, the kidney can excrete a highly concentrated urine that contains little NaCl. True / False

A

True

22
Q

Condition wherein there is failure to produce ADH

A

Central DI

23
Q

Condition wherein the kidneys fail to respond to ADH

A

Nephrogenic DI

24
Q

Two primary systems involved in regulating the concentration of Na and osmolarity of extracellular fluid

A
  • osmoreceptor-ADH system

- thirst mechanism

25
Q

Special nerve cells that shrink during an increase in ECF fluid osmolarity

A

Osmoreceptor cells

26
Q

stimuli for ADH secretion

A
  • high osmolarity
  • low arterial pressure
  • low blood volume
  • nausea
  • hypoxia
  • drugs (morphine, nicotine, cyclophosphamide)
27
Q

ADH is more sensitive to small changes in osmolarity than to similar changes in blood volume. True or False

A

True

28
Q

The desire to drink is completely satisfied only when?

A

Plasma osmolarity and/or blood volume returns to normal

29
Q

Threshold for drinking

A

Na concentration increases 2 mEq/L above normal

30
Q

Stimuli for thirst mechanism

A
Inc plasma osmolarity
Dec blood volume
Dec blood pressure
Inc angiotensin II
Dryness of mouth
31
Q

When either the ADH or the thirst mechanism fails, the other ordinarily can still control extracellular osmolarity and Na concentration with reasonable effectiveness. True or False

A

True

32
Q

Angiotensin II and aldosterone have great effect in Na concentration. True or False

A

False. Both have little effect except under extreme conditions

33
Q

Plasma sodium concentration

A

142 mEq/L (140-145 mEq/L)