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PHYSIOLOGY > CONCENTRATION AND DILUTION OF URINE > Flashcards

CONCENTRATION AND DILUTION OF URINE Flashcards

1
Q

TOTAL BODY WATER IS CONTROLLED BY:

A
  1. FLUID INTAKE -> REGULATED BY THE THIRST MECHANISM IN THE HYPOTHALAMUS AND RELATED HORMONES
  2. RENAL WATER EXCRETION SUCH AS CONCENTRATION AND DILUTION OF URINE -> REGULATED BY ADH AND COUNTER CURRENT MECHANISM IN THE KIDNEY
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2
Q

ADJUSTMENT OF THE FINAL URINE CONC. IS DONE AT THE

A

COLLECTING DUCT

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3
Q

TRUE/ FALSE:

A. OBLIGATORY REABSORPTION OF WATER NEED ADH
B. OBLIGATORY REABSORPTION OF WATER IS HIGHER IN THE DESCENDING LIMB LOOP OF HENLE
C. FACULTATIVE REABSORPTION OF WATER NEED ADH
D. ADJUSTMENT OF FINAL URINE CONC. IS DONE AT THE COLLECTING DUCT
E. WHEN OVERHYDRATION, THE URINE VOLUME DECREASE

A

A. FALSE
B. FALSE (HIGHER IN THE PCT)
C. TRUE
D. TRUE
E. FALSE

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4
Q

WHEN THE WATER IN THE BODY IS IN EXCESS, THE OSMOLARITY OF ECF IS HIGH/LOW

A

LOW

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5
Q

WHEN THE OSMOLARITY OF THE URINE EXCRETED IS HIGH, IT INDICATES THT

A

THE OSMOLARITY OF ECF IS HIGH D/T THE BODY WATER DEFICIENCY

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6
Q

TO CONCENTRATE THE URINE, THE KIDNEYS REQUIRE:

A
  1. HYPERTONIC INTERSTITIUM IN THE RENAL MEDULLA
  2. ADH
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7
Q

TO CREATE AND MAINTAIN A HYPERTONIC INTERSTITIUM IN THE RENAL MEDULLA, THE KIDNEY REQUIRE:

A
  1. COUNTERCURRENT MULTIPLIER -> LOOP OF HENLE IN WHICH IT WILL CREATE A HYPERTONIC INTERSTITIUM
  2. COUNTERCURRENT EXCHANGER -> VASA RECTA IN WHICH IT MAINTAINS THE HYPERTONIC INTERSTITIUM.
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8
Q

STATE THE MAJOR FEATURES REQUIRED FOR KIDNEY TO PRODUCE CONCENTRATED URINE.

A
  1. COUNTERCURRENT ARRANGEMENT OF THE ENTIRE NEPHRON AND COLLECTING DUCT (S SHAPE)
  2. TAL OF LOH -> IMPERMEABLE TO WATER AND PERMEABLE TO SOLUTE, CAPABLE OF NACL TRANSPORT
  3. CORTICO MEDULLARY OSMOTIC GRADIENT -> OSMOLARITY INCREASES FROM CORTEX TO MEDULLA
  4. ABILITY TO REGULATE THE WATER PERMEABILITY OF THE DISTAL TUBULE AND CD
  5. COUNTERCURRENT ARRANGEMENT OF BF -> PRESENT IN THE VASA RECTA.
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9
Q

DESCENDING LIMB IS HIGH PERMEABLE TO ___ BUT IMPERMEABLE TO ___

A

PERMEABLE TO WATER
IMPERMEABLE TO SOLUTES

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10
Q

PROPERTIES OF THE LOOP OF HENLE THAT HELP CREATE A HYPERTONIC INTERSTITIUM
- THIN DESCENDING LIMB
- THIN ASCENDING LIMB

A
  • THIN DESCENDING LIMB
    1. PERMEABILITY TO WATER: HIGHLY PERMEABLE
    2. PERMEABILITY TO SOLUTES: IMPERMEABLE
    3. PERMEABILITY TO UREA: PERMEABLE
  • THIN ASCENDING LIMB
    1. PERMEABILITY TO WATER: IMPERMEABLE
    2. PERMEABILITY TO SOLUTES: PERMEABLE
    3. PERMEABILITY TO UREA: PERMEABLE
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11
Q

PROPERTIES OF THE LOOP OF HENLE THAT HELP CREATE A HYPERTONIC INTERSTITIUM
- THICK ASCENDING LIMB
- DISTAL TUBULE AND COLLECTING DUCT

A
  • THICK ASCENDING LIMB
    1. PERMEABILITY TO WATER: IMPERMEABLE
    2. PERMEABILITY TO SOLUTE: ACTIVELY PUMO Na+ AND COTRANSPORT Cl- AND K+ OUT -> PRODUCING HIGH OSMOLARITY IN THE INTERSTITIUM UNDER THE INFLUENCE OF ADH
    3. PERMEABILITY TO UREA: IMPERMEABLE
  • DISTAL TUBULE AND COLLECTING DUCT
    1. PERMEABILITY TO WATER: PERMEABLE
    2. PERMEABILITY TO SOLUTE: PERMEABLE
    3. PERMEABILITY TO UREA: IMPERMEABLE
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12
Q

THE INNER MEDULLARY COLLECTING DUCT (IMCD) BECOME PERMEABLE TO UREA IN THE PRESENCE OF

A

ADH

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13
Q

ADH PROMOTE THE REABSORPTION OF WATER AT THE

A

DISTAL TUBULE
CORTICAL COLLECTING TUBULE
IMCD
TO PRODUCE CONCENTRATED URINE

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14
Q

ADH INCREASES THE PERMEABILITY TO UREA AT THE

A

IMCD
TO CREATE HYPEROSMOTIC INTERSTITIUM IN THE DEEP MEDULLA

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15
Q

THE MEDULLARY INTERSTITIUM OSMOTIC GRADIENT IS SET UP THROUGH 2 MAIN MECHANISM

A
  1. THE OSMOTIC GRADIENT IN THE OUTER MEDULLA IS DUE TO THE ACTIVE TRANSPORT OF NACL, BY THE THICK ASCENDING LIMB OF THE LOOP OF HENLE
  2. THE OSMOTIC GRADIENT IN THE INNER MEDULLA IS PRIMARILY DUE TO THE PASSIVE MOVEMENT OF UREA AND NACL.
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16
Q

EFFECTS OF ADH ON THE KIDNEY

A
  1. REGULATES WATER EXCRETION -> CAUSING THE ENTIRE COLLECTING DUCT BECOMES PERMEABLE TO WATER
  2. INCREASES THE UREA PERMEABILITY IN THE IMCD
  3. INCREASES THE RATE OF
    - ACTIVE NACL REABSORPTION IN THE MEDULLARY TAL OF LOH
    - ACTIVE NACL AND FLUID REABSORPTION IN THE MEDULLARY COLLECTING DUCT
17
Q

INCREASE IN THE NA+ REABSORPTION IS ASSOCIATED WITH HIGH ABUNDANCE OF 3 NA+ TRANSPORTER:

A

1NA+/K+/2CL- SYMPORTERS -> TAL
NA+/CL- SYMPORTERS -> DISTAL TUBULE
NA+ CHANNEL -> LATE DISTAL TUBULE AND COLLECTING DUCT

18
Q

STATE THE ROLE OF THE ADH IN THE CONCENTRATION AND DILUTION OF URINE

A
  1. ADH INCREASES THE PERMEABILITY OF THE COLLECTING DUCT TO WATER
  2. ADH HELPS IN CREATING AND MAINTAINING A HYPERTONIC INTERSTITIUM
    - ADH INCREASES THE PERMEABILITY OF IMCH TO UREA CREATING A HYPERTONIC INTERSTITIUM
    - ADH DECREASES THE BF IN THE MEDULLA TO MAINTAIN THE HYPERTONIC INTERSTITIUM
  3. ADH STIMULATES THE TRANSPORT OF NA+, K+, AND CL- IN TAL TO CREATE HYPERTONIC INTERSTITIUM
19
Q

AQP1 IS
- LOCATED AT
- DISTRIBUTED IN THE
- REGULATION

A
  • LOCATED AT:
    1. S2 AND S3 SEGMENT OF PROXIMAL TUBULES
    2. THIN DESCENDING LIMB OF LOH
    3. VASA RECTA
  • DISTRIBUTED IN THE
    1. APICAL MEMB
    2. BASOLATERAL MEMB
  • REGULATION
    NOT SENSITIVE TO ADH
20
Q

AQP2 IS
- LOCATED AT
- DISTRIBUTED IN THE
- REGULATION

A
  • LOCATED AT
    PRINCIPAL CELL OF CONNECTING TUBULE AND COLLECTING DUCT
  • DISTRIBUTED IN THE
    1. INTRACELLULAR VESICLES
    2. APICAL MEMB
  • REGULATION
    SENSITIVE TO ADH
21
Q

AQP 3 IS
- LOCATED AT
- DISTRIBUTED IN THE
- REGULATION

A
  • LOCATED AT
    PRINCIPAL CELL OF CORTICAL AND OUTER MEDULLARY COLLECTING DUCT
  • DISTRIBUTED IN THE
    BASOLATERAL MEMB
  • REGULATION
    CHRONIC ADH EXPOSURE
    INCREASE AQP3 ABUNDANCE
22
Q

AQP 4 IS
- LOCATED AT
- DISTRIBUTED IN THE
- REGULATION

A
  • LOCATED AT
    PRINCIPAL CELL OF IMCD
  • DISTRIBUTED IN THE
    BASOLATERAL MEMB
  • REGULATION
    LONG TERM ADH EXP. INCREASES THE AQP 4 LEVEL
23
Q

DESC THE AQP IN THE MEDULLARY COLLECTING DUCT

A
  1. ADH BIND TO ITS V2 RECEPTOR
  2. ADENYLATE CYCLASE ACTIVATED
  3. INTRACELLULAR CAMP INCREASE
  4. PROTEIN KINASE A INCREASE
  5. PHOSPHORYLATION OT INCREASE
  6. INCREASE IN THE FUSION RATE OF AQP 2 WITH THE APICAL MEMBRANE
  7. INCREASE THE WATER REABSORTION VIA PASSIVE DIFUSSION INTO THE CD CELLS
  8. WATER WILL LEAVE VIA AQP 3 AND 4.
24
Q

DESC THE RECIRCULATION OF UREA FROM CD TO LOH CONTRIBUTING TO HYPEROSMOTIC RENAL MEDULLA.

A
  1. RECIRCULATION OF UREA ABSORBED FROM MEDULLARY CD TO THE INTERSTITIAL FLUID.
  2. UREA IS SECRETED FROM INTERSTITIAL FLUID INTO THE DEEP MEDULLARY REGIONS OF LOH VIA THE UT-A2 TO RESTORE THE UREA CONTENT IN THE TUBULAR FLUID
  3. UREA DIFFUSES INTO THE THIN LOH AND THE PASSED THROUGH THE DISTAL TUBULE AND FINALLY PASSES BACK INTO THE CD.
25
Q

STATE THE SPECIAL FEATURES OF THE BF IN THE VASA RECTA.

A
  1. SLOW AND SLUGGISH BF
    - SUFFICIENT TO SUPPLY THE METABOLIC NEED OF THE TISSUE
    - HELPS TO MINIMIZE THE SOLUTE LOSS FROM THE MEDULLARY INTERSTITIUM
  2. THE U SHAPE OF THE VASA RECTA CAPILLARIES ACT AS COUNTERCURRENT EXCHANGERS -> MINIMIZING WASHOUT OF SOLUTES FROM THE MEDULLARY INTERSTITIUM
26
Q

STATE THE CHARACTERISTIC OF VASA RECTA THAT MAINTAIN THE HYPERTONIC INTERSTITIUM IN THE RENAL MEDULLA.

A
  1. VASA RECTA IS VERY PERMEABLE
  2. SOLUTE DIFFUSES FROM OUTLET LIMB INTO THE INLET LIMB BY CONCENTRATION GRADIENT
  3. WATER MOVES FROM THE INLET LIMB TO THE OUTLET LIMB BY OSMOSIS
  4. SOLUTE TEND TO ACCUMULATE IN THE VASA RECTA AND INTERSTITIUM
  5. ADH DECREASES THE RENAL MEDULLARY BF -> V1 RECEPTORS IN THE BV TO CAUSE VASOCONSTRICITION
  6. BLOOD FLOW IS VERY SLOW IN THE MEDULLA PRESERVING THE HYPERTONIC INTERSTITIUM
  7. FROM THE MEDULLARY INTERSTITIUM, ONLY VERY SMALL AMOUNTS OF SUBSTANCES ARE REMOVED, PROVIDING A HYPERTONIC INTERSTITIUM IN THE MEDULLA BY VASA RECTA AS AN EXCHANGER

PHYSIOLOGY (14 decks)

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