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Physio > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

constant __ of body fluid compartments essential for homeostasis

A

volume and stable composition

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2
Q

Na+ imbalances changes __ volumes

A

vascular and total volume

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3
Q

Ca2+ imbalance alters __ structure

A

skeletal, cardiac, neural and bone

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4
Q

conditions/ illnesses from extracellular osmolarity and cell volume

A

-vomiting, diarrhea
-burns, skin loss
-heat- induced sweating
-renal disease

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5
Q

too much ECF leads to

A

-edema
-ascites
-pleural effusions
-hypertension

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6
Q

H+ imbalance alters __ systems

A

multiple

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7
Q

Ka+ imbalance alters __ functions

A

cardiac and neural

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8
Q

ions high in the ECF

A

Na+, Ca2+, Cl-, HCO3-, glucose

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9
Q

ions high in the ICF

A

K+, Mg2+, H+, AA

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10
Q

__ edema more common than __

A

extracellular, intracellular

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11
Q

what regulates fluid vol. by controlling ECF volume and composition?

A

kidneys

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12
Q

too little ECF leads to

A

-volume contraction
-hypotension
-organ hypoperfusion

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13
Q

intracellular edema causes

A
  1. hyponatremia
  2. decreased metabolism (Na+/K+ pump failure), DONNAN EFFECT!!
  3. inflammation
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14
Q

hyponatremia Na+ and H2O input vs output

A

Na+ input< Na+ output
H2O input> H2O output

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15
Q

acute hyponatremia

A

-rapid decrease Na+ ECF
-loss Na+ or excess H2O
-brain tissue swells

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16
Q

hyponatremia- dehydration can be due to and cause

A

-increased NaCl loss
-vomiting, diarrhea, renal disease, diuretics, addison’s disease

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17
Q

hyponatremia- overhydration can be due to and cause

A

-excess H2O retention
-inappropriate ADH secretion, H2O toxicity

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18
Q

hyponatermia- low solute intake can be due to and cause

A

-decreased NaCl intake
-extreme diets

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19
Q

chronic hyponatremia

A

-gradual decrease Na+ ECF
-Na/K+ transport out of cells
-water diffusion out
-brain swelling

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20
Q

with chronic hyponatremia must correct Na+ ECF slowly to avoid __

A

osmotic demyelination

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21
Q

adding hypertonic NaCl to fluid

A

-increase ECF and
-increases ICF/ ECF osmolarity
-decreases ICF

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22
Q

common causes of extracellular edema

A

-capillary permeability
-increased capillary hydrostatic pressure
-decreased capillary osmotic pressure

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23
Q

filtration rate equation

A

Kf=((Pc+πic)-(Pif+πc))

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24
Q

adding hypotonic NaCl to fluid

A

-increases ICF and ECF volume
-decreases ICF nad ECF osmolarity

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25
Q

adding isotonic NaCl to fluid

A

-increases ETF
-no osmolarity change or ICF

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26
Q

renal functions to regulate

A

-water/ electrolyte balance
-arterial pressure
-erythropoiesis
-acid- base balance
-Vit. D
-gluconeogensis

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27
Q

the two kidneys are __

A

retroperitoneal

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28
Q

medulla composed of

A

renal pyramids and columns

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29
Q

renal pyramids

A

-has nephrons
-border cortex/ medulla
-papilla

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30
Q

urine dump in kidneys

A

minor calyx-> major calyx-> renal pelvis-> ureter-> urinary bladder-> micturition reflex

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31
Q

ureters contain __ and exhibit __

A

smooth muscle, peristalsis

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32
Q

__ enhances peristalsis
__ decreases peristalsis

A

-parasympathetic
-sympathetic

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33
Q

ureters enter bladder through __

A

detruser muscle

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34
Q

detruser muscle __ ureter and prevents __ of urine during micturition

A

compresses, back flow

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35
Q

Vesicoureteral Reflux characteristics

A

-backflow urine into ureter
-enlarges ureters
-increase renal pelvis pressure
-rich pain innervation

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36
Q

Ureterorenal reflex characteristics

A

-ureters blocked
-reduce RBF and urine formation
-protective

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37
Q

detrustor muscle has __ to conduct APs

A

gap junctions

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38
Q

neck of bladder has smooth muscle and elastic tissue that has __ tone

A

intrinsic

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39
Q

pelvic visceral sensory neurons detect __

A

degree of bladder stretch

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40
Q

pelvic parasympathetic neurons stimulate contraction of __ and relaxation of __

A

detrusor muscle, Internal Sphincter

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41
Q

pelvic has Pudendal nerve somatic motor neurons controlling __

A

external sphincter

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42
Q

pelvic sympathetic neurons control __

A

bladder blood vessels

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43
Q

micturition reflex effect response local and systemic

A

-local= contraction
-systemic= stretch

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44
Q

micturition reflex has __ feedback

A

positive

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45
Q

micturition reflex afferent __ and efferent __

A

visceral sensory, parasympathetic

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46
Q

micturition reflex once powerful enough, inhibits __ to override voluntary control

A

pudendal nerve

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47
Q

brain influence on micturition reflex (voluntary control)

A

-spinal reflex
-brain centrs (pons and cerebral cortex)
-overalll inhibits

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48
Q

brain influence on micturition reflex functions

A
  1. inhibit until desired urinate
  2. prevent relaxation of external urethral sphincter to wait
  3. initiate reflex and inhibit external urethral sphincter when desired urinate
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49
Q

the renal artery branches off __ and enters kidney at __

A

aorta, hilum

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50
Q

blood exits the kidney through

A

venules-> renal vein-> vena cava

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51
Q

peritubular capillaries have __ pressure

A

low

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52
Q

peritubular capillaries function

A

secretion and reabosrption

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53
Q

glomerular has a __ pressure for filtration

A

high

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54
Q

afferent and efferent arteriolar resistance alters __ in glomerular capillaries

A

Pc

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55
Q

renal microcirculation route

A

afferent arteriole-> glomerular capillaries-> efferent arteriole-> peritubular capillaries-> venules

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56
Q

cortical nephron characteristics

A

-70-80%
-glomerulus outer cortex
-short henle
-peritubular capillaries

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57
Q

juxtamedullary nephrons

A

-20-30%
-glomerulus cortex/ medulla border
-long henle (extends deep into medulla)
-vasa recta
-concentrates urine

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58
Q

filtration is a function of __ capillaries and occurs via __

A

glomerular, bulk

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59
Q

reabsorption removes unwanted substances from glomerular and goes back into blood via __

A

peritubular capillaries

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60
Q

removal of unwanted substances still in plasma and secrete into __

A

glomerular filtrate

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61
Q

__ have passive and active transport processes across nephron epithelium

A

reabsorption and secretion

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62
Q

excretion removes metabolic waste bu urine exciting the __ into __

A

collecting duct, minor calyx

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63
Q

Ex=

A

Fx-Rx+Sx

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64
Q

GFR unselective except for __

A

cells, plasma, Ca2+, FA

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65
Q

GFR/ RPF averages __ of renal plasma flow

A

20%

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66
Q

GFR standard normal __ ml/ min= __ L/day

A

125, 180

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67
Q

parts of renal corpuscle

A
  1. bowmans capsule
  2. glomerular capillaries
  3. bowmans space
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68
Q

3 negatively charges layers of the filtration barrier

A
  1. capillary endothelium (fenestrated)
  2. basal lamina (basement membrane)
  3. podocytes (visceral layer of bowmans)
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69
Q

podocytes cover the outside of __ and creates __

A

basal lamina, filtration slits

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70
Q

mesangial cells surround __

A

glomerular capillary loops

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71
Q

mesangial cells modify size of __ and alter rate of __ production

A

filtration slits, filtrate

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72
Q

more __ charge-> higher filterability

A

positive

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73
Q

results in loss of negative charge on GBM

A

-proteins through GBM
-proteinuria

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74
Q

GFR=

A

KfxNFP

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75
Q

Kf is not highly __ and does not regulate __

A

variable, GFR

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76
Q

Kf lower due to thickened basement membrane from __

A

-hypertension
-diabetes mellitus

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77
Q

decreased Kf can be due to decreased capillary surface area known as __

A

glomerulonephritis

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78
Q

2 reasons Kf can be lowered

A

-thickened basement membrane
-decreased capillary surface area

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79
Q

glomerular (Pg) is the primary control point for __ most subject to __ control

A

GFR, physiological

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80
Q

factors that influence PG

A

-arterial pressure
-afferent/ efferent arteriolar resistance

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81
Q

bowman’s capsule PB not a __ regulator of GFR

A

physiological

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82
Q

diseases can affect GFR via PB

A

-tubular obstruction (kidney stones, tubular necrosis)
-urinary tract obstruction (prostate hypertrophy/ cancer)

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83
Q

πG __ along the length of glomerular capillary

A

increases (affected by filtration fraction)

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84
Q

GFR __ along length of capillary

A

decreases

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85
Q

PG is alerted by altering the __ of afferent and efferent arterioles

A

resistance

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86
Q

decreased Kf decreases GFR due to __

A

-renal disease
-diabetes mellitus
-hypertension

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87
Q

increased PB decreases GFR due to __

A

urinary tract obstruction

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88
Q

increased πG decreases GFR due to __

A

increased plasma, dehydration

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89
Q

decreased PG decreases __

A

GFR

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90
Q

decreased MAP decreases PG due to __

A

arterial pressure

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91
Q

decreased RE decreases PG due to __

A

AngII

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92
Q

increased RA decreases PG due to __

A

-increased sympathetic
-vasoconstriction hormones

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93
Q

decreases in __ leads to decreases in GFR

A

-Kf
-PG

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94
Q

increases in __ leads to decreases in GFR

A

-PB
-πG

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95
Q

increases in __ leads to decreases in PG

A

-RA

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96
Q

decreases in __ leads to decreases in PG

A

-MAP
-RE

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97
Q

BRF=

A

(Pa-Pv)/ total renal vascular resistance

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98
Q

__ tightly control RBF via auto- reulation

A

kidneys

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99
Q

__ RBF= __ energy cost of active transport

A

high, high

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100
Q

primary active transports when RBF high

A

-Na+/K+ ATPase
-H+ ATPase
-H+/K+ ATPase
-Ca2+ ATPase

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101
Q

constrict afferent arteriole leads to __ PGC and GFR

A

decreased (flow in< flow out)

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102
Q

constrict efferent arteriole leads to __ PGC and GFR

A

increased (flow in> flow out)

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103
Q

dilate efferent arteriole leads to __ PGC and GFR

A

decreased (flow in< flow out)

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104
Q

dilate afferent arteriole leads to __ PGC and GFR

A

increased (flow in> flow out)

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105
Q

efferent arteriole resistance differs from afferent because GFR __ before it __

A

increases, decreases

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106
Q

with efferent and afferent arteriole resistance decreases __ in both

A

RBF

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107
Q

three controls of renal blood flow

A
  1. autoregulation
  2. local control
  3. systemic control
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108
Q

myogenic autoregulation reflex __ in response to increased MAP

A

constriction

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109
Q

what is between the afferent and efferent tubes?

A

thick limb

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110
Q

myogenic autoregulation __ to blood vessels

A

intrinsic

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111
Q

tubuloglomerular feedback found in the __

A

juxtaglomerular apparatus

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112
Q

tubuglomerular feedback ensures __ delivery to the distal nephron

A

Na+, Cl-

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113
Q

macula densa cells close to JG cells and sense __ in filtrate

A

Na+, Cl-

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114
Q

what senses flow rate in the thick limb?

A

macula densa cells

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115
Q

juxtaglomerular cells primarily in walls of __ and secrete __

A

afferent arterioles, renin

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116
Q

decrease in GFR leads to (chart)

A

decreased filtrate flow in nephron-> Na+/Cl- reabsorption-> decreased Na+/Cl- delivery to MD-> sensed by MD (secondary active transport)-> signals JG cells-> increased renin and other paracrines

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117
Q

if GFR is decreased (simple version)

A

-increased AngII
-increased paracrines
-increased RE (efferent resistance)
-decreased RA (afferent resistance)
-increased PG and GFR

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118
Q

__ smooths nromal SNS- induced changes in arterial pressure and CO

A

renal autoregulation

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119
Q

what decreases effect on RBF and increases GFR

A

AngII

120
Q

what increases effect on RBF and GFR

A

ANP, PGE2, PGI2, bradykinin, NO

121
Q

what increases renal afferent and efferent resistance?

A

NE/E, and endothelin

122
Q

what increases mainly renal efferent resistance?

A

angiotensin II

123
Q

what decreases effect on RBF and GFR?

A

NE/E, and endothelin

124
Q

what decreases RA and increases RE?

A

ANP

125
Q

What decreases RA?

A

PGE2, PGI2, bradykinin

126
Q

what decreases RA and RE?

A

NO

127
Q

renin release stimulated by decreased

A

BP, RBF, NaCl to macula densa

128
Q

whawt 3 paracrines have little affect on RBF and GFR

A

-PGE2, PGI2
-bradykinin
-NO

129
Q

other factors that increase GFR and RBF

A
  1. high protein diet
  2. high blood glucose levels
130
Q

peritubular capillaries have large __ values

A

kf and πc

131
Q

Na+ reabsorption can occurs via both __ pathways

A

transcellular (passive and active) and paracellular (passive)

132
Q

Na+ in absorption moves across the apical membrane with __

A

glucose

133
Q

Na+ in secretion moves into the cell while __ moves out of the cell

A

H+

134
Q

plasma concentration that saturates the carrier

A

renal threshold

135
Q

reabsorption of water is __

A

strictly passive

136
Q

__ tubule highly permeable to H2O

A

proximal

137
Q

proximal tubule reabsorption of Na+, Cl-, urea and H2O depends on

A

-electrochemical gradient
-tubular flow rate
-membrane permeability

138
Q

proximal tubule characteristics

A

-many mitochondria
-large surface area on apical and basolateral
-many proteins

139
Q

proximal tubule reabsorbs

A

-65% Na+, Cl-, HCO3-, K+
-glucose and amino acids

140
Q

proximal tubule secretes

A

-metabolic waste
-drugs/ toxins
-para- aminohippuric acid (PAH)

141
Q

early PT

A

-paracellulary
-passive down gradient
-solvent drag

142
Q

late PT

A

-transcellular
-apical secondary active formate/ Cl- antiporter
-basolateral facilitated diffusion
-paracellularly

143
Q

__ inhibitors used to treat type 2 diabetes mellitus

A

SGLT2

144
Q

SGLT2 vs. GLUT2 differences

A

SGLT2-
-apical
-secondary active
GLUT2-
-basolateral
-facilitated diffusion

145
Q

SGLT2 vs. GLUT2 similarities

A

-early PT
-low affinity
-high capacity
-90% FGLU reabsorbed

146
Q

SGLT1 vs. GLUT1 differences

A

SGLT1-
-apical
-secondary active
GLUT1-
-basolateral
-facilitated diffusion

147
Q

SGLT1 vs. GLUT1 similarities

A

-late PT
-high affinity
-low capacity
-10% FGLU reabsorbed

148
Q

proximal tubule Na+ and H2O, __ solution reabsorbed

A

isonotic

149
Q

distal portion reabsorbs more __

A

Cl- and urea

150
Q

in proximal tubule __ not actively reabsorbed

A

creatine

151
Q

thin descending limb has a high __ permeability and plays a major role in __ of urine

A

H2O, concentration/ dilution

152
Q

thin descending limb no __ transport and secretes __ via facilitated diffusion

A

active, urea

153
Q

thin ascending limb is impermeable to __ and __ secretion via facilitated diffusion

A

H2O, urea

154
Q

thick ascending limb impermeable to __

A

H2O and urea

155
Q

thick ascending limb has more __ reabsorbed than __

A

solute, H2O

156
Q

early distal tubule impermeable to __

A

H2O and urea

157
Q

early distal tubule is the __ segment

A

diluting

158
Q

early distal tubule has __ on apical membrane

A

Na+/Cl- antiport

159
Q

early distal tubule has __ on basolateral membrane

A

-Na+/K+ ATPase
-Cl- diffuses out

160
Q

late distal/ cortical collecting duct (CCD) has these 2 cells

A

principal and intercalated cells

161
Q

later distal/ CCD completely impermeable to __

A

urea

162
Q

principal cells site of __ action

A

aldosterone and ADH

163
Q

principal cells reabsorb __ and secrete __

A

Na+ and H2O, K+

164
Q

alpha intercalated cells

A

-acidosis
-secrete H+
-reabsorb K+ and HCO3-
-primary active transport of H+ across apical against concentration

165
Q

beta intercalated cells

A

-alkalosis
-secrete K+ and HCO3-
-reabsorb H+

166
Q

medullary collecting duct (MCD) site of __ action

A

aldosterone and ADH

167
Q

medullary collecting duct (MCD) __ reabsorbed via facilitated diffusion

A

urea

168
Q

medullary collecting duct (MCD) secretes H+ same mechanism as __

A

alpha- intercalated cells

169
Q

as tubular load increases, rate of __ increases

A

reabsorption

170
Q

GTB autoreg. of PT reabsorption rate related to __

A

tubular load

171
Q

local control mechanisms

A

-TGF
-GTB
-pressure natriuresis/ diuresis

172
Q

small changes in MAP increases urinary __

A

Na+ and H2O excretion

173
Q

TGF autoregulation of GFR afferent and efferent arteriolar R related to flow rate of __

A

NaCl by macula densa

174
Q

systemic control mechanisms hormones

A

-aldosterone
-angII
-ADH
-atrial natrietic peptide (ANP or ANF)
-PTH

175
Q

tubular reabsorption controlled by

A

-local control mechanisms
-nervous system
-endocrine system

176
Q

GTB autoreg. of PT depends on changes in __

A

peritubular capillary and renal interstitial fluid Starling’s fprces

177
Q

TGF autoregulation of GFR keeps __ constant

A

GFR

178
Q

systemic control also involves the __ nervous system

A

sympathetic

179
Q

natriuresis mechansisms ensure large changes in salt and water cause only minor changes in __

A

-ECF vol.
-CO
-MAP

180
Q

increases in __ in the ECF increases aldosterone secretion

A

AngII, K+, H+

181
Q

increase in __ causes a decrease in aldosterone

A

-ANP
-Na+ ECF

182
Q

aldosterone stimulates __ reabsorption

A

Na+, H2O

183
Q

aldosterone stimulates __ secretion

A

K+, H+ (alpha intercalated cells)

184
Q

aldosterone systemic effector responses

A

-increase Na+ ECF
-decrease K+ ECF
-increased ECF pH

185
Q

aldosterone regulator of __

A

ECF osmolarity

186
Q

AngII regulator of __

A

ECF vol., ECF osm., TPR

187
Q

decrease in __ increases renin secretion

A

MAP, BV, RBF, NaCl to macula densa (TGF)

188
Q

increase in __ increases renin secretion

A

symapthetic

189
Q

increase in __ decreases renin secretion

A

ANP

190
Q

aldosterone local effector responses stimulated aldosterone production and secretion from __

A

zona glomerulosa

191
Q

aldosterone local effector responses directly increases __ reabsorption

A

Na+

192
Q

aldosterone local effector responses increases __ secretion

A

H+ and ADH

193
Q

aldosterone local effector responses constricts __ arterioles

A

efferent and systemic

194
Q

aldosterone local effector responses increases __

A

thirst

195
Q

aldosterone systemic effector responses increases

A

-ECF vol.
-TPR
-MAP
-pH

196
Q

increase in __ stimulates ADH secretion

A

ECF vol.

197
Q

decrease in __ inhibits ADH secretion

A

BV, BP

198
Q

factors that stimulate ADH secretion

A

-nausea
-hypoxia
-nicotine and morphine
-angII
-ectasy

199
Q

factors that inhibit ADH secretion

A

-ethanol
-cold

200
Q

ADH secretion local effector responses

A

H2O reabsorption in distal

201
Q

ADH secretion systemic effector responses increases __

A

ECF vol. and MAP

202
Q

ADH secretion systemic effector responses decreases __

A

ECF osm.

203
Q

ADH secretion mechanism activation of __ protein linked receptor

A

Gαs

204
Q

ADH secretion mechanism increases synthesis and insertion of __ into luminal membrane

A

APQ-2

205
Q

ANP direct effector response inhibits __

A

-Na+ and H2O reabsorption in PT
-renin release and aldosterone formation

206
Q

increase in __ increases sympathetic

A

stress

207
Q

ANP direct effector response increases __

A

GFR

208
Q

decrease in __ increases sympathetic

A

MAP

209
Q

ANP direct effector response helps to minimize __ expansion

A

BV

210
Q

ANP systemic effector response decreases __

A

ECF osm. and BV

211
Q

aldosterone site of action

A

principal cells and alpha intercalated

212
Q

sympathetic regulates __

A

ECF vol. and MAP

213
Q

ANP regulates __

A

ECF vol.

214
Q

increases ANP secretion controlled by __ in response to stretch

A

cardiac atria

215
Q

decrease in __ decreases ANP secretion

A

BV

216
Q

sympathetic local effector responses stimulates __ release

A

renin

217
Q

sympathetic local effector responses constricts __

A

arterioles

218
Q

sympathetic local effector responses increases __ (decrease GFR and RBF)

A

-RAA
-REA

219
Q

sympathetic systemic effector responses increases __

A

-ECF vol.
-TPR
-MAP

220
Q

sympathetic local effector responses stimulates Na_ reabsorption via alpha receptors cells in the __

A

PT and TAL

221
Q

urine stays __ in absence of ADH

A

hyposmotic

222
Q

filtrate is isomotic in __

A

PT

223
Q

filtrate is hyperosmotic passing through __

A

tDL

224
Q

filtrate is hyposmotic passing through __

A

TAL and early distal tubule

225
Q

ADH increases H2O permeability of __

A

distal tubule and collecting duct

226
Q

urine with ADH enters capillaries of __ and removed

A

vasa recta

227
Q

with ADH large vol. of H2O diffuses into __

A

interstitium

228
Q

requirements for excreting a concentrated urine

A
  1. high ADH
  2. hyperosmotic medullary interstitial fluid
228
Q

hyperosmotic medullary interstitial fluid surrounds __ and sets gradient for __

A

collecting duct, water reabsorption

228
Q

obligatory urine volume (OUV)=

A

osmotic load (must be 600)/ max. urine

229
Q

hyperosmotic medullary interstitial fluid requires __

A

counter current multiplier mechanism

229
Q

hyperosmotic medullary interstitial fluid function of the juxtamedullary nephrons includes

A

-long loop of henle
-vasa recta
-slow flow rate

230
Q

high interstitial fluid osmolarity result of small amount of water into __

A

medullary interstitium

230
Q

high interstitial fluid osmolarity result of transport Na+ by __

A

ascending limb

230
Q

what forms the interstitial osmolar gradient?

A

Na+/K+ pump in collecting duct

231
Q

high interstitial fluid osmolarity result of faciliatted diffusion of urea by __

A

inner medullary collecting ducts

231
Q

concentrating urine requires a __ interstitial region

A

hyperosmotic

231
Q

high interstitial fluid osmolarity result of transport of ion from __ into __

A

collecting duct into interstitium

232
Q

with ADH __ become highly permeable to water

A

distal tubule and collecting ducts

232
Q

urea is secreted into the __

A

-descending limb
-thin ascending limb

232
Q

urea excrete __ of filtered load and contributes to __ of medullary interstitial osmolarity

A

20-50%, 40-50%

232
Q

urea is a waste product of protein metabolism produced continuously by the __

A

liver

233
Q

ADH requirements for urea

A

-concentrates urea
-activates carries for urea by medullary collecting duct cells

234
Q

concentrating urine requires a __ interstitial region

A

hyperosmotic

235
Q

CCM 25% of neprhons are __ with long loops of henle that extend into __

A

juxtamedullary, vasa recta and collecting ducts

236
Q

filtrate and descending and ascending LoH flows in __ direction of blood flow in vasa recta

A

opposite

237
Q

human kidney has a max. concentration of

A

1,200 mOsm/L

238
Q

CCM clears reabsorbed water so does not __

A

dilute medullary interstitial fluid

239
Q

countercurrent heat exchanger allows warm blood entering limb to transfer heat directly to __

A

blood blowing back into the body

240
Q

vasa recta preserves __ in medulla interstitium

A

hyperosmolarity

241
Q

__ acts centrally to increase thirst

A

AngII

242
Q

excessive secretion of ADH causes

A

-hyponatremia
-decreased plasma osmolarity
-urine hyperosmolarity

242
Q

polydipsic DI

A

-compulsive water drinking

242
Q

diabetes insipidus (DI) symptoms

A

-polyuria
-nocturia
-polydipsia

242
Q

hypothalamic or central DI

A

-defect ADH synthesis or release
-depressed ADH plasma

242
Q

ADH secretion more sensitive to change in __ than __

A

osmolarity, vol.

242
Q

__ have variable osmolarity

A

-late DT and CCD
-MCD

243
Q

osmolarity of-
-PT
-descending LOH
-ascending LOH

A

-isosmotic
-hyperosmotic
-hyposmotic

243
Q

with maximum vasopressin, the __ is permeable to water and urine is __

A

collecting duct, concentrated

244
Q

ADH controls both

A

-ECF osmolarity
-plasma vol.

245
Q

urine volume determined by 2 factors

A

-amount of solute excreted
-ADH plasma

245
Q

regulation of Na+ ECF mechanisms

A
  1. osmoreceptor- ADH system
  2. thirst mechanism
  3. aldosterone and angII (alter Na+ mass but not conc.)
  4. salt appetite
246
Q

nephrogenic DI

A

-defect ADH action
-failure of hyperosmotic medullary gradient
-elevated ADH plasma

246
Q

3 major mechanisms of polyuria

A

-decreased Na+ reabsorption
-reduced ADH secretion
-ADH resistance

246
Q

thirst increased by

A

-ECF hyperosmolarity
-decreased ECF vol.
-decreased MAP

246
Q

dehydration decreased volume and increased osmolarity causes

A

-increased CO and BP
-increased H2O reabsorption and volume
-decreased osmolarity

246
Q

stimuli that increase salt appetite

A

-Na+ deficits
-decreased BV
-decreased BP associated with circulatory insufficiency

246
Q

increased BV with no osmolarity change causes increased atrial stretch which causes

A

–less vasopressin and aldosterone
-decreased renin and BP
-increased GFR
-NaCl and H2O excretion

246
Q

decreased MAP with no change in volume or osmolarity leads to

A

-decreased BP
-increased sympathetic
-increases renin

246
Q

ingesting salt no change in volume and increases osmolarity causes

A

-increase vasopressin
-increased water intake
-increased ECF volume
-increased BP

246
Q

mechanisms controlling K+ homeostasis

A
  1. K+ distribution in ECF and ICF
  2. K+ excretion= K+ input
246
Q

factors that decrease K+ in ECF

A

-hyperkalemia
-insulin
-aldosterone
-B2- adrenergic stimulation
-alkalosis
-decreased ECF osm

246
Q

factors that increase K+ in ECF

A

-hypokalemia
-insulin deficiency
-aldosterone deficiency
-B2- adrenergic antagonists
-acidosis
-increased ECF osm
-strenuous exercise

246
Q

K+ secretion by __ cells

A

principal

246
Q

K+ reabsorption by __ cells

A

alpha intercalated

246
Q

mechanisms for K+ ECF increases K+ secretion

A
  1. increased Na+/K ATPase
  2. transepithelial potential difference (TEPD), more negative in lumen
  3. more K+ on apical
  4. stim. aldosterone
247
Q

causes of increased distal tubule flow rate increasing K+ secretion

A

-increased ECF vol.
-Na+ loading
-some diuretics

247
Q

mechanisms of increased distal tubule flow rate increasing K+ secretion

A
  1. increased tubule flow keeps luminal K+ lower
  2. increased #BK channels in apical membrane
247
Q

causes of hyperkalemia

A

-renal failure
-decreased distal nephron flow
-decreased aldosterone
-acidosis
-diabetes

247
Q

causes of hypokalemia

A

-low K+ intake
-diarrhea
-alkalosis
-excess insulin
-increased distal tubular flow]
-excess aldosterone

247
Q

diuretics decreased urine volume output by reducing __

A

edema and MAP

247
Q

diuretics mechanisms of action by decreasing reabsorption of __

A

Na+ and H2O

247
Q

osmotic diuretics inhibit __ reabsorption all along nephron stimilar to __ substances

A

H2O, endogenous

247
Q

osmotic diuretics results in diuresis-

A

-aquaresis
-increases Na+ and K+ excretion

247
Q

carbonic anhydrase inhibitor target in the __ and indirectly inhibits __

A

PT, Na+/H+ active symporter

247
Q

carbonic anhydrase inhibitor results in diuesis-

A

-natriuresis
-aquaresis
-acidosis

247
Q

loop diuretics target the __ and inhibit the __

A

thick ascending limb, Na+/K+/2 Cl- active symporter

247
Q

loop diuretics results in diuresis-

A

-natriuresis
-aquaresis
-most powerful
-overwhelm downstream absorption
-disrupt countercurrent multiplier

247
Q

thiazide diuretics target __ and inhibits __

A

DCT, Na+/Cl- secondary active symporter

247
Q

thiazide diuretics results in diuresis-

A

-natriuresis
-aquaresis
-overwhelm downstream absorption

247
Q

what are K+ sparing diuretics that act on the late distal and collecting tubule?

A

-aldosterone antagonists (spirolactone)
-Na channel blocker (triamterene)

248
Q

many diuretics cause K+ loss (hypokalemia) by

A

-increase K+ secr4etion in distal
-luminal K+ low

249
Q

aldosterone antagonists decreasing activity of

A

-Na+/K+ ATPase
-ENaC
-K channel

250
Q

ENaC blockers decreases __

A

-Na+ uptake
-Na+/K+ activity
-K+ secretion

251
Q

examples of aldosterone antagonists

A

spironolactone and eplerenone

252
Q

examples of ENaC blockers

A

amiloride and triamterene

253
Q

aldosterone antagonists and ENaC blockers results in diuresis-

A

-natriuresis
-aquaresis
-without hypokalemia

Physio (34 decks)

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