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REN > L12: Volume Regulation > Flashcards

L12: Volume Regulation Flashcards

1
Q

Where are juxtaglomerular cells located

A

Between the renal afferent arteriole and distal convoluted tubule

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2
Q

What system is the juxtaglomerular cells involved in

A

Renin angiotensin aldosterone system

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3
Q

Describe the renin angiotensin system when there is low blood volume

A

1)Low sodium is detected by the macula densa cells in the distal convoluted tubule
2) macula densa signals to the juxtaglomerular cells
3) juxtaglomerular cells release renin
4) renin converts angiotensinogen to angiotensin 1
5) ACE enzyme converts angiotensin 1 to angiotensin 2
6) angiotensin 2 causes vasoconstriction to increase blood pressure
7 angiotensin 2 also causes the release of aldosterone from the adrenal cortex which increases the expression of enac channels in the collecting duct so sodium is reabsorbed
8) as sodium is reabsorbed water is also reabsorbed
9) blood volume increases

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4
Q

Overall what does the renin angiotensin system maintain

A

GFR- due to vasoconstriction

Volume- due to increases sodium reabsorption

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5
Q

Where is aldosterone released form

A

Adrenal cortex

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6
Q

Apart from angiotensin 2 what are the other triggers that cause aldosterone release

A

Hyperkalaemia (high potassium)

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7
Q

How does aldosterone correct hyperkalaemia

A

Increase potassium excretion

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8
Q

How does aldosterone increase potassium excretion

A

Aldosterone stimulates the synthesis of potassium/sodium exchanger on the basolateral membrane of the collecting duct
More potassium is brought into the cells which leaves into the filtrate through potassium channels

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9
Q

What drugs are involved in inhibiting the renin angiotensin sytem

A

ACE inhibitors
AT1 receptors
Aldosterone receptor antagonist
Renin inhibitor

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10
Q

What is the role of ace inhibitors

A

Inhibit the enzyme ace which stops the conversion of angiotensin 1 to angiotensin 2

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11
Q

What is the role of AT1 receptor antagonist

A

Blocks angiotensin 2 from binding to AT1 receptors for it bring it effects

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12
Q

What is the role of the aldosterone receptor antagonist

A

Stop the action of aldosterone

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13
Q

What do renin inhibitors do

A

Block renin to stop it converting angiotensinogen to angiotensin 1

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14
Q

What receptor does angiotensin 2 bind to

A

AT1 receptors

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15
Q

Where are AT1 receptors found

A

Vasculature

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16
Q

What type of a receptor is AT1

A

GPCRs

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17
Q

What is the G protein of AT1 receptors

A

Gq

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18
Q

What happens when angiotensin 2 binds to AT1 receptors

A

Gq increases IP3/DAG
IP3 increases calcium release from sarcoplasmic reticulum
Calcium causes vasoconstriction

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19
Q

Name an AT1 inhibitor

A

Sartans

20
Q

Apart from vasoconstriction, what is the other role of angiotensin 2

A

Cause the release of aldosterone to increase sodium reabsorption in the collecting duct

21
Q

What happens to the blood volume when there is an haemorrhage

A

Decrease

22
Q

What happens to the renin angiotensin system in response to a decreased blood pressure

A

It becomes stimulated

23
Q

Which nervous system innervated the renal afferent arteriole

A

Sympathetic ns

24
Q

What happens to the SNS in haemorrhage

A

Becomes stimulated to cause vasoconstriction

25
Q

What neurotransmitter is released from the SNS

A

Noradrenaline

26
Q

Which nervous system innervates the juxtaglomerular cells

A

SNS

27
Q

Which receptors does noradrenaline bind to on the afferent arterioles

A

Alpha 1

28
Q

Which receptors do noradrenaline bind to on the JGA cells

A

Beta 1

29
Q

Does the volume regulation and osmoregulation interact during haemorrhage or a fall in BP

A

Yes

30
Q

What happens to ADH in haemorrhage

A

Angiotensin 2 causes the release of ADH

31
Q

What is the action of ADH

A

Increase water reabsorption

32
Q

Despite the reabsorption of water due to ADH what happens to the osmolality

A

Decreases because ADH does not cause the reabsorption of sodium
This give hyponatraemia

33
Q

What does the this mean in terms of volume regulation and osmoregulation

A

Volume regulation disturbs osmoregulation (osmolality) in a short period of time to correct the volume

34
Q

What is the primary effect of ADH

A

Regulate osmolality

35
Q

Apart from renin and ADH what are the other signalling molecules involved in regulating volume

A

ANP
Prostaglandins
Dopamine

36
Q

What does ANP stand for

A

Atrial natriuretic peptide

37
Q

Where is ANP released from

A

Atria

38
Q

When does ANP become released from the atria

A

In volume overload which causes the atria to stretch

39
Q

Which receptors does ANP act on in the kidney

A

ANP: a,b

40
Q

What does the activation of ANP receptors in the kidney lead to

A

Afferent arteriole to vasodilate
Decrease sodium/chloride activity in the distal tubule
Decrease sodium/potassium ATPase in the collecting duct

41
Q

Overall what does ANP lead to

A

Loss of sodium in the urine and therefore loss of water

42
Q

What is the effect of prostaglandins

A

Increase the loos of sodium in the urine

43
Q

Which drugs can decrease prostaglandins

A

NSAIDs

44
Q

Where is dopamine synthesised

A

Kidneys by epithelial cells and form SNS activity

45
Q

Which receptors do dopamine act on in the kidney

A

D1 receptors

46
Q

What is the effect of dopamine

A

Decrease the activity of sodium/potassium in the proximal tubule
Cause the release of sodium in the urine

REN (19 decks)

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