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Human Physiology > Lecture 18 > Flashcards

Lecture 18 Flashcards

1
Q

non electrolytes in Plasma that do not get filtered
- in mg/dL

280
150
125
100
15
10
3
1.5
0.5
trace

A

Phospholipids
Cholesterol
Fats
Glucose
Urea
Lactic acid
Uric acid
Creatinine
Bilirubin
Bile salts

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2
Q

positive and negative charges ______ intracellular fluid

positive and negative charges ______ in extracellular

A

equal
equal

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3
Q

______ is when Fluid has the same osmolarity as plasma

Things that can be given to patients
1. Normal Saline (__________)
2. _________________

Sodium, potassium, calcium (all as chlorides) and bicarbonate as a buffer.
Lactate may be used as a buffer (despite the fact that it is pH 6.5)

A

isotonic

N/S or 0.9% NaCl
Ringers Acetate(RA), Ringer’s lactate (RL)

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4
Q

_____ is when Fluid has fewer solutes (_____ mOsm/L) than plasma

Water, ___________
D5W (___________) after the sugar is used up

A

hypotonic
<282
1/2 N/S (0.45% NaCl)
5% dextrose in water

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5
Q

_______ is when Fluid has more solutes (_____ mOsm/L) than plasma

_______ in Normal Saline (_____)
___% saline solution, D5 in ___.

A

hypertonic
>282

5 % Dextrose (D5 N/S)
3%
RL

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6
Q

examples of isotonic solutions

A

Normal Saline (N/S or 0.9% NaCl)
Ringers Acetate(RA), Ringer’s lactate (RL)

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7
Q

examples of hypotonic solutions

A

Water, 1/2 N/S (0.45% NaCl)
D5W (5% dextrose in water) after the sugar is used up

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8
Q

examples of hypertonic solutions

A

5 % Dextrose in Normal Saline (D5 N/S)
3% saline solution, D5 in RL

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9
Q

sodium regulation occurs primarily in the _____

Majority is absorbed in the _________
Normally less than ____ % of filtered serum sodium is excreted

A

proximal nephron
1%

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10
Q

Most biologically active mineralocorticoid secreted by adrenal cortex

A

Aldosterone

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11
Q

aldosterone has

direct effect on sodium _______
Indirect effect on ___________

A

reabsorption

K+, Cl, Bicarb, pH

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12
Q

Overall kidney osmolarity

The cortex of the kidney (in Yellow) is very ____ in sodium
The outer medulla gets ______.
The inner medulla, which the loop of Henle dips into at its deepest, is ______

A

low
saltier
very salty

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13
Q

If Na+ and H20 reabsorbed equally – There will be_____ in Na+ concentration (and lacking other solute changes,
______ in osmolality or tonicity).

Allows rise in tubular _____ which facilitates the passive Na+ resorption distal proximal tubule

A

no change
no change

Cl-

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14
Q

Proximal Tubule

Reabsorbs iso-osmotically _____% filtered NaCl + H2O
Reabsorbs ____ % of the filtered HCO3-
Reabsorbs _____ of filtered glucose + amino acids
Reabsorbs K+, phosphate, calcium, magnesium, urea, uric acid
Secretes organic anions; urate, cations; creatine; protein-bound drugs, toxins

A

60 -65
90
almost all

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15
Q

loop of henle
Descending loop; begins at the end of the _____
____ ascending loop
_____ ascending loop-ends in the ________
Not uniform in appearance

doesn’t change tonicity*

A

pars recta
Thin
Thick
macula densa of the Distal Collecting Tubule.

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16
Q

loop of henle Plays a major role in the excretion of urine with high solute levels (_______ urine)
Reabsorbs _____ % filtered NaCl (normal intake of fluid and sodium)
______ multiplier as NaCl reabsorbed in excess of water
Major site of active regulation of ___ excretion

A

hyperosmotic
25 -35
Countercurrent
Mg

17
Q

countercurrent mechanism

Contributes to the maintenance of the osmotic gradient in the renal medulla (Salty medulla)

The primary event: active ____ transported out of the________ of the loop of Henle into the _______

A

NaCl
thick ascending limb
medullary interstitium

18
Q

Countercurrent Mechanism Permits the kidney to excrete urine with an osmolality that varies widely in humans
from a minimum of ___ mosmol/kg to a maximum of _____ mosmol/kg

A

50
900 to 1400

19
Q

Descending limb, Loop of Henle
Urine delivered from the proximal tubule becomes _______ in the descending limb as it equilibrates with the medullary interstitium
Mechanism is water movement ____ of tubule, passively. (reabsorption)

A

hyperosmotic
OUT

20
Q

Ascending limb, Loop of Henle
Filtrate then becomes _________ in the ascending limb as NaCl is _____ transported (reabsorbed) without water
The ascending limb is passively impermeable
The NaCl removed in the _____ is primarily responsible for the “salty” nature of the renal medulla

A

hypoosmotic (lower levels of fluid, NaCl being reabsorbed)

actively

ascending limb

21
Q

Distal Collecting Tubule

Reabsorbs __________

A

5% filtered NaCl, no water

22
Q

Distal Connecting Tubule and Cortical Collecting tubule

A

Late DCT and collecting duct are similar
(including some H2O reabsorption in Collecting duct)

23
Q

Medullary Collecting Tubule

____________ of the urine
____________ NaCl
concentration can be reduced to less than ___ meq/L
Reabsorb ______ relative to the amount of antidiuretic hormone present,
allows a concentrated or dilute urine to be excreted**

A

Final modification
Reabsorb
1
H20 and urea

24
Q

Final osmolality of the urine in the collecting tubules is dependent upon____:

A

ADH

25
Q

ADH present collecting tubule:

water permeability is ______, allowing osmotic equilibration of the tubular fluid with the iso-osmotic interstitium in the cortex and then the hyperosmotic interstitium in the medulla.

Results in excretion of a ________ urine
ADH also contributes to the ____ medullary osmolality by permitting urea entry into the interstitium (helps to maintain osmolarity of medulla)

A

increased

concentrated
high

26
Q

ADH absent:

________ urine leaving the loop of Henle does not __________, and a _____ urine is excreted

A

hypoosmotic
equilibrate with the interstitium
dilute

27
Q

the composition an volume of the tubular fluid are essentially the same at the end of the loop of henle as the excretion of concentrated or dilute urine is determined primarily in the ________

A

collecting tubules

28
Q

medullary collecting tubule also …

Secretes ________, (or retain)
urine pH can be reduced to as low as ______
Contributes to _______ balance by reabsorption or secretion

A

H+ and NH3
4.5 to 5.0
potassium

29
Q

Composition of UrineDiffers from constant extracellular fluid in two ways:

Quantity of solutes and water in the urine is highly _______ as opposed to ECF

Ions compose ___ percent of the extracellular fluid solutes whereas urine has high concentrations of ______ (___). Urine offered an ____ for urea and other metabolic end products rather than accumulating in body

A

variable

95
uncharged molecules (urea)
exit

30
Q

Quantity of solutes and water in the urine is highly variable as opposed to ECF

  • Dependent on the intake of these substances
  • In both instances, steady-state __________________
  • Urine volume is greater after a water load than after water restriction
  • Stable plasma Na+ concentration† (_____ mEq)
    No absolute “_____” values for urinary solute or water excretion
    Normal range reflects range of dietary intake, eg, 100 to 250 meq/day for Na+
A

(extracellular volume) - output = intake

145
normal

31
Q

Obligatory Urine Volume (OUV)

_______________
- Avg 70 kg person = 600 mOm solute/day
Maximum concentrating ability 1200 mOm/L

OUV = ?

A

Minimum amount to rid waste

600/1200 = 0.5 L/day

32
Q

Urine Specific Gravity
- Rapid estimate of urine solute concentration (weight)
- Range: ________

Affected by _________ such as glucose, contrast, ABX

more urine specific gravity = more _________

A

1.002-1.028
large molecules

urine osmolarity

33
Q

Solute reabsorption drives water reabsorption via _____

___% of water reabsorption by the kidneys occurs along with solute ______ (such as Na+, Cl-, and glucose)

This type of water reabsorption is termed _______-because the water is “obliged” to follow the solutes

occurring mainly in the ______ of the loop of Henle

A

osmosis

90
reabsorption

obligatory water reabsorption

proximal tubule and desecending limb

34
Q

Reabsorption of the final ____% of water occurs in the _____

This type of reabsorption is regulated by ___ and occurs in the _______

A

10
collecting ducts

ADH
collecting ducts

Human Physiology (24 decks)

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