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Urinary > Regulation of ECF volume > Flashcards

Regulation of ECF volume Flashcards

1
Q

What are the major ECF osmoses which dictate fluid movement?

A

Na & Cl

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2
Q

What % of the body is composed of water?

A

60% (42L)

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3
Q

In TBW, what does ICF make up?

A

2/3

28L

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4
Q

In TBW, what is the volume of plasma?

A

3L

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5
Q

What composes the ECF?

A

Interstitial fluid

Plasma

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6
Q

What is the volume of ECF?

A

14L (1/3)

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7
Q

What volume does the interstitial fluid compose?

A

11L

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8
Q

In what circumstances can high volumes of water be lost?

A

Vomiting
Diarrhoea
Excess sweating

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9
Q

A decrease in plasma volume resulting in a reduction in ____ to the heart.

A

Venous return

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10
Q

A reduction in venous return will result in a reduction in ___, ____ &____

A

SV
CO
BP

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11
Q

A drop is BP will be detected by which baroreceptors?

A

Carotid sinus baroreceptors

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12
Q

When the baroreceptors detect a drop in BP, what happens?

A

Sympathetic discharge

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13
Q

What does sympathetic activity do to the vasculature?

A

Increases TPR

Increases BP

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14
Q

What is released from the pituitary in response to hypovolaemia?

A

ADH

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15
Q

What does sympathetic activity do at the kidneys?

A

Increased renal arteriole constriction

Renin secretion

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16
Q

What does renin convert angiotensinogen to?

A

Angiotensin I

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17
Q

What converts Angiotensin I to Angiotensin II?

A

ACE

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18
Q

What effect does angiotensin II have at the peritubular capillaries?

A

Increases Na reabsorption at proximal tubule

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19
Q

What does angiotensin II stimulate the secretion of from the adrenal cortex?

A

Aldosterone

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20
Q

Where does aldosterone mediate its action?

A

Distal tubule

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21
Q

What maintains GFR?

A

Autoregulation

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22
Q

Where is the majority of water/ Na reabsorbed?

A

Proximal tubule

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23
Q

What is responsible for the constriction of afferent renal arterioles?

A

Sympathetic innervation

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24
Q

What is responsible for the constriction of efferent renal arterioles?

A

Angiotensin II

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25
Q

What is responsible for the control of Na reabsorption at the distal tubule?

A

Aldosterone

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26
Q

What type of hormone is Aldosterone?

A

Adrenal cortical steroid hormone

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27
Q

What mediates the release of aldosterone?

A

Kidneys

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28
Q

Where are the juxtaglomerular cells (JG) found?

A

In the afferent arteriole, just before the glomerulus

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29
Q

What is the specialised loop of the distal tubule called?

A

Macula densa

30
Q

What forms the juxtaglomerular apparatus?

A

Juxtaglomerular cells

Macula densa

31
Q

What cells produce the hormone renin?

A

JG cells

32
Q

What is renin?

A

A proteolytic enzyme

33
Q

What does renin act on?

A

Angiotensinogen

34
Q

Where is angiotensinogen constantly produced from?

A

Liver

35
Q

Where is ACE found?

A

Vascular endothelium

Pulmonary circuit

36
Q

What does angiotensin II stimulate the release of from the adrenal cortex?

A

Aldosterone

37
Q

Where in the adrenal cortex is aldosterone produced?

A

Zona Glomerulosa

38
Q

What is the rate - limiting step in the RAAS pathway?

A

Production of renin

39
Q

When is renin released?

A

When pressure in the afferent arteriole decreases, detected by JG cells

Sympathetic innervation

40
Q

What are the JG cells described as?

A

Renal baroreceptors

41
Q

When NaCl levels reduce, what happens to renin production?

A

Increases

42
Q

What inhibits renin production?

A

Angiotensin II

ADH

43
Q

In the kidneys, what detects changes in osmolarity?

A

Macula densa

44
Q

In hypovoleamia, where does Na reabsorption occur?

A

Proximal & distal tubules

45
Q

What 3 things does Angiotensin II mediate?

A

Aldosterone secretion
Potent vasoconstriction
Stimulates ADH secretion

46
Q

What does auto regulation ensure?

A

GFR maintained

47
Q

What has the biggest effect on ECF composition, volume or osmolarity in hypovolaemic conditions?

A

Volume

48
Q

With a small reduction in ECF volume, what is there a large increase in?

A

ADH secretion

49
Q

What has the biggest effect on ADH secretion, volume or osmolarity in normovolaemic conditions?

A

Osmolarity

50
Q

What does ANP promote?

A

Na excretion

51
Q

What happens to K levels in the presence of Aldosterone?

A

Loss of K, reabsorption of Na

52
Q

What effect does aldosterone have on fluid volume?

A

Increased volume

53
Q

What is the urination of Na called?

A

Natruiresis

54
Q

What overrides Aldosterone?

A

ANP

55
Q

What is Conn’s syndrome?

A

Hyperaldosteronism

Tumour of the adrenal cortex

56
Q

Where is ANP secreted from in response to what?

A

Atrial cells

Increased blood volume

57
Q

What does hyperglycaemia lead to? Why?

A

osmotic diuresis

Exceeds maximum reabsorptive capacity

58
Q

In DM, does water move out at the descending Loop of Henle? Why?

A

No

High levels of Na & glucose present therefore osmotically active

59
Q

Because water does not move out at the descending limb, the fluid will be less ____ in the ascending limb in DM.

A

Concentrated

60
Q

In DM, a large volume of ____ & ____ is delivered to the distal tubule.

A

NaCl

Water

61
Q

In DM, what happens to the medullary interstitial gradient?

A

Lost

62
Q

Under normal conditions, a large volume of NaCl & water delivered to the distal tubule will result in…

A

Diuresis, loss of NaCl & water

63
Q

If a large amount of NaCl is delivered to the distal tubule, what happens to renin secretion?

A

Inhibits renin secretion

64
Q

In DM, why does ADH have little effect at the CD?

A

Loss of the medullary interstitial gradient

65
Q

In DM, urinary diuresis occurs resulting in how much urine being produced/ day?

A

6-8L/day

66
Q

What is one of the first symptoms experienced in DM?

A

Thirst

67
Q

In DM, if diuresis occurs what will happen to the BP? What will be the worst outcome?

A

Hypotension

Hyperglycaemic coma

68
Q

Why does hyperglycaemic coma occur?

A

Inadequate blood flow to the brain

69
Q

Why does hypoglycaemic coma occur?

A

Inadequate glucose to the brain

70
Q

What can loop diuretics cause?

A

K loss

71
Q

Why is K lost with the use of loop diuretics?

A

Inhibits Na-K-Cl cotransporter.

Urinary (17 decks)

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