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Renal I Final > Regulation of ECF Volume and NaCl Balance > Flashcards

Regulation of ECF Volume and NaCl Balance Flashcards

1
Q

What is the Effecting Circulating Volume?

A

Portion of ECF under pressure thats perfusing tissues.

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2
Q

Triangle

A

ECF Salt balance influences ECF volume

ECF Water balance influences ECF osmolarity

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3
Q

Approximately how much of the vascular volume forms the ECV?

A

0.7L

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4
Q

What impact does congestive heart failure have on ECV?

A

ECV is decreased in patients with congestive heart failure due to decreased cardiac output.

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5
Q

How does edema occur in patients with CHF?

A

Patients start retaining more sodium and fluid, which increases ECF

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6
Q

What are the 4 ways that a low ECV is counteracted?

A
  1. Activation of RAAS pathway
  2. Baroreceptor reflex via sympathetic stimulation
  3. ADH secretion
  4. Fluid Retention via Starlings forces
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7
Q

What are the two functions of osmoreceptors?

A
  1. Increase Thirst

2. Stimulate ADH secretion

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8
Q

Where are osmoreceptors located?

A

Supraoptic and paraventricular areas of the hypothalamus

SON and PVN

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9
Q

What two receptor types control ADH secretion?

What do they each detect?

A

Osmoreceptors: detect changes in body osmolarity

Baroreceptors: detect changes in body volume

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10
Q

Of the two receptors that control ADH secretion, which receptor type is more sensitive?

A

Osmoreceptors

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11
Q

What changes in blood pressure and blood volume stimulate ADH secretion?

A

Decreased blood pressure

Decreased blood volume

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12
Q

What is the most important non-osmotic stimulus of ADH release?

A

A decrease in sensed body volume

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13
Q

What is the impact of sensed volume on osmolarity and ADH release?

A

Volume contraction: smaller change in osmolarity leads to a larger amount of ADH release.

Volume expansion: Higher threshold for ADH secretion needs to be met.

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14
Q

Where do arterial baroreceptors send afferent information to?

A

Brainstem vasomotor center

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15
Q

Where do cardiopulmonary baroreceptors send afferent information to?

A

Brainstem vasomotor center

Hypothalamus

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16
Q

What do the intrarenal baroreceptors influence?

A

RAAS system, GFR, NaCl/Water reabsorption

17
Q

What do the Cardiopulmonary baroreceptors influence?

A

ADH!!! (via Hypothalamus)

  • Brainstem vasomotor center
18
Q

What does the brainstem vasomotor center impact?

A

TPR
Cardiac performance
Sympathetic drive to kidney
Venous compliance

19
Q

What receptor senses changes in ECV as a result of changes in sodium balance?

A

Arterial and Cardiac baroreceptors

Sodium balance changes –> ECF change —> ECV change

20
Q

What receptor senses changes in Plasma osmolarity as a result of changes in water balance?

A

Hypothalmic osmoreceptors

(Water balance changes –> Plasma osmolarity changes_

21
Q

What are the effectors involved in the baroreceptor response to changed ECV?

A

AGT II
Aldosterone
SNS
ANP

22
Q

What are the effectors involved in the osmoreceptor response to changed plasma osmolarity?

A

ADH

23
Q

What are the steps involved in maintaining homeostasis after a change in sodium balance?

Increased sodium

A
  1. Increase in Na-> leads to INCREASED plasma osmolarity
  2. Osmoreceptors sense the change in plasma osmolarity
  3. Stimulate release of ADH
  4. ADH increases fluid reabsorption
  5. Fluid moves into the ECF from the ICF
  6. Na concentration in the ECF falls —> osmolarity is maintained and ECF volume increases
24
Q

What are the steps involved in maintaining homeostasis after a change in sodium balance?

Decreased sodium

A
  1. Decreased Na –> DECREASED osmolarity
  2. Osmoreceptors are decreased
  3. ADH is inhibited -> Thirst decreases, and fluid retention decreases
  4. Water loss = reduced ECF
  5. Homostasis maintained, ECF decreases
25
Q

What are the 4 effector mechanisms involved in volume sensing?

A

Renal Sympathetic Nerves
RAAS system
Natriuretic Peptides
AVP

26
Q

What happens when an increase in ECFV is sensed?

A

Increased excretion of salt and water

27
Q

What are the effects of increased activity of Renal Sympathetic nerves?

A

Decreased salt excretion

  • Decrease GFR
  • Increase Renin secretion
  • Increase sodium reabsorption
28
Q

What are the effects of increased secretion of RAAS?

A

Decreased salt excretion

AGT II: sodium reabsorption, ADH secretion
Aldosterone: Sodium reabsorption in DT and CD

29
Q

What are the effects of increased natriuretic peptides?

A

Increased sodium excretion

  • Increase GFR
  • Decreased Renin, aldosterone secretion
  • Decreased sodium and water reabsorption
30
Q

Whats the effect of increased ADh?

A

Increased water reabsorption

31
Q

What are the three types of Natriuretic peptides?

A

ANP, BNP, Urodilatin

32
Q

What three mechanisms regulate renin release?

A
  1. Perfusion pressure (decrease)
  2. Sympathetic nerve activity (increase)
  3. NaCl delivery to macula densa (decrease)
33
Q

What is the effect of ANP on RAAS?

A

It inhibits RAAS

Also inhibits secretion of aldosterone

34
Q

Where is ANP produced?

A

Atrial cardiac muscles

35
Q

What is the direct effect of ANP?

A

Inhibition of sodium reabsorption in the distal tubule

36
Q

What serum sodium levels are indicative of Hyponatremia?

A

Serum sodium below 135

Renal I Final (7 decks)

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