Regulation of Salt Balance Flashcards

1
Q

What is water excretion regulated by?

A

ECF osmolality

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2
Q

What is osmolality determined by?

A

Water and salt content

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3
Q

In ECF what is the major cation?

A

Na

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4
Q

What is excess Na a major factor in?

A

Hypertension

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5
Q

What can decreased Na levels result in?

A

Hypovolaemia and hypotension

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6
Q

What does decreased osmolality result in?

A

Water excretion

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7
Q

What does increased osmolality result in?

A

water retention and thirst

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8
Q

What is ECV?

A

Effective circulating volume - the component of blood which is perfusing the tissue

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9
Q

What is themodification of Na reabsorption changes in?

A

ECF , ECV

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10
Q

What is Renin?

A

An enzyme, synthesised and stored in the juxtaglomerular apparatus

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11
Q

What is the stimuli for renin release?

A

Increased sympathetic nerve activity via baroreceptor reflex

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12
Q

Why else is Renin released?

A

decresed wall tension in afferent arteriole, decreased Na delivery to the macula densa

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13
Q

What does the macula do in renin release?

A

releases prostaglanding I2 to stimulate granular cells to release renin into blood

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14
Q

How does macula densa release blood?

A

Through sympathetic nerves - via beta adrenergic receptors

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15
Q

What does Renin act on?

A

plasma protein - angiotensiongen to produce a decapeptide angiotensin 1

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16
Q

How is angiotensin 1 converted to angiotensin 2?

A

Plasma endothelial enzyme known as angiotensin converting enzyme ACE

17
Q

What is angiotensin 2?

A

Primary hormone in Na regulation, octapeptide

18
Q

What is angiotensin 2 broken into?

A

Angiotensin 3 and inactive products by plasma peptidases

19
Q

What does Angiotensin 2 cause ?

A

Vasoconstriction - intrarenal, systematic
Increased proximal tubular sodium reabsorption
Aldosterone release from zona glomerulosa for distal tubular sodium reabosorption
Thirst
ADH for water retention

20
Q

What does removal of adrenal glands cause?

A

Metabolic defects and death in 2 weeks

21
Q

Why does removal of adrenal glands cause?

A

Loss of NaCL from body via urine
Extracellular Na content falls
ECF volume markedly reduced
Circulatory collapse

22
Q

How can death be avoided if adrenal glands removed?

A

high sodium diet

administration of aldosterone

23
Q

What is aldosterone synthesised and secreted by?

A

zona glomerulosa of adrenal gland , steroid hormones synthesised from cholesterol, mineralocorticoid

24
Q

What causes aldosterone release?

A

Decrease in plasma Na concentration
Increase in plasma K concentration - sensitive
Decrease in ECV - angiotensin 2

25
What are the effects of aldosterone?
stimulates Na reaborption and K and H secretion in collecting duct and promotes Na reabsorption in gut and sweat glands
26
What is Atrial Natriuretic peptide?
28 aa hormone from 126 aa prohormones
27
Where is ANP released from?
Atrial cells in response to atrial stretch - hypervolemia
28
What does ANP act at?
ANP receptors in collecting duct - promotes Na loss in urine
29
What is ANP mechanism of action?
inhibits collecting duct NA-K-ATPase inhibits aldosterone secretion Reduces renin release promotes vasodilation of afferent arterioles
30
What is natriuretic mean?
decrease in Na reabsorption
31
What is urodilatin?
Origin in kidney, identical to ANP with 4 extra aa's, natriuretic
32
What is dopamine?
Synthesised in proximal tubule, inhibits Na-K-ATPase, inhibits Na-H antiport - natriuretic
33
What is Kinins?
Vasodilator peptides - produced from kininogens by enzyme kallikrein, counteracts ADH, natriuretic
34
What is adrenomedullin?
52 aa peptide synthesised in kidney, increases GFR, decreases sodium tubular reabsorption and natriuretic