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Bmsc 208 > Renal 5 > Flashcards

Renal 5 Flashcards

1
Q

why do we focus on 4 variables

A

body is in constant flux
- ingest 2l of fluid containing 6-15g NaCl
- take in varying ions

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2
Q

what is mass balance for fluid and electrolyte balance

A

whatever comes in must be excreted if not needed

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3
Q

how are fluids and electrolytes excreted

A

kidneys are primary route, small amounts in feces and sweat, lungs lose water and help remove H+, HCO3 by excreting CO2

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4
Q

why are we concerned with homeostasis fo H20 and Na

A

determine ECF and osmolarity

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5
Q

why are we concerned with K+ balance

A

can cause problems with cardiac and muscle function

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6
Q

why are we concerned with Ca2+

A

involved in many processes in body

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7
Q

why are we concerned with H+ and HCO3

A

determine body pH

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8
Q

why is maintaining osmolarity in the body important

A

water can cross most cell membranes freely
- can affect cell volume and most cells do not have mechanisms

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9
Q

what cells have independent mechanisms for maintaining cell volume

A

renal tubule cells
liver cells

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10
Q

how is fluid and electrolyte balance an integrative process

A

involves the respiratory, cardiovascular and renal systems as well as behavioural responses

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11
Q

what controls cardiovascular and respiratory systems

A

neural control and are rapid

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12
Q

what controls renal responses

A

endocrine and neuroendocrine control
slower

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13
Q

what can CV and resp. systems do before renal response

A

can kick in for temporary fix but renal will completely fix
- pathways overlap

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14
Q

what triggers homeostatic reflexes

A

volume receptors in atria and carotid and aortic baroreceptors respond to change in volume or bp

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15
Q

if decrease in blood volume and BP what does CV system do

A

increase cardiac output and vasoconstriction to increase BP

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16
Q

If decrease in blood volume and BP what does Behaviour response do

A

increases thirst which increase ECF and ICF volume and increases BP

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17
Q

if decrease in blood volume and BP what do kidneys do

A

conserve salt and water to minimize further volume loss

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18
Q

if increase blood volume and BP what does CV system do

A

decrease cardiac output and vasodilation to decrease BP

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19
Q

if increase in blood volume and BP what does kidneys do

A

excrete salts and H2O in urine, decreases ECF and ICF volume which decreases BP

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20
Q

water makes up how much of body weight

A

50-60%

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21
Q

water intake must match what

A

excretion

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22
Q

how much water in ICF

A

2/3

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23
Q

how much water in ECF

A

1/3
Plasma (25%)
interstitial fluid (75%)

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24
Q

what kind of mechanism is water loss in urine under normal conditions

A

regulated

25
Q

how is water gained

A

food and drink, metabolism

26
Q

how is water lost

A

skin, lungs, urine, feces

27
Q

what can the kidneys not do

A

can remove excess and conserve fluid but cannot replace what is lost

28
Q

what does volume loss result in

A

reduced GFR, volume loss in urine is reduced, reabsorption can be increased

29
Q

what must volume loss be replaced through

A

behavioural mechanisms

30
Q

what creates concentrated urine

A

renal medulla

31
Q

what is the osmolarity of urine a measure of

A

how much water is excreted by kidneys

32
Q

when removal of excess water is required what happens

A

kidneys produced large volume of dilute urine
- as low as 50mOsM

33
Q

if kidneys need to conserve water what do they do

A

low volume of concentrated urine
- up to 1200mOsM

34
Q

how do the kidneys control urine concentration

A

vary amounts of water and Na reabsorbed in distal nephron (distal tubule and collecting duct)

35
Q

how do kidneys produced dilute urine

A

distal nephron must reabsorb solute without allowing water to follow by osmosis (regulated aquaporins)

36
Q

how do kidneys produces concentrated urine

A

distal nephron must reabsorb water and little solute

37
Q

what happens in proximal tubule

A

only water reabsorbed (interstitial has lot of solute)

38
Q

what is osmolarity as further and further down medulla

A

more and more concentrated

39
Q

how do distal tubule and collecting duct alter their permeability to water

A

adding and removing water pore in apical membrane

40
Q

what are the aquaporins under direction of

A

posterior piuitary hormone vasopressin (AVP)

41
Q

what is another word for vasopressin

A

antidiuretic hormone (ADH)

42
Q

with max vasopressin what occurs

A

collecting duct is freely permeable
- water leaves carried away by vasa recta
- urine is concentrated

43
Q

what happens with absence of vasopressin

A

collecting duct is impermeable to water and urine is dilute
- large volume urine and no rebsorption

44
Q

what is insertion of AQP2

A

graded, depends on amount of AVP

45
Q

what stimulates vasopressin secretion

A

blood volume, pressure, and osmolarity (most potent)

46
Q

How does circadian rythm affect AVP

A

at night it is increased, prevents peeing, increased reabsorption of H20

47
Q

what is osmolarity monitored by

A

osmoreceptor neurons

48
Q

what is low blood volume sensed by

A

atrial stretch receptors

49
Q

what is decreased BP sensed by

A

carotid and aortic baroreceptors

50
Q

what produces and releases AVP

A

magnocellular neurosecretory cells (MNC’s)

51
Q

what are osmoreceptors

A

stretch sensitive neurons that increase firing rate as osmolarity increases

52
Q

what do the osmoreceptors signal to

A

to MNC’s where APs fire causing release of AVP containing vesicles

53
Q

what else signals to MNC’s

A

baro and atrial receptors

54
Q

where are vesicles containing AVP stores

A

posterior pituitary

55
Q

what is the countercurrent multiplier

A

the loop of henle

56
Q

what is necessary to create the concentration gradient for osmotic movement of water out of collecting duct

A

high osmolarity within the medullary interstitum

57
Q

what created hyperosmotic interstitium

A

countercurrent exchange systems
urea

58
Q

what is the countercurrent exchange system

A

loop of henle and vasa recta run in opposite directions and loop of henle close together

Bmsc 208 (33 decks)

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