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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

25
how is water gained
food and drink, metabolism
26
how is water lost
skin, lungs, urine, feces
27
what can the kidneys not do
can remove excess and conserve fluid but cannot replace what is lost
28
what does volume loss result in
reduced GFR, volume loss in urine is reduced, reabsorption can be increased
29
what must volume loss be replaced through
behavioural mechanisms
30
what creates concentrated urine
renal medulla
31
what is the osmolarity of urine a measure of
how much water is excreted by kidneys
32
when removal of excess water is required what happens
kidneys produced large volume of dilute urine - as low as 50mOsM
33
if kidneys need to conserve water what do they do
low volume of concentrated urine - up to 1200mOsM
34
how do the kidneys control urine concentration
vary amounts of water and Na reabsorbed in distal nephron (distal tubule and collecting duct)
35
how do kidneys produced dilute urine
distal nephron must reabsorb solute without allowing water to follow by osmosis (regulated aquaporins)
36
how do kidneys produces concentrated urine
distal nephron must reabsorb water and little solute
37
what happens in proximal tubule
only water reabsorbed (interstitial has lot of solute)
38
what is osmolarity as further and further down medulla
more and more concentrated
39
how do distal tubule and collecting duct alter their permeability to water
adding and removing water pore in apical membrane
40
what are the aquaporins under direction of
posterior piuitary hormone vasopressin (AVP)
41
what is another word for vasopressin
antidiuretic hormone (ADH)
42
with max vasopressin what occurs
collecting duct is freely permeable - water leaves carried away by vasa recta - urine is concentrated
43
what happens with absence of vasopressin
collecting duct is impermeable to water and urine is dilute - large volume urine and no rebsorption
44
what is insertion of AQP2
graded, depends on amount of AVP
45
what stimulates vasopressin secretion
blood volume, pressure, and osmolarity (most potent)
46
How does circadian rythm affect AVP
at night it is increased, prevents peeing, increased reabsorption of H20
47
what is osmolarity monitored by
osmoreceptor neurons
48
what is low blood volume sensed by
atrial stretch receptors
49
what is decreased BP sensed by
carotid and aortic baroreceptors
50
what produces and releases AVP
magnocellular neurosecretory cells (MNC's)
51
what are osmoreceptors
stretch sensitive neurons that increase firing rate as osmolarity increases
52
what do the osmoreceptors signal to
to MNC's where APs fire causing release of AVP containing vesicles
53
what else signals to MNC's
baro and atrial receptors
54
where are vesicles containing AVP stores
posterior pituitary
55
what is the countercurrent multiplier
the loop of henle
56
what is necessary to create the concentration gradient for osmotic movement of water out of collecting duct
high osmolarity within the medullary interstitum
57
what created hyperosmotic interstitium
countercurrent exchange systems urea
58
what is the countercurrent exchange system
loop of henle and vasa recta run in opposite directions and loop of henle close together

Bmsc 208 (33 decks)

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