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Physiology- Renal > Renal 6: Hormonal Regulation of Body Fluid Osmolarity > Flashcards

Renal 6: Hormonal Regulation of Body Fluid Osmolarity Flashcards

1
Q

What is insensible water loss

A

water loss from body outside of elimination through the kidneys
ex: evaporation, respiration, sweat

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2
Q 
What are the body fluid compartment volumes
TBW
ICF
ECF
ISF
P
T
A 
TBW(Total Body Water): 42 L
ICF(Intracellular Fluid): 28 L
ECF (Extracellular Fluid): 14 L
ISF (Interstitial Fluid): 10.5 L
P(Plasma):  3.5 L
T (Transcellular Water): 2L
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3
Q

How do we measure fluid volume using the dilution method?

A

Vspace = (Amtx given - amtx lost) /equilibrium [x] in space
D2O for TBW
Radiosulfate/sodium for ECF
Evans Blue for Plasma

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4
Q

How can you calculate the ICF and ISF

A 
ICF = TBW - ECF
ISF = ECF - Plasma
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5
Q

What is the normal osmolarity in every fluid compartment?

A

300 mosm/L

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6
Q

Rank these in terms of most to least in terms of protein concentrations
ICF, ISF, plasma

A

ICF> plasma > ISF

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7
Q

What happens when water intake exceeds/less than water loss from the body?

A

Exceeds : positive water balance -> hypoosmotic urine

Less: negative water balance -> hyperosmotic urine

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8
Q

What is the major determinant of plasma osmolality?

A

Na+

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9
Q

The kidney controls water excretion independentely/dependently with excretion of Na+, K+, and urea. Why is this good?

A

Independently. Allows water balance without disrupting other homeostatic functions of the kidney

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10
Q

How is ADH (Vasopressin) produced and stored

A

produced as preprohormone in neuroendocrine cells -> processed in RER and signal cleaved -> packed into secretory granules where it is further cleaved -> trafficked down to posterior pituitary -> stored in nerve endings until exocytosis

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11
Q

What are the physiological regulators for the negative feedback system for ADH?

A

plasma osmolality

volume and pressure of vascular system

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12
Q

What are the sensors used int he negative feedback system for ADH?

A

Hypothalamic Osmoreceptors: stimulate ADH release

Aortic Arch and Carotid Baroreceptors: inhibit ADH release

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13
Q

What are the effectors of the negative feedback system for ADH?

A

exocytosis of AHD from terminal axons of supraoptic neurons

paraventricular neurons in posterior pituitary

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14
Q

What are the targets for ADH

A

ExC ADH receptors in DT and CD

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15
Q 
How do these factors affect ADH release
Nicotine
Ethanol
Atrial Natriuretic peptide (ANP)
Angiotensin II
A

stimulates ADH release
inhibit ADH release
inhibit ADH release
stimulates ADH release

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16
Q

What are stimuli for ADH release

A

increases/decreases in plasma osmolarity

decreases in BP/volume

17
Q

What is the ADH release threshold for osmolarity

A

280 mOsm/kg H2O

18
Q

What is the thirst threshold for osmolarity

A

298 mOSm/kg H2O

19
Q

What is the ADH release threshold for pressure/volume

A

10% below normal pressure/volume

20
Q

What are some ADH disorders and their characteristics

A

Central(Pituitary) Diabetes Insipidus: polyuria, polydipsia
Nephrogenic Diabetes Insipidus: polyuria, polydipsia
Syndrome of Inappropriate ADH Secretion (SIADH): very high water retention

21
Q

What happens in response to ADH

A

increased water permeability of the upper and lower CDs to water -> insertion of aquaporin 2 water channels

increased urea permeability of only the lower CD

22
Q

Compare/Contrast the upper and lower collecting ducts with respect to urea

A

upper: water reabsorption concentrates urea which does not move with the water
lower: increased urea permeability allows urea reabsorption into the deep renal medulla

23
Q

Are there active transport mechanisms for urea?

A

No

24
Q

What are the axes and division in the Darrow Yannet Diagram?

A

Y Axis: fluid osmolarity (Top at 300 mOsm/L)
X Axis: compartment volume (-28 to 0 to 14)

ICF: 2/3 TBW = 28 L
ECF: 1/3 TBW: 14 L

25
Q 
Rank the following by percent water from greatest to least:
bone cells
fat cells
interstitium
plasma
A

plasma
interstitium
bone cells
fat cells

26
Q

The permeabilities of PW and ISF are similar/different to each other.

A

similar

27
Q

The permeabilities of ICF and ISF are similar/different to each other.

A

different

28
Q

What is the maximum stimulated ADH concentration from increased osmolality?

A

10 pmol/L

29
Q

What is the maximum stimulated ADH concentration from lower blood pressure?

A

50 pmol/L

30
Q

How does ADH secretion eventually lead to increased water permeability?

A

^ ADH&raquo_space; ^ ADH receptor stimulation&raquo_space; ^ Gs&raquo_space; ^ cAMP&raquo_space; ^ PKA&raquo_space; ^ inertion of aquaporin 2 water channels&raquo_space; ^ water perm.

Physiology- Renal (8 decks)

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