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Human physiology > renal and electrolyte balance > Flashcards

renal and electrolyte balance Flashcards

1
Q

wher does water input come from?

A

dietary food and drink

metabolic water, a product of cellular respiration

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2
Q

where does water output come from

A 
urine
air in the lungs
faeces
sweat
skin
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3
Q

define osmolarity

A

total concentration of solutes in the solution of plasma

in plasma it must stay the same even after drinking

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4
Q

what does the kidney do to keep the plasma osmolarity the same after a drink

A

amount of urine will increasing
it will be more dilute
amount of solutes being excrested is the same and remains constant

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5
Q

what is obligitory resorption

A

dilutes things
resorbs salts and water follows
uses an osmotic gradient across the medualla

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6
Q

what does obligitory resorption do

A

uses counter current multiplication

parallel tubes running in opposites directions concentrating the urine

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7
Q

describe facultative resorption

A

ADH dependent

affects the collecting ducts

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8
Q

how does the osmotic gradient affect obligitory resorpton

A

active Na/K and cl transportes set a gradient
Na actively out of ascending loop
tight junctions prevent water leaking out
increased osmolarity in ISF
decreased osmolarity in the ascending tubules
less salt in tubules
uses gradient set up

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9
Q

what are the three processes regulating water balance

A

obligitory:
osmotic gradient
counter current multiplication
facultative hormones

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10
Q

how does counter current multiplication work

A

the osmotic graident set up using Na pulls water from the descending loop into ascending
concentrates it

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11
Q

where does water move during concentrating in the loop of henle

A

water leaves the descending llop
but then stuck in the ascending
this concentrates the tubular fluid

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12
Q

describe the steps in counter currrent multiplication to concentrate urine

A
  1. tubular fluid osmolarity equal to ISF
  2. active transport of Na,K,Cl from ascending loop makes gradient
  3. water moves out of descending by osmosis into ISF untill gradient establised
  4. fluid enters the system from the top moving it all around
  5. further active transport of Na,K,Cl ions from ascending incerasing concentration gradient
  6. further mvoement of water out of descending limb until gradient established
  7. repeat
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13
Q

what does counter current multiplication result in

A

more solutes in ISF

creates a smaller volume of concentrated urine

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14
Q

what drives facultative resorption

A

hormones

ADH is the priciple one

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15
Q

what does aldosterone do

A

drives the rennin-angiotensin-aldosteron system
regulated electrolyte lvels and salts
affects P cells in dsital and collecting ducts

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16
Q

describe what aldosterol does

A

triggers Na to be resorbed into P cells
and K to be secreted out inot tubules
water then follows the Na
the amount of K to be lost depends on the amount of aldosterone

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17
Q

what does high aldosterone result in

A

concentrates urine

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18
Q

what regulated aldosterone secretion

A

negative feedback

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19
Q

what inhibits aldosterone secretion

A

high sodium levels
high blood volume
high blood pressure

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20
Q

what does low aldosterone levels do to urine

A

dilutes it

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21
Q

what is ANp

A

atrial natiuretic peptide

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22
Q

were does ANp come from

A

secreted by atria of the heart in response to stretch

large blood voumes cause it

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23
Q

what does ANP do to the kidney

A

decreases the absorption of sodium and water from proximal convoluted tubules and collecting ducts
causes there to be more dilute urine

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24
Q

what does high ANPcause

A

inhibted ADH and aldosterone secretion

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25
Q

what does ADH do

A

altes the collecting ducts permeablity to water and urea

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26
Q

what does ADH cause to happen

A

pathway to translocate aquaproins to the membrane allowing water back in to blood

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27
Q

what triggers ADH

A

high osmotic pressure triggers secretion of ADH from pituitary

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28
Q

low ADH=

A

dilute urine

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29
Q

High ADH

A

concentrated urine

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30
Q

stages leading to ADH being released

A 
blood osmotic pressure raised
sensed by osmoreceptors in hyppthalamun
stimulates the pituitary
more ADH secreted 
which leads to increase resorption of water 
blood osmotic pressure lowered
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31
Q

what is a diuretic

A

substances that slow renal respotion
causes diuresis
more urine

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32
Q

examples of duiretics

A 
caffine
alchol
cold weather
stress
some medicines
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33
Q

how does caffine increase urine

A

inhibits Na resoprtion

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34
Q

how does alchocol act as as diuretic

A

inhibits ADH secretion

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35
Q

what does cold weather do to cause more urination

A

skin vasoconstriction and deep vasodilation
higher BO inhibting ADH secretion
vasodilation of kidney afferent arteriole
increases GFR

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36
Q

what does the sympatetic nervous system do to the kidney

A

concentrates urine
triggers constriction of:
afferent arteriole to reduce GFR
stimulates rennin production

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37
Q

what does noradrenaline do?

A

constricts the afferent arteiole to reduce GFR
more rennin
higher angiotensin
increased Na and water resorbption

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38
Q

what is the key salt balancer

A

aldosterone

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39
Q

where is sodium most common?

A

ECF cation

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40
Q

where is potassium most common

A

cation ISF

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41
Q

what does ADH regulate

A

water

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42
Q

what regulate electrolytes

A

rennin-angiotensin-aldoserone mechanism

atrial nariuetic peptide

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43
Q

when is rennnin made

A

in response to low sodium levels

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44
Q

what detects low sodium levels to signal rennin

A

cells lining thd sital tubule detect the levels and signal nearby granular cells of the afferent artiole to release rennin

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45
Q

what does rennin do?

A

converts to precursor angiotensin 1

thn to angiotensin 2 using an enzyme called ACE can now act on the adreanal corext to mae aldosteroneq

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46
Q

what is hyperkalaemi

A

high blood potassium

also signals for aldosterone

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47
Q

what signals to release rennin

A

low blood volune
low blodo pressure
low sodium

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48
Q

what does aldosterone do to the kidneys

A

resortion of sodium and water
increased excrestion of potassium

results in higher blood Na levels
higher blood volume and higher BP

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49
Q

what causes rennin to be stopped

A

higher sodium in the blood

higher blood volume and BP

50
Q

what ca angiotensis 2 cause?

A

casoconstriction leading to increased blood pressure negativelt feddbacking the kidnesy to stop secreting rennin

51
Q

what does ANP cause

A

decreases resoprtion of sodium and water fromm proximal convoluted tubules nd collecting ducts
makes urine more dilute

52
Q

where is most of the sdum resorbed

A

proximal tubule by active transport

distal tubule and collecting duct by aldosterone

53
Q

what deos a low K diet mean

A

more is resorbed

54
Q

wher is pootassium resorbed

A

proximal convoluted tubule by leaky jucntions

55
Q

how do diuteitc impact potassium

A

inhibit water resorbtion by inhibiting the cotransporter
reduced the resorption of K therefore
causes hypokalaemia

56
Q

what is potassium excess

A

hyperkalaemia

57
Q

what is potassium deficiency

A

hypokalaemia

58
Q

what are luminal anions

A

presence of anions in the lumen caues secretion of K to neurtralise the charge

59
Q

what increased K secretion ( luminal anions)

A

increased gradient

60
Q

what factors decrease K secretion ( luminal anions)

A

decreased gradient

61
Q

factors affecting potassium levels

A 
aldosterone
electrochemica gradent of luminal anions
dietary K 
acid base disturbances
diuertics
62
Q

how does aldosterone impact K

A

increases the number of K channels in the luminal mmebrane to incrase K secretion by the P cells

63
Q

what causes hypokalaemia

A

alkalosis
K moves out of blood inot cells
K deficiency

64
Q

what cuses hyperkalameia

A

acidosis
K movesinto blood out of cells
K excess

65
Q

how do luminal anions affect potassium

A

presence of large anions such as sulfate in lumen of distal tubule and collecting duct incrase K secretion

66
Q

define hyponatraemia

A

low soodium levels
most common
caused by diarrohae, heart failure, hypothyriodism, diuretics

67
Q

define hypokalaemia

A

low potassium

can cause muscle weakness and cariac arrythmias

68
Q

what is hypoovaolaemic hyponatraemia

A

reduced ECF

69
Q

what is erythropeotin

A

Epo
regulates red cell production by the bone marrow
produced by the kidnesy in response to hypoxia

70
Q

what systems maintain acid base balance

A

blood bufferin
metabolis system]respiraotry system
renal system

71
Q

what do acids so when in olution

A

release H+ ions

72
Q

what do alkaline do in solution

A

accept H+ ions in solution

often release OH- which can accetp the H+ to form H2)

73
Q

what is a buffer?

A

chemical which can bind revesibly to hdrogen ions

they set the pH

74
Q

name the mian blood buffers?

A

protein bufffer system
phosphate buffer system
carbonic acid-biocarbonate system

75
Q

how doe the protein buffer systm wrok

A

haemoaglobin accepts and donated hydrogen ions

76
Q

role of haemalogin in protein buffering

A

accepts or donates hydrogen ions

prevents large changes in plasma p

77
Q

how can aminoa acids alo work in protein buffering?

A

some have basic side chains and accept hydrogen, some have cidic side chains donating electrons

78
Q

what is phsophate buffering

A

phosphate fund in bones

it can accetp H+ to mkae dihydrogenphosphate which is used intracellukarly and urinarry as a buffer

79
Q

what hapens if there is too much freee hydrogen

A

need more phsphate so its taken out of the bones leading to osteoporosis

80
Q

how does the bicarbonte buffering syste work

A

bicarbonate accepts and donates H+ions

used in the ECF

81
Q

how does bicarboate work as a buffe

A

bicarbonate accepts H to form carbonic acid

this can then dissociate to carbon iodixde and water

82
Q

what does high carbon iodxide to to pH

A

increases Hydrogen and loweres the blood pH

83
Q

what does low carbon dpxide to do pH

A

loweres the Hydrogen and raises the pH

84
Q

what does high bicarbonate cause

A

mops up the H

reduced the hydrogen leading to a raised pH

85
Q

what does a ow bicarbonate cause

A

increase hydrogen and thus a lower pH

86
Q

what controls acid base homeostasis

A

3 main body systems –>
metabolic
respiratory
renal

87
Q

which is the fasted form of acid base balancing

A

respiratory system and metabolic activity

88
Q

what is used in the long term to control buffering

A

renal system

89
Q

what eliminates hydrogen ions

A

respirtry exchange

90
Q

how does metabolic activity form acid?

A

normal cellular respiration generates CO2
this combines with water to make carbonic acid
this is trasnported to the lungs as bicarbonate and hydrogen
more hydrogen

91
Q

what dertmines a foods acidity or alkaniity

A

how t breaks down

eg citrus fruits are acidic by alkaline forming hen brokwn down

92
Q

how do we remove hyrdrogens through respiatory system

A

hyperventilate
change the breathing rate to alte the hydrogen concentration and the equibrium
largely subconscious

93
Q

in condictions of hiogh hydrogen what happens to breaing

A

hyperventilate
loss off carbon iodixde
lowers hydrogen

94
Q

how long does renal regulation of pH take?

A

slow

hours or days

95
Q

how does the kidne regulate high hydrogen

A

hgh hydrogen stimulate the kidney to secrete hydrogen

reabsorb bicarbonate where its then recycled

96
Q

how does the kidney deal with low hydrogen

A

resorbs hydrogen

secretes bicarbonate and lets go of it

97
Q

define acodisosi

A

too much hydrogen in the blood

98
Q

what does acidocisis cause?

A

trigers increase breathing rate to remoe carbon dioxide
hydrogen ions are secreted in kidnesy
bicarb is recyced and reabsorbed

99
Q

define alkalosis

A

low blood pH

100
Q

what happens in alakosis

A

slow breathing
reduced respiration
reduced hydrogen secretion
secretes bicarb instead

101
Q

how is ph/acid-base balance maintained?

A

renal secretion of H+ and reabsorption of bicarbonate

102
Q

what us HCO3

A

bicarbonate

103
Q

how is hydrogen removes in urine

A

active proton pump moves it into the urine making it acidic

but it combines with other things to make it less harsh

104
Q

how is H+ secreted in the proximal tubules

A

Na/H+ antiporter

105
Q

what can hydrogen combie with to be les harh

A

ammonia to mkae ammonia uions
hydrogen phosphate to make dihydrogen phosphate
both are excreted

106
Q

how much of they hydrogen made y the body is excerted?

A

all
most at ammonia ions
some as titiratable acids

107
Q

what happens to bicarbonate?

A

nearly all is reabsorbed to preserve the body supplies and be used as a buffer

108
Q

what is the body net acid-base balance?

A

acidic

renal system makes slightly acidic urine pH5

109
Q

what happen during kidney disease?

A

GFR down

110
Q

how do the lungs regulate pH

A

by excretion of carbon dioxide

111
Q

what does hyerpventilationc ause

A

decrease in hydogenions

and respiratory akalosis

112
Q

what does hypoventaltion cause?

A

increase in hydrogen ions

respiratory acidosis

113
Q

high H without renal buffing leads to

A

metabolic acidosis

114
Q

low H without renal buffering leads to

A

metabolic akalosis

115
Q

cause of metabolic acidosis

A

generation of hydrogen ion or loss of a base from the body

bicarb falls

116
Q

compensation for metabolic acidosis

A

respiratory hyperventilation

loweres hydrogen

117
Q

cause of respiratry acidsis

A

defective exchange of gasses in the lungs

carbon dioxide rises

118
Q

copensation for respiraotry acidosis

A

renal

urinary reabsorption of bicarbonate

119
Q

cause of metabolic alkalosis

A

loss of hydrogen ions or generation of bases in the body

rise in bicarbonate

120
Q

compensation for metabolic alkalosis

A

respiratory hypoventialtion

raise hydrogen levels

121
Q

cause of respiratry alkalosis

A

hyperventilation

carbo dixide falls

122
Q

compensation for resiratory alkaosis

A

renal
urinaey secretion of bicarbonate
lose some bicarb

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