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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
what does ADH do
altes the collecting ducts permeablity to water and urea
26
what does ADH cause to happen
pathway to translocate aquaproins to the membrane allowing water back in to blood
27
what triggers ADH
high osmotic pressure triggers secretion of ADH from pituitary
28
low ADH=
dilute urine
29
High ADH
concentrated urine
30
stages leading to ADH being released
``` 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 ```
31
what is a diuretic
substances that slow renal respotion causes diuresis more urine
32
examples of duiretics
``` caffine alchol cold weather stress some medicines ```
33
how does caffine increase urine
inhibits Na resoprtion
34
how does alchocol act as as diuretic
inhibits ADH secretion
35
what does cold weather do to cause more urination
skin vasoconstriction and deep vasodilation higher BO inhibting ADH secretion vasodilation of kidney afferent arteriole increases GFR
36
what does the sympatetic nervous system do to the kidney
concentrates urine triggers constriction of: afferent arteriole to reduce GFR stimulates rennin production
37
what does noradrenaline do?
constricts the afferent arteiole to reduce GFR more rennin higher angiotensin increased Na and water resorbption
38
what is the key salt balancer
aldosterone
39
where is sodium most common?
ECF cation
40
where is potassium most common
cation ISF
41
what does ADH regulate
water
42
what regulate electrolytes
rennin-angiotensin-aldoserone mechanism | atrial nariuetic peptide
43
when is rennnin made
in response to low sodium levels
44
what detects low sodium levels to signal rennin
cells lining thd sital tubule detect the levels and signal nearby granular cells of the afferent artiole to release rennin
45
what does rennin do?
converts to precursor angiotensin 1 | thn to angiotensin 2 using an enzyme called ACE can now act on the adreanal corext to mae aldosteroneq
46
what is hyperkalaemi
high blood potassium | also signals for aldosterone
47
what signals to release rennin
low blood volune low blodo pressure low sodium
48
what does aldosterone do to the kidneys
resortion of sodium and water increased excrestion of potassium results in higher blood Na levels higher blood volume and higher BP
49
what causes rennin to be stopped
higher sodium in the blood | higher blood volume and BP
50
what ca angiotensis 2 cause?
casoconstriction leading to increased blood pressure negativelt feddbacking the kidnesy to stop secreting rennin
51
what does ANP cause
decreases resoprtion of sodium and water fromm proximal convoluted tubules nd collecting ducts makes urine more dilute
52
where is most of the sdum resorbed
proximal tubule by active transport | distal tubule and collecting duct by aldosterone
53
what deos a low K diet mean
more is resorbed
54
wher is pootassium resorbed
proximal convoluted tubule by leaky jucntions
55
how do diuteitc impact potassium
inhibit water resorbtion by inhibiting the cotransporter reduced the resorption of K therefore causes hypokalaemia
56
what is potassium excess
hyperkalaemia
57
what is potassium deficiency
hypokalaemia
58
what are luminal anions
presence of anions in the lumen caues secretion of K to neurtralise the charge
59
what increased K secretion ( luminal anions)
increased gradient
60
what factors decrease K secretion ( luminal anions)
decreased gradient
61
factors affecting potassium levels
``` aldosterone electrochemica gradent of luminal anions dietary K acid base disturbances diuertics ```
62
how does aldosterone impact K
increases the number of K channels in the luminal mmebrane to incrase K secretion by the P cells
63
what causes hypokalaemia
alkalosis K moves out of blood inot cells K deficiency
64
what cuses hyperkalameia
acidosis K movesinto blood out of cells K excess
65
how do luminal anions affect potassium
presence of large anions such as sulfate in lumen of distal tubule and collecting duct incrase K secretion
66
define hyponatraemia
low soodium levels most common caused by diarrohae, heart failure, hypothyriodism, diuretics
67
define hypokalaemia
low potassium | can cause muscle weakness and cariac arrythmias
68
what is hypoovaolaemic hyponatraemia
reduced ECF
69
what is erythropeotin
Epo regulates red cell production by the bone marrow produced by the kidnesy in response to hypoxia
70
what systems maintain acid base balance
blood bufferin metabolis system]respiraotry system renal system
71
what do acids so when in olution
release H+ ions
72
what do alkaline do in solution
accept H+ ions in solution | often release OH- which can accetp the H+ to form H2)
73
what is a buffer?
chemical which can bind revesibly to hdrogen ions | they set the pH
74
name the mian blood buffers?
protein bufffer system phosphate buffer system carbonic acid-biocarbonate system
75
how doe the protein buffer systm wrok
haemoaglobin accepts and donated hydrogen ions
76
role of haemalogin in protein buffering
accepts or donates hydrogen ions | prevents large changes in plasma p
77
how can aminoa acids alo work in protein buffering?
some have basic side chains and accept hydrogen, some have cidic side chains donating electrons
78
what is phsophate buffering
phosphate fund in bones | it can accetp H+ to mkae dihydrogenphosphate which is used intracellukarly and urinarry as a buffer
79
what hapens if there is too much freee hydrogen
need more phsphate so its taken out of the bones leading to osteoporosis
80
how does the bicarbonte buffering syste work
bicarbonate accepts and donates H+ions | used in the ECF
81
how does bicarboate work as a buffe
bicarbonate accepts H to form carbonic acid | this can then dissociate to carbon iodixde and water
82
what does high carbon iodxide to to pH
increases Hydrogen and loweres the blood pH
83
what does low carbon dpxide to do pH
loweres the Hydrogen and raises the pH
84
what does high bicarbonate cause
mops up the H | reduced the hydrogen leading to a raised pH
85
what does a ow bicarbonate cause
increase hydrogen and thus a lower pH
86
what controls acid base homeostasis
3 main body systems --> metabolic respiratory renal
87
which is the fasted form of acid base balancing
respiratory system and metabolic activity
88
what is used in the long term to control buffering
renal system
89
what eliminates hydrogen ions
respirtry exchange
90
how does metabolic activity form acid?
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
what dertmines a foods acidity or alkaniity
how t breaks down | eg citrus fruits are acidic by alkaline forming hen brokwn down
92
how do we remove hyrdrogens through respiatory system
hyperventilate change the breathing rate to alte the hydrogen concentration and the equibrium largely subconscious
93
in condictions of hiogh hydrogen what happens to breaing
hyperventilate loss off carbon iodixde lowers hydrogen
94
how long does renal regulation of pH take?
slow | hours or days
95
how does the kidne regulate high hydrogen
hgh hydrogen stimulate the kidney to secrete hydrogen | reabsorb bicarbonate where its then recycled
96
how does the kidney deal with low hydrogen
resorbs hydrogen | secretes bicarbonate and lets go of it
97
define acodisosi
too much hydrogen in the blood
98
what does acidocisis cause?
trigers increase breathing rate to remoe carbon dioxide hydrogen ions are secreted in kidnesy bicarb is recyced and reabsorbed
99
define alkalosis
low blood pH
100
what happens in alakosis
slow breathing reduced respiration reduced hydrogen secretion secretes bicarb instead
101
how is ph/acid-base balance maintained?
renal secretion of H+ and reabsorption of bicarbonate
102
what us HCO3
bicarbonate
103
how is hydrogen removes in urine
active proton pump moves it into the urine making it acidic | but it combines with other things to make it less harsh
104
how is H+ secreted in the proximal tubules
Na/H+ antiporter
105
what can hydrogen combie with to be les harh
ammonia to mkae ammonia uions hydrogen phosphate to make dihydrogen phosphate both are excreted
106
how much of they hydrogen made y the body is excerted?
all most at ammonia ions some as titiratable acids
107
what happens to bicarbonate?
nearly all is reabsorbed to preserve the body supplies and be used as a buffer
108
what is the body net acid-base balance?
acidic | renal system makes slightly acidic urine pH5
109
what happen during kidney disease?
GFR down
110
how do the lungs regulate pH
by excretion of carbon dioxide
111
what does hyerpventilationc ause
decrease in hydogenions | and respiratory akalosis
112
what does hypoventaltion cause?
increase in hydrogen ions | respiratory acidosis
113
high H without renal buffing leads to
metabolic acidosis
114
low H without renal buffering leads to
metabolic akalosis
115
cause of metabolic acidosis
generation of hydrogen ion or loss of a base from the body | bicarb falls
116
compensation for metabolic acidosis
respiratory hyperventilation | loweres hydrogen
117
cause of respiratry acidsis
defective exchange of gasses in the lungs | carbon dioxide rises
118
copensation for respiraotry acidosis
renal | urinary reabsorption of bicarbonate
119
cause of metabolic alkalosis
loss of hydrogen ions or generation of bases in the body | rise in bicarbonate
120
compensation for metabolic alkalosis
respiratory hypoventialtion | raise hydrogen levels
121
cause of respiratry alkalosis
hyperventilation | carbo dixide falls
122
compensation for resiratory alkaosis
renal urinaey secretion of bicarbonate lose some bicarb

Human physiology (21 decks)

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