Week 2 - C - Physiology 5 - Countercurrent system in the kidney Flashcards
What is the gradient produced by the loop of henle due to the tubular reabsorption/secretion of substances?
Creates a corticomedullary solute concentration gradient in the interstitial fluid
What type of urine does the corticomedullary gradient allow for the production of?
Allows for the production of hypertonic urine in the presence of ADH
What is the opposing flow in the two limbs leading to the corticomedullary solute concentration gradient known as?
This is the countercurrent flow
The loop of Henle works with what to establish a hyper-osmotic medullary interstitial fluid ?
Works with the vasa recta to establish this
Descending limb (DL) of the loop of Henle This segment does not reabsorb NaCl and is highly permeable to water How does this differ from the ascending limb?
The ascending limb is impermeable to water however absorbs sodium and chloride
How is it that the hyper-osmotic medullary interstitial fluid is set up then?
As there is no salt reabsorption in the desceing loop of Henle this makes the interstitial fluid at the bottom of the medullary portio of loop very osmotic Salt is then reabsorbed in ascending loop of Henle

Easier way to understand it Imagine the loop of Henle is filled with isotonic fluid eg 300mosmol/l What would the sodium and chloride absorption in thick loop of henle cause? Why cant water counteract this?
Sodium and chloride is reabsorbed from the tubular lumen to interstitial fluid here therefore making the hypertonic interstitium As the ascending loop of Henle is impermeable to water, it cannot be reabsorbed into the ascending loop of Henle
What is the main transporter in thick ascending loop of Henle to transport substances from tubular lumen into the tubular cells/interstitium?
This is the Na+/K+/2Cl- symporter where absorbs all three substances into the tubular cells
What happens to the potassium once it is reabsorbed into the tubular cells?
It is then secreted back into the tubular lumen by different potassium channels
K+ recycling means that NaCl is absorbed into the interstitial fluid What is the pump specific to the basolateral membrane of the tubular cell accounting for the reabsorption of Na into the interstitial fluid?
This is the Na+/K+,ATPase (sodium, potassium pump) pump which causes the reabsorption of sodium Also have a K+/Cl- contransporter which transports both into the interstituim however potassium is recycled
What are the class of drugs which inhibit the Na+/K+/2Cl triple co-transporter?
These are the loop diuretics

Triple co-transporter pumps solute from the thick ascending limb of Loop of Henle into the interstitial fluid What does this result in from the descending loop of Henle?
The descending loop of Henle responds by reabsorbing water into the interstitial fluid due to the osmosis Descending loop of Henle is impermeable to salt
Once the hypotonic fluid in the thick ascending loop is formed, where does it move to?
It moves on to the distal tubule

This process continues to occur. State how the process of countercurrent flow continues.
The fluid moves along the tubule And again the solute is reabsorbed via Na+/K+/2Cl- cotransporter at the apical membrane into the tubular cell and the Na+/K+/ATPase pump at the basoleteral membrane into the interstitium This causes an increase in intertsitial omsolarity leading to water reabsorption from the descedning limb
Eventually the a steady state is reached in the loop of Henle, what is this steady state known as?
This is known as the corticomedullary solute concentration gradient
Describe enters of iso, hypo, hyper what the fluid entering and leaving the loop of Henle is?
The fluid entering the loop of Henle is iso-osmotic and leaving the loop of Henle is hypoosmotic
It is not only salt which contributes to the corticomedullary concnentration gradient Where else does the concentration gradient arise from?
Concentration gradient also arises from urea Urea along with salt contributes to the corticomedullary concentration gradient
What percentage of urea is reabsorbed and from which part of the nephron?
50% of urea that is filtered is reabosrbed from the nephron
The purpose of the countercurrent multiplication is to concentrate the medulary interstitial fluid Why is this?

This enables the kidney to produce urine of different volume and concentration in relevance to the quantity of ADH production (ADH = vasopressin)
The volume of urine produced per day is roughly 1.5l/day What is the Vu? (remember, rate of urine flow) What can it increase and decrease to depending on ADH?
It is 1ml/min roughly Can decrease to 0.3ml/min and increase to 25ml/min
What runs along the loop of Henle in juxtamedullary nephrons?
The vasa recta
Omsolality of the blood will rise as it dips into the medulla and fall as it goes back into the cortex Why is this?
This is due to the vasa recta reaching an equilibrium state with the interstitial fluid and therefore when the omsolarity of the interstitial fluid changes, so does the vasa recta omsolality

Vasa recta acts as a COUNTERCURRENT EXCHANGER Together, the Loop of Henlé and vasa recta form a COUNTERCURRENT SYSTEM. How does the vasa recta contribute?
Pssive exchange across the endothelium of the capillaries maintains the medullary gradient whilst ensuring that solutes are not washed away
The countercurrent multiplier and the urea cycle create what?
The corticomedullary solute concentration gradient
The countercurrent exchanger preserves that gradient What is the countercurrent exchanger? What forms the countercurrent system
The countercurrent exchanger is the vasa recta The loop of Henle together with the vasa recta forms the countercurrent system
What does the high medullary osmolality allow for?
This allows for the production of hypertonic urine in the presence of ADH