Term
| Infants have ___ body fat, __ bone mass, and are ___% or more water. |
|
Definition
|
|
Term
| Total water content __ throughout life. |
|
Definition
|
|
Term
| Healthy males are __% water. Healthy females are __% water. |
|
Definition
|
|
Term
| The differnce in water content between females and males reflects: |
|
Definition
| - females higher body fat amounts and smaller amount of skeletal muscle |
|
|
Term
| In old age, about __% of body is water. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| ___ of body fluid is intracellular, __ is extracellular. |
|
Definition
|
|
Term
| Extracellular fluid can be divided into ___, which is inside vessels, and ___ ___, which is outside vessels. |
|
Definition
- plasma
- interstitial fluid |
|
|
Term
| About ___% of extracellular fluid is plasma, while __% is interstitial fluid. |
|
Definition
|
|
Term
| total body water (TBW) can be calculated by: |
|
Definition
TBW= 0.6 x body weight
usually 42 Liters |
|
|
Term
| Usually have __L of total body water. __L in extracellular space, and __ L in intracellular space. Of the __L in the extracellular space, __ L are in the interstitial space and ___L are in the plasma. |
|
Definition
- 42 L
- 14L
- 28L
- 14L
- 10.5 L
- 3.5 L |
|
|
Term
| Extracellular fluids are similar composition, except plasma has a higher ___ concentration. But all extracellular fluid has ___ as the chief cation and ___ as the major anion. |
|
Definition
|
|
Term
| Intracellular fluids have __ sodium and chloride and ___ is the main cation, while ___ is the main anion. |
|
Definition
- low sodium and chloride
- potassium
- phosphate |
|
|
Term
| Water movement between each compartment is regulated by ___ and ___ pressures. Osmolarities of all body fluids are ___. Changes in solute concentrations are quickly followed by osmotic changes. |
|
Definition
- osmotic and hydrostatic
- equal |
|
|
Term
| Electrolytes move ___ between the ___ and ___ ___, but ___ between the ___ and ____ fluids. |
|
Definition
- freely between the blood and interstitial
- selectively between the interstitial and intracellular |
|
|
Term
| Proteins and blood cells are retained within ___ ___. |
|
Definition
|
|
Term
| To remain properly hydrated water intake must equal water output. Sources of water intake include: |
|
Definition
- ingested fluid (60%)
- solid food (30%)
- metabolic water or water or oxidation (10%) |
|
|
Term
|
Definition
- urine 60%
- feces 4%
- insensible loss 28%
- sweat 8% |
|
|
Term
| The hypothalamic thirst center is stimulated by: |
|
Definition
- a decline in plasma volume of 10-15%
- increases in plasma osmolarity of 1-2%
- via baroreceptor input , angiotension II, and other input |
|
|
Term
| Thirst is quenched as soon as we begin to drink water. Feedback centers that inhibit the thirst centers include: |
|
Definition
- moistening of the mucosa of the mouth and throat
- activation of stomach and intestinal stretch rececptors |
|
|
Term
| Go through the thirst mechanism caused by increased plasma osmolarity: |
|
Definition
| - increased plasma osmolarity> decreased saliva and osmoreceptors in hypothalamus detect the increased osmolarity> dry mouth> activation of hypothalamic thirst center> sensation of thirst> drink |
|
|
Term
| Go through thirst mechanism caused by decreased plasma volume: |
|
Definition
| - decreased plasma volume> decreased blood pressure> JG cells in kidney> renin-angiotension mechanism> increased angiotension II> hypothalamic thirst center> sensation of thirst> drink |
|
|
Term
| What three factors directly act on the hypothalamic thirst center? |
|
Definition
- dry mouth
- osmoreceptors in the hypothalamus that detect increased osmolarity
- increased angiotension II |
|
|
Term
| What has negative feedback on sensation of thirst? |
|
Definition
- water moistening mouth and throat and stretching stomach and intestine
- decreased plasma osmolarity |
|
|
Term
| Renal mechanism for dilution and concentration of the urine: |
|
Definition
| Kidney can excrete hyposmotic (as low as 50 mOsm) or hyperosmotic (as high as 1200 mOsm) urine based on the body conditions |
|
|
Term
| Urine dilution and concentration occurs by the ___ ____. |
|
Definition
|
|
Term
| Two prerequisits for the countercurrent mechanism to work to dilute or concentrate urien: |
|
Definition
1. Hyperosmolarity in renal medulla
2. Water permeability of collecting duct is regulated by ADH |
|
|
Term
| The ___ ____ creates the osmotic gradient needed for dilution/concentration of urine. |
|
Definition
|
|
Term
| Why is the renal medulla hyperosmotic? |
|
Definition
Countercurrent mechanism:
- Interaction between the flow of filtrate through the loop of Henle (countercurrent multiplier)and the flow of blood through through the vasa recta blood vessels (countercurrent exchanger)
- the solute concentration in the loop of Henle ranges from 300mOsm to 1200 mOsm
- dissipation of medullary osmotic gradient is prevented b/c the blood in the vasa recta equilibrates with intersitial fluid |
|
|
Term
| With the countercurrent mechanism the interaction between the flow of filtrate through the ___ __ ___, aka as the ___ ___, and the flow of blood through the __ ___ ___ ___, aka the __ ___. |
|
Definition
- loop of Henle, aka countercurrent multiplier
- vasa recta blood vessles, aka countercurrent exchanger |
|
|
Term
| The solute concentration in the loop of Henle ranges from ___ to ____. |
|
Definition
|
|
Term
| Dissipation of the medullary osmotic gradient is prevented b/c the blood in the ___ ____ ___ with the ___ fluid. |
|
Definition
- vasa recta
- equillibrates
- interstitial fluid |
|
|
Term
| The descending loop of Henle is impermeable to ___ but permeable to ___. |
|
Definition
- impermeable to solutes
- permeable to water |
|
|
Term
| The ascending loop of Henle is impermeable to ___, but permeable to ___. |
|
Definition
- impermeable to water
- permeable to solutes |
|
|
Term
| Collecting ducts in the __ ___ regions are permeable to ____. |
|
Definition
- deep medullary region
- permeable to urea |
|
|
Term
| As you go down the descending loop of Henle, ___ is being reabsorbed, so that by the bend in the loop, the filtrate is its most ____. So as you go down descending loop, filtrate becomes more and more ____. |
|
Definition
- water
- concentrated
- concentrated |
|
|
Term
| In the ascending loop of Henle, the fitrate is becoming ___ ____ as ___ are reabsorbed. |
|
Definition
- less concentrated
- solutes |
|
|
Term
| The concentration stays about the same in the distal tubule, but in the collecting duct, it becomes ___ ____ again as ___ is reabsorbed. |
|
Definition
- more concentrated
- water |
|
|
Term
| The first part of the descending loop of henle is in the ____, while second part is in the ____ ____ .and the bending point is in the ___ ___. |
|
Definition
- cortex
- outer medulla
- inner medulla |
|
|
Term
| The vasa recta is a ___ ___ that maintains ___ ___ and delivers ___ to cells in the area. |
|
Definition
- countercurrent exchanger
- osmotic gradient
- blood |
|
|
Term
| Formation of dilute urine will happen as long as ____ ____ is NOT being secreted. |
|
Definition
| - antidiuretic hormone (ADH) |
|
|
Term
| With formation of dilute urine, the collecting ducts remain ___ to water, so no further water reabsorption occurs. |
|
Definition
|
|
Term
| With the formation of dilute urine, sodium and selected ions can be removed by ___ and ___ processes. |
|
Definition
|
|
Term
| Urine osmolarity can be as low ___ mOsm, 1/6th that of plasma. |
|
Definition
|
|
Term
| So with dilute urine, think more water in urine, less solutes, so no ADH, no water reabsorption in collecting duct. |
|
Definition
|
|
Term
| To form concentrated urine (think less water in urine), ___ ____ inhibits diuresis. In the presence of this substance __% of water is reabsorbed. |
|
Definition
- antidiurectic hormone
- 99% |
|
|
Term
| Whether kidneys excrete a concentrated or dilute urine, is based on the level of ___ in the plasma. Low ADH levels produce ____ urine and ____ volume of body fluids. High ADH levels produce ___ urine. |
|
Definition
- ADH
- dilute
- reduced
- concentrated |
|
|
Term
| Explain the mechanism and consequences of ADH release: |
|
Definition
| - increased osmolarity and increased sodium concentration in plasma> osmoreceptors in the hypothalamus> in the mean time,decreased plasma volume and 10-15% drop in blood pressure inhibits baroreceptors in atrium and large vessels> so the stimulated osmoreceptors in the hypothalamus and the inhibited baroreceptors in the atrium and large vessels stimulate the posterior pituitary gland> ADH> collecting ducts of kidneys> increased water reabsorption> decreased osmolarity, increased plasma volume, and decreased urination |
|
|
Term
| Draw out slides 14 and 28 from this lecture. |
|
Definition
|
|
Term
| Sodium holds an essential role in fluid and electrolyte balance. Sodium salts account for ___-___% of all solutes in the ___. Sodium also contributes __mOsm of the total 300 mOsm ECF solute concentration. |
|
Definition
|
|
Term
| ___ is the single most abundant cation in the ECF. |
|
Definition
|
|
Term
| ___ is the only cation exerting signifanct ___ ___. |
|
Definition
- sodium
- osmotic pressure |
|
|
Term
| __% of sodium is reabsorbed in the proximal tubule, while __% is reabsorbed in the loop of Henle. |
|
Definition
|
|
Term
| When ___ levels are high, all remaining sodium is ___ absorbed in the ___ ___ and __ __. |
|
Definition
- aldosterone
- actively
- distal tubule
- collecting duct |
|
|
Term
| Sodium reabsorption in the proximal tubule and loop of Henle is ____. |
|
Definition
|
|
Term
| Sodium handling in the proximal tubule and and loop of Henle are maintained by the _____ balance mechanism. |
|
Definition
|
|
Term
| Reabsorption of the remaining portion of the filtered load of sodium by the ___ __ and ___ ____ is regulated by ___. |
|
Definition
- distal tubule
- collecting duct
- aldosterone |
|
|
Term
| what is the final adjustment in urine formation? |
|
Definition
| - Aldosterones affect on reabsorbing remaining filtered load of sodium |
|
|
Term
| The ___ ____ ____ triggers the release of aldosterone. This is regulated by the ___ ____ which releases ___ in response to what three stimuli? |
|
Definition
- renin-angiotensin mechanism
- juxtaglomerular apparatus
- renin
- sympathetic nervous system stimulation
- decreased filtrate osmolarity
- decreased stretch due to decreased blood pressure |
|
|
Term
|
Definition
| - catalyzes the production of Angiotensin II, which prompts aldosterone release |
|
|
Term
| decreased filtrate osmolality, decreased stretch due to decreased blood pressure, sympathetic stimulation> juxtaglomerular apparatus to make renin> Angiotensin II> Aldosterone> distal tubule and collecting duct absorb remaining sodium |
|
Definition
|
|
Term
| outline path of the Renin-Angiotensin Aldosterone System: |
|
Definition
| liver makes angiotensinogen> kindey makes renin which converts angiotensinogen to angtiotensin I> ACE from the lungs converts angiotensin I to angiotensin II> angiotensin II acts on the brain causing release of ADH, and acts on the adrenal glands to cause release of aldosterone, and acts on the kidney itself> decreased sodium excretion and decreased water excretion |
|
|
Term
| ___ ___ cells are directly stimulated to release aldosterone in reponse to elevated ___ levles in the ___. |
|
Definition
- Adrenal cortical
- K+
- ECF |
|
|
Term
| Aldosterone bring on its effects of diminished ___ ___ and increased ___ ___ ___. |
|
Definition
- diminished urine output
- increased blood volume
- slowly |
|
|
Term
| draw out slide 37 from this lecture |
|
Definition
|
|
Term
| Explain in words the regultion of sodium balance via aldosterone. |
|
Definition
| decreased sodium or increased potassium in blood and the renin-angiotensin pathway> (stimulate)> adrenal cortex to release> Aldosterone> kidney tubule> increased sodium reabsorption and increased potassium secretion> restores homeostasis plasma levels of sodium and potassium which have a negative feedback on the adrenal cortex |
|
|
Term
| Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) reduce ___ ___ and ___ ___ by inhibiting events that promote ___ and inhibiting ___ reabsorption and water retention. |
|
Definition
- blood pressure and blood volume
- vasoconstriction
- sodium |
|
|
Term
| ANP is released from the ___, while BNP is released from the ___. Both are released in response to ___ from ___ ___ __. |
|
Definition
- atria
- ventricles
- stretch
- elevated blood pressure |
|
|
Term
| ANP and BNP have potent ___ and ___ effects. They promote excretion of ___ and ___. They inhibit ___ __ production. |
|
Definition
- diuretic and natriuretic
- sodium and water
- Angiotensin II |
|
|
Term
| Look at and draw slide 39 from this lecture. |
|
Definition
|
|
Term
| go through pathway of ANP: |
|
Definition
| - increased stretch of heart due to increased blood pressure> ANP is released> JG apparatus, hypothalamus and pituitary gland, and adrenal cortex> JG apparatus decreases renin production which leads to increased sodium and water reabsorption and also decreases ang II, resulting in vasodilation> hypothalamus and posterior pituitary decrease ADH released which inhibits collecting duct leading to increased water and sodium excretion> adrenal cortex decreases aldosterone release which inhibits the kidneys leading to increased sodium and water excretion> ultimately decreased blood volume leads to decreased pressure which has negative feed back on the release of ANP and BNP |
|
|
Term
| Explain control of sodium excretion with decreased blood volume: |
|
Definition
| - decreased volume> decrease ANP and BNP from heart, increases ADH from brain, increases sympathetic activity which increases renin, increases renin also just from decreased volume> increased angiotensin II and aldosterone> decreased sodium and water reabsorption |
|
|
Term
| draw out slide 41 from this lecture |
|
Definition
|
|
Term
| With Central Diabetes Insipidus there is an ___ release of ___ from the posterior pituitary, so it presents with ____. |
|
Definition
- inadequate
- ADH
- polyuria |
|
|
Term
| With Nephrogenic Diabetes Insipidus the ___ ___ do not respond to ADH so you see ___ due to defects in the AQP2 and ADH V2 receptors. |
|
Definition
- collecting ducts
- polyuria |
|
|
Term
| With Syndrome of Inappropriate ADH Secretion (SIADH), there are ___ levels of ADH and ___ ___, so the patient is ____. |
|
Definition
- high
- water retention
- hyposmotic |
|
|
Term
| With Nephrogenic Syndrome of Inappropriate Antidiuresis the ____ receptor is ____ activated and you see ___ ___. However the plasma level of ADH is ___. |
|
Definition
- ADH V2
- constituitively
- water retention
- low |
|
|
