physiology Flashcards

1
Q

what is osmolarity?

A

-a concentration of osmotically active particles present in a solution

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2
Q

what are the units of osmolarity?

A

osmol/l or osmol/l

mosmol/l for body fluids as these are weak salt solutions

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3
Q

how can osmolarity be calculated?

A

It can be calculated if two factors are know:

  • the molar concentration of the solution and
  • the number of osmotically active particles present
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4
Q

what is the difference between osmolality and osmolarity?

A
  • osmolality has units of osmol/kg of water

- osmolarity has units of osmol/l

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5
Q

what is the osmolarity of body fluids?

A

approx 300 mosmol/l

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6
Q

what is tonicity?

A

-the effect a solution has on cell volume

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7
Q

what is isotonic solution?

A

one where there is no change in cell volume if you were to insert or add a cell to the solution

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8
Q

what is a hypotonic solution?

A

a solution that causes a cell to increase in cell volume

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9
Q

what is a hypertonic solution?

A

the solution causes a decrease in cell volume

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10
Q

what % of body weight does total body water take up?

A
males= roughly 60% of body weight
females= roughly 50% of body weight

this is due to women having more fat and fat has very little water

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11
Q

what does total body water consist of?

A

intracellular fluid (ICF) = 67% of total body water

extracellular fluid (ECF) = 33% of total body water

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12
Q

what does extracellular fluid include?

A
  • plasma
  • interstitial fluid
  • lymph and transcellular fluid
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13
Q

what is a tracer for measuring ECF?

A

inulin

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14
Q

what is a tracer for measuring plasma?

A

labelled albumin

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15
Q

what is a tracer for measuring total body water?

A

3H2O

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16
Q

how is total body water calculated?

A

TBW= ECF + ICF

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17
Q

How is volume of distribution calculated?

A
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18
Q

how is the distribution volume of a tracer measured?

A
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19
Q

what is needed to maintain homeostasis?

A

input must match the output

input (s)= output (s)

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20
Q

what is water imbalance manifested in?

A

-as changes in body fluid osmolarity

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21
Q

what are insensible losses of water in the body?

A
  • losses of water from the body where there are no physiological mechanisms that can stop it
  • e.g. skin always losing water due to diffusion to the environment, lungs when you lose water exhaling
  • skin, lungs
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22
Q

what are sensible losses of water in the body?

A
  • loss of water from the body through which there are physiological mechanisms in place and can control
  • e.g. sweat can be controlled by doing less exercise or changing jumper, faeces through diarrhoea, urine through dehydration decreasing urinary output or being overhydrated and increasing urinary output
  • sweat, faeces, urine
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23
Q

how is water balance maintained?

A
  • by increasing water ingestion

- decreased excretion of water by the kidneys alone is not enough to maintain water balance

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24
Q

what ions are found in ICF and ECF?

A

important:

  • more sodium, chloride and bicarbonate ions in the ECF compared to the ICF
  • more potassium ions in the ICF compared to the ECF
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25
Q

summary slide :0 xxx!

A
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26
Q

what is fluid shift?

A

-the movement of water between the ICF and ECF in response to an osmotic gradient

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27
Q

what occurs if the osmotic concentration of the ECF increases (the extracellular fluid would lose water but retain salt so the individual is dehydrated but no change in salt balance)?

A

ECF would become hypertonic compared to ICF

  • this would cause movement of water from the cells into the ECF until osmotic balance has been restored
  • this means cell volume would decrease and ECF would increase due to the fluid shift to try and restore osmotic balance
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28
Q

what occurs if the osmotic concnetration of the ECF decreases (individual is overhydrated so have too much water)?

A
  • ECF would become hypotonic compared to ICF
  • there would be movement of water from ECF to the cell to restore osmotic balance and as a result cell volume would increase and ECF volume would decrease
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29
Q

what are some challanges to fluid homeostasis?

A

-gain or loss of water changes the osmolarity with similar changes in ICF and ECF volumes

  • gain or loss of NaCl will change fluid osmolarity
  • Sodium is ‘excluded’ from ICF, it can only enter ECF

-gain or loss of isotonic fluid (no change in fluid osmolarity, change in ECF only)

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30
Q

what structure alters the composition and volume of ECF?

A

kidneys- this is vital for long term regulation of blood pressure

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31
Q

what are electrolytes?

A

-any substance that dissociated into free ions when dissolved

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32
Q

when does electrolyte balance occur?

A

-when rates of gain= rates of loss

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33
Q

whats an example of an electrolyte?

A

NaCl

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34
Q

why is electrolyte balance important?

A
  • total electrolyte concentrations can directly affect water balance (via changes in osmolarity)
  • the concnetrations of individual electrolytes can affect cell function
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35
Q

what role does sodium have in the ECF?

A

> 90% of the osmotic concentration of the ECF results from the presence of sodium salts

Na+ is a major determinent of ECF volume

Water follows salt in ECF

36
Q

what does the total amount of sodium in the ECF represent?

A

a balance between input (dietary) and output (primarily excretion of urine)

37
Q

what are the functions of the kidney?

A
  • water balance
  • salt balance
  • maintenence of plasma volume
  • maintenance of plasma osmolarity
  • acid base balance (excretion of hydrogen and reabsorption of bicarbonate)
  • excretion of metabolic waste products (e.g. bilirubin)
  • excretion of exogenous foreign compounds
  • secretion of renin (control ABP)
  • secretion of eythropoietin (EPO, stimultes RBC production)
  • conversion of vitamin D into active form (calcitrol: calcium absorption in GI tract)
38
Q

what does the urinary system consists of?

A
  • they kidneys (that produce the urine)

- the structures that store and carry the urine from the kidneys to the outside for elimination from the body

39
Q

what is contained in the medulla of the kidneys?

A

-renal pyramid which contain nephrons

40
Q

what is the functional unit of the kidney?

A

nephron (this is a picture of a cortical one)

41
Q

what is the blood supply to nephrons?

A

the renal artery has an afferent branch which joins to the glomerulus (a knot of capillaries) and drains into an efferent arteriole and into the peritubular capillaries into a venule and a vein

42
Q

where is the intitial tubular fluid formed and drains?

A

Bowman’s capsule

43
Q

what is the juxtaglomerular apparatus?

A

-part of the distal tubule passes between the afferent and efferent tubules

44
Q

what are the two types of nephrons?

A
  • juxtaglomedullary (20%) (on left)

- cortical (80%) (on right)

45
Q

difference between the two types of nephrons?

A

Juxtamedullary (20%):

  • longer loop of henle is longer
  • have a single capillary structure called the vasa recta

Cortical (80%):

46
Q

what is the tuft of capillaries found in Bowman’s capsule called?

A

glomerulus

47
Q

what is the inner and outer layer of Bowman’s capsule made up of?

A

inner= Podocytes

outer- simple squamous epithelial cells

48
Q

role of glanular cells?

A

-produce and secrete renin

49
Q

what do macula densa cell detect?

A

the amount of salt (sodium chloride) that is present in the tubular fluid as it passes through the juxtaglomerular apparatus

50
Q

where are granular cells located?

A

in the juxtaglomerular apparatus

51
Q

what do the kidneys require to produce urine?

A
  • need a filtration system
  • rich blood supply
  • mechanisms of urine modification (reabsorption and secretion)
52
Q

where does glomelura filtration start?

A

starts in the glomerulus

53
Q

what occurs to the plasma that enters the glomerulus and is not filtered ?

A

it leaves through the efferent arteriole

54
Q

for any substance what does the filtration (GF) + secretion (TS)= ?

A

Filtration (GF) + Secretion (TS) = Reabsorption (TR) + Excretion

55
Q

how to figure out rate of filtration of a substance?

A
56
Q

how to calculate rate of excretion of a substance?

A
57
Q

what does it mean if rate of filtration> rate of excretion?

A

-net reabsorption of that substance has occurred

58
Q

what does it mean if rate filtration < rate of excretion?

A

net secretion of that substance has occured

59
Q

what is larger, the diameter of the afferent or efferent arterial?

A

afferent

60
Q

what are the filtration barriers?

A
  • glomerular capillary endothelium
  • basement membrane (basal lamina)
  • slit process of podocytes
61
Q

what must the fluid filtered from the glomerulus into the Bowman’s capsule pass through?

A

-three layers that make up the glomerular membrane

62
Q

what are the forces that comprise net filtration pressure?

A
63
Q

what is GFR ?

A

the rate at which protein free plasma is filtered from the glomeruli into the Bowman’s capsule per unit time

64
Q

how to calculate GFR using Kf and net filtration rate?

A

GFR= Kf x net filtration rate

65
Q

what is a major determinent of GFR?

A

glomerular capillary flui (blood) pressure (BPgc)

66
Q

what is ‘normal’ GFR?

A

125 ml/min

67
Q

what can regulation of renal blood flow and GFR be broken into?

A
  • Extrinsic regulation of GFR

- Autoregulation of GFR (intrinsic)

68
Q

what controls extrinsic regulation of GFR?

A

-sympathetic control via baroreceptor reflex

69
Q

what controls intrinsic regulation of GFR?

A
  • myogenic mechanism

- tubuloglomerular feedback mechanism

70
Q

what occurs to GFR if you increase arterial blood pressure?

A
  • increase volume of blood coming in to the glomerulus
  • increase glomerular capillary BP
  • increase net filtration pressure
  • increasing GFR
71
Q

summary slide GFR and BP

A
72
Q

what mechanisms is autoregulation made up of?

A
  • Myogenic component (if vascular smooth muscle is stretched e.g. arterial pressure increased, it contracts this constricting the arteriole
  • Tuboglomelural feedback (involves the juxtoglomelural apparatus, if GFR rises more NaCl flows through the tubule leading to constriction of afferent arterioles)
73
Q

what would happen to GFR if there was a kidney stone?

A

it would decrease

74
Q

what would happen to GFR if a patient had diarrheoa?

A

it would decrease

75
Q

what would happen to GFR in a severely burned patient?

A

increase GFR

76
Q

what is plasma clearance?

A
  • a measure of how effectively the kidneys can clean the blood of a particular substance
  • it equals the volume of plasma completely cleared of a particular substance per minute
  • each substance that is handled by the kidney will have its own specific plasma clearance value
77
Q

what is the calculation for plasma clearance?

A
78
Q

what does measuring inulin clearance allow us to measure?

A

GFR

79
Q

what does amount of inulin filtered per unit time =?

A

amount of inulin excreted per unit time

80
Q

what will the clearance compared to GFR be for a substance which is filtered, secreted but not reabsorbed (e.g. H+)?

A

Clearance >GFR

81
Q

what does para-amino hippuric acid (PAH)?

A

-exogenous organic anion

82
Q

what is para-amino hippuric acid (PAH) used to measure?

A

-used clinically to measure renal plasma flow

83
Q

summary slide

A
84
Q

ideally any substance used as a clarance marker should have what properties?

A
  • non toxic
  • inert (not metabolised)
  • easy to measure
85
Q

how is filtration fraction measured?

A