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UROGENITAL > 8.1 Renal Physiology II - Fluid Balance ELECTROLYTES > Flashcards

8.1 Renal Physiology II - Fluid Balance ELECTROLYTES Flashcards

1
Q

HOMEOSTASIS includes balance of:

A
  • ELECTROLYCE BALANCE
    Ion gain each day = ion loss
  • FLUID BALANCE
    water gained daily = water lost
  • ACID-BASE BALANCE
    H+ gain is offset (balanced) by H+ loss

EXCESS of any can be fatal

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2
Q

ISOTONIC
HYPOTONIC
HYPERTONIC

A

ISOTONIC: salt conc same inside and outside cell, no net movement of water

HYPOTONIC: Higher salt conc. IN cell so water moves IN, cell swells

HYPERTONIC: Higher salt conc. OUTSIDE cell so water moves OUT, cell shrinks

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3
Q

REABSORPTION can occur by:

A
  • CO-TRANSPORTERS (Na/Glucose)
  • ACTIVE TRANSPORTERS (use ATP)
  • OSMOSIS
  • SOLVENT DRAG and Passive DIFFUSION
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4
Q

what is PARACELLULAR TRANSPORT

A

Movement of substances BETWEEN epithelial CELLS

eg Potassium K+

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5
Q

what is SOLVENT DRAG

A

movement of Salts BETWEEN CELLS (PARACELLULAR transport) and PULLS WATER with it (moves into interstitial space)

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6
Q

what is TRANSCELLULAR TRANSPORT

A

Movement of substances ACROSS and epithelial CELL

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7
Q

what is TUBULAR REABSORPTION

A

substances move FROM TUBULE INTO BLOOD

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8
Q

what is TUBULAR SECRETION

A

substances move FROM BLOOD INTO TUBULE

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9
Q

what happens in the PCT

A

REABSORPTION of WATER, IONS and organic nutrients

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10
Q

NO K+ TRANSPORTERS in the

A

PCT

(no potassium reabsorption here)

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11
Q

GLUCOSE TRANSPORTERS are ONLY in the

A

PCT

(glucose reabsorption only takes place from PCT)

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12
Q

in PCT what MOVE OUT OF FILTRATE (into PCT CELLS) for REABSORPTION

A

GLUCOSE
AMINO ACIDS
CHLORIDE
WATER

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13
Q

in the PCT what allows for the TRANSPORT of GLUCOSE, AMINO ACIDS, CHLORIDE and WATER from filtrate into PCT cells for REABSORPTION

A

NA+

  • Na+ moves DOWN conc. gradient into PCT cells and brings GLUCOSE, AMINO ACIDS, CHLORIDE, WATER with it

WATER brought by SOLVENT DRAG (moves with Na+)

Na+-Glucose Transporters
Na+-Amino Acid Transporters
Na+-Cl- Transporters

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14
Q

why does Na+ diffuse into PCT CELLS from lumen, DOWN its conc. gradient

A

NA+ also being PUMPED OUT via Na+-K+ CO-TRANSPORTER (3 Na+ OUT) into BLOOD

  • Na+ REABSORPTION for use
    (water reabsorbed with it)
  • creates conc. gradient for Na+ to diffuse in (carrying other substances)
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15
Q

PCT is the MAIN SITE of … REABSORPTION

A

WATER

Na+ Reabsorbed, so water moves out with it

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16
Q

what is different about the TRANSPORT of GLUCOSE OUT of FILTRATE

A

there is a TRANSPORT MAXIMUM
(limits how much glucose can move from filtrate to PCT cells for reabsorption)

17
Q

as Na+ moves INTO PCT CELLS from lumen, what does it cause to MOVE OUT, INTO LUMEN

A

Na+ in down conc. gradient moves H+ OUT (into filtrate) AGAINST CONC. GRADIENT

18
Q

what factors AFFECT REABSORPTION

A
  • RATE of the FLOW OF FILTRATE (how fast filtrate is moving) (faster means less reabsorption)
  • CONC. of SMALL MOLECULES in the FILTRATE
    (more conc/ more Na+, more reabsorption)
    but fixed number of transporters
19
Q

PCT REABSORBS how much of FILTERED SODIUM

LOOP OF HENLE?
DCT:
COLLECTING DUCT:

A

65%

LOOP OF HENLE: 25%
DCT: 8%
COLLECTING DUCT: 2% ONLY in presence of ALDOSTERONE

20
Q

COLLECTING DUCT can REABSORB last 2% of filtered NA ONLY in the presence of…

A

ALDOSTERONE

21
Q

how does the PERMEABILITY DIFFER in the LOOP OF HENLE

THIN DESCENDING LIMB:

A

PERMEABLE to WATER
IMPERMEABLE to SOLUTES
(impermeable to urea)

WATER REABSORBED (moves out)

22
Q

how does the PERMEABILITY DIFFER in the LOOP OF HENLE

THICK ASCENDING LIMB:

A

PERMEABLE TO SOLUTES
IMPERMEABLE to water
(moderately permeable to urea)

ACTIVE TRANSPORT of SOLUTES - REABSORPTION

Na+
Cl-

starts to become more permeable to K+ further up

23
Q

how does OSMOLALITY (conc. of solutes) in FILTRATE CHANGE in the LOOP OF HENLE

A

down DESCENDING LIMB
- INCREASES (more water out)

up ASCENDING LIMB
- DECREASES as salts can now leave

24
Q

why do solutes move out of LOOP OF HENLE (ASCENDING LIMB)

A

BLOOD capillary surrounding it / CIRCULATING has come from EFFERENT ARTERIOLE so has LOW CONCENTRATIONS of SODIUM, CHLORIDE, POTASSIUM

25
Q

extra SODIUM and CHLORIDE remaining that hasn’t already diffused out will leave ASCENDING LIMB by..

A

ACTIVE TRANSPORT using ATP or more so K+

K+ moves down conc. gradient OUT OF FILTRATE, MOVES NA+ and CL- with it

(1 K+, 1 Na+, 2 Cl-)

26
Q

how is BLOOD FLOW / CIRCULATION around the LOOP OF HENLE

A

going in the OPPOSITE DIRECTION

COUNTER-CURRENT

27
Q

how is BLOOD FLOW / CIRCULATION around the LOOP OF HENLE

A

going in the OPPOSITE DIRECTION

COUNTER-CURRENT MULTIPLIER SYSTEM

28
Q

from ASCENDING LIMB,
SOME K+ STAYS in the…

A

INTERSTITIAL FLUID

(does not all go into blood)

29
Q

how is the K+ TRANSPORTER in the ASCENDING LIMB (loop of henle)

A

ELECTROCHEMICALLY NEUTRAL
(NO ATP required)

30
Q

LONGER LOOP OF HENLE means..

(other animals)

A

MORE WATER can be CONSERVED

31
Q

why does increased GLUCOSE (diabetes) produce more urine volume

A
  • more glucose
  • harder for H20 to leave filtrate
  • Increased Rate of filtrate flow
  • Decreased Na+ & Cl- reabsorption
  • Blood less concentrated at ascending limb
  • Less water reabsorped

More water in filtrate (retained)

32
Q

why might high glucose (diabetes) cause proteins in urine

A
  • hypoglycosylation of proteins that make up podocytes
  • filtration bed damaged
  • proteins and cellular components filter through and enter filtrate
33
Q

CELLS of the MACULA DENSA can sense what in the DCT (as filtrate leaves loop of henle)

A

if there is LOW FLUID FLOW or LOW SODIUM CONC in DCT

34
Q

when MACULA DENSA CELLS sense low fluid flow or low sodium conc in DCT what is the RESPONSE

A

JUXTAGLOMERULAR CELLS SECRETE RENIN
(top up fluid volume by RAAS SYSTEM)

35
Q

RAAS SYSTEM

A

low renal fluid

  • KIDNEYS SECRETE RENIN (juxtaglomerular cells)
  • LIVER: ANGIOTENSINOGEN
  • LUNGS: ANGIOTENSINOGEN I CONVERTED into ANGIOTENSINOGEN II by ACE ENZYME
  • ADRENAL CORTEX: ALDOSTERONE
  • aldosterone increases SODIUM UPTAKE from DCT and COLLECTING DUCT
36
Q

what is SECRETED from the PLASMA INTO the PCT LUMEN

A

AMMONIA NH3

(specific transporters)

UROGENITAL (19 decks)

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