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Physiology Block 7 > Control Of Water Reabsorption And Body Osmolarity > Flashcards

Control Of Water Reabsorption And Body Osmolarity Flashcards

1
Q

Permeability of water in the different parts of the loop

A

Varies.

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2
Q

What does water move in response to in the loop

A

To physical or osmotic pressures

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3
Q

Where is water absorbed

A

Only in the descending limb

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4
Q

Where are solutes reabsorbed

A

Thick ascending limb

-this makes the interstitum of the medulla hyperosmotic

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5
Q

What makes the interstitum of the medulla hyperosmotic

A

Solutes being reabsorbed in the thick ascending limb

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6
Q

What is the driving force in making concentrated urine

A

Hyperosmotic medullary interstitium

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7
Q

Collecting ducts and the hyperosmotic interstitium

A

Collecting ducts pass through it and are able to reabsorb water if ADH is present

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8
Q

When can the collecting ducts reabsorb water from the interstitium?

A

If ADH is present

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9
Q

Where does the production of the hyperosmotic medulla occur

A

In the loop

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10
Q

Countercurrent exchange

A

Production of hyperosmotic medulla in the loop

  • active reabsorption in TAL to cxn interstitium, dilute tubule
  • hyperosmotic interstitium pulls water out of DTL
  • flow though kidney occurs and cycle repeats
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11
Q

Vasa recta and the hyperosmotic gradient

A

Blood flow is VERY SLOW so as not to disturb the gradient

Based upon RBF and things that affect it!

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12
Q

What does an increased flow in the vasa recta do

A

Watches out osmotic gradient, less water absorbed.

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13
Q

Urea

A
  • added back to the loop to further increase the cxn
  • waste product that we reabsorbs so we can reabsorbs more water
  • reabsorption from CD is increased when ADH is high
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14
Q

When is urea reabsorption in the CD higher

A

When ADH is present

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15
Q

What does water deprivation do to plasma omsolarity?

A

Increases

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16
Q

What does water deprivation do to release of ADH?

A

Increases it because the plasma osmolarity is increased

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17
Q

What does an increased release in ADH during water deprivation do the blood pressure and RBF

A

Decreases both of them

Allows cxn gradient to get higher

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18
Q

Vasa recta in times of water deprivation

A

Slows to allow for trapping of solutes in medulla

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19
Q

What does ADH increase when there is water deprivation

A

Permeability of CDs to water

-increases urea reabsorption too

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20
Q

What does the chain of events that is set off by water deprivation ultimately do

A

Reabsorbs water. Urea comes with it to increase the osmotic gradient for the next time around too

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21
Q

What happens to plasma osmolarity in a water surplus

A

Lowers.

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22
Q

ADH secretion in water surplus

A

Lower

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23
Q

Collecting ducts during water surplus

A

Not permeable to water. Less ADH so less permeability to water

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24
Q

Vasa recta in water surplus

A

Flow washes out gradient a little.

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25
Q

What happens when there is a significant RBF increase?

A

Vasa recta washes out the gradient a little bit

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26
Q

Where is there the greates volume of water reabsorbed?

A

PCT

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27
Q

Where is there the most control of water reabsorption?

A

Collecting ducts

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28
Q

Regulation of water reabsorption occurs in which segment of the nephron?

A

Collecting ducts

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29
Q

What are the ways in which body water is sensed

A

Baroreceptors

Osmoreceptors

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30
Q

Where are the baroreceptors that sense body water

A

Carotid bodies/aortic arches and arterial stretch

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31
Q

What do the baroreceptors respond to

A

Blood pressure changes

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32
Q

What is the most responsive method of sensing body water

A

Osmoreceptors

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33
Q

Where are the osmoreceptors

A

Hypothalamus

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34
Q

What do osmoreceptors respond to

A

ECF osmolarity, can sense swell/shrink of cell

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35
Q

If the cell is shrunken, what will the osmoreceptors do

A

Increase release of ADH

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36
Q

Increased ECF sodium causes osmoreceptors to do what

A

Release more ADH

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37
Q

What is ADH tightly regulated by

A

Osmoreceptros

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38
Q

Slight increase in Osm (plasma) causes

A

Huge increase in ADH

39
Q

What does a massive hemorrhage do to ADH

A

Increases it

40
Q

What can cause inhibited ADH secretion

A

High blood pressure/volume

41
Q

What is ADH sensitive to

A

Na+ unless massive blood loss

42
Q

If high volume, there is _____ ADH response to increased Na+ cxn in plasma

A

Less

43
Q

If low volume, there is ____ ADH response to increased Na+ concentrations in plasma

A

More

44
Q

When does maximal ADH secretion occur

A

In a patient with a massive hemorrhage AND a hypernatremia

Or

Dehydration due to water deprivation

45
Q

Which of the following conditions would cause a minimal ADH release

A

Hypertension and hyponatramia

46
Q

Where is ADH secreted from

A

Posteiror pituitary

-stored until needed

47
Q

Increased osmoreceptor firing, ___- ADH release

A

Increased

48
Q

Increased baraoreceptor firing, _____ ADH release

A

Decreased

High BP

49
Q

What does ADH have nothing to do with

A

Solutes in urine.

50
Q

What does ADH have an effect on

A

Water

51
Q

ADH and conservation of water

A

ADH cannot replace lost water volume nor can it stop water loss, it can only CONSERVE water

52
Q

How would you differentiate between water deprivation and diabetes insipidus

A

Both are volume depleted and hypernaremic

I don’t know the answer

53
Q

What does the feedback control of the kidney predict responses to?

A
  • excessive water consumption
  • hemorrhage
  • decreased cardiac contractility
  • non functional retinal ADH receptors (Nephrogenic diabetes insipidus)
  • inability to secreate ADH (central diabetes insipidus)
  • chronic vasodilator administration
  • alcohol consumption
54
Q

Which of the following would allow you to differentiate between nephrogenic diabetes insipidus and severe water deprivation

A

Free water clearance

55
Q

What does ADH control

A

Volume and osmolarity of ECF

56
Q

How does ADH control the volume and osmolarity of the ECF

A

By changing volume and osmolarity of urine

57
Q

What does RAAS control

A

ECF only

58
Q

What does aldosterone of the RAAS system reabsorbs

A

Reabsorbs water and Na equally

59
Q

What is aldosterone release in the RAAS triggered by

A

AngII or high ECF K levels

60
Q

What controls ECF volume only

A

RAAS

61
Q

What controls volume and osmolarity of ECF

A

ADH

62
Q

What is AngII major stimulus

A

Increase renin

63
Q

What part of the nephron does AngII target

A

PT, TAL, DT/CD

64
Q

What is the transport effect of AngII

A

Increased NaCL and water reabsorption

65
Q

What is aldosterone’ major stimulus

A

Increases AngII, increases K+ concentration in plasma

66
Q

Nephron target of aldosterone

A

TAL, DT/CD

67
Q

Transport effect of aldosterone

A

Increases NaCla and water reabsorption

68
Q

ANP/BNP major stimulus

A

Increased ECFV

69
Q

Nephron target of ANP/BNP

A

CD

70
Q

Transport effect of ANP/BNP

A

Decreases NaCl and water reabsorption

71
Q

Sympathetic major stimulus

A

Decreased ECFV

72
Q

Nephron target of sympathtics

A

PT, TAL, DT/CD

73
Q

Transport effect of sympathetic

A

Increased NaCal and water reabsorption

74
Q

ADH major stimulus

A

Decreased ECFV

75
Q

Nephron target of ADH

A

DT/CD

76
Q

Transport effect of ADH

A

Increased water reabsorption

77
Q

What is AngII stimulated by

A

Renin

78
Q

What does ANgII do

A

Increases Na and water reabsorption in PCT, TAL, and DCT

79
Q

What is a potent vasodilator for everything, and the efferent artery in the kidney

A

AngII

80
Q

What does the ANgII do to the vasa recta

A

Slows it

81
Q

When do catecholamines come into play in the kidney (NE/Epi)

A

When you are almost dead. Effective at EXTREMELY low ECV

82
Q

Where is aldosterone released from

A

Adrenal cortex. Mineralacorticoid

83
Q

Other than increased Na and water reabsorption in the DCT and CD, what else does aldosterone do

A

Increases potassium excretion

84
Q

What can high aldosterone do

A

Can cause alkalosis

-K+ excretion and H+ excretion are linked

85
Q

Causes loss of Na and water by blocking reuptake in collecting ducts. Also inhibits ADH release and function

A

ANP and BNP

86
Q

What can levels of ANP be used for

A

As a marker for severity of congestive heart failure

87
Q

What are the levels of ANP in someone with worse cardiac output

A

Higher levels of ANP

88
Q

What would happen with ANP during a massive MI

A

Heart stretches a lot, acute dump of ANP.

89
Q

What is the reason we have to pee a lot when we get in a pool

A

ANP

90
Q

If a patient has a hypothalamic tumor which produced too much ADH would there free water clearance be:

A

Lower than normal (making concentrated urine)

91
Q

Nephrogenic diabetes insipidus is a disease wher ethe V2 receptors in the kidney are unable to respond to ADH secreted from the pituitary gland. Which of the following statements would be true concerning a patient with this disease

A

Plasma osmolarity would be elevated

92
Q

Administration of a beta 1 receptor agonist (activator) would case which of the following

A

Increased GFR

93
Q

Administration of a carbonic anhydrase inhibitor would

A

Reduce HCO3 reabsorption in the PCT

Physiology Block 7 (10 decks)

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