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Renal Test 2 > Regulation of ECF Volume & Na/Water Balance > Flashcards

Regulation of ECF Volume & Na/Water Balance Flashcards

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1
Q

what part of Total Body Water (TBW) actually contributes to the effective circulating volume (ECV)

A

ECF

Specifically:
ECF–>Plasma–>arterial plasma (not the venous)

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2
Q

what are the 4 ways to counteract a decreased ECV

A
  1. activate RAAS
  2. increase ADH secretion
  3. stimulate SNS via baroreceptors
  4. increase renal fluid via peritubular capillary forces
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3
Q

why do CHF (congestive heart failure) patients have problems with ECV

A 
a low ECV means the following:
low CO
low venous return
increase Na retention --> leads to Edema
increased capillary hydrostatic pressure
*ECV is uncoupled from the ECFV
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4
Q

how do you regulate ECF volume

A

through salt balance

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5
Q

how do you regulate ECF osmolarity

A

water balance

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6
Q

what receptors sense salt balance

A

baroreceptors

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7
Q

what effectors are triggered as a result of baroreceptor sensing

A

angiotensin II –> and therefore aldosterone
ANP
SNS

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8
Q

what do the effectors of baroreceptor sensing affect

A

urine sodium excretion is affected which alters the ECF volume

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9
Q

how do you regulate ECF (plasma) osmolality

A

through water balance

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10
Q

what receptors sense water balance

A

osmoreceptors

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11
Q

what effectors are triggered as a result of osmoreceptors sensing

A

ADH/AVP

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12
Q

what do the effectors of osmoreceptors sensing affect

A

urine osmolality (water output) AND thirst

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13
Q

what receptor senses changes in body fluid osmolality

A

osmoreceptors

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14
Q

4 characteristics of osmoreceptors that make them effective

A
  1. high sensitivity
  2. low threshold
  3. increase ADH secretion
  4. RAPID change
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15
Q

where do osmoreceptors send signals to

A

hypothalamus which triggers the supraoptic and paraventricular nerves to make ADH/AVP

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16
Q

where is ADH/AVP released from

A

posterior pituitary (neurohypophysis)

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17
Q

what receptor senses changes in blood volume

A

baroreceptors

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18
Q

what are the 3 types of baroreceptors and where in the body are they located

A
  1. arterial (sense changes in the aorta & carotids)
  2. cardiopulmonary (sense changes in the atria & pulmonary arteries)
  3. Intrarenal (sense changes in the kidney)
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19
Q

where do arterial baroreceptors exert their effects

A

afferents –>brainstem vasomotor center

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20
Q

what are functions do arterial baroreceptors affect

A
  1. TPR
  2. venous compliance
  3. SNS actions
  4. cardiac actions
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21
Q

where do cardiopulmonary baroreceptors exert their efffects

A

afferents –> brainstem vasomotor center
AND
hypothalamus

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22
Q

when cardiopulmonary baroreceptors exert their forces on the afferents, what functions are affected

A
  1. TPR
  2. venous compliance
  3. SNS actions
  4. cardiac actions
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23
Q

when cardiopulmonary baroreceptors exert their forces on the hypothalamus, what functions are affected

Study These Flashcards
A

ADH secretion

24
Q

what functions to intrarenal baroreceptors affect

Study These Flashcards
A
  1. RAAS
  2. GFR
  3. salt and water reabsorption
25
when renal sympathetic activity is increased, what is the result
decreased salt secretion & excretion | salt retention
26
How do renal sympathetic nerves cause salt excretion
a decreased GFR (and low salt sensing by the macula densa) will trigger JG cell to increase renin secretion this increases Na reabsorption
27
when RAAS activity is increased, what is the result
decreased salt excretion
28
what volume sensor activity decreases salt excretion
increased activity of the renal sympathetic nerves and RAAS
29
action(s) of angiotensin II
Na+ reabsorption in to the blood | triggers adrenal cortex to release aldosterone
30
action of aldosterone
Na+ reabsortption
31
when AVP/ADH activity is increased, what is the result
decreased water excretion (water retention)
32
action(s) of AVP/ADH
insert aquaporins in DT/CD to increase water permeability and move more water into the blood
33
name the 3 natriuretic peptides
ANP BNP urodilatin
34
when natriuretic peptide activity is increased, what is the result
increased salt excretion - decrease GFR - decrease renin - decrease aldosterone - decrease Na+ reabsorption - decrease ADH (no aquaporins) so DT/CD impermeable to water
35
which 3 mechanisms influence renin release
1. perfusion pressure in afferent arterioles low perfusion pressure + renin high perfusion pressure -- renin 2. sympathetic nerve activity SNS activation of afferents + renin 3. NaCl deliver to macula densa low salt sensed by macula densa + renin secretion high salt sensed by macula densa - renin secretion
36
renin regulation by the macula densa is referred to as...
tubuloglomerular feedback
37
when RAAS triggers Na+ reabsorption, what are the ultimate outcomes?
increased GFR increased RBF increased BP
38
where is ANP synthesized
atrial cardiac muscle cells
39
what stimulates ANP to be released
cardiac muscle stretch increased ECF volume increased BP volume expansion (due to water and Na+ retention)
40
natriuresis
excrete Na+ in the urine
41
how does natriuresis work
**Inhibits Na+ reabsorption in distal tubule ``` result: increase Na+ excretion increase water excretion Inhibit RAAS Inhibit renin secretion Inhibit aldosterone secretion Inhibit ADH (no aquaporins inserted to CD) ```
42
ultimate outcomes of ANP release
decreased BP decreased blood volume (ECF volume) decreased plasma Na+
43
where is renin released from
juxtaglomerular (JG) cells in the kidney
44
what causes volume expansion
high blood volume due to Na+ and water retention
45
what does volume expansion lead to
Na+ excretion | Inhibition of sympathetics
46
what is inhibited/secreted to resolve volume expansion
increase ANP, BNP, urodilatin inhibit AVP/ADH and aquaporin insertion decrease renin (angiotensin II) and aldosterone
47
when volume expansion is corrected, what is the outcome
decreased ECF volume decreased BP decreased blood volume
48
what causes volume contraction
too little blood volume due to increased Na+ and water excretion
49
what does volume contraction lead to
Na+ retention | Activate sympathetics
50
what is inhibited/secreted to resolve volume contraction
``` increase the following: renin angiotensin II aldosterone AVD/ADH ```
51
where is urodilatin released from
kidneys
52
when volume contraction is corrected, what is the outcome
increased ECF volume increased BP increased blood volume
53
serum values for hyponatremia
<135 mEq/L
54
serum osmolality for hyponatremia
<285 mOsm/kg
55
what are the physiological consequences of hyponatremia
since the blood vessels have more water than sodium, the ECF/plasma is hypotonic in relation to the ICV/cells cells circulating in a hypotonic environment fluid will move from the hypotonic ECF into the more concentrated ICF/cells causing the cells to SWELL RESULT: EDV has less and less fluid
56
hypovolemia
decreased volume of circulating blood in the body **liquid portion of the blood is too low *caused by hyponatremia

Renal Test 2 (9 decks)

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