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Renal Final > Regulation of Na and H2O Balance > Flashcards

Regulation of Na and H2O Balance Flashcards

(52 cards)

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1
Q

Major Functions of Early Proximal Tubule

A

Isosmotic reabsorption of solute and water

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2
Q

Cellular Mechanism of Early Proximal Tubule

A

Na+-glucose, Na+ amino acid, Na+ phosphate costransporter

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3
Q

hormone action of early proximal tubule

A

PTH inhibits Na+phosphate cotranpsorter ANG II stimulates Na/H exchange

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4
Q

diuretic function of early proximal tubule

A

osmotic diuretics Carbonic anhydrase inhibitors

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5
Q

Major Function of Late Proximal tubule

A

isosmotic reabsorption of solute and water

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6
Q

cellular mechanism of late proximal tubule

A

NaCl reabsorption driven by Cl- gradient

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7
Q

Hormone action of late proximal tubule

A

not applicable

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8
Q

diuretic actions of late proximal tubule

A

carbonic anhydrase inhibitors

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9
Q

Major function of thick ascending limb of the loop of henle

A

Reabsorption of NaCl without water Dilution of tubular fluid Single effect of countercurrent multiplication Reabsorption of Ca+2 and Mg+2 dirven by lumen-positive potential

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10
Q

Cellular Mechanism of TAL of Loop of Henle

A

Na+, K+, 2Cl- cotransporter

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11
Q

Hormone action of TAL of loop of henle

A

ADH stimulates Na+, K+, 2Cl- cotransporter

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12
Q

Diuretic action of TAL loop of henle

A

Loop diuretics

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13
Q

Major function of Early Distal Tubule

A

Reabsorption of NaCl without water Dilution of tubular fluid

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14
Q

Cellular mechanism of Early Distal tubule

A

Na/Cl cotransporter

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15
Q

Hormone action of early distal tubule

A

PTH sitmulates Ca+2 reabsorption

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16
Q

Diuretic action of early distal tubule

A

Thiazide diuretics

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17
Q

Major function of late distal tubule and collecting ducts (principle cells)

A

Reabsorption of NaCl K+ secretion Variable water reabsorption

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18
Q

Cellular mechanisms of late distal tubule and collecting ducts (principle cells)

A

Na+ channels (ENaC) K channels AQP2 water channels

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19
Q

Hormone action of late distal tubule and collecting ducts (principle cells)

A

Aldosterone stimulates Na+ reabsorption Aldosterone stimulates K+ secretion ADH stimulates water reabsorption

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20
Q

diuretic action of late distal tubule and collecting ducts (principle cells)

A

K+ sparing diuretics

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21
Q

Major functions of late distal tubule and collecting ducts (alpha intercalated cells)

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A

Reabsorption of K+ Secretion of H+

22
Q

cellular mechanism of late distal tubule and collecting ducts (alpha intercalated cells)

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A

H+/K+ ATPase H+ ATPase

23
Q

Hormone action of late distal tubule and collecting ducts (alpha intercalated cells)

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A

H/K ATPase - none H+ ATPase - aldosterone stimulates H+ secretion

24
Q

Diuretic action of late distal tubule and collecting ducts (alpha intercalated cells)

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A

H/K ATPase - none H+ ATPase- K+ sparing diuretics

25
Where is Aldosterone secreted?
zona glomerulosa of the adrenal cortex
26
Mechanism of action of aldosterone
Aldosterone diffuses into cell and induces synthesis of mRNA for a protein involved with Na+ transport in principal cell
27
K+ sparing diuretics Mechanism of action
interfere with Na+ reabsorption in the principal cells leads to non working Na/K ATPase so K can't diffuse into lumen.
28
Factors that promote Na+ reabsorption
- Activation of renal sympathetic nervous system - Activation of RAAS - Secretion of Aldosterone
29
Factors that promote Na+ excretion
- Release of ANP, BNP - Release of urodilatin - Intrarenal prostaglandins
30
Renal Sympathetic activity
increased Na+ reabsorption increased renin secretion ADD IMAGE
31
Factors that promote Renin secretion
- renal sympathetic stimulation (fall in perfusion pressure sensed at cardiopulmonary baroreceeptors leads to direct stimulation of renin secretion via beta 1 receptor activation in JG apparatus) - tubuloglomerular feedback (dec NaCl deliver to macular densa = inc renin secretion) - intrarenal baroreceptor (wall of afferent arteriole; afferent arteriolar vasoconstriction = dec pressure at granular cells = inc renin secretion
32
Renal sympathetic stimulation
fall in perfusion pressure sensed at cardiopulmonary baroreceeptors leads to direct stimulation of renin secretion via beta 1 receptor activation in JG apparatus
33
Tubuloglomerular feedback
dec NaCl deliver to macular densa = inc renin secretion
34
Intrarenal baroreceptors
located in wall of afferent arteriole; afferent arteriolar vasoconstriction = dec pressure at granular cells = inc renin secretion
35
What effect would a loop diuretic have on renin secretion?
Loop diuretic causes diuresis leads to decreased ECV and dec perfusion pressure leading to an INCREASE in renin secretion
36
ANGII stimulates:
- inc systemic arteriolar cosntriction - inc renal arteriolar contriction (efferent \> afferent, inc GFR, dec RBF) - inc Na reabsorption at PCT - inc Thirst - inc ADH secretion from posterior pituitary - inc aldosterone secretion from adrenal cortex
37
Effect of ANGII on Efferent Arteriole
ANGII increases Efferent Arteriolar constriction =\> inc GFR =\> dec RBF =\> increased glomerular hydrostatic pressure =\> increased filtration
38
Effect of ANGII on glomerular mesangial cells
Glomerular mesangial cell contraction =\> dec surface area available for filtration =\> decrease filtration to offset increase in filtration caused by efferent arteriolar constriction
39
Response of RAAS to dec ECF vol
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40
Aldosterone action at late distal convoluted tubule principal cell
reabsorbs Na excretes K, H reabsorbs Cl- hyperaldosteronism = hypokalemia, alkalemia
41
Feedback control of Aldosterone
things that inhibit aldosterone - decreased plasma K - increased ECV - increased ECF volume - increased BP
42
Factors controlling aldosterone secretion
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43
ANP does:
- inc GFR (via afferent dilation/efferent constriction) - inhibits Na reabsorption at medullary collecting duct - decreases renin secretion - decreases aldosterone secretion - systemic vasodilation - decreased AVP secretion, action
44
ANP response to increased ECF volume
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45
Urodilatin made by and why:
DCT, CD due to increased atrial pressure and increased ECF volume
46
Urodilatin mechanism of action
suppresses Na and water reabsorption by medullary collecting duct \*\*\*No effect on systemic circulation
47
Response to increased Na intake
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48
response to decreased Na intake
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49
ADH/AVP action
- increased permeability of late distal tubule and collecting duct to water via insertion of aquaporis - increases activity of Na/K/2Cl co transporter - increases urea permeability in the inner medullary collecting ducts
50
ADH secreted by:
supraoptic nucleus in hypothalmus transported to posterior pituitary gland and released
51
Control of ADH secertion
osmoreceptors, baroreceptors
52
Two major stimuli for ADH release
hyperosmolality volume depletion (hypothalamic osmoreceptors more important then hepatic osmoreceptors)

Renal Final (4 decks)

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