US Lecture 5 - Water Balance Flashcards Preview

LSS 2 - Abdomen, Alimentary and Urinary systems > US Lecture 5 - Water Balance > Flashcards

Flashcards in US Lecture 5 - Water Balance Deck (29):
1

What is osmolarity?

Measure of the solute concentration in a solution - depends on the number of dissolved solutes present. The greater the number of dissolved particles, the greater the osmolarity

2

How much more water and salt than we need do we consume to replace that which was lost?

20-25%

3

Why do we need to get rid of excess volume, water and salt?

Volume: oedematous and BP rises Water: Dilute salt in body > decreased osmolarity so cells will SWELL Salt: Too high salt levels > cells will SHRINK

4

What is the most abundant component of the plasma and ECF?

Water

5

What is the most prevalent solute in the plasma ad ECF?

Sodium

6

What does the level of salt determine and what is water balance used for?

Salt determines ECF volume and water balance regulates plasma osmolarity

7

Of the total body water, how much is intracellular fluid and how much is ECF?

8

How is water removed from the body?

Skin and sweat: variable and uncontrollable (fever, climate, activity) - 450ml/day Faeces: uncontrollable (diarrhoea) - 100ml/day Urine output: variable and controllable - 1500ml/day

9

How much of the filtered load reaches the descending loop of Henle, the distal convoluted tubule and the collecting duct?

10

How is the urine concentrated above normal plasma osmolarity?

A region of hyperosmolar interstitial fluid is produced

11

How is the region of hyperosmolar interstitial fluid established?

Countercurrent mechanism

Descending loop impermeable to salts but permeable to water

Ascending loop impermeable to water but 'permeable' (pumps out) salts

Urea permeability of the bottom of the loop and the collecting duct

12

What is the function of the vasa recta?

It is permeable to water and solutes - water diffuses out of the descending limb and solutes diffuse into the desc. limb In the ascending limb the opposite happens, so O2 and nutrients are delivered without the loss of gradient

13

What is Vasopressin?

Peptide hormone - 9 a.a. Synthesised in hypothalamus, packaged into granules Secreted from posterior pituitary Binds to specific receptors on basolateral membrane of principal cells in the collecting ducts

14

What does VP cause in the collecting duct?

Causes the insertion of aquaporins in the cell membranes, increaing water permeability - AQ2 mainly

15

What does VP stimulate in the CD?

Stimulates urea transport from CD into thin asc. limb of LoH and interstitial tissue by increasing the membrane localisation of UTA1 and UTA3 in the CCD

16

What is the trigger for ADH release?

Plasma osmolarity above 300mOs - regulated by osmoreceptors in the hypothalamus Marked fall in blood volume and BP - monitored by baroreceptors/stretch receptors

17

What substance inhibits ADH release?

Ethanol, leading to dehydration as urine volume increases

18

What is the water permeability like in the nephron?

19

What happens when there is a decrease in plasma osmolarity? - Water Load

Decreased plasma osmolarity (detected by hypothalamic osmoreceptors) -> decreased ADH release -> Decrease CD permeability -> increase urine flow rate

20

What happens when there is low ADH/water diuresis?

Solute reabsorption without water reabsorption lowers urine osmolarity to 50mosmol/l SO: large volume of dilute urine

21

What happens when there is increased plasma osmolarity? - Dehydration

^ Plasma osmolarity -> ^ thirst and ^ ADH release (both detected by hypothalamic receptors) -> ^ ADH release -> ^ CD permeability -> Decrease urine flow rate

22

What tends to lower plasma osmolarity?

Increased water intake AND decreased fluid loss

23

What happens when there is high ADH/maximal antidiuresis?

Osmotic equilibration in the cortex and medulla leads to high urine osmolarity - so SMALL volume of concentrated urine

24

What is the negative feedback loop of increased plasma osmolarity?

25

What are the 3 classes disorders of water balance?

No/insufficient production of ADH No detection of ADH (mutant ADH receptor) No response to ADH signal (AQ mutant)

26

Give an example of a water balance disorder and of its symptoms

Diabetes insipidus - unremitting thirst and excretion of large amount of watery urine

27

Why is the hyperosmolar environment required for retention of water?

Water is reabsorbed by osmosis so need to generate a hyperosmolar env compared to the fluid in the collecting duct

Fluid starts with osmolarity approaching that of plasma and contains solutes that need to be excreted - removal of water would increase the osmolarity, needing to maintain osmotic gradient that allows this to happen as the fluid passes along the latter part of the nephron

28

What is the importance of the urea permeability in the CD in response to ADH?

Increased urea permeability causes urea to move down its conc gradient into the interstitium and increase the interstitial osmolarity so more water can be reabsorbed

29

Identify 2 triggers of ADH secretion

Hyperosmolarity identified by osmoreceptors

Low BP identified by baroreceptors