BMS11-1037 Kidney Function III: Regulation of Osmolarity and Blood Volume

Beschreibung

Describe the main fluid compartments of the body and factors that affect movement of water between them. Explain the relationship between osmolality and volume and their multiple regulatory pathways, sensors and effectors. Understand the role of the juxtaglomerular apparatus in renin release. Understand the roles of the renin-angiotensin-aldosterone and sympathetic nervous systems and atrial stretch receptors in the regulation of ECF volume.
Evian Chai
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Evian Chai
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What are the three locations of Ca+/Mg2+ reabsorption? What drives this process? 1. Proximal Convoluted Tubule 2. Thick Ascending Limb 3. Distal Convoluted Tubule+Collecting Duct Passive process, so concentration gradient
How does activation of renal sympathetic nerves affect Na+ reabsorption following fall in BP? 1. Baroreceptors in central arterial tree detect fall in blood pressure 2. GFR lowers due to: -vasocontriction - reduced surface area of filtration barrier 3. Renin release stimulated 4. Overall increase in Na+ reabsorption to increase H20 bulk flow, blood volume, blood pressure
As Na+ levels rise, the juxtaglomerular apparatus will 1. Macula densa cells uptake more Na+ 2. Adeosine formation increases to bind to A1 receptors on SM 3. Increase in Ca2+ leading to contraction of the A.A 4. Renin release inhibited
In the collecting duct Aldosterone: ... Na+ reabsorption by increasing expression of ...and .... Also increases K+ secretion/excretion In the DCT Aldosterone: increases expression of the ... Also ... absorption in gut, sweat glands, salivary glands 1. Increases 2. ENAC 3. Na+/K+ ATPase 4. Na+/K+ ATPase 5. Increases
Plasma has ...of free calcium Intracellular fluid has ... of free calcium 1. 1.1.25mM 2. 0.001mM
Sodium excretion is regulated by? (2) 1. GFR (starling forces, hydraulic permeability, SA of filtration barrier) 2. Amount of Na+ reabsorption
The main solute in Extracellular Fluid is .... The main solute in Intracellular Fluid is .... Extracellular: Na+ Intracelluar: K+
What are the 3 actions of Type A/B Natriuretic Peptides? 1. Natriuetic (increases Na+ excretion) 2. Diuretic (inhibits ADH release so more dilute urine) 3. Hypotensive - systematic vasodilation - Dilates AA to increase GFR
How do natriuretic Peptides increase Na+ excretion ? 1. block ENAC channels 2. Inhibit renin/aldosterone
What are the 3 impacts of angiotensin II? 1. Stimulates PCT Na+ reabsorption by activating ...pump on basolateral membrane and.... pump on luminal 2. Stimulates ... release/increases ... 3. Aldosterone secretion from adrenal cortex which ... Na+ reabsorption in ... 1. Na+/K+ 2. H+/Na+ 3. ADH 4. thirst 5. increases 6. DCT/CD
What are the effector pathways of Na+ reabsorption? 1. Renal Sympathetic Nerves (increase renin release) 2. Renin/Angiontensin II/Aldosterone System (RAAS) 3. Atrial Natriuretic Peptide 4. Direct Pressure on kidney 5. Dopamine
How does dopamine affect Na+ Reabsorption? Inhibits Na+ reabsorption
What are the mechanisms of extrinsic control of GFR in response to a fall in blood pressure? 1. Barareceptors activated in carotid sinus/aortic arch, SNS activated 2. Vasoconstriction of AA lowers SA of filtration barrier (mesangial cells), lowering GFR 3. Na+/H20 conserved, increased BP/Volume
What are the three factors promoting renin release? 1. Lowered sodium delivery to macula densa 2. Lowered wall tension in AA 3. SNS Activity
What are the two intrinsic mechanisms of GFR control? 1. Myogenic response by renal SM -sudden rise in BP stretches SM, vasocontriction in response -this lowers GFR 2. Tubuloglomelular feedback by juxtaglomelular apparatus (vasoconstriction+renin release)
What are the two types of Natriuetic Peptides released when the heart is stretched and from where? 1. A type from atrial myocardium 2. B type from ventricular myocardium
Increased osmolarity is detected by .... at .... in .... They produce ... molecule, causing ... to be released from posterior pituitary 1. Osomoreceptors 2. Paraventricular/suboptic nuclei 3. Hypothalamus 4. ADH precursor 5. ADH
What do osmoreceptors in the lateral preoptic area do compared to those in the paraventricular/suboptic nuclei Increase thirst instead of promoting ADH release
What is the function of renin? Renin converts angiotensinogen-->angiotensin I-->angiotensin II
The main regulator of blood volume is... Na+ balance/quality
What senses Na+ concentration? (4) 1. Macula densa cells 2. Pressure receptors in central arterial tree 3. Pressure receptors in renal AA 4. Volume receptors in cardiac atria/intrathoracic veins
When free Ca2+ <... ... hormone is released leading to: 1. ... excretion in urine 2. Vit D2/D3 hydroxylation to active form, upregulate Ca2+ receptor of ... cells of parathyroid gland, promote Ca2+/phosphate absorption 3. Ca2+ reabsorption in kidney 1. 1mM 2. Parathyroid 3. Phosphate 4. Cheif
...reabsorbs CA2+ via TRPUS Ca2+ transporters, Mg2+ via channels/active transport Distal Collecting Tubule 2. TRPUS Ca2+ transporters 3. Channels/active transport
What does atrial natriuretic peptide do?
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