A&p Ii - Lecture - Week Of 3/7

Front 1

Filtered out into Bowman’s capsule:

Back 1

Salts,
Water,
Amino acids
Glucose
Nitrogenous waste: urea (from breakdown of amino acids), uric acid (from breakdown of old nucleic acids), creatinine (waste from creatinine phosphate)
Bilirubin (urochrome)
(should never see: RBCs, WBCs, plasma proteins)

Front 2

Totally reabsorbed:

Back 2

Amino acids
Glucose

Front 3

_______ clearance is a good indicator of how the kidneys are doing

Back 3

creatinine

Front 4

complete renal clearance –

Back 4

all of the substance that goes into the kidney comes out in the urine. None of it stays in the blood.

Front 5

Transport maximum –

Back 5

Max about of a substance that can be reabsorbed. Can be overwhelmed.

Front 6

Glomerular Filtration rate:

Back 6

Volumes of filtrate formed each minute by both kidneys:125 mL

Front 7

Low GFR –

Back 7

dehydration, blood loss.

Front 8

High GFR caused by...

Back 8

high blood pressure. Proteins get out.

Front 9

Fenestrated –

Back 9

leaky

Front 10

Filtrate composition is similar to _________

Back 10

plasma

Front 11

Proximal convoluted tubule:

Back 11

~90% of all reabsorption occurs (total reabsorption of glucose and amino acids). Lots of active transport, requiring ATP. Water is passively transported by following solutes. Secretion of H+ ions for acid/base balance

Front 12

Thin descending limb of the loop of henle allows _______ reabsorption of H2O

Back 12

passive

Front 13

The _______ the loop of Henle, the more can concentrate the urine

Back 13

longer

Front 14

Thick ascending loop of Henle actively pumps out _________ (reabsorption)

Back 14

salt

Front 15

Thick ascending loop of Henle has cells that are ___________ to water

Back 15

impermeable

Front 16

The three jobs of the DCT:

Back 16

1) Most sensitive to aldosterone (causes salt reabsorption), 2) Secretion of excess hydrogen ions, and 3) Abuts corpuscle and can release erythropoietin when blood volume is low (makes more red blood cells) and rennin

Front 17

Collecting duct –

Back 17

most sensitive to ADH which allows reabsorption of water.

Front 18

Without ADH, you would pee ______L/day. With max ADH, down to 0.5L day

Back 18

25

Front 19

Three substance mostly reabsorbed:

Back 19

water, amino acids, and glucose

Front 20

Three substances never filtered out:

Back 20

Whit blood cells, albumin, and red blood cells.

Front 21

Acid-base balance in important because...

Back 21

acidity and alkine-ness can change the shape of protien

Front 22

Alkalosis –

Back 22

pH higher than 7.45

Front 23

Acidosis –

Back 23

pH lower than 7.35

Front 24

An increase in exhalation of carbon dioxide results in inc. blood pH and a decrease in exhalation causes...

Back 24

... decrease in blood pH.

Front 25

Extracellular Fluid (ECF) –

Back 25

interstitial fluid, plasma, lymph, CSF, synovial fluid, serous fluid, etc.

Front 26

The production of hydrogen ions by metabolism must be matched by loss of these H+ ions at the ____________ and ______________

Back 26

kidney (protons: H+) and lungs (carbonic acid)

Front 27

Antidiuretic Hormone (ADH) –

Back 27

Osmoreceptors in the hypothalamus monitor the ECF and release ADH in response to high osmotic concentration

Front 28

↑ Osmotic concentration =

Back 28

↑ ADH levels

Front 29

Primary effects of ADH:

Back 29

A) Stimulate water conservation at kidneys
B) Stimulate thirst center

Front 30

Aldosterone –

Back 30

Released by the adrenal cortex to regulate Na+ absorption and K+ loss in the DCT and collecting system in the kidney

Front 31

Retention of Na+ will result in H2O ___________

Back 31

conservation

Front 32

Aldosterone is released in response to:

Back 32

A) high K+ or low Na+ in ECF (e.g. renal circulation)
B) activation of the renin-angiotensin system due to a drop in BP or blood volume
C) decline in kidney filtrate osmotic concentration at the DCT (more water less solutes)

Front 33

Addison’s Disease =

Back 33

hypoaldosteronism: results in massive loss of NaCl and H2O in the urine; must adjust diet to compensate

Front 34

Hydrostatic pressure –

Back 34

pushes water from the plasma into the interstitial fluid

Front 35

Colloid osmotic pressure –

Back 35

draws water from the interstitial fluid to the plasma

Front 36

Edema -

Back 36

abnormal amount of water leaves the plasma and accumulates in the interstitial fluid

Front 37

Hyponatremia –

Back 37

hypotonic hydration: condition of low Na+ concentration (i.e. excess water).

Front 38

Four causes of hyponatremia:

Back 38

1) Ingestion of a large volume of fresh water or injection of a hypotonic solution.
2) Inability to eliminate excess water at the kidney
3) Endocrine disorder (e.g. too much ADH)
4) Excessive sweating

Front 39

Hyponatremia results in water moving from the ______to the ______causing cellular damage and possibly plasmolysis

Back 39

ECF…ICF

Front 40

Hypernatremia –

Back 40

dehydration: condition of high Na+ concentration (i.e. water depletion). This results in decreased plasma volume and blood pressure that can lead to hypovolemic shock (inadequate circulation) and confusion

Front 41

Na+ is the dominant cation in the ______ cellular fluid

Back 41

extra

Front 42

The total amount of Na+ in the ECF is due to a balance between Na+ uptake in the digestive system and Na+ excretion in _____ and __________

Back 42

urine…perspiration

Front 43

ECF volume too low → ______-_______ system is activated to conserve water and Na+

Back 43

renin-angiotensin

Front 44

ECF volume too high → natriuretic peptides released: block _____ and _______ resulting in water and Na+ loss

Back 44

ADH…aldosterone

Front 45

K+ is the dominant cation in the ___cellular fluid (98% of the total body K+ is inside cells)

Back 45

Intra-

Front 46

The concentration of K+ in the ECF depends on absorption in the GI vs. _________

Back 46

excretion in urine

Front 47

The exchange pump at the kidney tubules secrete K+ (or H+) in order to reabsorb ____

Back 47

Na+

Front 48

The rate of tubular secretion of K+ in the kidney is controlled by three factors:

Back 48

1. Changes in the K+ concentration of the ECF ↑ K+ in ECF = ↑ K+ secretion
2. Changes in blood pH at low pH, H+ is used for Na+ reabsorption instead of K+ at the exchange pump ↓ pH in ECF = ↓ K+ secretion
3. Aldosterone levels↑ aldosterone = ↑ Na+ reabsorption and ↑ K+ secretion

Front 49

Hypokalemia –

Back 49

low K+ concentration in the ECF: will cause muscular weakness and mental confusion

Front 50

Hypokalemia caused by:

Back 50

1. Inadequate dietary K+ intake
2. Some diuretic drugs
3. Excessive aldosterone
4. Increased pH of ECF

Front 51

Hyperkalemia –

Back 51

high K+ concentration in the ECF: will cause cardiac arrhythmia and flaccid paralysis

Front 52

Hyperkalemia caused by:

Back 52

1. Renal failure
2. Diuretics that block Na+ reabsorption
3. A decline in pH

Front 53

______ functions to lower blood Ca2+ levels

Back 53

Calcitonin

Front 54

Gout –

Back 54

A kind of arthritis that occurs when uric acid builds up in the joints

Front 55

Ketoacidosis –

Back 55

results from starvation or diabetus mellitus

Front 56

Function of Glomerulus –

Back 56

Selective filtration

Front 57

Function of Proximal convoluted tubule (PCT) -

Back 57

Reabsorption of 90% of electrolytes and water; reabsorption of all glucose and amino acids; reabsorption of HCO3-; secretion of H+ and creatinine

Front 58

Function of Loop of Henle -

Back 58

reabsorption of water in descending loop; Reabsorption of Na+ and Cl- in ascending limb; concentration of filtrate

Front 59

Function of Distal convoluted tubule (DCT) -

Back 59

Secretion of K+, H+, ammonia; reabsorption of water (regulated by ADH); reabsorption of HCO3-; regulation of Ca2+ and PO42- by parathyroid hormone, reabsorption of Na+ (regulated by aldosterone)

Front 60

Function of Collecting duct -

Back 60

Reabsorption of water (ADH required)

Front 61

Look of Henle: Descending limb is ________ to water, ascending limb is _________ to water

Back 61

permeable…impermeable

Front 62

Water is reabsorbed in ________ limb (concentrates urine)

Back 62

descending

Front 63

Salt is actively reabsorbed in the _______ limb (establishes ability to concentrate even further)

Back 63

ascending

Front 64

_________ convoluted tubule reabsorbs even more salt under the influence of aldosterone.

Back 64

Distal

Front 65

The _________ _______ reabsorbs water under the influence of antidiuretic hormone (ADH)

Back 65

collecting duct

Front 66

Kidney’s effect on low BP: Rennin released, which…

Back 66

…converts angiotensinogen into angiotensin I which is converted by ACE into angiotensin II

Front 67

Three roles of angiotensin II:

Back 67

1)Potent vasoconstrictor, 2) stimulates release of aldosterone, and 3) stimulates release of ADH

Front 68

ADH increase _______ reabsorption and secretion of ________

Back 68

water…potassium

Front 69

Erythropoietin –

Back 69

hormone that stimulates erythropoiesis, RBC production

Front 70

Renal failure leads to anemia because…

Back 70

…of a lack of erythropoietin (EPO)

Front 71

Fluid breakdown: Male adult –

Back 71

60% of BW

Front 72

Fluid breakdown: Female adult –

Back 72

55% of BW

Front 73

Fluid breakdown: Overweight adult –

Back 73

40% of BW

Front 74

Fluid breakdown: Elderly adult –

Back 74

40% of BW

Front 75

Three fluid compartments:

Back 75

1) Intracellular (ICF) – 60%
2) Interstitial (ECF) – 30%
3) Plasma (ECF) – 10%

Front 76

Electrolytes –

Back 76

substances that disassociate in water

Front 77

Key ion found IN the cell (ICF)

Back 77

– Potassium (K+) 3.5-5.1 mEq/L

Front 78

Key ion found OUTside of the cell (ECF) –

Back 78

sodium (NA+) Normal concentration: 136-145 mEq/L

Front 79

Three types of solutes:

Back 79

colloids, ions/electrolytes, and non-electrolytes

Front 80

Colloids –

Back 80

proteins that are charged and act like an electrolyte. Amine and carboxyl group

Front 81

Non-eletrolytes –

Back 81

glucose

Front 82

Adding a hypotonic solution –

Back 82

water is attracted to the salts in the cells and the cell swells/possibly bursts (plasmolysis)

Front 83

Adding a hypertonic solution –

Back 83

Water leaves the cell and it shrinks. Crenation.

Front 84

Adding an Isotonic solution –

Back 84

a good idea

Front 85

Edema is caused by fluid ____________ in the interstitial compartment

Back 85

accumulation

Front 86

4 Causes of Edema:

Back 86

1) Decrease in capillary osmotic pressure
2) Increased capillary pressure
3) Leaky capillaries
4)Obstruction of lymph capillaries

Front 87

Decrease in capillary osmotic pressure –

Back 87

caused be a lack of albumin which can happen if the liver fails

Front 88

Increased capillary pressure –

Back 88

High blood pressure pushes water out of blood vessels

Front 89

Leaky capillaries –

Back 89

due to inflammation (red, hot, swollen, painful) like a sprained ankle

Front 90

Obstruction of lymph capillaries –

Back 90

removal of lymph nodes

Front 91

Hyponatremia –

Back 91

decrease of Na+ in the plasma

Front 92

Hypernatremia –

Back 92

increase in plasma levels of sodium

Front 93

What hormone works on the kidney to absorb salt?

Back 93

Aldosterone

Front 94

Major stimulus for the release of aldosterone:

Back 94

angiotensin II

Front 95

Hormone necessary for the reabsorption of water –

Back 95

ADH

Front 96

Causes secretion of potassium –

Back 96

ADH

Front 97

An increase in ADH will lead to a ________ of plasma levels of potassium

Back 97

decrease

Front 98

Some diuretics will cause a _______ in plasma levels of potassium

Back 98

decrease

Front 99

Hyperkalemia could be caused by:

Back 99

acidosis, diuretics, kidney failure, or increased potassium intake.
exchange for _________.

Front 100

Hypokalemia could be caused by:

Back 100

alkalosis, diuretics, decreased potassium intake.

Front 101

When the blood is acidic, cells pump inH+ in exchange for _________. This is called the hydrogen-_________ pump

Back 101

potassium

Front 102

Tetany –

Back 102

result of hypocalcemia

Front 103

_____________ hormone increases plasma levels by increasing osteoclasts

Back 103

parathyroid

Front 104

Symptoms of hypernatremia –

Back 104

confused, tired, and possibly dehydrated

Front 105

Symptoms of hyperkalemia –

Back 105

cardiac arrest, cramping, and restlessness

Front 106

Symptoms of hypokalemia –

Back 106

ECG abnormalities, muscle weakness, and respiratory arrest.

Front 107

3 Mechanisms to restore blood pH:

Back 107

1) Chemical buffers (seconds),
2) Respiratory buffers (within minutes), and
3) Kidneys (hours and days. But most powerful)

Front 108

3 Important Chemical pH Buffer Systems:

Back 108

1) Phosphate buffer system, 2) Carbonic acid/bicarbonate system, 3) Proteins

Front 109

Carbonic acid/bicarbonate’s effect on blood pH:

Back 109

can go from HCO3- to H2CO3 by absorbing an extra H+ ion

Front 110

Protein’s effect on pH:

Back 110

Protein resists pH change intracellularly.

Front 111

Carboxyl (COO-) can accept an extra

Back 111

H+ ion.

Front 112

Amine groups can also add or drop

Back 112

H+ ions (NH3 <--> NH2 + H)

Front 113

Respiratory Buffer systems –

Back 113

breathing harder and faster lets us breath off more CO2, preventing acidosis

Front 114

Renal mechanisms in acidosis -

Back 114

tubules secrete more H+ and reabsorb more HCO3

Front 115

Renal mechanisms in alkalosis –

Back 115

tubules secrete more HCO3 and H+

Front 116

Respiratory acidosis –

Back 116

caused by rapid, shallow breathing, a build up of CO2

Front 117

Respiratory alkalosis –

Back 117

caused by hyperventilation

Front 118

Metabolic acidosis –

Back 118

low blood pH and HCO3- levels. Caused by too much alcohol, diarrhea, intense exercise (lactic acid), or ketosis (starvation/diabetes)

Front 119

Metabolic alkalosis –

Back 119

high blood pH and HCO3. Caused by vomiting or excessive antacids.

Front 120

Death occurs when pH is above _____ and below _____

Back 120

7.8…7.0

Front 121

Milliequivilant (mEq) –

Back 121

(mmol/L)(valence electrons)