Organs Sem 2 Test 2 Kidneys And Bp

Front 1

WHAT IS DIURESIS

Back 1

increased H2O excretion

Front 2

what is Naturiuresis

Back 2

increased Na excretion

Front 3

what happens when the ECF increases

Back 3

increase in ECF > increase Blood Volume > Increase Venous return > Increase Cardiac Output > increase BP > Kidney reduces retention and increases excretions (natureisis/diuresis)

Front 4

what is oliguria and when does it occurs

Back 4

it is less urine output and occurs when there is a drop in ECF

Front 5

what happens when the BP is bellow 50mmHg

Back 5

the kidney stops making urine (anuria) because it can't afford to lose fluids

Front 6

what causes an increase in ECF

Back 6

increase Salt intake or increased H2O intake

Front 7

how does increased Salt intake effect ECF

Back 7

increase in salt intake > become more thirsty/drink more water > increase in ECF > increase in Blood Volume

Front 8

what determines long term arterial pressure

Back 8

salt/h2o intake
salt/h2o excretion

a problem arises when there is an imbalance between these two causing increase in BP

Front 9

why is it not detrimental if we consume a lot of salt in one day

Back 9

kidney makes sure that our body has an optimum amount of sodium and will secrete the excess

Front 10

what are the two classes of hormones that effect BP

Back 10

natriuretic (na excretion)
antinatruretic (na retention)

Front 11

what does Blood lose do to Bp

Back 11

causes a drop in BP

Front 12

when are antinaturetics needed

Back 12

when there is a decrease in BP or blood loss

Front 13

what does longterm regulation of arterial BP involve

Back 13

kidneys and hormones (SNS is for short term)

Front 14

what is RAS

Back 14

renin angiotensin system

Front 15

what does RAS do

Back 15

when there is a decrease in BP or Blood volume

kidneys release the enzyme renin

renin converts angiotensinogen to ANGIOTENSIN I

Angiotensin I gets converted to Angiotensin II by ACE (comes from lungs)

Front 16

what is ACE

Back 16

angiotensin converting enzyme

Front 17

what does Angiotensin II do

Back 17

vasoconstrictor (constricts BV therefore Increase in BP)

acts directly on the kidney or inderectly (via aldosterone) causing Na/H2O retention (increases blood volume)

Front 18

what comes into action when someone loses a lot of blood

Back 18

RAS and SNS

Front 19

what does SNS effect

Back 19

CO and TPR

Front 20

what does the Kidney effect

Back 20

CO by altering blood volume

Front 21

what do Hormones/Peptides effect

Back 21

TPR and CO

Front 22

what does an Increase in SNS do to the kidneys

Back 22

causes kidney to retain more water

Front 23

what is the most potent substance in the body for Na/H2O retention

Back 23

Angiotensin II

Front 24

what causes the activation of the RAS

Back 24

blood loss
decrease in BP
low salt intake

Front 25

what are the renin levels if you intake a lot of salt

Back 25

low/0 because the body doesn't want to retain fluid

Front 26

what does an increase in Blood Volume do to renin levels

Back 26

makes it 0 because body doesn't want to retain fluid

Front 27

what does an increase in BP do to renin levels

Back 27

makes it 0 because body doesn't want to retain fluid which causes an increase in BP

Front 28

what is the process that occurs w/ renin/angiotensin when INCREASE NA INTAKE

Back 28

increase Na intake

increase ECF

increase in BP

decrease in renin/angiotensin II levels

decreases Na/H2O retention

normalization of ECF and BP

Front 29

when is angiotensin II released

Back 29

when BP is low

Front 30

what does Angiotensin do to arterioles

Back 30

causes constriction

Front 31

what does Angiotensin 2 do to the heart

Back 31

causes ventricular hypertrophy

Front 32

what does Angiotensin 2 do to the brain

Back 32

causes an increase in SNS activity and release of antiduiretic hormone (ADH)

Front 33

what does Angiotensin 2 DIRECTLY do to the kidneys

Back 33

causes them to retain Na/H2O

Front 34

what does Angiotensin 2 INDIRECTLY do to the kidneys

Back 34

causes the kidneys to release aldosterone which causes Na/H2O retention

Front 35

why are ACE inhibitors and Angiotensin II antagonist given to people with high BP

Back 35

because people w/ high BP are hypersensitive to angiotensin 2

ace inhibitors inhibit the enzyme ACE from converting Angiotensin I to Angiotensin II

Angiotensin II antagonist block the receptor that Angiotensin II binds to

Front 36

what factors increase BP and retention of Na/H2O

Back 36

SNS and Angiotensin II increase BP

Angiotensin II increases fluid reteniton as well

Aldosterone acts on kidney increasing fluid retention and therefore increasing BP

Endothelin - hormone secreted by endothelial cells that line cardiovascular system and acts as a vasoconstrictor

Front 37

what is endotholin

Back 37

a hormone secreted by endothelial cells that line the cardiovascular system. endothelins act as a vasoconstrictor

Front 38

what factors increase renal secretion and decrease BP

Back 38

atrial natriuretic peptide
Nitric Oxide
Dopamine
Bradykinin

Front 39

what does atrial natriuretic peptide do

Back 39

released when the atria is stretched too much (occurs when there is a high volume)

CAUSES NA/H2O EXCRETION TEHREFORE DECREASES BP AND RETENTION

Front 40

what does nitric oxide do

Back 40

made by endothelial cells

acts as a vasodilator and therefore decreases BP

Front 41

what does Dopamine do

Back 41

acts on kidneys causing Na/H2O excretion

CAUSES NATURYESIS/DIURESIS

Front 42

what hormone causes naturiesis/diuresis

Back 42

dopamine

Front 43

what does bradykinin do

Back 43

causes vasodilation

Front 44

what has increased in chronic hypertension

Back 44

afterload in the ventricles

Front 45

what can hypertension lead to

Back 45

stroke

uncontrolled hypertension leads to kidney failure

Front 46

what is the BP of someone with hypertension

Back 46

140/90 or higher

Front 47

what are the two main forms of hypertension

Back 47

primary (essential) hypertension - no known cause

secondary hypertension - high bp is secondary because it is caused by something else

Front 48

where is aldosterone relesed

Back 48

cortex of adrenal gland

Front 49

where is epinephrin and norepinephrin released

Back 49

medulla of adrenal gland

Front 50

what is Phetochromocytoma

Back 50

tumor in adrenal medula causing increased production of epi/norepi leading to an increase in BP

Front 51

what is Primary Aldosteronism

Back 51

occurs when adrenal cortex is making an excess amount of aldosterone which causes Na/H2O retention and increases BP

Front 52

what is Preeclempsia

Back 52

high BP due to pregnancy

theory is placenta is ischemic and releases toxic compounds causing decrease in NO levels therefore constriction occurs

Front 53

what is Renal hypertension

Back 53

occurs b/c narrowing/occlusion of arterioles that supply kidney with blood.

this causes the kidney to think that there is low BP and it responds by retaining Na/H2O and INCREASES RENIN SECRETION CAUSING INCREASE BP

Front 54

what is primary hypertension

Back 54

majority of people with hypertension have this

unknown cause

theory is it may be due to excess Na intake or stress

40-50% OF PEOPLE WITH PRIMARY ARE SALT SENSITIVE

Front 55

how does BMI effect BP

Back 55

the higher the BMI the greater the chance of high BP

Front 56

what occurs in stage one of hypertension

Back 56

stage 1 = early hypertension

increase CO b/c kidney retaining more water, ECF, Blood Volume all of which increase BP

Front 57

what happens in stage two of hypertension

Back 57

stage 2 = well established hypertension
ECF/CO/Blood Volume are normal but TPR and Arterial pressure has increased

vascular hypertrophy occurs
increase in vascular reactivity

Front 58

what do diuretics do

Back 58

lower blood volume by promoting na/h2o excretion

Front 59

what is the SNS activity in early stages of hypertension (stage 1)

Back 59

increased activity therefore increased water retention of kidney

Front 60

what is the SNS activity in established hypertension (stage 2)

Back 60

variable SNS activity

Front 61

why is there an increase in TPR in established hypertension (stage 2)

Back 61

this is due to the organs throughout the body getting more blood than they need and as a result they constrict their blood vessels (this is a response to the increased CO) (AUTOREGULATION)

Front 62

what kind of dysfunction do people with hypertension have

Back 62

endothelial and they are hypersensitive to angiotensin 2

Front 63

what happens when endothelial cells are dysfunctional

Back 63

decrease NO release
increase Endotholin release

THIS CAUSES INCREASE IN BP

Front 64

what drugs inhibit Na absorption

Back 64

diuretics

Front 65

what happens when you stand up

Back 65

venous pooling occurs in the leg causing a decrease in venous return/CO therefore decrease in BP this leads to REFLEX TACHYCARDIA which increases your HR

Front 66

what is reabsorbed in the proximal tubule

Back 66

65% water
65% salt

Front 67

what transporters are in the proximal tubule

Back 67

Na/H
Na/Glucose
Na/AA

Front 68

what is being pumped in the proximal tubule

Back 68

glucose
amino acids
H pumped out

NA IS PUMPED IN

Front 69

what is the fluid that leaves the proximal tubule

Back 69

isotonic

Front 70

what is the purpose of the Na/Glucose pump and Na/AA pump

Back 70

insures that 100% glucose is reabsorbed and tries to absorb 100% AA

Front 71

what is the absorption in the thin descending loop of henle

Back 71

reabsorbs 10% of water

Front 72

what areas of the tubule are permeable to water

Back 72

thin descending loop of henle

late distal tubule/collecting tubule water permeability depends on whether ADH is there

Front 73

is the thin descending loop of henle permeable to water

Back 73

yes

Front 74

what is the absorption in the thick ascending loop of henle

Back 74

25% sodium absorption

Front 75

what areas of the tubule are not permeable to water

Back 75

thick ascending loop of henle
early distal tubule

Front 76

fluid leaving the descending loop of henle is

Back 76

hyperosmotic

Front 77

fluid leaving the ascending loop of henle is

Back 77

hypoosmotic

Front 78

what transporters are in the thick ascending loop of henle

Back 78

NK2CL
Na/H

Front 79

what does the NK2CL pump do

Back 79

2ndary diffusion of CL
fascilitated diffusion of Na

Front 80

what do loop diuretics do and where do they act on

Back 80

they effect the NK2CL pump in the thick ascending loop of henle and cause Na not to be reabsorbed therefore Na/K will be excreted more

this means that 25% of Na will not be reabsorbed

Front 81

what is the absorption in the early distal tube

Back 81

5-7% Na

Front 82

what is the early distal tube not permeable to

Back 82

water

Front 83

what pump does the early distal tube have

Back 83

Na/Cl pump

Na transported via fascilitated diffusion
Cl transported via cotransporter/2ndary diffusion

Front 84

what do thiozide diuretics do and where do they work

Back 84

they inhibit the Na/Cl pump in the early distal tubule meaning decrease in Na reabsorption

Front 85

what are the diluting segments in the tubule

Back 85

thick ascending loop
early distal tubule