Urinary- Water Balance

  1. _______ accounts for the major sensible water loss.
  2. The intracelluar compartment is _______ of total body water; the extracellular fluid is further divided into... (2)
    2/3; interstitial fluid and plasma.
  3. The effective circulating fluid volume includes ____________ and ultimately determines ______.
    blood in the arterial side; BP
  4. Why are the concentrations of important solutes markedly different inside cell compared to the extracellular fluid?
    interstitial fluid is separated from intracellular fluid by the phospholipid bilayer, which is permeable to water but restrict passage of electrolytes
  5. The intracellular fluid has very little __(3)__; it is rich in __(2)__.
    sodium, chloride, and calcium; potassium and phosphate
  6. The balance b/w plasma and interstitium is determined by the balance b/w _________ and _________, which is determined by ___________.
    hydrostatic pressure; osmotic pressure; protein content
  7. What are the major osmoles in the blood? (6)
    sodium, chloride, potassium, bicarb, urea, and glucose
  8. Intracellular edema occurs when the ___________ are depressed and unable to maintain the ___________.
    metabolic systems; sodium gradient
  9. Extracellular edema can occur when __________ is increased or ____________ is decreased.
    capillary filtration; lymphatic drainage
  10. Decreased ___________ decreases the power of capillaries to hold fluid in; this occurs with _________.
    colloid osmotic pressure; hypoproteinemia
  11. The majority of sodium is reabsorbed in the _________.
    proximal tubule
  12. In the proximal tubule, the __________ moves sodium from inside the cell to the basolateral side, creating a _________ inside the cell and generating a gradient that favors ____________.
    Na+K+ATPase pump; relative sodium deficit; movement of sodium from the lumen inside the cell
  13. In the first half of the proximal tubule, sodium is reabsorbed with __(3)__ by means of the ___________.
    glucose, AAs, and bicarb; Na+K+ATPase pump
  14. In the second half of the proximal tubule, sodium is reabsorbed with ________ via a _________ pathway through ____________.
    chloride; paracellular;  Na+H+ countertransporter
  15. The descending thin limb of the loop of henle is impermeable to ________ but highly permeable to _________.
    sodium; water
  16. The Na+K+2Cl- pump is exclusive to the ________.
    ascending thick limb of the loop of henle
  17. In the ascending thick limb of the loop of henle, sodium is reabsorbed through the _________; there's a slight backleak of ______ into the lumen, making a favorable gradient for Ca++ and Mg++ to diffuse to the _________ through a ________ pathway.
    Na+K+2Cl- pump; K+; interstitium; paracelllular
  18. What 2 mechanisms for sodium reabsorption are present in the ascending thick limb of the loop of henle?
    Na+K+2Cl- pump, Na+H+ countertransporter
  19. The collecting duct has __(2)__ for sodium reabsorption.
    principal cells, intercalated cells
  20. Principal cells in the collecting duct have __(2)__ channels in the luminal membrane; ________ is reabsorbed and ________ is excreted; ______ is also reabsorbed via a paracellular pathway.
    sodium and potassium; sodium; potassium; chloride
  21. Aldosterone increases the number of __(2)__ on the luminal side and increases the activity of _________ in the _________.
    open sodium and potassium channels; Na+K+ATPase pump; collecting duct
  22. Where are baroreceptors located?
    carotid sinus, aortic arch
  23. Increase in blood pressure stimulates reflexes that cause _________ and decrease _________, which ultimate decrease _______.
    vasodilation; heart rate; blood pressure
  24. Osmoreceptors are present in the _________; they shrink when exposed to increased ___________, ie. ________ is high. This ultimately leads to the production of _________.
    hypothalamus; extracellular fluid osmolality; sodium conc; ADH
  25. If GFR increases, the total volume of __________ increases.
    tubular reabsorption
  26. Glomerulotubular balance only comes into play when...
    there is a spontaneous change in GFR.
  27. Increased GFR leads to increased _________ and ultimately increased _________.
    tubular load; reabsorption
  28. Increased filtration factor leads to ________ colloid osmotic pressure, ultimately increased ________.
    increased; reabsorption
  29. An increase in systemic arterial pressure will lead to an increase in ____________, but the effect is blunted by ___________.
    peritubular capillary pressure; autoregulation
  30. An increase in resistance in the afferent or efferent arterioles will lead to ___________ peritubular capillary hydrostatic pressure, leading to _________ resorption from the tubular lumen.
    decreased; increased
  31. Increased efferent arteriolar resistance causes _________ glomerular capillary pressure upstream, thus increasing ______, and causing _________ peritubular capillary pressure downstream.
    increased; GFR; decreased
  32. The filtration fraction can be increased by ____________.
    efferent arteriolar constriction
  33. An increase in systemic arterial pressure increases ________ and _________.
    urine output; sodium excretion
  34. 3 results of increased arterial pressure.
    increased GFR, increased peritubular capillary pressure, inhibition of RAAS
  35. An increase in peritubular capillary pressure causes a decrease in net _________ and ________ reabsorption in the __________.
    water; sodium; proximal tubule
  36. Ang II and aldosterone increase __________; both are decreased with _________, allowing more __________.
    sodium reabsorption; increased pressure; sodium excretion
  37. Describe the RAAS.
    low flow detected by macula densa--> renin release--> renin cleaves cirulating angiotensinogen from liver to Ang I--> Ang I ccleaved to Ang II by ACE in the lung capillaries--> Ang II goes to kidneys, vessels, adrenal
  38. Functions of Ang II in vessels. (4)
    potent vasoconstrictor, increase systemic pressure, enhances reabsorption, corrects hypovolemia
  39. Functions of Ang II in the kidneys. (4)
    increase action of Na+H+ countertransporter in in proximal tubule, increase FF, decrease peritubular capillary pressure to enhance reabsorption
  40. Function of Ang II in adrenal gland. (1)
    stimulates aldosterone production
  41. A drug that inhibits angiotensin converting enzyme (ACE) would...
    decrease the amount of Ang II formed, decrease tubular reabsorption
  42. A drug can antagonize angiotensin receptors by...
    blocking binding of Ang II.
  43. Low flow will _______ RAAS, which works to...
    retain sodium and water to reverse hypovolemia.
  44. What are potential stimuli for renin release? (2)
    low arterial pressure in kidney (decreased NACl to macula densa), SNS activation of beta-1 receptors on JG cells,
  45. Aldosterone works in the...
    principal cells of the late distal and cortical collecting duct
  46. Aldosterone increases activity of the __________.
    Na+K+ATPase pump
  47. Aldosterone works to remove _______ from the cell to create a concentration gradient for the diffusion of ________ into the cell.
    sodium; ultrafiltrate
  48. Aldosterone increases intracellular _________, enhancing its movement into the _________.
    potassium; ultrafiltrate
  49. Aldosterone increases the number of open __(2)__ on the luminal side, augmenting its affects on the Na+K+ATPase pump.
    Na+ and K+ channels
  50. Hypoaldosteronism causes life-threatening ________ and ________; this disorder is called _________.
    hyperkalemia; hyponatremia; Addison's disease
  51. Stretching the right atrium causes formation of _________, which... (2)
    atrial natriuretic peptide (ANP); inhibits reabsorption of sodium and water in the collecting tubule.
  52. _________ inhibits aldosterone secretion, impairing proximal and distal tubule sodium reabsorption.
  53. What are the effects of the SNS on the kidneys? (3)
    reduce GFR, increase sodium reabsorption, increase renin release
  54. Stimuli for thirst. (4)
    increased blood osmolality, decreased extracellular fluid volume and arterial pressure, Ang II, dry mouth
  55. What stimulates salt appetite? (2)
    Decreased extracellular fluid sodium conc and decreased blood volume/pressure
  56. What is the mechanism of ADH in collecting ducts?
    inserts aquaporins to increase tubular reabsorption of water
  57. What conditions must be met for the kidneys to excrete water? (3)
    adequate delivery of water to diluting sites, ascending LoH must be able to remove NaCl, collecting ducts must remain impermeable to water if ADH is not present
Card Set
Urinary- Water Balance
vetmed urinary system