Transcript Exam Four material

Exam Four material
• Assignment due:
• Exam Four:
• Chapter 20
Urinary
• Chapter 21
Balances
Kidney
• Bean shaped
• Retroperitoneal: _
• Near _
Kidney
• Renal pelvis: _
– Subdivided into _
• ____________________:
project from _
Kidney
• Inner region: _
– Contains
• Outer region:
– Forms _
– Granular appearance _
Kidney Function
• _
• Remove __________________________ from
blood
• Control ___________________________ by
secreting _______________________
• Regulate __________________________ by
enzyme ________________________
• Activates _
Nephron
• The ______________________________ of
the kidney
• Two sections
– Renal corpuscle:
•
•
– ________________________________: leads
away from the glomerular capsule.
Nephron
• Renal Tubule:
–
–
• Descending nephron loop
• Ascending nephron loop
–
• Collecting Duct:
Juxtaglomerular apparatus
• Contains both
–
• At _________________________________, the tubule
passes by arterioles, and at some point,
_____________________________. This area of cells
is the macula densa
– Juxtaglomerular cells: _
• JG apparatus: _
Nephrons
• Cortical nephron: _
– Short loops that _
• Juxtamedullary nephrons:
–
Shows both a
cortical and
Juxtamedullary
nephron
Urine formation
• Main function nephron:
–
– Remove
•
Urine
• Urine formation involves three processes:
– 1.
– 2.
– 3.
Glomerular Filtration
• Fluids filtered out of
__________________________ (capillaries)
and into _
• Glomerular capillaries are _
Glomerular filtration
• _______________________________: the
______________________ that leaves the
capillaries and _
– Mostly water
• Also contains glucose, amino acids, urea, uric acid and
more
•
Filtration Pressure
• _________________________________
responsible for getting material out of
capillary and into glomerulus
•
GFR
• Glomerular Filtration Rate
• _________________________________ to
the filtration pressure
Regulation of GFR
• Remains relatively constant by autoregulation
• If _________________________________
vasoconstriction of afferent arterioles
(leading into glomerulus) 
Regulation of GFR
• If ____________________________ 
__________________________ of afferent
arterioles  increases filtration pressure 
Regulation of GFR
• Renin-angiotensin system
– JG cells
___________________________________ when
blood pressure is_
– Macula densa senses _
– When low, _
Renin
• Renin enters blood stream
• Reacts with plasma protein called
•
•
Renin
• Along the
_________________________________ is an
enzyme called
• Angiotensin I in the presence of ACE will
become
•
Angiotensin II
• Major effect on the kidneys through the
adrenal cortical _
• Aldosterone: _
–
ANP Atrial natriuretic peptide
• Atrial natriuretic peptide
–
– Affects _
– ANP increases when _
– Stimulates _
– Increases
Tubular Reabsorption
• _________________________________.
Body needs to pull some substances out of the
filtrate, such as
_____________________________, and
________________________________ other
substances.
Tubular reabsorption
•
• Renal tubule runs alongside
Peritubular
____________________
(2)
Tubular reabsorption
•
• Segments of the tubule are adapted to
reabsorb specific substances
–
– Water: through _
Diuresis
• Any
•
•
• Called _
Tubular reabsorption
– Amino acids: reabsorbed in_____________ by _
– Proteins: Glomerular filtrate has little protein
except for small albumins: _
– Also reabsorbs: creatine, lactic, citric, uric and
ascorbic acids, phosphate, sulfate, calcium,
potassium and sodium
Tubular reabsorption
•
• If more _
• Converse true as well.
Tubular reabsorption
• The PCT reabsorbs about 70% of water and
ions.
• By end of PCT the
_________________________________:
concentration in the __________ is same as
concentration in the _
Distal Collecting Tubule
• At end of PCT conditions isotonic
• At beginning of
_________________________________
(figure 20.22 in your text)
• ____________ cells are
________________________ to water. Even if
the balance is uneven, _
Antidiuretic hormone
• Posterior lobe of __________________
releases ___________ when body’s water
concentrations _
• ADH ________________________________
and water is moved _
• Urine volume
Countercurrent system
• Countercurrent Multiplier System
1) Each region has a special permeability for water, ions,
and/or urea
2) Interstitial spaces accumulate ions and urea to build up
a ________________________________ that increases
with depth into the medulla
Countercurrent system
• 3) Parallel to nephrons lies a capillary network
which has freely permeable walls. These
capillaries passively participate in
maintenance of the concentration gradient in
the interstitium by removal of reabsorbed _
Tubular Secretion
• Substances move from __________________ of
capillary to _
– Secretes
–
–
–
Urine formation
• Glomerular filtration:
• Tubular reabsorption: filtrate in tubule sends
_
– Glucose, water, etc
• Tubular secretion: materials in _
Urine Elimination
•
•
•
•
•
•
•
Forms in _
Passes into _
Passes into _
Enters _
Enters _
Enters _
Ureter
• Originates as the _
•
• Layers of Ureter
– Inner layer: _________________________.
Continuous with renal tubules and bladder
– Middle layer: ________________________ Smooth
muscle fibers both circular and longitudinal
– Outer layer: _____________________________
Connective tissue
Peristalsis
• ____________________________ enters
renal pelvis and ureters
• Pushed along by ______________________
to urinary bladder
• _______________________: at entrance of
bladder to _
Urinary Bladder
• Located in _
– Male:
– Female:
• Like stomach, has rugae. _
Urinary bladder
• ________________: ________________ area
composed of
–
–
– _________________________ of the bladder (opens
to urethra)
• Trigone remains
_____________________________ as rest of
bladder expands and contracts
Bladder
• Layers of the bladder
– 1. Inner layer: mucous coat
•
– 2. Submucous coat: _
Bladder
– 3. Muscular coat: _________________ muscles
•
•
– 4. Serous coat
Micturition
• ______________________ reflex _
• ______________________ of the bladder
stimulates _
• ______________________ muscle contracts
– Aided by _
• External urethral sphincter relaxes
–
Bladder volume
• Bladder may hold up to ____________ of
urine
• Urge may be present at _
• At about 300 ml, sensation _
Bladder
• As bladder fills and distends, detrusor muscle
contracts
• Contractions may force _
– Involuntary muscle
• However, in adults, urination is a
______________________________ action.
Urination
• Depends on control of the _
Urethra
•
• Contains several _
– Secrete _
Female Urethra
•
•
•
•
About _______ long
Travels below _
Empties between _
Empties as _
Male Urethra
• Has both _
• Divided into three sections
– _________________________________: passes through
prostate gland
– ________________________________ urethra: passes
through urogenital diaphragm. Surrounded by external
urethral sphincter muscle
– ________________________________ urethra: passes
through corpus spongiosum of penis
• Ends as _
Chapter 21
• Water, Electrolyte, and acid/base balances
Distribution of body fluids
• Fluid compartments
– Intracellular fluid compartment
• All water and electrolytes _
– Extracellular fluid compartment
• All fluid _
– Interstitial fluid, plasma, lymph
– Transcellular fluid: _________________________________,
aqueous humor, _______________________________,
synovial fluid, _
Body fluid
•
– _________________________________ of
sodium, chloride bicarbonate ions
– _________________________________ of
potassium, calcium, magnesium, phosphate, and
sulfur
Body fluid composition
• Intracellular fluids
– Higher concentrations of potassium, phosphate,
and magnesium ions
– Lower concentrations of sodium, chloride,
bicarbonate than extracellular fluids
– Greater concentration _
Movement of fluid
• Two major factors for movement
– ___________________________________:
pressure exerted by fluids
• Fluid _
– ___________________________________: the
potential pressure of a solution caused by nondiffusible solute particles in the solution
Osmosis
If two solutions of different concentration
are separated by a semi-permeable
membrane which is permeable to to the
smaller solvent molecules but not to the
larger solute molecules, then the solvent
will tend to diffuse across the membrane
from the less concentrated to the more
concentrated solution. This process is called
osmosis.
Water balance
• Adult water intake
– 60% from _
– 30% from _
– 10% __________________________________:
by product of metabolizing nutrients
Thirst
• Primary regulator:
–
– Related to
________________________________________
of brain
– Body loses water  _____________________ of
the EC (extracellular) fluids _______________ 
Thirst
• Stimulates ________________________ in
the thirst center 
• Dry mouth:
• Thirst triggered when total body water is
decrease _
Quenching thirst
• Drinking water 
_________________________________ 
triggers impulses to brain  _
• Prevents ___________________________
Mechanism is inhibited with
________________________ of water, not
________________________ of water
Water output
• Loss in
–
–
–
– Evaporation and
– Lungs during breathing 28%
Water loss
• If 2500 ml taken in on daily basis, then 2500
ml should be eliminated to maintain _
Imbalances
• If not enough water taken in  _
–
Anti-Diuretic Hormone
• DCT linings are _______________________
to water.
• Blood plasma becomes _______________ due
to _____________________  triggers
posterior pituitary gland to release _
• ADH in bloodstream  reaches
____________________  increases
permeability of__________  water is _
Dehydration
• EC fluid becomes _
• Change in osmotic pressure stimulates
_____________________ to release ADH
• ADH carried by blood to kidneys
• Changes permeability of DCT
• Water output _
Excess water intake
• EC fluid becomes _
• Stimulates _
• Pituitary _
• Water ________________________ and
collecting ducts
• Removed from _
Diuretics
• Alcohol, some narcotics: _
• Caffeine: inhibit _______________________
 reduces reabsorption of water  urine
output increases
Electrolyte Balance
• Important electrolytes:
– Sodium
–
– Calcium
– Magnesium
–
– Sulfate
– Phosphate
–
–

Primarily obtained from
 Foods
 Beverages
 Byproducts of
metabolism
Electrolyte output
• Body loses electrolytes
–
–
– Greatest amount lost in _
Regulation of Sodium
• Regulated through ______________________
and hormone _
– Aldosterone _
Regulation of Potassium
• Rising potassium ion concentration will _
– Enhances sodium _
– Causes renal tubules to _
Regulation of Calcium
• Dropping Ca concentration stimulates
•
– Secretes parathyroid hormone
– Which _______________________________
concentrations of both calcium and phosphate
ions in extracellular fluids
– Also increases _
Parathyroid hormone
• Causes the kidneys to
– Conserve calcium ions
–
• Net result of PTH:
– returns calcium ion concentration of EC fluid to
normal levels
– Maintains phosphate ion concentration
Hyponatremia
•
–
–
– Diarrhea
–
– Drinking
• Effects:
– Movement of water into cells, swelling
–
Hypernatremia
• Causes:
– High fever
– Diabetes insipidus
• Effects:
–
Hypokalemia
•
• Causes:
–
– Diuretic drugs
– Prolonged vomiting, diarrhea
• Effects:
– Muscular weakness, paralysis, _
Hyperkalemia
•
• Causes:
– Renal disease, drugs,
__________________________________
(Addison’s Disease)
• Effects
–
–
Acid Base Balance
• Acids:
–
• Bases:
–
• Balance: regulation of the _
Sources of H+
• As _
• 1.
– Carbon dioxide reacts with water to form carbonic
acid which ionizes to release hydrogen ions and
bicarbonate ions
• CO2 + H20  H2C03  H+ + HCO3-
Sources of H+
• 2.
– Glucose in anaerobic respiration produces
_______________________ which adds H+
• 3. Incomplete oxidation of _
– Produces ____________________________
which increase H+ concentration
• 4. Oxidation of a.a. containing _
– Produces H2SO4  which releases H+ ions
Sources of H +
• 5. ______________________ of
phosphoproteins and nucleic acids
– These substances contain phosphorus which lends
itself to _________________________ which can
release H +
Regulation
• Acid/base regulation is essential because a
shift towards more acid or more base can
threaten the internal environment
– Which is why we have
•
•
•
Acid Base buffer systems
•
•
•
•
Bicarbonate buffer system
Present in both IC fluids and EC fluids
Involves _
Involves carbonic acid _
– If there is ___________________ in system:
• H + will add to bicarbonate ion
• H + + HCO3-  H2CO3
Bicarbonate Buffer system
• If there is not enough H + in system
– Carbonic acid _
H2CO3  H + + HCO3-
Phosphate buffer system
• Present in IC and EC fluids
• More important in _
• Contains
H2PO4-
• And
HPO42-
Phosphate Buffer system
• If _
– Monohydrogen phosphate acts as weak base and
_______________________________ to form
dihydrogen phosphate
• H + HPO4 –2  H2PO4 –
• If conditions are too basic:
– Dihydrogen phosphate will _
• H2PO4-  H + HPO4 -2
Protein Buffer system
• Uses _
• Review Ch 2 for protein structure and
chemistry
• Some proteins have a carboxyl group –COOH
that _________________________ when too
alkaline
• Or, if conditions are too acidic, the COO- can _
Protein Buffer system
• Amino acids also have amino groups: --NH2
– If conditions become too acidic:
• The ________________________ will accept a H+
• --NH2 + H+  --NH3+
– If conditions become too basic:
• NH3 can give up a H+ if there is an OH- group to accept it
Respiratory Excretion of CO2
• Previous buffer systems good for
______________________________ …but
presence of excess acid or base needs to be
more completely remedied.
• ______________________________ will
affect more permanent changes
Respiratory Excretion of CO2
• Respiratory center in brain stem
– Controls _
• During exercise:
– If body cells __________________________
production
– Increases ________________________H2CO3
– Carbonic acid dissociates and _
– the pH starts to drop
Respiratory Excretion of CO2
• Increase in H+ and increase in CO2 _
• Response:
– increase ___________________ of breathing
– Increase ___________________ of breathing
• Result: _
Respiratory Excretion of CO2
•
•
•
•
•
During rest:
Concentrations of CO2 and H+ _
Breathing rate and depth falls
Decreased respirations allows _
Returns pH to normal
Respiratory Excretion of CO2
• Increased H+ More acidic
–
• Decreased H+ More basic
–
Renal excretion of H+ ions
• Nephrons __________________________
into the urine
• Kidney also regulates concentration of _
Renal excretion of H+ ions
• Metabolism can result in acid formation
– Amino acids when metabolized can result in
•
•
• Kidneys will secrete _
Renal excretion of H+
• So, why if the body secretes H+ into the renal
tubules doesn’t the urine have a low pH?
– Some of the same buffering systems _
• Phosphate buffer system
• Ammonia: NH3 + H+  NH4+
– Prevents urine from becoming acidic
Rates of regulation
• Acid base buffers:
– Can convert strong acids and bases to _
– Considered
_____________________________________ for
pH shifts
• Respiratory systems __________________
and renal __________________ and function
more slowly
–
Effects of pH changes
• Acidosis:
– Increased _
• Depressed neuron activity
• Decrease in consciousness
• Alkalosis
– Increased _
• Neurons become excitable
•
Acidosis
• Results from an ______________________ or
_
• Respiratory acidosis
– Accumulation of _
– Decreased ventilation
• Injury to _
• Obstruction in air passages
• Pneumonia, emphysema
Respiratory acidosis
• As the H+ increases in the acidosis, the
breathing rate will _
• As the body returns to normal, the acidosis is
_
Respiratory acidosis
• Symptoms
–
–
– Stupor
– Labored breathing
– If it remains uncompensated: _
Metabolic acidosis
• Due to ___________________________ (not
related to respiration) or _
• Contributing conditions:
–
– Prolonged vomiting (including contents of small
intestine)
– Prolonged _
– Diabetes mellitus (fatty acids converted into
ketone bodies)
Respiratory alkalosis
• Hyperventilation: blows off _
– Anxiety
– Fever
– Salicylate poisoning (aspirin)
Respiratory alkalosis
• Body’s response:
–
– Kidneys _
– Kidneys increase _
• Symptoms
– Light-headedness
– Agitation
– Dizziness
– Muscle tetany if severe
Metabolic alkalosis
• Results from
• a_
• Increase in bases
–
– Prolonged vomiting _
– Diuretic drugs
– Too much _
Metabolic alkalosis
• Will result in a _
– Allows CO2 and H+ to recuperate