Endocrine E3 Regulation of Salt & Water Balance
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| what system regulates sodium and water | endocrine
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| how is osmolality of the ECF monitored and adjusted | regulating water excretion by the kidney in response to ADH
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| Na+ is the major ________ in ECF, maintenance of vascular volume depends on what | electrolyte, maintenance sodium balance
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| renal mechanisms of Na+ balance are regulated by | 1)renin-angiotensin-aldosterone system
2)atrial natriuretic peptide
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| hormonal mechanisms also regulate | salt and water intake and vascular tone
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| all renal reabsorption is due to what | 1)passive Na+ reabsorption into tubular cells following a concentration gradient at luminal surface
2)active Na+ removal from tubular cells due to Na+/K+ ATPase(pump) at basolateral surface keeps tubular intracellular Na+ low
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| Na+ coupled transport also reabsorbs | 1)glucose
2)amino acids
3)phosphate
4)HCO3-
5)H20
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| hormones that regulate NaCl/H20 | 1)antidiurectic hormone
2)renin-angiotensin-aldosterone
3)atrial natriuretic peptide
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| what signals the kidney to conserve H20 | ADH
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| when is ADH released in the kidney to conserve H20 | 1)plasma osmolality is increases(>280 mOsm/Kg)
2)plasma volume is decreased at least 10-15%
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| powerful vasoconstrictor targeting the arteriolar smooth muscle | ADH
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| ADH via V2 receptor causes insertion of _______ making the collecting duct permeable to ______ | aquaporins, H20
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| osmole receptors are found where | in the circumventricular organs near the 3rd ventricle
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| what is the most potent osmolyte | NaCl
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| what stimulates ADH during dehydration | 1)increased osmolality
2)decreased volume(pressure)
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| what happens if there is a decrease in both osmolality and a decrease in volume | osmolality is kept constant if volume depletion is small but if volume loss is large osmolality is sacrificed to maintain integrity of circulation
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| 1)decreased ADH production(central) or decreased response of kidney to ADH(nephrogenic) 2)large amounts of dilute urine 3)concentrated body fluids if intake is not increased | diabetes insipidis
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| 1)increased ADH secretion as plasma osmolality is low 2)death can occur due to dilution of plasma electrolytes due to excessive reabsorption of free H20 | syndrome of inappropriate ADH
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| what is renin synthesized and secreted by | juxtaglomerular cells in walls of afferent renal arterioles
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| what is renin release stimulated by (3) | 1)SNS activation associated with decreased blood pressure sensed by baroreceptors
2)decreased tension on afferent arterioles in glomerulus
3)decreased pressure in glomerulus, decreased rate of NaCl delivery to macula densa
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| renin catalyses the formation of ___________ from _____________ | angiotensin I, angiotensinogen(liver)
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| angiotensin I is converted to angiotensin II by converting what enzyme | ACE
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| where is angiotensin I converted to angiotensin II | pulmonary endothelium as blood perfuses the pulmonary capillaries
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| angiotensin II is produced locally in what different tissue | 1)blood vessels
2)adipose
3)brain
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| angiotensinogen, renin, and ACE may act as a ________ to stimulate prostaglandins or act as what | paracrine, local growth factor
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| what is the primary signal for release of aldosterone | angiotensin II
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| what acts in vasoconstriction in the kidney decreasing renal blood flow & glomerular filtration | angiotensin II
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| what increases cardiac contractility | angiotensin II
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| what redistributes blood flow: increase brain, heart, skeletal muscle, decrease skin, viscera | angiotensin II
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| what is the most potent pressor substance known | angiotensin II
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| angiotensin II may act as growth factor for what | cardiac and smooth muscle
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| what are the actions of angiotensin II in the CNS | stimulates thirst, appetite for Na+, secretion of ADH
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| ADH receptors are found where | in hypothalmic cells(subfornical organ & organum vasculosum) which project to supraoptic & paraventricular N. and vasomotor centers
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| what is renin-angiotensin-aldosterone regulated by | negative feedback, regulated by blood volume which increases as a result of sodium retention
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| what promotes the excretion of sodium in the urine | atrial natriuretic peptide
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| what is atrial natriuretic peptide syntehsized and secreted from | atrial myocyctes, 28aa in response to stretch(increased atrial pressure)
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| another form of brain natiuretic peptide is synthesized and secreted by | atrial and ventricles isolated from the brain
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| CNP is found in | CNS and endothelial cells
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| ANP/BNP binds to | natriuretic peptide receptor-A(NPR-A)
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| natriuretic peptide receptor-B (NPR-B) binds to | CNP
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| natriuretic peptide receptor-C (NPR-C) binds to | ANP/BNP/CNP
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| ANP half life is ________ and BNP half life is _______ | 3 minutes, 20 minutes
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| both ANP and BNP do what | stimulate formation of cyclic GMP which modify functions
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| what are the 3 mechanisms used to modify cellular functions | 1)phosphorylation of regulatory proteins
2)cyclic nucleotide phosphodiesterases
3)direct ion channel regulation
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| physiologic actions of ANP | 1)prevent volume overloading
2)lower blood volume & decrease blood pressure
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| what is the physiologic action of ANP on the cardiovascular system | vasodilation of vascular smooth muscle
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| what is the physiologic action of AnP on the kidney | 1)increase Na+ & H2O excretion by increase glomerular filtration & decrease Na+ & H2O reabsorption
2)decrease renin secretion by decreasing angiotensin II
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| what are physiologic actions of ANP on the hypthalamus | 1)decrease ADH secretion
2)decrease vasomotor activity
3)inhibits thirst
4)decreases Na+ appetite
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| what is the physiologic action of ANP on the pituitary gland | inhibits release of ACTH (decreases adrenal support)
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| what is the physiologic action of ANP on the adrenal gland | decrease aldosterone secretion
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| what is the physiologic action of ANP on the sympathetic nervous system | may decrease norepinephrine release from SNS & decrease epinephrine release from adrenal medulla
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| what are the 4 derangements of fluid balance discussed in class | 1)hemorrhage
2)dehydration
3)salt loading
4)salt depletion
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| what happens during a hemorrhage | 1)immediate response is massive vasoconstriction mediated by SNS
2)slower in onset stimulated by renin-angiotensin-aldosterone
3)stimulation of ADH
4)inhibition of ANP
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| what happens during dehydration | 1)H2O loss > solute loss leads to increase in both ECF and ICF osmolality
2)ADH primary way to correct because it promotes H2O reabsorption without reabsorbing solute
3)inhibition of ANP
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| what happens during salt loading | promotes the excretion of increased Na+ in the urine
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| what happens during salt depletion | minimizes excretion of Na+ in the urine
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| when salt loading 350 mm/day/5days what are the levels | 1)plasma Na+ 140mm
2)hematocrit 38%
3)ADH, ANP, urine Na+ all increase
4)plasma renin activity, aldosterone decrease
5)plasma protein concentration stays constant
6)volume expansion
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| when salt depletion 10mm/day/5days what are the levels | 1)plasma Na+ 140mm
2)hematocrit 41%
3)ADH, ANP, urine Na+ decrease
4)plasma renin activity, aldosterone increase
5)plasma protein concentration stays constant
6)volume contraction
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