1. Exam Four material Assignment due: Exam Four: Chapter 20 Urinary Chapter 21Balances

2. Kidney Bean shaped Retroperitoneal: _ Near _

4. Kidney Renal pelvis: _ – Subdivided into _ ____________________: project from _

5. Kidney Inner region: _ – Contains Outer region: – Forms _ – Granular appearance _

6. Kidney Function _ Remove __________________________ from blood Control ___________________________ by secreting _______________________ Regulate __________________________ by enzyme ________________________ Activates _

7. Nephron The ______________________________ of the kidney Two sections – Renal corpuscle: – ________________________________: leads away from the glomerular capsule.

8. Nephron Renal Tubule: – Descending nephron loop Ascending nephron loop – Collecting Duct:

9. 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: _

10. Nephrons Cortical nephron: _ – Short loops that _ Juxtamedullary nephrons: –

11. Shows both a cortical and Juxtamedullary nephron

12. Urine formation Main function nephron: – – Remove

13. Urine Urine formation involves three processes: – 1. – 2. – 3.

14. Glomerular Filtration Fluids filtered out of __________________________ (capillaries) and into _ Glomerular capillaries are _

15. Glomerular filtration _______________________________: the ______________________ that leaves the capillaries and _ – Mostly water Also contains glucose, amino acids, urea, uric acid and more

16. Filtration Pressure _________________________________ responsible for getting material out of capillary and into glomerulus

17. GFR Glomerular Filtration Rate _________________________________ to the filtration pressure

18. Regulation of GFR Remains relatively constant by autoregulation If _________________________________  vasoconstriction of afferent arterioles (leading into glomerulus) 

19. Regulation of GFR If ____________________________  __________________________ of afferent arterioles  increases filtration pressure 

20. Regulation of GFR Renin-angiotensin system – JG cells ___________________________________ when blood pressure is_ – Macula densa senses _ – When low, _

21. Renin Renin enters blood stream Reacts with plasma protein called

22. Renin Along the _________________________________ is an enzyme called Angiotensin I in the presence of ACE will become

23. Angiotensin II Major effect on the kidneys through the adrenal cortical _ Aldosterone: _ –

24. ANP Atrial natriuretic peptide Atrial natriuretic peptide – – Affects _ – ANP increases when _ – Stimulates _ – Increases

25. Tubular Reabsorption _________________________________. Body needs to pull some substances out of the filtrate, such as _____________________________, and ________________________________ other substances.

26. Tubular reabsorption Renal tubule runs alongside Peritubular ____________________ (2)

27. Tubular reabsorption Segments of the tubule are adapted to reabsorb specific substances – – Water: through _

28. Diuresis Any Called _

29. 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

30. Tubular reabsorption If more _ Converse true as well.

31. 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 _

32. 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, _

33. Antidiuretic hormone Posterior lobe of __________________ releases ___________ when body’s water concentrations _ ADH ________________________________ and water is moved _ Urine volume

34. 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

35. 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 _

36. Tubular Secretion Substances move from __________________ of capillary to _ – Secretes –

37. Urine formation Glomerular filtration: Tubular reabsorption: filtrate in tubule sends _ – Glucose, water, etc Tubular secretion: materials in _

38. Urine Elimination Forms in _ Passes into _ Enters _

39. 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

40. Peristalsis ____________________________ enters renal pelvis and ureters Pushed along by ______________________ to urinary bladder _______________________: at entrance of bladder to _

41. Urinary Bladder Located in _ – Male: – Female: Like stomach, has rugae. _

42. Urinary bladder ________________: ________________ area composed of – – _________________________ of the bladder (opens to urethra) Trigone remains _____________________________ as rest of bladder expands and contracts

43. Bladder Layers of the bladder – 1. Inner layer: mucous coat – 2. Submucous coat: _

44. Bladder – 3. Muscular coat: _________________ muscles – 4. Serous coat

45. Micturition ______________________ reflex _ ______________________ of the bladder stimulates _ ______________________ muscle contracts – Aided by _ External urethral sphincter relaxes –

46. Bladder volume Bladder may hold up to ____________ of urine Urge may be present at _ At about 300 ml, sensation _

47. Bladder As bladder fills and distends, detrusor muscle contracts Contractions may force _ – Involuntary muscle However, in adults, urination is a ______________________________ action.

48. Urination Depends on control of the _

49. Urethra Contains several _ – Secrete _

50. Female Urethra About _______ long Travels below _ Empties between _ Empties as _

51. 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 _

52. Chapter 21 Water, Electrolyte, and acid/base balances

53. 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, _

54. Body fluid – _________________________________ of sodium, chloride bicarbonate ions – _________________________________ of potassium, calcium, magnesium, phosphate, and sulfur

55. Body fluid composition Intracellular fluids – Higher concentrations of potassium, phosphate, and magnesium ions – Lower concentrations of sodium, chloride, bicarbonate than extracellular fluids – Greater concentration _

56. Movement of fluid Two major factors for movement – ___________________________________: pressure exerted by fluids Fluid _ – ___________________________________: the potential pressure of a solution caused by non- diffusible solute particles in the solution

57. 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.

58. Water balance Adult water intake – 60% from _ – 30% from _ – 10% __________________________________: by product of metabolizing nutrients

59. Thirst Primary regulator: – – Related to ________________________________________ of brain – Body loses water  _____________________ of the EC (extracellular) fluids _______________ 

60. Thirst Stimulates ________________________ in the thirst center  Dry mouth: Thirst triggered when total body water is decrease _

61. Quenching thirst Drinking water  _________________________________  triggers impulses to brain  _ Prevents ___________________________ Mechanism is inhibited with ________________________ of water, not ________________________ of water

62. Water output Loss in – – Evaporation and – Lungs during breathing 28%

63. Water loss If 2500 ml taken in on daily basis, then 2500 ml should be eliminated to maintain _

64. Imbalances If not enough water taken in  _ –

65. 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 _

66. Dehydration EC fluid becomes _ Change in osmotic pressure stimulates _____________________ to release ADH ADH carried by blood to kidneys Changes permeability of DCT Water output _

67. Excess water intake EC fluid becomes _ Stimulates _ Pituitary _ Water ________________________ and collecting ducts Removed from _

68. Diuretics Alcohol, some narcotics: _ Caffeine: inhibit _______________________  reduces reabsorption of water  urine output increases

69. Electrolyte Balance Important electrolytes: – Sodium – – Calcium – Magnesium – – Sulfate – Phosphate – Primarily obtained from Foods Beverages Byproducts of metabolism

70. Electrolyte output Body loses electrolytes – – Greatest amount lost in _

71. Regulation of Sodium Regulated through ______________________ and hormone _ – Aldosterone _

72. Regulation of Potassium Rising potassium ion concentration will _ – Enhances sodium _ – Causes renal tubules to _

73. Regulation of Calcium Dropping Ca concentration stimulates – Secretes parathyroid hormone – Which _______________________________ concentrations of both calcium and phosphate ions in extracellular fluids – Also increases _

74. 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

75. Hyponatremia – – Diarrhea – – Drinking Effects: – Movement of water into cells, swelling –

76. Hypernatremia Causes: – High fever – Diabetes insipidus Effects: –

77. Hypokalemia Causes: – – Diuretic drugs – Prolonged vomiting, diarrhea Effects: – Muscular weakness, paralysis, _

78. Hyperkalemia Causes: – Renal disease, drugs, __________________________________ (Addison’s Disease) Effects –

79. Acid Base Balance Acids: – Bases: – Balance: regulation of the _

80. Sources of H + As _ 1. – Carbon dioxide reacts with water to form carbonic acid which ionizes to release hydrogen ions and bicarbonate ions CO 2 + H 2 0  H 2 C0 3  H + + HCO3 -

81. 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 H 2 SO 4  which releases H + ions

82. Sources of H + 5. ______________________ of phosphoproteins and nucleic acids – These substances contain phosphorus which lends itself to _________________________ which can release H +

83. 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

84. 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 + + HCO 3 -  H 2 CO 3

85. Bicarbonate Buffer system If there is not enough H + in system – Carbonic acid _ H 2 CO 3  H + + HCO3 -

86. Phosphate buffer system Present in IC and EC fluids More important in _ Contains H 2 PO 4 - And HPO 4 2-

87. Phosphate Buffer system If _ – Monohydrogen phosphate acts as weak base and _______________________________ to form dihydrogen phosphate H + HPO 4 –2  H 2 PO 4 – If conditions are too basic: – Dihydrogen phosphate will _ H 2 PO 4 -  H + HPO 4 -2

88. 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 _

89. Protein Buffer system Amino acids also have amino groups: --NH 2 – If conditions become too acidic: The ________________________ will accept a H + --NH 2 + H +  --NH 3 + – If conditions become too basic: NH 3 can give up a H + if there is an OH - group to accept it

90. Respiratory Excretion of CO 2 Previous buffer systems good for ______________________________ …but presence of excess acid or base needs to be more completely remedied. ______________________________ will affect more permanent changes

91. Respiratory Excretion of CO 2 Respiratory center in brain stem – Controls _ During exercise: – If body cells __________________________ production  – Increases ________________________H 2 CO 3 – Carbonic acid dissociates and _ – the pH starts to drop

92. Respiratory Excretion of CO 2 Increase in H + and increase in CO 2 _ Response: – increase ___________________ of breathing – Increase ___________________ of breathing Result: _

93. Respiratory Excretion of CO 2 During rest: Concentrations of CO 2 and H + _ Breathing rate and depth falls Decreased respirations allows _ Returns pH to normal

94. Respiratory Excretion of CO 2 Increased H + More acidic – Decreased H + More basic –

95. Renal excretion of H + ions Nephrons __________________________ into the urine Kidney also regulates concentration of _

96. Renal excretion of H + ions Metabolism can result in acid formation – Amino acids when metabolized can result in Kidneys will secrete _

97. 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: NH 3 + H +  NH 4 + – Prevents urine from becoming acidic

98. 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 –

99. Effects of pH changes Acidosis: – Increased _ Depressed neuron activity Decrease in consciousness Alkalosis – Increased _ Neurons become excitable

100. Acidosis Results from an ______________________ or _ Respiratory acidosis – Accumulation of _ – Decreased ventilation Injury to _ Obstruction in air passages Pneumonia, emphysema

101. Respiratory acidosis As the H+ increases in the acidosis, the breathing rate will _ As the body returns to normal, the acidosis is _

102. Respiratory acidosis Symptoms – – Stupor – Labored breathing – If it remains uncompensated: _

103. 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)

104. Respiratory alkalosis Hyperventilation: blows off _ – Anxiety – Fever – Salicylate poisoning (aspirin)

105. Respiratory alkalosis Body’s response: – – Kidneys _ – Kidneys increase _ Symptoms – Light-headedness – Agitation – Dizziness – Muscle tetany if severe

106. Metabolic alkalosis Results from a _ Increase in bases – – Prolonged vomiting _ – Diuretic drugs – Too much _

107. Metabolic alkalosis Will result in a _ – Allows CO 2 and H + to recuperate