Water Regulation & Kidney Function

Chapters 25, 26, 27, 28, 29, 30, 31

  1. Intake
    1. Sources
      1. Preformed
      2. Metabolic
      3. Fluids
    2. Regulation
      1. Osmoreceptors
      2. Volume receptors
      3. Renin-Angiotensin System
  2. Loss
    1. Sources
    2. Regulation
      1. ADH
      2. Aldosterone

Kidney

  1. Major Functions
  2. Macroscopic AnatomyDiagram of Kidney
  3. Microscopic Anatomy (Nephron defined)
    1. Vascular Structures
    2. Tubular Structures
    Diagram of Tubular Structures
  4. Steps in urine formation and physiological diagram of nephron
  5. Renal Clearance
  6. Filtration
    1. The Pressures
    2. The Filter
    3. Quantitation of Glomerular Filtration Rate
    4. Regulation of G.F.R. -- G.F.R. = KfxNet filtration pressure
      1. Regulation of filtration pressure
        1. External Mechanisms
          • Atrial naturitic factor
          • Neuronal control
        2. Autoregulation
          • Myogenic Hypothesis
          • Tubuloglomerular Feedback Hypothesis
            1. Anatomy of J.G.A.
          Anatomy of JGA
        3. Factors effecting signal
          • prostaglandins
          • bradykinins
          • adenosine
          • angiotensin II
        4. Renin-Angiotensin System
      2. Regulation of Kf
  7. Reabsorption
    1. Organic reabsorption
      1. Proteins
      2. Transport maximum mechanism
    2. Ionic Reabsorption
      transport maximum mechanism
      Tranport Maximum Machanism
      Ionic Reabsorption
      Ionic Reabsorpotion

      1. Na+
      2. Cl-
      3. K+
      4. Aldosterone regulation
        1. Mechanism of action
        2. Factors effecting secretion of aldosterone
      5. Atrial natriuretic peptide regulation
  8. Osmotic Stratification
    1. Facts about ascending and descending limb
    2. Counter current multiplier
      counter currnet multiplier
    3. Role of Urea
  9. Volume Reabsorption
    1. Locations
    2. Regulation of A.D.H. mechanism
  10. Two-Solute Hypothesis of Stratification
  11. Secretion
    1. Examples
    2. Value of Para Amino Hippurate (P.A.H.)
  12. Uricosurics and Uric Acid
  13. Acid-Base Balance
    1. Introduction
      1. Acids & Bases
      2. Expression of concentration & pH values
      3. Effects of altered state
      4. Physiological challenges to homeostasis
    2. Defenses
      1. Chemical Buffer Systems
        1. Definitions
        2. Examples
          • Bicarbonate H,CO,:HCO,-
          • Proteins
          • Phosphate NaH,PO4: Na,HPO4
          • Hemoglobin
      2. Respiratory System
      3. Kidneys
    3. Acid-Base Imbalances
      1. Respiratory acidosis
      2. Respiratory alkalosis
      3. Metabolic acidosis
      4. Metabolic alkalosis
  14. Diuretics
    1. Uses
    2. Examples
      1. Non-pharmacological
        1. Methylxanthine
        2. ETCH
      2. Pharmacological
        1. Carbonic anhydrase inhibitor
          • acetazolamide (Diamox)
        2. Manitol (Osmitrol)
        3. Thiazides
          • chlorothiazide (Diuril)
          • hydrochlorothiazide (Hydro-Diuril) (Esidrex)
        4. Loop Diuretics
          • furosemide (Lasix)
          • bumetanide (Butex)
        5. Potassium sparing
          • sprinonolactone (Aldactone)
        6. Combinations
          • Aldactazide
          • Dyazide
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