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Regulation of Body Fluid

Balance

Osmotic Relations Between Intracellular Fluid, Interstitial Fluid and Plasma

Plasma
Plasma

Na +

protein

protein Intracellular fluid Na +
protein
Intracellular
fluid
Na +

K +

fluid

Na +

Osmotic Relations Between Intracellular Fluid, Interstitial Fluid and Plasma Plasma Na protein protein Intracellular fluid Na
Osmotic Relations Between Intracellular Fluid, Interstitial Fluid and Plasma Plasma Na protein protein Intracellular fluid Na

H 2 O

Osmotic Relations Between Intracellular Fluid, Interstitial Fluid and Plasma Plasma Na protein protein Intracellular fluid Na

H 2 O

K +

K +
K +

Interstitial

Crucial points

Animal plasma membranes are so delicate that no

osmotic gradient between ISF and ICF can exist.

Only impermeant solutes can act as osmotic effectors

Cytoplasmic protein is the major osmotic effector of the ICF; its osmotic effect is balanced by the transmembrane Na + gradient, otherwise cells would swell.

Plasma proteins are the major osmoeffectors of plasma they counteract the effect of capillary hydrostatic pressure.

Na + is the major osmoeffector of ECF versus ICF. ECF volume closely tracks total body Na + content.

Characteristics Of ICF and ECF Compartments

Intracellular Fluid

Extracellular

 

Fluid

30 L total volume

15 L total volume

9000 mOsm total

4500

mOsm total

solute

solute

Posm = 300 mOsm

2175

mEq total

Na +

 

[Na + ] = 145 mEq/L

Posm = 300

mOsm

The ECF consists of the ISF compartment and the plasma compartment

Posm = 300 mOsm Na + mEq total 2175 Fluid Extracellular solute mOsm total 4500 15
Posm = 300
mOsm
Na +
mEq total
2175
Fluid
Extracellular
solute
mOsm total
4500
15 L total volume
Posm = 300 mOsm Na + mEq total 2175 Fluid Extracellular solute mOsm total 4500 15
Interstitial Fluid Plasma 3.75 L 11.25 L total volume total volume 3375 mOsm 1125 total solute
Interstitial Fluid
Plasma
3.75 L
11.25 L total
volume
total
volume
3375 mOsm
1125
total solute
mOsm
total
Posm = 300
mOsm
solute
Posm =
300
mOsm

There are three basic homeostatic challenges

Gain or loss of isotonic solution

Affects only the ECF volume

Gain or loss of pure water

Both ICF and ECF compartments change volume proportionately osmotic concentration changes in each are equal

Gain or loss of pure salt

Na + is confined to the ECF compartment loss results in volume shift from ECF to ICF; gain results in volume shift from ICF to ECF.

Regulation of Renal Function

Intrinsic Baroreceptor Reflex Three endocrine systems

ADH system Renin-Angiotensin-Aldosterone System Atrial Natriuretic Hormone system

Intrinsic regulation

Intrinsic regulation Blood Volume Arterial Blood Pressure GFR

Blood Volume

Intrinsic regulation Blood Volume Arterial Blood Pressure GFR
Arterial Blood Pressure GFR
Arterial Blood Pressure
GFR

Intrinsic regulation + Baroreceptor reflex

Intrinsic regulation + Baroreceptor reflex Blood Volume Arterial Blood Pressure GFR Afferent arteriole dilates Baroreceptor Reflex

Blood Volume

Intrinsic regulation + Baroreceptor reflex Blood Volume Arterial Blood Pressure GFR Afferent arteriole dilates Baroreceptor Reflex
Arterial Blood Pressure GFR Afferent arteriole dilates
Arterial Blood Pressure
GFR
Afferent
arteriole
dilates

Baroreceptor

Reflex

ADH system

“Peripheral volume receptors” are stretch receptors located in the right atrium increased stretch signals a plasma volume increase and exerts an inhibitory effect on ADH secretion

ADH system “Peripheral volume receptors” are stretch receptors located in the right atrium – increased stretch

Osmoreceptor cell bodies are in ventromedial hypothalamus sensitive mainly to [Na + ]

ADH = arginine vasopressin an octapeptide with two major peripheral

effects:

Increased water permeability of collecting duct

Vasoconstriction (at high levels)

Response of ADH system in gain of pure water

Response of ADH system in gain of pure water

Response of ADH system to loss of pure water

The Renin-Angiotensin-Aldosterone System response to loss of pure Na + or loss of isotonic solution

Macula densa (Juxtaglomerular apparatus) secretes renin (a protease) when:

Blood [Na + ] falls below normal Glomerular blood volume flow decreases

Angiotensin cascade

Angiotensinogen

Angiotensin cascade Angiotensinogen Renin Angiotensin I Angiotensin Converting Enzyme (ACE) in lung Angiotensin II Adrenal Cortex

Renin

Angiotensin I

Angiotensin cascade Angiotensinogen Renin Angiotensin I Angiotensin Converting Enzyme (ACE) in lung Angiotensin II Adrenal Cortex

Angiotensin Converting Enzyme (ACE) in lung

Angiotensin II

Angiotensin cascade Angiotensinogen Renin Angiotensin I Angiotensin Converting Enzyme (ACE) in lung Angiotensin II Adrenal Cortex

Adrenal Cortex

Angiotensin cascade Angiotensinogen Renin Angiotensin I Angiotensin Converting Enzyme (ACE) in lung Angiotensin II Adrenal Cortex

Distal tubule (also sweat glands, salivary glands, colon, etc.

Aldosterone

Angiotensin cascade Angiotensinogen Renin Angiotensin I Angiotensin Converting Enzyme (ACE) in lung Angiotensin II Adrenal Cortex
Angiotensin cascade Angiotensinogen Renin Angiotensin I Angiotensin Converting Enzyme (ACE) in lung Angiotensin II Adrenal Cortex

Increased Na + reabsorption

3 Major factors that increase Aldo secretion

Increased Plasma [K + ]

Angiotensin II
Angiotensin II

Adrenocorticotrophic

Hormone (ACTH)

3 Major factors that increase Aldo secretion Increased Plasma [K ] Angiotensin II Adrenocorticotrophic Hormone (ACTH)

Adrenal Cortex

Aldosterone

Kidney distal tubule

3 Major factors that increase Aldo secretion Increased Plasma [K ] Angiotensin II Adrenocorticotrophic Hormone (ACTH)

Na + reabsorption K + secretion H + secretion

Aldosterone effects

Steroid hormone that increases expression of Na + /K + ATPase in target epithelia

Directly regulates total body Na + - Indirectly regulates ECF volume.

Also involved in K + regulation by a direct effect on the adrenal cortex: increased plasma [K + ] increases aldo secretion

Atrial natriuretic peptide response to gain of isotonic solution

Stretched atria release 22 aa peptide which

increases GFR by vasodilating renal afferent arterioles and constricting efferent arterioles Inhibits Aldo secretion and antagonizes tubular effect of aldosterone Inhibits ADH secretion and blocks its action

Causes marked diuresis (volume loss) and natriuresis (net loss of Na + )

Study Goals

Be able to trace the responses of each of the 3 major renal endocrine systems to each of the 3 simple homeostatic challenges.

Integrate your understanding of these systems with what you know about the baroreceptor

reflex and capillary filtration to arrive at a complete picture of whole-body responses to blood loss and plasma volume expansion i.e. short term and long term regulation of mean arterial pressure.