Renal Physiology - PowerPoint PPT Presentation

1 / 30
About This Presentation
Title:

Renal Physiology

Description:

3. Given appropriate data, calculate the volume of distribution of a substance. ... Substances to Measure Volumes of Body Water Spaces. Markers for body water spaces ... – PowerPoint PPT presentation

Number of Views:117
Avg rating:3.0/5.0
Slides: 31
Provided by: Apr35
Category:

less

Transcript and Presenter's Notes

Title: Renal Physiology


1
Renal Physiology
  • Dr. April Strader
  • Course PHYS 410-
  • MWF 8-9am
  • Chapters -3, 32-39
  • Office 453-1533
  • Email astrader_at_siumed.edu
  • Office hours
  • Life Science III Room 2066

2
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

3
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

4

1. Total Human Body Water Spaces
example for 70kg male with 45 hematocrit
(60 of Body Weight)
Total Body Water (TBW) 42 L
Intracellular Fluid -25 L
Extracellular Fluid 17 L
Fluid within all body cells.
Blood Plasma 3 L
Interstitial Fluid 13 L
Transcellular Fluid -1 L
(does not include the 2.5L of cellular elements
of Blood cells, platelets, etc) Total Blood
Volume 5.5L
Dense connective tissue, cartilage and tendons,
and bone matrix.
Synovial fluid in joints and CSF. Does NOT
include fluids that are considered outisde body
such as urine in bladder.
Table 3-1 p.51
5

1. Intracellular and Extracellular Fluids
25L
17L
42 LITERS
Fig. 3-1 p.51
6
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

7
  • Determining the Volume of Distribution of
  • Substances to Measure Volumes of Body
    Water Spaces.


Markers for body water spaces Body water
space Markers Total body water T20,
D20 Extracellular water inulin (NOT
insulin) Plasma 125I albumin, 51Cr
erythrocytes, Evans blue (binds to
albumin)
Some spaces you cannot measure with markers and
need to be calculated by subtraction.
Intracellular water Total Body water
Extracellular water Interstitial water
(extravascular water) Extracellular water -
Plasma
nib
8
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

9
3. Given the appropriate data, calculate the
volume of distribution of a substance.
  • V1 volume injected V2 volume of
    distribution
  • C1 concentration injected C2 final
    concentration
  • After injection, allow time for equilibration
  • V2(volume of dist.) V1 x C1
  • C2

10
3. Eg. Calculate the Extravascular Extracellular
Volume of a Patient Using an infusion of inulin.
  • 1 mM of inulin is intravenously infused into
    your patient in 100 ml of physiological saline.
    Inulin cannot enter cells, but can diffuse freely
    across blood vessel walls and therefore
    distributes in the extravascular extracellular
    space. The final inulin concentration in blood
    plasma after equilibrium (and accounting for
    excretion in urine) is 7.7µM.
  • What is the Extracellular Volume of the Patient
    (in liters)?
  • What is the Extravascular Extracellular Volume
    (in liters)?
  • Using the equation C1xV1 C2xV2
  • C1 1mM C2 7.7 µM
  • V1 100ml V2 ?

11
3.
C1
V1
C2
V2
( 1 mM ) x ( 100ml ) ( 0.0077 mM ) x V2
V2
12, 987 ml ( or approx. 13 L)
This is the Extracellular Volume. To find
Extravascular Extracellular Volume, remember,
plasma volume 3L , therefore, this volume is
13 L 3 L 10 L
12

Intracellular and Extracellular Fluids
25L
17L
42 LITERS
Fig. 3-1 p.51
13
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

14
What factors determine the distribution of fluid
between the intracellular and extracellular
compartments.
  • Extracellular Fluid (ECF) vs. Intracellular
    Fluid (ICF)
  • -plasma
  • -interstitial fluid (IF)

1. OSMOLALITY
  • Solute concentrations vary dramatically between
    ECF and ICF.
  • -The plasma and the interstitial fluid have very
    similar composition (solutes).
  • -The major difference between plasma and
    interstitial fluid is plasma proteins.
  • HOWEVER, the Osmolality of the ECF and the
    ICF are the same!!!

Osmolality total concentration of ALL
particles that are in a solution
Table 3-2 and Figure 3-1 (p. 51-52) BB
15
4.
2. ELECTRONEUTRALITY
All solutions must respect the principle of bulk
electroneutrality the number of positive
charges in the solution must equal the negative
charges (Table 3-2) p.52
Adding up the cytosolic Na and K we see
that the sum GREATLY exceeds the sum of the
Cl- and HCO3- ions. The excess positive
charge is balanced by the negative charge on
intracellular proteins and smaller anions and
inorganic phosphates. (p. 53-54)
16
4.
In general, particles move according to
concentration (osmolality) and electrochemical (
? ) gradients.
p. 54
Water movement is PASSIVE and moves from low
osmolality to high osmolality.
The actual transport of solutes is very complex
(including transporters and pumps) and will be
covered in more detail later, but for now,
remember that NaCl is largely excluded from the
intracellular compartment.
17
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

18
5. Describe the effects of drinking water, or
the intravenous infusion of saline solutions of
different osmolalities on the volumes and
osmolalities of various body fluid spaces.
  • EC vol. IC vol. EC
    osm. IC osm.
  • Isotonic saline

Water
Hypertonic Saline
Hypotonic saline
Think these through, dont memorize it! Page
79. (study figure 3-17)
19
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

20
6. Outline the forces which govern the
distribution of fluid between plasma and
interstitial fluid.
  • Starling Forces Starlings law of the Capillary

Pc hydrostatic pressure of capillary ?c
protein (oncotic) pressure of capillary Pi
hydrostatic pressure of interstitual fluid ?i
protein osmotic (oncotic) pressure of the
interstitual fluid Kf hydraulic conductance of
capillary (ml/min) Net movement out of capillary
into interstitium (ml/min) Kf (Pc Pi) (?c
?i) Basically, movement is governed by
(hydrostatic pressure protein (oncotic)
pressure)
21
5. Filtration when fluid moves OUT of a
capillary Absorption when fluid moves INTO a
capillary
  • FIND THE NET PRESSURE FOR EACH SCENARIO
  • Net Filtration

B. Net Absorption
capillary
capillary
Pc pc
Pc pc
-1
-1
3
3
26
32
Pi
30
Pi
25
pi
pi
Assume that Kf equals 1.
22
5. Filtration when fluid moves OUT of a
capillary Absorption when fluid moves INTO a
capillary
  • FIND THE NET PRESSURE FOR EACH SCENARIO
  • Net Filtration 8mmHg

B. Net Absorption -5mmHg
capillary
capillary
Pc pc
Pc pc
-1
-1
3
3
26
32
Pi
30
Pi
25
pi
pi
Assume that Kf equals 1.
23
Lymph
  • The lymphatic capillaries are responsible for
  • returning interstitial fluid and proteins to
    the vascular compartment.
  • -one-way flap valves permits fluid and protein
    to enter, not leave.
  • -lymph capillaries merge into large thoracic
    duct which empties into the large veins.
  • -lymph vessels have smooth muscle for movement
    and
  • surrounding skeletal muscle contractions.

24
Lecture 1Objectives - Body Water Spaces
  • 1. Learn the approximate volumes of total body
    water, extracellular, intracellular, interstitual
    and plasma volumes.
  • 2. Describe how determining the volume of
    distribution of various substances can be used to
    measure the volumes of the above body water
    spaces.
  • 3. Given appropriate data, calculate the volume
    of distribution of a substance.
  • 4. Describe the principles which govern the
    distribution of fluid between the intracellular
    and extracellular compartments.
  • 5. Describe the effects of drinking water, or
    the intravenous infusion of saline solutions of
    different osmolalities on the volumes and
    osmolalities of various body fluid spaces.
  • 6. Outline the forces which govern the
    distribution of fluid between plasma and
    interstitial fluid.
  • 7. Define edema and explain the mechanism by
    which it develops in various pathological
    situations.

25
7. Define edema and explain the mechanism by
which it develops in various pathological
situations.
  • EDEMA
  • Accumulation of fluid in interstitial space (due
    to filtration out of the capillaries), usually
    caused by a disruption in Starling forces, that
    exceeds the ability of lymphatics to return it to
    the circulation (p. 472-473)

26
(No Transcript)
27
7. Various examples of Edema Formation
EXAMPLE
CAUSE
Pc
(Arteriolar dilation, venous constriction,
heart failure)
pc
(decreased plasma protein concentration, severe
liver failure, nephrotic syndrome loss of
protein in urine)
Burns Inflammation (release of histamines or
cytokines)
Kf
Standing, parasitic infection of lymph nodes
(filariasis)
Impaired Lymphatic drainage
28
EDEMA FROM THE NEPHROTIC SYNDROME
29
7.
Kwashiorkor the one who is displaced
  • Severe protein deficiency and malnutrition
  • Edema results from decreased plasma proteins
  • (decreased albumin in blood).

30
FILARIASIS
Write a Comment
User Comments (0)
About PowerShow.com