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MindMap Gallery Physiology—production and excretion of urine

Physiology—production and excretion of urine

This is a mind map about physiology - the production and excretion of urine. It is full of useful information, interested friends can refer to it.

Edited at 2023-11-16 17:43:57

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Physiology—production and excretion of urine

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Outline

production and excretion of urine

discharge of urine

nature

Innervation of bladder and urethra

micturition reflex

clearance rate

Concepts and calculations

significance

Measuring the glomerular filtration rate (GFR)

Inulin

Neither reabsorbed nor secreted

Accurate results, easy to operate

endogenous creatinine clearance

Determination of renal plasma flow, filtration fraction and renal blood flow

Presumed renal tubular function

Regulation of urine production

neuromodulation

body fluid regulation

Antidiuretic hormone ADH (vasopressin AVP)

adjust

Plasma crystal osmolality → hypothalamic osmoreceptor (most important)

circulating blood volume

arterial blood pressure

other factors

Renin-angiotensin-aldosterone system (RAAS)

Aldosterone function

adjust

atrial natriuretic peptide

Physiological significance of regulation of urinary production

Maintain body water balance and electrolyte balance (Na, K, Ca)

Maintain the body's acid-base balance

Functional anatomy of the kidney and renal blood flow

Functional unit of kidney - nephron

nephron

collecting tube

Cortical nephron and juxtamedullary nephron

juxtabulbar

Location

Mainly distributed in cortical nephron

composition

juxtaglomerular cells

Synthesis, storage and release of renin

macula densa

Tube-ball feedback

Sensing changes in NaCl content in tubular fluid, transmits information to juxtaglomerular cells, regulates renin secretion, and thereby regulates urine production

extraglomerular mesangial cells

swallow, shrink

filter membrane

constitute

capillary endothelial cells

capillary endothelial cell basement membrane

Podocyte (kidney capsule epithelial cells) slit membrane

Schizosin

leakage of constituent proteins

adjust

Intraclobular mesangium (vasculature)

By contracting or relaxing mesangial cells, the area of the filtration membrane and the glomerular filtration coefficient are adjusted to affect urine production.

vasoconstrictor substance

Vasopressin (antidiuretic hormone), norepinephrine, angiotensin II, endothelin, thromboxane A2

vasodilator

Atrial natriuretic peptide, prostaglandin E2, prostacyclin, dopamine, NO

Factors affecting filter membrane permeability

The size of the filtration membrane pores (filtered material)

The charge carried by the filter membrane (filtered substance)

innervation of kidneys

Sympathetic nerve

Characteristics and regulation of renal blood flow (RBF)

1200ml/min

Most supplies renal cortex

adjust

mechanism

myogenic theory

tube-ball feedback theory

Nervous and humoral regulation

glomerular filtration function

glomerular filtration

Filtrate components

Same as plasma except for protein

glomerular filtration rate and filtration fraction

Glomerular filtration rate (GFR)

filtration fraction (FF)

about 1/5

acute glomerulonephritis

Renal blood flow does not change much, glomerular filtration rate decreases→filtration fraction decreases

heart failure

Renal blood flow decreases, glomerular filtration rate remains unchanged → filtration fraction increases

Effective filtration pressure

determining factors

Promote

glomerular capillary hydrostatic pressure

Colloidal osmotic pressure of renal capsule fluid

confrontation

intrarenal intracapsular pressure

glomerular capillary plasma colloid osmotic pressure

Glomerular effective filtration pressure = (glomerular capillary hydrostatic pressure intracystic fluid colloid osmotic pressure) - (plasma colloid osmotic pressure renal glomerular intracapsular pressure) = (45 0) - (25 10) = 10mmHg

Factors affecting glomerular filtration

glomerular capillary filtration coefficient

Filter coefficient (Kf)

=Effective transmission coefficient (k)×filtration area (s)

Effective filtration pressure

glomerular capillary blood pressure

intracystic pressure

plasma colloid osmotic pressure

renal plasma flow

Substance transport function of renal tubules and collecting ducts

How substances are transported in the renal tubules and collecting ducts

Tubular and collecting duct reabsorption is large and highly selective

canalicular fluid

final urine

1.5L/d

Reabsorption by renal tubules and collecting ducts

99% of water is reabsorbed by renal tubules and collecting ducts

Glucose and amino acids are all reabsorbed

Na, Ca, urea partially reabsorbed

Creatinine, H can be secreted and excreted from the body

Secretion of renal tubules and collecting ducts

excretion

Includes substances filtered by the glomerulus but not reabsorbed Substances excreted in the urine by renal tubular secretion

How substances are transported

Passive transport Active transport

Reabsorption of Na, Cl and water

Proximal tubule (65%~70%)

anterior half of proximal tubule

posterior half of proximal tubule

Marrow loop (20%)

The thin segment of the descending branch of the medullary loop has very low permeability to solutes

The thin segment of the ascending branch of the medullary loop is impermeable to water, but easily permeable to Na and Cl (facilitated diffusion)

The thick ascending branch of the medullary loop has high metabolic activity and active reabsorption of Na, K, and Cl.

Na-K pump at the base of epithelial cells → low intracellular Na → conducive to Na reabsorption

Type II Na-K-Cl symporter (NKCC2)

Na, K, Ca paracellular pathway

Impermeable to water → absorb and separate water and salt

Distal tubule and collecting duct (12%)

distal tubule

Reabsorb Na, Cl

Does not reabsorb water

collecting tube

chief cell

Reabsorb Na, Cl, water

Secretion K

leap cells

secrete H

HCO3 reabsorption and H secretion

proximal tubule

marrow loop

distal tubule

Na-H exchange

collecting tube

A type intercalary cells

proton pump

hydrogen pump

potassium hydrogen pump

The relationship between the secretion of NH3 and NH4 and the transport of H and HCO3

K reabsorption and secretion

Proximal tubule (65%~70%)

Medullary loop (25%~30%)

Glucose and amino acid reabsorption

Calcium reabsorption and excretion

proximal tubule

Mostly via solvent drag→paracellular pathway

Thick segment of ascending branch of medullary loop

distal tubule collecting duct

Active transport across cellular pathways

Reabsorption and excretion of urea

Intrarenal urea recirculation

Renal tubular urea reabsorption

The thin segment of the ascending branch of the medullary loop → the cortex and outer medullary collecting duct: impermeable to urea → water is continuously reabsorbed → the concentration of urea in the collecting duct continues to increase

Inner medullary collecting duct: urea channel proteins (UT-A1 and UT-A3)

Highly transparent to urea

Thin segment of descending branch of medullary loop: UT-A2

Highly transparent to urea

The influence of small blood vessels on urea osmotic gradient

Factors affecting reabsorption and secretion in renal tubules and collecting ducts

Concentration of solute in tubular fluid

Osmotic diuresis

diabetes

ball-tube balance

Concentration and dilution of urine

Urine concentration mechanism

reason

Water is reabsorbed while solutes remain in the tubular fluid

necessary factors

Permeability of collecting duct to water

antidiuretic hormone (ADH)

Increase the expression of AQP2 at the apex of renal collecting duct epithelial cells

The interstitial fluid in the renal medullary forms a hypertonic concentration gradient

counter current multiplication mechanism

countercurrent

Counter flow system

countercurrent multiplication

Renal medullary interstitial fluid hyperosmotic concentration gradient

form

The formation of high osmotic concentration gradient of interstitial fluid in the outer marrow

Active reabsorption of NaCl by the thick ascending branch of the medullary loop

NKCC2

Na active reabsorption, Cl secondary active reabsorption

Formation of high osmotic concentration gradient of interstitial fluid in the inner marrow

Reabsorption of urea NaCl by collecting ducts and ascending limbs of medullary loops

Formative elements

premise

Each segment of renal tubule and collecting duct has different permeability to water, urea, and NaCl

Starting power

The thick ascending branch of the medullary loop actively reabsorbs NaCl and is impermeable to water → increases the osmotic concentration of the outer medullary interstitial fluid

The thin segment of the descending branch of the medullary loop is permeable to water but impermeable to NaCl → increases the osmotic concentration of tubular fluid

The thin segment of the ascending branch of the medullary loop is impermeable to water but permeable to NaCl → the high concentration of NaCl in the tubular fluid diffuses into the inner marrow

Urea recirculation→increases urea concentration and forms hypertonic interstitial fluid in the inner marrow together with NaCl

The fluid in the small tubes is continuously filtered, driving the flow

The mechanism of countercurrent exchange in the recta small vessels

Blood in the descending branch of the small vessel recta

Diffusion of solutes from medullary interstitial fluid into small vessels

Water diffuses from blood vessels into medullary interstitial fluid

blood in the ascending branch of the recta small vessel

Diffusion of solutes from blood into interstitial fluid

Water enters blood vessels from interstitial fluid

effect

It prevents the solutes in the medullary interstitial fluid from being taken away by the circulating blood, and only returns the excess water and solutes to the blood circulation to maintain the high osmotic pressure of the renal medullary interstitial fluid.

Antidiuretic hormone promotes water reabsorption in the collecting duct and concentrates urine

Factors affecting urine concentration and dilution

Adjustment part

Mainly in the collecting tube

Factors affecting the formation of renal medullary hypertonicity (the power of water reabsorption)

The thick ascending branch of the medullary loop actively reabsorbs NaCl

inhibitor

Loop diuretic-furosemide

Malnutrition, long-term insufficient protein intake → reduction of urea → affecting urea recycling

Length of medullary loops and number of juxtamedullary nephrons

Factors affecting water permeability of collecting duct (determination of water reabsorption amount)

ADH

Deficiency → diabetes insipidus

Straight small vessel blood flow and blood flow velocity

clinical examples