PHIS 206 Lecture Notes - Lecture 21: Tubular Fluid, Clearance Rate, Reabsorption

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blueskunk578

2 May 2018

School

VCU

Department

Physiology and Biophysics

Course

PHIS 206

Professor

Charles Anderson; Steven Price

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Lecture 21: Excretion & Balance

All Together

• Filtration is simple and passive, driven by the pressures of the capillary.

• Reabsorption, for the most part, is an active process (proteins recognize components of

filtrate and transport them to the blood - carrier-mediated transport)

• Secretion is an active process (carrier-mediated transport from blood into tubular fluid)

Excretion

• Following filtration, reabsorption, and secretion, the tubular fluid (urine) achieves its

final form. This urine is excreted from the kidney and body. Don’t confuse secretion with

excretion.

• An excretion rate speaks to amount of substance x that leaves the kidney with respect to

time.

• Excretion rate of x = (Urine Flow Rate) x (Urine Concentration of x)

• Know formula

Excretion Rate

• So, if nearly everything is filtered (with exceptions), it truly is the amount (the rates) of

reabsorption and secretion that controls the excretion of a substance.

• For example, if something is nearly completely reabsorbed, there will be none of the

substance remaining in the urine. Excretion rate would be zero.

• But, if something is filtered freely, and then heavily secreted as well, it will have a very

high excretion rate.

• Secretion is getting rid of a substance

This Suggests Math…

• Physiologists have been able to figure out how the kidney handles a substance by

measuring the filtration of the substance and the excretion of the same substance...

• If the excretion of a substance is less than the filtration of the same substance → the

substance must have been reabsorbed***

• And, if the excretion of a substance is greater than the filtration of the same substance →

the substance must have been secreted***

But Isn’t This About the Blood?

• The blood was the original focus - the kidney conditions the blood. So

measurements/descriptions can focus on the substance (excretion rate), or we can focus

on the blood flowing through the kidney instead.

• This creates the odd concept of clearance.

• The clearance of a substance is the amount of blood that the kidney clears of the

substance with respect to time.

• Only place the kidney can find a place to get rid of is the blood

• Clearance rate speaks to the blood, secretion rate speaks to the substance

• If excretion is high, than clearance is high

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Document Summary

Excretion: following filtration, reabsorption, and secretion, the tubular fluid (urine) achieves its final form. This urine is excreted from the kidney and body. Don"t confuse secretion with excretion: an excretion rate speaks to amount of substance x that leaves the kidney with respect to time, excretion rate of x = (urine flow rate) x (urine concentration of x, know formula. Excretion rate would be zero: but, if something is filtered freely, and then heavily secreted as well, it will have a very high excretion rate, secretion is getting rid of a substance. This suggests math : physiologists have been able to figure out how the kidney handles a substance by measuring the filtration of the substance and the excretion of the same substance But isn"t this about the blood: the blood was the original focus - the kidney conditions the blood. If excretion is high, than clearance is high.

Related Questions

1. Which hormone responsible for calcium absorption is synthesized by the kidneys?
a. Calcitriol b. Glucagon c. Erythropoietin d. Antidiuretic hormone

2. Which of the following regulations is not performed by the kidney?
a. acid-base balance b. blood pressure c. glycolysis d. blood production

3. The hormone require for blood pressure regulation and release by the kidney is _____.
a. erythropoietin b. renin c. calcitriol

4. Almost all nutrients and about 65% of sodium are actively reabsorbed in this part of the nephron, transported from the filtrate back to the plasma.
a. proximal tubule b. descending limb c. ascending limb d. collecting duct

5. Which site is where most regulation happens?
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False

amaranthfrog191

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False