「SHolroydAtWeilCornellMedQatar/Endocrinology/VasopressinADH/ControlToSweating」の版間の差分

提供:一歩一歩
ナビゲーションに移動 検索に移動
編集の要約なし
編集の要約なし
35行目: 35行目:
[[ファイル:ADHControlToSweating3Eng.jpg|left|500px]]
[[ファイル:ADHControlToSweating3Eng.jpg|left|500px]]
[[メディア:ADHsweatControl-4Eng.mp4|video showing the changes in plasma and urine after the increase in vasopressin (ADH) caused by sweating]]<br>
[[メディア:ADHsweatControl-4Eng.mp4|video showing the changes in plasma and urine after the increase in vasopressin (ADH) caused by sweating]]<br>
Step 5: The ratio of Na<sup>+</sup> to water entering the plasma due to reabsorption decreases. This decreases plasma osmolarity. This will lead to a decrease in the increased plasma osmolarity from sweating (hypertonic plasma), returning it towards normal (baseline) osmolarity (isotonic plasma). Because a lower ratio of Na<sup>+</sup> to water leaves the tubule due to reabsorption, the fluid remaining in the tubule has a higher osmolarity (hypertonic). Also, with the increase in water reabsorption, there is less water remaining in the tubule. Overall, the urine becomes more concentrated (hypertonic) and lower in volume.
Step 5: With increase in water reabsorption, thinner (hypotonic) solution enters the plasma. This decreases plasma osmolarity. This will lead to a decrease in the increased plasma osmolarity from sweating (hypertonic plasma), returning it towards normal (baseline) osmolarity (isotonic plasma). Because thinner (hypotonic) solution leaves the tubule due to reabsorption, the fluid remaining in the tubule has a higher osmolarity (hypertonic). Also, with the increase in water reabsorption, there is less water remaining in the tubule. Overall, the urine becomes more concentrated (hypertonic) and lower in volume. <br style="clear:both;" />
<br style="clear:both;" />
</div>
</div>



2019年9月15日 (日) 07:11時点における版

POINT!

narrated video explanation

ADHbaseline-Eng.jpg

video prior to sweating
Prior to sweating (at baseline), we will make the assumption that the subject is in homeostasis with normal plasma and urine osmolarities (isotonic) and urine volume.

ADHControlToSweating1Eng.jpg

video just after sweating
Step 1: With sweating, water leaves the plasma and osmolarity increases (the plasma becomes hypertonic).

Step 2: With reabsorption (through the water channels, which are increased by vasopressin, ADH), water enters the plasma and osmolarity decreases. This is the opposite effect of sweating. Thus, with the high plasma osmolarity produced by sweating (hypertonic plasma), the baseline strength of the plasma osmolarity-decreasing effect of reabsorption would be too weak. Control by negative feedback is needed.





ADHControlToSweating2Eng.jpg

video just after the increase in vasopressin (ADH) caused by sweating
Step 3: With the baseline effect of the reabsorption (through the water channels, which are increased by vasopressin, ADH) being too weak, the negative feedback increases the synthesis, secretion, and blood concentration of vasopressin (ADH).

Step 4: The water channel-increasing effect of vasopressin (ADH) becomes stronger, which increases the number of water channels. This increases the reabsorption of water by the kidney.

ADHControlToSweating3Eng.jpg

video showing the changes in plasma and urine after the increase in vasopressin (ADH) caused by sweating
Step 5: With increase in water reabsorption, thinner (hypotonic) solution enters the plasma. This decreases plasma osmolarity. This will lead to a decrease in the increased plasma osmolarity from sweating (hypertonic plasma), returning it towards normal (baseline) osmolarity (isotonic plasma). Because thinner (hypotonic) solution leaves the tubule due to reabsorption, the fluid remaining in the tubule has a higher osmolarity (hypertonic). Also, with the increase in water reabsorption, there is less water remaining in the tubule. Overall, the urine becomes more concentrated (hypertonic) and lower in volume.

Challenge Quiz

1.

With sweating, negative feedback increases decreases the synthesis, secretion, and blood concentration of vasopressin (anti-diuretic hormone, ADH).

2.

With sweating, negative feedback increases decreases the number of water channels in the kidney.

3.

With sweating, negative feedback increases decreases water reabsorption by the kidney.

4.

With sweating, negative feedback increases decreases urine volume.

5.

With sweating, negative feedback increases decreases urine osmolarity.

6.

With sweating, negative feedback increases decreases plasma osmolarity.

7.

With sweating, the plasma osmolarity decreases increases . The effect would be the same as opposite to that of reabsorption of water by the kidney, which decreases increases plasma osmolarity. The effect of the reabsorption would be too weak too strong prior to control by negative feedback. Negative feedback increases decreases the synthesis, secretion, and blood concentration of vasopressin (anti-diuretic hormone, ADH). This in turn increases decreases the number of water channels in the kidney causing increased decreased water reabsorption. Urine osmolarity increases decreases while volume increases decreases . This decreases increases plasma osmolarity, returning to normal separating from normal .