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

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{{Point|Following water intake, the plasma osmolarity decreases, and negative feedback decreases (synthesis, secretion, and blood concentration of) ADH.}}
{{Point|With water intake, the plasma osmolarity decreases and negative feedback decreases the synthesis, secretion, and blood concentration of ADH.}}


[[メディア:6-ADHcontrol-water.mp4|narrated video explanation]]<br>
[[メディア:6-ADHcontrol-water.mp4|narrated video explanation]]<br>
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[[ファイル:ADHbaseline.jpg|left|500px]]
[[ファイル:ADHbaseline.jpg|left|500px]]
[[メディア:ADHcontrol-water-start.mp4|video prior to water intake]]<br>
[[メディア:ADHcontrol-water-start.mp4|video prior to water intake]]<br>
Prior to water intake, we assume our subject is in homeostasis with normal plasma and urine osmolarities (isotonic) and volumes.
Prior to water intake (at baseline), we will make the assumption that the subject is in homeostasis with normal plasma and urine osmolarities (isotonic) and volumes.  
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[[ファイル:ADHControlToWaterIntake1Eng.jpg|left|500px]]
[[ファイル:ADHControlToWaterIntake1Eng.jpg|left|500px]]
[[メディア:ADHcontrol-water-middle.mp4|video just after water intake]]<br>
[[メディア:ADHcontrol-water-middle.mp4|video just after water intake]]<br>
Step 1: With water intake, water enters the plasma and osmolarity decreases (become hypotonic). <br>
Step 1: With water intake, water enters the plasma and osmolarity decreases (the plasma becomes hypotonic). <br>
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Step 2: ADH, water channels, and reabsorption of water by the kidney decreases plasma osmolarity, having the same effect of water intake. Thus, with low plasma osmolarity following water intake (hypotonic plasma), the plasma osmolarity-decreasing effect of ADH, water channels, and reabsorption would be too much prior to control by negative feedback.  
Step 2: With reabsorption (through the water channels, which are increased by ADH), water enters the plasma and osmolarity decreases. This is same to the effect of water intake. Thus, with the low plasma osmolarity produced by water intake (hypotonic plasma), the baseline strength of the plasma osmolarity-decreasing effect of reabsorption would be too strong. Control by negative feedback is needed.  
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[[ファイル:ADHControlToWaterIntake2Eng.jpg|left|500px]]
[[ファイル:ADHControlToWaterIntake2Eng.jpg|left|500px]]
[[メディア:WaterDuringADHcontrol.mp4|video just after the decrease in ADH following water intake]]<br>
[[メディア:WaterDuringADHcontrol.mp4|video just after the decrease in ADH caused by water intake]]<br>
Step 3: With too much of an effect of ADH, water channels, and reabsorption, the negative feedback decreases (synthesis, secretion, and blood concentration of) ADH.<br>
Step 3: With the baseline effect of the reabsorption being too strong, the negative feedback decreases the synthesis, secretion, and blood concentration of ADH.<br>
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Step 4: The water channel-increasing effect of ADH decreases, thereby decreasing the number of water channels. This decreases the reabsorption of water by the kidney.  
Step 4: The water channel-increasing effect of ADH decreases, thereby decreasing the number of water channels. This decreases the reabsorption of water by the kidney.
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[[ファイル:ADHControlToWaterIntake3Eng.jpg|left|500px]]
[[ファイル:ADHControlToWaterIntake3Eng.jpg|left|500px]]
[[メディア:ADHcontrol-water-end.mp4|video showing the changes in plasma and urine after the decrease in ADH caused by negative feedback following water intake]]<br>
[[メディア:ADHcontrol-water-end.mp4|video showing the changes in plasma and urine after the decrease in ADH caused by water intake]]<br>
Step 5: The ratio of Na+ to water reabsorption by the kidney increases. This means plasma osmolarity increases. Briefly, the decreased plasma osmolarity from water intake (hypotonic plasma) increases and returns to normal (isotonic). Because a higher ratio of Na+ is reabsorbed, the fluid remaining in the tubule now has a lower osmolarity (hypotonic). Also, with decreases in water reabsorption, there is more water. Overall, the urine becomes less concentrated (hypotonic) and higher in volume.
Step 5: The ratio of Na<sup>+</sup> to water entering the plasma due to reabsorption increases. This increases plasma osmolarity. This will lead to a increase in the decreased plasma osmolarity from water intake (hypotonic plasma), returning it towards normal (baseline) osmolarity (isotonic plasma). Because a higher ratio of Na<sup>+</sup> to water enters the tubule due to reabsorption, the fluid remaining in the tubule has a lower osmolarity (hypotonic). Also, with an decrease in water reabsorption, there is more water remaining in the tubule. Overall, the urine becomes less concentrated (hypotonic) and higher in volume.  
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//LEVEL:2  
//LEVEL:2  
//RAND  
//RAND  
Following water intake, negative feedback {increases~=decreases} (synthesis, secretion, and blood concentration of) ADH.
With water intake, negative feedback {increases~=decreases} the synthesis, secretion, and blood concentration of ADH.


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
Following water intake, negative feedback {increases~=decreases} water channels in the kidney.  
With water intake, negative feedback {increases~=decreases} the number of water channels in the kidney.  


//LEVEL:2  
//LEVEL:2  
//RAND  
//RAND  
Following water intake, negative feedback {increases~=decreases} water reabsorption by the kidney.
With water intake, negative feedback {increases~=decreases} water reabsorption by the kidney.


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
Following water intake, negative feedback {~=increases~decreases} urine volume.  
With water intake, negative feedback {~=increases~decreases} urine volume.  


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
Following water intake, negative feedback {increases~=decreases} urine osmolarity.
With water intake, negative feedback {increases~=decreases} urine osmolarity.


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
Following water intake, negative feedback {~=increases~decreases} plasma osmolarity.
With water intake, negative feedback {~=increases~decreases} plasma osmolarity.


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
Following water intake, the plasma osmolarity {~=decreases~increases}.  The effect would be the {=same as~opposite to} that of ADH, water channels and reabsorption of water by the kidney, which {=decreases~increases} plasma osmolarity.  The effect of (synthesis, secretion, and blood concentration of) ADH would be {too little~=too much}.  Negative feedback {~increases~=decreases}  (synthesis, secretion, and blood concentration of) ADH.  This in turn {increases~=decreases} the production of water channels in the kidney causing {increased~=decreased} water reabsorption. Urine osmolarity will {increase~=decrease} while volume will {~=increase~decrease}.  This will {decrease~=increase} plasma osmolarity, {~=returning to normal~separating from normal}.
With water intake, 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 reabsorption would be {too little~=too much}.  Negative feedback {~increases~=decreases}  the synthesis, secretion, and blood concentration of ADH.  This in turn {increases~=decreases} the production of water channels in the kidney causing {increased~=decreased} water reabsorption. Urine osmolarity will {increase~=decrease} while volume will {~=increase~decrease}.  This will {decrease~=increase} plasma osmolarity, {~=returning to normal~separating from normal}.
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2019年7月25日 (木) 15:58時点における版

POINT!

narrated video explanation

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

ADHControlToWaterIntake1Eng.jpg

video just after water intake
Step 1: With water intake, water enters the plasma and osmolarity decreases (the plasma becomes hypotonic).

Step 2: With reabsorption (through the water channels, which are increased by ADH), water enters the plasma and osmolarity decreases. This is same to the effect of water intake. Thus, with the low plasma osmolarity produced by water intake (hypotonic plasma), the baseline strength of the plasma osmolarity-decreasing effect of reabsorption would be too strong. Control by negative feedback is needed.

ADHControlToWaterIntake2Eng.jpg

video just after the decrease in ADH caused by water intake
Step 3: With the baseline effect of the reabsorption being too strong, the negative feedback decreases the synthesis, secretion, and blood concentration of ADH.

Step 4: The water channel-increasing effect of ADH decreases, thereby decreasing the number of water channels. This decreases the reabsorption of water by the kidney.

ADHControlToWaterIntake3Eng.jpg

video showing the changes in plasma and urine after the decrease in ADH caused by water intake
Step 5: The ratio of Na+ to water entering the plasma due to reabsorption increases. This increases plasma osmolarity. This will lead to a increase in the decreased plasma osmolarity from water intake (hypotonic plasma), returning it towards normal (baseline) osmolarity (isotonic plasma). Because a higher ratio of Na+ to water enters the tubule due to reabsorption, the fluid remaining in the tubule has a lower osmolarity (hypotonic). Also, with an decrease in water reabsorption, there is more water remaining in the tubule. Overall, the urine becomes less concentrated (hypotonic) and higher in volume.

Challenge Quiz

1.

With water intake, negative feedback increases decreases the synthesis, secretion, and blood concentration of ADH.

2.

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

3.

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

4.

With water intake, negative feedback increases decreases urine volume.

5.

With water intake, negative feedback increases decreases urine osmolarity.

6.

With water intake, negative feedback increases decreases plasma osmolarity.

7.

With water intake, 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 reabsorption would be too little too much . Negative feedback increases decreases the synthesis, secretion, and blood concentration of ADH. This in turn increases decreases the production of water channels in the kidney causing increased decreased water reabsorption. Urine osmolarity will increase decrease while volume will increase decrease . This will decrease increase plasma osmolarity, returning to normal separating from normal .