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

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


[[メディア:ADHwaterintake.mp4|narrated video explanation]]<br>
[[メディア:ADHcontrolToWaterIntakeEng.mp4|narrated video explanation]]<br>


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[[ファイル:ADHbaseline-Eng.jpg|left|500px]]
[[ファイル:ADHbeforeWaterIntake-Eng.jpg|left|500px]]
[[メディア:ADHbaseline-Eng.mp4|video prior to water intake]]<br>
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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.  
[[メディア:ADHbeforeWaterIntake-Eng.mp4|video before water intake]]<br>
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Before water intake (at baseline), we will make the assumption that the subject is in homeostasis with adequate strength of the plasma osmolarity-decreasing effect of water  reabsorption (through the water channels, which are increased by vasopressin, ADH) as well as normal plasma and urine osmolarities (isotonic) and urine volume.  
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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>
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Step 1: With water intake, water enters the plasma and osmolarity decreases (the plasma becomes hypotonic). <br>
[[メディア:ADHwaterControl-2Eng.mp4|video just after water intake]]<br>
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Step 1: With water intake, water enters the plasma and osmolarity decreases (diluted, hypotonic). <br>
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Step 2: With reabsorption (through the water channels, which are increased by vasopressin, ADH, water enters the plasma and osmolarity decreases. This is the same effect as 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.  
Step 2: This is in the same direction as the plasma osmolarity-decreasing effect of the water reabsorption (through the water channels, which are increased by vasopressin, ADH). Thus, although the strength of the plasma osmolarity-decreasing effect of water reabsorption (through the water channels, which are increased by vasopressin, ADH) was adequate before water intake (at baseline), this strength is now <font color="#ff0000">too strong (red)</font> to reverse the decreased plasma osmolarity (diluted, hypotonic) produced by water intake. Control by negative feedback is needed. <br style="clear:both;" />
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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 vasopressin (ADH) caused by water intake]]<br>
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Step 3: With the baseline effect of the reabsorption (through the water channels, which are increased by vasopressin, ADH) being too strong, the negative feedback decreases the synthesis, secretion, and blood concentration of vasopressin (ADH).<br>
[[メディア:ADHwaterControl-3Eng.mp4|video just after the decrease in vasopressin (ADH) caused by negative feedback]]<br>
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Step 3: With the strength of the plasma osmolarity-decreasing effect of the water reabsorption (through the water channels, which are increased by vasopressin, ADH) before water intake (at baseline) being <font color="#ff0000">too strong (red)</font>, the negative feedback <font color="#00f">decreases (blue)</font> (the synthesis, secretion, and blood concentration of) vasopressin (ADH). <br>
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Step 4: The water channel-increasing effect of vasopressin (ADH) becomes weaker, which decreases the number of water channels. This decreases the reabsorption of water by the kidney.
Step 4: The water channel-increasing effect of vasopressin (ADH) becomes weaker, which decreases the number of water channels. This decreases the water reabsorption from the tubule.
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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 vasopressin (ADH) caused by water intake]]<br>
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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 an 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 leaves the tubule due to reabsorption, the fluid remaining in the tubule has a lower osmolarity (hypotonic). Also, with a decrease in water reabsorption, there is more water remaining in the tubule. Overall, the urine becomes less concentrated (hypotonic) and higher in volume.  
[[メディア:ADHwaterControl-4Eng.mp4|video showing the changes in plasma and urine after the decrease in the reabsorption]]<br>
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Step 5: With the decrease in water reabsorption, concentrated (hypertonic) solution enters the plasma. This will lead to a reverse in the decreased plasma osmolarity (diluted, hypotonic) produced by water intake, increasing it towards normal (baseline, isotonic) osmolarity. Because concentrated (hypertonic) solution leaves the tubule due to reabsorption, the fluid remaining in the tubule has a decreased osmolarity (diluted, hypotonic). Also, with the decrease in water reabsorption, there is more water remaining in the tubule. Overall, the urine becomes diluted and increases in volume.
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//LEVEL:2  
//LEVEL:2  
//RAND  
//RAND  
With water intake, negative feedback {increases~=decreases} the synthesis, secretion, and blood concentration of vasopressin (anti-diuretic hormone, ADH).
With water intake, the plasma osmolarity decreases, and negative feedback {increases~=decreases} the synthesis, secretion, and blood concentration of vasopressin (anti-diuretic hormone, ADH).
 
//LEVEL:3
//RAND
With water intake, negative feedback {increases~=decreases} the number of water channels in the kidney.
 
//LEVEL:2
//RAND
With water intake, negative feedback {increases~=decreases} water reabsorption by the kidney.


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
With water intake, negative feedback {~=increases~decreases} urine volume.  
With water intake, the plasma osmolarity {~increases~=decreases}. This is in the {~=same direction as~opposite direction to} the plasma {~osmolarity-increasing~=osmolarity-decreasing} effect of the water reabsorption from the tubule (through the water channels, which are increased by vasopressin, ADH). The negative feedback {~increases~=decreases} (the synthesis, secretion, and blood concentration of) vasopressin (ADH). This will {~=increase~decrease} plasma osmolarity (towards isotonic).


//LEVEL:3
//LEVEL:4
//RAND  
//RAND  
With water intake, negative feedback {increases~=decreases} urine osmolarity.
With water intake, water {~=enters~leaves} the plasma and osmolarity {~increases~=decreases}. This is in the {~=same direction as~opposite direction to} the plasma osmolarity-decreasing effect of the water reabsorption (through the water channels, which are increased by vasopressin, ADH). Thus, although the strength of the plasma osmolarity-decreasing effect of water reabsorption (through the water channels, which are increased by vasopressin, ADH) was {~too strong~=adequate~too weak} before water intake (at baseline), this strength is now {~=too strong~adequate~too weak} to reverse the {~increased~=decreased} plasma osmolarity produced by water intake. The negative feedback {~increases~=decreases} (the synthesis, secretion, and blood concentration of) vasopressin (ADH). The water channel-increasing effect of vasopressin (ADH) becomes {~stronger~=weaker}, which {~increases~=decreases} the number of water channels. With the {~increases~=decrease} in water reabsorption from the tubule, {~=concentrated~diluted} solution enters the plasma. This will lead to a reverse in the {~increased~=decreased} plasma osmolarity from water intake, {~=increasing~decreasing} it {~=towards~separate from} normal osmolarity. Because {~=concentrated~diluted} solution leaves the tubule due to reabsorption, the fluid remaining in the tubule has {~an increased~=a decreased} osmolarity. Also, with the {~ increase~=decrease} in water reabsorption, there is {~=more~less} water remaining in the tubule. Overall, the urine becomes {~concentrated~=diluted} and {~=increases~decreases} in volume.


//LEVEL:3
//RAND
With water intake, negative feedback {~=increases~decreases} plasma osmolarity.
//LEVEL:3
//RAND
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 vasopressin (anti-diuretic hormone, 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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2020年3月31日 (火) 17:53時点における最新版

POINT!

narrated video explanation

ADHbeforeWaterIntake-Eng.jpg

Before water intake (at baseline), we will make the assumption that the subject is in homeostasis with adequate strength of the plasma osmolarity-decreasing effect of water reabsorption (through the water channels, which are increased by vasopressin, ADH) as well as normal plasma and urine osmolarities (isotonic) and urine volume.


ADHControlToWaterIntake1Eng.jpg

Step 1: With water intake, water enters the plasma and osmolarity decreases (diluted, hypotonic).

Step 2: This is in the same direction as the plasma osmolarity-decreasing effect of the water reabsorption (through the water channels, which are increased by vasopressin, ADH). Thus, although the strength of the plasma osmolarity-decreasing effect of water reabsorption (through the water channels, which are increased by vasopressin, ADH) was adequate before water intake (at baseline), this strength is now too strong (red) to reverse the decreased plasma osmolarity (diluted, hypotonic) produced by water intake. Control by negative feedback is needed.





ADHControlToWaterIntake2Eng.jpg

Step 3: With the strength of the plasma osmolarity-decreasing effect of the water reabsorption (through the water channels, which are increased by vasopressin, ADH) before water intake (at baseline) being too strong (red), the negative feedback decreases (blue) (the synthesis, secretion, and blood concentration of) vasopressin (ADH).

Step 4: The water channel-increasing effect of vasopressin (ADH) becomes weaker, which decreases the number of water channels. This decreases the water reabsorption from the tubule.


ADHControlToWaterIntake3Eng.jpg

Step 5: With the decrease in water reabsorption, concentrated (hypertonic) solution enters the plasma. This will lead to a reverse in the decreased plasma osmolarity (diluted, hypotonic) produced by water intake, increasing it towards normal (baseline, isotonic) osmolarity. Because concentrated (hypertonic) solution leaves the tubule due to reabsorption, the fluid remaining in the tubule has a decreased osmolarity (diluted, hypotonic). Also, with the decrease in water reabsorption, there is more water remaining in the tubule. Overall, the urine becomes diluted and increases in volume.

Challenge Quiz

1.

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

2.

With water intake, the plasma osmolarity increases decreases . This is in the same direction as opposite direction to the plasma osmolarity-increasing osmolarity-decreasing effect of the water reabsorption from the tubule (through the water channels, which are increased by vasopressin, ADH). The negative feedback increases decreases (the synthesis, secretion, and blood concentration of) vasopressin (ADH). This will increase decrease plasma osmolarity (towards isotonic).

3.

With water intake, water enters leaves the plasma and osmolarity increases decreases . This is in the same direction as opposite direction to the plasma osmolarity-decreasing effect of the water reabsorption (through the water channels, which are increased by vasopressin, ADH). Thus, although the strength of the plasma osmolarity-decreasing effect of water reabsorption (through the water channels, which are increased by vasopressin, ADH) was too strong adequate too weak before water intake (at baseline), this strength is now too strong adequate too weak to reverse the increased decreased plasma osmolarity produced by water intake. The negative feedback increases decreases (the synthesis, secretion, and blood concentration of) vasopressin (ADH). The water channel-increasing effect of vasopressin (ADH) becomes stronger weaker , which increases decreases the number of water channels. With the increases decrease in water reabsorption from the tubule, concentrated diluted solution enters the plasma. This will lead to a reverse in the increased decreased plasma osmolarity from water intake, increasing decreasing it towards separate from normal osmolarity. Because concentrated diluted solution leaves the tubule due to reabsorption, the fluid remaining in the tubule has an increased a decreased osmolarity. Also, with the increase decrease in water reabsorption, there is more less water remaining in the tubule. Overall, the urine becomes concentrated diluted and increases decreases in volume.