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

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{{Point|Intake of water will decrease plasma osmolarity.  This will in turn lead to a decrease in the 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 vasopressin (anti-diuretic hormone, ADH).}}


[[メディア:6-ADHcontrol-water.mp4|動画と音声での説明 ]]<br>
[[メディア:ADHcontrolToWaterIntakeEng.mp4|narrated video explanation]]<br>


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[[ファイル:IncADHeffect1.jpg|left|500px]]
[[ファイル:ADHbeforeWaterIntake-Eng.jpg|left|500px]]
[[メディア:ADHcontrol-water-start.mp4|飲水前の動画]]<br>
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Prior to drinking we assume our subject is in homeostasis with normal plasma and urine osmolarities 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:6-ADHcontrol-water1.jpg|left|500px]]
[[ファイル:ADHControlToWaterIntake1Eng.jpg|left|500px]]
[[メディア:ADHcontrol-water-middle.mp4|飲水直後、調節前の動画]]
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Steps 1 and 2: Water was taken.  Water will enter the plasma and its osmolarity will decrease.  Both intake of water and the ADH/water channels/reabsorption of water by the kidney will decrease plasma osmolarity, having the same effect. Thus, in this case with low plasma osmolarity, the effect of ADH/water channels/reabsorption would be too much.
[[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: 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:WaterDuringADHcontrol.jpg|left|500px]]
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[[メディア:WaterDuringADHcontrol.mp4|飲水に対してADHが低下した直後の動画]]
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Steps 3 and 4: With too much effect of ADH/water channels/reabsorption, the negative feedback decreases (the synthesis, secretion, and blood concentration of) ADH.  The ADH-facilitating effect on the water channels will decrease, decreasing the number of water channels. This decreases the reabsorption of water by the kidney.
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[[ファイル:ADHControlToWaterIntake2Eng.jpg|left|500px]]
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[[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 water reabsorption from the tubule.
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[[ファイル:6-ADHcontrol-water2.jpg|left|500px]]
[[ファイル:ADHControlToWaterIntake3Eng.jpg|left|500px]]
[[メディア:ADHcontrol-water-end.mp4|飲水に対してADHが低下した後の血漿、尿の2次的変化の動画]]
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Step 5:  The ratio of Na+ to water reabsorption by the kidney increases. This means plasma osmolarity increases.  The decreased plasma osmolarity from intake of water will increase returning to normal.  
[[メディア:ADHwaterControl-4Eng.mp4|video showing the changes in plasma and urine after the decrease in the reabsorption]]<br>
Because a higher ratio of Na+ is reabsorbed the fluid left in the tubule now has a lower osmolarity. The decrease in the number of water channels decreases water reabsorption so there is more water. So overall the urine becomes dilute and high volume.
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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  
The negative feedback reaction to an increased intake of water is a(n) {increase~=decrease} of ADH secretion.
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
The negative feedback reaction to an increased intake of water is a(n) {increase~=decrease} of aquaporin channels in the kidney.
 
//LEVEL:2
//RAND
The negative feedback reaction to an increased intake of water is a(n) {increase~=decrease} in water reabsorption by the nephron.
 
//LEVEL:3
//RAND
The negative feedback reaction to an increased intake of water is a(n) {~=increase~decrease} in urine volume.  


//LEVEL:3  
//LEVEL:3  
//RAND  
//RAND  
The negative feedback reaction to an increased intake of water is a(n) {increase~=decrease} of urine osmolarity.
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  
The negative feedback reaction to an increased intake of water is a(n) {~=increase~decrease} of plasma 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
</GIFT>
//RAND
When you drink water the plasma osmolarity {~=decreases~increases}.  This has the effect of {increasing~=decreasing} the release ADH.  This in turn {increases~=decreases} the production of aquaporins by the nephron causing {increased~=decreased} water reabsorption. Urine osmolarity will {increase~=decrease} while volume will {~=increase~decrease}.  This will lead to plasma osmolarity {~=returning to normal~decreasing~=increasing}.

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.