THIRD EDITION

HUMAN PHYSIOLOGY
AN INTEGRATED APPROACH
Dee Unglaub Silverthorn, Ph.D.

Chapter 20, part B

Integrative Physiology II:
Fluid and Electrolyte Balance
PowerPoint Lecture Slide Presentation by
Dr. Howard D. Booth, Professor of Biology, Eastern Michigan University
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Sodium Recycling: Recycling and Excretion

Ascending loop of Henle
H2O impermeable
Na+ Active Transport
To ECF
Gradient
Diffuses to blood
Collecting Duct:
Aldosterone regulates
Na+ recycled or excreted
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Mechanism of Na+ Selective Reabsorption in

Collecting Duct

Aldosterone: steroid H from adrenal cortex

Stimulates Na+ uptake (& K+ secretion)
channel synthesis

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Mechanism of Na+ Selective Reabsorption in

Collecting Duct

Figure 20-12: Aldosterone action in principal cells

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Angiotensin Pathway: Maintains BP , Volume &

Osmolarity Angiotensinogen, ANGI, ANG II, rennin,
& ACE

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Figure 20-13: The renin-angiotensin-aldosterone pathway

Artial Natruretic Peptide: Regulates Na+ & H2O

Excretion

Hormone from myocardial cells

Stimulates: hypothalamus, kidney, adrenal, &
medulla

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Artial Naturetic Peptide: Regulates Na+ & H2O

Excretion

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Figure 20-15: Atrial natriuretic peptide

Potassium Balance:
Critical for Excitable Heart & Nervous Tissues

Hypokalemia low [K+] in ECF, Hyperkalemia high [K+]

Reabsorbed in Ascending Loop, secreted in
Collecting duct

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Potassium Balance:
Critical for Excitable Heart & Nervous Tissues

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Figure 20-4: Osmolarity changes as fluid flows through the nephron

Potassium Balance:
Critical for Excitable Heart & Nervous Tissues

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Figure 20-12: Aldosterone action in principal cells

Response to Dehydration & Osmolarity Imbalance

Thirst & "salt craving", or avoidance behavior

Integrated circulatory & excretory reflexes

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Response to Dehydration & Osmolarity Imbalance

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Figure 20-17 : Homeostatic compensation for severe dehydration

Acid/Base Homeostasis: Overview

Acidosis: plasma pH
Protein damage
CNS depression
Alkalosis: plasma pH
Hyperexcitability
CNS & heart
Buffers: HCO3- & proteins
H+ input: diet & metabolic
H+ output: lungs & kidney
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Acid/Base Homeostasis: Overview

Figure 20-18: Hydrogen balance in the body

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Kidney Hydrogen Ion Balancing: Proximal Tubule

H+ & NH4+ secreted into lumen and excreted

HCO3- is reabsorbed

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Kidney Hydrogen Ion Balancing: Proximal Tubule

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Figure 20-21: Proximal tubule secretion and reabsorption of filtered HCO 3-

Kidney Hydrogen Ion Balancing: Collecting Duct

Type A Intercalated cells excrete H+ absorb HCO3 Type B intercalated cells absorb H+ secrete HCO3-

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Kidney Hydrogen Ion Balancing: Collecting Duct

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Figure 20-22: Role of the intercalated cell in acidosis and alkalosis

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Classifications of Acute Kidney Injury and Chronic Kidney Disease.

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Pathophysiological Features of Acute Kidney Injury Leading to

Chronic Kidney Disease.

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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings

Figure 1
An overview of the pathogenesis of CKD
progression. Although there is considerable
interaction between BP-dependent and BPindependent initiating mechanisms, BPdependent mechanisms predominate in
hypertensive CKD states. BP independent
mechanisms may modulate hypertensive injury
and also contribute to CKD progression in
normotensive states. AR, autoregulation; BP,
blood pressure; CKD, chronic kidney disease; NO,
nitric oxide; RAAS, reninangiotensin
aldosterone system; ROS, reactive oxygen species
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Summary
Electrolyte balance depends on integration of
circulatory, excretory and behavioral physiology
Water recycling and ECF/plasma balance
depends on descending loop of Henle and
vasopressin regulated collecting duct for
conservation
Osmolarity depends on aldosterone and
angiotensin pathway to regulate CNS & endocrine
responses
Along with respiration, proximal tubule and
collecting duct cells reabsorb or excrete H+ &
HCO3- to balance pH
Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings