18.

1 FUNCTIONS OF THE URINARY SYSTEM ● Outer cortex ​and i​ nner medulla​; together
● Major excretory system of the body surround the renal sinus
● 2 ​kidneys​ (primary excretory organs) ● Bases of ​renal pyramids​ are located at the
○ Each kidney's waste products are boundary between the cortex and the
carried by a ​ureter -> single urinary medulla, while the tips of these pyramids
bladder )then emptied by the project toward the center of the kidney
urethra​) ● Calyx​ (​funnel-shaped​) surrounds tip of each
○ Each filter a large volume of blood renal pyramid
(waste from blood are collected and ○ Calyces join to form a larger funnel
form urine) called the ​renal pelvis​, which
● Urine consists of ​excess water, excess ions, narrows to form the ​ureter​, which
metabolic wastes (urea), and toxic exits the kidney and connects to the
substances urinary bladder
● As long as 1/3 of one kidney remains ● Flow of urine
functional, survival is possible ○ Tips of renal pyramids -> calyces ->
renal pelvis -> ureter -> bladder
Functions:
1. Excretion - ​remove waste products from the The Nephron
blood ● Functional unit of each kidney
2. Regulation of blood volume and pressure ● 1.3 million in each kidney
3. Regulation of the concentration of solutes ● Consists of ​renal corpuscle, proximal
in the blood convoluted tubule ​in the cortex, ​loop of
4. Regulation of extracellular fluid pH Henle​ with sections in both the cortex and
5. Regulation of red blood cell synthesis the medulla, and a ​distal convoluted tubule
6. Regulation of vitamin D synthesis also with sections in both the cortex and the
medulla
18.2 ANATOMY OF THE KIDNEYS ● Blood is filtered in the renal corpuscle
LOCATION AND EXTERNAL ANATOMY OF THE ○ Filtered fluid then flows -> proximal
KIDNEYS convoluted tubule -> loop of Henle
● Behind the peritoneum, ​retroperitoneal
● Located on each side of the vertebral column ● Each loop of Henle consists of a ​descending
● Bean-shaped, size of a tightly clenched fist limb​ and an ​ascending limb
● Renal capsule​ surrounds each kidney; a ● Limbs are further categorizes into ​a thin
thick layer of adipose tissue surrounds the segment of descending limb, thin segment
renal capsule, protects kidney from of the ascending limb, and thick segment
mechanical shock of the ascending limb
● Hilum - ​on the medial side of each kidney; ● Descending limb extends ​toward the renal
where the renal artery and nerves enter and sinus​ -> hairpin turn
where the renal vein, ureter, and lymphatic ● Ascending limb extends back​ toward the
vessels exit the kidney cortex
○ Opens into ​renal sinus​, which ● Filtered fluid flows -> ascending limb of the
contains blood vessels, part of the loop of Henle -> distal convoluted tubule ->
system for collecting urine, and collecting duct​, which carries fluid from
adipose tissue cortex -> ​single papillary duct​ -> calyx

INTERNAL ANATOMY AND HISTOLOGY OF THE ● 2 types of nephrons in the kidney

KIDNEYS ○ Juxtamedullary ​and ​cortical​.

Larraine Castillo, 1NUR2

● 15% of the nephrons are ​juxtamedullary afferent arteriole enters the renal
(next to the medulla) ​nephrons​, which have corpuscle (​juxtaglomerular cells​)
loops of Henle that extend deep into the 2. Part of the distal convoluted tubule of
medulla of the kidney the nephron lies between the afferent
● Remaining 85% are ​cortical nephrons​, and efferent arterioles next to the
which have loops of Henle that do not extend renal corpuscle. In this section, there
deep into the medulla is the ​macula densa

● Filtration portion​ of the nephron is housed The Renal Tubule

in the ​renal corpuscle ● Proximal convoluted tubules, the thick
● Renal corpuscle​ consists of ​Bowman segments of the loops of Henle, the distal
capsule​ and the ​glomerulus convoluted tubules, and collecting ducts
● Bowman capsule​ - enlarged end of the consists of ​simple cuboidal epithelium
nephron, which is indented to form a ● These portions of the nephron ​actively
double-walled chamber transport molecules and ions across the
● Glomerulus - ​tuft of capillaries that wall​ of the nephron
resembles a ball of yarn ● Thin segments of descending + ascending
○ Lies within the indentation of the limbs of loops of Henle have thin walls made
Bowman capsule up of simple squamous epithelium
● Cavity​ of the Bowman capsule opens into -> ● Water and solutes pass through the walls of
proximal convoluted tubule​, which carries these portions of the nephron by ​diffusion
fluid away from the capsule ● Thin segment of descending limb of the loop
● Inner layer​ of Bowman capsule consists of of Henle is ​permeable to water​ and solutes
podocytes​, which wrap around glomerular ● Thin segment of ascending limb is
capillaries; ​outer layer​ consists of ​simple permeable to solutes​, but not to water
squamous epithelial cells
ARTERIES AND VEINS
● Filtration membrane​ consists of Renal arteries - ​branch off the abdominal aorta and
endothelium of the glomerular capillaries, enter the kidneys
podocytes, ​and ​basement membrane 1. Interlobar arteries​ pass between renal
● In the first step of urine formation, fluid pyramids
passes from blood in glomerular capillaries -> 2. Arcuate arteries​ branch from the interlobar
filtration membrane -> Bowman capsule arteries, arch between the cortex and the
● Filtrate - ​fluid that is forced across the medulla
filtration membrane 3. Interlobular arteries​ branch off the arcuate
arteries and project into the cortex
● Afferent arteriole​ supplies blood ​to the 4. Afferent arterioles​ arise from branches of
glomerulus​ for ​filtration the interlobular arteries, lead into the
● Efferent arteriole ​transports the filtered glomerular capillaries
blood ​away from the glomerulus 5. Efferent arterioles​ extend from the
● Juxtaglomerular apparatus​ is located next glomerular capillaries
to the glomerulus; consists of a unique set of 6. Peritubular capillaries​ branch from the
afferent arteriole cells and specialized cells in efferent arterioles, surround the proximal
the distal convoluted cells convoluted tubules, distal convoluted tubules,
● These specialized cells include: and loops of Henle
1. A cuff of specialized smooth muscle 1. Vasa recta​ are specialized portions of
cells found at the point where the the peritubular capillaries that extend

Larraine Castillo, 1NUR2

 deep into the medulla of the kidney (active transport + cotransport) ->
and surround loops of Henle and cells of nephron -> interstitial fluid
collecting ducts ○ Water reabsorption: osmosis
2. Blood from peritubular capillaries, across nephron wall
including the vasa recta, will return to ○ Molecules and ions that enter the
the general circulation through the interstitial fluid surrounding
veins of the kidneys nephron move -> peritubular
capillaries
18.3 URINE PRODUCTION 1. Tubular secretion - ​certain tubule cells
● Primary function of the kidney: ​regulation of actively transport ​solutes from blood ->
body fluid composition filtrate
● Substances are either removed or conserved,
the ​nephrons​ do the sorting FILTRATION
● The "throw away" group ends up in the urine ● Nonspecific process whereby materials are
● The "save" items go back into the blood separated based on ​size or charge
● Movement of materials ​across filtration
THE AVERAGE CONCENTRATION OF MAJOR URINE membrane -> Bowman’s capsule​ to form
SUBSTANCES filtrate
● Driving force: ​gravity
● An average of 21% of blood pumped by heart
per minute flows through kidneys; of the total
volume of blood plasma, about 19% passes
through the filtration membrane -> Bowman
capsule to become filtrate
● In all nephrons, ​about 180 L of filtrate are
produced per day​, but about ​1% or less of
filtrate becomes urine

● Filtration membrane allows some substances

to pass from blood -> Bowman capsule (+
water and small solutes, - blood cells and
most proteins)

1. Glomerular capillary pressure - ​BP within

the glomerulus, moves fluid from the blood
into the Bowman capsule
2. Capsular pressure - ​pressure inside the
Urine formation​ has 3 major processes Bowman capsule, moves fluid from the
1. Filtration - ​blood pressure in glomerular capsule into the blood
capillaries forces fluid and molecules out of 3. Colloid osmotic pressure - ​produced by
blood -> Bowman capsule​ (fluid is filtrate) the concentration of blood proteins, moves
2. Tubular reabsorption - ​cells throughout fluid from the Bowman capsule into the
nephron move substances from ​filtrate -> blood by osmosis
blood in peritubular capillaries 4. Filtration pressure = ​glomerular capillary
○ Certain solute molecules and ions pressure minus the capsular and colloid
osmotic pressure
are reabsorbed by processes

Larraine Castillo, 1NUR2

Filtration pressure forces fluid from glomerulus -> lack of O2 -> permanent kidney
Bowman capsule ~ glomerular capillary pressure > damage
both capsular and colloid osmotic pressures
● Filtration pressure usually remains within a TUBULAR REABSORPTION
narrow range of values ● As filtrate flows from Bowman capsule ->
● When ​filtration pressure increases​ -> both proximal convoluted tubule, loop of Henle,
filtrate volume and urine volume increases distal convoluted tubule, and collecting duct,
● When the ​filtration pressure decreases​, many of the solutes in the filtrate are
both filtrate volume and the urine volume reabsorbed (99%)
decrease ● It enters the peritubular capillaries -> flows
through the renal veins to enter the general
● Filtration pressure is influenced by: circulation
○ Blood pressure in glomerular ● Only 1% of the original filtrate volume
capillaries becomes urine
○ Blood protein concentration ○ The small volume of urine contains a
○ Pressure in Bowman capsule high conc. Of ions and metabolic
● Glomerular capillary blood pressure > blood waste
pressure in most other capillaries
● Filtration pressure increases = glomerular URINE-CONCENTRATING MECHANISM
capillary blood pressure increases,​ and
vice versa

● Increase in blood protein concentration

encourages osmosis of water -> glomerular
capillaries; it ​reduces overall filtration
pressure
● Decrease in blood protein concentration
inhibits osmosis of water -> ​increases overall
filtration pressure

Regulation of Filtration
● Blood pressure is tightly regulated in
glomerular capillaries ~ afferent and efferent
arterioles can either dilate or constrict
● Filtration pressure and rate of filtrate
formation are usually maintained within a
range of values

● Filtration pressure changes under ​intense

sympathetic stimulation​, it causes
constriction of the kidney arteries ->
decreases renal blood flow and filtrate
formation
○ It may decrease filtrate formation and
urine volume; renal blood flow can be
so low that the kidneys suffer from

Larraine Castillo, 1NUR2

 ● Wall of thin segment of descending limb is
permeable to water
● As the filtrate moves through the medulla
with interstitial fluid, water moves out of the
nephron by osmosis. Solutes move into the
nephron by diffusion
● Another 15% of filtrate volume is reabsorbed
by the descending limb of the loop of Henle ->
becomes concentrated
● Reabsorbed water and solutes enter the vasa
recta

REABSORPTION IN THE LOOP OF HENLE: THE

DESCENDING LIMB AND THE THIN SEGMENT OF
THE ASCENDING LIMB

REABSORPTION IN THE PROXIMAL CONVOLUTED

TUBULE

● The​ ascending limb of the loop of Henle

dilutes the filtrate by removing solutes
● Thin segment of the ascending limb​ is n ​ ot
permeable to water, only to solutes, ​which
● Descending limb of the loop of Henle​ = site diffuse out of the nephron
for water reabsorption
● Filtrate is concentrated as it passes through ● Cuboidal epithelial cells of the thick segment
the descending limb of the loop of Henle of the ascending limb actively transport Na+
(osmosis for water reabsorption) out of the nephron, while K+ and Cl- are
● Renal medulla contains interstitial fluid with cotransported out of the nephron with Na+
large amounts of Na+, Cl- and urea ● Thick segment of ascending limb ​is​ not
permeable to water
Larraine Castillo, 1NUR2
 ● Na+, K+ and Cl-, but little water, are removed ● Removes some substances from the blood
from the filtrate (by-products of metabolism that become
● Highly conc. Filtrate that enters the ascending toxic in high concentrations)
limb of the loop of Henle becomes a ​dilute ● Occurs through either active or passive
solution​ when it reaches the distal mechanisms (ammonia secretion is passive;
convoluted tubule secretion of H+, K+, creatinine, histamine, and
● Only about 20% of the original filtrate volume penicillin by active transport)
remains
● The solutes from the ​ALLH​ enter the 18.4 REGULATION OF URINE CONCENTRATION
interstitial fluid of the medulla and keep conc. AND VOLUME
Of solutes in the medulla high. Excess solutes ● When body fluid concentration increases, the
enter the vasa recta increased water reabsorption​ -> s​ mall
volume of concentrated urine
REABSORPTION IN THE LOOP OF HENLE: THE ○ Eliminates solutes, conserves water,
THICK SEGMENT OF THE ASCENDING LIMB decreased body fluid concentration
1. The thick segment of ascending limb of loop ● When the body fluid concentration decreases,
of Henle is not permeable to water the ​decreased water reabsorption​ -> ​large
2. Na+ moves by active transport, and K+ and volume of dilute urine
Cl- move by cotransport, out of the ○ Water is lost, solutes are conserved,
ascending limb of the loop of Henle body fluid concentration increases

REABSORPTION IN THE DISTAL CONVOLUTED HORMONAL MECHANISMS

TUBULES AND COLLECTING DUCT ● Renin-angiotensin-aldosterone mechanism +
1. Water moves by osmosis from the distal ANH mechanism are sensitive to ​blood
convoluted tubule and collecting duct pressure
2. Na+ moves by active transport and Cl- ● ADH mechanism is sensitive to ​blood
moves by cotransport out of the DCT and concentration
collecting duct
3. The reabsorbed water and solutes enter the Renin-Angiotensin-Aldosterone Mechanism
peritubular capillaries and vasa recta ● Initiated under ​low blood pressure
conditions
● In summary, most solutes that pass through ● When blood pressure decreases, ​cells of
filtration membrane into the Bowman capsule the juxtaglomerular apparatuses in the
are reabsorbed in the proximal convoluted kidneys secrete ​renin
tubule ● Angiotensinogen - ​plasma protein produced
● Filtrate volume is reduced by 65% in by the liver
proximal convoluted tubule and by 15% in ● Renin converts angiotensinogen to
the descending limb of the loop of Henle angiotensin
● In the ascending limb of the loop of Henle, ● Angiotensin-converting enzyme (ACE)
Na+, K+ and Cl-, but little water are removed converts angiotensin I to angiotensin II (AII
from the filtrate (filtrate becomes dilute) will stimulate the adrenal cortex to secrete
● In the ​distal convoluted tubule and aldosterone)
collecting duct​, Na+ and Cl- are removed, ○ Aldosterone​ will stimulate an
water moves out by osmosis, and filtrate increase in the reabsorption rate of
volume is reduced by another 19%, leaving Na+ and Cl- in the distal convoluted
1% of the original filtrate volume as urine tubules and collecting ducts

TUBULAR SECRETION
Larraine Castillo, 1NUR2
 ● Water follows the Na+ and Cl- from filtrate Ureters - ​small tubes that carry urine from the renal
into blood -> increases blood volume -> pelvis of the kidney to the posterior inferior portion
increases blood pressure of the urinary bladder
Urinary bladder - ​hollow, muscular container that
lies in the pelvic cavity just posterior to the pubic
Antidiuretic Hormone Mechanism symphysis
● Stimulated by a ​high blood solute ● Stores urine
concentration ● Can hold from a few mL to a maximum of
● Antidiuretic hormone (ADH) ​increases the about 1000 mL of urine
permeability​ of the distal convoluted tubules ● When a few hundred mL is reached, the wall
and collecting ducts to ​water is stretched enough to activate a reflex that
● More water reabsorption + kidneys produce a causes the smooth muscle to contract -> most
small volume of concentrated urine urine flows out of the bladder towards
● Low ADH levels decrease urine volume urethra
● Cystitis - ​inflammation of urinary bladder;
● Release of ADH from the posterior pituitary is most common: E. Coli
regulated by the hypothalamus
● ADH-producing neurons in the hypothalamus Urethra - ​tube that carries urine from the urinary
are sensitive to ​solute concentration bladder to the outside of the body
○ Increased solute concentration​ of ● Trigone - ​triangle-shaped portion of the
the blood triggers ADH secretion urinary bladder located between the opening
○ Reduced solute concentration​ of the of the ureters and the opening of the urethra
blood inhibits ADH secretion
● ADH secretion is also regulated by blood ● Transitional epithelium​ lines the ureters
pressure and the urinary bladder
○ Decrease in blood pressure​ leads to ● When volume increases -> epithelial cells
increased ADH secretion change from columnar to flat + number of
○ Increase in blood pressure ​leads to epithelial cell layers decreases
decreased ADH secretion ● When volume decreases -> transition
● ADH is more sensitive to changes in ​blood epithelial cells assume their columnar shape
osmolarity​ > blood pressure + form a number of cell layers

Atrial Natriuretic Hormone ● Regular waves of smooth muscle contraction

● Triggered by an ​increased blood pressure in the ureters produce the force that causes
● ANH is secreted from cardiac muscle cells in urine to flow -> kidneys -> urinary bladder
the​ right atrium of the heart​ when blood ● Contractions in the urinary bladder force
pressure in the right atrium increases above urine to flow -> bladder -> urethra
normal
● ANH acts on the kidney to ​decrease Na+ Internal urethral sphincter - ​at the junction of the
reabsorption​ -> Na+ remains in the nephron urinary bladder and the urethra
● Water moves by osmosis into the nephron -> ● Formed by smooth muscle
Na+ -> increased urine volume and reduced ● Prevents urine leakage from the urinary
blood volume and pressure bladder
External urethral sphincter - ​formed by skeletal
18.5 URINE MOVEMENT muscle that surrounds the urethra as the urethra
ANATOMY AND HISTOLOGY OF THE URETERS, extends through the pelvic floor
URINARY BLADDER, AND URETHRA

Larraine Castillo, 1NUR2

 ● Allows a person to voluntarily start or stop ○ Lithotripsy - ​ultrasound technique
the flow of urine through the urethra that pulverizes kidney stones into
In ​males, ​urethra extends to end of penis; female small particles that can pass easily
urethra is shorter through the ureter

MICTURITION REFLEX APPROXIMATE VOLUMES OF BODY FLUID

● Activated by ​stretch of the urinary bladder COMPARTMENTS
● When bladder is filled with urine -> pressure
is increased -> stretch receptors are
stimulated -> action potentials from urinary
bladder to spinal cord through pelvic nerves
-> integration of reflex -> action potentials
along parasympathetic nerve fibers to
bladder -> urinary bladder contracts
● External urethral sphincter is contracted ~
stimulation from somatic motor nervous 18.6 BODY FLUID COMPARTMENTS
system Composition of water for total body weight: 60% for
○ ~ micturition reflex, action potentials adult male, 50% for adult female
conducted along somatic motor ● Fraction of the body's weight composed of
nerves to external urethral sphincter water decreases as the amount of adipose
decrease -> ​sphincter relaxes tissue increases
● Higher brain centers prevent micturition:
sending action potentials through spinal cord Intracellular fluid compartment - ​includes fluid
to decrease intensity of autonomic reflex and inside all the cells of the body
stimulate nerve fibers that keep the external ● Enclosed by the cell membranes of individual
urethral sphincter contracted; this ability cells
develops at 2-3 years ● 2/3 of all water in the body
● Composition of fluid in these compartments +
● Voluntary initiation of micturition requires an regulation of fluid movement across all cell
increase in action potentials sent from membranes = similar
cerebrum Extracellular fluid compartment - ​includes all the
● Voluntary contraction of abdominal muscles fluid outside the cells
increases abdominal pressure + enhances ● 1/3 of total body water
micturition reflex ● Includes interstitial fluid, plasma within
● Awareness of the need to urinate stimulates blood vessels, fluid in the lymphatic vessels
sensory nerve fibers that increase action ● Small portion is separated by membranes
potentials into subcompartments which contain
● Irritation of the urinary bladder or urethra specialized fluid
can also initiate urge to urinate ○ This includes aqueous humor and
vitreous humor of the eye,
● A ​kidney stone​, or ​renal calculus​, can cause cerebrospinal fluid, synovial fluid in
pain in the lateral abdominal region, which joint cavities, serous fluid in the body
can radiate to the inguinal region on left side cavities, fluid secreted by glands,
of the body renal filtrate, and urine in bladder
○ Consist of calcium oxylate
○ Keeping urine dilute reduces the COMPOSITION OF THE FLUID IN THE BODY FLUID
chance of kidney stones COMPARTMENTS

Larraine Castillo, 1NUR2

 ● Intracellular fluid contains a high ION CONCENTRATION REGULATION
concentration of ions (​K+, Mg2+, phosphate, ● If ion concentration is abnormal, cells cannot
sulfate​) > extracellular fluid control movement of substances across cell
● Lower concentration of ​Na+, Ca2+, Cl-, and membranes or composition of intracellular
HCO3​- than extracellular fluid fluid
● Concentration of protein in intracellular > ● Negatively charged ions such as Cl- are
extracellular secondarily regulated by the mechanisms that
control the positively charged ions
EXCHANGE BETWEEN BODY FLUID ● Since negatively and positively charged ions
COMPARTMENTS are attracted to each other, they move
● Cell membranes that separate compartments together
are selectively permeable (water, but not
ions) Sodium Ions
● Water movement is regulated by ​hydrostatic ● The ​dominant ions in the extracellular
pressure and osmotic differences fluid
● At the venous end of the capillary, blood ● 90-95% of the osmotic pressure of EF
pressure <, and fluid returns to the capillary results from sodium ions​ and their
~ osmotic pressure is higher inside capillary associated negative ions
> outside ● Recommended intake: 2.4 g/day ~
● Osmosis controls movement of water association with high blood pressure
between intracellular and extracellular ● Stimuli that control​ aldosterone secretion
spaces influence ​reabsorption of Na+​ from
● Intracellular fluid can help maintain the nephrons of kidneys and its total amount
extracellular fluid volume if it is depleted ● Reabsorption of Na+ from DCT and collecting
(dehydration) ducts is efficient -> little Na+ is lost when
○ Water moves from intracellular to aldosterone is present
extracellular fluid ● When aldosterone is absent, reabsorption of
● If concentration of ions in the extracellular Na+ is reduced -> more gets lost in the urine
fluid decreases, water moves by osmosis from
the extracellular fluid into the cells, which ● Sodium ions are also excreted by sweat
will swell ● Important for determining EF volume; Na+
concentration in EF increases = water moving
18.7 REGULATION OF EXTRACELLULAR FLUID into EF by osmosis
COMPOSITION
Homeostasis requires that the intake of substances Potassium Ions
equals their elimination (water and ions) ● Electrically excitable tissues, such as muscles
and nerves, are sensitive to changed in
THIRST REGULATION extracellular K+ concentration
● Water intake is controlled by the ● Aldosterone regulates concentration of K+
hypothalamus - ​thirst center in EF
● Thirst occurs​ when blood becomes more ● Dehydration, circulatory system shock, and
concentrated​ (drinking decreases blood tissue damage cause extracellular K+
concentration) concentrations to increase; response:
● Sudden drop in blood pressure activates aldosterone secretion increases and causes
thirst center; consumption of water returns K+ secretion to increase
blood pressure to normal

Larraine Castillo, 1NUR2

 ● Low K+ concentration in EF slows Concentration of H+ in the body fluids is reported as
aldosterone secretion​; kidneys decrease pH
rate of K+ secretion
BUFFERS
Calcium Ions ● Chemicals that resist a change in the pH of a
● Increases and decreases in extracellular solution when either acids or bases are added
concentration of Ca affect electrical to the solution
properties of excitable tissues ● Contain salts of either weak acids or bases
○ Decreased Ca concentration​ = ​cell that bind to H+ or release H+
membranes are more permeable to ● Keeps pH within a narrow range of values
Na+​; cause spontaneous action ● 3 major buffers: ​proteins, PO4 3- buffer
potentials in nerve and muscle cells system, HCO3- buffer system
(hyperexcitability and muscle tetany)
○ Increased Ca concentrations​ = ​cell Proteins and PO4 3- bind reversibly to H+; this
membranes are less permeable to prevents decrease in pH
Na+​, less electrically excitable; inhibit When H+ concentration decreases, proteins and PO4
action potentials 3- release H+, preventing an increase in pH
● Parathyroid hormone ​increases
extracellular Ca concentrations
○ Rate of PTH secretion is regulated by
the extracellular Ca concentrations
○ Elevated Ca concentration inhibits
secretion of PTH
Monohydrogen phosphate ions bind to H+ to form
○ Reduced Ca concentration stimulates
dihydrogen phosphate ions when excess H+ is
secretion of PTH
present
○ PTH stimulates osteoclasts to
When H+ concentration declines, some H+ separates
reabsorb bone, increasing Ca levels in
from dihydrogen phosphate
blood; stimulates Ca reabsorption in
kidneys
Proteins act as buffers because amino acids have side
● Calcitonin ​reduces the blood Ca
chains that can function as weak acids and bases
concentration
○ Elevated blood Ca concentration
causes increased calcitonin secretion
○ Low blood Ca concentration inhibits
calcitonin secretion
○ Reduces bone breakdown rate,
decreases release of Ca from bone

Phosphate and Sulfate Ions

Bicarbonate buffer system is unable to bind as many
● Reabsorbed by active transport in the
hydrogen ions as can proteins and PO4 3- buffers
kidneys; slow rate of reabsorption
CO2 + H20 = H2CO3, which in turn makes H+ and
● If concentration of these ions in filtrate is too
HC03-
much for nephron, excess goes into the urine
● If concentration of ions is low, nearly all are
reabsorbed

18.8 REGULATION OF ACID-BASE BALANCE

Larraine Castillo, 1NUR2

Reaction between CO2 and H20 is catalyzed by ● CO2 accumulates in body fluids -> so does H+
carbonic anhydrase -> decreased pH

The higher the concentration of CO2, the lower the KIDNEYS

pH ~ more H2CO3 is formed, making more H+ and ● Nephrons of kidneys secrete H+ into urine
HCO3 and can directly regulate the pH of the body
Increase in H+ concentration lowers the pH fluids
H+ and HCO3- combine to form H2CO3, pH increases ● Responds more slowly than respiratory
system
REPRESENTATIVE DISEASES AND DISORDERS: ● Ells in the walls of the distal convoluted
URINARY SYSTEM tubules are responsible for secretion of H+
○ Secretes when blood pH is too low,
reabsorption of HCO3
○ Secretion decreases when blood pH is
too high, amount of HCO3 lost in urine
increases

ACIDOSIS AND ALKALOSIS

Acidosis
● Occurs when blood pH falls below 7.35
● Respiratory acidosis - ​when respiratory
system is unable to eliminate enough CO2
● Metabolic acidosis - ​results from excess
production of acidic substances like lactic
acid and ketone bodies because of increased
metabolism or decreased ability of kidneys to
eliminate H+ in the urine
Alkalosis
● Occurs when blood pH increases above 7.45
● Major effect is hyperexcitability
● Spontaneous nervous stimulation, spasms
and tetanic contractions
● Respiratory alkalosis -​ results from
hyperventilation, as can occur in response to
RESPIRATORY SYSTEM stress
● Responds to change in pH ● Metabolic alkalosis - ​results from rapid
● Neurons in respiratory center of brain are elimination of H+ from the body (vomiting or
sensitive to CO2 levels and acidic pH excess aldosterone is secreted)
● High CO2 levels and low pH cause
hyperventilation -> CO2 is eliminated faster
● As CO2 levels decline, H+ also declines -> pH
rises to normal

● Low blood CO2 levels or increased pH cause

hypoventilation
● CO2 is eliminated from the body slower

Larraine Castillo, 1NUR2