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BIOL 3324 Human Physiology - 3324_lecture20_1109
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00:01 Okay, only four minutes late. just drives me up. Sleep,
00:06 . But you know, we just to get on with life. All
00:10 . Long time ago we talked about remember that. Did we remember everything
00:16 About that hospitality. What's the what the rule? I taught you guys
00:21 water and salutes wherever water goes. follows vice versa too. Right.
00:28 salt water follows? Did I? told you guys the story, of
00:32 , of high school politics. I tell you that story. Do
00:37 remember high school politics? Oh, sure you go is interesting.
00:44 Yeah, I did tell you Okay, see you guys remember
00:48 All right. A lot of people at the kidney and they get
00:51 really upset and they think, oh goodness, this is so difficult.
00:54 , I'm never going to understand What was me? It's the end
00:56 days. Uh, Right. no, no, no,
01:01 Reabsorption follows all the rules we've already , right, Wherever water goes,
01:07 follows and vice versa. Where studying water follows. Now, if we're
01:10 the first, wherever studying goes water , then who goes after water?
01:17 , well, we have a whole of other solids, don't we?
01:20 have chlorine, right? We have , we have glucose and amino
01:26 We have all these things that are to move as a response to or
01:31 response well, in response to osmotic . So really if we know our
01:37 is going we know our water's We know where water is going on
01:40 here. Everything else is going All . And that's how the kidney
01:45 correct. And let's go home. don't believe me. She's looking at
01:51 we can go home. Yeah. don't think you think is a little
01:56 more difficult than that. All Well, let's take a look and
01:58 if it is more difficult. So, reabsorption is highly selective.
02:02 the first the first rule. All . So, it's selective, meaning
02:06 only gonna reabsorb those things back in body. Remember how we started
02:11 We filtered indiscriminately? Well, there this discrimination is discrimination being things that
02:18 too big will not be filtered and stay in the plasma flowing through the
02:23 and on through the different arterial. anything that has a certain size and
02:27 gets just filtered through. So we care what we do care. But
02:32 body can't regulate what's being filtered through than by size. All right.
02:37 , obviously in there, there's gonna things that the body wants. Does
02:41 body want to pr glucose or did work really hard for your glucose?
02:47 worked hard for your glucose, didn't ? I mean, I've stood in
02:50 at Taco Bell for like five minutes and you know, listening to the
02:55 in front of me. That was lot of work. You don't believe
03:00 . That's there used to be a bell down there and there was freshman
03:04 boy, they wine. It was . I just want to start smacking
03:10 . All right, granted. I go find a wooly mammoth.
03:13 But I still worked hard for that . So do I want to give
03:15 my glucose? No, I want hold onto my glucose so I'm gonna
03:20 glucose back of the body. All . Are there other things that are
03:23 the plasma which I want to Yeah, everyone should be on their
03:28 . Of course. All right. what we're gonna do is we're going
03:31 selectively bring back those things that we out of the filter it back into
03:37 body. This is what the process reabsorption is. Bring those things I
03:41 and anything that I don't want. leave it on the curb. Someone
03:46 is going to go get it You've done that, right. Have
03:53 you don't want to put it on curb. Walk in the house,
03:55 back out. Yeah, that's kind what the reabsorption is. We're going
03:59 leave the stuff in there. All . So things that we need,
04:04 going to do things we don't We don't get. So, what
04:07 glamorous infiltrate basically? It's plaza minus plasma proteins that are too big to
04:11 reabsorbed or to be filtered so that stay in there. And so basically
04:16 gonna reabsorb those things that allow for to maintain both composition and volume of
04:22 interstitial fluid. All right. Now , how much are we filtering per
04:26 or sorry, per minute. Do guys remember? Okay, 125.
04:31 could have said a lot that I I would accept that as an
04:33 Right. How much are we re back in? Do you remember almost
04:38 of it? Right. So, left behind is about a mil?
04:43 . And so really what we're doing we're saying we are changing the constitution
04:47 the plasma when we filter and we to return all that stuff back.
04:51 necessary to maintain that. All Because we want to maintain that
04:55 We want to maintain the water concentrations the most part. So, we're
05:00 gonna leave a little bit back in that's really what we're doing.
05:03 what we're doing is we're concentrating the that the body doesn't want into that
05:07 trait which were ultimately going to turn urine. So, those two processes
05:11 transport. That's basically through the So, basically it'll be trans cellular
05:15 then para celular would be in between cells. All right. And which
05:19 was going to be used is gonna dependent upon the permeability at that particular
05:23 . Right? So water is typically both between the cells and through the
05:29 . But say sodium can only go the cells. All right.
05:32 it's going to use sodium would be cellular transport. Water would be whichever
05:37 you can get through fastest. just as an example. And
05:41 what I wanna do is I just to kind of focus in here on
05:45 reabsorption because if we understand so, we understand everything else? All
05:50 And so if you're looking at this Ron, what we'd say is
05:55 well, sodium is reabsorbed along almost entire life, most of it about
06:01 thirds of it is going to be here in the proximal convoluted tubules.
06:04 when we're talking about sodium reabsorption, is what we're focusing on. Is
06:08 particular uh absorptive region. All So, the amount of sodium that
06:15 absorbing here plays a role in absorbing else. So, this is the
06:18 amino acid, water, chlorine All that fun stuff there. I
06:24 you. The loop of Henle er loop of Henle is gonna be a
06:26 bit weird. All right. We reabsorb sodium there. The purpose of
06:29 absorbing sodium there is to absorb water we can create this concentration gradient that
06:35 can then take advantage of uh to your in varying concentrations. All
06:41 So, it's a different type of and it's used in a different
06:46 So, up here is what we're about when we're talking about the reabsorption
06:49 interested in here is a little bit . And then lastly in the distal
06:53 tubules collecting duct and collecting tubules were a role in sf volumes. All
06:58 , to put that in plain When you've heard that salt causes high
07:02 pressure. This is what they were on. All right. So,
07:06 we're looking at here is the uh reabsorption of sodium in response to changes
07:13 blood pressure. So, when my pressure drops, what do I want
07:18 do is I want to put sodium my body which draws water in which
07:22 my blood pressure. Okay, that's the regulatory sodium that we're looking
07:27 and notice how much it is. a very very small portion of the
07:31 sodium that's being involved or being So, we're focusing here first and
07:36 we'll get to these a little bit today. All right. So,
07:41 reabsorption. Well, there's lots of that we can do it. We
07:43 go through channels. All right. can use the sodium glucose co
07:47 You can see now how I'm getting across the thing. I can use
07:50 exchangers and I'm just trying to look the pictures do have There's a sodium
07:55 right there. All right. there's different ways that we do
07:59 So, one step is always going be passive. The other one is
08:02 going to be a pump. in other words, I'm moving it
08:06 and then the other is using an step. Alright. And what they're
08:09 is basically where that allows us to up and then back down or vice
08:14 . All right. In terms of , what we're doing is removing sodium
08:17 the fill trait using one of these so that sodium ends on the other
08:23 . And when that happens, water going to follow for osmotic reasons.
08:28 is what this slide says. Water sodium reabsorption. All right. That's
08:36 . Okay. Now, remember where were in the proximal convoluted tubules?
08:39 can we do this? Well, can go through Aqua porn's an approximate
08:43 uh tubules. Aqua porn's are always be open. So, water is
08:47 going to naturally follow sodium, but the collecting ducts and the distal
08:54 they're not open. Their dependent their and their availability is dependent upon the
08:58 of vasopressin. So, I'm gonna and make those or I'm gonna make
09:04 . Uh Aqua porn is available under conditions. All right. So,
09:10 only going to absorb water under certain in the distal convoluted tubules. We'll
09:16 to that in a bit. All . And they can pass through the
09:21 tight junctions, as I said through the cells. All right. What
09:27 chlorine? What's chlorine attracted to second that are positive. But in particular
09:35 we just said in in our list things, sodium. Yeah.
09:41 remember in our little our little uh play, whatever. Remember sodium is
09:47 the uh girlfriend. Right? Water is well, did I get that
09:53 . I can't remember how I set up. It's a long time
09:58 I haven't been able to think about today other than freshman grades. Um
10:02 basically it's gonna follow sodium, So if sodium goes, it's an
10:06 an electrical attraction towards sodium. So gonna move down an electrical gradient and
10:12 gradient to get with sodium. And it's going to move along that.
10:17 right. And you can you can at all. This is so you
10:20 go between cells, right? You go through sales using exchangers, so
10:24 and so on and so forth. really it's a passive form of reabsorption
10:28 you're just following that sodium gradients or electrical gradient that sodium is creating.
10:34 about potassium? Well, potassium is . All right. Now, potassium
10:39 the proximal convoluted tubules gonna follow All right. And again, this
10:43 a result of water. Water goes here. That means potassium concentrations are
10:48 higher in the tube. You'll And I'm going to follow water so I
10:53 reach equilibrium. So it naturally follows . All right. And so this
10:58 about 60-80% of the potassium being reabsorbed the kidneys is going to be done
11:03 this way. All right. But also have reabsorption into Franek loop.
11:11 ? And then we have also reabsorption the collecting tubules and this is the
11:14 we're going to spend a little bit time talking about. All right.
11:18 The Taipei interrelated cells are playing the the robot re absorbing potassium and well
11:25 like I said, we'll get to in just a minute. What about
11:29 ? How we get glucose in the ? We want to spend energy.
11:32 it. You guys want to spend to store energy? No. So
11:40 do we do it passive? sort of It's co transport. Secondary
11:47 transport. Alright, so ever sodium , glucose goes all right, So
11:52 is going using the sodium glucose transporter glucose to get in the sales and
11:56 glucose goes down using a a different carrier to move to the other
12:02 So it's going to be passive And just moving using the transporters in this
12:07 . All right. That's easy. far. So good. I
12:12 I'm like literally running through all this , but it's like if I know
12:15 sodium is going, I know where is going and then I know where
12:18 else is going. You know? about amino acids. Same thing.
12:22 . We got specialized carriers for each the different types of amino acids.
12:26 it's basically a sodium amino acid That's not too difficult. Alright.
12:31 active transport using co transporters and exchanges right. Again, proximal convoluted
12:39 Where's reabsorption mostly taking place approximately convoluted nitrogenous waste the bane of our existence
12:52 uric acid and uh crowning. Remember way back and Biology one when
13:01 have to learn the difference between these things. Did you have to learn
13:05 differences between the 3? Okay. , constantly forget them. All
13:10 Three main types Yuria Okay. Uric created in your area. Breaking down
13:18 . We're going to re absorb it secreted. So not only are being
13:23 but it's being reabsorbed as being secreted . It's doing weird stuff. Uric
13:30 . This is when we break down acids, not nuclei acids.
13:33 I can't spell. So nucleic acids what we're doing is breaking that down
13:37 . And then this is also gonna reabsorbed and secreted. Um For the
13:41 don't know um for people who have there's a broken mechanism in here dealing
13:46 the uric acid. So uric acid build up and that's what causes the
13:52 . Water follows the uric acid to to dilute it? That's where you
13:56 the information. And then the crystals start poking at cells and cells don't
14:00 to be poked. So that's where pain comes from. Breaking down nucleic
14:07 create in me. Well, basically which we haven't really talked a lot
14:12 but creating is one of the ways we store up energy and cells.
14:16 so when we break down Corey 18 get creatinine. That's basically secreted.
14:21 creatinine. All right. So, have different ways to get rid of
14:26 out of our bodies and it's for things. Um Let me ask you
14:30 question. Everything and you everything that eat. Is it is it uh
14:35 ? In other words, it comes something that was living at some
14:41 You're shaking your head. No. me an example of something that is
14:48 three. Well, that's probably But they're still organic there. I
14:53 , look back in the day, in the box was always rumored to
14:57 just serving Zoo grade meat was like or something like that. I think
15:01 got sued once. I had a whose father was an attorney and they
15:04 Arby's And so they had to know they made their meats. They got
15:09 meats and basically they got their gelatinous uh created protein. Um sludge and
15:18 they compressed it down and squeezed out water. And that's Yeah, you
15:22 want to know where food comes But it all comes from something living
15:25 some point. A Cheeto Alright. . Cheetos Yeah. Where does it
15:32 from? Corn? Yeah. Not it's good for you. Just saying
15:37 came from something living. So everything consume is made up of proteins and
15:41 acids. All right. And so have to have always break those
15:44 We have to get rid of that nitrogen. Which is these methods.
15:47 right. So, we're gonna look how do we get rid of your
15:50 because your area is one of these structures or these weird molecules. All
15:57 , it's freely filtered. All So basically it just follows the
16:01 But when it gets in the proximal , basically 50% is gonna be passively
16:06 . So basically you think about if 100% is filtered in then half
16:09 it leaves again through reabsorption. And when you get down to the net
16:13 loop, well you basically secrete. basically you pump out As much as
16:17 can so you're back up to 100% . And then when you get down
16:21 collecting tubules, your re absorbing it more time. All right. And
16:24 whatever is left over is what you're eliminating his waist. All right.
16:30 reabsorption along with the sodium that we're to be pumping out. Epinephrine include
16:36 to establish the osmotic gradient. Now way I the way that you can
16:41 about this um in a really really terms is Yuria moves like your friend
16:48 understands your jokes right? We've already already talked about our slow friend
16:53 Are slow friend is back, You tell your friend that joke,
16:57 kind of stare at you for a and then they laugh. That's how
17:01 real moves, it's like everything is in the areas like oh okay,
17:05 sorry, excuse me. And then like everything's moved the other extra like
17:11 just give me a second. So always moving a little bit behind everything
17:16 is really the kind of the way can think about it. And so
17:19 your body you have Yuria everywhere. right. It's not like it's being
17:24 away and kicked out of your body , really fast. There's actually high
17:28 of Yuria but not toxic levels, ? Otherwise you'd all be dead and
17:32 all be dead in this conversation would happening. It's basically the removal rate
17:37 enough to keep your real levels low . But your area is moving in
17:41 passive manner, with the exception of you see the secretion, where it's
17:46 , nope, I didn't want you . I want you over there and
17:48 like, okay, but I'm going follow the water. I'm moving down
17:53 concentration gradients and I'm constantly going back this pathway. That's why it's being
18:02 . And when we see here in net Franek loop along with the
18:05 it's this salute that we're gonna use draw water into the kidney to help
18:13 concentrate out the urine. All But we're I'm not gonna say
18:19 I was I was about to say was going to say this is the
18:21 difficult part, but it's not it's easy, all easy now.
18:27 does it make sense? Yuri follows but it has weird rules. And
18:32 you're pumping it out, or you're filtering it and re absorbing it and
18:36 secretive and your re absorbing it And so that's It's it's you're still
18:41 rid of some but you're not getting of 100%. You're only getting rid
18:44 about half of what you thought you going to get rid of. If
18:46 were just filtering is really what I'm to get at Mhm. Okay.
18:55 secretion. So, reabsorption is Okay, we're just gonna reiterate it
19:01 sodium goes. Water follows. All ? And because we're sodium is going
19:05 where water is going we're going to osmotic considerations for everything else.
19:11 So, that's the easiest thing that can learn about the kid.
19:16 It's just like reabsorption easy mode. , creation is not that hard.
19:20 just complex in its um in its . All right. So, what
19:28 secretion secretion basically boils down to this you have stuff in your body your
19:32 wants to get rid of faster than capable of doing. All right?
19:35 , if I filter something that would however much is in the fill
19:39 that's that's the most I can get of. Right? So, Let's
19:44 I have 20 molecules Let's start with molecules that are in the plasma let's
19:50 half of them end up in the it. Right. All right.
19:53 see, nothing else happens. That just goes on. I got rid
19:56 10. But I still have 10 in the plasma and that plasma has
19:59 go all the way through the body ? Show up and then I can
20:02 out half. Right now, I've five and I get rid of
20:06 but I still got five stuck So I have to go all the
20:08 through the body. And now I'm to those weird numbers at 2.5.
20:12 so it's like where does that half ? But you know, just play
20:16 me. We'll just move three. ? So, I'm left with
20:19 And that that's going next go Now I got to one goes and
20:23 I got to go one more round now this one's gonna go which way
20:25 I go? We're gonna be nice move one and it's out.
20:28 that was a lot of rounds to rid of all those molecules. All
20:32 . And let's say it's something that don't want in your body, something
20:35 going to cause you much harm. , I need to get rid of
20:38 faster. So, this is what is for getting rid of things that
20:44 body doesn't want faster than you're normally of doing in the process of
20:49 All right, now, there are simple ones. Protons. Alright.
20:55 are secreted. That's really easy. is going to be across all
20:58 And basically what we're doing, What is the acidity of the body
21:01 the blood's acidity is too high. ? In other words, the ph
21:05 too low. What do you want get rid of protons? So just
21:11 get rid of them. They're gonna be filtered. But you know
21:13 We got too many of them. let's just start grabbing them out of
21:15 blood. We got carriers that can them up and throw them into the
21:19 it and we can get rid of faster than the natural rate person.
21:23 pretty easy. Right, okay, can do the same thing with
21:28 Alright, potassium. Remember we said filtered and then reabsorbed in the proximal
21:34 tubules, but in the distal this is where we're doing our
21:40 All right. And what we're trying do is we're trying to make sure
21:43 we have enough pet potassium in our to make sure the body's functioning
21:47 So, what we're gonna do is saying, oh, well, I've
21:49 too much potassium. So, I've the secretion mechanism. So, I'm
21:52 to start throwing potassium back out in field trip because I've got just too
21:56 of it. That's really the So, what does this look
22:01 It looks like this? Not a picture. Never mind. I thought
22:06 had a better picture of this. right. Anyway. Oh, it's
22:09 the next slide. That's why. , so when potassium countries concentrations are
22:14 in the plasma we're gonna diffuse into interstitial fluid, right, That's a
22:18 diffusion and then what we're going to is we're going to take advantage of
22:22 pump. Here's our pump, We're gonna pump to potassium and we're
22:27 move three sodium out. Mm. a simple pathway. And what are
22:34 doing? We're moving sodium in the convoluted tubules. So, what's going
22:37 happen when we move sodium in when goes water follows? All right.
22:47 know that tattoo I told you to this is this is one of
22:51 All right. Put it right there your arm. You they can't make
22:55 cover up tattoos In the end I don't think maybe they can.
22:58 don't know where sodium goes. Water . Got that. You've covered like
23:03 of the questions. That's biochemistry in nutshell. Alright, Wherever seven goes
23:07 follows. Right. No, probably. Yeah. Okay.
23:14 we're also doing because we also have exchange mechanism in here with chlorine.
23:19 ? So, basically chlorine, potassium moving out together that way. We
23:22 ensure that uh there's not gonna be imbalance here. Now, this is
23:27 controlled through a wonderful little molecule called alone. Have we talked about our
23:32 run yet a little bit. I to bitsy. So, here's Valdosta
23:37 . All right. When do we start producing Valdosta own Well, when
23:41 sodium levels get low, the sodium in our body are low, that
23:46 our water levels are low. That our blood pressure is low. Our
23:52 starts producing valdosta rhone. And what does if we're focusing on this
23:58 Right, That's going to cause sodium be reabsorbed. So water is
24:04 So blood pressure goes up. So austrians measures is responsible for maintaining blood
24:10 . But the other place where we're to see al dossari being produced is
24:13 our plasma potassium levels go up. going to cause an uptick in Valdosta
24:18 production, which basically causes an increase tubular potassium secretion. Sal doctrine has
24:24 major roles here. One is potassium . The other is to maintain blood
24:31 in response to a drop in blood which is usually measured through one of
24:38 three. Either arterial blood pressure, at volume or really a drop in
24:44 ? Where do we measure the drop sodium you guys remember? Mm
24:52 Let's think hard about the last time talked about sodium levels dropping. Was
24:58 last class? Mhm mm. Was last class or was it before the
25:15 ? Mm Students get nervous. Were paying attention? His doctor Wayne?
25:22 stuff up? Yeah, the answer last class. When blood pressure increases
25:32 the different arterial is detected by the cells and it produces Renan. What's
25:41 other mechanism that we cause Renan to produced. We talked about little tiny
25:49 . You guys remember the ducks remember ducks? We talked about ducks,
25:56 said we're monitoring salt concentrations in the a medullary apparatus. We're counting the
26:03 as it's going by at the sodium drop. That's an indicator and a
26:08 in blood pressure. When there's a in blood pressure. I need to
26:12 that blood pressure up. I'm gonna up the process of producing. I'm
26:17 use the macula densest cells to talk the granular cells to tell the granule
26:22 to make Renan and then Renan does and magic happens in blood pressure goes
26:27 . Mhm. Remember that? You , roughly familiar the word Renan.
26:37 familiar. Okay. Mhm. All . But dr wayne. I like
26:48 poppy seed muffins and I got a test tomorrow. How am I going
26:53 possibly get rid of all that opiate of my body. So I don't
26:57 positive for my drugs. Well, body is looking out for you.
27:05 right. We have a bunch of bunch of these carriers that are capable
27:12 recognizing metabolites from these organic molecules, organic and ions. And what they
27:19 is they bind those and when they them in the plasma, they pick
27:22 up and they move them over. what do they belong to basically a
27:25 metabolites, metabolic ways. Certain hormones picked up this way and there's lots
27:30 different ones. Um They're showing you couple of them here but you don't
27:33 to know them by name. There's a lot of them. What they
27:36 is you pick them up and you're them over into the limit,
27:40 So when I have metabolic waste I to get rid of faster. I
27:45 have to rely solely on the Phil to get rid of that material because
27:52 going to take a lot of time that to happen, right? Takes
27:56 five minutes for your blood circulate Right? And so if you like
28:01 said, if you had 20 molecules go 2010 five, 2.5, 1.25
28:09 six out of it. But we use whole numbers. So at least
28:12 or six rotation, that's 25 minutes get rid of 20 molecules.
28:18 If I could do in two wouldn't that be better five minutes or
28:25 minutes instead? Would that be? that be nice? Yeah. And
28:29 what this does because you can think some of these toxins that are in
28:32 body that are going to cause you harm and your body doesn't want
28:36 And so this is what the secretion is for get rid of those things
28:40 cause great harm. So I'm increasing secretion of this substance cause me
28:46 I encourage the release of ions from carriers unless they get eliminated faster.
28:51 lot of molecules are carried by carriers the blood. So basically if I'm
28:55 the rules of mass action right? basically if I have stuff that is
29:01 versus unbound. Every time I get of my unbound, I'm going to
29:05 to balance out the equation again. guys learned this in chemistry,
29:09 I hope please nod your head and yes because I'm gonna have to go
29:13 there. Start swinging. If if , would you like to see that
29:17 ? Mhm. Me taking out dr , I might be able to take
29:21 . I'm not sure. Um All now again, this is approximate convoluted
29:29 . So where's secretion primarily taking Approximate convoluted tubing. All right,
29:36 far so good. Reabsorption easy. it easy wherever sodium goes,
29:46 There you go and wherever water Everything else follows. Right. That's
29:50 his way to think see resources. isn't easy. Yes. Right.
29:57 I don't want body has carriers that up and get rid of things that
30:01 faster rate than normal filtration would take . Where does this primarily take
30:05 Both of them. The proximal tubules the exception of potassium secretion, which
30:08 tied to the production of testosterone distal tubules. You're like man who's going
30:17 go to pharmacy school who wants to a pharmacist? Who wants to play
30:20 drugs. Alright, pharmacy school. ? There's nobody in here that want
30:25 go to pharmacy school when they're liars who lie. All right.
30:32 not expecting anyone coming to ask for letter of recommendation apartments in school,
30:36 ? I don't know. All What we're about to look at here
30:39 that pharmacists really need to care about lot. All right. I'm just
30:43 use this as an example so that guys can understand you have a
30:46 horrible headache. So you go when take your regular ibuprofen, how long
30:50 you take your next ibuprofen to get of the headache? You guys really
30:57 take care of medicine, do I heard the correct answer in
31:01 but you guys I heard four and . Let's let's decide for four
31:05 Six hours. Put your hands up six four I think six hours has
31:12 ? The answer is yes. I grow from six hours. All
31:16 Every six hours you're allowed to take dose of ibuprofen. All right.
31:20 talk about acetaminophen. acetaminophen is How much time between each Tylenol?
31:24 are you allowed to repeat your Four hours? All right,
31:31 How about I leave 12 hours? right. Why? Why do they
31:38 those random numbers? They're not random the way. Right. Why is
31:42 six hours for ibuprofen four hours for me. A set of benefit.
31:47 hours for relief. Right. it's the rate at which the body
31:55 get rid of that uh that uh drug or metabolites of that drug so
32:01 you can take another dose so you build up toxicity. All right vitamin
32:06 . Do you guys know how much C. You can take in a
32:10 ? There is a limit. You actually get vitamin C toxicity.
32:14 You know anyone. No. Because mean if you eat those tang flavored
32:19 , chewy balls or oh my You go for the gummies. I
32:22 that's just like candy. All I don't buy don't buy vitamins now
32:26 aren't dummies. You know it's hard to sit there going I can only
32:31 one If you look at the dose supposed to be two. But I
32:36 I do 1:00 AM in the afternoon it's like a special treat. All
32:44 , Vitamin C. Dose Toxicity. mg. Yeah. So you can
32:49 five taps after that. You can't any more. You have to wait
32:53 it leaves your body. Okay? don't want to know what when that
32:57 , how many out. But all . But you have this horrible horrible
33:01 horrible headache. Right, take your three hours later the headache is still
33:07 . Can you take that ibuprofen? . Right. Because it can be
33:11 . So what do you do Go take This is not medical
33:16 Please do not seu doctor Wayne if do this. But this is what
33:20 physician told us to do when we our little poor little Children who had
33:24 fevers that wouldn't go down. It so sad and they would just cry
33:27 they'd be so little hot and you're like oh how do I deal with
33:31 ? I can't dunk them in a water. Anything. Now what you
33:34 is you give them you go with ibuprofen and then three hours later you
33:37 him acetaminophen And then you do ibuprofen hours later. Then see them in
33:41 three hours later and so on so . And notice what you've done.
33:44 stayed within that range of the toxicity being removed and you do it for
33:51 drugs because they're two different drugs that in two different ways. Two different
33:55 . They just both happen to be steroidal. Right? Anti inflammatories.
34:02 right. Say. So what what you talking about this stuff? I
34:05 this word picture of here by the . F. R. G.
34:07 . R. Is the globular filtration . Right. And if we were
34:10 to figure out how how the kidney functioning, what we can do is
34:13 can look at G. F. . And determine whether or not our
34:16 filtering at the proper rates. All . So what you do and they
34:23 this at the doctor's office, you wonder why you pee in the cup
34:25 the doctor's office? It's not because want to have p wars in the
34:28 or anything like that? I don't . They might I don't know you
34:32 work in hospitals. Do you guys things at each other? No.
34:35 sure? I don't know about you guys wear masks and all sorts of
34:41 . I don't know if we can you. All right. Know what
34:45 do is they're they're looking at specific in, you know, in the
34:50 that they can actually measure G fr . And there's there's a basic mathematical
34:54 they use. It's similar to this they don't use this one in particular
34:59 this is usually used with an agent they put in your body. Like
35:03 , not insulin, insulin, which a plant sugar. It's a massive
35:07 sugar that's only filtered. And so they can say, I can look
35:11 the filtration rate by knowing how much put in and then how much comes
35:15 . Right. And so here, This is A G. F.
35:18 . Can be calculated as the concentration whatever it is that you're using
35:21 Well, I guess this is the . So here's how much of that
35:25 is in the urine. What is volume of urine that I'm measuring?
35:28 what is the concentration found in the ? That's why they're also doing the
35:32 at the same time. And so you can do is you can calculate
35:35 in your GFS fr is low. they say you have kidney disease.
35:39 they send you to the nephrologist who's happy to see you. No one
35:42 goes to the nephrologist. Um, basically they can determine why you're
35:47 Not functioning appropriately. All right. , what we're looking at here is
35:53 clearance. And that's what those numbers I was talking about. You
35:56 the number of hours it takes. much time does it take to get
35:59 of this material? Now, plasma is weird in the sense that what
36:04 doing is they're looking at the clearance the volume of plasma. So they're
36:07 how much plasma has to go through before you're cleared of a substance and
36:13 per minute. So it's not the of substance removed. It's the volume
36:17 they're focusing on, which to me the weirdest way to measure stuff.
36:21 it makes sense to them. And we'll just let it be All
36:25 Just say they're measuring volume of material you're clearing. Not the amount that
36:30 clearing from that volume. That kind makes you know, it's backwards
36:35 But just understand that they're measuring the that you think you would just be
36:40 unit that you think would be. backwards. All right. So every
36:45 has different plasma clearance rates. We talked about that with regard to ibuprofen
36:52 acetaminophen in the left and I don't what I believe is what is,
36:56 , what's it naproxen. Yeah. . I just want to make sure
37:02 got the sodium part. Right. was the other part. I was
37:05 like, I'm I don't know. All right. So, just how
37:11 effective are you able to remove this the body? So, this is
37:15 it boils down to. And this the part that you actually have to
37:18 attention to. Right. So, real simple. And I'm saying that
37:21 as a as a trigger. It simple. Right? Look,
37:24 look, if something is filtered but don't reabsorb or secrete then the plasma
37:29 rate for that substance is equivalent to G fr. All right.
37:34 in other words, if all I is filter something, then the rate
37:36 it's filtered is its rate of It's pretty stupid. Right?
37:42 that's baseline. Alright. But then have some substances right? There are
37:46 be filtered and reabsorb. So, plasma clearance rate is always gonna be
37:50 than the G fr example of Look at glucose. All right.
37:57 much glucose do you have in your ? If you're a normal non diabetic
38:04 . Mhm. None. Zero. glucose is valuable. You stood in
38:11 for it. You want to keep so, you re absorb it
38:15 So, as 100% reabsorption rate. . If you find glucose in your
38:20 something is going wrong either you are processing glucose and storing it up properly
38:26 you're not storing a glucose properly is I can't think of anything else on
38:29 of my head. Right. All . So, that's an example,
38:33 is an example of partial, What do we say? Start off
38:37 gets filtered, whatever that unit Right. And then part of it
38:41 reabsorbed and then we secrete it, though we're not supposed to put screeched
38:45 there. But then it gets reabsorbed . So we're only losing half of
38:51 area that we want to get rid that normally in our plasma. All
38:56 . So that would be an example this in terms of uh the substance
39:03 filtered and secreted than its plans and rate is going to be greater than
39:06 G fr All right. It's If I'm filtering this much and I'm
39:10 more in, then the amount that getting rid of has to be greater
39:13 the amount that I'm filtering. I , I know these are redundant
39:18 but sometimes we kind of put that out. Look that I'm seeing on
39:23 of y'all's faces just kind of and I want to reiterate the simplicity
39:31 this. All right. Most of drugs that we have in our body
39:37 , you know, we're trying to rid of those metabolites faster than we
39:41 filter them. So, their plasma is greater than the G fr
39:52 We're talking about the renal system, just about the kidney. So,
39:55 need to talk about a couple of structures here. The urinary bladder plays
39:59 role in temporarily storing urine as you're it. All right, you're storing
40:03 until Mick Parish in nutrition is a word for peeing. I think we
40:07 that last on last week, There are four layers with regard to
40:12 . And this is gonna be true a lot of our hollow organs.
40:14 have a mucosa, sub mucosa, . There's an advantage to in very
40:19 terms, the mucosa is the epithelial . The sub mucosa is the connective
40:24 just underneath the epithelial layers. The says the muscle areas that can squeeze
40:29 tube where the hollow organ and the to is the wrapping around um
40:34 that structure that basically creates it from it from ripping or tearing. It
40:39 of creates the boundary for that Now, the bladder is interesting in
40:43 it's epithelial to actually can increase and in terms of its size and it
40:50 so through two mechanisms. One is recycling, meaning that it has a
40:54 of vesicles that it can add to surface or take away from the surface
40:58 that you can decrease or increase that area. The other thing that it
41:02 is that it folds on itself like bunch of pleats on the skirt.
41:07 looking at all the guys because all girls already know what I'm talking about
41:10 . You know, pleats in a are like, let me see.
41:13 I see what head in the back . Okay, I'm gonna draw it
41:17 for you so that you understand. right. A pleat is if you
41:23 looking at it from like if this a flat a cloth, a pleat
41:28 basically do like So so what would is that I fill up underneath?
41:33 going to happen is this will expand So I get something that's much,
41:36 longer. All right. So that's idea of the bladder is actually fairly
41:41 when it's empty. But then it expand outward in two different ways to
41:46 accommodate all that urine. That is filling up that space. All right
41:53 , if you look at a bladder can see where the ureter comes
41:56 So there's your to your orders. then there's a point where the urethra
42:00 in this area underneath. Those three is the lowest point inside the
42:05 The lowest point being actually after but it's formed by these three points
42:11 . So the three points together is to as the triggerman. So basically
42:15 in is pushing in through the your and it's basically to go to its
42:19 point and slowly fill upward and And that's when the bladder is going
42:22 expand. All right now the structures are going to innovate this. This
42:28 gonna be the parasympathetic and the sympathetic the parasympathetic is responsible for creating contractions
42:34 give you that urge to go to restroom. All right. Uh
42:41 Urethra is your tube between the bathroom the bladder. All right.
42:45 we have protective mucosa. Just to clear. The female urethra solely serves
42:50 a person uh solely serves the purpose the pathway between the bladder and the
42:56 . Whereas the male urethra, while does have that role, has a
42:59 role as the pathway for Stephen which we'll get to when we talk
43:04 the male reproductive system. So, it's dual functional in the males.
43:09 there are two sphincters that I want point out here. All right.
43:12 have an internal urethral sphincter which is a true sphincter. And we have
43:15 external urethral urethral sphincter which is a sphincter. True sphincters are structures that
43:20 uh skeletal muscle. Right? what we can do is we can
43:25 and regulate that. Whereas the internal is non controllable. This is smooth
43:30 . So skeletal controllable. Non So, what I want to do
43:34 is I want to paint a picture you. Make sure I don't have
43:37 extra side. I do. All . So, when the bladder is
43:41 the relaxed phase. All right. the bladder is relaxed, basically,
43:45 outlet the internally ritual sphincter is going be at its tightest. All
43:50 And so it's going to prevent materials leaving the bladder. All right.
43:55 , when the bladder is relaxed, other words, there's no pressure
43:58 it's empty. All right. But the external resource center is something we
44:04 control. Right? Have you ever to the bathroom because your parents told
44:11 to we're going on this road You go to the bathroom right
44:16 I don't need to go. You Yes, mom. And you go
44:22 you can right, because you do some control. All right. Or
44:29 the other example. You go into restroom, go to go pee.
44:33 . And the first thing you do you have to kind of relax.
44:36 relax your pelvic floor, don't That relaxation of the pelvic floor is
44:43 your relaxing that skeletal muscle and the begins to flow. All right.
44:56 is not the actual statue that's called P but it's actually very close to
45:00 similar to they were very popular mannequin is is I think in Belgium it's
45:06 actual statuette Was made in the 1600s it's a fountain. It just
45:13 And during the 50s everyone had them their yards. I don't know where
45:18 thing growing up. I was just grandparents had one of these in their
45:24 . Okay. All right. So Mick tradition there are two reflex of
45:29 reflex and a nutrition reflex basically the reflex is gonna occur during bladder
45:37 Now remember this is autonomic. So going to have both parasympathetic and sympathetic
45:41 are involved. And there's also a component that's involved. Alright, so
45:46 regard to the sympathetic, what you're is you're constantly causing the Patricia muscles
45:51 are the muscles that make up the of the bladder to relax or to
45:55 . So as the bladder fills, is basically saying keep relaxing, keep
46:00 , keep relaxing and your bladder fills . All right, simultaneously. What
46:04 doing is it's causing the internal urethral to be contracted. All right.
46:11 with those two things you're in isn't leave. So right now you're not
46:16 yourself because the sympathetic dominates what's going with the bladder. Alright, It's
46:23 its relaxation phase. But when you enough fluid in the bladder um we're
46:29 get to the maturation reflex now with to systematic right? We said that
46:34 can control the external urethral sphincter, right now we're basically contracting that.
46:39 if you can think of the Aretha two gates, two doors,
46:43 The first door is closed, that's externally Rachel's finger and then the second
46:48 is closed. That's the pair of . Or sorry, the sympathetic
46:52 That's the internally research center. Right you don't need another nerve but just
46:57 case that's the panhandle nerve just for . Now, time for the maturation
47:02 . Alright. Four steps basically basically the volume of the bladder fills
47:06 200 300 mils. That's about that in a bottle, actually hold up
47:13 bottle again. Barrett 500 mils. , we're looking from here to about
47:21 there when your bladder fills up that . That's when you stretched the
47:27 your muscles, the barrel receptors within producers recognize that stretch and say,
47:32 , you know what time to All right. The internal urethral sphincter
47:38 because of the tritium muscle stretch have been stretched. So it's not quite
47:43 the flow of urine out. It , but it's like it's relaxed,
47:47 state. Now right now you're sitting these chairs. If those two things
47:52 right now, would you just let and just let the urine flow?
47:58 . Right. I mean we're not here were like, no,
48:02 it's not time to go the bathroom you start feeling that urge to
48:06 Right? It's like, so what you do? Might do the little
48:11 . All right, here's a couple you can do. Right?
48:14 You say body it's not time for to go the bathroom. Right?
48:17 you can ignore that. Right? what's happening here is that the initial
48:22 the sympathetic is being down regulated, starts going up and those contraction of
48:28 Patricia muscles are basically saying it's time pee And that's where the urge comes
48:32 . All right now, you can that urge. Right? You can
48:37 it off. It'll go away. notice that butt. Check it out
48:41 a little bit. It's gonna go . No problem. All right.
48:45 then about Every 200 300 mils that add to that bladder. Blatter
48:50 um remember me and you can try shake it off, Right? But
48:56 there's gonna be a point where the just says, uh, no mind
48:58 matter. Doesn't work here. I'm boss and I'm going to win.
49:03 , there's gonna be a point where body is going to win and you're
49:07 to just be yourself. All That's around 500 600 mils. All
49:14 . You can also, as I , you can avoid the bladder when
49:18 time or whenever you're told because you control uh, your external urethral
49:26 And you can also press down on bladder. That's actually what's going on
49:29 you force yourself to pee. As you compress the abdominal cavity down
49:33 the pelvic. So, you put pressure on the bladder. The bladder
49:37 that increased pressure. And so basically causes parasympathetic contractions that allows you to
49:42 you internally. Region speaker and out a year. Aren't you excited?
49:49 just learned how to pee today? , Not, not not.
49:56 Okay. I got bad news in couple days. We're gonna learn how
49:58 poop census. All right now, I said, the body can conserve
50:08 or the kidney can conserve water. . And what it can't do is
50:13 you're in has been formed, you go and claim the water from the
50:18 , this is you have to do while you're in the process of making
50:22 right now. Where do we get water from what we get water from
50:25 and from drink? We usually think drink, but we don't think that
50:28 actually carries water and right. But mean, pete take anything that you
50:34 , whether it's tofu or green beans meat. And if you squeeze that
50:39 enough with liquid come out of Yeah. And it would and there's
50:45 of water and most of the food we eat, all right now,
50:47 lose water through our skin in our . We can see the water loss
50:52 from our skin when we're sweating. easy. Houston. The sweating part's
50:57 From our from our mouth. It's lot harder to see that that oral
51:02 , you know, when we breathe , but when it gets cold,
51:04 50°, you know, I mean, this last weekend we all bundled up
51:09 last weekend. Yeah, I went a football game. I swear to
51:13 . It was Mhm. It was I rather would have stayed home.
51:17 think It was like a total of with the wind. I felt like
51:22 was 40. All right. So happens? You drink too much
51:26 What's going to happen? Well, kidneys are going to remove the excess
51:28 and we're gonna see how it does a second. But if the water
51:31 too low, what it can do it can remove water from that Phil
51:38 before it becomes urine and it can that water back to the body to
51:42 keep the water levels high. All . And the reason the table to
51:47 this is this thing that I keep about this medulla and its osmotic
51:53 All right. So, this is trying to show you here's a
51:56 You can see the kidney on the of the cortex. 30 milli Oz
52:00 is what? Or 300 millions Right? That's like the rest of
52:03 body. So everything in your body roughly $300 million mel's and then you
52:09 down into the medulla and you can there goes 304 100. Yeah,
52:12 got it down to about 1200 million Mel's. All right. Now,
52:17 I recollect your your textbook is goes more detail about this, then I'm
52:21 to talk about all right, that actually can modify and adjust it a
52:24 bit. But I want you to in terms of $300 million 1200 millions
52:29 . All right. And to remind just in case because this Can become
52:35 on exam. If you're isotonic, means you're at roughly $300 million dollars
52:39 . If your hip atomic, that you are less than meaning you have
52:43 salute than you normally do. you have too much water. And
52:47 here this is more solute. So great that millie as well. So
52:50 too little water. So, what seeing here is we're going from an
52:54 state to a hyper tonic state, ? It's getting more and more more
53:02 . All right. Now, if need to remove excess water and I
53:06 want to expend energy to do I just need to have an environment
53:09 draws water out, Right? And what I've created here. I create
53:15 environment that has a higher solute than . So, if I run a
53:18 through there that has aqua por I can pull water out. Can't
53:24 I don't want to pull water out the time. I only want to
53:26 it out when it's necessary. And so, what we're gonna look
53:31 first is how do I create And then the second I'm gonna
53:35 How do I use it? All . And there's a lot of
53:41 I'm seeing the tired looks on the and the shaking of the bodies.
53:46 all right. I was in your . This is the part that I
53:51 consider. And I told you I gonna do this, but I'm just
53:53 keep doing it because I'm me and gonna be me. This is what
53:57 consider the hardest part about the kidney understanding the osmotic gradient. All right
54:03 , why do I say that I if it is as an undergrad,
54:08 a post back as a grad So at least three times. And
54:13 all three of those times, I my fingers in my ears, I
54:17 la la la la la la la . Too complicated, la la la
54:20 la. You can't make me learn . And then I had to teach
54:26 . And I looked at it and like, oh crap, I gotta
54:28 you something. And I looked at like, oh, this is really
54:32 . This isn't as bad as I the engineer is gonna go nuts.
54:36 gonna go like, this is the thing ever. The rest of you
54:40 gonna like, I'm not as hyped this as the engineer, but what
54:44 want to show you here is a that allows us to create these different
54:50 of urine at will when we need . So, our starting point here
54:56 looking at the loop of Henle. , the loop of Henle is a
54:59 current multiplier? If the biologists in department did their job sometime during
55:07 during biology to they talk about counter multipliers. Did they ever talk about
55:12 of current multipliers? I'm gonna have have a talk with dr cheek and
55:16 like, I don't know, it's so long. I don't know.
55:18 right, then they ever talk about birds and the cold water and ask
55:21 their legs don't freeze off. All right. Mhm. Got 20
55:33 . Yeah this is how it The birds have their arteries and the
55:38 and arteries are going down. The are coming back up, right?
55:43 arteries are carrying hot blood. The are going carrying cold blood back
55:49 And so what you want to do you want to heat up the blood
55:52 so that it doesn't freeze you know cause damage to the heart tissues.
55:56 you also don't want um you know legs to freeze to death. So
55:59 want to make sure that you get circulation. So what you do is
56:02 put an artery right next to a , right? One's going down,
56:06 going up and so they're right next each other. So the heat from
56:09 artery heats up the blood that's going towards the heart. And the blood
56:15 from the from the feet are actually down. So they basically average
56:20 And so they're basically carrying warm blood the legs. And that's why the
56:24 legs don't freeze off when they're sitting the pond when it's you know,
56:27 cold out, right? That's counter because current going one direction is going
56:32 other direction, right there next to other and they're affecting each other.
56:35 when you see the word counter you need to think that the current
56:39 the fluid is going in opposite directions that's what we're seeing with the loop
56:42 Henley, right, the fluid first down and then it comes back
56:48 Now, you also notice out we have the Va's direct to All
56:51 , the Va's director is going down then it comes back up, there's
56:54 current. But look at where they're counter current. The loop of Henley
56:59 right next to the Va's Director, it's going up in the loop of
57:02 e. It's coming the blood next it is going down is descending and
57:06 on the opposite side in the loop where the fluid is going down in
57:11 tube, you'll the blood is going in the Va's director. So we
57:16 a lot of counter current going on . Here's me, testing it
57:21 What's the purpose of the loop of E to establish the counter current
57:29 And what is the VA's director to it? All right, so,
57:35 structures that we're looking at here are for those two aspects of this osmotic
57:41 . All right, now, why it a multiplier? Well, what
57:44 gonna do is we're going to see feedback loop that basically says,
57:47 I'm starting off with 300 million oz and then over time, what's going
57:50 happen is I'm going to become really concentrated and then as I
57:54 I'm going to become dilute again. , I'm actually changing the concentration of
58:00 fluid by multiplying first and then basically some changes along the way.
58:05 this is gonna be happening in the regularly. Net front where we saw
58:08 vast direct us. Right, that's what we're looking at here in
58:11 of structure. Now, to put in a different perspective here, you
58:14 see it from this, you can see that loop of Henle a little
58:17 better. We have the descending and the a sending side. All
58:21 And you can see how it's diving deep. Alright. And what makes
58:25 unique is that the descending side And what's found in there is different
58:31 what's on the ascending side. And they're gonna do is we're gonna respond
58:35 each other. Now, the easiest to look at this is this
58:42 I've circled the ascending and the descending for you. All right. And
58:47 on. The descending loop. Well, I guess I wanna start
58:50 the a sitting side. That much . What I have here is I
58:54 a series of pumps. Alright. what these pumps are doing in this
58:59 down here, we're passive but up we have these active transport. I'm
59:02 out sodium chloride on the opposite I have aqua porn's And so,
59:09 happening is as sodium comes out? can imagine these are all over the
59:12 as sodium comes out, that's gonna water because what whatever sodium goes water
59:19 , right? And so as water , the concentration of the sodium on
59:23 inside gets greater and greater and greater greater and greater and greater and greater
59:28 greater. Right? Because water is leaving. And why is it leaving
59:32 following sodium? But why sodium Well? First off, I'm pumping
59:35 out, Right. But also because is leaving. I also have sodium
59:40 out over on this side. And what I have is I have this
59:43 that is basically drawing water out of system and creating a more concentrated.
59:47 now because there's an imbalance, sodium to leave and create equilibrium, but
59:52 never able allowed to because we also the Va's director playing a role in
59:56 that sodium in the water around. so we end up with is something
60:00 really, really concentrated down here at bottom and up at the top it's
60:06 are more similar to what's going on there in the medulla. Now,
60:09 saw the face back here in the and it was just more like all
60:13 . So, we use something like to kind of explain this. There's
60:16 I think a video that or a not a video. It might be
60:20 flash animation if those still work. can't remember. It might be a
60:24 now that's going to be on blackboard after class. And it basically is
60:28 to put this thing in motion so you can see this. All
60:31 So, you can imagine on one got sodium being pumped out, water
60:35 falling on the other side and it's this path pattern so that the fluid
60:40 it travels down, getting more and and more concentrated. And then as
60:45 traveling up, because you have all sodium, it becomes less and less
60:48 as it leaves. So, what's happen? I'm gonna back up by
60:52 time the filtration gets up here in distal tubules, Its osmolarity is three
60:59 less then when it started. I've got more watery urine. And
61:07 only thing energy I'm using are a of pumps over. Mhm.
61:16 A couple of pumps sitting on that . I don't have to use a
61:18 of energy. I'm using osmotic gradients create this mechanism. This is the
61:28 I wanted to go, I All right. So, looking at
61:31 fill trade only I'm looking at the , filtration is getting more and more
61:35 because water is leaving wise, water because sodium is being pumped out on
61:41 other side. So, as the leaves, the concentration of this
61:45 trade gets more and more dense, concentrated. And then As I'm moving
61:52 up, sodium is going to be and so it's becoming less and less
61:57 until it gets up to about 100 or sorry, Millie Oz Miles.
62:03 . If nothing else were to happen now, I've got this tube that
62:07 going to travel back down again. my collecting tubules. My collecting to
62:11 travels right back through that concentration Now, if I have aqua porn's
62:17 the place, water is going to out to where there's a higher concentration
62:21 solute. Whereas the higher concentration of , it's out in this environment,
62:27 ? But if I don't have a , porn's and the water is just
62:29 to flow, right? Or the , going to just flow right on
62:32 . So, what puts the aqua in a place? Well, that's
62:35 vast suppressant as the anti diuretic The anti peeing hormone is really how
62:44 think about it. So, I've got to talk about the vast
62:48 . So, sorry. So, ? Why the resurrected? Why is
62:53 important? All right. On the over here, this would be how
62:57 and I would design a blood We'd say I want to start on
63:00 outside. You know, the And I want to go all the
63:04 back down to where um all the and the veins are back to the
63:08 , right? Because that's simple and and I can conceive that pretty
63:14 All right. I'm looking at a faces going out. Sure, I'm
63:16 getting you that. All right. me draw me a kidney. Here's
63:20 kidney, Here's my medulla. here's my helium. So, there's
63:25 artery in my vein. If you I were designing would say no,
63:28 want to go straight there and just up in my vein and be done
63:32 it. Right. That would be capillary system. If I could do
63:36 , because that's easy. Right? it says no. If I did
63:41 , then what would happen is that that I made would draw that sodium
63:47 and then distributed throughout the body. then it would basically break that
63:51 In other words, my osmolarity in in that region would become just like
63:54 rest of my body. So, a useless tool. So,
63:59 what I want to do is I to come down and then I want
64:03 go back up and then I'm going join up with something that will eventually
64:07 back around and get through there. that's a vein, right? That
64:11 gonna allow exchange. And so, that means is that I'm traveling
64:15 I might be pulling sodium out. as I'm traveling back up, I'm
64:22 water and sodium along the way. , I'm maintaining the gradient that I've
64:27 . And I'm redistributing stuff so I ensure that the gradient is always gonna
64:31 there. It's kind of cool. , it's a little complicated. All
64:38 . So, I've got a tube creates a gradient because I'm pumping sodium
64:43 water sodium on one side and water following on the other and then to
64:49 where the soda and the water I've got a vascular chair, a
64:52 system that basically moves things around to they need to go to maintain that
65:01 . So that's what's going on in you can see comes in and everything
65:08 just being exchanged and redistributed. I love how it jumped over like
65:18 things. All right back to the . What is that suppressing do?
65:22 , it excellent distal convoluted tubules. introduces aqua porn's when we need to
65:28 water back in our bodies. In words, when I'm dehydrated and I
65:33 get water. I know I can on my kidneys to provide me with
65:37 enough water to help maintain that blood in order to keep me alive.
65:42 good. So, what does it ? Well, basically, I'm going
65:46 act on the Luminal cells, the that make up the lumen of the
65:51 convoluted tubules and of the collecting And what I'm gonna do is I'm
65:55 insert aqua porn's into their surface. basically holding them back. They're already
65:59 the vesicles and I can actually produce as well. But basically, I'm
66:02 to move those vesicles onward to move to the surface. So now that
66:06 aqua porn's can be useful. when I need water. Well,
66:11 easy mode, all I gotta do turn the uncle porn's water moves from
66:15 fill trait where there's lots of Use that concentration to draw the water
66:20 and now the water is going to picked up by the vase, direct
66:23 and move back into my body without the gradient. Ah But I drink
66:30 lot of water. What's going to ? You don't get vasopressin,
66:34 No. Aka porn porn that dilute just keeps or that dilute urine or
66:39 trait keeps going forms. You're in out. It goes water leaves with
66:42 urine. And that's what these two . Here I am starting at the
66:47 300 mils. I'm adding in 300 miles becomes 1200 or millions.
66:52 1200 millions miles. Goes up to million. Cosmo's got aqua porn's So
66:56 I'm going through my concentration gradient, drawing water out. So by the
67:00 that Phil trait leaves, it's at same concentration through which it just
67:07 I pulled the water back out of out of the filter and put it
67:10 in my body. All right? , by suppressing startup at $300 million
67:16 mel's It says 500 but we're going keep our lives simple. It's gonna
67:20 the same as that over there. goes back up to 100 and 20
67:24 then it travels right down the tube water is not going to be
67:28 So what happens is that that Phil holds on to all of its
67:32 Water leaves your body pretty easy. look at me like, no,
67:40 make it simple for you. Not it's just her. She just grab
67:45 attention front row, that sort of . All right. When there's vasopressin
67:50 when I'm when I'm thirsty, when need water in my body, I
67:53 fast suppressant, I draw water out the filter instead of paying it
67:57 Anti diuretic hormone, I have too water in my body. Don't make
68:04 suppressant water leaves. How does water pulled back in my body, introduce
68:10 porn through the collecting tubules? Or it collecting tubules travel through that
68:15 So, the water gets drawn out that gradient. How we doing on
68:21 ? I'm not too terrible. All . So, sodium load. Remember
68:26 talked about sodium Well, we didn't sodium load simply. Is the amount
68:28 salt you have in your body. many of you have been told your
68:31 life if you drink or eat lots lots of salt, then you'll retain
68:36 . All right. We'll increase your pressure. And it does. There's
68:39 evidence for that, but not as as they suggest. All right.
68:44 going to put that little cabin on , but we're going to learn it
68:46 way so that you understand it. , So when my salt levels rise
68:50 my body. What's going to happen I'm going to retain water. So
68:54 this natural reabsorption of salt in the convoluted tubules, but there's also me
69:01 salt leave the body when salt leaves body, Water is going to flow
69:05 it natural. All right, But say I'm becoming dehydrated down the water
69:12 . My body is getting low and blood pressure is dropping. Well,
69:15 I need to do is I need get water back in my body,
69:18 ? So what do I want to ? Well, I want to move
69:22 into my body and then the water going to naturally follow. This is
69:26 the distal convoluted tubules for. I promise you, we're gonna talk
69:29 three of them. So, we've the first one. We just finished
69:32 second one, the loop of Henley the sodium reabsorption. And now we're
69:35 at the distal convoluted tubules. so how do I get sodium to
69:40 back into my body. Well, got this hormone sitting around just doing
69:44 in south Australia. Valdosta introduces sodium channels or post, sorry, put
69:50 potassium pumps. I pump in sodium follows. I pump out potassium because
69:56 don't need it. We'll go eat banana later. I don't know if
70:01 true. All right, So sodium . What we teach is that it
70:08 with SCF volume. In other words salt I eat. You know the
70:13 by sf volume because of that relationship sodium and water. We're going to
70:17 this entire system through is the rain uh angiotensin Valdosta own system called the
70:23 . A. S. Ren. we've already learned about briefly, we
70:27 we have these granular cells that are on the different arterials right there,
70:32 muscle cells. And what they're doing when you stretch them, they produce
70:36 . Renan is an enzyme that goes the blood and then affects the next
70:41 downstream. Sii angiotensin. Alright, , what this is going to do
70:46 going to ultimately result in the reabsorption sodium. Right? And that's
70:51 All right. That's ultimately what it's do. But Renan itself doesn't do
70:54 . It's dependent upon the other hormones to do this. So what it's
71:00 , what Renan is specifically doing is changes a plasma protein called angiotensin angiotensin
71:07 , is converted into a molecule called one 81 81 now is circulating in
71:14 body but it has spent a lot time there when that blood goes into
71:17 lungs, there's a hormone or an enzyme there that converts angiotensin one
71:23 angiotensin two. What's the name of hormone? Or that enzyme? Come
71:28 someone. What's the name of the zone? It's like crap angiotensin converting
71:38 ace. It's not just a place the helpful hardware, man is we
71:45 about ace this last year. What we know about ace? Don't mess
71:51 . Well, it's actually the target this horrible little virus that keeps rolling
71:55 in our bodies. Right? Is right? Am I getting it
72:05 I'm counting on you guys know the so I can make statements. All
72:12 . Angiotensin two does a whole bunch stuff. Alright, there's actually an
72:16 three and an angiotensin for which we don't understand all that much. It
72:20 be a metabolite. It might actually stuff we don't know. Ace isn't
72:23 found in the lungs. Also. angiotensin converting enzyme is primarily found in
72:29 . But as we've looked harder and for it, we find it's all
72:31 the place. So aces everywhere. lungs is like the like the big
72:36 . All right now, what angiotensin does it stimulates the secretion of Valdosta
72:41 . So notice what we have We have the Renan angiotensin Aldo Austrian
72:45 . It tells you what the order . Right? So you just kind
72:48 walk those through. So what does Doctorow do? Well, we told
72:52 write it increases sodium reabsorption and just the collecting ducts. Right? That's
72:57 we just saw. It promotes potassium . So if I'm re absorbing our
73:03 , which is where we're focusing now what's going to happen is I'm going
73:06 draw more water in and when I more water in. I'm increasing blood
73:11 . So you can kind of think the whole pattern that looks like
73:14 And you can use something like this look um I got my rent
73:17 where did I get the running That was the drop in blood
73:21 right? Which is measured by So what I'm gonna do is I'm
73:24 convert this plasma protein into another protein gets converted by ace and the and
73:30 attention to the X on the Plans produce valdosta. And what is
73:34 stones to? It basically acts back the kidneys that says, hey,
73:37 start re absorbing sodium using the sodium pump. And that brings water back
73:44 angiotensin. Does a whole bunch of stuff as well. I know you
73:49 are desperate to get out of but I've got one little thing
73:51 Alright, stimulates thirst. Have you when you're thirsty, what do you
73:56 ? You drink water? And what trying to do is you're responding to
74:00 osmolarity in your body. So basically water uptake, increases blood pressure.
74:05 stimulates there's the other molecule vasopressin. right, so what am I doing
74:10 vasopressin? I'm basically trying to draw out of my blood and back into
74:15 out of my filtration back into my and then also I vase a construct
74:20 increases blood pressure. So what are seeing here? We're seeing an increase
74:24 volume, you know, a fluid or blood volume? We're seeing an
74:28 in pressure. So what does Renan ? Elderhostel own play a role in
74:35 blood pressure? Long term blood Not minute to minute, but more
74:40 day to day, hour to hour blood pressure. This is just putting
74:45 all together and then we have this little bit right here and then I'll
74:51 to the last thing on the next . H. O. Natural credit
74:56 . If I turn something on I to have a mechanism to turn it
75:00 rent an angiotensin, testosterone increases blood , increases fluid volume. So the
75:06 I'm going to detect that increase in is in the heart and my
75:10 Right? And so that a tree a molecule hormone called atrial natural diuretic
75:17 . And what atrial natural peptide does it blocks the activity or really blocks
75:22 production of Renan so that I block those other steps so that I can
75:27 drop my blood pressure and then drop blood volume. So you can think
75:31 it this way angiotensin. Elderhostel alone a VP or a th or whatever
75:37 wanna call it. Just call the A's. Is counter to uh the
75:42 natural peptide A. And P. forays of the Apocalypse one is Is
75:49 the other three before I'm going to . I mean we can talk
75:54 oh no, there's one slide with help. All right, sorry.
75:57 is really really simple basically what this is look in those tubular segments that
76:01 permeable to water, where I'm going reabsorb something, it's always gonna be
76:08 by comparable water reabsorption where sodium goes follows. Thank you. All
76:15 Second one solid excretion is always going buy a comparable water excretion because of
76:19 considerations. All right, Wherever sodium , water follows. All right,
76:24 , you can throw anything at us you want to in there. But
76:26 , that's what it's trying to glasses. If you have a gain
76:29 loss of pure water that's not accompanied a uh a salute deficit, then
76:35 can lead to changes in your CCF . Alright? Or E C.
76:40 . Osmolarity. Now, that's a statement basically says, look, if
76:42 put water in my body without putting the comparable salutes, then I'm changing
76:47 osmolarity. And that should make But I just want to give you
76:49 example of this. All right. I go to the beach and I
76:53 a whole bunch of beer because beer my thirst. What's going to happen
76:59 you don't really have a buy You rent beer and so you're gonna
77:02 out a lot of water because alcohol um vasopressin. And basically you basically
77:10 out all this water. So even you think, for example, you
77:15 be encountering the thirst issues and the of water actually compounding it because you're
77:22 something that doesn't match with this, the uh dehydration is what we're trying
77:29 get at. And if you drink lot of water, you're gonna be
77:31 a lot of water. There you . There you go. That's that's
77:35 kidney now, as you're leaving and up. Just let you know everything
77:39 here on out, I think, even easier than this. You're looking
77:45 me like, this wasn't easy. , if this wasn't easy, then
77:47 have things to look forward to digestive . Food in my back mouth,
77:52 on the other side, I And then the last two is reproduction
77:56 reproduction. Which is what I live . If I could talk 27 x
78:01 reproduction, I would I do teach class like that. All right,
78:07 guys you have a great day.
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