By: Dr.

Foadoddini
Department of Physiology & Pharmacology
Birjand University of Medical Sciences

28: Regulation of Extracellular Fluid
Osmolarity and Sodium Concentration
0.5 20 L
50 1200 mOsmol/L
 Countercurrent Mechanism
• Interaction between the flow of filtrate through the loop of Henle
(countercurrent multiplier) and the flow of blood through the vasa recta
blood vessels (countercurrent exchanger)
• The solute concentration in the loop of Henle ranges from 300 mOsm to
1200 mOsm
 Countercurrent Mechanism
Produces a Hyperosmotic Renal Medullary Interstitium

http://www.colorado.edu/intphys/Class/IPHY3430-200/countercurrent_ct.html
http://www.cellphys.ubc.ca/undergrad_files/urine.swf
http://bio-alive.com/animations/anatomy.htm
 Urea Contributes to 
Hyperosmotic Renal Medullary Interstitium and to a Concentrated Urine

Permeable 
to H2O 
if ADH

50%
 Countercurrent Exchange in the Vasa Recta 
Preserves Hyperosmolarity of the Renal Medulla
 Countercurrent Multiplier and Exchange

• Medullary osmotic
gradient
• H2O→ECF→vasa recta
vessels
Quantifying Renal Urine Concentration and Dilution:
"Free Water" and Osmolar Clearances

2.1 * 142 = 298 mOsmol/L

29: Renal Regulation of Potassium, Calcium, Phosphate, and
Magnesium;  Integration of Renal Mechanisms for Control of 
Blood Volume and Extracellular Fluid Volume
Pressure Diuresis & Natriuresis importance in BV and ECF control

Directly
BP UO
Indirectly
Pressure Natriuresis and Diuresis Are Key Components of a Renal‐Body Fluid Feedback
for Regulating Body Fluid Volumes and Arterial Pressure
BV CO BP UO
 Factors Increase the Effectiveness
of Renal-Body Fluid Feedback Control

‰Neural control
‰AgII
‰Aldostrone
‰ADH
‰ANP
Factors affect K secretion:
[K]o
Aldostrone
Tubular flow
Acidosis
30: Regulation of Acid‐Base Balance
extremely low

pH: is not linear but logarithmic function

ie, more change in acidemia

normal range of arterial pH: 7.37 to 7.42

Volatile acids: CO2
carbonic anhydrase

Non‐ Volatile acids:  H2SO4, H3PO4

β‐hydroxybutyric acid, Acetoacetic acid
Lactic acid
Salcylic acid, formic acid
Gycolic acid, oxalic acid
Isohydric law
 Acetazolamide

brush border
carbonic anhydrase
2

5 1

no net secretion of H+
little change in tubular fluid pH
DT, CT
Acid-base nomogram
 Micturition (Voiding or Urination)

• Bladder can hold 250 ‐ 400ml

• Greater volumes stretch bladder walls initiates
micturation reflex:
• Spinal reflex
– Parasympathetic stimulation causes bladder to contract
– Internal sphincter opens
– External sphincter relaxes due to inhibition
Urination: Micturation reflex

Figure 19-18: The micturition reflex

Micturition (Voiding or Urination)

Figure 25.20a, b