Reabsorption in Loop of Henle
•Download as PPTX, PDF•
1 like•1,591 views
The document summarizes reabsorption processes in the proximal convoluted tubule (PCT), thick ascending limb (TAL), and early distal convoluted tubule (DCT). It outlines the objectives of reabsorption of electrolytes and water, the mechanisms involved including passive and active transport, and how medications can alter absorptive processes. Specific reabsorption topics discussed include bicarbonate, the concept of transport maximum, reabsorption in the TAL, calcium reabsorption, and reabsorption in the early DCT.
Report
Share
Report
Share
Recommended
Counter current mechanism
The countercurrent mechanism in the kidney produces a hyperosmotic renal medullary interstitium through three key processes: 1) the countercurrent multiplier effect of the thick ascending loop of Henle which repetitively reabsorbs sodium chloride, 2) active transport of ions from the collecting ducts into the medullary interstitium, and 3) facilitated diffusion of urea from the inner medullary collecting ducts into the medullary interstitium. This hyperosmotic interstitium is maintained by the countercurrent exchange function of the vasa recta blood vessels.
Renal handling of water
kidney tubule
Collecting
duct
lumen
Filtrate
300 mOsm
Medullary
interstitial
fluid
Collecting duct cell
Vasa
recta
600 mOsM
600 mOsM
700 mOsM
1. The kidney plays a pivotal role in maintaining water homeostasis by conserving water during deprivation and excreting excess water. This is accomplished through a complex anatomical arrangement of the nephron and renal vasculature.
2. Key elements include a hypertonic medullary interstitium generated by active transport of solutes out of the thick ascending limb of the loop of Henle and collecting
Tubular reabsorption (The Guyton and Hall physiology)
It is the second step of urine formation.
It is defined as;
“ The process by which water and other substances are transported by renal tubules back to blood is called Tubular Reabsorption”.
Tubular reabsorption is highly selective.
Some substances like glucose and amino acids are completely absorbed from tubules. So, the urinary excretion is zero.
Ions such as Na+, Cl-, HCO3- are highly absorbed but rate of absorption and excretion varies, according to body needs.
Materials Not Reabsorbed
Nitrogenous waste products
Urea
Uric acid
Creatinine
Excess water
Renal Physiology.ppt
The document discusses renal physiology and the functions of the kidney. It covers the major topics of:
1. The functions of the kidney including regulating fluid balance, electrolyte balance, and excreting wastes.
2. The anatomy of the nephron and kidney including glomerular filtration, tubular reabsorption and secretion.
3. The processes involved in forming urine including filtration, reabsorption of water and electrolytes, and secretion of wastes - with most of the filtered materials being reabsorbed.
Microcirculation
This document outlines a lecture on microcirculation. It begins by stating the objectives of understanding microcirculation functions and control. The content includes the structure of capillaries and microcirculation, factors that influence permeability, exchange of fluids between blood and tissues, Starling forces, and abnormalities in capillary pressure. Examples are given of typical capillary beds and how structures vary between tissues. The key concepts of vasomotion, Starling equilibrium, and net filtration pressure are also explained.
Endocrine function of kidney
The kidney plays an important endocrine role by secreting several hormones. The document discusses four key hormones secreted by the kidney: erythropoietin, calcitriol, thrombopoietin, and renin. Erythropoietin stimulates red blood cell production. Calcitriol helps absorb calcium. Thrombopoietin stimulates platelet production. Renin regulates blood pressure through the renin-angiotensin system. The kidneys secrete these hormones through specialized cells like the juxtaglomerular cells and extraglomerular mesangial cells to perform critical functions in the body.
Tubular function
The document describes renal physiology and the processes of urine formation in the nephron. It discusses how solutes are transported across renal tubules through passive and active transport mechanisms. Key parts of the nephron, including the proximal tubule, loop of Henle, and collecting duct, reabsorb water and solutes like sodium, chloride, and glucose to varying degrees. The countercurrent multiplier system in the loop of Henle and transport of urea in the medullary interstitium allow the kidney to concentrate urine up to 1200-1400 mOsm/L.
Proximal renal tubule physiology
The proximal tubule reabsorbs approximately 60-65% of the filtered load, including sodium, chloride, bicarbonate, potassium, glucose, and amino acids. Transport occurs through both transcellular and paracellular pathways. Glucose is actively transported across the apical membrane via sodium-glucose co-transporters and exits across the basolateral membrane. Sodium is reabsorbed primarily via the sodium-potassium ATPase pump. Bicarbonate is reabsorbed through secretion of hydrogen ions via sodium-hydrogen exchange and reabsorption of bicarbonate. The proximal tubule also plays an important role in reabsorption of other substances like phosphate, calcium, magnesium and
Recommended
Counter current mechanism
The countercurrent mechanism in the kidney produces a hyperosmotic renal medullary interstitium through three key processes: 1) the countercurrent multiplier effect of the thick ascending loop of Henle which repetitively reabsorbs sodium chloride, 2) active transport of ions from the collecting ducts into the medullary interstitium, and 3) facilitated diffusion of urea from the inner medullary collecting ducts into the medullary interstitium. This hyperosmotic interstitium is maintained by the countercurrent exchange function of the vasa recta blood vessels.
Renal handling of water
kidney tubule
Collecting
duct
lumen
Filtrate
300 mOsm
Medullary
interstitial
fluid
Collecting duct cell
Vasa
recta
600 mOsM
600 mOsM
700 mOsM
1. The kidney plays a pivotal role in maintaining water homeostasis by conserving water during deprivation and excreting excess water. This is accomplished through a complex anatomical arrangement of the nephron and renal vasculature.
2. Key elements include a hypertonic medullary interstitium generated by active transport of solutes out of the thick ascending limb of the loop of Henle and collecting
Tubular reabsorption (The Guyton and Hall physiology)
It is the second step of urine formation.
It is defined as;
“ The process by which water and other substances are transported by renal tubules back to blood is called Tubular Reabsorption”.
Tubular reabsorption is highly selective.
Some substances like glucose and amino acids are completely absorbed from tubules. So, the urinary excretion is zero.
Ions such as Na+, Cl-, HCO3- are highly absorbed but rate of absorption and excretion varies, according to body needs.
Materials Not Reabsorbed
Nitrogenous waste products
Urea
Uric acid
Creatinine
Excess water
Renal Physiology.ppt
The document discusses renal physiology and the functions of the kidney. It covers the major topics of:
1. The functions of the kidney including regulating fluid balance, electrolyte balance, and excreting wastes.
2. The anatomy of the nephron and kidney including glomerular filtration, tubular reabsorption and secretion.
3. The processes involved in forming urine including filtration, reabsorption of water and electrolytes, and secretion of wastes - with most of the filtered materials being reabsorbed.
Microcirculation
This document outlines a lecture on microcirculation. It begins by stating the objectives of understanding microcirculation functions and control. The content includes the structure of capillaries and microcirculation, factors that influence permeability, exchange of fluids between blood and tissues, Starling forces, and abnormalities in capillary pressure. Examples are given of typical capillary beds and how structures vary between tissues. The key concepts of vasomotion, Starling equilibrium, and net filtration pressure are also explained.
Endocrine function of kidney
The kidney plays an important endocrine role by secreting several hormones. The document discusses four key hormones secreted by the kidney: erythropoietin, calcitriol, thrombopoietin, and renin. Erythropoietin stimulates red blood cell production. Calcitriol helps absorb calcium. Thrombopoietin stimulates platelet production. Renin regulates blood pressure through the renin-angiotensin system. The kidneys secrete these hormones through specialized cells like the juxtaglomerular cells and extraglomerular mesangial cells to perform critical functions in the body.
Tubular function
The document describes renal physiology and the processes of urine formation in the nephron. It discusses how solutes are transported across renal tubules through passive and active transport mechanisms. Key parts of the nephron, including the proximal tubule, loop of Henle, and collecting duct, reabsorb water and solutes like sodium, chloride, and glucose to varying degrees. The countercurrent multiplier system in the loop of Henle and transport of urea in the medullary interstitium allow the kidney to concentrate urine up to 1200-1400 mOsm/L.
Proximal renal tubule physiology
The proximal tubule reabsorbs approximately 60-65% of the filtered load, including sodium, chloride, bicarbonate, potassium, glucose, and amino acids. Transport occurs through both transcellular and paracellular pathways. Glucose is actively transported across the apical membrane via sodium-glucose co-transporters and exits across the basolateral membrane. Sodium is reabsorbed primarily via the sodium-potassium ATPase pump. Bicarbonate is reabsorbed through secretion of hydrogen ions via sodium-hydrogen exchange and reabsorption of bicarbonate. The proximal tubule also plays an important role in reabsorption of other substances like phosphate, calcium, magnesium and
Regulation of respiration
1. The respiratory center located in the medulla contains inspiratory and expiratory neurons that generate rhythmic breathing movements.
2. Respiration is regulated by peripheral reflexes like the Hering-Breuer reflex, chemical factors like carbon dioxide and oxygen levels that influence the respiratory center, and higher brain centers.
3. An increase in carbon dioxide, hydrogen ions, or decrease in oxygen stimulates respiration to maintain homeostasis, while stretch receptors in the lungs inhibit inspiration when full.
Microcirculation
The document discusses microcirculation and the structure and function of capillaries. It defines microcirculation as blood flow through vessels smaller than 100μm, including arterioles, capillaries, and venules. Capillaries function to transport cells, oxygen, and other substances to and from tissues, and regulate body temperature. The capillary wall has a single layer of endothelial cells and pores of different sizes depending on the organ, through which substances diffuse. Interstitial fluid in the spaces between cells contains a gel-like substance that allows fluid to diffuse but not flow.
Control of respiration
Like heartbeat, breathing must occur in a continuous, cyclic pattern to sustain life processes.
Inspiratory muscles must rhythmically contract and relax to alternately fill the lungs with air and empty them.
The rhythmic pattern of breathing is established by cyclic neural activity to the respiratory muscles
PULMONARY FUNCTION TESTS
Pulmonary function tests provide quantitative measurements of lung volumes and capacities. Static measurements include tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, inspiratory capacity, functional residual capacity, vital capacity, and total lung capacity. Dynamic measurements include timed vital capacity, forced expiratory flow, minute ventilation, maximum breathing capacity, and peak expiratory flow rate. These tests help diagnose and evaluate obstructive and restrictive lung diseases by measuring how well lungs can inflate and expire air.
Transport of oxygen (the guyton and hall physiology)
Supply of oxygen to tissues mainly involves two systems i.e. respiratory system and the cardiovascular system.
Supply of oxygen to tissues depends upon
Adequate PO2 in atmospheric air
Adequate pulmonary ventilation
Adequate gaseous exchange in the lungs
Adequate uptake of oxygen by the blood
Adequate blood flow to the tissues
Adequate ability of the tissues to utilize oxygen
Oxygen diffuses from the alveoli into the pulmonary capillary blood because the oxygen partial pressure (Po2) in the alveoli is greater than the Po2 in the pulmonary capillary blood.
In the other tissues of the body, a higher Po2 in the capillary blood than in the tissues causes oxygen to diffuse into the surrounding cells.
The Po2 of the gaseous oxygen in the alveolus averages 104 mm Hg,
whereas the Po2 of the venous blood entering the pulmonary capillary at its arterial end averages only 40 mm Hg
Therefore, the initial pressure difference that causes oxygen to diffuse into the pulmonary capillary is 104 – 40, or 64 mm Hg.
About 98 percent of the blood that enters the left atrium from the lungs has just passed through the alveolar capillaries and has become oxygenated up to a Po2 of about 104 mm Hg.
Another 2 per cent of the blood which supplies mainly the deep tissues of the lungs and is not exposed to lung air. This blood flow is
called “shunt flow,” meaning that blood is shunted past the gas exchange areas
One gram of Hb can bind 1.34 ml of Oxygen
Normal level of Hb is 15 grams/dL
Thus 15 grams of hemoglobin in 100 milliliters of blood can combine with a total of almost exactly 20 milliliters of oxygen if the hemoglobin is 100 per cent saturated
This is usually expressed as 20 volumes per cent
Hemoglobin is a conjugated protein consisting of heme and globin.
The ferrous form can bind oxygen.
Hemoglobin molecule consists of four subunits each consists of one heme and one polypeptide chain
Each subunit can bind one molecule of Oxygen
Oxygenation is a very rapid and reversible process and it can occur in 0.01 seconds
When PO2 is high, oxygen binds with Hb to form Oxyhemoglbin
When PO2 is low oxygen leaves Hb to form Deoxy Hb.
Factors that shift the oxygen hemoglobin dissociation curve
potassium homeostasis and its renal handling
This presentation discusses potassium homeostasis and its renal handling. It begins with objectives and an introduction on potassium physiology. It then covers the roles of potassium, mechanisms maintaining potassium levels, and hormonal and other factors involved. A major section discusses renal handling of potassium by different regions of the nephron and how secretion is regulated. The presentation concludes by reviewing clinical implications of disorders like hyperkalemia and hypokalemia.
Oxygen dissociation curve
Following induction of anesthesia, factors such as decreased functional residual capacity, increased ventilation/perfusion mismatching, and development of atelectasis can increase venous admixture from 1% to around 10%. Anesthetic agents also suppress hypoxic pulmonary vasoconstriction and decrease cardiac output, reducing oxygen delivery. However, anesthesia and artificial ventilation lower oxygen requirements by around 15-21% due to decreased metabolism and work of breathing. Oxygen is transported in the blood bound to hemoglobin or dissolved in plasma, and the oxygen dissociation curve illustrates hemoglobin's changing affinity for oxygen at different partial pressures. Multiple factors can shift this curve, facilitating either oxygen loading or unloading as needed.
Compliance Resistance & Work Of Breathing
This document discusses the mechanics of respiration and resistance to breathing. It covers:
1. Elastic resistance makes up around 65% of total resistance and is due to the elastic recoil of lung tissue and surface tension forces. Lung compliance measures a lung's elastic resistance.
2. Non-elastic resistance accounts for the remaining 35% and includes airway resistance. Dynamic compliance is lower than static compliance due to factors like airway obstruction.
3. Several lung diseases can decrease compliance by increasing elastic or non-elastic resistance, requiring more work from respiratory muscles. Surfactant reduces surface tension forces and the work of breathing.
Renal physiology-1
The document provides an overview of kidney anatomy and physiology. It discusses:
1. The basic functions and structures of the kidney, including filtration, homeostasis, and hormone production.
2. The anatomy of the kidney, including locations of the cortex, medulla, renal pyramids and other structures.
3. The nephron as the functional unit of the kidney, describing its role in filtration, reabsorption, secretion and other processes.
4. Key physiological concepts like the countercurrent multiplier mechanism and regulation of electrolytes and acid-base balance.
TRANSPORT OF CARBON DIOXIDE
Dr. Nilesh Kate's document discusses the transport of carbon dioxide in the body. It describes how CO2 moves from cells to blood through diffusion down a partial pressure gradient, and is transported in the blood in three forms: dissolved, bicarbonate, and carbamino compounds. The document outlines the roles of hemoglobin, oxygen levels, and temperature in facilitating CO2 transport from tissues to the lungs, where it diffuses into the alveolar air and is exhaled. Key factors like pH regulation and the respiratory quotient are also briefly covered.
Renal blood flow & jga
1. Renal blood flow is tightly regulated to maintain a constant rate of around 1200 mL/min despite wide changes in blood pressure, through mechanisms like autoregulation and tubuloglomerular feedback.
2. The kidneys receive a high blood flow of around 20-30% of cardiac output despite their small size, and oxygen consumption in the kidneys is very high, second only to the heart.
3. Blood enters the kidneys through the renal artery and is distributed through a branching network of arteries before entering the glomerular capillaries and surrounding the nephron tubules, with the renal veins collecting the blood and returning it to circulation.
Renal blood flow and its regulation
A comprehensive presentation on glomerular filtration rate (GFR) & renal blood flow and how these entities are impacted by intrinsic and extrinsic regulation.
This was presented by the author in the finals of the physiology seminar presentation in medical school.
Bohr and haldane effect
Bohr’s effect- The Bohr effect is a physiological phenomenon first described by Danish physiological Christian Bohr, stating that the “oxygen binding affinity of hemoglobin is inversely related to the concentration of carbon dioxide and hydrogen ion.
#An increase in blood CO2 concentration which leads to decrease in blood pH will results in hemoglobin proteins releasing their oxygen load.
#One of the factor that Bohr discovered was pH. He found that if the pH is lower than the normal, then hemoglobin does not bind oxygen.
#And this effect of CO2 on oxygen dissociation curve is known as Bohr effect.
Haldane effect- The Haldane effect is first discovered by John Scott Haldane.
#The Haldane effect describe the phenomenon by which binding of oxygen to hemoglobin promotes the release of carbon dioxide.
#Haldane effect is the mirror image of Bohr effect.
#The decrease in carbon dioxide leads to increase in the pH, which result in hemoglobin picking up more oxygen.
#This is a helpful biochemical feature which facilitates exchange of carbon dioxide for oxygen in the pulmonary and peripheral circulations.
Urine concentration
The kidney can concentrate urine by continuing to excrete solutes while reabsorbing more water, producing urine 4-5 times more concentrated than plasma. This ability is essential for terrestrial mammals to survive on land. The countercurrent mechanism in the loops of Henle and vasa recta allows solutes like urea to accumulate in the renal medulla, establishing a high osmotic gradient for water reabsorption. When ADH increases collecting duct permeability, this gradient enables production of highly concentrated urine, minimizing water loss and fluid intake needs.
Counter current mechanism in kidney
The document discusses countercurrent exchange systems in various organs and tissues of the body including the kidney. It describes how the countercurrent multiplier system in the loop of Henle establishes a gradient that is maintained by the countercurrent exchanger system of the vasa recta, allowing the kidney to produce concentrated urine through the medullary countercurrent system. It also discusses how diuretics work by targeting different sites along the nephron to increase urine output.
Renal tubule transport mechanisms
I. The proximal tubule reabsorbs sodium, bicarbonate, glucose and other solutes. Carbonic anhydrase and NHE3 transporters facilitate reabsorption. Carbonic anhydrase inhibitors and adenosine receptor antagonists act in the proximal tubule.
II. In the loop of Henle, the thin descending limb is water permeable while the thick ascending limb actively transports sodium via NKCC2 transporters. Loop diuretics inhibit this transporter.
III. The distal convoluted tubule reabsorbs sodium and chloride via NCC cotransporters and regulates calcium reabsorption. Thiazide diuretics act on the NCC transporter.
IV
urine formation
The document discusses renal physiology and the urinary system. It contains the following key points:
1. The urinary system includes the kidneys, ureters, bladder, and urethra. The kidneys contain nephrons which filter blood to form urine.
2. The kidneys regulate fluid volume, electrolyte and acid-base balance, and remove waste. Nephrons contain a renal corpuscle for filtration and a tubule for reabsorption and secretion.
3. The proximal convoluted tubule reabsorbs the majority of filtered sodium, water, and other electrolytes using active transport mechanisms like sodium-glucose co-transport. This maintains electrolyte and fluid balance
Oxygen transport
This document discusses oxygen transport from the atmosphere to tissues. It describes how oxygen is absorbed in the lungs and bound to hemoglobin to be carried by the blood. The oxyhemoglobin dissociation curve is explained, showing how hemoglobin releases oxygen in tissues. Factors affecting oxygen diffusion and binding such as partial pressure gradients, carbon dioxide levels, 2,3-DPG, and fetal hemoglobin are covered. The document also briefly discusses oxygen toxicity and ischemia-reperfusion injury.
Renal physiology, renal blood flow, autoregulation, golmerular filtration. hu...
This document discusses renal physiology, including renal blood flow, oxygen consumption, regulation of blood flow, glomerular filtration, and factors affecting glomerular filtration rate (GFR). Some key points:
- Renal blood flow is approximately 1/4 of cardiac output, or 1200 ml/min. Blood flow to the cortex is higher than to the medulla.
- Glomerular filtration is determined by the net filtration pressure and filtration coefficient. Forces increasing filtration are glomerular hydrostatic pressure and oncotic pressure in Bowman's space. Forces decreasing filtration are plasma oncotic pressure and hydrostatic pressure in Bowman's space.
- GFR is regulated through autoregulation mechanisms like tub
Renal tubular reabsorption, secretion, regulation & renal function tests
Renal tubular reabsorption and secretion involves the transport of substances across tubular epithelial cells. Substances may be reabsorbed from the tubular fluid back into the blood (reabsorption exceeds filtration) or secreted from the blood into the tubular fluid (secretion exceeds filtration). Clearance tests can measure glomerular filtration rate (GFR) and renal plasma flow. Substances like inulin that are freely filtered but not reabsorbed/secreted will have a clearance equal to GFR, while clearance of substances like para-aminohippuric acid (PAH) that are secreted can estimate renal plasma flow. Hormones and other factors regulate tubular transport and fluid/electroly
Update on Fluid Resuscitation
1) The patient has signs of shock including hypotension, tachycardia, and elevated lactate and base deficit.
2) Fluid resuscitation with 2L LR improved hemodynamics but lactate and base deficit remain elevated, indicating ongoing shock.
3) Aggressive resuscitation with blood products following a 1:1:1 ratio of PRBCs, FFP, and platelets is indicated to replace blood loss and prevent coagulopathy, given the suspicion for hemorrhage.
Approach to child with metabolic acidosis
This document discusses the approach to metabolic acidosis. It defines metabolic acidosis and provides normal values for arterial blood gases. Causes of metabolic acidosis include loss of bicarbonate from the body, impaired kidney function, and addition of acids. The body responds by respiratory compensation through hyperventilation and renal compensation by increasing bicarbonate reabsorption. Diagnosis involves measuring low pH and bicarbonate levels. Treatment focuses on addressing the underlying cause, while bicarbonate therapy is controversial and its risks must be weighed.
More Related Content
What's hot
Regulation of respiration
1. The respiratory center located in the medulla contains inspiratory and expiratory neurons that generate rhythmic breathing movements.
2. Respiration is regulated by peripheral reflexes like the Hering-Breuer reflex, chemical factors like carbon dioxide and oxygen levels that influence the respiratory center, and higher brain centers.
3. An increase in carbon dioxide, hydrogen ions, or decrease in oxygen stimulates respiration to maintain homeostasis, while stretch receptors in the lungs inhibit inspiration when full.
Microcirculation
The document discusses microcirculation and the structure and function of capillaries. It defines microcirculation as blood flow through vessels smaller than 100μm, including arterioles, capillaries, and venules. Capillaries function to transport cells, oxygen, and other substances to and from tissues, and regulate body temperature. The capillary wall has a single layer of endothelial cells and pores of different sizes depending on the organ, through which substances diffuse. Interstitial fluid in the spaces between cells contains a gel-like substance that allows fluid to diffuse but not flow.
Control of respiration
Like heartbeat, breathing must occur in a continuous, cyclic pattern to sustain life processes.
Inspiratory muscles must rhythmically contract and relax to alternately fill the lungs with air and empty them.
The rhythmic pattern of breathing is established by cyclic neural activity to the respiratory muscles
PULMONARY FUNCTION TESTS
Pulmonary function tests provide quantitative measurements of lung volumes and capacities. Static measurements include tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, inspiratory capacity, functional residual capacity, vital capacity, and total lung capacity. Dynamic measurements include timed vital capacity, forced expiratory flow, minute ventilation, maximum breathing capacity, and peak expiratory flow rate. These tests help diagnose and evaluate obstructive and restrictive lung diseases by measuring how well lungs can inflate and expire air.
Transport of oxygen (the guyton and hall physiology)
Supply of oxygen to tissues mainly involves two systems i.e. respiratory system and the cardiovascular system.
Supply of oxygen to tissues depends upon
Adequate PO2 in atmospheric air
Adequate pulmonary ventilation
Adequate gaseous exchange in the lungs
Adequate uptake of oxygen by the blood
Adequate blood flow to the tissues
Adequate ability of the tissues to utilize oxygen
Oxygen diffuses from the alveoli into the pulmonary capillary blood because the oxygen partial pressure (Po2) in the alveoli is greater than the Po2 in the pulmonary capillary blood.
In the other tissues of the body, a higher Po2 in the capillary blood than in the tissues causes oxygen to diffuse into the surrounding cells.
The Po2 of the gaseous oxygen in the alveolus averages 104 mm Hg,
whereas the Po2 of the venous blood entering the pulmonary capillary at its arterial end averages only 40 mm Hg
Therefore, the initial pressure difference that causes oxygen to diffuse into the pulmonary capillary is 104 – 40, or 64 mm Hg.
About 98 percent of the blood that enters the left atrium from the lungs has just passed through the alveolar capillaries and has become oxygenated up to a Po2 of about 104 mm Hg.
Another 2 per cent of the blood which supplies mainly the deep tissues of the lungs and is not exposed to lung air. This blood flow is
called “shunt flow,” meaning that blood is shunted past the gas exchange areas
One gram of Hb can bind 1.34 ml of Oxygen
Normal level of Hb is 15 grams/dL
Thus 15 grams of hemoglobin in 100 milliliters of blood can combine with a total of almost exactly 20 milliliters of oxygen if the hemoglobin is 100 per cent saturated
This is usually expressed as 20 volumes per cent
Hemoglobin is a conjugated protein consisting of heme and globin.
The ferrous form can bind oxygen.
Hemoglobin molecule consists of four subunits each consists of one heme and one polypeptide chain
Each subunit can bind one molecule of Oxygen
Oxygenation is a very rapid and reversible process and it can occur in 0.01 seconds
When PO2 is high, oxygen binds with Hb to form Oxyhemoglbin
When PO2 is low oxygen leaves Hb to form Deoxy Hb.
Factors that shift the oxygen hemoglobin dissociation curve
potassium homeostasis and its renal handling
This presentation discusses potassium homeostasis and its renal handling. It begins with objectives and an introduction on potassium physiology. It then covers the roles of potassium, mechanisms maintaining potassium levels, and hormonal and other factors involved. A major section discusses renal handling of potassium by different regions of the nephron and how secretion is regulated. The presentation concludes by reviewing clinical implications of disorders like hyperkalemia and hypokalemia.
Oxygen dissociation curve
Following induction of anesthesia, factors such as decreased functional residual capacity, increased ventilation/perfusion mismatching, and development of atelectasis can increase venous admixture from 1% to around 10%. Anesthetic agents also suppress hypoxic pulmonary vasoconstriction and decrease cardiac output, reducing oxygen delivery. However, anesthesia and artificial ventilation lower oxygen requirements by around 15-21% due to decreased metabolism and work of breathing. Oxygen is transported in the blood bound to hemoglobin or dissolved in plasma, and the oxygen dissociation curve illustrates hemoglobin's changing affinity for oxygen at different partial pressures. Multiple factors can shift this curve, facilitating either oxygen loading or unloading as needed.
Compliance Resistance & Work Of Breathing
This document discusses the mechanics of respiration and resistance to breathing. It covers:
1. Elastic resistance makes up around 65% of total resistance and is due to the elastic recoil of lung tissue and surface tension forces. Lung compliance measures a lung's elastic resistance.
2. Non-elastic resistance accounts for the remaining 35% and includes airway resistance. Dynamic compliance is lower than static compliance due to factors like airway obstruction.
3. Several lung diseases can decrease compliance by increasing elastic or non-elastic resistance, requiring more work from respiratory muscles. Surfactant reduces surface tension forces and the work of breathing.
Renal physiology-1
The document provides an overview of kidney anatomy and physiology. It discusses:
1. The basic functions and structures of the kidney, including filtration, homeostasis, and hormone production.
2. The anatomy of the kidney, including locations of the cortex, medulla, renal pyramids and other structures.
3. The nephron as the functional unit of the kidney, describing its role in filtration, reabsorption, secretion and other processes.
4. Key physiological concepts like the countercurrent multiplier mechanism and regulation of electrolytes and acid-base balance.
TRANSPORT OF CARBON DIOXIDE
Dr. Nilesh Kate's document discusses the transport of carbon dioxide in the body. It describes how CO2 moves from cells to blood through diffusion down a partial pressure gradient, and is transported in the blood in three forms: dissolved, bicarbonate, and carbamino compounds. The document outlines the roles of hemoglobin, oxygen levels, and temperature in facilitating CO2 transport from tissues to the lungs, where it diffuses into the alveolar air and is exhaled. Key factors like pH regulation and the respiratory quotient are also briefly covered.
Renal blood flow & jga
1. Renal blood flow is tightly regulated to maintain a constant rate of around 1200 mL/min despite wide changes in blood pressure, through mechanisms like autoregulation and tubuloglomerular feedback.
2. The kidneys receive a high blood flow of around 20-30% of cardiac output despite their small size, and oxygen consumption in the kidneys is very high, second only to the heart.
3. Blood enters the kidneys through the renal artery and is distributed through a branching network of arteries before entering the glomerular capillaries and surrounding the nephron tubules, with the renal veins collecting the blood and returning it to circulation.
Renal blood flow and its regulation
A comprehensive presentation on glomerular filtration rate (GFR) & renal blood flow and how these entities are impacted by intrinsic and extrinsic regulation.
This was presented by the author in the finals of the physiology seminar presentation in medical school.
Bohr and haldane effect
Bohr’s effect- The Bohr effect is a physiological phenomenon first described by Danish physiological Christian Bohr, stating that the “oxygen binding affinity of hemoglobin is inversely related to the concentration of carbon dioxide and hydrogen ion.
#An increase in blood CO2 concentration which leads to decrease in blood pH will results in hemoglobin proteins releasing their oxygen load.
#One of the factor that Bohr discovered was pH. He found that if the pH is lower than the normal, then hemoglobin does not bind oxygen.
#And this effect of CO2 on oxygen dissociation curve is known as Bohr effect.
Haldane effect- The Haldane effect is first discovered by John Scott Haldane.
#The Haldane effect describe the phenomenon by which binding of oxygen to hemoglobin promotes the release of carbon dioxide.
#Haldane effect is the mirror image of Bohr effect.
#The decrease in carbon dioxide leads to increase in the pH, which result in hemoglobin picking up more oxygen.
#This is a helpful biochemical feature which facilitates exchange of carbon dioxide for oxygen in the pulmonary and peripheral circulations.
Urine concentration
The kidney can concentrate urine by continuing to excrete solutes while reabsorbing more water, producing urine 4-5 times more concentrated than plasma. This ability is essential for terrestrial mammals to survive on land. The countercurrent mechanism in the loops of Henle and vasa recta allows solutes like urea to accumulate in the renal medulla, establishing a high osmotic gradient for water reabsorption. When ADH increases collecting duct permeability, this gradient enables production of highly concentrated urine, minimizing water loss and fluid intake needs.
Counter current mechanism in kidney
The document discusses countercurrent exchange systems in various organs and tissues of the body including the kidney. It describes how the countercurrent multiplier system in the loop of Henle establishes a gradient that is maintained by the countercurrent exchanger system of the vasa recta, allowing the kidney to produce concentrated urine through the medullary countercurrent system. It also discusses how diuretics work by targeting different sites along the nephron to increase urine output.
Renal tubule transport mechanisms
I. The proximal tubule reabsorbs sodium, bicarbonate, glucose and other solutes. Carbonic anhydrase and NHE3 transporters facilitate reabsorption. Carbonic anhydrase inhibitors and adenosine receptor antagonists act in the proximal tubule.
II. In the loop of Henle, the thin descending limb is water permeable while the thick ascending limb actively transports sodium via NKCC2 transporters. Loop diuretics inhibit this transporter.
III. The distal convoluted tubule reabsorbs sodium and chloride via NCC cotransporters and regulates calcium reabsorption. Thiazide diuretics act on the NCC transporter.
IV
urine formation
The document discusses renal physiology and the urinary system. It contains the following key points:
1. The urinary system includes the kidneys, ureters, bladder, and urethra. The kidneys contain nephrons which filter blood to form urine.
2. The kidneys regulate fluid volume, electrolyte and acid-base balance, and remove waste. Nephrons contain a renal corpuscle for filtration and a tubule for reabsorption and secretion.
3. The proximal convoluted tubule reabsorbs the majority of filtered sodium, water, and other electrolytes using active transport mechanisms like sodium-glucose co-transport. This maintains electrolyte and fluid balance
Oxygen transport
This document discusses oxygen transport from the atmosphere to tissues. It describes how oxygen is absorbed in the lungs and bound to hemoglobin to be carried by the blood. The oxyhemoglobin dissociation curve is explained, showing how hemoglobin releases oxygen in tissues. Factors affecting oxygen diffusion and binding such as partial pressure gradients, carbon dioxide levels, 2,3-DPG, and fetal hemoglobin are covered. The document also briefly discusses oxygen toxicity and ischemia-reperfusion injury.
Renal physiology, renal blood flow, autoregulation, golmerular filtration. hu...
This document discusses renal physiology, including renal blood flow, oxygen consumption, regulation of blood flow, glomerular filtration, and factors affecting glomerular filtration rate (GFR). Some key points:
- Renal blood flow is approximately 1/4 of cardiac output, or 1200 ml/min. Blood flow to the cortex is higher than to the medulla.
- Glomerular filtration is determined by the net filtration pressure and filtration coefficient. Forces increasing filtration are glomerular hydrostatic pressure and oncotic pressure in Bowman's space. Forces decreasing filtration are plasma oncotic pressure and hydrostatic pressure in Bowman's space.
- GFR is regulated through autoregulation mechanisms like tub
Renal tubular reabsorption, secretion, regulation & renal function tests
Renal tubular reabsorption and secretion involves the transport of substances across tubular epithelial cells. Substances may be reabsorbed from the tubular fluid back into the blood (reabsorption exceeds filtration) or secreted from the blood into the tubular fluid (secretion exceeds filtration). Clearance tests can measure glomerular filtration rate (GFR) and renal plasma flow. Substances like inulin that are freely filtered but not reabsorbed/secreted will have a clearance equal to GFR, while clearance of substances like para-aminohippuric acid (PAH) that are secreted can estimate renal plasma flow. Hormones and other factors regulate tubular transport and fluid/electroly
What's hot (20)
Transport of oxygen (the guyton and hall physiology)
Transport of oxygen (the guyton and hall physiology)
Renal physiology, renal blood flow, autoregulation, golmerular filtration. hu...
Renal physiology, renal blood flow, autoregulation, golmerular filtration. hu...
Renal tubular reabsorption, secretion, regulation & renal function tests
Renal tubular reabsorption, secretion, regulation & renal function tests
Similar to Reabsorption in Loop of Henle
Update on Fluid Resuscitation
1) The patient has signs of shock including hypotension, tachycardia, and elevated lactate and base deficit.
2) Fluid resuscitation with 2L LR improved hemodynamics but lactate and base deficit remain elevated, indicating ongoing shock.
3) Aggressive resuscitation with blood products following a 1:1:1 ratio of PRBCs, FFP, and platelets is indicated to replace blood loss and prevent coagulopathy, given the suspicion for hemorrhage.
Approach to child with metabolic acidosis
This document discusses the approach to metabolic acidosis. It defines metabolic acidosis and provides normal values for arterial blood gases. Causes of metabolic acidosis include loss of bicarbonate from the body, impaired kidney function, and addition of acids. The body responds by respiratory compensation through hyperventilation and renal compensation by increasing bicarbonate reabsorption. Diagnosis involves measuring low pH and bicarbonate levels. Treatment focuses on addressing the underlying cause, while bicarbonate therapy is controversial and its risks must be weighed.
Renal physiological function
The kidney has several key functions:
1. It acts as a filter for the blood, removing waste and regulating water and electrolyte balance.
2. It helps regulate blood pressure and volume by controlling sodium and water excretion.
3. Through complex tubular reabsorption and secretion mechanisms, the kidney helps balance acids, electrolytes like sodium, potassium, calcium and maintains pH levels in the blood.
4. It produces hormones like renin, erythropoietin and activates vitamin D, and can also perform gluconeogenesis during fasting.
Fluid management in dialysis
Understand principles of fluids, fluid compartments and composition
Identify role of kidneys in fluid management
Establishing Target Weight
Understand consequences of fluid overload
Assessing and implementing successful fluid overload management practices according to guidelines
CAPD 3 Abdul Rahman .pptx
This document discusses peritoneal dialysis (PD) management, including adequacy assessment, ultrafiltration failure, and peritonitis treatment. It notes that adequate PD is defined as a weekly Kt/V of at least 1.7. Ultrafiltration failure can occur in different transport types and be addressed through prescription modifications. Peritonitis treatment involves empiric antibiotics, monitoring response, and sometimes catheter removal for refractory or relapsing cases. A multidisciplinary approach is emphasized for optimal PD program management.
Electrohfvb.ppt
This document provides an overview of gastrointestinal physiology, focusing on absorption of water and ions. It describes how intestinal epithelial cells regulate ion and fluid movement through transcellular and paracellular transport. Key transport mechanisms involve sodium-hydrogen exchangers, sodium-glucose cotransporters, and chloride channels. Disruptions in these pathways can cause secretory diarrhea from enterotoxins or malabsorptive diarrhea from mucosal damage. Overall, tight regulation of electrolyte transport across the gut epithelium maintains fluid homeostasis and absorptive vs secretory functions in health and disease states.
Water_and_electrolytes_final_NASPGHAN (1).ppt
This document provides an overview of gastrointestinal physiology, focusing on absorption of water and ions. It describes how intestinal epithelial cells regulate ion and fluid movement through transcellular and paracellular transport. Key transport mechanisms involve sodium-hydrogen exchangers, sodium-glucose cotransporters, and chloride channels. Disruptions in these pathways can lead to secretory diarrhea from enterotoxins or inflammatory cytokines. The document also reviews absorption of minerals, vitamins and how transport is regulated throughout the gastrointestinal tract.
Pancreas transplant
Pancreatic transplantation involves transplanting a whole pancreas or pancreatic islets to treat diabetes. The main types are simultaneous pancreas-kidney transplant, pancreas after kidney transplant, and pancreas transplant alone. Patient selection criteria are strict to identify those who will benefit without risks to safety. Younger donor pancreases without steatosis or damage are preferred. Outcomes of pancreas transplant alone versus islet transplantation were compared, finding similar rates of insulin independence at one and three years post-transplant. Immunosuppression protocols aim to prevent rejection while avoiding side effects.
Histology of Renal Tubule and its Variation in relation to Function
The structural and functional unit of kidney, the nephron is highly specialized in view of its function. Here we look at the various histological variations/modification in relation to its function of the Renal Tubule
Aki
1) AKI is defined as an increase in serum creatinine within 48 hours or 1.5 times baseline within 7 days, or urine output less than 0.5 ml/kg/h for 6 hours. Prevention focuses on optimizing volume status, limiting nephrotoxic medications, and hydration for procedures requiring contrast.
2) Secondary prevention of AKI aims to avoid further injury, facilitate recovery, and prevent complications. For rhabdomyolysis, aggressive hydration and bicarbonate are recommended to prevent myoglobin precipitation in tubules. Fluid management must be monitored to avoid electrolyte abnormalities.
Laboratory role in renal replacement therapy.pptx
This document discusses the role of the laboratory in renal replacement therapy. It begins by outlining the normal functions of the kidneys and describing acute kidney injury (AKI), chronic kidney disease (CKD), and the various forms of renal replacement therapy including dialysis and transplantation. It then discusses guidelines for assessing and treating AKI and CKD patients undergoing renal replacement therapy. The document also covers the laboratory's role in monitoring transplant patients and various immunosuppressive drugs. It concludes by discussing new markers being used to monitor renal replacement therapy and important considerations for long-term therapy.
Fluidos intraopratorios
This document discusses how perioperative fluid balance influences postoperative outcomes. It begins by describing how fasting, anesthesia, and surgery affect the body's ability to regulate internal and external fluid balance. Abnormal fluid balance can negatively impact organ function and surgical recovery. The goal of fluid therapy for elective surgery patients is to maintain effective circulatory volume while minimizing interstitial fluid overload. Optimal fluid management should aim for a "zero fluid balance" and avoid overhydration, while ensuring patients are not fluid depleted prior to surgery.
Hypokalemia
hypokalemia - pediatric overview,
common causes,
illustrative figures,
pnemonics,
easy to understand concepts,
practically oriented.
Clinical significance of carbohydrates presentation
The document discusses carbohydrates of biological and clinical significance and glucose absorption. It covers classification of carbohydrates, their biological and clinical importance, digestion and absorption of glucose through sodium-glucose cotransporters, and important glucose transporters. The seminar objectives were to discuss carbohydrate structure and function, glucose homeostasis, dietary fiber significance, and digestion and absorption of carbohydrates. Key topics included biological roles of carbohydrates, clinical implications such as glycated hemoglobin, and the five phase mechanism of glucose homeostasis.
ACTIVE TRANSPORT Pgp,BCRP,NT.pptx
primary and secondary active transport difference,Computer aided drug design P glycoprotein transport,bcrp,nt,Abst,oATP,oct,BBB choline transporter,hpepti
Parenteral Nutrition
The document discusses parenteral nutrition for critically ill patients. It begins by noting the high prevalence of malnutrition in ICUs and challenges in predicting metabolic needs. It then covers the indications for and types of parenteral nutrition, including total and peripheral parenteral nutrition. Practical considerations for intravenous site selection and formulations are discussed. The requirements and recommendations for energy, fluids, carbohydrates, proteins, fats, electrolytes, trace elements and vitamins are provided. Finally, preparations of single and multi-nutrient parenteral nutrition solutions are described.
Fluid in pancreatitis final
Fluid resuscitation is an important part of treating acute pancreatitis. Early resuscitation within the first 24 hours is most effective. Lactated Ringer's solution is preferred over normal saline as it is more pH balanced and reduces inflammation. The goal is to resuscitate at a rate of 5-10 ml/kg/hour to a total of 2500-4000 ml in the first 24 hours. Response should be monitored using clinical goals like heart rate, blood pressure, urine output and biomarkers like CRP and hematocrit to guide further fluid administration. Early resuscitation with Lactated Ringer's reduces complications and mortality in acute pancreatitis.
Fluid and electrolyte balance in oral surgery
• ELECTROLYTE BALANCE
• Def: - concentration of individual electrolytes in the body fluid compartments is normal and remains relatively constant.
• Electrolytes are dissolved in body fluids
• Sodium predominant extracellular cation, and chloride is predominant extracellular anion. Bicarbonate also in extracellular spaces
• Electrolyte balance
• Na + (Sodium)
– 90 % of total ECF cations
– 136 -145 mEq / L
– Pairs with Cl- , HCO3- to neutralize charge
– Low in ICF
– Most important ion in regulating water balance
– Important in nerve and muscle function
• Electrolyte imbalances: Sodium
• Hypernatremia (high levels of sodium)
– Plasma Na+ > 145 mEq / L
– Due to ↑ Na + or ↓ water
– Water moves from ICF → ECF
– Cells dehydrate
• HYPERATREMIA
• Hypernatremia Due to:
– Hypertonic IV soln.
– Oversecretion of aldosterone
– Loss of pure water
• Long term sweating with chronic fever
• Respiratory infection → water vapor loss
• Diabetes – polyuria
– Insufficient intake of water .
• Clinical manifestations
of Hypernatremia
• Thirst
• Lethargy
• Neurological dysfunction due to dehydration of brain cells
• Decreased vascular volume
• TREATMENT OF HYPERNATREMIA:
• Lower serum Na+
– Isotonic salt-free IV fluid [5% dextrose]
– Oral solutions preferable
• Hyponatremia
• Overall decrease in Na+ in ECF
• Two types: depletional and dilutional
• Depletional Hyponatremia
Na+ loss:
– diuretics, chronic vomiting
– Chronic diarrhea
– Decreased aldosterone
– Decreased Na+ intake
• Clinical manifestations of Hyponatremia
• Neurological symptoms
– Lethargy, headache, confusion, apprehension, depressed reflexes, seizures and coma
• Muscle symptoms
– Cramps, weakness, fatigue
• Gastrointestinal symptoms
– Nausea, vomiting, abdominal cramps, and diarrhea
• Tx – limit water intake or
• discontinue medicines such as diuretics
• TREATMENT OF HYPONATREMIA
• Hyponatremia which develops quickly should be treated quickly & vice-versa
• Patients with severe hypoNa (<115) are at risk of neurological damage
• Too rapid correction causes CENTRAL PONTINE MYELINOLYSIS.
• Targeted rate of correction: 0.5-1.0 mEq/L/hour
• Raise plasma Na by <10-12 mEq/L on first day
• Correction @ rate >25mEq/L places at high risk for central pontine myelinolysis
• Hypokalemia
• Normal serum k+ conc is 3.5 to 5.0 mEq/l
• Serum K+ < 3.5 mEq /L
• Beware if diabetic
– Insulin gets K+ into cell
– Ketoacidosis – H+ replaces K+, which is lost in urine
• β – adrenergic drugs or epinephrine
• Causes of Hypokalemia
• Decreased intake of K+
• Increased K+ loss
– Chronic diuretics
– Acid/base imbalance
– Trauma and stress
– Increased aldosterone
– Redistribution between ICF and ECF
• Treatment of hypokalamia
• Metabolic acidosis increases serum K+ levels & vice versa
• Post-op patients on fluid therapy should receive approx 60mEq/day to prevent hypokalemia
• 1mEq/L fall in serum K+= 200-400 mEq total body K+ deficit
• Failure to ↑ Sr. K+ even after sufficient correction should
Physiology of Diuretic Action
The document summarizes the physiology of diuretic action. It defines diuretics as substances that increase urine flow and water excretion. It describes the classes and sites of action of various diuretics including loop diuretics, thiazide diuretics, potassium-sparing diuretics, and aquaretics. It discusses factors that affect diuretic action such as the volume of extracellular fluid and delivery of diuretics to their site of action. It also covers the effects of diuretics on absorption of water, electrolytes, and other solutes as well as their clinical applications and side effects.
Mechanisms
The document discusses the mechanisms of drug absorption from various routes of administration into systemic circulation. It defines absorption and describes the common routes like intravenous, oral, etc. It focuses on gastrointestinal absorption and the mechanisms involved, including transcellular transport (passive diffusion, active transport), paracellular transport, and vesicular transport. Cell membranes allow movement of drugs via diffusion, facilitated transport or active transport utilizing carriers. The summary provides an overview of the key topics and processes related to drug absorption covered in the document.
Similar to Reabsorption in Loop of Henle (20)
Histology of Renal Tubule and its Variation in relation to Function
Histology of Renal Tubule and its Variation in relation to Function
Clinical significance of carbohydrates presentation
Clinical significance of carbohydrates presentation
More from Dr. Aryan (Anish Dhakal)
Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
Book trailer of one of the most anticipated and the best book for CEE MD/MS Entrance Examination of Nepal.
NMCLE in a Nutshell Book Trailer
Trailer of the best book for Nepal Medical Council Licensing Examination (NMCLE). Presenting to you: "NMCLE in a Nutshell"
Essential Drugs Dosage and Formulations (Medical Booklet Series by Dr. Aryan ...
Essential Drugs Dosage and Formulations (Medical Booklet Series by Dr. Aryan ...Dr. Aryan (Anish Dhakal)
This is the 22nd part of medical booklet series created by Dr. Aryan in order to familiarize doctors and medical students about the basic doses of drugs. Many students remember the mechanism of actions and other details of drug very well and regard doses as unnecessary. While you prescribe, this becomes one of the most important aspect. This study material is focused to resolve such issues.Osteoarthritis 2021 Updated Guidelines
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Preterm Labor 2021 Update
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
Delirium by Dr. Aryan
Delirium, also referred to as "acute confusional state" or "acute brain syndrome," is a condition of severe confusion and rapid changes in brain function.
Warts (Verruca) by Dr. Aryan
Skin warts are benign tumours caused by infection of keratinocytes with HPV, visible as well‐defined hyperkeratotic protrusions. We will explore the detailed types, presentation, and treatment modalities of most common warts.
Journal Club: Prophylactic Thyroidectomy in Multiple Endocrine Neoplasia 2
The study aims to analyze the long-term results of a large cohort of MEN2 patients with the C634Y mutation who had undergone prophylactic thyroidectomy in a tertiary referral hospital, and to analyze the results in terms of age and calcitonin levels.
Surgery Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part...
Surgery Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Pediatrics Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan P...
Pediatrics Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan P...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Medicine Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...
Medicine Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Gynaecology and Obstetrics Review Booklet by Dr. Aryan (Medical Booklet Serie...
Gynaecology and Obstetrics Review Booklet by Dr. Aryan (Medical Booklet Serie...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Radiology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...
Radiology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Ophthalmology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Arya...
Ophthalmology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Arya...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Forensic Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...
Forensic Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. ENT Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part 12)
ENT Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part 12)Dr. Aryan (Anish Dhakal)
This document is a preface and introduction to a study material on ear, nose and throat disorders created by Dr. Aryan. It outlines that the material aims to provide a concise review of key information through slides with minimal relation between slides. It is meant as a high-yield review and recommends referring to textbooks for more comprehensive understanding. The preface emphasizes executing on knowledge gained and includes motivational quotes throughout. It is signed off by the creator, Dr. Aryan, wishing readers best of luck and success in their work.Dentistry Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...
Dentistry Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Dermatology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...
Dermatology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes.Anaesthesia Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...
Anaesthesia Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes. Hypertension 2020 Updated Guidelines
Management of hypertensive condition in 2020 according to AHA/ASA guidelines. We will discuss the presentation, clinical assessment, investigations, and management of hypertension along with major randomized controlled trials and guidelines.
More from Dr. Aryan (Anish Dhakal) (20)
Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
Essential Drugs Dosage and Formulations (Medical Booklet Series by Dr. Aryan ...
Essential Drugs Dosage and Formulations (Medical Booklet Series by Dr. Aryan ...
Journal Club: Prophylactic Thyroidectomy in Multiple Endocrine Neoplasia 2
Journal Club: Prophylactic Thyroidectomy in Multiple Endocrine Neoplasia 2
Surgery Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part...
Surgery Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part...
Pediatrics Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan P...
Pediatrics Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan P...
Medicine Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...
Medicine Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...
Gynaecology and Obstetrics Review Booklet by Dr. Aryan (Medical Booklet Serie...
Gynaecology and Obstetrics Review Booklet by Dr. Aryan (Medical Booklet Serie...
Radiology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...
Radiology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...
Ophthalmology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Arya...
Ophthalmology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Arya...
Forensic Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...
Forensic Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Par...
ENT Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part 12)
ENT Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part 12)
Dentistry Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...
Dentistry Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Pa...
Dermatology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...
Dermatology Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...
Anaesthesia Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...
Anaesthesia Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan ...
Recently uploaded
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
ABDOMINAL TRAUMA in pediatrics part one.
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Top Effective Soaps for Fungal Skin Infections in India
Swisschem Dermacare has mentioned the List of The Best Antifungal Soap In India 2022. All of these soaps are trusted by various Dermatology Experts.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Recently uploaded (20)
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Reabsorption in Loop of Henle
- 1. REABSORPTION: PCT, THICK ASCENDING LIMB & EARLY DCT Prepared by: Anish Dhakal (Aryan) MBBS Student Patan Academy of Health Sciences
- 2. OBJECTIVES • Reabsorption of important electrolytes and water along the tubule • Mechanisms involved in those reabsorption processes • Mechanisms of alteration of the absorptive processes by some medications
- 3. TRANSPORT MECHANISMS • Passive transport Simple diffusion Facilitated diffusion • Active transport: Primary Active Secondary Active • Protein mediated transport: Symport Antiport
- 5. GENERATION OF THE DRIVING FORCE
- 11. LIMIT OF REABSORPTION: CONCEPT OF TRANSPORT MAXIMUM • Difference between Renal Threshold and Transport Maximum • Introduction of Splay • Classic example is reabsorption of Glucose
- 13. REABSORPTION IN THICK ASCENDING LIMB
- 15. REABSORPTION IN EARLY DCT
- 16. REFERENCES: • Guyton and Hall Textbook of Medical Physiology 13th Edition • BRS Physiology, Linda S Costanzo ,Wolters Kluwer Health • Ganong’s Review of Medical Physiology, 24th Edition