Fisiología Veterinaria S13 - (parte 1)

I want to talk about the renal vasodilator, which is one of the most important systems because it is in charge of filtering the blood, of purifying those substances and compounds that the organism may still take advantage of or that it completely eliminates. I'm going to close the door for now. Very well, so we were talking about what we have to talk about. We have here, as always, we have to...

to get them to dig up their knowledge. In this case, we have a case that tells us that a 10-year-old cat comes to the consultation with lethargy, dry mucosa, and loss of elasticity of the skin, which is already indicating that it is possibly dehydrated. The owner refers that the animal has stopped eating and drinking properly.

The urine is scarce and very concentrated. So from there, you know what to do, you have to go here. We have two questions that say: What mechanisms does the kidney use to preserve water in this situation? And what hormones could be participating? What do you think of what you already know? Of what we have already seen at some point? Those who got 17, 17.5,

So, the first thing is that since it is not receiving water,

is not eating, is eating in small amounts. So what it is telling us is that its organism, which is physiologically trying to concentrate water. Where does this happen? At the level of the gene loop. Where there is a physiological mechanism, which we are going to see today, which is known as the counter-current mechanism, or counter-current multiplier mechanism, which is in charge of

absorb water at the level of the gene-descending bone and from where the urine concentrates. Why? Because the water is going towards the intestine, therefore the vulnerability at the level of the gene-descending bone will increase. For what? To be able to concentrate. In addition, we will also see that the anti-uretic hormone will act. In the anti-uretic hormone, we know

that has its receptors at the level of the collector tube. Once it joins, what it does is externalize water by itself and therefore the water will be interspersed. What it seeks is to avoid water loss. How? By retaining it, through the countercurrent multiplier mechanism and through the action of the anti-brembo hormone. Therefore, here again the urinal will be concentrated. And what does that mean?

in which we have a decrease in urinary volume and that they are more hyperosmotic because they have more concentration, they have more solutes than water. Why? Because the water is more sustainable. Now, here it also tells us that there is an increase in the reaction of sodium. Why? Because we have another hormone, which is aldosterone, which has its receptors in the

the final phase of the distal contoured tube and the first part of the collector tube. And what it does is that it is externalized, that some channels are activated for the sodium that are known as Na. So it retains sodium and by retaining sodium, you know that sodium, being a solute, tends to drag water. So the water is following it, so it also retains the water in this way.

What hormones participate? The ones we have mentioned. Antibiotic hormone or azopressin, we already know its effects. The angiotensin-aldosterone-relin system, to be able to absorb sodium and with it also to absorb water. And what we are going to see, remember the atrial natriuretic effect that had an effect contrary to the angiotensin-aldosterone-relin system? In this case it will be inhibited.

And when it is seen, there is no loss of sodium or water with the opening. Why? Because the purpose is that the organism does not burn it. This is what happens physiologically. They are mechanisms, because there are several, you can see, they are mechanisms of compensation. Can they fail? Yes, they can fail. And that's when we call a patient who is totally decayed, very dehydrated, and we have to put fluidotherapy on him.

In this case, the body already tried, but it didn't respond. And we are going to see it now. We are going to talk a little about the degrees of dehydration, where we are going to talk again about this, reinforcing what you already know. Is it clear about this case? The point of the learning is that you are going to learn the basic principles of general physiology.

filtration, absorption, and secretion. We will see that today. Don't forget to subscribe. And this is the content of the class. I hope you enjoyed it. Very good. Now, if we talk about kidneys, we have to talk about water. And something very important is the balance of water in animals.

What does this mean? That there is a balance between the entrance and exit of water. As long as that balance is maintained, the animal will find itself in a homeostasis. The problem is when there is a imbalance, because that's where we start talking about pathology. If we talk about a decrease in water entrances, but there is an increase in losses, then we talk about dehydration. But if we have

an increase in water income, and a decrease in losses, there is also a imbalance, and it can be due to multiple options. And one of the best known is the "pandestinema", when the water accumulates at the level of what it should be in a purported way among the animals. To give you just one example. What are the water contributions for the animal? Without a doubt, drinking water.

The water that we put in the drinking water tanks or the animal that goes to a water source is a main source of income. The water of food also. For example, if we feed the cattle with green pastures, they have a greater proportion of water.

So, the water content is much more important. If we give them an older and drier pasture, they already know that they have more lignin and that they practically did not digest. Or, for example, we can also compare the dry and moist food that they like more. The dry food is the balanced one. And the moist food, you may have seen the flatbreads or the cheeses that are made in the famous pâté, the pâté for animals.

The water content is higher in the pate. You will take a course after physical education, in which you will learn to make the rations. What percentage of water does the patient or the team need according to the pathology.

or according to the production you are looking for. There you will learn that you always have to have certain components of water, but many times the component must be higher or maybe it must be lower, according to what you see. And we have another source of input, which is the oxidation water, also known as metabolic water. What does the oxidation water or metabolic water mean? It is the water that is formed within the organism

because of multiple processes. And there is one very important one that you know and that we have been seeing for weeks. Which is, where have we seen water forming? We know that it has a component of water, but how is the process? I want to know, what would that water be like? How does it form? If I tell you the immediate reversible reaction, the carbonic acid, do you understand how the water forms? Yes or no?

Through carbon dioxide, CO2 and water are dissociated. That water molecule is water oxidation or water depletion. So all the processes within the body need the formation of water molecules, and it will always be water oxidation or water depletion. It is an important gateway, an water supply.

Now, water loss can be seen through different ways. The main one through urine. Through urine is the main water loss, the most abundant. The respiratory ways too, but it is not on a large scale as it happens with urine. This is done through the exhalation.

When they are children, they have not glued their faces to the glass, they have breathed and they form like little drops. That would be a form of water loss. It is also minimal, but there is water output. Through the skin, there are many species that we know that sweat. For example, for us, they have the horse. They have this great ability to sweat after exercising. Through the breasts, too.

Regarding the feces, it will depend a lot on the type of food. It always has a juicy component and it will depend a lot on the type of food you eat. If there is more fiber, there is less fiber. And what to talk about if there is pathology. There is pathology in losses through the feces that are greater. Why? Because it develops, for example, in the liver. Many times it tends to be very liquid and it is an important loss that generates dehydration.

And the obtaining of products is also a form of water waste. For example, dairy cows, dairy cows that are giving a product, in this case milk, that generate waste of liquid, water waste, but that later they will recover it. How do they recover it? With drinking water, with water contained in food, which is the corrugation, and with the oxidation water that is going to be formed.

So there has to be a balance between the inputs and outputs. So what? So that we can maintain the balance. When this balance is lost, we begin to see the balance. This balance of the liquids also contributes to the maintenance

the concentrations of the different ions, as you already know, at the level of what would be the intracellular and extracellular liquid. We also see it there, right? We already know at the extracellular level, whether plasma or at the level of the interface, we have a greater presence of sodium, of chlorine, of bicarbonate, of calcium, unlike the

We have more potassium, we have organic anions, we have proteins that we know will give that negative load to our membranes. We have more phosphates, more sulfates, and less sodium, less chlorine, less bicarbonate, and less calcium. Because remember that everything is lost at the level of calcium. Now, as we had seen, the losses are greater.

After the water is drained, we begin to see a dehydrated patient. This dehydration is classified into percentages. You will see in the different books, even with different professors, they use different scales. But this is the most common one. It tells us that if dehydration is mild, it is in 5-6%.

we are going to call it moderate, between 7 and 8%, and severe when it is greater than 10%. Now, there are other authors who say that if it is more than 8%, we are already talking about severe. When we talk about severe, it means that the patient is already very close to being able to specialize, it means that the disease is very strong. And see how we can recognize it. If it is minor,

a 4% we are not going to see it, it is very difficult to see it. So what happens in this case? It is not detectable and possibly the physiological organism is the one who is trying to compensate for this dehydration. So what we have seen in the clinical case is what is happening here. We don't see it, but we know it. Now, if we start to see

certain mucus dryness, we can classify it as 4-6%. If in addition to that mucus dryness, we see there is a subtle delay in the cutaneous fold, which is a test that we do to see if the patient is dehydrated. It is one of the many tests that is easy, we simply take the cutaneous fold, we release it and it has to return immediately. But if there is a certain delay, a delay in that return,

we can also talk about it going from 6 to 8%. And if we also do a hematocrit test, we will see that the hematocrit is usually increased. Why? Because it has less lithium, more sodium, more solute. In this case, more red blood cells. And then the hematocrit increases. If in addition to this, we see that the eyelids begin to look a little darker and also with the eyes closed,

we already started to say that it is going from moderate to severe and even more severe when there is already a corneal dryness, which is like the cornea looks like, if I could say, I don't want to say like a papyrus because it is not exactly a papyrus, but something similar. So it tells us that water losses are very important, apart from all the signs that we have already seen, to the corneal dryness and between 12 to 15 percent

We even see signs of hypoperfusion. What is perfusion? The arrival of blood to the tissues, as in the pressure. So, it means that here there is a hypoperfusion, that is, the arrival of blood to low pressure, and therefore the oxygen supply is not adequate. What do we see? We are going to see possibly a patient with certain areas, even mucous, that can be cyanotic.

Why? Because there is no good health outcome. This is another classification. Different from the books you will find. But what most people agree with is that when it is less than 4%, it is very difficult to detect. The organism is trying to compensate through the mechanism of antidiuretic hormone release, of the mechanism of the countercurrent, of the release of the alosterone, to try to concentrate

Is that clear, guys? Very good. So now we are going to go fully into what is the renal syphilis. We know that the functional unit of the kidneys is the nephrol. And you will remember that if we make a cut, we will find two marked areas, which would be the cortex and the renal medulla, which is where the nephrol is going to be distributed. Remember that they are located in the kidneys.

from 1 million to 1.5 million in each kidney. What species does this kidney belong to? Echinus. How are the bovines? Globulinous. And the ears? Globulinous. It has a form of... No, it has a form of... What do they call it?

Now, what are the functions

of the kidneys, there are several, because they are vital organs, necessary for the blood to be filtered. So, what functions do we find? Look at what it says: expression of the final products of metabolism and of foreign urinary substances or ligaments, is filtered and secreted. Remember that we had

three processes within the field of renal filtration, renal absorption and renal excision. Many of these compounds will be filtered, others will be secreted in the tubule. The tubule where the other is controlled, the other will be used to make a distal, which are the two points where there is usually a secretion. And what do these final products of the metabolism mean? When you apply a drug,

Once it has taken action, metabolites are formed. Metabolites that organisms no longer need. Therefore, they have to be eliminated. Some will be filtered, but others can be secreted, as is the case with penicillin. The metabolism of the sulps tends to be secreted at the level of the tubular, with the first proximal.

are going to be dragged throughout the whole population to be able to eliminate or for example the famous food additives example in snacks that have the yellow orange almost radioactive color with cheese flavor cheese we ingest them but they do not provide any nutrients they have all those additives that give that color flavor aroma that is not rich we made a craving but

to the nervous system. So all those metabolites that are formed are secreted and are eliminated with the blood. Some with the feces, but most are eliminated with the blood. Conservation of substances. What does this mean? They are substances that either are not filtered at all or are filtered and are absorbed. We are going to see that when the filtration process occurs, there are some substances that are not going to be filtered.

Other yes, as long as they meet certain requirements. Those that are filtered, many times, are reabsorbed. Why? Because the organism still needs them. So it tries to take advantage of them, to preserve them, and not to eliminate them. Above all, it happens, for example, with amino acids, it happens with calcium, it happens with, in short, with various ions, with various molecules, as we will see.

Regulation of the hydro and electrolytic balance. That is, it allows for a balance between the water molecules and the electrolytes, which will be secreted or reabsorbed. Here again we are going to talk about the transport through the membranes.

Regulation of acid-base balance. We are going to see that the cells that are part of the tubular function generate hydrogel.

tend to generate these hydrocarbons that are going to be released to the tubular portion to avoid acidification. But just as they are releasing hydrocarbons, they also have to form bicarbonate or even molybdenum. Why? To maintain that balance, to neutralize it. It also has endocrine functions because it is responsible for synthesizing and secreting

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but it could be vitamin D3, that is, the active form of the vitamin, which is calcium triol, also active at the renal level. Next week we are going to talk about the calcium regulation, there we are going to talk again about the vitamin D of calcium triol. And in addition to endocrine functions, there is a sixth function, which you will surely find in some books, which says that at the renal level, gluconeogenesis is also generated.

Logically, not at the liver level, because at the liver level is the main place of gluconogenesis. But also, in a small percentage, it is said that 3 to 5% of gluconogenesis occurs at the renal level. That is, glucose formation from compounds that are not carbohydrates and that the body is going to re-use. Very well, so those would be the functions.

Remember a little the vascularization of the kidney, which is very important for the physiological part. The blood comes through the renal artery. We continue to do the anatomical record through the experimental artery, it continues with the interlobar, with the arcuate, the intertabular and continues with the aferin artery.

The aferent arteriole, which is the one that will enter the bone capsule, to continue with the glomerular capillaries, which is the place where the filtration is going to be done. So, what is done thanks to the filtration? We are going to see that it continues with the aferent arteriole. So, what does that tell us? We have already seen that here there is a short system.

A special portal system that is the one that is used at the hepatic level, at the level of the lipotomy and at the level of the retina. That is the portal system. Where we see that the deferent artery is going to be coordinated with the rectal base, that is, with the peritubular capillaries. It is very important because that rectal base continues in parallel with the genus.

It is very important so that this exchange of electrolysis can be given, that is, of ripples and water in general. And then it continues with the portion of the veins, the interlobular vein, the interlobar, the segmental, the segmental, I don't know how you saw it, and finally the renal vein that is going to lead to what would be the caudal vein.

What part of the body is interesting to us in physiology? This part here. Because this is what happens at the level of the nephrons. The anterior afferent, glomerular capillaries, anterior afferent and the right side, or peritubular capillaries. Let's remember how this nephron is formed, in which we will find what would be the glomerulus, another glomerulus,

that will continue with the proximal contorneado tubule, it continues with the Hegelian axis, the descending and ascending branch, it continues with the distal contorneado tubule and ends in the olfate tubule. Just to give you a little bit of memory and be able to continue. Now we can have

nephrons, which can be cortical or just medullary. If they are cortical, as we can see, they usually have the cortical genus. Let's locate them, see, cortex, medulla, the medulla is divided into the external zone and the internal zone, which is the deepest part, and we can see that what would be the glomerulus is very close to the cortex, the most external part of the cortex.

and the genus is just entering the medial level, just as you can see, unlike the medullary yuscas, in which we can see that their glomerules are in the cortex, but they are very close to the limit of what would be the medial. Therefore, it has a much longer genus, it goes to the

deeper than the internal area. Now, most species have the same, two types of flora. But, in the animals that live in the desert and have less access to water, they have a developed type of flora. That would be, if we talk about wild animals, cortical or juxtamedular. What happens to them? The one that has the longest gene pool, the one that has the shortest gene pool.

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In those species, they do have a higher development of just-type nephronas. Because of their ability to concentrate more, to retain more. I have put some data on these nephronas with the animals that you are going to encounter. You can send it to the delegate, the test subjects, so that they can have them too. Now,

What we are going to see first is the filtration process. Filtration that occurs exclusively at the level of what would be the muon. What is going to be filtered is the blood, that is, the plasma, the components of the plasma. And we are going to see, so that this filtration process can be given, there are some barriers. In fact, there are three, and we have them here.

We have them here, maximized so you can understand. We are going to locate ourselves, we have here the capillary light, which is going to be in contact with the first barrier, which is called glomerular filtration barrier or endothelial barrier. It is characterized by having these pores that we see here, which are called fenestras. It has the fenestras or pores.

Through which certain substances will pass, certain molecules, but not all of them. What is not going to happen? Red blood cells will not pass, platelets will not pass, white blood cells will not pass, and neither will proteins. Remember that proteins

have large size. There are albumins that can generate 250,000, 265,000 daltons, which is large size. And well, we don't see it, but talking about through this network that would have to pass, it doesn't pass. So they are large molecules. So, therefore, we have this first barrier that will allow all plasma substances to pass, except the one I have named.

Next, we have the second membrane, known as the basal membrane, which is the one that is here in a medium-color, a little green. This barrier is composed of paracetamol, proteolytic, it has collagen, it has... It has a special characteristic, and that is that it has negative carcinogens. This membrane has negative carcinogens.

Why is this important? Because we know that proteins should not pass through the first barrier. But what happens if they are small proteins? They pass through the first barrier, but the second one does not. Why? Because remember, we said that there were organic anions but also proteins, and those proteins have negative caddies.

Therefore, if the membrane has negative charge, negative radioactivity, it repels. It doesn't pass. The second barrier. And then we have the third barrier, which is the epithelial barrier, also called podocytal barrier. Why? Because it presents cells that are called podocytes, which are like star-shaped cells. Let's see what the importance of podocytes is.

What is the name of this particular cell? O-Docitus. The way? O-Docitare or epitare. The importance of having this star shape, it presents these extensions as if they were pseudopods, which are known as pedicels. These pedicels intertwine with each other, as it happens in this case. It's as if our fingers were joined, intertwined, and leave some gaps, some space, a strainer.

This is the last barrier, through which only those with less than 4 nanometers can pass. Less than 4 nanometers. Approximately 40,000 altitudes. Between 40,000 and 50,000 altitudes. 4 nanometers. It generates these grooves, as I said, through which they will be able to pass, for example, I ask, could glucose pass? No, no, no.

Yes, it could happen. Why? Because glucose is a large molecule, but it has less than 40,000 daltons. No, but glucose does. It has between 25,000 and 35,000 to 36,000 daltons approximately. So it can happen. What does this mean? That glucose does filter. Amino acids will pass. Yes, they will pass.

Yes, they can pass because they have less than 4 nanometers. Now, as polypeptides or as proteins, they do not pass, but as amino acids, they can pass, if filtered. I, in that filter, yes, they can be filtered, of course, metabolites, additives, as long as they have less than 4 nanometers, they will pass. This is our last barrier. And many consider it, let's say, the most important barrier.

and that is the emotional serenity. Why? Because it is the last, in quotes, "slipper" so that they can pass. And something very important about the podocytes is that they do not have replicative power. That is, they do not live. There is no uterus. What does this mean? That if they get damaged, they no longer know what to expect. So if we have, for example, a patient with chronic kidney failure, that barrier will be affected in all ways.

So what do we see in this patient? That the patient has a large amount of proteins, especially the amount of albumin, which should not be. There are three barriers that this patient has. It is a very important barrier. We started to see that there is a presence of erythrocytes. Now you are going to see in pathology courses, in the pathology of what? According to these diseases, if from the signs and diagnosing with the laboratory, you can find

a little bit of proteins, a little bit of leukocytes, a little bit of blood, but you have to see what the origin is. Maybe these membranes are not very damaged, because it is not a chronic terminal insufficiency. And then, obviously, that means that not all the leukocytes have been damaged. You will have to do the right treatment to be able to maintain it. So, go back to normal.

Now, what can we say more about the little things? Look here how it is interdigitated. It forms like a kind of intertwined finger with small openings that are the ones that will allow it to pass to those that have less than 4 nanometers. They also have other functions. These functions are important because in addition to serving as a barrier of filtration, they also have a protective function.

They tend to phagocytate strange substances that can be found within the bone capsule, within the glomerulus. It maintains the glomerular architecture, because it has dextro-milican integrins, which you know from biology, that help to keep the membranes stable.

synthesis of some substances, such as type 4 collagen, laminin, fibronectin, which we find present in the basal membrane, that is, it also contributes to the basal membrane, that is, the second membrane, to be able to maintain its negative charges by the synthesis of these substances. Well, here you have the protective function,

And we also have to talk about what mesangial cells should talk about. Mesangial cells have many functions. Among them, for example, they are responsible for synthesizing electroponidin, as we have seen, but they also have a protective function, which also generates phagocytosis of foreign substances that could have reached the nephropathy.

has a structural and regulatory function. Why? Because it releases, for example, renin. In the case of low pressure, it begins to synthesize and release renin. Now, just as we have our filtration barriers, we also have to keep in mind that there is pressure.

And for there to be a good glomerular filtration, we have to take into account what should be the permeability coefficient for the effective filtration pressure. There is a formula that talks about the permeability coefficient and the effective filtration pressure. In the case of the filtration coefficient, it refers to how the permeability of the membranes is.

which is through which these exchanges are going to be made. And we can see that if there is more surface, greater permeability, it translates into greater filtration. If there is less surface, less permeability, logically we will have less filtration.

It has to meet certain requirements of these molecules and ions, but it will also depend a lot on the permeability of these membranes. As long as they are maintained within their normal patterns, there will be good filtration. But we also have this effective filtration pressure. This effective filtration pressure would be the difference between hydrostatic and glucotic pressures.

The effective filtration pressure is also known as net filtration pressure. You can find it with this name in some books and in some articles, with any of the names. What does the simplest formula tell us? Because there are other formulas as well. What does it tell us? That we have the hydrostatic glomerular pressure, which is usually very high, let's see here, 60 mmHg. And I ask, we have been doing this for several weeks,

The hydrostatic pressure of the peripheral blood vessels, how much is it? Is it also 60? How much is it? How much is it? It wasn't 40. The capillary strength of the capillaries, how much is it? It was approximately 25-26 mmHg. Therefore, we see that here it is much more.

Why does this hydrostatic pressure at the glomerular level have to be high? Because this hydrostatic pressure is what will push the liquids through the walls of these capillaries. This needs to be a high pressure. We have, as I said before, the hydrostatic pressure of the glomerular, minus the hydrostatic pressure of the Bowman capsule,

usually have an average of 18 mmHg, minus the glomerular oncotic pressure, which has an average of 30-32 mmHg. You make the difference, you calculate, and you have 10 mmHg. This effective filtration pressure, while it is maintained at 10 mmHg, or around 10 mmHg,

we will have a good non-mehcular filtration. So it is important that these pressures are maintained within those ranges or within that average that we have here. Something very important that you remember, in the case of hydrostatic pressure, the molecular one favors the filtration, but remember that it is the force of the pressure that will be pushing the fluids.

while the other two pressures, that is, the hydrostatic pressure of the bomb capsule plus the pressure of the balloon, are opposed to the filtration. They are opposed to the filtration and according to that we are going to have that this glomerular filtration and this rate, the rate of glomerular filtration, is much more effective. Remember, it must be maintained at around 10 mmHg.

Okay, so remember, permeability is sufficient and effective filtration pressure. Remember the formula, I think I mentioned it yesterday, I think I mentioned it last time, and I didn't ask you for a calculator or anything, but among the options, the results were presented in this formula, and you realize that it's not that complicated to get the formula. Here we have another formula, over there, the effective filtration pressure.

It is basically the same. We see here the hydrostatic pressure of the glomerular, minus, I open parentheses, the hydrostatic pressure of the Bowman capsule, plus the oncotic pressure of what would be the glomerular portion, I close parentheses. If you supplant the values, you have to give 10 mm of mass, equal.

is another way of calculating you use the ones that are most useful or the ones that are easiest for you to apply now something important that is in the other I will go back here says the onco-cotic pressure of the ultrafiltrated eye the ultrafiltrated is what has already been filtered and is the result of the filtration says the onco-cotic pressure of the ultrafiltrated eye

is so low that it can be considered zero. Now the question is why? Why is the oncotic pressure of the ultrafiltrated so low that it can be considered zero? According to what Jan is already talking about. Why? What happens to them? Why is it practically zero, the oncotic pressure of the ultrafiltrated?

I told you that ultrafiltration is what happens after filtration, it is the product of the filtration. So why zero? Because it does not let protein pass. So that's why it's zero. We should not find protein in the urine. If we find protein in the urine, we should already suspect that something is happening. So the ultrafiltration of this mucotic pressure is basically zero.

In the case of selective permeability, we have seen that the higher the surface, the higher the permeability, the higher the filtration. But they always have to use certain conditions. According to the size of the molecule, if it has more than 4 nanometers, its filtration rate is practically zero. Why? Because it will not pass through this last barrier that we have seen. If it is less than 2 nanometers, its filtration rate will be much higher. Let's say it is the ideal size.

According to the charge of the molecule, the more negative charges it has, the lower the filtration rate, as it happens with proteins. And if it has more positive charges, or even if it is neutral, its filtration rate will be higher. And in the case of the form and capacity of deformation, it refers to the cells of the blood, which you know are deformable. And the more

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we have the renal degeneration or clarification. This practice is only used when we need to know how the concentrations of a substance or molecule are at the level of the organism. There is a formula. The formula shows us that renal degeneration would be the product between the urinary concentration

by the urinary volume per minute between the concentration of that substance at the level of the blood or at the level of the plasma. You will have a practice with Professor Fernanda on urinary dilution concentration and there you will apply by

What is this anal depuration for? To measure and know how well the kidney is filtering and eliminating a substance. Like which ones? It can be creatinine, it can be inulin, which is often used in the laboratory to measure concentrations.

Induline is not a compound of the body, but a polymer of fructose. What does it mean? If there is induline in the body, it will be filtered to 100% and also it will be eliminated to 100%. That is, induline enters the body, it has to be eliminated in the same way. This allows us to know how

that filtration and emulsification is being generated. It is the capacity of the kidneys to remove plasma molecules and excrete them into the urine. So we can know the concentrations. Good morning. A little bit of heat. Thank you. So we can know creatinine, urea. Thank you.

or different compounds that are required. Even glucose, when it is required to know how the glucose is in the urine, that there should not be glucose in the urine. We know that it is filtered, but glucose that is filtered, glucose that has to be reabsorbed. That is why in normal physiological conditions in a healthy patient there should not be glucose. Now we are going to talk about the glucose in the blood.

How could we explain what we think is happening so that we can see all the substances that are present? First, there is a damage to the endocrine, which will affect the arteries, the arteries that allow the administration. That is one of the barriers. But also the increase of certain substances in the blood can affect, as is the case with glucose.

now

a little table where it shows us some molecules, their molecular weight and their filtration capacity. For example, in the case of water, its molecular weight, as you remember, is biochemical, it has a filtration capacity of 1, which means that it is basically 100% water. Sodium also at 100%. Glucose is filtered at 100%, as I said. Glucose is filtered. In all ways it will be filtered. Inulin, which is this

As I said, it has a molecular weight of 5,500 daltons, which can happen. It has a maximum filtration capacity of 100%. Let's go to myoglobin, which has a molecular weight of 15,000 daltons, which can be filtered. Maybe not 100%, but 75%.

Physiologically, it shouldn't be a trap. But if the myoglobin reaches its cells, it will infiltrate them. In a big way. How are we going to see that urine? We can't. It's an urine that has a coloration that can be like a tea or a Coca-Cola. It's dark. So, we can suspect that there may be a very illicit rat. So, we can add that to the urine.

which makes the neoglobin start to reach the body. The neoglobin can be filtered, but physiologically it should not be there. But if it reaches, it will be filtered. The albumin, here it shows us that it has a molecular weight of 69,000 daltons, which is above 40,000-50,000 daltons, which are the four nanometers. So, look at its filtration capacity, practically null, as it should be.

by size and by negative charge. And there are some, as I told you, here it does not show 69,000, but it can reach 150,000 or 160,000 grams, which is much more, obviously. There is a reason why it is not filtered. Proteins should not be filtered. Now, how is the flow of blood regulated, that is going to be going down through this molecular process?

First, we have to take into account the pressure of the blood pressure. We know that blood pressure has to be high so that we also have a good hydrostatic pressure. If the blood pressure increases, then we will have an increase in the flow of blood. The vascular resistance, if we talk about resistance, we know that it is something that is going to affect the flow of blood.

So, the higher the vascular resistance, the higher the position for the passage of the blood. And logically, this will be reflected by an intrinsic and extrinsic regulation. So, we will see mechanisms that will try to regulate that vascular resistance that could be present. Here we have the mechanisms, the intrinsic ones, we have the myogenic mechanism,

and the tubulomelular renal mechanism. There are two extrinsic and two extrinsic. They are represented by the sympathetic autonomic nervous system, or only sympathetic, and the angiotensin-relin system. They are two extrinsic systems. They are one and the same.

In the case of the myogenic mechanism, "mio" comes from the muscle, which refers to the smooth muscle present in the afferent arteriole, which is sensitive to stretching. And by being sensitive to stretching, calcium and sodium channels begin to be seen. What is this going to translate into? If we know that calcium levels increase,

they will generate the contraction of that nucleus, so it generates vasoconstriction. And when we generate vasoconstriction, we will have less light, less radius. Not only what happens with the male flux, it will decrease because it has less space where the male flux passes. And then it is a mechanism to be able to control this fluid. And that is represented in the first round, which is a intrinsic mechanism, a biogenic mechanism.

Then we have the next intrinsic mechanism, which is the retrolimentation mechanism of the glomerular tunnel. In this case, it is in charge of the dense macula. The dense macula, we know that those who have already taken histology know that it is like a cell stain that forms between the distal corpus and the different and inferior arterioles.

What happens with the dense macula? The dense macula begins to recognize when the sodium and chlorine levels are high. It recognizes that increase in sodium chloride and begins to release substances of the type vasoconstrictor, such as adenosine, ATP, thrombocanes, and they generate vasoconstriction. Again, they generate vasoconstriction, the light is reduced,

and therefore the vascular flow decreases. Another way to regulate, we go with the extreme systems. In this case we have the Sympathetic Nervous System, which through the autonomic-prenal nerves will reach the mesangial cells of the gluco-sternal-medular apparatus, where we find beta-1 receptors.

and it favors the release of renin, but also those sympathetic fibers with that release of noradrenaline

reaches the different and different anterior lobes and will generate a decrease in the non-menular filtration rate and therefore there will be a decrease in this product, or filtration, in the vascular system. Why? Why? Why when the sympathetic reaches the anterior and the non-menular environment, it generates a decrease in the non-menular filtration rate and the non-menular filtration condition.

and that's what happens with the knowledge that you have. What happened when the sympathetic came from the basculous? He constricted himself. Why did he constrict himself? Because he had to centralize himself. And he was going to centralize himself, so he said: "Very well, I'll start with the basculous, therefore, a sense of culture, filter, okay?" And they didn't know anything. Then we have the next mechanism, which is the renal system, the anchotensile.

and the 2-serone if they want to continue the complete process. We all know that we have certain stigmas, such as a low percussion, low pressure, and we have seen that the sympathetic carrier also stimulates the instant cells. Why? So that they can activate the renin. The renin is found in the angiotensinogen, it is converted into angiotensin I, angiotensin I is found in the ECA, the angiotensin-converting enzyme, and it activates it in angiotensin II.

and the 2-quotient actinine generates vasoconstriction. When generating vasoconstriction, what we will see is that it also diminishes the light and therefore will decrease the vascular flow as a regulation mode. And we also know that the 2-quotient actinine favors the release of the aldosterone, which helps in the retention of sodium. For what? To increase the vascular volume, especially at the peripteral level.

Now, we have another system that opposes the renin-lutensin-allosterone system. It is known as the calicreinase minin system. Calicrein is an enzyme that is released at the level of the cells of the distal contorneal nucleus. And it usually releases calicrein when the pressure is high.

So, the calicrine will be found in the bradycinogens that are circulating in the blood, which means inactive. So, the bradycinogen that is found in the calicrine becomes bradycinine, which is active. The bradycinine will generate vasodilation. Therefore, it is a vascular tumor. Its response will be

very different from the four systems that we saw earlier. But the bradycinine does not do it directly, but the bradycinine that is activated favors the release of nitric oxide. So, in reality, it is the nitric oxide that generates vasodilators. Venerate by the activation of bradycinine. Now, something very important, and you are seeing that the ECHA

is pointing to the question of how to make this system. And it is that, as they are opposite systems, the ECA activates the renin system, but inhibits the calibrinicinine system. Why? Because when the ECA is there, it inactivates the bradycinine and turns it into an ectapeptide inactive, or you will find some books as bradycinone, that is, inactive.

because both at the same time can't work. It's either one or the other, depending on the type. So the ECA, I repeat, activates the renal and prognostical system and inhibits the synapsic caligrein system. Is that clear, guys? I think so. The caligrein is activated when there is normally a bad pressure to release. This is a result of the four systems that we have seen, the four mechanisms.

The myofascial system, we already know that the distension, the stretching, makes it capture that stretching and therefore open channels of calcium and sodium. The increase of calcium, above all, generates basal constriction, therefore, the menular blood vessels are destroyed. The menular glomerular tubular reglamentation system, the issue is in the mastitis, which is the one that will detect the high levels of sodium and chlorine.

Therefore, it generates the integration of basic constrictors, such as adenosine, mainly. Therefore, it reduces the vascular effect. Neural regulation, in charge of what would be a sympathetic hormone, liberal adrenaline, reaches the previous different experiences. We know that there are alpha 1 receptors. They generate basic constriction, therefore, it reduces the effect of the neurons.

and we have the hormonal or moral regulation by the angiotensin remin. We already know that when there is a low pressure, when there is a low pressure or when there is a sympathetic adhesion, it stimulates the release of remin until angiotensin II is activated and generates more angiotensin. And if you want to give it,

the fifth, which is the opposite, which would be the calibridine-senine system. In this case, bradycyrine is activated, through bradycyminophen, the calibridine, and generates everything opposite to what we are going to define as vasodilation. And as for vascular or glomerular fluid, the lines go upwards, because it tends to increase. Can you get to this picture? Any questions here? Do you think we have a process?

Hmm?