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Samenvatting Toetsmatrijs BS11&12
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Toetsmatrijs van beroepssituatie 11 en 12
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Toetsmatrijs Integrale toetsBeroepssituatie 11&12
Beroepssituatie 11
1. Kan de regulatie van de bloeddruk door de nieren uitleggen en de rol van
het Renine Angiotensine Aldosteron Systeem (RAAS) hierbij verklaren
(BS11, MB)
Nieren
- Kapsel van Bowman
- Glomerulus
- Proximale tubulus contortus
- Lis van Henle
- Distale tubulus contortus
- Verzamelbuis
- Arteria renalis
- Interlobulaire arteriën
- Arteriolen
- Peritubulair capillair netwerk
- Interlobulaire venen
- Vena renalis
1
,Nefron
- Functie
o Filtratie
▪ Filtratiedruk; daling bloeddruk → daling filtratiedruk
▪ Glomerulaire filtratie snelheid (GFS) → 125 ml/min
o Reabsorptie
o Actieve excretie
Regulering glomerulaire filtratiesnelheid
- Plaatselijke regulering (autoregulatie)
o Diameter afferente en efferente arteriolen en glomerulaire capillairen
2
, o Compenseren kleine variaties in de bloeddruk
- Sympathisch zenuwstelsel
o Sterke vernauwing afferente arteriolen
o Bij stress/inspanning
- Hormonale regulering
o Angiotensine II
o Antidiuretisch hormoon (ADH)
o Aldosteron
o Atriaal natriuretisch peptide (ANP)
Renine-angiotensinesysteem
- Renine-angiotensinesysteem
o Lage glomerulaire druk
o Juxtaglomerulaire complex geeft renine af
- Angiotensine II
o Krachtige vaatvernauwing capillairnetwerk: druk
nierarteriën
o Vernauwing efferente arteriolen: GFS
o Bevordering ADH afgifte → reabsorptie water en
Na+
o Afgifte aldosteron en epinefrine door bijnieren: bloeddruk
reabsorptie Na+
Antidiuretisch hormoon (ADH)
- ADH
o Afgifte door angiotensine II of hypothalamus
o Vergroot de doorlaatbaarheid van water
▪ Distale tubulus contortus
▪ Verzamelbuis
o Versterkt het dorstgevoel
3
, Aldosteron
- Aldosteron
o Afgifte door angiotensine II en stijging K+
o Bevordert reabsorptie Na+ en afgifte kalium in de DTC
Atriale natriuretische peptiden (ANP)
- ANP
o Afgifte door hartspiercellen atria bij hoge bloeddruk/bloedvolume
▪ Afname Na+ resorptie
▪ Verwijdering glomerulaire capillairen → toename GFS en waterverlies
▪ Remming RAAS
4
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