RENIN-ANGIOTENSIN-ALDOSTERONE REFLEX by Professor Fink.wmv

In this lecture, Professor Fink describes the Renin-Angiotensin-Aldosterone homeostatic reflex, including its function [Regulation of Blood Volume/Blood Pressure & the circulating Na+ & K+ electrolyte levels], its mechanism, and its actions. Reference is made to the Juxtaglomerular (J-G) Cells, angiotensinogen, Angiotensin 1, Angiotensin Converting Enzyme (ACE), and Angiotensin 2. Professor Fink compares and contrasts Aldosterone with Antidiuretic Hormone (ADH). Professor Fink then describes the clinical conditions of Hypoaldosteronism and Hyperaldosteronism, making reference to hyperkalemia, hypokalemia, circulatory shock, hypovolemia, hypervolemia, and Renal Hypertension. Professor Fink ends the lecture by describing the use of Aldosterone Blockers (spironolactone; Aldactone), Angiotensin 2 Blockers (losartan; Cozaar), and ACE Inhibitors (lisinopril; Zestril) in the management of Renal Hypertension.
Check-out professor fink's web-site or additional resources in Biology, Anatomy, Physiology & Pharmacology: www.professorfink.com
Down-loadable e-books of the Lecture Outlines by Professor Fink (as well as "hard copy" versions) can be purchased from the WLAC Bookstore at: onlinestore.wlac.edu/fink.asp

[@maishaferdousi4865]

God bless you Professor Fink,May He shower you with abundance for making this knowledge free for all.

[@rayoh2011]

This lecture is so well taught, the video views should have another digit in front of it! Thank you, Professor Fink.

[@rosavallejo4211]

Thank you Dr. Fink!!! I am an FNP students and obtained my bachelors in nursing over 20 years ago. You videos are a great! You have are a gifted professor.

[@peruviangentry2738]

Thank you so much, I am retaking A&P2 this semester and going over your lectures is a lifesaver. I truly feel like I know have knowledge and understanding. Thank you Professor Fink!

[@quantumchang4410]

This is the best lecture ever. Provided a lot of side-tracked information which helps students to connect the dots with other leacture very well to this one subject.

[@josipvran]

As a student of Kinesiology I've read a bunch of sport physiology textbooks as I am interested in the subject. I had no elementary knowledge of chemistry and biology because I went to high school to become a civil engineer (we didn't have chemistry at all, and had only 2 years of biology)... Your lectures are the number one thing that accelerated my knowledge in the biology and physiology fields to the point where I can understand what I'm reading and apply it to my practice. Thank you professor Fink! This is so useful, every once in a while I go through all the notes that I was taking as I was going through your lectures - the information is invaluable!

[@professorfink]

Thank YOU, Josip, for your kind words. My sincere Best Wishes for Your SUCCESS! -- professor fink

[@stelae1]

You are fantastic ! I love how you clap your hands to prove a point, it makes it dramatic and really helpful. Thank you !!!!

[@amandapalazzolo9217]

Just wanted to say thank you! I am in advanced pathophysiology and we do not have lectures. I am so glad I came across all of your lectures. You make everything a lot easier to understand so I can actually then go read my text and learn. I have tired to watch other youtube videos to supplement but they are boring, still too much in depth, or too simplified. Can’t thank you enough for posting. I look forward to watching your videos on the various subjects we cover!

[@sarahpirani297]

Thank you so much Prof. Fink. You are amazing. Your have this extraordinary ability to keep my attention alive during the entire lecture.

[@KidKennedy5]

You are my hero! Thank you for bringing your education format to the public. We have a poster up at my University promoting your videos as a study aid, and watching them has saved me as I pursue a nursing degree. You've helped me understand and master the fundamentals of Anatomy and Physiology better than my University professors, and kept me awake with your fun explanations and loud clapping when making a point. Please keep up the good work and know you have helped thousands of people stick with pursuing a career in medicine. Cheers!

[@professorfink]

Dear Elizabeth, THANK YOU so very much for your kind words. I sincerely appreciate it! Incidentally there are many additional resources on my web site ( www.professorfink.com ) that you may find helpful. BEST WISHES for your continued SUCCESS! -- professor fink

[@MrVersace505]

You are the BEST PERFECT TEACHER EVER!!!!

[@skynguyen3342]

Thank you so much Professor ! I love the fact that you have your own idea about RAAS to be shortened :)). It's great that we do not only learn facts and also think why they have to be like this but not that. Your videos are very helpful for my personal learning.

[@oralynnquiroz3202]

The only reason I understand A&P II and am getting a good grade is because of Prof. Fink's video lectures. My prof can't answer any questions and I don't think she's even read the book. She just reads slides and make no correlation to real life or clinical situations. THANK YOU Prof. Fink! You're a life saver.

[@margrettchisholm4072]

This Professor is very through while being specific, thanks

[@maryamhadi7828]

Thank you so much. Your an amazing Professor. You go above and beyond for your students. Thank you for making these amazing videos available to students like us that truly wants to learn about human body.

[@carebees]

Superb lectures, Prof. Fink. Thank you so much. You are one of the best teachers I have taken classes from, not only online. You know the subject, you know how to present it so that there are minimal (if any) surprises of the "what?!" kind, you link what's related (helping converting familiarity with seemingly discrete concepts into a solid understanding of the continuum of human physiology), and you meaningfully emphasize the "important" in the sea of the "less important", this - essential - skill I miss in 90% of the teachers. And you are fun. If you don't mind I'd like to comment on (your joke about the "design" of) the RAA pathway. In essence, we're probably looking at evolutionary breadcrumbs. It's possible that some or all of the intermediate products benefit the organism's survival in some ways even today, but it's more than reasonable to suspect - and investigate the notion - that they supported the lineage's survival in some past segments of its evolutionary pathway directly as end-products; today's intermediaries are "yestereons" end-products (today's aldosterone). Thanks to Darwin, this now appears straightforward. What is still a mystery to me, however, is how - in the light of all what we've learned about the Universe and about ourselves in the past few centuries - does a person of your knowledge and broad understanding hold on to his/her religious/spiritual/supernatural/divine/etc. beliefs derived from texts written by people over 2,000 years ago. This puzzles me. Aside from that, thank you for your amazing lectures on human anatomy and physiology!

[@noahswift361]

Dr. Fink is a God amongst men!!!!!!!

[@Arthur-hg7ny]

12:25 remind them the vascular system is a closed system. Compromising this closed system by creating break in the vessel, hemorrhage, reduces the pressure in that system

[@TheAwkwardAnatomist]

Well stated, Arthur. I thought the exact same thing. 😊

[@autumnrose3943]

Thank you. Perfect explanation. You really cleared things up.

[@KyotoMelody]

Sir, I know know why "the design team" ignores your idea of a short-cut for the renin-angiotensin-aldosterone reflex now: they would not be able to make so many kinds of anti-hypertension drugs! Pharmaceutical firms would be extremely angry if it were so! :)) And the kidneys would be upset too: "We need some break before making new hormone, arghhhh!" said the kidneys. :)) Thank you for your amazing lectures! I wish you were my professor! Thank you, sir!

[@QuyenTran-hq4sb]

Thank u for ur awesome & thorough yet relatable lectures

[@yvettelanier893]

This video was EXCELLENT!!!!! It is the 4th video that I have watched today and it provided the most understandable and thorough explanation. Thank you very much :).

[@anneuppal4078]

love your lectures...thanks

[@vibhor91]

I guess i also have become a professor. "PROF. RAAS-INK", outclassed .. outspoken .. speechless .. no words ... thanks alot sir !!!

[@isabelmakwangwala1955]

He is so good. You can easily follow him.

[@cameronwhite4422]

Thank u,professor FINK!

[@meltean14]

Thank you very much professor!

[@Mimi-6798]

God BLESS you!!!! Truly a gifted professor....

[@hemexever]

Professor you are simply awesome!!!!! thanyou so much for your videos

[@adedoyinkoyi]

Awesome prof!!! :-)

[@suisse38]

I think SIADH should have been mentioned here even just in passing, because of its importance. Severe hypotonicity can lead to cerebral edema and seizures. SIADH can be caused by: 1. small cell lung cancer 2. head trauma 3. pulmonary disease 4. cyclophosphamide. Overall his lectures are great and I enjoyed them. Thanks a lot Professor Fink!

[@mhomerrr]

Thank You!

[@professorfink]

Lecture Outlines by Professor Fink can be purchased from the WLAC Bookstore on-line. The LINK is posted at the bottom of the Video DESCRIPTION above.

[@gapurathebest940]

very good explaination

[@FSAYED04]

I love it. Thank you so much professor Fink. God bless you with good karma.

[@k3lvln]

agree its such a good lecture :D! Why SIADH is not accounted, is because ADH release is not inhibited with patient's osmolarity reduces cuz they ingest more fluid. So SIADH is more of a excess water loading problem than a fluid loss problem. Therefore in practice usually ppl treat with simply decrease intake/reabsorption of water :D!

[@ShrinidhiKulkarni]

Professor, I am a big fan of your lectures. Very good tool for quick review. What about SIADH(Syndrome of Inappropriate ADH secretion)? Is it not a ADH excess condition?

[@thepowerofpositivity8075]

Professor may you explain mechanism(s) that respond to an increase in renal flow and increased/high GFR? I absolutely understood the RAAS in response to low BP, decreased GFR. Thank you.

[@Jtrp73]

+professorfink great lecture, but I just want to help clarify: the insulin pump, though it is worn 24/7, must be rotated every 5-8 days to avoid infection. The "site" is connected via catheter, as you correctly stated, to either the buttock, stomach, thigh, or upper arm -- a location with adipose is best. Also you said that "blood flows through this device" but that is not true; most insulin pumpers have a reservoir filled with fast-acting insulin connected via catheter and tubing to their site. The insulin flows into the body this way and there is a valve at the location where the catheter meets the site itself and extends into the subcutaneous space, preventing reflux of "boluses". The insulin is pumped through this device at all times; individuals remove the pump and place a waterproof cap over the site during showers or baths to prevent water from entering the site. I really enjoy your lectures -- just wanted to clarify these points (current med student and pumper since 2003).

[@professorfink]

+Jenna Paulson  Thank You, Jenna, for providing more details on the actual use of an Insulin Pump.  My sincere Best Wishes for your Good Health and Continued Achievements!

[@ahmadfadel9220]

Dear Professor Fink,First of all thank you very much for all the great work,you have such an amazing method in explaining the processes and mechanisms of how our human body functions,and you have helped me a lot.But I have a comment on your believe that you could propose or there is a better designing than what we got.I think it's made perfectly precise at least in what this lecture talk about (Renin-Angiotensin-Aldosterone homeostatic reflex),for example the ACE actually has another actions in the body,converting the angiotensins is not it's only job ! . And the same for almost all other components of this system,here and in the other body systems,these cascades are not made like this for nothing,they all have a specific action and effect on the whole system.so In my opinion I think that this body is made the best way it can be made.It's just a comment i have,and I had to say.And again thank you a lot for your channel.Best wishes.

[@professorfink]

Thank You for your kind words, Ahmad. I actually do AGREE with YOU, that the Human Body is "fearfully & wonderfully made" [Psalms 139:14]. I was being a little facetious about the complexity of the body, and how commonly its workings are a challenge to comprehend. I actually made a short video about Religion & Science:PROFESSOR FINK VIDEO ON RELIGION & SCIENCE kzbin.info/www/bejne/bqStm6xvd6-ffNU ; AND my web-site has an entire page devoted to Religion & Science: www.professorfink.com/RELIGION___SCIENCE.html ; ---BEST WISHES, --professor fink

[@berndgo]

SIR, I love your videos!!!! One remark: Diabetes - greek - flowthrough/passage. Mellitus - latin - honeysweet.

[@LaceTunes]

Professor Fink, do you have a video with the structure and function of the kidney and the nephron? One that explains the permeability of the nephron, function of Bowman's Capsule, loop of Henle, etc? I watched the anatomy video of the urinary system but I cannot find the renal physiology :(

[@professorfink]

I'm sorry that I haven't yet (as of July 2016) had a chance to videotape my physiology lecture on the Kidney & nephron.

[@lacetunes5563]

+professorfink thank you for replying. It's ok. Best wishes professor. You've helped me in more ways than one. God bless!

[@amirlalji]

Thanks Very well done but i thought the ace inhibitors were discovered before the arbs…???

[@shgh8359]

is this video detail enough to use as medical student or its goo for high schoollevel? he just have 1 video for urniary system or kidney ?

[@HongNguyen-lx2vi]

Hi Dr. Fink, Thank you for this great video. I have a question. The renin-angiotensin-aldosterone reflex happen to compensate for decrease in BP, or decrease in sodium levels, or increase in potassium levels. If a person has normal sodium and potassium level, but just low bp. Beside helping increase the bp, is this compensation will cause that person to have higher sodium level and lower potassium level than before? Thank you!!

[@professorfink]

Excellent Question! The primary function of the Renin-Angiotensin-Aldosterone (RAA) Reflex appears to be the regulation of Blood Pressure. So, you are correct in concluding that it is possible that in compensating for low Blood Pressure it may lead to hypokalemia. (The sodium concentration will probably not increase so much, since there is a concomitant increase in water retention.)

[@SlaveofChrist_]

Great video in my opinion. I had a question. If ACE Inhibitors are used for people with Diabetes (Renal Hypertension) to block the ACE Enzyme fro converting Angiotensin I to Angiotensin II. Just from not studying the Lungs as of yet, is there anything that directly affects the ACE Enzyme in relationship to exercise?

[@SlaveofChrist_]

+Selrahc Namdloc Just found out my dad actually takes a blocker for calcium that you were discussing in the video in development. Called Amlodipine. :)

[@ritikashukla6057]

professor fink do you have video lecture on angian and its pharmacology

[@professorfink]

Professor Fink's Video Lecture on STATINS & BLOOD THINNERS: kzbin.info/www/bejne/hIGsYZeYjb6ojcU Professor Fink's Video Lecture on ANTI-ANGINAL DRUGS: kzbin.info/www/bejne/pH6agauObJV2j68 Professor Fink's Video Lecture on ANTI-HYPERTENSIVE DRUGS: kzbin.info/www/bejne/sGjUc6eiqruIl80

[@glendeloid9210]

correction: renin doesn't cleave 4 aas from angiotensinogen, it cleaves 443 aas. (angiotensinogen is pretty huge). angiotensin 1 is a decapeptide, angiotensin 2 an octapeptide.

[@professorfink]

You are correct regarding the "details" of this biochemical cascading sequence. With any explanation, the lecturer must decide how much "detail" to go into. Thank you for addition!

[@olubabafernandex5011]

prof and the other viewers, pls I want to know if renin is a hormone or enzyme? 2. want to knw the difference between reNin and reNNin?

[@Drsparjan]

Professor fink,would you please videotape and upload the video of kidney and nephron...

[@professorfink]

While I have not yet recorded a Video Lecture on Renal Physiology, I do describe 3 of the major processes occurring in the Nephron in my Video Lecture on the Urinary System: PROFESSOR FINK'S VIDEO LECTURE ON THE URINARY SYSTEM: kzbin.info/www/bejne/q6LaaqKoeth0m6M

[@dr.sarisaazizidc3660]

Professor Fink, do you have Video Lecture on Renal physiology yet?

[@raleighwooddriftwoodmanor]

Prof, Can you answer some questions for me? I have had life long chronic low blood pressure (fainting spells) which appear to be Adrenal Crises. These have become acute in the last 2 years (I am now 43). Endocrinologist tested cortisol, seemed normal. "Theory" is I have secondary Addison's caused by the Pituitary. He proscribed Steroids, but I didn't take them (side effects). Instead, started taking PhenylPiracetam, which levels my blood pressure. Sometimes the blood pressure spikes high? Why?

[@wassimabdou7649]

Good morning Profesor, I was just wondering how does hyperaldosteronism defines as excess production of aldosterone but results in low Renin ? low renin is suppose to mean low production of aldosterone ? thank you

[@professorfink]

Increasing levels of Aldosterone will produce a "negative feed-back" response resulting in the JG Cells in the Kidney secreting LESS Renin.

[@phaniraghavendraksv8214]

Sir, as we know that pressure is inversely proportional to volume, but how can blood pressure increase as their is increased blood volume.

[@professorfink]

+Phani Raghavendra KSV Pressure is inversely proportional to volume (space), IF the number of molecules (n) remains constant: P = nRT/V What is happening in the Cardiovascular System, is that the number of molecules (n; the amount of blood WITHIN the vessels) is increasing, while the Volume of the blood vessels (the space within the vessels) is remaining the same. So, if n increases, P increases. Interesting question!

[@greencamixx]

Is renin a hormone or an enzyme? Great video, please upload more.

[@professorfink]

Renin functionally acts as an enzyme on the polypeptide Angiotensinogen.

[@greencamixx]

Thanks, I asked bc you said it was a hormone in the beginning of the video.

[@professorfink]

Renin could also be viewed as a hormone, acting as a chemical that circulates in the bloodstream & acts at a distance. Chemical substances can fall under more than one category. For example, epinephrine is a neurotransmitter and it is a hormone.

[@xDomglmao]

There are also (pro)renin receptors (discovered few years ago (?)), hence hormone would be a fine description, too

[@maududahmed4779]

Dear professor How can I download this video ?

[@edgargonzalezgallegos3024]

atube cather man. ;)

[@mothertodaughter9383]

Sounds need to be higher, can't hear

[@727angelo]

Hi professor Fink, i have been watching this video and i am preparing for my rn nclex exam. I noticed u said that Hyperkalemia increases the blood pressure and causes death. But according to my nursing book and i have checked it in a lot of website tha Hyperkalemia causes a decreased in blood pressure. Im very confused, can you please explain to me what is it really? Thanks

[@professorfink]

Hi Angelo. Hyperkalemia does not lead to hypertension. HYPERALDOSTERONISM leads to BOTH hyperkalemia AND hypertension.

[@quantumchang4410]

professorfink Professor Fink, I thought excess aldosterone production would drive more K+ into the urine in exchange for Na+ reabsorption, thus resulting in HYPOkalemia. Could you please explain why it is completely opposite to how I thought it ought to behave? Thanks in advance.

[@professorfink]

Quantum Chang Ooops. YOU ARE CORRECT (my typo). It does cause HYPOkalemia (for the reasons you stated). Thank you for catching my error.

[@craigosullivan7350]

I would hesitate to recommend the good professor for the "design team" on the suggestion that the RAS is inefficient. Better to recognize the limits of our understanding than to assume a design flaw. Pretending it should be another way is the antithesis of the scientific method. Note that Ang1 has recently been shown to exert a compensatory role via vasodilatory effects upon coronary arteries in the setting of congestive heart failure.This helps explain the beneficial effects of ACE inhibitors apart from simply decreasing Ang2. Additionally, there are a host of biologically active end products of RAS for which ongoing investigation is warranted. Please edit the arrogance.

[@professorfink]

My comments on the design of the Renin-Angiotensin-Aldosterone Reflex were not intended to mock the design, but -- in fact -- show the complexity of the mechanism and how it is "wired" into so many interacting systems. I have -- in fact -- articulated my beliefs on my web-site: www.professorfink.com/RELIGION___SCIENCE.html and on a short video that I have made: RELIGION & SCIENCE by Professor Fink Thank you for your comments.

[@Intuition11111]

Good Stuff (______)

[@theblumgirls]

Crushings

[@myspoonistoobig5]

Stop clapping 😔 it picks up so loud when you are listening with earphones (your videos are still very helpful they just hurt lol)

[@kakany12]

God is real!!! Amazing!!!!! you are blessed professor!! i love uuu

[@Andrew-kh7rz]

i get scared when he effing claps his hands

[@davidazinger5639]

if you were on the design team? In other words, if you were God ? You're not God; and its not wise to question God but spend time asking your self why is that way rather than if I were on the design team? There is no design team; God doesn't need anyone's help. But your lecture is interesting; well explained, thanks

[@professorfink]

You may find my web-site page devoted to Religion & Science interesting. I strive to bring honor to God to the best of my ability. www.professorfink.com/RELIGION___SCIENCE.html