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   [27]June 14, 2008

[28]Why Pretzels and Gunshot Wounds Make Us Thirsty

   [29]June 14, 2008/ [30]Neurosci

   I re-watched one of my all-time favorite movies the other night:
   [31]Unforgiven. After William Munney ([32]Clint Eastwood) shoots his
   first victim, the camera zooms in on the fallen cowboy as he begins
   complaining about how thirsty he is, begging his companions for water.
   In a moment of compassion, Munney agrees to put down his gun to allow
   the cowboy’s friends to bring him a canteen.
   You’ve probably all seen a similar scene before in another movie, if
   not this one (hopefully you’ve never seen it in person). Victims of
   gunshot wounds, or other wounds that involve a drastic loss of blood,
   are often portrayed as being very thirsty. I’m not sure if the reason
   why this occurs is common knowledge, but in case it’s not, I thought I
   would write a quick explanation.
   First, a little about water in the body. The cells in our body not only
   contain water, but also are surrounded by what is called
   [33]interstitial fluid. This fluid bathes the cells in a “seawater”
   type solution that contains water, [34]sodium (Na), amino acids,
   sugars, neurotransmitters, hormones, etc. The cell is normally in an
   [35]isotonic, or balanced, state in relation to its extracellular
   environment, meaning water doesn’t generally leave or enter the cell at
   large rates.
   Water is also an important constituent of blood. It is essential for
   keeping blood volume at a level that allows for proper functioning of
   the heart. If volume gets too low, the atria of the heart don’t fill
   completely, and the heart cannot pump properly.
   The need to keep the fluid balance in the body at a regular level
   results in the occurrence of two types of thirst that affect us when
   that equilibrium is disturbed: osmometric thirst and volumetric thirst.
   Osmometric thirst occurs when the [36]osmotic balance between the
   amount of water in the cells and the water outside the cells becomes
   disturbed. This is what happens when we eat salty pretzels. The Na is
   absorbed into the [37]blood plasma, which disrupts the osmotic balance
   between the blood plasma and the interstitial fluid. This draws water
   out of the interstitial fluid and into the plasma, now upsetting the
   balance between the cells and the interstitial fluid. The result is
   water leaving the cells to restore the balance.
   The disruption in the interstitial solution is recognized by neurons
   called [38]osmoreceptors, located in the region of the anterior
   [39]hypothalamus. They send signals that cause us to drink more water,
   in order to restore the osmotic balance between the cells and the
   surrounding fluid. In the case of pretzel eating, if we don’t drink
   more water, eventually the excess Na is simply excreted by the kidneys.
   Now, to the graver situation of a gunshot wound, and the other type of
   thirst: volumetric. Volumetric refers to the volume of the blood
   plasma, which is highly dependent upon water content of the body. As
   mentioned above, maintaining an adequate blood plasma volume is
   essential to proper functioning of the heart. If it gets too low, the
   heart can’t pump effectively.
   When someone is injured and loses a lot of blood volume (known as
   [40]hypovolaemia), less blood reaches the kidneys. This causes the
   kidneys to secrete an enzyme called [41]renin, which enters the blood
   and catalyzes a hormone called angiotensinogen to convert it into a
   hormone called [42]angiotensin. One form of angiotensin (angiotensin
   II) causes the [43]pituitary gland and [44]adrenal cortex to secrete
   hormones that prompt the kidneys to conserve water as a protective
   measure. Angiotensin II also affects the [45]subfornical organ (SFO),
   an organ that lies just outside the blood-brain barrier. Through the
   SFO angiotensin II stimulates thirst.
   There are also receptors in the heart that recognize decreases in blood
   plasma. Known as atrial [46]baroreceptors, they detect reductions in
   blood plasma volume and subsequently stimulate thirst by signaling
   neurons in the [47]medulla. So, when someone is shot and losing a lot
   of blood, it is because of the decrease in blood plasma volume that
   brain regions are stimulated through both of the above pathways to
   stimulate thirst.
   Processes that stimulate thirst are really much more complicated than
   this brief explanation. But, I thought this was enough to give a
   general idea of why salty foods and gunshot wounds have similar effects
   on our desire to drink water.

   [48]June 14, 2008/ [49]Neurosci/ [50]5 Comments
   [51]Hormones & behavior

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