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NCERT Exemplar · Q26

Q.Exchange of calcium between bone and extracellular fluid takes place under the influence of certain hormones a. What will happen if more of Ca++ is in extracellular fluid? b. What will happen if very less amount of Ca++ is in the extracellular fluid?

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Blood calcium level is controlled by two opposing hormones -- PTH and calcitonin: excess extracellular Ca++ suppresses PTH release and stimulates calcitonin, together lowering calcium and neuromuscular excitability; very low extracellular Ca++ raises neuromuscular excitability and produces tetany.

a. If more Ca++ is present in the extracellular fluid: the parathyroid glands sense this rise in blood calcium and respond by reducing their secretion of parathyroid hormone (PTH). Since PTH normally raises blood calcium by activating osteoclasts to break down bone (releasing Ca++ into the blood) and by increasing calcium reabsorption in the kidney tubules, a fall in PTH secretion reduces both of these effects. At the same time, the rise in blood calcium stimulates the thyroid gland to secrete more calcitonin, a hormone whose job is the opposite of PTH's -- it inhibits the bone-dissolving activity of osteoclasts and promotes the deposition of calcium into bone, actively pulling the excess calcium out of the blood. Between reduced PTH activity and increased calcitonin activity, the extracellular calcium level is brought back down towards normal, and neuromuscular excitability is lowered -- the opposite of the effect seen when calcium is too low. …

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