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20005 > body fluid compartments > Flashcards

body fluid compartments Flashcards

1
Q

what is interstitual fluid

A

water that lies between blood circulation and cells

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2
Q

what is transcellular fluid

A

CSF, pleural, synovial etc

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3
Q

what is included in extracellular fluid

A
  • plasma
  • interstitial
  • transcellular
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4
Q

how does cellular movement occur between the lumen and the intersitium

A
  • absorbing sodium, chloride and potassium creates osmotic gradient
  • is paracellular
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5
Q

why is high sodium, glucose and potassium solutions needed

A

to maximise water translocation

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6
Q

how does sodium movement occur

A
  • across basolateral membrane
  • sodium potassium atpase
  • build up make positive electrochemical gradient
  • helps chloride movement
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7
Q

what is colloid osmotic pressure

A

osmotic gradient created by the differential distribution of protein across this barrier

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8
Q

how does movement between cappilaries occur

A

hydrostatic pressure in capillary and extracellular fluid hydrostatic pressure makes net outward force

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9
Q

what is starlings force

A

determines the ratee of plasma filtration from blood to intersitium

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10
Q

what are the effects of right sided heart failure

A
  • hard for blood to be pumped back into heart from veins
  • blood build up makes backlog increasing pressure
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11
Q

how does right sided heart failure affect fluid

A
  • increased net filtration out of capillaries
  • pressure is greatest at feet
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12
Q

what are the effects of left sided heart failure

A
  • pressure build up until excessive build up of blood into the pulmonary interstitial fluid
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13
Q

how is there stable levels of plasma nd interstitial fluid

A

blood filtration is equal to drainage rate of the liver of the lymph

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14
Q

what causes lymphedema

A

blockage to the lymphatic system

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15
Q

what causes pitting oedema

A
  • no blockage to the lymph system
  • there is a change in starling forces
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16
Q

how does water move intracellularly and extracellularly

A
  • difference in osmolarity
  • water soluble membrane
  • aquaporins
  • move from low to high
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17
Q

how do solutes exert an osmotic force

A
  • differential distribution across a membrane
  • increased permeability will decrease the osmotic force
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18
Q

how do you have effective osmoles

A
  • cell impermeant to solute
  • low permeability
19
Q

what occurs in an isotonic solution

A
  • cell volume remains constant
  • no net movement of water
  • impermeable so osmotic forces
20
Q

what occurs in a hypotonic solution

A
  • movement from low effective osmolarity to high effective osmolarity
  • cell swells
21
Q

what is a hypertonic solution

A

the solution outside of the cell is more concentrated than inside the cell

22
Q

what are the main differences between the composition of the intracellular and extracellular fluids

A

-intra = higher potassium
- extra = high sodium
- similar osmolarity

23
Q

what are signs of increased extracellular volume

A
  • hypoxia
  • high BP
  • periorbital oedema
  • raised JVP
  • bi-basal crackles
  • leg oedema (pitting)
24
Q

what are signs of decreased extracellular volume

A
  • tachycardia
  • hypotension
  • dry mouth
  • reduced JVP
  • cool peripherals
  • oliguria
25
Q

what is hypertonic dehydration

A
  • lose more water then sodium
  • excessive water loss or not enough intake
26
Q

what is isotonic dehydration

A
  • lose same amount of water as sodium
  • trauma, vomiting, burns, sweating
26
Q

what is hypotonic dehydration

A
  • lose more sodium than water
  • Addison’s, diuretics
27
Q

why is dehydration more common in the elderly

A
  • decreased total body water
  • reduce urine concentration
  • reduced thirst
28
Q

how does a decreased heart volume affect MAP

A
  1. decreases venous pressure
  2. decreases venous return
  3. decrease in edv
  4. decrease cardiac output
  5. decreased MAP
29
Q

how does an increase in blood volume affect MAP

A
  1. increase venous pressure
  2. increase venous return
  3. increase EDV
  4. increase cardiac output
  5. increase MAP
30
Q

what mechanisms do the kidneys use to regulate Na

A
  1. decreased blood volume triggers baroreceptors
  2. cause the sympathetic nervous system to fire for more sodium reabsorption
  3. release renin starting RAAS
  4. retains more sodium
31
Q

stages of RAAS

A
  1. angiotensinogen
  2. renin release
  3. cleave angiotensin I
  4. angiotensin I and ACE
  5. angiotensin II into kidney
  6. release aldosterone
32
Q

what are the effects on an increase in angiotensin II

A
  • increase arteriolar vasoconstriction
  • increase thirst and Na appetite
  • increased aldosterone secretion
33
Q

how is the feeling of thirst triggered

A
  • stimulation of subfornical organ and organum vasculosum of the lamina terminals
  • modulated by GI afferents and baroreceptor inputs
34
Q

what are the stages of response to a decrease in extracellular fluid volume

A
  1. stabilise arterial blood pressure with baroreflex
  2. neuroendocrine reflexes increase plasma - vasoconstriction
  3. reduced starlings force, net reabsorption
  4. stable circulating volume, increasing reabsorption
  5. increase thirst and Na appetites
  6. increase albumin, platelets and erythrocytes
35
Q

what are the changes in starlings force in decreased capillary hydrostatic pressure

A
  • loss of gradient
  • limited net filtration out
  • albumin levels are ok
  • force exceeds that of capillary hydrostatic pressure so increase water reabsorption
36
Q

what are the short term effects of decrease blood volume

A
  • reduced arterial and cardiopulmonary baroreceptors firing
  • increased CO
  • arterial vasoconstriction + venoconstriction
37
Q

what are the long term effects of blood volume

A
  • increase thirst
  • decrease urinary loss of water and sodium
38
Q

what is the long term aim in blood volume loss

A

restore the blood volume

39
Q

what is the short term aim in blood volume loss

A

stabilise the MAP

39
Q

what are the different types of fluid for IV fluid resucitation

A
  • crystalloid
  • colloid
40
Q

what is a risk of using crystalloid IV fluid therpay

A

risk of exacerbating oedema

41
Q

what are the risks of using colloid IV therapy

A
  • risk of anaphylactic reactions
  • expand intravascular volume
  • infused can cause haemodilution impacting coagulation

20005 (29 decks)

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