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CPR Exam 2 > Body Fluid Compartments > Flashcards

Body Fluid Compartments Flashcards

1
Q

What is volume contraction?

A

A decrease in ECF volume
Also called volume depletion
Causes decreased blood volume and decreased BP

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2
Q

What is volume expansion?

A

An increase in ECF volume

Causes increased blood pressure and edema

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3
Q

How are fluid shift disturbances categorized?

A

According to whether they involve an increase or decrease in ECF volume
According to whether they cause a change in body fluid osmolarity

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4
Q

What does isosmotic mean?

A

No change in body fluid osmolarity

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5
Q

What does hyperosmotic mean?

A

Body fluid osmolarity is increased

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6
Q

What does hyposmotic mean?

A

Body fluid osmolarity is decreased

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7
Q

What is the only fluid that can be acted on directly to control its volume and composition?

A

Plasma

Any control mechanism that operates on plasma in effect regulates the entire ECF

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8
Q

What are non-electrolytes that dissolve in water?

A

Contain covalent bonds that prevent them from dissociating in solution and therefore have no electrical charge (e.g. glucose, lipids, urea)

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9
Q

What are electrolytes?

A

Dissociate into ions (ionize) in water
Ex. Mg, Na, Cl, K
Have a greater ability to cause fluid shift

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10
Q

Which ions are high in ECF?

A

HCO3, Na and Cl

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11
Q

Which ions are high in the ICF?

A

K and phosphate anions

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12
Q

Cellular proteins in ICF cannot leave what?

A

The cell

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13
Q

ECF volume must be closely regulated to help maintain what?

A

BP

Maintaining salt balance is of primary importance in the long term regulation of ECF volume

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14
Q

ECF osmolarity must be closely regulated to prevent what?

A

Swelling or shrinking of cells

Maintaining water balance is of primary importance in regulating ECF osmolarity

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15
Q

All body fluid compartments have approximately the same what?

A

Osmolality

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16
Q

What is the tonicity of a solution?

A

The effect the solution has on cell volume—whether the cell remains the same size, swells or shrinks—when the solution surrounds the cell

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17
Q

If cells are placed in an isotonic solution what will happen?

A

There will be equal movement of water in and out of the cell

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18
Q

If cells are placed in a hypertonic solution what will happen?

A

There will be a net movement of water out of the cell which will cause the cell to shrink

19
Q

What will happen if cells are placed in a hypotonic solution?

A

There will be a net movement of water into the cell which will cause the cell to swell

20
Q

What are the main solutes in the ECF?

A

Na, glucose and urea

21
Q

What are the hormonal mechanisms to balance fluid compartments?

A

Renal sympathetic nerves
RAAS
ADH
Natriuretic peptide secretion

22
Q

ADH is secreted in response to what?

A

Angiotensin II
Atrial receptors in presences of low preload
Increased osmolality of blood
Sympathetic nervous system activation

23
Q

What does secretion of ANP induce?

A 
Arteriolar dilation (decreases TPR)
Increases fluid loss (decreases preload) 
Inhibits renin (decreases both TPR and preload)
24
Q

What is the main action of ANP?

A

To directly inhibit Na reabsorption in the distal parts of the nephron thus increasing Na excretion and accompanying osmotic water excretion in the urine

25
Q

What are the other actions of ANP?

A

Inhibits renin, aldosterone and ADH secretion

26
Q

What are the two forms of dehydration?

A

Hypernatremic and hyponatremic dehydration

27
Q

Describe hypotonic (hyponatremic) dehydration

A

Loss of Na is greater than loss of water in ECF
Serum Na concentration in the ICF is greater than that of the ECF
Water shifts from the ECF to the ICF to establish osmotic equilibrium
Serum Na and serum osmolality will be less than the normal range

28
Q

Describe hypertonic (hypernatremic) dehydration

A

Loss of water is greater than the loss of Na in ECF
Serum Na concentration in the ECF is greater than in the ICF
Water shifts from ICF to ECF
Serum osmolality will exceed 300 mOsm/kg
Serum Na will be more than 150 mEq/L

29
Q

Describe hyponatremia

A

Serum Na level below 130-135 mEq/L
Na deficit decreases the ECF osmotic pressure and water moves into the cells
Water movement causes sx related to hypovolemia and cellular swelling

30
Q

What are the results of hyponatremia?

A

Increased ICF causes edema, brain cell swelling, irritability, depression, confusion, weakness, muscle cramps, anorexia, nausea and diarrhea
Pure Na deficits cause hypotension, tachycardia, and decreased urine output

31
Q

Describe hypernatremia

A

Serum Na levels above 147-150 mEq/L

Water moves from ICF to ECF causing intracellular dehydration including shrinkage of brain cells but there is excess ECF

32
Q

What are the results of hypernatremia?

A

Increased ECF causes edema and increased BP
High Na level causes muscular weakness and hyperactive reflexes
Decreased ICF causes thirst, decreased urine output, confusion and ultimately coma

33
Q

Darrow Yannet diagrams are used to study the effect of what?

A

Various clinical conditions such as dehydration, shock, vomiting, and diarrhea on osmolality and volume of ECF and ICF

34
Q

What changes occur during dehydration (hyperosmotic volume contraction)?

A

Hypotonic fluid loss conditions like dehydration, diabetes insipidus, and alcoholism
Insensible water loss from ECF, solute is left behind and becomes concentrated
Decrease in ECF and ICF but an increase in body osmolality

35
Q

What is diabetes insipidus?

A

Body is either unable to produce ADH or kidneys cannot respond to it leading to a hyperosmotic volume contraction
There is a decrease in free water reabsorption from the distal tubules leading to free water loss

36
Q

What is diabetes mellitus?

A

Body does not produce insulin
High levels of glucose in blood
Osm will be 330 in DKA

37
Q

What are the 4 mechanisms that can cause polyuria?

A

Increased intake of fluids as in psychogenic causes, stress and anxiety
Increased GFR as in hyperthyroidism, fever and hypermetabolic states
Increased output of solutes occurs in DM, HTN, hyperparathyroidism, use of diuretics
Inability of the kidney to reabsorb water in DCT as in CDI, NDI, drugs and chronic renal failure

38
Q

What is water diuresis?

A

Increased water excretion without corresponding increase in salt excretion
Primary cause is increased intake of water due to polydipsia or diabetes insipidus

39
Q

What is solute (osmotic) diuresis?

A

Increased water excretion concurrent with increased salt excretion
Primary cause is significant increase in salt present in tubular fluid
Hyperglycemia, high protein intake, recovery from AKI

40
Q

What changes occur with adrenal insufficiency (hyposmotic volume contraction)?

A

ICF volume increase, ECF volume and osmolarity decrease
Adrenal insufficiency due to loss of aldosterone leading to excessive loss of NaCl in urine
Transient response is that ECF osmolarity decreases and fluid shifts to ICF until osmolarity equilibrates

41
Q

What changes occur during SIADH (hyposmotic volume contraction)?

A

Gain of hypotonic fluid
Conditions like excess water drinking and SIADH (syndrome of inappropriate ADH)
Increase in ECF and ICF volume but a decrease in body osmolality

42
Q

What changes occur with isosmotic volume contraction?

A

Acute fluid loss conditions like hemorrhage, diarrhea and vomiting
Diarrhea causes loss of isosmotic fluid from the GI tract
Decrease in ECF volume and no change in body osmolality or ICF volume

43
Q

What changes occur with isosmotic volume expansion?

A

ECF volume expands, ICF and osmolality don’t change

Isotonic saline injection of NaCl

44
Q

What changes occur with hypertonic volume expansion?

A

ECF volume increases, ICF volume decreases, osmolality increases
Transiently ECF osmolarity increases so volume shifts from ICF to ECF until osmolarity equilibrates
High NaCl intake or infusion of hypertonic solution (ex. 2-3% NaCl)

CPR Exam 2 (18 decks)

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