Cellular Physiology (Chapters 1, 2, 4, 25, & 31) Flashcards

1
Q

What is homeostasis?

A

maintenance of nearly constant conditions in the internal environment

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2
Q

What are examples of homeostasis?

A

Lungs provide oxygen to the extracellular fluid to replenish oxygen used by cells
Kidneys maintain constant ion concentration

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3
Q

What is a state of disrupted homeostasis?

A

Body still tries to regulate function in disease state which can make it difficult to distinguish between primary cause of disease and compensatory response

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4
Q

What is an example of disturbed homeostasis?

A

Impaired ability of kidney to excrete salt and water may lead to high blood pressure which initially is compensatory to return blood pressure to normal but can in turn cause many other problems instead

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5
Q

How do control systems of the body work?

A

Many control systems operate within the organs to control functions of individual parts of the organs whereas others operate throughout the entire body to control the interrelations between organs

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6
Q

What is an example of control system of the body?

A

Oxygen-buffering function of hemoglobin: hemoglobin combines with O2 as the blood passes through the lungs and then as blood passes through the capillaries hemoglobin (due to strong affinity for O2) does not release O2 if there is already enough there – only releases it if it needs to

If a higher than normal concentration of CO2 is in the blood this excites the respiratory center causing a person to breath rapidly and deeply (negative control)

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7
Q

What is negative feedback?

A

If some factor becomes excessive or deficient, a control system initiates negative feedback, a series of changes that return the factor toward a certain mean value, thus maintaining homeostasis

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8
Q

What is positive feedback?

A

When the initiating stimulus causes more of the same
Positive feedback is better known as a “vicious cycle,” but a mild degree of positive feedback can be overcome by the negative feedback control mechanisms of the body and the vicious cycle fails to develop.

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9
Q

What is an example of negative feedback?

A

When the arterial pressure rises too high, the baroreceptors (bifurcation of carotid arteries in neck and arch of aorta) send barrages of nerve impulses to the medulla of the brain. Here these impulses inhibit the vasomotor center, which in turn decreases the number of impulses transmitted from the vasomotor center through the sympathetic nervous system to the heart and blood vessels. Lack of these impulses causes diminished pumping activity by the heart and also dilation of the peripheral blood vessels, allowing increased blood flow through the vessels.

Conversely, a decrease in arterial pressure below normal relaxes the stretch receptors, allowing the vasomotor center to become more active than usual, thereby causing vasoconstriction and increased heart pumping. The decrease in arterial pressure thus initiates negative feedback mechanisms that raise arterial pressure back toward normal.

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10
Q

How is the degree of effectiveness with a control system is determined?

A

The degree of effectiveness with which a control system maintains constant conditions is determined by the gain of the negative feedback. Gain = correction/error. (Gain = sensitivity of the system), error is due to not being perfect, i.e. blood pressure can still be elevated from baseline even when feedback is trying to return it from elevated state

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11
Q

What are examples of positive feedback?

A

When a blood vessel is ruptured and a clot begins to form, multiple enzymes called clotting factors are activated within the clot itself. Some of these enzymes act on other inactivated enzymes of the immediately adjacent blood, thus causing more blood clotting. This process continues until the hole in the vessel is plugged and bleeding no longer occurs (this process is part of a larger negative-feedback mechanism, the stopping of bleeding and maintenance of normal blood volume)

When uterine contractions become strong enough for the baby’s head to begin pushing through the cervix, stretch of the cervix sends signals through the uterine muscle back to the body of the uterus, causing even more powerful contractions

To generate an action potential, there is slight leakage of sodium ions through sodium channels which then change the membrane potential which in turn opens more sodium channels so that a small leak can become an explosion of sodium entering the cell

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12
Q

What is feed-forward control?

A

Often used for muscle contractions when these movements need to occur so rapidly that there is not enough time for nerve signals to travel to the brain and back

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13
Q

What is an example of feed-forward control?

A

Sensory nerve signals from the moving parts apprise the brain whether the movement is performed correctly. If not, the brain corrects the feed-forward signals that it sends to the muscles the next time the movement is required. Then, if still further correction is necessary, this process will be performed again for subsequent movements. This process is called adaptive control

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14
Q

What is adaptive feedback in context of feed-forward control?

A

Adaptive feedback corrects itself after feed forward: delayed negative feedback

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15
Q

Describe the difference between the different G-protein coupled receptors and identify how their signaling pathways work

A

G protein-coupled receptors transmit information through the trimeric G proteins.

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16
Q

G-αs vs. G-αi

A

Different hormone stimulate different receptors which activate different kinds of G-Proteins.
The main difference is the α-subunit which can be stimulatory (G-αs) or inhibitory (G-αi)

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17
Q

G-αq

A

Causes PIP2 to be cleaved (by PLC) to IP3 and DAG
IP3 stimulates calcium release from the SR

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18
Q

G-αt

A

At interacts with phosphodiesterase (PDE) and causes a reduction in cGMP in cells
Common in the visual pathways of the photoreceptor cells

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19
Q

What is the lipid bilayer?

A

Constitutes a barrier against movement of the water molecules and water-soluble substances between the extracellular and intracellular fluid compartments; fluid mosaic model; formed by phospholipids with cholesterol in between (stiffens membrane and prevents transport through)

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20
Q

What is intracellular fluid?

A

Contains a large amount of potassium and only a small amount of sodium
Contains very few chloride ions
Significantly higher concentration of phosphates and proteins than the extracellular fluid

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21
Q

What is extracellular fluid?

A

Contains a large amount of sodium and only a small amount of potassium
Contains many chloride ions

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22
Q

What interrupts the continuity of the lipid bilayer? What is the purpose of this disruption?

A

Protein molecules interrupt the continuity of the lipid bilayer generating an alternative way through the cell membrane
Transport proteins, channel proteins, carrier proteins
Channel and carrier proteins are usually selective for the types of molecules or ions that are allowed to cross the membrane

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23
Q

What is diffusion?

A

Passive random molecular movement of substances molecule by molecule either through intermolecular spaces in the membrane or in combination with a carrier protein

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24
Q

What is active transport?

A

Movement of ions or other substances across the membrane in combination with a carrier protein in such a way that the carrier protein causes the substance to move against the energy gradient

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25
Q

What is the major difference between active transport & diffusion?

A

Diffusion does NOT require extra energy - energy for this process is through normal kinetic motion of matter
Active transport DOEs require an additional source of energy besides kinetic energy

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26
Q

What is diffusion through the plasma membrane?

A

The movement of all molecules and ions in the body fluids that consists of greater motion at a greater temperature so that more intermolecular interactions occur

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27
Q

What is simple diffusion?

A

Kinetic movement of molecules or ions occurs through a membrane opening or through intermolecular spaces without any interaction with carrier proteins in the membrane

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28
Q

How is the rate determined for diffusion?

A

The rate is determined by the amount of substance available, the velocity of kinetic motion, and the number and sizes of openings in the membrane through which the molecules or ions can move

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29
Q

What factors govern the rate of diffusion through the lipid membrane?

A

If a substance is lipid soluble (O2, N2, CO2, alcohol, etc) then it can diffuse directly through the lipid bilayer
If more lipid soluble the substance is, the faster it can diffuse through
If a substance is not lipid soluble but still smaller enough it can diffuse through large transport proteins
Aquaporins: selectively permit passage of water through the membrane
As substances get larger, their ability to diffuse falls off (ex. Urea is bigger than H2O and its penetration is drastically less)

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30
Q

What is facilitated diffusion?

A

Requires interaction of a carrier protein that aids passage of the molecules or ions through the membrane by binding chemically with them and shuttling them through the membrane

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31
Q

What do ion channels do?

A

Protein pores and channels allow various substances in and out of the cell membrane however the diameter and electrical charge of a pore permit selectivity of certain molecules

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32
Q

How do ion channels work?

A

Ex: The potassium channel permits passage of K+ ions across the cell membrane about 1000 times more readily than Na
The ability of K+ to pass through but not Na+ which has a slightly smaller diameter can be explained by the structure of the protein

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33
Q

What is the structure of an ion channel?

A

Tetrameric structure: consists of four identical protein subunits surrounding a central pore with pore loops that form a narrow selectivity filter lined with carbonyl oxygens

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34
Q

What occurs with potassium movement in the ion channel?

A

When hydrated potassium ions enter the selectivity filter, they interact with the carbonyl oxygens and shed most of their bound water molecules, permitting the dehydrated potassium ions to pass through the channel. The carbonyl oxygens are too far apart, however, to enable them to interact closely with the smaller sodium ions, which are therefore effectively excluded by the selectivity filter from passing through the pore

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35
Q

How does a sodium channel work?

A

Inner surface of channel is lined with amino acids that are strongly negatively charged and can pull small dehydrated sodium ions into these channels therefore pulling the ions away from their hydrating water molecules

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36
Q

What are gated channels?

A

Gatelike extensions of the transport protein molecule which can close or open by conformational change of the shape of the protein molecule itself

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37
Q

How does voltage-gated channels work?

A

Molecular conformation of gate responds to the electrical potential across the cell membrane

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38
Q

What is an example of volage gated channels?

A

If charge is strongly negative on inside the outside sodium gates will remain shut because this is the desired charge across the membrane but if the inside suddenly loses charge then the gates would open to allow Na+ into the cell
K+ channels are located closer to the inside of the membrane while Na+ channels are located closer to the outside of the membrane
Opening K+ channels are responsible for terminating an action potential

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39
Q

What is chemical (ligand) gating?

A

Binding of a ligand causes a conformational change that opens or closes the gate
Ex. Acetylcholine Channel: binding of Ach opens this channel

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40
Q

What are the different states of ion channels?

A

Channels conduct current in an all or nothing fashion
At one specific voltage potential, a channel may be closed all the time whereas at another voltage potential a channel may be open all the time
At in between voltages, gates tend to snap open and closed intermittently resulting in average current flow somewhere between the minimum and maximum

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41
Q

What is facilitated diffusion?

A

Substance diffuses through the membrane with the help of a specific carrier protein

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42
Q

What uses facilitated diffusion?

A

Glucose and amino acids uses this type of diffusion and GLUT4 is the glucose transporter sensitive to changes in insulin level

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43
Q

How does simple & facilitated diffusion differ?

A

Simple diffusion increases proportionately with the concentration of the diffusing substance, but in facilitated diffusion the rate of diffusion approaches a maximum, called Vmax, as the concentration of the diffusing substance increases

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44
Q

How does facilitated diffusion work?

A

In facilitated diffusion the molecule to be transported is bound and the carrier protein undergoes a conformational change so the pore now opens to the opposite side of the membrane. Because the binding force of the receptor is weak, the thermal motion of the attached molecule causes it to break away and be released on the opposite side of the membrane. The rate at which molecules can be transported by this mechanism can never be greater than the rate at which the carrier protein molecule can undergo change back and forth between its two states

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45
Q

What is osmosis?

A

Net movement of water caused by concentration difference across a membrane – water moves towards the higher concentration of solute

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46
Q

What is osmotic pressure?

A

The amount of pressure required to stop osmosis
Number of particles (molar concentration) per unit volume of fluid not by the mass of the particles and this is because each particle in a solution regardless of its mass exerts on average the same amount of pressure against the membrane
Particles that are bigger often have a slower velocity and vice versa

47
Q

How is osmotic pressure calculated?

A
48
Q

What is osmolality?

A

The osmolar concentration expressed as osmoles per kilogram of water/solvent rather than solution

49
Q

What is osmolarity?

A

The osmolar concentration expressed as osmoles per liter of solution rather than water

50
Q

Why are measurements of osmolarity more practical in physiological studies compared to measurements of osmolality?

A

The body is not only made up of water

51
Q

What is an osmole?

A

Used to express the concentration of solution in terms of numbers of particles

52
Q

What is the context of osmoles with NaCl?

A

If a substance such as NaCl can completely dissociate into ions then 1 gram in molecular weight would equal 2 osmole because it can fully dissolve into two different ions whereas glucose cannot dissolve into ions so the same molecular weight of glucose would be equal to 1 osmole

53
Q

What is the normal osmolality of intracellular & extracellular fluids?

A

300 milliosmoles per kilogram of water

54
Q

What is the osmotic pressure of one osmole with normal body conditions? Why may it be higher than normal conditions?

A

1 osmole per liter will cause 19,300 mm g osmotic pressure in solution however in reality it may be lower than the calculated value because many ions in solution are highly attracted to one another and therefore do not fully dissociate to create full osmotic pressure potential

55
Q

What is active transport?

A

When a cell membrane moves molecules or ions “uphill” against a concentration gradient requiring an energy source

56
Q

What must be proportional to the amount of energy required to move against the concentration gradient?

A

The logarithm of the degree of substance concentration
Ex: 100-fold concentration requires twice as much energy as 10-fold concentration

57
Q

What is primary active transport? What are the most important examples of primary active transport?

A

Energy needed is derived directly from breakdown of ATP or other high-energy phosphate compound
Sodium-potassium pump, calcium pump, hydrogen pump

58
Q

Explain the mechanism of the sodium potassium pump

A

Sodium-Potassium Pump: pumps Na+ out of cell while pumping K+ inside of the cell to maintain the negative electrical voltage across the membrane
Larger subunit is alpha and smaller subunit is beta (unknown function)

When three Na+ bind on inside and two K+ bind on outside then ATPase cleaves ATP causing conformational change leading to exchange of ions against concentration gradient
This reaction can also happen in the other direction generating ATP depending on the needs of the cell

59
Q

What are the three specific functions of the larger subunit of the sodium-potassium pump?

A

Three specific functions of the larger subunit:
1. It has three binding sites for sodium ions on the portion of the protein that protrudes to the inside of the cell
2. It has two binding sites for potassium ions on the outside
3. The inside portion of this protein near the sodium binding sites has adenosine triphosphatase (ATPase) activity

60
Q

Why is the sodium potassium a protective mechanism of cell swelling?

A

Protective against cell volume causing swelling because since there are a large amount of negatively charged proteins and other organic compounds that cannot escape the cell, these compounds will attract positive ions which will cause osmosis into the cell so Na+-K+ pump will prevent this by readjusting the ion concentrations

61
Q

What is the mechanism of the calcium pump?

A

Calcium Pump: maintains the low concentration of calcium ions in the intracellular space
One calcium pump pumps calcium out of the cell
The other calcium pump pumps calcium into an intercellular vesicular organelle such as the sarcoplasmic reticulum
Both pumps have same ATPase activity as Na+-K+ pump

62
Q

What is the mechanism of the hydrogen pump?

A

Hydrogen Pump: by same mechanism transports H+ at cortical collecting ducts in kidneys for excretion in urine to eliminate excess

63
Q

What is secondary active transport?

A

Two types: cotransport or counter transport
energy is derived secondarily from energy that has been stored in the form of ionic concentration differences across a cell membrane created originally by primary active transport

64
Q

What is an example of co-transport (secondary active transport)?

A

Sodium-glucose co-transport: Note that the transport carrier protein has two binding sites on its exterior side, one for sodium and one for glucose. Also, the concentration of sodium ions is high on the outside and low inside, which provides energy for the transport. A special property of the transport protein is that a conformational change to allow sodium movement to the interior will not occur until a glucose molecule also attaches. When they both become attached, the conformational change takes place, and the sodium and glucose are transported to the inside of the cell at the same time

65
Q

Where is the sodium-glucose pump important?

A

This is important in intestinal tract and renal tubules in kidneys

66
Q

What is an example of counter transport (secondary active transport)?

A

Sodium-Calcium Counter-Transport: This is different because transport is occurring in opposite directions. Sodium ion binds to the carrier protein where it projects to the exterior surface of the membrane, while the calcium to be counter-transported binds to the interior projection of the carrier protein. Once both have become bound, a conformational change occurs, and energy released by the action of the sodium ion moving to the interior causes the calcium to move to the exterior

67
Q

What is fluid intake?

A

Highly variable and must be carefully matched by equal output of water from body to prevent body fluid volumes from increasing or decreasing
Ex: Water can be ingested or can be synthesized in the body (~2100ml/day) by oxidation of carbohydrates (~200ml/day)

68
Q

What ways can fluid loss occur in the body?

A

Through skin (not sweating)
Through the respiratory tract
Sweat
Feces
Kidneys

69
Q

What is the most variable fluid loss mechanism?

A

Sweat -> depending on physical activity & environmental temperature

70
Q

How does fluid loss occur via the respiratory tract?

A

As air enters it becomes saturated with water and therefore this water is lost when respiration occurs through lungs
More in cold weather

71
Q

How is fluid loss via skin regulated?

A

Minimized by cholesterol-filled cornified layer of skin but if this is compromised such as with burns loss can increase up to 10-fold or 3-5 L/day

72
Q

What is the most minimal method of fluid loss?

A

Feces

73
Q

What is the most important mechanism of fluid loss?

A

Water loss by the kidneys which are the most important means of controlling balance between input and output of both water and electrolytes

74
Q

What is the distribution of blood fluids in a person? In a pregnant individual? In a newborn?

A

Total body water is about 60% body weight but as person grows older this percentage decreases likely due to increase in body weight being fat
In women water is about 50% body weight because they have more fat than men
In newborns water is about 70 to 75% of body weight

75
Q

How much is intracellular fluid?

A

~28-42 liters of fluid or 40% of total body weight
Different mixture of constituents but relatively similar between cells

76
Q

How much is extracellular fluid?

A

~14 liters of fluid or 20% of total body weight

77
Q

What are the components of extracellular fluid?

A

Interstitial Fluid: ~11liters of fluid
Plasma: ~ 3 liters of fluid; noncellular part of the blood that exchanges substances continuously with the interstitial fluid through pores in capillary membranes (permeable to most things except protein) therefore plasma and interstitial fluids are constantly mixing and have same concentration except for proteins which have a higher concentration in the plasma

78
Q

How much is blood volume?

A

contain intracellular and extracellular fluid (~5 liters of fluid or 7% of body weight)
About 60% of blood is plasma and 40% is red blood cells

79
Q

What is hematocrit?

A

Fraction of the blood composed of red blood cells
True hematocrit is only about 96% of measured because when centrifuged a small amount remains trapped among RBCs

80
Q

What is the ionic concentration of Na?

A

Plasma: 142
Intracellular: 14

81
Q

What is the ionic concentration of H+?

A

Plasma: 7.4
Intracellular: 6.0-7.4

82
Q

What is the ionic concentration of K+?

A

Plasma: 4.2
Intracellular: 140

83
Q

What is the ionic concentration of Ca2+?

A

Plasma: 1.3
Intracellular: 0

84
Q

What is the ionic concentration of HCO3-?

A

Plasma: 24
Intracellular: 10

85
Q

What is the ionic concentration of glucose?

A

Plasma: 5.6
Intracellular: -

86
Q

What is the ionic concentration of Cl-?

A

Plasma: 106
Intracellular: 4

87
Q

What is the total osmolarity of plasma?

A

282

88
Q

What is the total osmolarity of intracellular fluid?

A

281

89
Q

What is the indicator-dilution method?

A

The volume of a fluid compartment in the body can be measured by placing an indicator substance in the compartment, allowing it to disperse evenly throughout the compartment’s fluid, and then analyzing the extent to which the substance becomes diluted

90
Q

What does one need to know to calculate the indicator dilution method? What needs to happen for the calculations to work?

A

All one needs to know for this calculation is (1) the total amount of substance injected into the chamber (numerator) and (2) the concentration of the fluid in the chamber after the substance has been dispersed (denominator)

The requirements for this calculation to work are (1) the indicator disperses evenly throughout the compartment (2) the indicator disperses only in the department being measured (3) the indicator is not metabolized or excreted

91
Q

What are the indicators of fluid compartments in the indicator dilution method? Why are these selected?

A
  1. Total Body Water: Antipyrine is a soluble lipid and can rapidly penetrate cell membranes and distribute itself uniformly between intracellular and extracellular compartments
  2. Extracellular Fluid: can use any of several substances that disperse in the plasma and interstitial fluid but do not permeate the cell membrane
  3. Radioactive sodium may diffuse into cells in small amounts so using this indicator is measuring the “sodium space” or “inulin space” rather than true extracellular fluid volume
  4. Intracellular Fluid: this compartment cannot be measured directly but can be calculate (equation in chart)
  5. Plasma Volume: must use a substance that does not readily penetrate capillary membranes but remains in vascular system after injection
  6. Blood Volume: can be measured in hematocrit is known (equation in chart) or RBCs can be labelled with radioactive substance
  7. Interstitial Fluid: this compartment cannot be measured directly but can be calculate (equation in chart)
92
Q

What is the difference between osmolarity & osmolality?

A

Most of the time these calculations are pretty similar on body fluids, but it makes more sense to us OSMOLARITY because body fluids consist of more than just water

93
Q

Why is there a difference in total osmolarity of the plasma & intracellular fluid?

A

There is about a 1 mOsm/L difference between the total osmolarity of the plasma and intracellular fluids and this is due to osmotic effect of the plasma proteins causing greater pressure in the capillaries and therefore the plasma

94
Q

What is tonicity?

A

Depends on the concentration of impermeant solutes and refer to whether solutions will cause a change in cell volume
Measure of the osmotic pressure gradient because this value is only characterized by the solutes that cannot cross the membrane

95
Q

What is osmolarity in context of tonicity?

A

Does not depend on whether solutes can or cannot pass the membrane; considers the total concentration of solutes
Measure of the total solute concentration
Transfer of fluid across the cell membrane occurs so rapidly that any difference in osmolarity is usually corrected within minutes

96
Q

What does isotonic mean?

A

The cells will not shrink or swell because the water concentration in intracellular and extracellular fluids is equal and the solutes cannot enter or leave the cell
Ex. 0.9% sodium chloride solution or 5% glucose solution are important in medicine because they can be infused in the blood without danger of upsetting osmotic equilibrium between intracellular and extracellular fluids

97
Q

What does hypotonic mean?

A

Solution has lower concentration of impermeant solutes than the solution it is placed in: water diffuses in and cell swells

98
Q

What does hypertonic mean?

A

Solution has higher concentration of impermeant solutes than the solution it is placed in; water diffuses out and cell shrinks

99
Q

What does isosmotic mean?

A

Solutions with osmolarity the same as the cell

100
Q

What does hyperosmotic mean?

A

Solution that has higher osmolarity than the normal extracellular fluid the cell is used to

101
Q

What does hypo-osmotic mean?

A

Solution that has lower osmolarity than the normal extracellular fluid the cell is used to

102
Q

What happens to a cell in an isotonic environment?

A

No change

103
Q

What happens to a cell in a hypotonic environment?

A

Short term water moves into cell, long term cell swells and may burst

104
Q

What happens to a cell in a hypertonic environment?

A

Short term water moves out of cell, long term cell shrinks and shrivels

105
Q

What happens to a cell in osmotic solutions?

A

Generally substances will become equal in two compartments over time (initially there may be net water flux)

106
Q

What happens when saline or glucose is added to an isotonic solution?

A

When saline and glucose solutions are injected into IV they are adjusted to isotonicity so that osmotic equilibrium of body fluids is not disturbed
Ex. If an individual is dehydrated they likely have a hypertonic state in their extracellular fluid due to lack of water so if 5% glucose is injected then this isotonic solution increases the extracellular fluid volume without disrupting solute concentrations

107
Q

What happens when saline or glucose is added to an hypertonic solution?

A

Would likely cause movement of water out of cells and into extracellular space
Would be use for treatment of condition causing cellular swelling

108
Q

What happens when saline or glucose is added to an hypotonic solution?

A

Would likely cause movement of water from extracellular space into cells
Would be used for treatment of condition causes cellular shrinking

109
Q

How does fluid change in Dannet-Yarrow diagrams?

A

With addition of isotonic NaCl you see increase in volume of extracellular fluid but no change in osmolarity
With addition of hypotonic NaCl you see decrease of osmolarity in extracellular fluid as well as movement of fluid into cells
With addition of hypertonic NaCl you see increase in osmolarity in extracellular fluid as well as movement of fluid out of cells and into extracellular space

110
Q

What is the plan of administration of IV for hyponatremia?

A

Swelling: loss of sodium concentration in extracellular fluid causes movement of water into cells
Can be caused by dehydration states or overhydration states (anything that results in loss of sodium or gain of water in extracellular space)
dehydration, diarrhea, vomiting, retention of water, or overuse of diuretics that inhibit the ability of the kidneys to conserve sodium
This loss of sodium inside cells can cause cellular swelling that can cause neurological symptoms and can lead to brain damage or possibly death
With acute hyponatremia there is diffusion of H2O into cells but with chronic hyponatremia the swelling is attenuated by the transport of solutes from the cell
Treatment = hypertonic solutions: cannot be added too quickly because this may outpace the brain’s ability to recapture lost solutes and cause demyelination (less than 10-12 mmol/L in 24 hours and less than 18 mmol/L in 48 hours)
This treatment would cause the water that moved into the cells and caused brain swelling to slowly move back towards the hypertonic solution in extracellular fluid space

111
Q

What is the plan of IV treatment for hypernatremia?

A

Shrinkage: increased sodium concentration in extracellular space causes movement of water out of cells
Can be caused by dehydration states or overhydration states (anything that results in gain of sodium or loss of water in extracellular space)
Can be caused by inability to secrete antidiuretic hormone which is needed for kidneys to conserve water or simply dehydration
Excessive secretion of aldosterone can cause overhydration which can also cause hypernatremia
This condition is much less common than hyponatremia because it promotes intense thirst and stimulates secretion of antidiuretic hormone and both protect against this happening
Treatment = hypoosmotic solutions: slowly because body has natural defense mechanisms that protect the cells from changes in volume

112
Q

What is the diagnostic table for abnormalities?

A
113
Q

What is intracellular edema?

A

Intracellular Edema: caused by hyponatremia, depression of metabolic systems of tissues, or lack of nutrition to the cells
Ex. Loss of blood flow to tissue then ion pumps stop working
Inflammation typically increases cell membrane permeability allowing sodium and other ions to diffuse into interior of cell causes subsequent osmosis of water into cells

114
Q

What is extracellular edema?

A

Extracellular Edema: caused by abnormal leakage of fluid from plasma to interstitial spaces across the capillaries or failure of the lymphatics to return fluid from the interstitium back to the blood (lymphedema)
Lymphedema: can be caused by increased capillary pressure (kidney or heart failure), decreased plasma proteins (burns or liver disease), increased capillary permeability (infection or vitamin deficiency), blockage of venous return (surgery or cancer)