Chapter 26 (Lecture) Flashcards

1
Q

if the cause of the imbalance is respiratory, often what will try to compensate

A

kidneys

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2
Q

if the cause of imbalance is metabolic, what will try to compensate

A

respiratory system

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3
Q
  • breathing is imparied so PCO2 levels are high and blood pH is low
  • if the kidneys are trying to compensate, HCO3- levels will also elevate
A

respiratory alkalosis

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4
Q
  • breathing rate is increased - PCO2 levels will be lower and pH will be higher
  • if the kidneys are trying to compensate HCO3- levels will begin to fall
A

respiratory alkalosis

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5
Q
  • the is a renal problem-blood pH is lower and blood HCO3- levels are lowered
  • respiratory systems compensates by increasing the increasing the rate and depth of breathing–so PCO2 levels go down below normal
A

metabolic acidosis

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6
Q
  • there is a renal problem–blood pH is higher and blood HCO3- levels are elevated
  • respiratory systems compensates by decreasing the rate and depth of breathing–so PCO2 levels go up and pH levels go down
A

metabolic alkalosis

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7
Q
  • caused by any condition that impairs gas exchange, also shallow breathing can cause it
  • most common cause of acidosis
  • PCO2 increases and pH decreases
A

respiratory acidosis

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8
Q
  • hyperventilation, tumor affecting respiratory center
  • CO2 is washed out of the body too quickly
  • PCO2 decreases and pH increases
A

respiratory alkalosis

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9
Q
  • severe diarrhea, renal failure, starvation, excessive alcohol intake
  • low blood pH and low blood HCO3- levels
  • not caused by CO2 fluctuations
A

metabolic acidosis

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10
Q
  • vomiting or suctioning of acidic gastric contents, excessive bicarbonate intake
  • increasing blood pH and increasing HCO3- levels
A

metabolic alkalosis

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11
Q

normal pH range of plasma

A

7.35-7.45

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12
Q

normal range of PCO2 in plasma

A

35-45 mmHg

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13
Q

normal range of HCO3- in plasma

A

22-26 mEq/L

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14
Q
  • the ultimate acid-base regulatory system
  • slowest action, but it is the only system that can get rid of acids generated by metabolism (phosphoric, lactic, ketoic acids)
  • kidneys can also conserve and generate new bicarbonate ions as needed
A

renal regulation

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15
Q

increased H+ leads to increased CO2 levels and to

A

increased respiration

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16
Q

buffer types

A
  • physiological (respiratory and renal)
  • chemical
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17
Q
  • 1-2 times stronger than chemical buffers
  • acts more slowly than chemical buffers
  • works with CO2 levels
  • increased H+ leads to increased CO2 levels and to increased respiration
A

respiratory regulation

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18
Q
  • intracellular proteins are the most powerful ICF buffers in the body
  • can bind or release H+ when necessary
A

protein buffer system

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19
Q
  • does the same as a bicarbonate buffer, but works more in the nephron than in the plasma
  • has a more powerful effect on the ICF and nephron
A

phosphate buffer system

NaH2PO4

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20
Q
  • converts strong acids and bases into weak acids and bases
  • primary buffer in the ECF
A

bicarbonate buffer system

H2CO3

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21
Q
  • one or two molecule systems that resist changes in pH
  • bind H+ if pH drops
  • release H+ is pH rises
A

chemical buffers

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22
Q

types of chemical buffers

A
  • bicarbonate
  • phosphate
  • protein
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23
Q

dissociate completely in solution and greatly affect pH

A

strong acids

ex: HCl

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24
Q

partially dissociate and act as buffers

A

weak acids

ex: H2CO3

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25
Q

whenever pH drops below 7.35

A

acidosis

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26
Q

fluid inside of cells, makes up about 40% or 25L of body weight

A

intracellular compartment

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27
Q

whenever pH rises above 7.45

A

alkalosis

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28
Q

decreased calcium ions in plasma

A

hypocalcemia

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29
Q

causes of hypocalcemia

A

nutritional, vitamin D deficiencies, burns

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30
Q

symptoms of hypocalcemia

A
  • neuromuscular excitability
  • tetany
  • depressed excitability of the heart
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31
Q

increased calcium ions in the plasma

A

hypercalcemia

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32
Q

causes of hypercalcemia

A

hyperparathyroidism, too much vitamin D

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33
Q

symptoms of hypercalcemia

A
  • bone wasting
  • fractures
  • kidney stones
  • cardiac arrhythmias
  • depressed respiration
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34
Q

total body water =

A

40L or roughly 60% of total body weight

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35
Q

all fluid outside of cells, makes about 20% or 15L of body

A

extracellular compartment

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36
Q

subcompartments within the extracellular fluid

A
  • interstitial fluid
  • plasma
  • lymph
  • CSF
  • synovial fluid
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37
Q
  • different than extracellular composition due to the presence of selectively permeable cell membrane
  • most proteins, larger molecules remain in the intracellular fluid
  • water moves in and out via osmosis
A

intracellular compartment composition

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38
Q
  • fluid and electrolyte intake must equal output by kidneys, liver, and lungs
  • substances such as RBC, albumins stay in the blood vessels
A

extracellular compartment composition

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39
Q

water intake should = ……. each day

A

water ouput

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40
Q

average daily water intake/output should equal

A

2500ml/day

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41
Q

water is obtained through

A
  • 60% drinking
  • 30% moist food
  • 10% internal metabolic pathways
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42
Q

water is lost through

A
  • urine = 60%
  • feces = 4%
  • sweat = 8%
  • skin diffusion and lung evaporation (heat) = 28%
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43
Q

calcium levels are regulated by which hormone majorly

A

parathyroid hormone

smaller extent calcitonin

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44
Q

decreased blood calcium =

A

increased PTH secretion; raises blood calcium

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45
Q

PTH targets

A

bone, kidneys, GI tract

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46
Q

increased blood calcium =

A

decreased calcitonin; lowers blood Ca

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47
Q

increased K+ ions in plasma

A

hyperkalemia

48
Q

causes of hyperkalemia

A

decreased aldosterone, cell rupture due to burns or other trauma

49
Q

symptoms of hyperkalemia

A
  • restlessness
  • neuromuscular irritability followed by fatigue due to overexcitement, which leads to muscular weakness and flaccid paralysis
50
Q

decreased K+ ions in plasma

A

hypokalemia

51
Q

causes of hypokalemia

A

too much aldosterone, reduced intake, GI tract problems

52
Q

weak acids that can accept H+ ions if the pH is too acidic, or can release H+ ions if the pH is too alkaline

A

buffers

53
Q

symptoms of hypokalemia

A

causes hyperpolarization, leads to muscle weakness and mental confusion

54
Q

decreased ECF K+ =

A

hyperpolarization of cell membranes

55
Q

increased ECF K+ =

A

depolarization of cell membranes

56
Q

major ICF cation

A

K+

57
Q

what does the ICF-ECF concentration of K+ affect

A

membrane permeability

58
Q

what are exchanged between the compartments

A

water, nutrients, gas

59
Q

mEq/L

A

measures of electrical charges per liter

60
Q

Fluid in both the ICF and ECF have a concentration of about

A

290-300 mOsm

.9%

61
Q

concentration (osmolality) is due to which factors

A
  • amount of solutes present
  • amount of water present
62
Q

increasing the number of solutes will do what to the concentration

A

increase

63
Q

increasing the amount of water will do what to the concentration

A

lower it

64
Q

pushes fluid into ICF from ECF

A

hydrostatic pressure

65
Q

draws fluid from ICF into ECF

A

osmotic (oncotic) pressure

66
Q

the more solutes a solution has, the ______ its osmotic pressure

A

greater

67
Q

how can you raise osmolality of ECF

A
  • losing water
  • ingesting excess electrolytes
68
Q
  1. excessive water loss of H2O from ECF
  2. ECF osmotic pressure rises
  3. cells lose H2O to ECF by osmosis; cells shrink
A

dehydration

69
Q
  1. excessive H2O enters the ECF
  2. ECF osmotic pressure falls
  3. H2O moves into cells by osmosis; cells swell
A

hypotonic hydration

70
Q

disorders of water imbalance

A
  • dehydration
  • hypotonic hydration
71
Q

results from fluid in the interstitial space

A

edema

72
Q

major ECF electrolyte

A

Na+

73
Q

maintained mainly by aldosterone

A

Na+ homeostasis

74
Q

too much Na+ in the plasma =

A

dehydration

75
Q

too little Na+ in the plasma =

A

edema

76
Q

causes of hypernatremia

A
  • too much aldosterone
  • hypertonic saline solutions
  • dehydration
77
Q

symptoms of hypernatremia

A
  • CNS dehydration leads to confusion and lethargy
  • neuromuscular irritability with twitching and convulsions
78
Q

causes of hyponatremia

A
  • vomiting
  • diarrha
  • burns
  • dilution
  • increased diuresis
  • aldosterone deficiency
79
Q

volume = 40 L, 60% body weight

A

total body water

80
Q

volume = 25 L, 40% body weight

A

intracelluular fluid (ICF)

81
Q

volume = 12 L, 80% of ECF

A

interstitial fluid (IF)

82
Q

volume = 3L, 20% of ECF

A

plasma

83
Q

what triggers the thirst mechanism

A

increased osmolality, decreased plasma volume

84
Q

in the hypothalamus near the third ventricle

A

thirst center

85
Q

causes the sensation of thirst, causes dry mouth

A

osmoreceptor over activity

86
Q

quenches thirst

A

drinking

87
Q

inhibits osmoreceptors

A

drinking, activation of stretch receptors in SI and stomach

88
Q

typical sodium ion value

A

142 mEq/L

89
Q

typical potassium value

A

3.7 mEq/L

90
Q

typical calcium value

A

5 mEq/L

91
Q

causes of edema

A
  • incompetent venous valves
  • hypoproteinemia
  • liver disease
92
Q

what would occur if there was an increase in plasma osmolality

A
  • thirst
  • release of ADH
  • concentrated urine
93
Q

what type of tissue is least hydrated

A

adipose tissue

94
Q

water lost through expired air

A

insensible water loss

95
Q

promotes net osmosis into tissue cells, causing them to swell as they become abnormally hydrated

A

hyponatremia

96
Q

diuresis peaks how long after drinking water

A

one hour

97
Q

what type of individual would have the most body water

A

infant

98
Q

acts on the kidneys to decrease water excretion

A

ADH

99
Q

when water output exceeds intake over a period of time

A

dehydration

100
Q

most water is excreted via

A

kidneys

101
Q

associated with the swelling of cells

A

hypotonic hydration

102
Q

least abundant positive electrolyte in ECF

A

magnesium

103
Q

common stimuli of ADH

A
  • increased ECF osmolality
  • decreased BP
  • reduced blood volume
  • stimulation of baroreceptors
104
Q

what hormone increases sodium excretion

A

progesterone

105
Q

aldosterone targets what area of the kidney

A

kidney tubules

106
Q

most important factor that incluences K+ secretion

A

K+ concentration in ECF

107
Q

what process is most affected by calcium levels

A

neuromuscular excitability

108
Q

a condition that results from solute loss, water retention, or both

A

hyponatremia

109
Q

enhances release of calcium from bone

A

parathyroid hormone

110
Q

what happens when the concentration of Na+ decreases in the ascending limb of the nephron

A

aldosterone levels increase

111
Q

electrolyte balance in the body usually refers to the balance of

A

salts

112
Q

most abundant negative electrolyte in ECF

A

chloride

113
Q

in addison’s disease, the adrenal cortex produces too little aldosterone, and so Na+ is lost. people with this disorder often crave

A

salty foods

114
Q

most important force causing net outward water flow across capillary walls

A

hydrostatic pressure of capillary blood

115
Q
A