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a & p II exam 3 > chapter 27: fluid, electrolyte, pH balance > Flashcards

chapter 27: fluid, electrolyte, pH balance Flashcards

1
Q

what ions from dissociated compounds will conduct an electrical charge in the solution?

A

electrolyte

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2
Q

why, on average, does a male body contain more water than a female body?

A

males more muscle, which contains more water than adipose tissue

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3
Q

most of the water in your body is where?

A

inside cells (intercellular fluid)

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4
Q

what is the most common positively charged ion in the extracellular fluid?

A

sodium

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5
Q

water will always move between ICF and ECF by what?

A

osmosis

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6
Q

what does ‘high osmotic concentration’ mean?

A

many solutes, osmotic draw for water

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7
Q

antidiuretic hormone release is controlled by osmoreceptors where in the brain?

A

hypothalamus

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8
Q

a decline in the kidney filtrate osmotic concentration at the distal convoluted tubule can trigger the release of what from the adrenal gland?

A

aldosterone

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9
Q

someone with Addison’s disease will lose a lot of what 2 things in the urine?

A

NaCl & water

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10
Q

what are released in response to stretching of
the heart and will block the release of ADH & aldosterone?

A

natriuretic peptides

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11
Q

what is insensible perspiration?

A

evaporation through the skin (NOT beads of sweat from sweat glands, that’s sensible perspiration)

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12
Q

how do your cells make water?

A

dehydration synthesis reactions & aerobic cellular respiration

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13
Q

what is the condition of low sodium ions in the body fluids & can lead to water intoxication?

A

hyponatremia

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14
Q

how are sodium ions typically lost from the body?

A

urine & perspiration

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15
Q

why can consuming a bunch of salt increase your blood pressure?

A

water follows salt: salt absorbed into the blood from the digestive tract will become an osmotic draw for water to leave your cells & move to the blood thus increasing blood volume and then pressure

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16
Q

where are most of the potassium ions in your body located?

A

inside cells

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17
Q

what happens to the levels of potassium ions in your blood when your blood becomes acidic?

A

potassium ion levels will rise

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18
Q

what happens to the levels of potassium ions in your blood when you have a lot of aldosterone floating around?

A

potassium ions levels will fall

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19
Q

hyperkalemia can lead to flaccid paralysis & what else?

A

cardiac arrhythmia

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20
Q

what is the most abundant mineral in the body?

A

calcium

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21
Q

name the hormone that functions to lower blood calcium levels?

A

calcitonin

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22
Q

what function do Chloride ions have in the body?

A

there isn’t one, it’s just typically the other half of NaCl

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23
Q

what is a substance that dissociates to release protons?

A

acid

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24
Q

what functions to absorb protons to stabilize pH?

A

buffer

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25
Q

what enzyme in erythrocytes functions to create
bicarbonate ions?

A

carbonic anhydrase

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26
Q

excess protons are removed from the body either as water in the lungs or as
protons at what organ?

A

kidney

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27
Q

any condition that prevents lung function of the flow of blood to the lungs will lead to respiratory what?

A

acidosis

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28
Q

hyperventilation will cause respiratory what?

A

alkalosis

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29
Q

what illness/condition can lead to metabolic alkalosis?

A

extreme vomiting (or a steady diet of antacids)

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30
Q

extracellular fluid (ECF)

A

interstitial fluid, plasma, lymph, CSF, synovial fluid, serous fluid, etc.

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31
Q

intracellular fluid (ICF)

A

cysotol

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32
Q

fluid balance (stabilizing ECF & ICF)

A

must have equal gain (food & metabolism: water made by body chemistry) & loss (urine & perspiration) of water

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33
Q

electrolyte balance (stabilizing ECF & ICF)

A

must have equal gain (absorption in GI) & loss (urine in kidney & perspiration in skin)

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34
Q

electrolytes

A

ions from dissociated compounds that will conduct an electrical charge in solution

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35
Q

acid-base balance (stabilizing ECF & ICF)

A

the production of hydrogen ions by metabolism must be matched by loss of these H+ ions in the kidney (protons: H+) & lungs (carbonic acid)

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36
Q

fluid & electrolyte balance (water & ions move together):

A
  • average male ~60% H2O (more muscle which can be ~75% H2O)
    -average female ~50% H2O (more adipose which is only ~10% H2O)
    -most of the water in body found in ICF (~2/3)
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37
Q

although different ions dominate, both fluid divisions have the same osmotic conc.:

A

-ions cant pass freely through cell membranes, but water can by osmosis & equilibrium
- solute/electrolyte concentrations of fluid divisions will directly impact water distribution

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38
Q

principal cation & anions in ECF:

A

principal cation = Na+
principal anions = Cl-, HCO3-

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39
Q

principal cation & anions in ICF:

A

principal cation = K+, Mg2+
principal anions = HPO4 & negatively charged proteins (phosphates)

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40
Q

all homeostatic mechanisms for fluid composition responds to changes in ECF (1st rule of regulation of fluids):

A

-receptors monitor the composition of plasma & CSF and trigger neural & endocrine mechanisms in response to change
- individuals cells cannot be monitored & thus ICF has no direct impact

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41
Q

no receptors directly monitor fluid or electrolyte balance (2nd rule of regulation of fluids):

A

only plasma volume & osmotic conc. are monitored, which gives an indirect measure of fluid or electrolyte levels

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42
Q

“water follows salt” (3rd rule of regulation of fluids):

A

-cells can’t move water by active transport
-water will always move by osmosis & this movement can’t be stopped

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43
Q

the body’s content of water or electrolytes rises & falls with gain & loss to and from environment (4th rule of regulation of fluids):

A

-too much intake = high content in body
-too much loss = low content in body

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44
Q

antidiuretic hormone (ADH) (primary regulatory hormone)

A

-osmoreceptors in hypothalamus monitor ECF & release ADH in response to high osmotic conc. (low water, high solute)
-↑ osmotic conc. = ↑ ADH levels

45
Q

what are the primary effects of ADH? (primary regulatory hormone)

A

a) stimulate water conservation at kidneys
b) stimulate thirst center

46
Q

aldosterone (primary regulatory hormone)

A

-released by adrenal cortex to regulate Na+ absorption & K+ loss in DCT & collecting system in kidney
-retention Na+ will result in H2O conservation

47
Q

when is aldosterone released in response to? (primary regulatory hormone)

A

a) high K+ or low Na+ in ECF (renal circulation)
b) activation of renin-angiotensin system due to a drop in BP or blood volume
c) decline kidney filtrate osmotic conc. at the DCT (more water loss than solutes)

48
Q

addison’s disease

A

hypoaldosteronism
-results in massive loss of NaCl & H2O in the urine; must adjust diet to compensate

49
Q

natriuretic peptides (primary regulatory hormone)

A
  • ANP (atrial) & BNP (brain) are released in response to stretching of heart wall
    -function to reduce this & block release of ADH & aldosterone, resulting in diuresis
50
Q

diuresis

A

fluid loss in kidney

51
Q

fluid movement within the ECF (fluid balance)

A

two important divisions: plasma (~20%) & interstitial fluid (~80%)

52
Q

what is the continuous flow between plasma & interstitial fluid? (fluid movement in ECF -> fluid balance)

A

a) hydrostatic pressure pushes water from the plasma into interstitial fluid
b) colloid osmotic pressure draws water leaves the plasma & accumulates in interstitial fluid

53
Q

edema

A

abnormal amount of water leaves the plasma & accumulates in interstitial fluid

54
Q

water loss (fluid exchange with environment -> fluid balance)

A

~2500 mL/day in urine, feces & insensible perspiration = obligatory water loss
- sensible perspiration: can reach up 4L/hr under extreme conditions
- fever: for each degree rise, insensible perspiration will increase by 200mL/day

55
Q

water gains (fluid exchange with environment -> fluid balance)

A

-must match water losses or dehydration will result
-typical gain:
~1000 mL from drink
~1200mL from food
~300mL metabolic “waste”
-water not easily measure, so ion content, particularly Na+ is measured & regulated

56
Q

when does metabolic generation of water occur?(water gains -> fluid exchange with environment -> fluid balance)

A

from dehydration synthesis reactions & aerobic respiration in mitochondria: water is the waste product of those reactions

57
Q

hyponatremia

A

hypotonic hydration
-condition of low Na+ concentration (ie. excess water)

58
Q

what causes hyponatremia?

A

1) ingestion of a large volume of freshwater or injection of hypotonic solution
2) inability to eliminate excess water at kidney
3) endocrine disorder (eg. too much ADH)

59
Q

what is the result of hyponatremia?

A

cerebral edema & CNS dysfunction
-water moving from ECF to ICF causing cellular damage = “water detoxification”

60
Q

hypernatremia

A

dehydration
-condition of high Na+ conc. (i.e., water depletion)

61
Q

what is the result of hypernatremia?

A

decreased plasma volume & blood pressure that can lead to hypovolemic shock (inadequate circulation)

62
Q

fluid shifts (fluid balance)

A

movement of water will occur between ECF & ICF due to changes in osmotic concentrations

63
Q

water will always come to equilibrium (fluid shifts -> fluid balance):

A

-if osmotic conc. of ECF ↑ (hypertonic) due to loss of water but not electrolytes, water will leave ICF
-if osmotic conc. of ECF ↓ (hypotonic) due to gain of water but not electrolytes, water will enter ICF

64
Q

total amount of water is greater in ICF than ECF (fluid shifts -> fluid balance):

A

this allows ICF to act as a reserve to accommodate changes in ECF until hormones can restore homeostasis

65
Q

why is electrolyte balance important?

A

1) total electrolyte conc. directly affects water balance
2) conc. of individual electrolytes can affect cell functions
- 2 most important electrolytes are sodium & potassium

66
Q

sodium balance (electrolyte balance)

A

-normal blood values: 130-145
-Na+ is the dominant cation in ECF
-90% of ECF osmotic conc. is due to sodium salts
-total mount of Na+ in ECF is due to balance between Na+ uptake in digestive system & Na+ excretion in urine & perspiration

67
Q

what are the 2 sodium salts involved in ECF osmotic conc.?

A

NaCl & NaHCO3

68
Q

overall sodium conc. in body fluid rarely changes because water always moves to compensate (sodium balance -> electrolyte balance):

A

high sodium levels in blood will cause retention of water to maintain the same Na+ conc., but this results in high blood volume (why salt is bad for hypertensive patients)

69
Q

minor gains & losses of Na+ in ECF are compensated by water in ICF & later adjusted by hormonal activities (sodium balance -> electrolyte balance)

A

-ECF volume too low -> renin-angiotensin system activated to conserve water & Na+
-ECF volume too high -> natriuretic peptides released: block ADH & aldosterone resulting in water & Na+ loss

70
Q

potassium balance (electrolyte balance)

A

-normal blood values: 3-5-5.5
-K+ dominant cation in ICF (98%)
-conc. of K+ in ECF depends on absorption in GI vs. excretion in urine
- exchange pump at kidney tubules secrete K+ (or H+) in order to reabsorb Na+

71
Q

the rate of tubular secretion of K+ in kidney is controlled by three factors (potassium balance -> electrolyte balance):

A
  1. changes in K+ conc. of ECF
    - ↑ K+ in ECF =↑ K+ secretion
  2. changes in blood pH
    -at low pH, H+ is used for Na+ reabsorption instead of K+ at exchange pump
    - ↓ pH in ECF = ↓ K+ secretion
  3. aldosterone levels
    - ↑ aldosterone = ↑ Na+ reabsorption & ↑ K+ secretion
72
Q

hypokalemia

A

low K+ conc. in ECF, will cause muscular weakness & mental confusion

73
Q

what are the causes of hypokalemia?

A
  1. inadequate dietary K+ intake
  2. some diuretic drigs
  3. excessive aldosterone
  4. increased pH of ECF
74
Q

hyperkalemia

A

high K+ conc. in ECF will cause cardiac arrhythmia & flaccid paralysis

75
Q

what are the causes of hyperkalemia?

A
  1. renal failure
  2. diuretic that block Na+ reabsorption
  3. decline in pH
76
Q

calcium balance (electrolyte balance)

A

-normal blood values: 4.5-5.8
-Ca2+ most abundant mineral in the body
-99% is located in the skeleton for structure
-Ca2+ homeostasis involves interplay between skeletal reserves, uptake at the GI, & loss at the kidney
-parathyroid hormone & calcitriol function to raise blood Ca2+ levels
-calcitonin functions to lower blood Ca2+ levels

77
Q

why is calcium (Ca2+) so important? (electrolyte balance)

A

-muscular & neural cell activities
-blood clotting
-a cofactor for enzymes
-a second messenger (intercellular signaling)

78
Q

hypercalcemia

A

-high Ca2+ concentration in ECF: can be due to
hyperparathyroidism or cancers
-can cause fatigue, confusion,
cardiac arrhythmia & calcification of organs

79
Q

hypocalcemia

A

-low Ca2+ concentration in ECF: can be due to
hypoparathyroidism, VitD deficiency, or renal failure
-can cause muscle spasms, convulsions, weak heartbeats, reduced
clotting & osteoporosis

80
Q

magnesium balance (electrolyte balance)

A

-normal blood values: 1.4-6
-most Mg 2+ is located in skeleton
-remainder is located in ICF
-Mg 2+ is important as a cofactor for enzymes & a structural component of the skeleton
-excess can cause lethargy & coma
-insufficient magnesium can cause convulsions

81
Q

phosphate balance (electrolyte balance)

A

-normal blood values: 1-6
-free phosphate (HPO42- ) is found in ICF
-phosphate tends to accompany calcium, so physiological effects of
excess or deficiency are related to calcium levels

82
Q

what is phosphate used for in the body? (electrolyte balance)

A

-mineralization of bone
-formation of high energy compounds (ATP)
-cofactors for enzymes
-synthesis of nucleic acids

83
Q

chloride balance (electrolyte balance)

A

-normal blood values: 95-105
-Cl- is abundant anion in the ECF
-body has no use for it other than the fact that it travels with Na+
-excess can cause metabolic acidosis
-Deficiencies can cause metabolic alkalosis

84
Q

acid

A

a substance that dissociates to release H+

85
Q

base

A

a substance that dissociates to release OH- ions or absorbs H+ ions

86
Q

pH

A

-potential of hydrogen
-water is neutral: H+ = OH-
-basic or alkaline solution (pH 7-14) has more OH - than H+

87
Q

acid-base balance

A

-pH scale is used to measure the concentration of H+ ions in a solution
-strong acids or bases dissociate completely in solution (e.g. HCl → H + + Cl- )
-weak acids or bases do not completely dissociate: many molecules remain intact
(e.g. H 2 CO 3 )

88
Q

what is the normal pH of the ECF? (acid-base balance)

A

-7.35 – 7.45.
-above or below this range will disrupt cell membranes & denature proteins
-acidosis = ECF pH below 7.35
alkalosis = ECF pH above 7.45
-acidosis more common problem since metabolism generates acid waste products

89
Q

volatile acids (type of acid -> acid-base balance)

A

can leave solution and enter the atmosphere
-e.g. CO 2 + H 2 O ↔ H 2 CO 3 ↔ H + + HCO 3
-lungs -> blood

90
Q

fixed acids (acid type -> acid-base balance)

A

remain in solution until they are excreted
-e.g. sulfuric acid, phosphoric acid

91
Q

organic acids (acid type -> acid-base balance)

A

products of metabolism
-usually metabolized into other wastes, but can build up under anaerobic conditions or starvation
-e.g. Lactic acid, Ketone bodies

92
Q

buffers (mechanism of pH control -> acid-base balance)

A

dissolved compounds that can remove H+ ions to stabilize pH
-buffers are a weak acid & its corresponding salt
-three major buffering systems: protein, carbonic acid-bicarbonate & phosphate systems

93
Q

protein buffer system (buffer-> mechanisms of pH control -> acid-base balance)

A

proteins are used to regulate pH in ECF & ICF (most effective in ICF)

94
Q

amino acids can be used to accept or release H+ ions (protein buffer system -> buffer-> mechanisms of pH control -> acid-base balance):

A

-at typical body pH, most carboxyl groups exist as COO- & can accept H+ ions if pH drops
-histidine & cysteine remain as COOH at normal pH & can donate H+ if pH rises
-most proteins provide some degree of buffering with carboxyl terminal

95
Q

what are the effects of hemoglobin on blood pH? (hemoglobin (Hb) buffering system -> protein buffer system -> buffer-> mechanisms of pH control -> acid-base balance):

A

-most effective in ECF: blood
-in RBCs, the enzyme carbonic anhydrase converts CO2 into H2CO3 which then dissociates
-H+ remains inside RBC, but HCO3- enters plasma where its absorb excess H+

96
Q

carbonic acid-bicarbonate buffer system (buffer-> mechanisms of pH control -> acid-base balance)

A

-most important buffer for ECF (in plasma or Hb)
-carbon dioxide & water from carbonic acid which dissociates into hydrogen ions & bicarbonate ions
-bicarbonate ions can be used to absorb H+ ion in ECF & can be released as CO2 & H2) at lungs

97
Q

when does the carbonic acid-bicarbonate buffer system work? (buffer-> mechanisms of pH control -> acid-base balance)

A
  1. CO2 levels are normal
  2. respiration is functioning normally
  3. free bicarbonate ions are available
    -bicarbonate ions can be generated from CO2 + H2O or NaHCO3- but have free HCO3-, H+ ions must be excreted at kidney
98
Q

phosphate buffer system (buffer-> mechanisms of pH control -> acid-base balance)

A

-phosphate is used to buffer ICF & urine
-H2PO4 or NaPO4 can dissociate to generate HPO4-2, which can absorb H+ (as above, only as long as H+ is excreted at kidney)

99
Q

maintenance of acid-base balance (acid-base balance)

A

buffering will only temporarily solve H+ problem: permanent removal as H2O at lungs or through secretion at kidney necessary to maintain pH near neutral

100
Q

respiratory compensation (pH homeostasis -> maintenance of acid-base balance)

A

-respiration rate is altered to control pH
-↑ CO2 = ↓ pH
-↓ CO2 = ↑ pH

101
Q

renal composition (pH homeostasis -> maintenance of acid-base balance)

A

-the rate of H+ & HCO3- secretion or reabsorption can be altered as necessary
- ↑ H+ = ↓ pH
- ↓ HCO3- = ↑ pH

102
Q

factors that disturb the acid-base balance:

A

a) disorders of buffers, respiratory problems or renal function
b) cardiovascular conditions that alter blood flow to lungs & kidney
c) CNS disorders that effect cardiovascular or respiratory reflexes

103
Q

respiratory acidosis (disturbance of acid-base balance)

A

respiratory system fails to eliminate all CO2 generated by peripheral tissues causing decline in pH
-caused by cardiac arrest, emphysema, CHF, pneumonia, pneumothorax, etc.

104
Q

respiratory alkalosis (disturbance of acid-base balance)

A

lungs remove too much CO2 causing an ↑ in pH
-result of hyperventilation due to anxiety or pain: usually corrects itself

105
Q

what are the 3 causes of metabolic acidosis (disturbance of acid-base balance)?

A
  1. production of fixed or organic acids: lactic acidosis & ketoacidosis
  2. impaired ability to excrete H+ at kidney (diuretics)
  3. severe bicarbonate loss eg. diarrhea: buffering agents from intestinal secretions are lost before they can be reabsorbed
106
Q

lactic acidosis (metabolic acidosis -> disturbance of acid-base balance)

A

results from hypoxia & usually linked to respiratory acidosis

107
Q

ketoacidosis (metabolic acidosis -> disturbance of acid-base balance)

A

results from starvation or diabetes mellitus

108
Q

metabolic alkalosis (metabolic acidosis -> disturbance of acid-base balance)

A

-rare condition, caused by ↑ HCO3-
-secretion of HCl in stomach releases HCO3- in ECF
- severe vomiting causes continuous acid production & loss
-corresponding HCO3- then accumulates ECF
-also results from chronic & excessive use of antacids

109
Q

age-related changes in fluid, electrolyte & acid-base balance

A

-↓ water content affects solute conc. (elderly ~40% H2O)
-↓ renal compensation (reduced kidney function)
-↓ mineral reserves (Ca2+, Mg2+, HOP42-)
-↓ respiratory compensation (reduced lung function)

a & p II exam 3 (3 decks)

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