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Pathophysiology > Chapter 8- Fluids, Electrolytes, Acid-Base Balance > Flashcards

Chapter 8- Fluids, Electrolytes, Acid-Base Balance Flashcards

1
Q

Relative concentration Cl-

A

ECF: 98-106 mEq/L

ICF: 3-4 mmol/L

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2
Q

Relative concentration Mg

A

ECF: 1.8-3.0 mg/dL (slides: 1.5-2.5)

ICF: 20 mmol/L

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3
Q

Relative concentration bicarbonate

A

ECF: 24-31 mEq/L

ICF: 7-10 mmol/L

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4
Q

Relative concentration Na+

A

ECF: 135-145 mEq/L

ICF: 10-14 mmol/L

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5
Q

Relative concentration K+

A

ECF: 3.5-5.0 mEq/L

ICF: 140-150 mmol/L

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6
Q

Relative concentration Ca2+

A

ECF: 8.5-10.5 mg/dL

ICF: <0.25 mmol/L

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7
Q

Relative concentration P

A

ECF: 2.5-4.5 mg/dL

ICF: variable

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8
Q

Electrolytes

A

Dissociate into ions in water

Conduct electricity
Eg: Na+ and Cl-

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9
Q

Non-electrolytes

A

Anything that does not dissociate into ions (urea and glucose)

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10
Q

Cations

A

Positively charged ions

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11
Q

What do electrolytes impact?

A

All cell functions

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12
Q

Barrier for movement of substances between ECF and ICF

A

Cell membrane

  • Lipid soluble pass through (02 or C02)
  • Ions need transport mechanism (Na+, K+)
  • Water passes through via osmosis and the use of TMPs
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13
Q

Organ that maintains electrolytic ranges

A

Kidneys main regulators

- maintain electrolytes within narrow ranges

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14
Q

Control H+ concentration

A

Buffers

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15
Q

Acidosis

A

Too many acids are present

Imbalance of acids and bases

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16
Q

Alkalosis

A

Imbalance of acids and bases

More bases than acids

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17
Q

Where are fluids and electrolytes present in the body?

A

Cells, tissue spaces between cells, blood (vascular)

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18
Q

Body fluids transport

A

Nutrients, gases, wastes, transform food to energy, generate electrical activity

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19
Q

Where are body fluids found?

A

ECF and ICF

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20
Q

What is an ECF compartment?

A

Extracellular fluid compartment; outside of cell and interstitial tissues spaces, blood volumes

Large amounts of NaCl, moderate bicarbonate, small K, Mg, Ca, P

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21
Q

What is the ICF compartment?

A

Intracellular fluid compartment; inside the cell

2/3 of water in body

No Ca2+, little Na, Cl, bicarbonate, P; moderate Mg; lots of K+

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22
Q

Anions

A

Negatively charged ions

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23
Q

Diffusion

A

Movement of charged or uncharged particles along a concentration gradient (move from higher concentration to lower concentration)

Energy is a result of collision of particles

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24
Q

Electroneutrality

A

The total number of cations in the body equals the total number of anions

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25
Q

Osmosis

A

Movement of water across semipermeable membrane (permeable to water but impermeable to most solutes)

Moves down concentration gradient

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26
Q

What kind of pressure is created during osmosis?

A

Osmotic pressure which equals hydrostatic pressure

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27
Q

Osmolarity

A

Refers to fluids outside the body

Higher the osmolarity, the higher the solutes in the fluid

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28
Q

Osmolality

A

Refers to body fluids

The higher the osmolality, the more solutes present in the body fluid

29
Q

What is a normal range for serum osmolality?

A

275-295 mOsm/kg

30
Q

What key clinical manifestation does urine osmolality tell us?

A

It tells us about the kidney’s ability to produce a concentrated or diluted urine based on serum osmolality, as well as the need for water conservation or excretion

31
Q

Tonicity

A

Tension or effect that the effective osmotic pressure of a solution with impermeable solutes exerts on cell size due to water movement across cell membrane

32
Q

Effective osmole

A

One that exerts an osmotic force and cannot permeate the cell membrane

33
Q

Ineffective osmole

A

Exerts an osmotic force but cross the CM

34
Q

What determines tonicity?

A

Effective solutes (glucose) that cannot permeate CM —> creates osmotic force that pull water out of cell

35
Q

Isotonic Solution

A

Same effective osmolality as ICF

Cell neither shrinks or swells

Eg: NaCl

36
Q

Hypotonic Solution

A

Lower effective osmolality than ICF, cells swell

37
Q

Hypertonic Solution

A

Greater effective osmolality than ICF

Cells shrink as water is pulled out of cell

38
Q

What areas of the body constitute the ECF?

A

Interstitial fluid
Plasma compartment
Transcellular compartment (CSF and fluid in body spaces like the peritoneal cavity, joint spaces, GI tract)

39
Q

What regulates ICF volume?

A

Proteins and organic compounds within cells

Water and solutes that move between the ECF and ICF

40
Q

What charge do intracellular proteins typically contain?

A

Negative, so they attract positively charged ions

41
Q

What does the sodium potassium pump do?

A

Removes three sodium ions from cell for every two potassium ions that move into cell
- helps to ensure sodium doesn’t pull water until cell until rupture

42
Q

What conditions impair function of sodium potassium pump?

A

Hypoxia —> causes cells to swell due to accumulation of sodium ions in the cell

43
Q

Function of vascular compartment

A

Contains blood that transports substances (electrolytes, gases, nutrients, waste) throughout the body

44
Q

Function of fluid in interstitial spaces

A

Transports gases, nutrients, wastes,and other materials that move between vascular compartment and body cells

Serves as reservoir where vascular volume can be help during hemorrhage of loss of vascular fluid

45
Q

Tissue gel

A

Sponge-like material that has lots of proteoglycan filaments
Fills tissues spaces
Aids in even distribution of interstitial fluids

Helps prevent accumulation of free water here and opposes outflow of water from capillaries

46
Q

Where does the transfer of water from the vascular and interstitial compartments occur?

A

Capillaries

47
Q

What controls movement of water between capillary and interstitial spaces?

A

1- Capillary filtration pressure
2- Capillary colloidal osmotic pressure
3- Interstitial hydrostatic pressure
4- Tissue colloidal osmotic pressure

Work together to leave small amount of fluid in interstitial compartment that will later be removed by the lymphatic system and returned to circulation

48
Q

Capillary filtration pressure

A

Pushes water out of capillary and into interstitial spaces

49
Q

Capillary colloidal osmotic pressure

A

Plus water back into capillary

50
Q

Interstitial Hydrostatic pressure

A

Opposes movement of water out of capillary

51
Q

Tissues colloidal osmotic pressure

A

Pulls water out of capillary and into interstitial spaces

52
Q

Capillary filtration

A

Movement of water through capillary pores due to mechanical forces

53
Q

Capillary filtration pressure or capillary hydrostatic pressure

A

Pressure pushing water out of capillary and into interstitial space

Reflects arterial, venous pressures, precapillary and postcapillary resistances, force of gravity

54
Q

What happens to capillary pressure where there is an increase in arterial or venous pressure?

A

It will increase

55
Q

Capillary colloidal osmotic pressure

A

Osmotic pressure generated by plasma proteins that are too large to pass through pores of capillary wall

Pulls fluid back into capillary since the plasma proteins do not normally penetrate the capillary pores and their concentration is greater in the plasma than in the the interstitial fluids

56
Q

Edema

A

Palpable swelling produced by expansion of interstitial fluid volume

57
Q

Contributors to edema

A

Factors that increase capillary pressure, decrease capillary colloidal osmotic pressure, increase capillary permeability, produce obstruction to lymph flow

58
Q

What does the lymphatic do for excess fluid in interstitial spaces?

A

Returns fluid to circulation

Removes plasma proteins and osmotically active particulate matter from tissue spaces

59
Q

What are factors that increase capillary pressure?

A

Increased vascular volume (heart failure, kidney disease, premenstrual sodium retention, pregnancy, environmental heat stress, thiazolidinedione (eg: pioglitazone and rosiglitazone) therapy)

Venous Obstruction (liver disease with portal vein obstructions, acute pulmonary edema, venous thrombosis (thrombophlebitis))

Decreased arteriolar resistance (calcium channel-blocking drug responses)

60
Q

What are factors that decrease colloidal osmotic pressure?

A

Increased loss of plasma proteins (protein-losing kidney diseases, extensive burns)

Decreased production of plasma proteins (liver disease, starvation, malnutrition)

61
Q

What are factors that increase capillary permeability?

A

Inflammation
Allergic reactions (eg: hives)
Malignancy (eg: ascites and pleural effusion)
Tissue injury and burns

62
Q

What are factors that obstruct lymphatic flow?

A

Malignant obstruction of lymphatic structures

Surgical removal of lymph nodes

63
Q

What happens to vascular fluid when capillary filtration pressure rises?

A

Movement of vascular fluid into interstitial spaces increases

64
Q

What factors increase capillary pressure?

A

Increased arterial pressure, decreased resistance to flow through precapillary sphincters, increase in venous pressure or increased resistance to outflow of the postcapillary sphincter, and capillary distinction due to increased vascular volume

65
Q

Localized edema

A

Occurs in a limited anatomical space (eg: thrombophlebitis obstructs venous flow —> elevation of venous pressure and edema)

66
Q

Generalized edema (anasarca)

A

Due to increased vascular volume

Eg: CHF, fluid retention

67
Q

Dependent edema

A

Impacted by gravity, resulted when fluid accumulates in dependent parts of body (eg: ankles when standing for longer periods of times)

68
Q

Examples of plasma proteins and their functions

A

Albumin, globulins, fibrinogen

Work to pull fluid back into capillary from tissue spaces by exerting osmotic force

Impairment of protein production or lack of can lead to edema

69
Q

When does capillary permeability increase?

A

Capillary pores become enlarged or the integrity of the capillary wall is damaged —> increase in interstitial fluid to due leaking of proteins and particles into interstitial spaces

Eg: burn injury, capillary congestion, inflammation, immune response

Pathophysiology (9 decks)

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