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Pathophysiology > Disorders of Fluid, Electrolytes, Acid Base, and Blood > Flashcards

Disorders of Fluid, Electrolytes, Acid Base, and Blood Flashcards

1
Q

This is the mechanical pressure exerted on one object by another

A

Fluid Pressure

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2
Q

Pressure caused by the weight of fluid, and is exerted in the weight of a column

A

Hydrostatic pressure

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3
Q

Where is hydrostatic pressure the largest?

A

The legs and feet

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4
Q

What is a clinical example of failed hydrostatic pressure

A

Varicose veins

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5
Q

This is the increment of pressure that is created by the resistance to the flow of a fluid in a closed system

A

Hydrodynamic pressure

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6
Q

What is an example of hydrodynamic pressure?

A

The cardiovascular system

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7
Q

This is the hydrodynamic pressure of moving blood

A

Blood pressure

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8
Q

What is the equation of blood pressure?

A

Blood pressure= blood flow rate (cardiac output) * vascular resistance

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9
Q

What % of water is intracellular?

A

2/3

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10
Q

For fluid to flow, there must be ______

A

Pressure acting on that fluid

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11
Q

Where is the pressure highest in the heart?

A

Left ventricle

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12
Q

Where is the pressure lowest in the heart?

A

Right atrium

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13
Q

Where is the area of the greatest resistance?

A

The arterioles (provided by the smooth muscle tone)

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14
Q

The pressure gradient is driven by the ______ work for the left ventricle myocardial muscle

A

Mechanical

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15
Q

What determines the flow into the arterial tree?

A

Cardiac output

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16
Q

What determines flow out of the arterial tree?

A

Vascular resistance

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17
Q

What is the equation for cardiac output?

A

CO= HR * SV

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18
Q

What influences cardiac output?

A

Blood volume

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19
Q

The lesser the blood volume, the ____ cardiac output and the _____ blood pressure

A
  • Lesser cardiac output

- Lesser the Blood pressure

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20
Q

What determines vascular resistance?

A

The collective size of the small peripheral arterioles

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21
Q

The arterioles _____ to increase out flow

A

Constrict

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22
Q

The arterioles _____ to decrease out flow

A

Dilate

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23
Q

Where are the arterial blood pressures the highest?

A

The aorta

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24
Q

What is the relative arterial blood pressure in the upper arm?

A

100 mmHg

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25
Q

What is the average blood pressure when it reenters the heart near the aorta?

A

0 mmHg

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26
Q

What triggers the RAA system?

A

Low Blood pressure

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27
Q

What secretes renin

A

Kidneys

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28
Q

Why is renin secreted?

A

To increase BP

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29
Q

What does renin do?

A

Acts on angiotensinogen and converts it to angiotensin 1

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30
Q

What makes angiotensinogen?

A

Liver

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31
Q

What converts angiotensin 1 to angiotensin 2

A

ACE

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32
Q

Where is acetylcholinesterase (ACE) made from?

A

The lungs

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33
Q

What does angiotensin 2 do?

A

Increases blood pressure by increasing peripheral resistance and cardiac output

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34
Q

Is angiotensin 2 a vasoconstrictor/dilator?

A

Vasoconstrictor

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35
Q

What does angiotensin 2 stimulate?

A

the secretion of aldosterone

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36
Q

Where is aldosterone secreted from?

A

The adrenal cortex

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37
Q

What does aldosterone do?

A

Acts on the kidney and tells it to hold onto water and Na to increase blood volume, to increase blood pressure, and to increase cardiac output

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38
Q

This is a mixture of a solvent and solute

A

Solution

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39
Q

This is what the solute is dissolved in

A

The solution

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40
Q

What is the bodies solvent?

A

Water

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41
Q

What is equivalent to blood concentration

A

0.9% NaCl (normal saline)

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42
Q

What does too much water cause?

A

Dilution of the solute concentration

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43
Q

What happens if the brain becomes hypervolumic?

A

It doesn’t have anywhere to expand and when the cells swell it increases pressure and can cause swollen brain and seizures

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44
Q

What does the solute contain?

A
  • Carbohydrates
  • Proteins
  • Salts
  • Vitamins
  • Hormones
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45
Q

Is fat a solute?

A

NOPE

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46
Q

What is the average solute concentration?

A

0.9% solution of NaCl

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47
Q

This is the concentration of the solute

A

Osmolarity

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48
Q

Under the normal conditions, ICF ___ ECF

A

ICF=ECF

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49
Q

Where does water go if there is a decrease in the ECF solute concentration?

A

ICF (water follows salt, so if salt is higher in the cell compared to the outside, water goes into the cells too)

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50
Q

A membrane that is permeable to the solvent but not the solute

A

Semipermeable membrane

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51
Q

This is the flow of water across a semipermeable membrane

A

Osmosis

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52
Q

Low osmolality=

A

Less stuff

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53
Q

High osmolarity=

A

Lots o stuff

54
Q

What direction does water move?

A

Low osmolarity to high osmolarity (bc water wants to follow stuff)

55
Q

This is the measure of the tenancy of water to move by osmosis from an area of high water (low solute) to low water (high solute)

A

Osmotic pressure

56
Q

Lower pressure= ____ attraction

A

Lower

57
Q

What is osmotic pressure mostly caused by?

A

Salt and Albumin

58
Q

Low osmotic pressure tends to lose water and result in…

A

Third spacing

59
Q

The inner most walls are…

A

endothelium

60
Q

What drives water out of the vascular space?

A

Hemodynamic pressure

61
Q

What vascular vessel has the highest hydrostatic pressure?

A

Veins

62
Q

Describe what happens in varicose veins

A

The hydrostatic pressure is too large and the blood starts coming out

63
Q

Treatment for varicose veins

A
  • Exercise
  • Compression socks
  • Diuretics
  • Collapse incompetent veins (surgery)
64
Q

What 2 types of pressure combine to cause the flow of small amounts of fluid from blood to interstitial space

A
  • Hydrodynamic Pressure

- Osmotic pressure

65
Q

What is responsible for forcing water out of the vascular space?

A

Blood pressure

66
Q

This type of pressure tends to retain water within the vascular space

A

Osmotic pressure

67
Q

What percentage of the body is solids?

A

45%

68
Q

What percentage of the body is fluid?

A

55% (mostly water)

69
Q

What is needed to move water?

A

Force

70
Q

How is water maintained?

A
  • Metabolic reactions

- Food and drinks

71
Q

How is water regulated?

A

Cells in the thirst center of the hypothalamus which sense osmolality

72
Q

High osmolality= ____ water

A

Low water and signals to the thirst center that they need water

73
Q

This works and acts on the kidney and causes you to retain water and concentrate the urine

A

ADH

74
Q

What does alcohol do to ADH?

A

Inhibits ADH so you cant retain anything

75
Q

How is water lost?

A
  • Stool
  • Urine
  • Precipitation
  • Respiratory Air
76
Q

What are 3 mechanisms of water loss?

A
  1. Antidiuretic hormone
  2. Aldosterone
  3. Atrial Naturetic hormone
77
Q

Describe antidiuretic hormone

A
  • Secreted by posterior pituitary
  • Responds to osmoreceptors
  • Osmoreceptors influence the kidney to retain water
78
Q

Describe aldosterone

A
  • Secreted by the adrenal cortex on command of renin

- Influences the kidney to retain water

79
Q

Describe atrial Naturetic hormone

A
  • Secreted by the atrial cardiac muscles in response to increased blood volume
  • Influences the kidney to release Na and water which lowers blood pressure by lowering blood volume
80
Q

Where is the thirst center?

A

Hypothalamus

81
Q

What is plasma made of?

A

-90% water and electrolytes

82
Q

What is the normal kidney output?

A

1 liter per day

83
Q

What is the sign of heart failure in a patient?

A

An increase in about 2 pounds in a day (1 liter= 2.2 lbs of fluid)

84
Q

These are chemicals that separate into ions when they are dissolved in water

A

Electrolytes

85
Q

What is the main determinant of volume shifts?

A

Salt

86
Q

What is the relationship of between salt and water

A

Water follows salt

87
Q

This is an abnormal accumulation of fluid in a tissue or body cavity

A

Edema

88
Q

Is edema generalized or localized?

A

Generalized- it is hard to see

89
Q

Causes of edema

A
  • Lymphatic obstruction
  • Back flow
  • Low plasma osmotic pressure
90
Q

What are the 3 types of edema?

A
  1. Inflammatory edema
  2. Lymphatic edema
  3. Non-Inflammatory edema
91
Q

Describe inflammatory edema

A
  • AKA exudate

- High protein

92
Q

How does inflammatory edema occur

A

In response to increased vascular permeability of inflammation (bc of an inflammatory response)

93
Q

Does inflammatory edema pit?

A

NOPE

94
Q

Describe lymphatic edema

A
  • Non-pitting
  • High protein
  • Bilateral
  • Due to bad lymph absorption
95
Q

What can help decrease lymph edema

A

Losing weight

96
Q

Describe non-inflammatory edema

A
  • Low protein
  • AKA transudate
  • caused by pressure imbalances
97
Q

What happens to capillary fluid pressure in non-inflammatory edema

A

High capillary pressure

98
Q

Describe the osmotic pressure in non-inflammatory edema

A

Low osmotic pressure (low attraction for water)

99
Q

What is the definitive factor in osmotic pressure?

A

Albumin

100
Q

Does non-inflammatory edema pit?

A

Yes aka pitting edema

101
Q

Why does pitting occur in non-inflammatory edema?

A
  • Pressure imbalance
  • Increased capillary pressure
  • Decreased osmotic pressure
102
Q

Examples of non-inflammatory edema

A
  • Liver failure
  • Kidney failure
  • CHF
  • DVT
  • Glomerular disease
  • Venous Insufficiency
  • Right side heart failure
103
Q

This is a collection of fluid in body cavities

A

Ascites

-seen in patients with liver failure

104
Q

Body wide edema

A

Anasarca

105
Q

Collection of edema in a space

A

Effusion

-Ex. Pleural effusion- between lung and chest wall)

106
Q

What are the 2 forms of edema

A
  1. Localized

2. Generalized

107
Q

Describe localized edema

A
  • Swelling associated with tissue injury and inflammation

- Easy to see

108
Q

Describe generalized edema

A

-May be hidden

Ex. Heart failure

109
Q

Sign of pleural effusion

A

SOB

110
Q

Signs of pericardial effusion

A

Heart is not as efficient

111
Q

Describe venous stasis/chronic edema

A
  • Lymph edema causes breakdown of melanocytes

- Causes brown skin tone

112
Q

What does chronic edema lead to?

A
  • Atrophy
  • Get ulcerations
  • Due t skin breakdown
  • Can lead to infection
113
Q

Example of isotonic water loss

A

Sweating

114
Q

Example of hypertonic fluid loss

A

GI loss/diarrhea

115
Q

What is an example of hypotonic fluid loss

A

UTI

116
Q

What can prolonged glucose in diabetes cause

A

Brain cell destruction and coma

117
Q

2% dehydration=

A

Mild dehydration

118
Q

5% dehydration=

A

Moderate dehydration

119
Q

8% dehydration=

A

Severe dehydration

120
Q

Who experiences the most severe dehydration?

A
  • Infants
  • Elderly
  • Debilitated
121
Q

Where does water shift in dehydration?

A

Out of the vascular space

122
Q

Define third spacing

A

Shift of fluid out of blood into another body surface

123
Q

Loss of fluid roughly eq to normal plasma

A

Normotonic dehydration

124
Q

Loss of fluid with low electrolyte concentration

A

Hypotonic dehydration

125
Q

Loss of fluid with high electrolyte concentration

A

Hypertonic dehydration

126
Q

Signs of dehydration

A
  • Dry mucus membranes
  • Low BP
  • Weak
  • Rapid pulse
  • Increased RBC (as a fraction of blood volume)
127
Q

Does aldosterone and K have a direct or indirect relationship

A

Indirect

128
Q

Do calcium and phosphate levels have an inverse relationship

A

Yes

129
Q

How is Ca balance maintained?

A

By parathyroid hormone

130
Q

What does parathyroid hormone do?

A
  • Shifts Ca into blood
  • Stimulates intestinal absorbtion of Ca
  • Reduces urine Ca excretion
131
Q

What causes hypocalcemia

A
  • Low PTH
  • Renal Failure
  • Vitamin D deficiency
  • Prolonged Alkalosis

Pathophysiology (18 decks)

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