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Physio II > Fluid Compartments & Fluid Shifts- Exam 2 > Flashcards

Fluid Compartments & Fluid Shifts- Exam 2 Flashcards

1
Q

What needs to be stable for cells to perform at an optimum level?

A

Stable external environment

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2
Q

What must be constant to maintain a stable external environment?

A

Overall volume and composition of the body fluids

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3
Q

What organ plays a major role in maintaining the body fluids in terms of volume and composition?

A

Kidneys

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4
Q

What is the daily fluid intake?

A

2300 mls/day

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5
Q

How much of the daily intake is by oxidation of carbohydrates?

A

200 mls/day

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6
Q

How much of the daily intake is by ingested fluids?

A

2100 mls/day

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7
Q

What is the fluid loss/output per day?

A

2300 mls/day

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8
Q

How much of fluid loss is insensible loss via respiratory tract and skin (not sweat)?

A

700 mls/day

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9
Q

How much of fluid loss is sweat?

A

100 mls/day

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10
Q

How much of fluid loss is feces?

A

100 mls/day

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11
Q

How much of fluid loss is urine?

A

1400 mls/day

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12
Q

How much of the body is normally water?

A

Male: 60% body weight
Female: 50% body weight (more fat)

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13
Q

How much of body weight is ECF?

A

20%

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14
Q

How much of body water is ECF?

A

1/3 total volume

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15
Q

How much of ECF is interstitial fluid?

A

75% of ECFV

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16
Q

How much of ECF is plasma?

A

25% of ECFV; composition similar to ISF

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17
Q

How much of water is transcellular fluid?

A

1 to 2 liters

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18
Q

What are some examples of transcellular fluid?

A 
Synovial
Peritoneal
Pericardial
Intraocular
Cerebrospinal
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19
Q

How much of body weight is intracellular fluid?

A

40% of body weight

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20
Q

How much of body water is intracellular fluid?

A

2/3 total volume

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21
Q

Concentration of the non-electrolytes of the plasma

A 
Phospholipids- 280 mg/dl
Cholesterol- 150 mg/dl
Neutral Fat- 125 mg/dl
Glucose- 100 mg/dl
Urea- 15 mg/dl
Lactic acid- 10mg/dl
Uric acid- 3 mg/dl
Creatinine- 1.5 mg/dl
Bilirubin- 0.5 mg/dl
Bile salts- Trace
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22
Q

What 4 forces influence distribution between plasma and interstitial compartments?

A

Capillary hydrostatic pressure
Interstitial hydrostatic pressure
Capillary colloid oncotic pressure
Interstitial colloid oncotic pressure

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23
Q

What two ions control distribution between intracellular an extracellular compartments across membranes?

A

sodium and chloride

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24
Q

What kind of permeability do cell membranes have for water?

A

High permeability

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25
Q

What type of permeability do cell membranes have for solute?

A

Low permeability

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26
Q

What moves quickly into or out of the cell to keep ICF isotonic with ECF?

A

water

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27
Q

Osmole

A

means of measuring total concentration of particles in solution

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28
Q

1 osmole is how many moles of particles?

A

1 mole of particles (6.02 x 10^23 particles)

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29
Q

1 mole glucose in 1 liter is how many osm/L?

A

1 osmole/L of glucose

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30
Q

1 mole salt in 1 liter is how many osm/L of sodium and chloride?

A

2 osm/L of sodium and chloride

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31
Q

1 mole sodium sulfate (Na2SO4) in 1 liter is how many osm/L

A

3 osm/L

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32
Q

1mOsm is how many osmoles?

A

1/1000 osmoles

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33
Q

Osmolality

A

osmoles/kg water

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34
Q

Osmolarity

A

osmoles/L water

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35
Q

Plasma Osmolarity

A

301.8 mOsm/L (plasma protein)

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36
Q

Interstitial Osmolarity

A

300.8 mOsm/L

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37
Q

Intracellular Osmolarity

A

301.2 mOsm/L

38
Q

Each mOsm of solute that cannot cross membrane generates what pressure?

A

Osmotic pressure of 19.3 mmHg

39
Q

_________ changes in the concentration of impermeable solut will create _______ shifts of water creating large changes in compartment volumes.

A

Small; large

40
Q

Isotonic solution

A 
Same osmolarity (i.e. same concentration of impermeant solutes)
Will not upset osmotic balance between intra and extracellular fluid when administered
0.9% sodium chloride (0.9 grams of NaCl/100mls solution = 9 grams/L)
41
Q

Isosmotic

A

Solutions with same osmolarity as intracellular osmolarity even if some solute is permeable

42
Q

Hypo-osmotic

A

solutions with lower osmolarity than intracellular fluid even if some solute is permeable

43
Q

Hyperosmotic

A

solutions with higher osmolarity than intracellular fluid even if some solute is permeable

44
Q

Causes of osmotic imbalance

A

water ingestion
dehydration
fluid loss from GI tract
abnormal fluid loss by sweating or kidneys

45
Q

What will happen if the osmoliarty of a solution is the same as ECF

A

No change in ECF osmolarity

Expand volume of ECF by volume of solution

46
Q

If you add a liter of normal saline….

A

the liter starts in the plasma of the CBV within 15 minutes 75% will move to the interstitial fluid and 25% will remain i the CBV

47
Q

What is the most common nutrient solution?

A

Glucose

48
Q

What are nutrient solutions adjusted to?

A

To or nearly isotonic

49
Q

What happens if a nutrient solution is not adjusted to be isotonic?

A

Given slowly so it does not upset balance

50
Q

As nutrient solution is metabolized, patient is left with what?

A

Surplus of water; usually removed by the kidney

51
Q

What is a good measure of plasma osmolarity?

A

Plasma sodium concentration

52
Q

Sodium and chloride account for what percent of solute in the ECF?

A

90%

53
Q

What is the normal plasma sodium concentration?

A

142 mEq/L

54
Q

Hypernatremia

A

higher than normal osmolarity

55
Q

Hyponatremia

A

lower than normal osmolarity

56
Q

What is the effect of hyponatremia? (Loss of sodium)

A

Decrease in plasma [Na+]
Decreased ECFV
Increased ICFV

57
Q

What is hyponatremia?

A

Loss of sodium from ECF

Addition of excess water to ECF

58
Q

What causes hyponatremia? (Loss of sodium)

A

Diarrhea & vomiting
Diuretic overuse (inhibits ability to conserve sodium)
Renal disease that “wastes” sodium
Addison’s disease results form decrease secretion of aldosterone

59
Q

What is the effect of hyponatremia? (excess water)

A

Decrease in plasma [Na+]
Increased ECFV
Increased ICFV

60
Q

What causes hyponatremia? (Excess water)

A

Excess water retention

Excessive secretion of ADH

61
Q

What is a major consequence of hyponatremia?

A

Cell swelling; cerebral edema is a major problem

62
Q

What are some symptoms of hyponatremia?

A

headache; nausea; lethary; disorientation

63
Q

What concentrations of sodium cause significant problems?

A

120-115 mEq/L range

64
Q

What does low concentration of sodium cause?

A 
Significant brain swlling
Seizures
Coma
Permanent brain damange (if volume increases by 10%)
death
65
Q

Brain volume must increase by how much to get permanent brain damage?

A

10%

66
Q

How does brain attempt to compensate for hyponatremia?

A

Moving sodium, chloride, potassium, organic solutes from cells out to ECF

67
Q

What is the max rate the brain can compensate for hyponatremia?

A

10 to 12 mmol/L over 24 hours

68
Q

What is the most common electrolyte disorder?

A

Hyponatremia

69
Q

What percent of hospitalized patients have hyponatremia?

A

15-25%

70
Q

What is hypernatremia?

A

Water loss from the ECF

Addition of excess sodium into the ECF

71
Q

What is the effect of hypernatremia? (Water loss)

A

Incraesed plasma [Na+]
Decreased ECFV
Decreased ICFV

72
Q

What causes hypernatremia? (water loss)

A

inability to secrete ADH (needed for urine concentration)- produce large amounts of dilute urine (diabetes insipidus)
Excessive sweating so output greater than intake

73
Q

What condition produces a large amount of dilute urine?

A

Diabetes insipidus

74
Q

What are the effects of hypernatremia? (excess sodium)

A

Increased plasma [Na+]
Increased ECFV
Decreased ICFV

75
Q

What causes hypernatremia? (excess sodium)

A

excessive secretion of aldosterone

Resorbs water and sodium

76
Q

What are the consequences of hypernatremia?

A

Tissue cells shrink

77
Q

What sodium concentration will result in hypernatremia?

A

158-160 mEq/L

78
Q

Why is hypernatremia not very common?

A

Results in excessive thirst

79
Q

What disease causes impaired thirst reflex?

A

Hypothalamic disease

80
Q

What causes intracellular edema?

A

Hyponatremia
Depression of metabolic systems within cells
Lack of adequate nutrition delivery to cells
Inflammation

81
Q

What causes depression of metabolic systemis within cells?

A

Sodium-potassium pump- shift of sodium into cell

82
Q

What does inflammation result in?

A

Increased cellular permeability- shift sodium into cell

83
Q

What causes extracellular edema? (slides)

A

Abnormal leakage of fluid from plasma to interstitial space across the capillary
Failure of lymphatics to return fluid to vascular system

84
Q

What are the 4 main causes of extracellular edema? (book)

A
  1. Increased capillary edema
  2. Decreased plasma proteins
  3. Increased capillary permebaility
    4 .Blockage of lymph return
85
Q

What can cause increased capillary pressure?

A

Excessive kidney retention of salt and water
High venous pressure and venous constriction
Decreased arteriolar resistance

86
Q

What can cause excessive kidney retention of salt and water?

A

Acute or chronic renal failure

Mineralcorticoid excess

87
Q

What can cause high venous pressure?

A

Heart failure
Venous obstruction
Failure of venous pumps (paralysis of muscles, immobilization of parts of body, failure of venous valves)

88
Q

What can cause decreased arteriolar resistance?

A

Excessive body heart
Insufficiency of sympathetic nervous system
Vasodilator drugs

89
Q

What can cause decreased plasma proteins?

A

loss of proteins in urine (nephrotic syndrome)

loss of protein from denuded skin areas (burns, wounds)

90
Q

What causes failure to produce proteins?

A 
liver disease (cirrhosis)
serious protein or caloric malnutrition
91
Q

What causes increased capillary permeability

A 
immune rxns that cause release of histamine and other immune products
toxins
bacterial infections
vitamin deficiency, especially vitamin C
prolonged ischemica
burns
92
Q

What causes blockage of lymph?

A

Cancer
infections (filaria nematodes)
surgery
congenital absence or abnormality of lymphatic vessels

Physio II (14 decks)

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