Fluid, Electrolyte and Balance Flashcards
1
Q
Between an adult male, female, elder, and baby which has the higher body water content?
A
the baby due to low body fat therefore low bone mass
2
Q
Why do males have 10 percent more body water content that females?
A
Males have more skeletal muscle than women who have higher body fat
3
Q
What are the 2 main fluid compartments?
A
Intracellular fluid and extracellular fluid
4
Q
What are the 2 subparts of the extracellular fluid? Percentages?
A
Plasma- 20%
Interstitial fluid-80%
5
Q
What is the fluid in the blood called?
A
plasma
6
Q
Which of the compartments consist of 2/3 total fluid content?
A
intracellular fluid
7
Q
What is the fluid between cells called?
A
Interstitial fluid
8
Q
Which of the compartments consist of 1/3 total fluid content?
A
Extracellular fluid
9
Q
What is the percentage of the ICF in the body?
A
40%
10
Q
What is the percentage of ECF in the body?
A
20%
11
Q
What is the percentage of the total body weight of ECF and ICF?
A
60%
12
Q
Nonelectrolytes
A
do not dissociate in water; no charged particles are created
13
Q
Electrolytes
A
dissociate into ions in water; ions conduct electrical current
14
Q
What are some examples of electrolytes?
A
acids, bases, salts, and some proteins
15
Q
What are some examples of nonelectrolytes?
A
glucose and most organic molecules
16
Q
What is the major cation in the ECF?
A
Na+
17
Q
What is the major anion in the ECF?
A
Cl-
18
Q
What is the major cation in the ICF?
A
K+
19
Q
What is the major anion in the ICF?
A
HSO4-(2-)
20
Q
Where are the electrolyte concentrations similar except for higher protein content of plasma?
A
ECF
21
Q
Where are there more proteins than in plasma?
A
ICF
22
Q
Where do exchanges between plasma and IF occur?
A
Across capillary walls
23
Q
Where do exchanges between IF and ICF occur?
A
Across plasma membranes
24
Q
What must occur for the body to remain stable?
A
its inout through ingestion or metabolic production = its output through excretion or metabolic consumption
25
Which 2 factors are regulated to maintain fluid balance?
1. ECF osmolality
| 2. ECF volume
26
How is ECF osmolality regulated?
must be regulated to prevent swelling or shrinking of cells
27
What is ECF osmolality involved in maintaining?
water balance
28
How is ECF volume regulated?
must be regulated to help maintain BP
29
What is ECF volume involved in maintaining?
maintaining sodium balance
30
What leads to net water flow?
a change in solute concentration in any compartment
31
Controlling ECF osmolality prevents what?
changes in ICF volume
32
What occurs when water leaves the cell to enter the ECF?
hypertonic solution
33
What occurs when water moves into the cell from the ECF?
hypotonic solution
34
What happens to the cell in a hypertonic solution?
the cell shrinks
35
What happens to the cell in a hypotonic solution?
the cell lysis or burst
36
What is the total amount of water intake/output in a day?
2500 mL/day
37
What are the ways water is taken into the body? Percentages?
Beverages: 60%
Food: 30%
Metabolism: 10%
38
What are the ways water is released from the body?
Urine: 60%
Insensible loss via skin and lungs: 28%
Sweat 8%
Feces: 4%
39
What is the range of plasma osmolality maintained?
280-300 mOsm
40
What causes rise in osmolality?
stimulates thirst and stimulates ADH release
41
What causes a decrease in osmolality?
inhibits thirst and ADHA RELEASE
42
ADH stimulation does what to urine output?
decreases urine output
43
ADH inhibition does what to urine output?
increases urine output
44
What drives water intake?
thirst mechanism
45
Where in the brain is the thirst center located?
in the hypothalamus
46
Which 3 factors activate the thirst center in the hypothalamus?
1. Dry mouth
2. Decrease in BP and BV
3. Hypothalamic osmoreceptors
47
How are water reabsorption and excretion are adjusted through changes in what?
ADH secretion
48
What monitors ECF solute concentration and trigger or inhibit ADH release?
hypothalamic osmoreceptors
49
What leads to the events of water reabsorption and small volume of concentrated urine?
ECF osmolality stimulates ADH release
50
What leads to to water reabsorption and large volume of dilute volume?
ECF osmolality inhibits ADH release
51
What is the term for excessive water loss?
Dehydration
52
What are 3 major ways dehydration occurs?
1. Diabetes insipidus
2. Excessive water loss
3. insufficient water intake
53
What are the effects of the cell of dehydration?
the cell shrinks
54
What is the term for excessive water gain?
overhydration
55
What are 3 major ways overhydration occurs?
1. Rapid ingestion of excess water
2. Inappropriate ADH secretion
3. Renal failure
56
What are the effects of the cell due to hypotonic hydration?
the cell swells
57
What is the term for atypical accumulation of interstitial fluid?
edema
58
Changes in what affects plasma volume, BP and CF and IF volumes?
change in plasma NA+ levels
59
How does sodium control ECF volume and water distribution?
this is because water follows salt
60
What are the three determinations of concentration of Na+ in ECF?
1. determines ECF osmolality
2. remains stable because water always follows salt to maintain osmotic equilibrium
3. regulated by controlling water or loss or gain
61
What are the 2 determination of total body content of Na+?
1. regulated by controlling Na+ loss or gain
| 2. determines ECF volume and BP
62
How do the kidneys maintain total body Na+ content?
by regulating rate of sodium excretion
63
What brings the body sodium content and ECF volume back into line?
changes in blood volume or pressure trigger neural and hormonal
64
Which two processes allow the kidneys adjust amount of salt excreted?
1. amount of sodium filtered
| 2. amount of sodium reabsorbed
65
What controls amount of sodium filtered?
controlled by regulating GFR
66
What controls amount of sodium reabsorbed?
controlled by renin-angiotensin-aldosterone mechanism
67
Blood volume is monitored and regulated to maintain what?
BP
68
What determine fluid volume?
sodium content
69
What determines blood pressure?
fluid volume
70
What monitors BP and so indirectly monitor sodium content?
cardiovascular baroreceptors
71
What plays the biggest role in regulation of sodium by kidneys?
aldosterone
72
What occurs when aldosterone is low?
no sodium reabsorption occurs beyond DCT
73
What occurs when aldosterone is high?
all remaining Na+ is reabsorbed in DCT and collecting duct
74
What are the 2 triggers for aldosterone released?
1. renin-angiotensin-aldosterone mechanism
| 2. elevated K+ levels in ECF
75
What is the role of ANP?
controls Na+ reabsorption
76
What are the 2 effects of ANP?
1. promotes excretion of sodium and water
| 2. decreases BV and BP
77
What is the importance of potassium?
effects resting membrane potential on neurons and cardiac muscle cells
78
Define hyperkalemia
increased ECF potassium concentration
79
Define hypokalemia
decreased ECF potassium concentration
80
What causes depolarization and reduced excitability?
hyperkalemia
81
What causes hyperpolarization and nonresponsiveness?
hypokalemia
82
As K+ leaves the cell and H+ enters the cell what effect does this have on the ECF?
ECF potassium concentration rises with acidosis
83
As K+ enters the cell and H+ leaves the cell, what effect does this have on the ECF?
ECF potassium concentration falls with alkalosis
84
What are three major events calcium in the ECF is important?
1. blood clotting
2. secretory activities
3. muscle contraction
85
Define hypcalcemia
decreased ECF calcium concentration
86
Define hypercalcemia
increased ECF calcium concentration
87
What is the result of hypocalcemia?
inhibits neurons and muscle cells and may cause heart arrhythmias
88
What is the result of hypocalcemia?
increases neuromuscular excitability and can lead to muscle tetany
89
ECF calcium levels closely are regulated by what?
PTH hormone
90
PTH promotes increase in calcium levels by targeting which 3 organs?
1. Bones
2. kidneys
3. small intestine
91
Most filtered calcium ions and phosphate ions are reabsorbed where?
PCT
92
What does PTH inhibit what?
ion reabsorption; decreases transport maximum
93
What 2 events occur when ECF calcium is low?
1. more calcium ions are reabsorbed
| 2. more phosphate is excreted
94
Changes in what alter tertiary structure of proteins?
hydrogen concentration of ECF
95
Arterial pH>7.45
alkalosis
96
Arterial pH
acidosis
97
Neurons become less excitable -> CNS depression
alkalosis
98
Neurons become hyperexcitable -> respiratory arrest
acidosis
99
What is the normal pH of arterial blood?
7.4
100
Fat metabolism is broken down into
fatty acids and ketone bodies
101
Anaerobic respiration of glucose is broken down into
lactic acid
102
Catabolism of proteins is broken down into
phosphoric acid and sulfuric acid
103
H+ gain through metabolism must be attached with H+ loss by?
1. removal of CO2 by respiration
| 2. excretion of H+ in urine
104
H+ concentration is regulated sequentially by which 3 mechanisms?
Chemical buffer systems -> brain stem respiratory centers -> renal mechanisms
105
Dissociate only partially; only small effect on pH
weak acids
106
Dissociate completely in water; can dramatically affect pH
strong acids
107
Dissociate completely in water; quickly tie up hydrogen ions
strong bases
108
Weak bases
dissociate only partially
109
System of one or more compounds that resists pH changes by reversibly binding hydrogen ions
chemical buffer
110
What are the 3 major chemical buffer systems?
1. bicarbonate
2. phosphate
3. protein
111
Mixture of H2CO3 and NaHCO3
bicarbonate buffer system
112
only important ECF buffer
bicarbonate buffer system
113
If a strong acid is added to a bicarbnonate buffer system, what happens to the pH?
pH decreases slightly
114
If a strong base is added to a bicarbonate buffer system what occurs to the pH?
the pH rises only slightly
115
What type of buffer system is important in buffering urine and ICF?
phosphate buffer system
116
what are the components of sodium salts in the phosphate buffer system?
dihydrogen phosphate and monohydrogen phosphate
117
If a strong acid is added to a phosphate buffer system what happens to the pH?
pH decreases
118
If a strong base is added to a phosphate buffer system what happens to the pH?
pH increases
119
What type of buffer system involves plasma and in cells?
Protein buffer system
120
True or false. A protein molecule can function reversibly as a weak acid or weak base
true
121
True or False. When pH falls, amino groups release H+
False, amino groups bind H+
122
True or false. When pH rises, organic acid or carboxyl groups release H+
true
123
Respiratory and renal system are what type of buffering systems?
physiological buffering systems
124
What are the 3 functions of the physiological buffering system?
1. regulate amount of acid or base in body
| 2. act more slowly than chemical buffer systems but have more buffering power
125
What do lungs eliminate by eliminating CO2?
volatile acid carbonic acid
126
What do kidneys eliminate by cellular metabolism?
nonvolatile acids produced by cellular metabolism
127
What are the 3 effects if pressure in CO2 or plasma rises?
1. respiratory rate and depth increase
2. more CO2 removed from blood
3. reaction shifts to left and reduces H+ concentration
128
What are the 3 effects if plasma falls?
1. more CO2 accumulates in blood
2. respiratory rate and depth decrease
3. reaction shifts to right and increases hydrogen ions concentration
129
What are the 2 ways kidneys regulate acid-base balance by adjusting amount of HCO3-?
1. conserving or generating new HCO3-
| 2. Excreting HCO3-
130
When plasma decreases kidneys excrete large quantities what happens to the pH?
plasma H+ increases toward normal
131
When plasma increases kidneys reabsorb HCO3- what happens to the plasma H+?
Plasma H+ decreases toward normal
132
What is the term caused by too much CO2 in the blood?
respiratory acidosis
133
what is the term caused by too little CO2 in the blood?
respiratory alkalosis
134
Respiratory acidosis and alkalosis are indicated by what?
Blood partial pressure of CO2 levels above or below normal range
135
What is the term for all abnormalities other than those caused by excess retention or loss of CO2?
Metabolic acidosis or alkalosis
136
Metabolic acidosis and alkalosis are indicated by what?
indicated by HCO3- levels above or below normal range
137
What causes hypoventilation, shallow breathing and impaired gas exchange?
Respiratory acidosis
138
What happens to the CO2 and blood pH in respiratory acidosis?
1. CO2 accumulates in blood, lower than normal range
| 2. Blood pH drops
139
What causes hyperventilation?
Respiratory alkalosis
140
What happens to the CO2 and blood pH in respiratory alkalosis?
1. CO2 eliminated faster than produced, above normal range
| 2. Blood pH rises
141
What is cause by ingesting too much alcohol, excessive loss of HCO3-, accumulation of lactic aid, and ketosis?
metabolic acidosis
142
What happens to the HCO3- and blood pJ in metabolic acidosis?
low blood and HCO3- levels
143
What does vomiting acidic stomach contents and intake of excess antacids lead to?
metabolic alkalosis
144
What happens to the blood pH and HCO3- in metabolic alkalosis?
rising blood pH and HCO3- levelsn
145
True or false. If acid-base imbalance due to malfunction of one physiological buffer system, other system tries to compensate
true
146
Respiratory system attempts to correct metabolic acid-base imbalances b what?
by changing respiratory rate and depth
147
Kidneys attempt to correct respiratory acid-base imbalances by what?
retaining or eliminating HCO3-
148
How does the respiratory system try to compensate for metabolic acidosis?
increasing rate and depth of breathing
149
How does the respiratory system compensate for metabolic alkalosis?
with slow, shallow breathing
150
How do the kidneys compensate for respiratory acidosis?
by retaining more HCO3-
151
How do the kidneys compensate for respiratory alkalosis?
kidneys compensate by excreting more HCO3-
152
Low blood, High Pco2 and high HCO3- levels
respiratory acidosis
153
Low blood, low HCO3-, and Pco2 below normal
metabolic acidosis
154
High blood pH, high HCO3-, and Pco2 above normal
metabolic alkalosis
155
High blood pH, low Pco2, and low HCO3- levels
respiratory alkalosis
