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► Med - Anatomy & Physiology > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

Body water content in infants

A

73% or more water (low body fat, low bone mass)

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2
Q

Adult males body water content

A

~60% water

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3
Q

Adult females body water content

A

~50% water (higher fat content, less skeletal muscle mass)

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4
Q

Water content in old age

A

45%

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5
Q

Total body water =

A

40L

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6
Q

Two main fluid compartments

A

–Intracellular fluid (ICF) compartment: 2/3 in cells

–Extracellular fluid (ECF) compartment: 1/3 outside cells

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7
Q

Universal solvent

A

Water

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8
Q

What is dissolved in water

A

Solutes

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9
Q

Two classifications of solutes

A
  1. Electrolytes

2. Nonelectrolytes (most organic, do not dissociate in water)

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10
Q

Dissociate into ions in water; e.g., inorganic salts, all acids and bases, some proteins

A

Electrolytes

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11
Q

ECF electrolytes

A
  • Major cation: Na+

* Major anion: Cl–

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12
Q

ICF electrolytes

A

–Low Na+ and Cl–
–Major cation: K+
–Major anion HPO42–(hydrogen phosphate)

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13
Q

Regulate continuous exchange and mixing of fluids

A

Osmotic and hydrostatic (pressure of a fluid in a system) pressures

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14
Q

Increased ECF osmolality

A

Water leaves cell

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15
Q

Decreased ECF osmolality

A

Water enters cell

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16
Q

Water intake must =

A

Water output (~2500ml/day)

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17
Q

Water output

A

Urine (60%), insensible water loss (lost through skin and lungs), perspiration, and feces

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18
Q

Rise in plasma osmolality =

A

–Stimulates thirst

–ADH release

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19
Q

Decrease in plasma osmolality =

A

–Thirst inhibition

–ADH inhibition

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20
Q

Driving force for water intake

A

Thirst mechanism

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21
Q

Hypothalamic osmoreceptors detect ECF osmolality; activated by …

A
  • IncreasedPlasma osmolality of 1 – 2%
  • Dry mouth
  • Decreased blood volume or pressure
  • Angiotensin II or baroreceptor input
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22
Q

Creates inhibition of thirst center

A

Drinking water

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23
Q

Inhibitory feedback signals for thirst center

A

–Relief of dry mouth

–Activation of stomach and intestinal stretch receptors

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24
Q

Obligatory water losses

A

–Insensible water loss from lungs and skin
–Feces
–Minimum daily sensible water loss of 500 ml in urine to excrete wastes

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25
Q

How many days can you survive without water?

A

~3 days

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26
Q

Water reabsorption in collecting ducts is proportional to …

A

ADH release

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27
Q

Decreased ADH =

A

Diluted urine

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28
Q

Increased ADH =

A

Concentrated urine

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29
Q

Deacreased BP =

A

Increased ADH release

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30
Q

ECF water loss due to: hemorrhage, severe burns, prolonged vomiting or diarrhea, profuse sweating, water deprivation, diuretic abuse, endocrine disturbances

A

Negative fluid balance

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31
Q

Signs and symptoms of negative fluid balance

A

“Cottony” oral mucosa, thirst, dry flushed skin, oliguria(decreased production of urine)

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32
Q

Negative fluid balance may lead to …

A

Weight loss, fever, mental confusion, hypovolemic shock, and loss of electrolytes

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33
Q

Cellular overhydration, or water intoxication

A

Hypotonic hydration

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34
Q

Hypotonic hydration occurs with …

A
  1. Renal insufficiency

2. Rapid excess water ingestion

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35
Q

Treatment for hypotonic hydration

A

Hypertonic saline

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36
Q

Atypical accumulation of fluid in the interstitial space, leading to tissue swelling

A

Edema

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37
Q

Four causes of edema

A
  1. IncreasedBlood pressure (hypertension)
  2. Increased Capillary permeability (usually due to inflammatory chemicals)
  3. Incompetent venous valves, localized blood vessel blockage
  4. Congestive heart failure, Increased blood volume
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38
Q

Osmotic pressure exerted by proteins

A

Colloid osmotic pressure

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39
Q

Decreased plasma proteins

A

Hypoproteinemia

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40
Q

Blocked (or surgically removed) lymph vessels

A

–Cause leaked proteins to accumulate in interstitial fluid (IF)
–IncreasedColloid osmotic pressure of IF draws fluid from the blood
–Results in low blood pressure and severely impaired circulation

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41
Q

Usually refers only to salt balance

A

Electrolyte balance

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42
Q

Salts are important for:

A
  1. Neuromuscular excitability
  2. Secretory activity
  3. Membrane permeability
  4. Controlling fluid movements
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43
Q

Holds a central position in fluid and electrolyte balance

A

Sodium

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44
Q

Account for 90-95% of all solutes in the ECF

A

Sodium salts

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45
Q
  • The single most abundant cation in the ECF
  • The only cation exerting significant osmotic pressure
  • Leaks into cells and is pumped out against its electrochemical gradient
  • Content may change but ECF concentration remains stable due to osmosis
A

Sodium

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46
Q

Regardless of aldosterone presence …

A

–65% Na+ reabsorbed in proximal tubules; 25% reclaimed in loops of Henle
–Na +never secreted into filtrate

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47
Q

Increases active reabsorption of remaining Na+ in distal convoluted tubule and collecting duct. Also causes increased K+ secretion.

A

Aldosterone

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48
Q

IncreasedNa+ in urine =

A

Increased water loss

49
Q

Main trigger for aldosterone release

A

Renin-angiotensin-aldosterone mechanism

50
Q

Granular cells of JGA secrete renin in response to …

A
  • Sympathetic nervous system stimulation
  • Decreased filtrate osmolality
  • Decreased stretch (due to decreased blood pressure) of granular cells
51
Q

Released by atrial cells in response to stretch (Increased blood pressure)

A

ANP

52
Q

Four effects of ANP

A
  1. Decreases blood pressure and blood volume
  2. DecreasesADH, renin and aldosterone production
  3. Increases excretion of Na+ and water
  4. Promotes vasodilation directly and also by decreasing production of angiotensin II
53
Q

Increases NaCl reabsorption (like aldosterone) and increases H2O retention during menstrual cycles and pregnancy

A

Estrogen

54
Q

Decreased Na+ reabsorption (blocks aldosterone)

•Promotes Na+ and H2O loss

A

Progesterone

55
Q

Increased Na+reabsorption and promotes edema

A

Glucocorticoids (ex: cortisol)

56
Q

Importance of potassium

A

Affects RMP(resting membrane potential) in neurons and muscle cells (especially cardiac muscle)

57
Q

Decreases RMP causing depolarization followed by reduced excitability

A

Increased ECF [K+]

58
Q

Causes hyperpolarization and nonresponsiveness

A

Decreased ECF [K+]

59
Q

Too much K+

A

Hyperkalemia

60
Q

Too little K+

A

Hypokalemia

61
Q

Both disrupt electrical conduction in heart –> Sudden death

A

Hyperkalemia and hypokalemia

62
Q

Part of they body’s buffer system

A

K+

63
Q

Shifts in and out of cells in opposite direction of K+ to maintain cation balance

A

H+

64
Q

ECF K+ levels rise with …

A

Acidosis, as K+ leaves and H+ enters the cell

65
Q

ECF K+ levels fall with …

A

Alkalosis, as K+ enters and H+leaves the cell

66
Q

Most important factor affecting K+ secretion

A

K+ concentration in ECF

67
Q

Ca2+ in ECF important for …

A
  1. Blood clotting
  2. Cell membrane permeability
  3. Secretory activities
  4. Neuromuscular excitability - most important
68
Q

Increases excitability and muscle tetany

A

Hypocalcemia

69
Q

Inhibits neurons and muscle cells, may cause heart arrhythmias

A

Hypercalcemia

70
Q

Controlled by parathyroid hormone (PTH) from parathyroid gland

A

Calcium balance

71
Q

PTH promotes increase in calcium levels by targeting …

A
  1. Bones – osteoclasts break down matrix, releasing calcium and phosphate to blood
  2. Kidneys – increases calcium reabsorption; decreases phosphate ion reabsorption
  3. Small intestine – increases calcium absorption (indirectly through stimulation of kidney to activate vitamin D precursor)
72
Q

Percentage of filtered calcium is reabsorbed due to PTH

A

98%

73
Q

PTH secretion inhibited

A

If ECF calcium levels are normal

74
Q

Released in response to rising blood calcium levels

A

Calcitonin

75
Q

–Helps maintain osmotic pressure of blood

–99% is reabsorbed under normal pH conditions

A

Cl-

76
Q

When acidosis occurs …

A

Fewer chloride ions are reabsorbed

77
Q

Normal pH of blood

A

7.35 to 7.45

78
Q

Arterial pH >7.45

A

Alkalosis or alkalemia

79
Q

Arterial pH <7.35

A

Acidosis or acidemia

80
Q

Four ways H+ produced by metabolism

A
  1. Breakdown of phosphorus-containing protein releases phosphoric acid into ECF
  2. Lactic acid from anaerobic respiration of glucose
  3. Fatty acids and ketone bodies from fat metabolism
  4. H+ liberated when CO2 converted to HCO3–in blood
81
Q

Concentration of hydrogen ions regulated sequentially by …

A
  1. Chemical buffer systems: rapid; first line of defense
  2. Brain stem respiratory centers: act within 1–3 min
  3. Renal mechanisms: most potent, but require hours to days to effect pH changes
82
Q

Dissociate completely in water; can dramatically affect pH

A

Strong acids

83
Q

Dissociate partially in water; are efficient at preventing pH changes

A

Weak acids

84
Q

Dissociate easily in water; quickly tie up H+

A

Strong bases

85
Q

Accept H+ more slowly

A

Weak bases

86
Q

System of one or more compounds that act to resist pH changes when strong acid or base is added

A

Chemical buffer

87
Q

Three chemical buffer systems

A
  1. Bicarbonate buffer system
  2. Phosphate buffer system
  3. Protein buffer system
88
Q
  • Mixture of carbonic acid and salts of sodium bicarbonate
  • Buffers ICF and ECF
  • The only important ECF buffer
A

Bicarbonate buffer system

89
Q
  • Components are sodium salts of Dihydrogen phosphate (weak acid) and monohydrogen phosphate (weak base)
  • Unimportant in buffering plasma
  • Effective buffer in urine and ICF, where phosphate concentrations are high
A

Phosphate buffer system

90
Q
  • Intracellular proteins are the most plentiful and powerful buffers; plasma proteins are also important
  • Protein molecules are amphoteric (can function as both a weak acid and a weak base)
A

Protein buffer system

91
Q

–Regulate amount of acid or base in body
–Act more slowly than chemical buffer systems
–Have more capacity than chemical buffer systems

A

Respiratory and renal systems

92
Q

Eliminate volatile carbonic acid by eliminating CO2

A

Lungs

93
Q

Eliminate nonvolatile (fixed) acids produced by cellular metabolism (phosphoric, uric, and lactic acids and ketones) to prevent metabolic acidosis

A

Kidneys

94
Q

Regulate blood levels of alkaline substances; renew chemical buffers

A

Kidneys

95
Q

During carbon dioxide unloading …

A

Hydrogen ions are incorporated into water

96
Q

Expels more carbon dioxide (during acidosis)

A

Deeper and more rapid breathing

97
Q

–Causes slower and more shallow breathing

–Causing H+ to increase

A

Alkalosis

98
Q

Hypoventilation =

A

Respiratory acidosis

99
Q

Hyperventilation =

A

Respiratory alkalosis

100
Q

Three most important renal mechanisms

A
  1. Conserving (reabsorbing)
  2. Generating new HCO3–
  3. Excreting HCO3–
101
Q

Generating or reabsorbing one HCO3– is the same as …

A

Losing one H+

102
Q

Excreting one HCO3– is the same as …

A

Gaining one H+

103
Q

To reabsorb bicarbonate kidney must …

A

Secrete H+

104
Q

To excrete excess bicarbonate kidney must …

A

Retain H+

105
Q
  • Caused by failure of respiratory system to perform pH-balancing role
  • Single most important indicator is blood PCO2
A

Respiratory acidosis and alkalosis

106
Q

All acid-base abnormalities other than those caused by PCO2 levels in blood; indicated by abnormal HCO3– levels

A

Metabolic acidosis and alkalosis

107
Q

Most common cause of acid-base imbalance

A

Respiratory acidosis

108
Q

Occurs when a person breathes shallowly, or gas exchange is hampered by diseases such as pneumonia, cystic fibrosis, or emphysema

A

Hypoventilation –> respiratory acidosis

109
Q

Can occur from stress, anxiety, panic attack, bleeding, heart or lung disorder, infection, oxygen deficiency from high altitude

A

Hyperventilation –> respiratory alkalosis

110
Q

Second most common cause of acid-base imbalance

A

Metabolic acidosis

111
Q

Three causes of metabolic acidosis

A

–Ingestion of too much alcohol (which is metabolized to acetic acid)
–Excessive loss of HCO3– (e.g., persistent diarrhea)
–Accumulation of lactic acid, shock, ketosis in diabetic crisis, starvation, and kidney failure

112
Q

Treatment of metabolic acidosis

A

Administer IV sodium bicarbonate and correct cause of acidosis

113
Q

Much less common than metabolic acidosis

–Indicated by rising blood pH and HCO3–

A

Metabolic alkalosis

114
Q

Typical causes of metabolic alkalosis

A
  • Vomiting of the acid contents of the stomach
  • Intake of excess base (e.g., from antacids)
  • Constipation, in which excessive bicarbonate is reabsorbed
115
Q

Treatment of metabolic alkalosis

A

Give fluid solutions to correct Cl-, K+and other electrolyte deficiencies and correct cause of alkalosis

116
Q

Blood pH below 6.8

A

Depression of CNS –> coma –> death

117
Q

Blood pH above 7.8

A

Excitation of nervous system –> muscle tetany, extreme nervousness, convulsions, death often from respiratory arrest

118
Q

Attempts to correct metabolic acid-base imbalances

A

Respiratory system

119
Q

Attempt to correct respiratory acid-base imbalances

A

Kidneys

► Med - Anatomy & Physiology (130 decks)

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