Fluid, Electrolytes, and Acid-Base Flashcards

1
Q

What is a body fluid?

A

any substance, usually a liquid, that is produced by the body and consists of water and dissolved solutes

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2
Q

What makes up over half of the mass of the adult body?

A

Body fluids

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3
Q

What are the two “compartments” of body fluids (separated by a barrier)?

A

Intracellular (Cytosol) and Extracellular (Interstitial fluid, includes lymph, CSF, pleural, serous, etc, and blood plasma)

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4
Q

When does fluid balance occur?

A

When the required amount of water and solutes are present and correctly spread amongst the “compartments”

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5
Q

What percentage of total body mass does water account for?

A

45-75%

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6
Q

What allows for constant water and solute exchange between compartments?

A

Processes such as filtration, reabsorption, diffusion and osmosis

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7
Q

What is an electrolyte?

A

An inorganic compound that dissociates into ions in H2O

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8
Q

What is an ion

A

An atom or molecule with a net electrical charge due to a loss or gain of electrons

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9
Q

What is the main source of water gain?

A

Ingestion

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10
Q

What is another source of water gain?

A

Metabolic water can be gained during aerobic respiration and dehydration synthesis

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11
Q

How is water lost in the kidneys?

A

Excrete the majority of water in urine

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12
Q

How is water lost in the skin?

A

Evaporation by insensible and regular perspiration

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13
Q

How is water lost from the lungs?

A

Exhaling water vapor

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14
Q

How is water lost through the GI system?

A

Water elimination as feces

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15
Q

The quantity of metabolic water created is directly proportional to what?

A

the level of aerobic respiration (more ATP produced = more water produced)

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16
Q

What is dehydration?

A

water loss is greater than water gain (decrease in volume and increase in osmolarity)

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17
Q

What creates an urge to drink when the body is dehydrated?

A

The thirst center in the hypothalamus

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18
Q

What different triggers exist that activate the thirst center and create the urge to drink?

A
  • Increased activity from osmoreceptors in the hypothalamus
  • Volume receptors in the atria
  • Baroreceptors in blood vessels
  • Angiotensin II
  • Neurons in the mouth detect decreased salivary slow
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19
Q

What is the main function for eliminating excess water and solutes?

A

Via excretion in the urine

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20
Q

How do the kidneys regulate water loss in urine?

A

by increasing or decreasing the reabsorption of Na+ and Cl-

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21
Q

What hormones are involved in regulating water and solute loss?

A

*ADH (water)
*Aldosterone (solute)
*ANP (solute)

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22
Q

What is Antidiuretic Hormone (ADH)?

A

*The primary hormone involved in regulating water loss
*When the thirst center is triggered it increases
the synthesis and release of ADH
*Promotes water reabsorption by increasing the water permeability in the principal cells of
the tubule and duct of the DCT
*Other factors stimulate the release of ADH: Atrial volume receptors, baroreceptors in the BV, pain, nausea, and stress

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23
Q

What is aldosterone?

A

*decreased blood volume or Na+ deficiency in plasma trigger the RAAS
* Increases Na+ reabsorption in the DCT and ducts

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24
Q

What is Atrial Natriuretic Peptide (ANP)?

A
  • Stretch receptors in the atria trigger the release of ANP
  • Promotes Na+ excretion in the urine (water follows sodium)
  • Slows the release of renin (and therefore aldosterone
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25
Q

When there is increased osmolarity of ECF what happens to the fluid?

A

Turns the fluid hypertonic – Cells shrink

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26
Q

What can happen if ECF stays hypertonic for an extended period of time?

A

it can cause confusion, convulsions, coma, or death

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27
Q

When there is decreased osmolarity of ECF what happens to the fluid?

A

Turns the fluid hypotonic – Cells swell

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28
Q

What is water intoxication?

A

A state in which excessive body water causes cells to swell dangerously

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29
Q

What functions do electrolytes have in the body?

A
  • Regulate osmosis of water between fluid compartments
  • Maintain the acid-base balance required for cell function
  • Carry electrical current (production of action potentials)
  • Cofactors needed for optimal enzyme activity
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30
Q

What is an anion?

A

Negatively charged ion

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31
Q

What is a cation?

A

Positively charged ion

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32
Q

What is the main difference between blood plasma and interstitial fluid?

A

Blood plasma contains a higher amount of protein anion, intracellular fluid has a much higher concentration of K+, HPO42-, and proteins

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33
Q

What are the two most abundant ions in extracellular fluid?

A

Na+ and Cl-

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34
Q

What is the most abundant ion in ECF?

A

Na+, accounting for 90% of EC cations

35
Q

What is normal blood plasma concentration of sodium

A

136-148mEq/L

36
Q

What concentration of Na+ would be considered hyponatremia?

A

Na+ <136mEq/L

37
Q

What concentration of Na+ would be considered hypernatremia?

A

Na+ >148mEq/L

38
Q

What is Na+ responsible for?

A

Generation of action potentials in neurons and muscle fibers

39
Q

What are Na+ levels in the blood regulated by?

A

Aldosterone, ADH, and ANP

40
Q

What is the most abundant anion in extracellular fluid?

A

Cl-

41
Q

What is the role of Cl-?

A

*Aids in maintaining the balance of anions in fluid
*HCO3- plays a major role in the elimination of CO2, Cl- is exchanged for HCO3- to maintain the anion balance

42
Q

What helps regulate Cl- balance?

A

ADH regulates Cl- balance because it regulates water loss in urine, Cl- typically follows Na+

43
Q

What is the most abundant cation in intracellular fluid?

A

K+, 140mEq/L

44
Q

What is the role of K+?

A

Helps regulate pH levels and heavily responsible in maintaining resting membrane potential and in the repolarization phase of action potentials

45
Q

What regulates blood plasma concentration of K+?

A

Regulated by aldosterone

46
Q

What is a normal concentration of K+?

A

3.5-5mEq/L

47
Q

What concentration of K+ would be considered hyperkalemia?

A

K+ >5mEq/L

48
Q

What concentration of K+ would be considered hypokalemia?

A

K+ < 3.5mEq/L

49
Q

What is the second most abundant ECF anion?

A

HCO3-

50
Q

What is HCO3- responsible for?

A

Heavily responsible for CO2 elimination in maintaining acid-base balance

51
Q

How are HCO3- levels regulated?

A

Kidneys can synthesize and release HCO3- into the blood when needed, or secrete more into urine if levels are too high

52
Q

What happens when CO2 released during cellular metabolism combines with H2O?

A

Forms carbonic acid (H2CO3) which then dissociates into H+ and HCO3-

53
Q

What is a normal level of HCO3-?

A

22-26mEq/L

54
Q

What is the most abundant mineral in the body?

A

Ca2+ due to the amount stored in bone

55
Q

What does Ca2+ play a role in?

A

blood clotting, neurotransmitter release, muscle tone and contractility, and excitability of nervous and muscle tissue

56
Q

What are low levels of Ca2+ regulated by?

A

Mainly regulated by parathyroid hormone

57
Q

What are the functions of magnesium?

A

-Aids in the metabolism of carbs and proteins.
-Involved in synaptic transmission, cardiac function, neuromuscular activity

58
Q

What is an acid?

A

A substance that dissociates into one or more hydrogen ions (H+) and one or more anions - aka a proton donor

59
Q

What is a base?

A

A substance that dissociates into one or more hydroxide ions (OH-) and one or more cations - removes H+ from a solution – aka proton acceptor

60
Q

What is pH?

A

the measure of acidity and alkalinity in a solution

61
Q

What does a pH = 7 mean?

A

neutral (pure H2O)

62
Q

What does a pH > 7.0 mean?

A

basic (alkaline) or more OH- than H+

63
Q

What does a pH < 7.0 mean?

A

acidic or more H+ than OH-

64
Q

What should the pH of arterial blood be to maintain homeostasis?

A

7.35-7.45

65
Q

What are the three major mechanisms for the elimination of H+ from the body?

A

Buffer Systems, Exhalation of CO2, and Kidney Excretion of H+

66
Q

How does a buffer system work to eliminate excess H+?

A

bind to excess H+. Temporary increase in pH but doesn’t remove H+ from the body

67
Q

How does exhalation of CO2 work to eliminate excess H+?

A

increased RR and depth to eliminate more CO2 thus decreased blood carbonic acid (H2CO3) - raises pH

68
Q

What does the protein buffer system do?

A

-Can buffer both acids and bases
-Important in regulating the pH level within RBCs during gas exchange - Hgb is the protein involved
-

69
Q

What are the 2 ways the protein buffer system can work?

A

*Release a H+ when pH rises (H+ can than react with excess OH- to form water)
*Pick up any excess H+ at the other end of the chain when pH drops

70
Q

How does the Bicarbonate Buffer System work?

A

-Excess H+ can be picked up by HCO3- and forms H2CO3 (which then dissociates into H2O and CO2 to be exhaled)
-Decreased H+ causes carbonic acid to dissociate into H+ and HCO3-

71
Q

How does exhalation of CO2 effect pH?

A

*Because CO2 and H2O form H2CO3, CO2 directly impacts pH levels in the body
* H2CO3 can be eliminated by exhaling CO2
* Changes in the rate and depth of breathing can alter the pH of body fluids very rapidly
* Increased RR —> decreased CO2 —> H+ drops —> pH rises
* Decreased RR —> increased CO2 —> H+ rises —> pH drops

72
Q

What is the process of the respiratory negative feedback loop that effects pH?

A

*Increased acidity (low pH) or elevated CO2 levels are detected by chemoreceptors in the medulla oblongata (central) and the carotid and aortic arteries (peripheral)
*Stimulates the respiratory center in the medulla to increase the rate and depth of breathing (exhale more CO2) until pH levels return to normal
* Process works in the opposite as well - decreased CO2 or increased alkalinity (high pH) slow the respiratory drive down until homeostasis is achieved

73
Q

What happens in kidney elimination of H+?

A

*The kidneys have the ability to excrete excess H+ when pH is low and excess HCO3- when pH is high
*The H+ that is excreted into the tubules is often buffered (combined) with other ions to prevent the reabsorption of H+

74
Q

What pH would be considered acidosis?

A

pH < 7.35

75
Q

What physiological effects can occur in acidosis?

A

CNS depression via depression of synaptic
transmission which can cause disorientation, coma, lethargy, death

76
Q

What pH would be considered alkalosis?

A

pH > 7.45

77
Q

What physiological effects can occur in alkalosis?

A

Major physiological effects include: over-excitability of CNS and PNS causing nervousness, muscle spasms, convulsions, death.

78
Q

What happens if a person has altered pH due to metabolic causes?

A

the respiratory system can compensate by hyper or hypoventilation – fast change

79
Q

What happens if the altered pH is due to a respiratory cause?

A

the renal system must compensate by changes in H+ secretion and HCO3- reabsorption - slow change

80
Q

What levels would be seen in respiratory acidosis?

A

pH < 7.35
CO2 > 45mmHg
HCO3- –> 22-26mEq/L

81
Q

What levels would be seen in respiratory alkalosis?

A

pH > 7.45
CO2 < 35mmHg
HCO3- –> 22-26mEq/L

82
Q

What levels would be seen in metabolic acidosis?

A

pH < 7.35
CO2 —> 35-45mmHg
HCO3- < 22mEq/L

83
Q

What levels would be seen in metabolic alkalosis?

A

pH > 7.45
CO2 —> 35-45mmHg
HCO3- > 26mEq/L