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2nd block > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

What do the body fluids consist of?

A

Water and dissolved solutes

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2
Q

What are electrolytes?

A

Solutes that dissolved in body fluids and dissociate into ions

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3
Q

How much of the human body mass does water account for?

A

45%-75%

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4
Q

Describe distribution of body fluids in the average lean female

A

55% fluids but 45% solids

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5
Q

Describe the distribution of body fluids of the average, lean male

A

40% solids

60% fluids

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6
Q

Describe the chemical composition of total body fluid

A

2/3 intracellular fluids

1/3 extracellular fluids

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7
Q

Describe the chemical composition of extracellular fluid

A

80% interstitial fluid

20% plasma

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8
Q

What is fluid balance?

A

Water and solutes are in equivalent proportion in various body compartments

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9
Q

____________ is the primary way in which water moves in and out of body compartments

A

Osmosis

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10
Q

The concentration of ___________ mandates the direction of water movement and hence …

A

Solutes

…are the major determinants of fluid balance

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11
Q

What is osmolarity?

A

The measure of solute concentration defined as number of moles per liter of solution

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12
Q

What are the units of osmolarity?

A

Osmol/L

Or

Osm/L

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13
Q

ICF and ECF normally have equal osmolarity so cells…

A

…neither shrink nor swell

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14
Q

_____________ occurs if the osmolarity changes

A

Imbalance

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15
Q

What happens due to an increase in osmolarity in interstitial fluid?

A

Will draw water out of the cell and cause the cell to shrink

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16
Q

What happens when there is a decrease in osmolarity in the interstitium(ECF)?

A

Water will draw out of the cell and cause it to swell and can lead to water intoxication

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17
Q

In the CNS, water intoxication/decrease in osmolarity in ECF causes

A

Convulsions
Coma
Death

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18
Q

Convulsions, coma and death may result from water intoxication/decreased osmolarity in ECF unless…

A

… oral rehydration includes small amount of salt in water intake

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19
Q

_____________ secretion shuts off after intake of water

A

ADH

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20
Q

ADH secretion is increased if there is:

A
  • Large decrease in blood volume
  • Severe dehydration and drop in blood pressure
  • Vomiting, diarrhea, heavy sweating or burns
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21
Q

ADH does what in terms of fluid balance?

A

Stimulates thirst

Increases permeability of principle cells in collecting ducts to assist in water reabsorption

-Very concentrated urine is formed

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22
Q

What is dehydration?

A

The loss of body fluids

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23
Q

Describe the process of thirst stimulation to increase water intake

A

Dehydration

  • > decreased saliva flow, increased blood osmolarity and decreased blood volume
  • > dry mouth and pharynx due to decreased saliva flow
  • > increased blood osmolarity leads to stimulation of osmolarity in the hypothalamus
  • > decreased blood volume leads to decreased pressure, this causes renin to be secreted by juxtamedullary cells in kidney to produce angiotensin 2

-> angiotensin 2, dry mouth and pharynx and stimulation of osmoreceptors in hypothalamus stimulate thirst center in hypothalamus and increases thirst

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24
Q

What is hyponatremia?

A

Decreased Na+ concentration of interstitial fluid and plasma

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25
Q

What hormones increase Na+ and Cl- reabsorption

A

Aldosterone and Angiotensinogen 2

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26
Q

What hormone increases Na+ and Cl- excretion?

A

Atrial naturiuretic peptide

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27
Q

What are the 4 general functions of electrolytes?

A

Control the osmosis of water between body compartments

Maintain acid base balance

Carry electrical current which allows for production of action potentials and graded potentials

Serve as cofactors needed for optimal activity of enzymes

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28
Q

Explain the series of events which can lead to coma, convulsions and possible death?

A
  1. Blood loss, sweating, vomiting or diarrhea coupled with intake of plain water
  2. Decreased Na+ concentration of interstitial and plasma(hyponatremia)
  3. Decreased osmolarity of interstitial fluid and plasma
  4. Osmosis of water from interstitial fluid into intracellular fluid
  5. Water intoxication(cells swell)
  6. Convulsions, coma and possible death
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29
Q

Explain hormonal regulation of Na and Cl reabsorption

A
  1. Increased intake of NaCl
  2. Increased plasma concentrations of Na+ and Cl-
  3. Increased osmosis of water from intracellular fluid to interstitial fluid to plasma
  4. This leads to increased blood volume
  5. In the heart: increased atrial stretching leads to release of atrial natriuretic peptide
  6. Decreased renin, angiotensin 2 and aldosterone from increased blood pressure leads to increased glomerular filtration rate
  7. Atrial natriuretic peptide, decreased aldosterone and increased glomerular filtration rate leads to reduced NaCl reabsorption in the kidneys
  8. Increased loss of Na+ and Cl- in urine leads to increased water loss and decreased blood volume
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30
Q

How is the charge carried by ions in different solutions compared?(units)

A

Milliequivalents/liter (mEq/ liter)

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31
Q

What is expressed in milliequivalents/liter (mEq/Liter)?

A
  • Cations(positively charge)

- Anions (negatively charged) in a solution

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32
Q

What electrolytes does the extracellular fluid contain?

A

Na+ and Cl-

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33
Q

What does intracellular fluid contain?

A

K+ and phosphates

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34
Q

Contrast plasma and interstitial fluid in terms of contents

A

Plasma contains many proteins but interstitial fluid doesn’t

Interstitial fluid- Na+ and Cl-

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35
Q

What is the most abundant ion in the ECF?

A

Sodium, Na+

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36
Q

_________ accounts for half of the serum osmarility

A

Sodium

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37
Q

This electrolyte is the mist abundant in ECF and necessary for action potentials across cellular membranes

A

Sodium Na

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38
Q

What 3 hormones regulate Sodium and how?

A

Aldosterone increases sodium absorption

ADH secretion increases if Na+ level are less than 135 mEq

ANP excretes Na+ and water

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39
Q

What is the most prevalent anion in the ECF?

A

Chloride, Cl-

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40
Q

Why do chloride ions move easily between compartments?

A

Due to Cl leakage channels

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41
Q

Chloride anions help balance _________ in different compartments

A

Anions

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42
Q

Explain the regulation of Chloride

A
  • Follows Na+ passively so it is indirectly regulated by aldosterone
  • ADH helps regulate Cl in body fluids because it controls water loss in urine
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43
Q

How does chloride shift across red blood cells?

A

With buffer movement

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44
Q

What is the most abundant cation in the intracellular fluid?

A

Potassium cation

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45
Q

What is the function of potassium in the nervous system?

A

Helps establish resting potential and repolarization of membrane in nerve and muscle fibers

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46
Q

What is the function for K+ for pH regulation in the body?

A

K+ exchanged for H+

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47
Q

Explain the relationship between K+ and aldosterone

A

High levels of K+ stimulates secretion of aldosterone which increases K+ excretion in the kidneys

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48
Q

Abnormal plasma K+ levels adversely effect ________ and ______________________ function

A

Cardiac

Neuromuscular

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49
Q

What causes blood increase and decrease of bicarbonate? HCO3-

A

Major component of the plasma acid-base buffer system

  • Concentration increases as blood flows through systemic capillariesbdue to carbon dioxide is released from cell metabolism
  • concentration decreases as blood flows through pulmonary capillaries and carbon dioxide is exhaled

Intercalated cells excrete more if levels are low

Excess is excreted in urine

50
Q

What are the main regulators of plasma levels?

A

Kidneys

51
Q

What are the functions of calcium?

A

Structural component of bones and teeth

Important to blood clotting, neurotransmitter release, muscle tone and function and nerve function

52
Q

What regulates calcium levels?

A

Parathyroid hormone (PTH)

Stimulates osteoclasts to release calcium from bone

Increases production of calcitrol(Ca2+ absorption from GI tract and reabsorption from glomerular filtration rate

53
Q

What is the second most common intracellular cation?

A

Magnesium

54
Q

How much of magnesium is found in bone matrix?

A

54%

55
Q

What are the functions of magnesium?

A
  • activates several enzyme systems involved in carb and protein metabolism
  • needed for operation of sodium pump
  • neuromuscular activity
  • neural transmission within the central nervous system

Myocardial functioning

56
Q

_________ accounts for half of the serum osmarility

A

Sodium

57
Q

This electrolyte is the mist abundant in ECF and necessary for action potentials across cellular membranes

A

Sodium Na

58
Q

What 3 hormones regulate Sodium and how?

A

Aldosterone increases sodium absorption

ADH secretion increases if Na+ level are less than 135 mEq

ANP excretes Na+ and water

59
Q

What is the most prevalent anion in the ECF?

A

Chloride, Cl-

60
Q

Why do chloride ions move easily between compartments?

A

Due to Cl leakage channels

61
Q

Chloride anions help balance _________ in different compartments

A

Anions

62
Q

Explain the regulation of Chloride

A
  • Follows Na+ passively so it is indirectly regulated by aldosterone
  • ADH helps regulate Cl in body fluids because it controls water loss in urine
63
Q

How does chloride shift across red blood cells?

A

With buffer movement

64
Q

What is the most abundant cation in the intracellular fluid?

A

Potassium cation

65
Q

What is the function of potassium in the nervous system?

A

Helps establish resting potential and repolarization of membrane in nerve and muscle fibers

66
Q

What is the function for K+ for pH regulation in the body?

A

K+ exchanged for H+

67
Q

Explain the relationship between K+ and aldosterone

A

High levels of K+ stimulates secretion of aldosterone which increases K+ excretion in the kidneys

68
Q

Abnormal plasma K+ levels adversely effect ________ and ______________________ function

A

Cardiac

Neuromuscular

69
Q

What causes blood increase and decrease of bicarbonate? HCO3-

A

Major component of the plasma acid-base buffer system

  • Concentration increases as blood flows through systemic capillariesbdue to carbon dioxide is released from cell metabolism
  • concentration decreases as blood flows through pulmonary capillaries and carbon dioxide is exhaled

Intercalated cells excrete more if levels are low

Excess is excreted in urine

70
Q

What are the main regulators of plasma levels?

A

Kidneys

71
Q

What are the functions of calcium?

A

Structural component of bones and teeth

Important to blood clotting, neurotransmitter release, muscle tone and function and nerve function

72
Q

What regulates calcium levels?

A

Parathyroid hormone (PTH)

Stimulates osteoclasts to release calcium from bone

Increases production of calcitrol(Ca2+ absorption from GI tract and reabsorption from glomerular filtration rate

73
Q

What is the second most common intracellular cation?

A

Magnesium

74
Q

How much of magnesium is found in bone matrix?

A

54%

75
Q

What are the functions of magnesium?

A
  • activates several enzyme systems involved in carbohydrate and protein metabolism
  • needed for operation of sodium pump
  • neuromuscular activity
  • neural transmission within the central nervous system

Myocardial functioning

76
Q

What factors regulate magnesium ion concentration in plasma?

A

Hypo- or hyperglycemia

Hypo or hypermagnesemia

Increase or decrease in extra cellular fluid volume

An increase or decrease in the parathyroid hormone

Acidosis or alkalosis

77
Q

In what form is phosphate present in bones and teeth?

A

Calcium phosphate?

78
Q

What regulates phosphate levels in the plasma?

A

Parathyroid hormone and calcitriol

79
Q

How do parathyroid hormone and calcitriol regulate phosphate plasma levels?

A

Reabsorption of bone releases phosphate

In the kidney, PTH increase phosphate excretion

Calcitriol increases GI absorption of phosphate

80
Q

People at risk for electrolyte Imbalance include:

A

Dependents in others for fluid and food needs

Undergoing medical treatment using intravenous infusions, drainage or suction and urinary catheters

Receiving diuretics

Post-operative individuals

Burn victims

Patients with chronic disease and with altered states of consciousness

81
Q

High protein diets tend to ___________ the blood

A

Acidify

82
Q

The overall acid-base balance is maintained by controlling the _______________ of body fluids, especially ECF

A

Proton concentration

83
Q

What are the 3 major mechanisms to regulate pH in body fluids?

A
  1. Buffer systems
  2. Exhalation of Carbon Dioxide(respiratory system)
  3. Kidney excretion of protons (urinary system)
84
Q

Why is HPO4- an important buffer?

A

Acts as a buffer of protons in body fluids and urine.

Mono and dihydrogenphosphate act as buffers in the blood

85
Q

What are the functions of buffer systems?

A

Prevent rapid, drastic changes in pH

Change either strong acid or base into a weaker one

Work in fractions of a second

86
Q

What are the 3 principle buffer systems?

A
  • protein buffer system
  • carbonic acid-bicarbonate buffer system
  • phosphate buffer system
87
Q

Explain the protein buffer system

A

Some side chains buffer protons

-Amino acids have at least one carboxyl group (COOH) and releases a protein when pH is high(in alkaline solution)

-Amino acids also contain an amino group
Which acts as a base and accepts a protein when is in an acidic solution/ or pH is low

88
Q

Explain the carbonic acid buffer system(use equations)

A

Carbonic acts as an extracellular and intracellular buffer system

  • bicarbonate acts as a weak base if there is too much acid= H+ and HCO3- -> H2CO3 -> CO2 + H2O

carbonic acid(H2CO3) can act as a weak acid if there is too little

H2CO3 -> H+ and HCO3-

89
Q

The phosphate buffer system is most important _______________ but also acts to buffer acids in _______________

A

Intracellularly

Urine

90
Q

Explain the phosphate buffer system(using equations)

A

Dihydrogen phosphate acts as a weak acid that can buffer a strong base

OH- + H2PO4 -> H2O + H2PO4 ^2-

Mono hydrogen phosphate acts as a weak base by buffering the H+ released by a strong acid

H+ and HPO4 ^2- -> H2PO4 ^-

91
Q

Explain regulation of pH by exhaling Carbon Dioxide

A
  • Increasing breathing rate increases blood pH
  • Slow breathing rage causes pH to drop
  • Kidneys excrete H+ and absorb HCO3^- to aid in maintaining pH(slower)
  • H+ detected by chemoreceptors in medulla oblangata, carotid and aortic bodies
  • Respiratory centers inhibited or stimulated by changes is pH
92
Q

Go back to chart

A

Go back to chart

93
Q

Kidneys eliminate excess __________ or _______

A

Acids

Bases

94
Q

Why can renal failure cause death very rapidly?

A

Due to its role in pH balance

95
Q

How much nonvolatile acid is produced by metabolic reactions?

A

1 mEq/liter of nonvolatile acid for every kilogram of body weight

96
Q

What are the 2 types of cells that make up the intercalated cells in the kidney

A

Beta cells

Alpha cells

97
Q

What is the responsibility of the alpha cells in intercalated cells?

A

Secrete excess protons and reabsorb bicarbonate ions

98
Q

What is the responsibility of beta cells in the intercalated cells?

A

To secrete bicarbonate ions and reabsorb protons

99
Q

What cells are responsible for acid-base homeostasis that are in the kidneys?

A

Alpha cells and beta cells

100
Q

Ammonia and mono hydrogen phosphate are _______ _________

A

Urinary buffers

101
Q

How do ammonia and mono hydrogen phosphate act as urinary buffers?

A

They both accept protons

Ammonia becomes ammonium

Monohydrogen phosphate becomes adihydrogen phosphate

102
Q

What is acidosis?

A

Blood pH below 7.35

103
Q

What is alkalosis?

A

pH above 7.45

104
Q

What is the principle effect of. Acidosis?

A

The depression of the central nervous system through depression of synaptic transmission

105
Q

What is the principle effect of alkalosis?

A

The principle effect is the over-excitability of the central nervous system through facilitation of synaptic transmission

106
Q

What is compensation?

A

An attempt to correct an acid base imbalance

107
Q

What are the 2 types of compensation?

A

Renal compensation

Respiratory compensation

108
Q

Acidosis causes…

A

Depression of CNS and coma

109
Q

Alkalosis causes …

A

Excitability of nervous tissue leading to spasms convulsions and death

110
Q

How is acid base balance diagnosed/ evaluated?

A

Systemic arteriole blood pressure

Concentration of bicarbonate( too low or too high)

Partial pressure of carbon dioxide( Too low or too high)

111
Q

What are respiratory acidosis and alkalosis?

A

Disorders involving changes in partial pressure if carbon dioxide in blood. Supposed to be (35- 45mEq/L)

112
Q

What are metabolic acidosis and alkalosis?

A

Disorders due to changes bicarbonate ion concentration in blood. Supposed to be 22-36 mEq/L

113
Q

Why do infants produce more metabolic wastes?

A

Higher metabolic rate

114
Q

In infants kidneys cannot __________ _______ nor remove excess _________

A

Concentrate urine

Protons/H+

115
Q

Why do infants lose more water through skin?

A

Because surface area to volume ratio is greater

116
Q

Why do infants have a higher breathing rate?

A

Due to increased water loss from lungs

117
Q

Compare ion concentration in infants to adults

A

Higher K+ and Cl- concentrations than adults

118
Q

Compare the amount of body water in ECF of infants to adults

A

Infants have more body water in ECF

119
Q

Compare fluid intake between infants and adults

A

Rate of fluid intake/output is 7 times higher than adults

120
Q

Compare K+ concentration in elderly to younger adults

A

Decreased total body K+ due to loss of muscle tissue or potassium depleting diuretics for treatments of hypertension or heart disease

121
Q

Why do the elderly experience decreased renal function and respiratory function?

A
  • Slowing of exhalation of CO2
  • decreased blood flow and glomerular filtration rate
  • reduced sensitivity to ADH and impaired ability to produce dilute urine
  • Renal tubule cells produce less ammonia to combine with H+ and excrete as NH4^+

2nd block (6 decks)

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