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Physiology: Exam 3 > Lecture 1: Fluid Compartments > Flashcards

Lecture 1: Fluid Compartments Flashcards

1
Q

What is Total Body Water (TBW)?

A

The total amount of water in an individiuals body

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2
Q

How is TBW determined?

A
  • It varies from 50-70% of body weight. Average=60%
  • In an average person (70 Kg), TBW is 42kg or 42 L of water (0.60x70kg)
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3
Q

What is the TBW of an average person (70 kg)?

A

42 Kg or 42 L of water

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4
Q

List the percentage of water, percentage of body weight, and L of H2O in:

  • Muscle
  • Skin
  • Blood
  • Skeleton
A
  • Muscle:76% H2O, 41.7% body weight, 22.1 L of H2O (most H2O)
  • Skin:72% H2O, 18% body weight, 9.1 L of H2O (second most)
  • Blood:83% H2O, 8.0% body weight, 4.65 L of H2O
  • Skeleton: 22% H2O, 16% body weight, 2.5 L of H2O

Review Slide 6

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5
Q

List the percentage of water, percentage of body weight, and L of H2O in:

  • Brain
  • Liver
  • Intestine
  • Adipose Tissue
A
  • Brain:74.8% H2O, 2.0% body weight, 1.0 L of H2O
  • Liver: 68.3% H2O, 2.3% body weight, 1.0 L of H2O
  • Intestine: 74.5% H2O, 1.8% body weight, 1.0 L of H2O
  • Adipose Tissue: 10.0% H2O, 10% body weight, 0.7 L of H2O

Review Slide 6

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6
Q

Which tissue in the body has the largest amount of water? What is the amount?

A

Muscle: 76% H2O, 41.7% body weight, 22.1 L of H2O

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7
Q

How is the 42 L TBW (60% of body weight) seperated in the body?

A

Separated into the:

  • Extracellular fluid (plasma and intersitial fluid)
  • Intracellular fluid
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8
Q

What is the percent body weight and liters of H2O present in the extracellular fluid (ECF) & including its separations?

Part of the TBW

A

ECF

  • 20% of body weight
  • 14 L of H2O

Interstitial Fluid

  • 75% of ECF

Plasma

  • 25% of ECF
  • 4-5 % body weight
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9
Q

What is the percent body weight and liters of H2O present in the intracellular fluid (ICF)?

Parts of the TBW

A
  • 40% of Body Weight
  • 28L of H2O
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10
Q

What seperates the ECF from ICF?

A

Cell membrane

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11
Q

What seperates the interstitial fluid and plasma in the ECF?

A

Capillary wall

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12
Q

In the ICF, how is the water distributed (3), and include the amounts?

A

ICF (28 L of H2O)

  • Intracellular fluid=24 L
  • Bone=3 L
  • Transcellular fluid=1 L
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13
Q

In the ECF, how is the water distributed, and include the amount?

A

ECF (14 L of H2O)

  • ISF and Lymph= 8 L
  • Plasma=3 L
  • Connective Tissue ISF=3 L
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14
Q

What is the only way to access and measure major fluid compartments in the body?

A

Through the plasma

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15
Q

What is used as a marker to measure TBW?

A

Water specifically H+ isotropes (ex. deuterium, tritium)

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16
Q

How are MOST fluid compartments measured?

A

The Standard Equation:
Compartment Volume= Amount injected/Final concentration

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17
Q

List the steps to calculate the Standard Equation

A
  1. Inject the marker/substance through the plasma
  2. Allow all the compartments to reach equilibrium
  3. Collect the sample again from the plasma and measure the final concentration
  4. Divide the amount initially injected over the final concentration to determine compartment volume
  • NOTE: Inter-tissue volumes are measured indirectly (interstitial & ICF)

Marker/substance is specific to the fluid compartment being measured

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18
Q

For the compartments listed, what substance and equation is used to measure size?

  • TBW
  • ECF
  • Plasma
  • Blood
A
  • TBW: HTO & D2O, Standard Equation
  • ECF: Inulin & Radio-sodium; Standard Equation
  • Plasma: 131 I-albumin & Evans Blue; Standard Equation
  • Blood: 51 Cr-RBCs; Standard Equation
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19
Q

For the compartments listed, how are they measured (include equation)?

  • Interstitial
  • ICF

Inter-tissue volumes

A
  • Interstitial: Indirect (ECF-Plasma)
  • ICF: Indirect (TBW-ECF)
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20
Q

List the approx. equivalent concentrations (mEq/L) and molar concentrations (mmol/L) of plasma electrolytes

A

Cations

  • Na+: 142.0 mmEq/L; 142.0 mmol/L
  • K+: 4.3 mmEq/L; 4.3 mmol/L
  • Ca2+: 5 mmEq/L; 2.5 mmol/L

Anions

  • Cl-: 104.0 mmEq/L; 104.0 mmol/L
  • HCO3-: 24.0 mmEq/L; 24 mmol/L
  • Proteins: 15.0 mmEq/L; 1.5 mmo;/L

Assume Protein charge is positive 10

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21
Q

Define Osmolarity

A

Distinct from molarity. It measures osmoles of solute particles rather than mole of solute. The distinction is made when the compound can dissociate in solution (H2O)

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22
Q

What is the Osmolarity (molar concentration) Equation?

A

Osmolarity (molar conc.)= # atoms or charge of ions x mmol/L

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23
Q

Define Osmole

A

A unit of osmotic pressure equivalent to the amount of solute that dissociate in solution to form one mole of particles

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24
Q

Explain why 1 mole NaCl=2 osmole

A

When NaCl is dissociated in solution (H2O) it becomes 1 osmole of Na and 1 osmole of Cl=2 osmole

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25
Q

What is the normal plasma osmolarity

A

Approx. 300 mOsmoles/L of H2O

Actual amount closer to 285 but round to 300

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26
Q

What is the difference between Osmolality and Osmolarity?

A
  • OsmoLALity: milimoles of solute/Kg of H2O
  • OsmoLARity: millmoles of solue/L of H2O
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27
Q

As Osmolality increases, activity of H2O _____________

A

decreases

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28
Q

What does the Colligative Properties of Solution depend on?

A

The number of molecules and not on their nature

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29
Q

List the 4 Colligative Properties of Solution

A
  • Boiling Point
  • Freezing Point
  • Vapor Pressure
  • Osmotic Pressure
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30
Q

Using the image below, Which compartment have higher osmotic pressure?

A

A. the more particles the higher the osmotic pressure

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31
Q

Using the image below, which compartment does the H2O have the highest activity?

A

B. Activity of H2O increases as Osmolality decreases

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32
Q

Usint the image below, what is the direction of the water flow?

A

B to A. Move from high H2O activity to low H2O activity

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33
Q

Which cation has the highest concentraton in the ECF (Plasma & Interstitial fluid)?

A

Na+

  • Plasma: 142.0 mmoles/L
  • Interstitial fluid: 145.1 mmoles/L
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34
Q

Which cation has the highest concentration in the ICF (Skeletal muscle cell)?

A

K+

  • Skeletal muscle cell: 140.0 mmoles/L
35
Q

Which anion has the highest concentration in the ECF (Plasma & Interstitial fluid)?

A

Cl-

  • Plasma: 114.0 mmoles/L
  • Interstitial fluid: 117.4 mmoles/L
36
Q

Which anion has the highest concentration in the ICF (Skeletal muscle cell)?

A

HPO42-, H2PO4

  • Skeletal muscle cell: 40.0 mmoles/L

Note: Other(s) has 84.0 mmoles/L

37
Q

What is the role of HCO3- in the ECF?

A

Used in the buffer system to maintain blood pH level

38
Q

What is the role of H2PO42- (H2PO4) in the ICF?

A

Buffer system; Used for force in the skeletal muscle cells

39
Q

What are the levels of Na+ and K+ concentrations intracellularly and in the capillaries?

A
  • Intracellular: LOW Na+ (10 mM), HIGH K+ (140 mM)
  • Capillary: HIGH Na+ (140 mM), LOW K+ (4.5 mM)
40
Q

True or False. The capillary is permeable to most solutes including large proteins

A

FALSE

  • Permeable to most solutes, BUT impermeable to large proteins
41
Q

True or False. Intracellular compartments are imperable to most solutes

42
Q

What is the Darrow-Yannet Diagram?

HIGH yield

A

A graph that shows the osmolality and volume changes of body fluids in the different compartments

Normal D-Y Diagram

43
Q

What is the principal determinant of extracellular and intravascular fluid volume?

A

The total body content of sodium (Na+)

Water follows solutes

44
Q

If injected, Na+ & anions (Cl-) go to which fluid compartment?

A

Extracellular fluid (ECF)

45
Q

If injected, K+ & anions (HPO42-) go to which fluid compartment?

A

Intracellular fluid (ICF)

46
Q

If injected, D5W (5% of glucose in water) goes to which fluid compartment?

A
  • None, glucose is metabolized so NO osmoles are added
  • Basically water only adds to the volume
47
Q

At equilibrium, osmolality is the ________ in all compartments

48
Q

What is the equation used to calculate the volume of fluid compartments?

A

Volume=Total osmoles/osmolality=Tosm/Osm

49
Q

We infuse 1 liter of D5W (5% Dextrose in water).

  • How many total osmoles have been infused?
  • What is the new osmolality after infusion?
  • What is the new volume for TBW, ECF, and ICF?
  • What are the new total osmoles for the TBW, ECF, and ICF?
A
  • 0 osmoles infused because glucose (D5) is metabolized
  • 293 d/t solution being diluted b/c we added 1 L of H2O
  • TBW=43, ECF=14.33 (1/3 of TBW), ICF=28.67 (2/3 of TBW)
  • TBW, ECF, ICF=293 osmoles (same throughout compartments)
50
Q

Using the D-Y diagram below, explain the changes that occur with Osmolality, ECF and ICF with 1 L of H2O w/ D5W.

A

Addition of 1 L of H2O w/ D5W

  • Osmlality decreases d/t dilution b/c addition of water
  • ECF volume increases
  • ICF volume increases
51
Q

We infuse 1 liter of normal saline (0.9%) of 0.150 M.

  • How many total osmoles have been infused?
  • What is the new osmolality after infusion?
  • What is the new volume for TBW, ECF, and ICF?
  • What are the new total osmoles for the TBW, ECF, and ICF?
A
  • 300 total osmoles (150mM Na+150mM Cl)
  • 300 d/t 300 osmoles being infused
  • Volume: TBW=43 L, ECF=15 L, ICF=28 L
  • Tosm: TBW=129600, ECF=4500, ICF=3400
  • NOTE: Na+ and Cl- goes to ECF so all the 300 infused osmoles go to ECF b/c ISOTONIC
52
Q

Using the D-Y diagram below, explain the changes that occur with Osmolality, ECF, and ICF with 1 L of Normal Saline (NaCl) 0.150 M (0.9%) added.

A

Isotonic Solution: Added 1 L of Normal Saline (NaCl) 0.150 M (0.9%)

  • Osmolality stays the same @ 300 osmoles
  • ECF increases by 300 osmoles since all the saline solution (NaCl) goes to the ECF
  • ICF stays the same
53
Q

We infuse 2 L of a 0.45% solution of NaCl

  • How many total osmoles have been infused?
  • What is the new osmolality after infusion?
  • What is the new volume for TBW, ECF, and ICF?
  • What are the new total osmoles for the TBW, ECF, and ICF?
A
  • 300 total osmoles have been infused (math in image in red letters)
  • 293 from dividing the Tosm/vol of the TBW (12900/44)
  • Volume: TBW= 44, ECF=15.3, ICF=28.7
  • Tosm: TBW=12900, ECF= 4500, ICF= 8400 (TBW & ECF increase by 300, while ICF stays the same)
  • NOTE: This is a HYPOTONIC solution
54
Q

Which fluid compartments will increase the most if you infuse KCl?
a. Plasma
b. Interstitial
c. ECF
d. ICF

55
Q

Which body systems are fluids commonly lost?

A
  • GI
  • Skin
  • Blood
56
Q

In Saliva (GI) how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

HIGH yield

A

ECF

  • Na+: 20-80 meq/L
  • Cl-: 20-40 meq/L

ICF

  • K+: 10-20 meq/L
  • HCO3-: 20-60 meq/L
57
Q

In Gastric Juice (GI) how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

HIGH yield

A

ECF

  • Na+: 20-100 meq/L
  • Cl-: 120-160 meq/L

ICF

  • K+: 5-10 meq/L
  • HCO3-: 0 meq/L
58
Q

In Bile (GI) how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

Low Yield

A

ECF

  • Na+: 150 meq/L
  • Cl-: 40-80 meq/L

ICF

  • K+: 5-10 meq/L
  • HCO3-: 20-40 meq/L
59
Q

In Pancreatic juice (GI) how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

Low Yield

A

ECF

  • Na+: 120 meq/L
  • Cl-: 10-60 meq/L

ICF

  • K+: 5-10 meq/L
  • HCO3-: 80-120 meq/L
60
Q

In Ileal juice (GI) how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

Low Yield

A

ECF

  • Na+: 140 meq/L
  • Cl-: 105 meq/L

ICF

  • K+: 5 meq/L
  • HCO3-: 40 meq/L
61
Q

In Colonic fluid (GI) how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

Low Yield

A

ECF

  • Na+: 140 meq/L
  • Cl-: 85 meq/L

ICF

  • K+: 5 meq/L
  • HCO3-: 60 meq/L
62
Q

In Sweat how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

Low Yield

A

ECF

  • Na+: 65 meq/L
  • Cl-: 39 meq/L

ICF

  • K+: 8 meq/L
  • HCO3-: 16 meq/L
63
Q

In Plasma how much of the ions listed are lost

  • Na+
  • K+
  • Cl-
  • HCO3-

Low Yield

A

ECF

  • Na+: 140 meq/L
  • Cl-: 110 meq/L

ICF

  • K+: 3-5 meq/L
  • HCO3-: 24 meq/L
64
Q

Vomiting causes the loss of ________

A

Protons (b/c of HCl)

65
Q

Diarrhea causes the loss of ________

A

bicarbonate (HCO3-)

66
Q

What is the average weight, TBW, Turnover and % TBW of infants?

A
  • Average weight: 3 kg
  • TBW: 2.3 L (77% body weight)
  • Turnover: 0.375
  • % TBW: 16 (1/6)
67
Q

What negative effects happen to infants d/t higher H2O turnover compared to adults?

Infant turnover: 0.375 L/day; Adult turnover: 2.5 L/day

A

More susceptible to dehydration b/c higher H2O turnover and less TBW

68
Q

Which diease is associated with the Darrow-Yannet Diagram below?

Volume Contraction

A
  • Diarrhea
  • lose H2O and solutes, decrease volume w/ same osmolality
69
Q

Which diease is associated with the Darrow-Yannet Diagram below?

Volume Contraction

A
  • Water deprivation
  • decreases H2O, more solute and not diluted= increases osmoles (more osmoles than H2O)
70
Q

Which diease is associated with the Darrow-Yannet Diagram below?

Volume Contraction

A
  • Adrenal insufficiency
  • lose Na+ here, H2O move to ICF to keep osmolality the same
71
Q

80 year old male with AD-over medicated because of irritability and has had nothing to drink for 3 days. What IV solution would you give to the 80 year old who has had nothing to ddrink for 3 days?
a. D5W
b. Normal Saline
c. 1/3 Normal Saline
d. Blood
e. Plasma

72
Q

3 week old infant with vomiting and diarrhea for 2 days. What IV solution would you give to the infant with vomiting and diarrhea for 2 days?
a. D5W
b. Normal Saline
c. 1/3 Normal Saline
d. Blood
e. Plasma

A

b. Normal saline

73
Q

Gunshot wound-loss of 2 liters of blood. What IV solution would you give to the gunshot wound victim?
a. D5W
b. Normal Saline
c. 1/3 Normal Saline
d. Blood
e. Plasma

A

d.Blood & e. Plasma

74
Q

True or False. ECF is 2/3 of total body water (TBW).

A

FALSE

  • ECF is 1/3
  • ICF is 2/3
75
Q

True or False. The major ECF cation is Na+

A

TRUE

Major ICF cation is K+

76
Q

True or False. A normal saline infusion increases ECF volume but decreases ICF volume.

A

FALSE

Normal saline increases the ECF and ICF volume

77
Q

True or False. Hypertonic NaCl infusion increases ECF volume but decreases ICF volume.

78
Q

True or False. Plasma volume=the distribution of water minus the distribution of Na+.

79
Q

The total body water volume in the average human is:
a. 24 L
b. 28 L
c. 14 L
d. 42 L

80
Q

The major anion found in the ICF and ECF, respectively, is:
a. Cl- ; HCO3-
b. HCO3- ; Cl-
c. HPO42- ; Cl-
d. Cl- ; HPO4-

A

c. HPO42-; Cl-

81
Q

All of the following would occur in a child with diarrhea, EXCEPT:
a. Increased ECF osmolality
b. Decreased ECF volume
c. Increased ICF volume
d.Decreased total body water osmolality

A

b. Decreased ECF volume

82
Q

All of the following can be calculated using the standard equation except:
a. ECF
b. Blood
c. ICF
d. TBW

83
Q

If a mouse is injected with a 0.45% saline solution, what changes would be observed in their ICF?
a. The ICF volume would decrease due to water moving from the ICF compartment to the ECF compartment
b. The ICF volume would increase due to the solution containing more water than sodium
c. The ICF osmolality would increase by 2/3 from the total body water’s osmolality
d. The total osmoles of the ICF would increase by 300 milliosmoles

A

b. The ICF volume would increase due to the solution containing more water than sodium

Physiology: Exam 3 (10 decks)

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