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2.1 Control and Integrative Physiology > Mairead - Fluid Balance > Flashcards

Mairead - Fluid Balance Flashcards

1
Q

What is fluid balance regulated in association with?

A

Electrolyte balance

Acid/base balance

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2
Q

What does it mean if you are in fluid balance?

A

Fluid in=fluid out

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3
Q

Where does fluid in come from

A

From ingested food and metabolic fluid

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4
Q

Where does fluid out come from

A

Urinary output

Evaporation

Sweat

Faecal output

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5
Q

What are the main differences between ICF and ECF

(4 characteristics of ICF)

A

High K+

High MG++

High PO4-

High protein

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6
Q

What are the main differences between ICF and ECF

(3 characteristics of ECF)

A

High Na+

High Cl-

High HCO3-

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7
Q

Write a note on ECF in fluid balance

A

All homeostatic mechanisms for fluid balance adjust composition of the body fluids response to changes in the ECF not the ICF

The ECF is constantly mixing -> change in one area affect all of the ECF

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8
Q

Where are the receptors for fluid balance
(6)

A

Aortic arch

Carotids

JGA

Medulla oblongata

Hypothalamus

Brainstem

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9
Q

What do receptors for fluid balance respond to?
(2)

A

Change - increase or decrease in blood pressure

Change in osmolarity of the blood and cerebro-spinal fluid

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10
Q

What sensory receptors are responsible for fluid balance

A

Baroreceptors

Chemoreceptors

Osmoreceptors

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11
Q

How is fluid balance altered
(3)

A

Fluid shifts (ECF <-> ICF)

Short term regulation of circulation (ANS and hormones)

Long term restoration of homeostasis (hormones)

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12
Q

Our cells cannot move water by active transport, how is water moved?
(2)

A

Water follows salt

Salts are moved by active transport: H2O follows by osmosis

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13
Q

Give three examples of where water follows salt

A

GIT absorption

Reabsorption in the renal tubule

Production of sweat

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14
Q

When will body H2O or electrolytes rise?
(2)

A

Intake > output

Output < intake

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15
Q

What hormones are involved in renal excretion and thirst (4)

A

Aldosterone (renin-angiotensin pathway)

Anti-diuretic hormone

Atrial and Brain Naturetic Peptide (ANP and BNP)

Adrenaline and noradrenaline also involved if blood pressure is lowered

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16
Q

What does ANP stand for

A

Atrial Naturetic Peptide

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17
Q

What does BNP stand for

A

Brain naturetic peptide

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18
Q

How are hormones involved in regulation
(4)

A

Enhance the short term (ANS) response

Direct the long term response.

A) Affect cardiac output and peripheral
resistance and in the longer term

B) Regulate blood volume and blood
composition

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19
Q

Write a note on how fluid shifts between ECF to ICF
(4)

A

If ECF osmotic concentration decreases; H2O shifts from ECF
to ICF.

This is a water gain and no change in the electrolytes.

The ICF acts as a reservoir (2/3 H2O in ICF).

At first little effect on ICF (larger vol) but may proceed to CVS shock

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20
Q

Give three situations for water loss

A

Following severe perspiration (ex in heat)

With inadequate H2O consumption (elderly),

Following repeated vomiting or diarrhoea

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21
Q

How does the body respond to water loss?
(2)

A

To prevent further fluid loss with ADH and Renin

To stimulate fluid intake

22
Q

How does the body respond to water gain
(3)

A

Inhibiting ADH and Aldosterone,

Increasing renal output and

Avoidance of fluid intake

23
Q

What does a shift of water into the cells do?
(4)

A

This is H2O intoxication and results in confusion, and leads to hallucinations, convulsions, coma and death

Distorts the cells

Changes the solute concentration around enzymes

Disturbs normal cell function.

24
Q

What happens when ECF osmotic concentration increases?
(4)

A

H2O shifts from ICF to ECF.

This is a
water loss, with no change in electrolytes.

The ICF acts as a reservoir (2/3 H2O in
ICF).

If there is a large shift the cell solute
concentration may result in altered cell
function.

25
How is fluid intake regulated (3)
Partially regulated by thirst. If output > input dehydration initiates thirst Thirst stimulates fluid intake and return to homeostasis
26
What does dehydration do? (3)
Dryness of the mouth Wrinkling of skin Increase osmotic pressure
27
What are electrolytes (4)
Inorganic elements of body fluids with at least one ionic bond. Dissociate into cations (positive) and anions (negative). Can conduct electrical current in a solution. Eg acids, bases and salts
28
What are the functions of electrolytes? (4)
As essential minerals in the diet. To control osmosis. For excitability of nervous and muscle tissue To maintain acid/base balance
29
Describe the relationship between electrolytes and osmosis (4)
Electrolytes dissociate Electrolytes have a greater effect on osmosis than a nonelectrolyte solute as it is the number of particles that attract H2O. Total electrolyte balance directly affects water balance. The concentration of individual electrolytes can affect cell function
30
What are the two most common electrolytes
Na+ K+
31
What problems surround Na+
The most common problems with electrolyte balance are caused by an imbalance between gains and losses in Na+
32
What problems surround K+
Problems with K+ balance are less common but significantly more dangerous than those related to sodium balance
33
Write a note on sodium
Represents 90% of all extracellular cations. ◦ Regulated at 132 – 142mEq/L ◦ Important for nervous excitation. ◦ Creates most of the ECF Osmotic pressure. ◦ Dietary Intake (NaCl 18g) >> requirement (NaCl 6g) ◦ Xs excreted by the kidney, with small losses in perspiration. ◦ Regulation by Aldosterone (increases absorption in the distal tubule in exchange for K+ or H+
34
Write a note on hyponatremia (5)
(low levels of sodium in the blood: <130mEq/L) results from:  xs perspiration,  vomiting, diarrhoea and  burns  ingestion of hypotonic fluids
35
How is hyponatremia treated
Sodium imbalances do not alter sodium concentration as water will follow salt.  Regulatory mechanisms change the ECF volume but keep the sodium concentration relatively constant.  When [sodium] in blood is reduced ADH is inhibited and water is excreted.  When [sodium] in the blood is increased, ADH is released to conserve water and homeostasis is restored
36
List the symptoms of hyponatremia
muscular weakness, dizziness, headache  hypotension  mental confusion, stupor and coma.  Treatment includes diuretic use and infusion of hypertonic salt.
37
What happens if you try to rehydrate without salts
Decreased Na+ in ECF  Decreased ECF osmotic pressure  Decreased interstitial osmotic pressure  Water moves from the plasma to interstitial fluid.  Plasma volume decreases and this may lead to :  Circulatory shock.  Water may also move to the ICF and cause overhydration (intoxification) of cells
38
Write a note on hypernatremia
high blood sodium, >150mEq/L  results from dehydration.  Symptoms include: ◦ Thirst ◦ dryness of mouth ◦ reduced blood volume and pressure ◦ may proceed to circulatory collapse.  Treatment includes ingestion of water or intravenous infusion of hypotonic solution
39
Write a note on chloride
major extracellular anion  moves between the ICF and ECF easily  reabsorbed with Na+ by Active Transport
40
What causes hyperchloremia
Dietary xs or  increased chloride retention  Symptoms include Acidosis (Cl- moves into the RBC in exchange for HCO3-). (Metabolic acidosis in late stage diabetes)
41
What causes hypochloremia
xs vomiting  dehydration
42
What are the symptoms of hypochloremia
muscle spasm ◦ alkalosis ◦ depresses respiration ◦ coma
43
What happens in hypokalemia?
 Membrane hyperpolarisation occurs and they become less responsive to stimulation.  Nodal cells become hyperpolarized, this slows the heart rate, decreases cardiac output and blood pressure falls.  In severe cases the heart may stop
44
What happens in hypoerkalemia
Muscle depolarises, repolarisation is inhibited, cardiac contractions become weak and irregular
45
Write a note on calcium
most abundant ion in the body  found with phosphorus in bone matrix  98% as bone/teeth
46
What are the functions of calcium
◦ bone structure ◦ blood clotting ◦ nervous system function – presynaptic release of NT ◦ muscle contraction – NB cardiac muscle
47
How is Calcium regulated
 Calcium is regulated by Parathyroid hormone (PTH), Calcitonin and Calcitriol  PTH and Calcitriol increase the release of Ca++ from the bone and increase the absorption of calcium from the GIT.  Calcitonin (from the thyroid C cells) decreases blood Ca++ by increasing the absorption of calcium by bone
48
Write a note on hyppercalcemia (5)
Calcium elevated.  Cardiac muscle cells become extremely excitable, in extreme cases the muscle may enter an extended state of contraction.  Contractions of skeletal muscle become powerful and prolonged.  Calcification of the kidney and connective tissue.  Caused by hyperparathyroidism, Vit D toxicity, XS calcium supplements
49
Write a note on hypocalcemia
 Calcium lowered  Contractions of the heart become weak and may cease  Very rare condition  Symptoms include skeletal muscle spasm, osteoporosis., intestinal cramps.  Causes include poor diet, lack of Vit D, hypoparathyroidism, hypomagnesia
50
Write a note on phosphate
 85% in bone as Ca10(PO4)6(OH)2  mainly intracellular.  Rest combines with:  Lipids  Protein  CHO  Nucleic acids  ATP/ADP  Buffer  Regulated by the PTH, Calcitriol and Calcitonin in a similar manner to Calcium.
51
Write a note on magnesium
 50% in bone, 45% intracellular and 5% in the ECF  Acts as a Co-enzyme  Important in nervous function.  Regulated by Aldosterone, increases Mg+ + reabsorption.

2.1 Control and Integrative Physiology (21 decks)

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