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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
Q

How is fluid intake regulated
(3)

A

Partially regulated by thirst.

If output > input dehydration initiates thirst

Thirst stimulates fluid intake and return to
homeostasis

26
Q

What does dehydration do?
(3)

A

Dryness of the mouth

Wrinkling of skin

Increase osmotic pressure

27
Q

What are electrolytes
(4)

A

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
Q

What are the functions of electrolytes?
(4)

A

As essential minerals in the diet.

To control osmosis.

For excitability of nervous and muscle
tissue

To maintain acid/base balance

29
Q

Describe the relationship between electrolytes and osmosis
(4)

A

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
Q

What are the two most common electrolytes

A

Na+

K+

31
Q

What problems surround Na+

A

The most common problems with electrolyte
balance are caused by an imbalance between
gains and losses in Na+

32
Q

What problems surround K+

A

Problems with K+ balance are less common but
significantly more dangerous than those
related to sodium balance

33
Q

Write a note on sodium

A

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)&raquo_space; 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
Q

Write a note on hyponatremia
(5)

A

(low levels of sodium in the blood:
<130mEq/L) results from:
 xs perspiration,
 vomiting, diarrhoea and
 burns
 ingestion of hypotonic fluids

35
Q

How is hyponatremia treated

A

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
Q

List the symptoms of hyponatremia

A

muscular weakness, dizziness, headache
 hypotension
 mental confusion, stupor and coma.
 Treatment includes diuretic use and
infusion of hypertonic salt.

37
Q

What happens if you try to rehydrate without salts

A

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
Q

Write a note on hypernatremia

A

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
Q

Write a note on chloride

A

major extracellular anion
 moves between the ICF and ECF
easily
 reabsorbed with Na+ by Active
Transport

40
Q

What causes hyperchloremia

A

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
Q

What causes hypochloremia

A

xs vomiting
 dehydration

42
Q

What are the symptoms of hypochloremia

A

muscle spasm
◦ alkalosis
◦ depresses respiration
◦ coma

43
Q

What happens in hypokalemia?

A

 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
Q

What happens in hypoerkalemia

A

Muscle depolarises, repolarisation is
inhibited, cardiac contractions become
weak and irregular

45
Q

Write a note on calcium

A

most abundant ion in the body
 found with phosphorus in bone matrix
 98% as bone/teeth

46
Q

What are the functions of calcium

A

◦ bone structure
◦ blood clotting
◦ nervous system function – presynaptic release
of NT
◦ muscle contraction – NB cardiac muscle

47
Q

How is Calcium regulated

A

 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
Q

Write a note on hyppercalcemia
(5)

A

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
Q

Write a note on hypocalcemia

A

 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
Q

Write a note on phosphate

A

 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
Q

Write a note on magnesium

A

 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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