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Renal - Larmon > Renal - Body Fluid Compartments > Flashcards

Renal - Body Fluid Compartments Flashcards

1
Q

How can water be synthesized by the body?

A

from carbohydrate metabolism

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2
Q

How is water lost from the body

A

insensible loss, sweat loss, loss in feces, loss by kidneys

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3
Q

Extracellular fluid includes

A

interstitial fluid and blood plasma

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4
Q

Intracellular fluid amount

A

28 L

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5
Q

Extracellular fluid amount

A

14 L (intersitial 11 L and plasam 3L)

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6
Q

Most abundant extracellular cation

A

Na

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7
Q

Most abundant extracellular anion

A

Cl

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8
Q

Most abundant Intracellular cation

A

K

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9
Q

Most abundant intracellular anion

A

Phos

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10
Q

When two solutions containing ions are separated by membrane that is permeable to some of the ions and not to others and electrochemical equilibrium is established. Electrical and chemical energies on either side of the membrane are equal and opposite each other.

A

Gibbs Donnan Equilibrium

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11
Q

Gibbs Donnan Equilibrium creates an additional pull on either side of the ______

A

membrane

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12
Q

Review slide 7

A

The principle of conservation of mass

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13
Q

Distribution of fluids between intracellular and extracellular compartments determined by _____ ______ of small solutes

A

osmotic effect

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14
Q

__________ or small ions (i.e. sodium and chloride) determine distribution of fluids across the semi-permable cell membrane

A

electrolytes

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15
Q

________ factors cause fluids to shift between compartments

A

osmotic

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16
Q

RATE OF OSMOSIS - Because cell membranes are relatively impermeable to most solutes but HIGHLY permeable to _____ (i.e selectively permeable), whenever there is a higher concentration of solute on one side of the cell membrane, ______ diffuses across the membrane toward the region of ______ ______ concentration.

A

water / water / higher solute

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17
Q

RATE OF OSMOSIS - Thus, if a solute such as sodium chloride is added to the extracellular fluid, water diffuses rapidly from the _______ through the cell membranes into the _______ fluid until the water concnentration of both sides of the membrane become equal. Conversely, if a solute such as sodium chloride is removed from the extracellular fluid, water diffuses from the extracellular fluid thorught the cell membranes and into the _______.

A

cells / extracellular /cells

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18
Q

The rate of diffusion of WATER is call the rate of _______

A

osmosis

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19
Q

______ is the term defining a specific quantity of moelcules

A

mole

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20
Q

_______ refers to the number of particles in solution rather than molar concentration

A

osmole

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21
Q

One osmole (osm) =

A

1 mole (mol) (6.02 x 10^23)

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22
Q

total number of particles in a solution is measured in ______

A

osmoles

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23
Q

molecules (mole) which contain more than one paritcle dissociate into separate ions when dissolved in solution (osmole). Give an example

A

1 mole of NaCl dissolved into solvent (1L). Concentration of 2 osm/L solution

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24
Q

osmotic activity of solutes in body expressed in milliosmole (mOsm) which equal

A

1/1000 osmole

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25
Q

osmolality

A

osmoles / kg of water

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26
Q

osmolarity

A

osmoles / liter of solution

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27
Q

_______ is the net diffusion of water across a selective membrane

A

osmosis

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28
Q

osmosis is going from a _____ water concentration to a _____ water concentration

A

high / low

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29
Q

____ ______ refers to the amount of pressure required to prevent osmosis

A

osmotic pressure

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30
Q

osmotic pressure OPPOSES _______

A

osmosis

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31
Q

Osmotic pressure of a solution is ________ to the concentration of osmotically active particles

A

proportional

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32
Q

Osmotic pressure is independent of _____ ______

A

molecular size

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33
Q

Molecules which disassociate when dissolved into solution have more _____ ______

A

osmotic effect

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34
Q

Osmolarity of Body fluids FACTS - Interstitial fluid and plasma

A

80% due to sodium and chloride, plasma is 1 mOsm/L > interstital fluid, plasma proteins maintain 20 mmHg greater pressure in capillaries than surrounding tissue

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35
Q

Osmolarity of Intracellular fluid

A

almost 50% due to potassium ions, remainder divided among other intracellular substances, total osmolarity of each compartment @ 300 mOsm/L

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36
Q

Osmolarity should be about ____ of Na

A

twice

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37
Q

Large osmotic pressures can develop across cell membranes with relatively small changes in _____ ______

A

solute concentrations

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38
Q

Small changes in concentration of impermeable solutes cause tremendous changes in ____ ______

A

cell volume

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39
Q

Hypotonic - cell _____

A

swells

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40
Q

Hypertonic - Cell _______

A

shrinks

41
Q

Review slide 17

A

Effects of abnormal fluid conditions

42
Q

Hyponatremia

A

excess water and loss of sodium

43
Q

hypnoatremia conditons

A

diarrhea and vomiting, diuretic abuse, Addison’s disease, excess water retention (ADH)

44
Q

Hypernatremia

A

loss of water and Excess sodium

45
Q

Hypernatremia conditons

A

Lack of ADH, diabetes insipidus, dehydration, aldosterone secretion

46
Q

Review slide 19

A

Na abnormalities

47
Q

Rapid chagnes in cell volume as a result of hyponatremia can have profound effects on tissue and organ function, especially the ______. A rapid reduction in plasma sodium concentration, for example, can cause brain cell _____ and neurological symptoms, including headache, nausea and disorientation.

A

brain / edema

48
Q

If plasma soidum concentration rapidly falls below ___ to ____ mOsm/L, brain swelling may lead to seizures, coma, damage, death. Brain can’t increase its volume by more than ___% without it being forced down neck (herniation)

A

115 to 120 / 10%

49
Q

Causes of hypernatremia

A

water loss OR excess sodium

50
Q

Primary loss of water from the extracellular fluid result in ________ and ________

A

hypernatremia / dehydration

51
Q

ADH helps the kidneys to ________ water

A

conserve

52
Q

An inability to secrete ADH, which is needed to conserve water. As a result of lack of ADH, the kidneys excrete large amounts of _______ _____, a disorder referred to as _______ ______ ______ which causes dehydration and INCREASED concentration of sodium chloride din the ECF

A

dilute urine / central diabetes insipidus

53
Q

In certain types of renal diseases, the kidneys can’t respond to ADH, causing a type of ________ _______ _______

A

nephrogenic diabetes insipidus

54
Q

Hypernatremia can also occur when excessive sodium chloride is added to the ______ ________. This often results in _________-________ because excess extracellular sodium chloride is usually associated with at least some degreee of _______ __________ by the kidneys as well.

A

extraceullular fluid / hypernatremia-overhydration / water retention

55
Q

Excessive secrertion of the sodium-retaining hormone ___________ can cause mild degree of hypernatremia and overhydration

A

aldosterone

56
Q

Sodium retention caused by increased aldosterone secretion also stimulates secretion of ADH and causes the _______ to also reabsorb greater amounts of water

A

kidneys

57
Q

Edema is excess fluid body in ______

A

tissue

58
Q

Edema occurs mostly in the _______ _________ ________

A

extraceullular fluid compartment

59
Q

T/F Intraceullular edema can occur in certain condtions

A

TRUE

60
Q

What are the 3 conditions prone to cause INTRACELLULAR swelling?

A

hyponatremia, depression of the metabolic systes of the tissues, AND lack of adequate nutrition to the cells (from decreased blood flow which reduces oxygen and nutrient supply)

61
Q

As it relates to Intracellular edema, inflammation has a direct effect on increasing cell membrane _________.

A

permeability

62
Q

Ionic pumps of cell membrane require oxidative metabolism (ATP) to remove ______ _______

A

intracellular sodium

63
Q

Two general causes for extracellular edema

A

abnormal leakage from plasma AND lymphatic failure to return fluids to blood

64
Q

Abnormal leakage from plasma can be due to excessive capillary filtration rate, which filtration is dependent on ________ and _____ ______ of capillary, AND ________ pressure and _________ osmotic pressure

A

permeability and surface area / hydrostatic / colloid

65
Q

Lymphatic failure to return fluids to blood is caused by lymphatic blockage preventing return of ______ to plasma, increased interstitial ______ _____ _____ , and cancer, surgery, infection (filaria nematodes)

A

proteins / colloid osmotic pressure

66
Q

What do the following cause? Increased capillary filtration coefficient, increased capillary hydrostatic pressure and decreased plasma collooid osmotic pressure

A

increase the capillary filtration rate

67
Q

Extracellular edema as it relates to Increased Capillary Pressure caused by excessive retention of salt and water

A

acute or chronic kidney failure, mineralcorticoid excess

68
Q

Extraceulluar edema as it relates to Increased Capillary Pressure from high venous pressure and venous constriction

A

heart failure, venous obstruction, failure of venous pumps (paralysis of muscles, immobilization of parts of the body, failure of venous valves)

69
Q

Extracellular edema as it relates to Increased Capillary pressure caused by decreased arteriolar resistance

A

excessive body heat, insufficiency of SNS, vasodilator drugs

70
Q

Extracellular edema as it relates to decreased plasma proteins as it relates to loss of proteins in urine

A

nephrotic syndrome

71
Q

Extracellular edema as it relates to decreased plasma proteins from denuded skin areas

A

burns and wounds

72
Q

Extraceulluar edema as it relates to decreased plasma proteins due to failure to produce proteins

A

liver disease and serous protein or caloric malnutrition

73
Q

Extracellular edema as it relates to increased capillary permeability

A

immune reactions that cause release of histamine and other immune products, toxins, bacterial infections, vitamin deficiency (especially Vit C), prolonged ischemia, Burns

74
Q

Extracellular edema as it relates to blockage of lymph return

A

cancer, infections, (filaria nematodes), surgery, congential absence or abnormality of lymphatic vessels

75
Q

When edema is caused by heart failure, the heart fails to pump blood normally from the veins into the arteries, which raises venous pressure and capillary pressure, causing increased ______ ______

A

capillary filtration

76
Q

With edema caused by heart failure, the arterial pressure tends to _______, causing decreased excretion of _____ and ______ by the kidneys, which causes still more edema

A

fall / salt / water

77
Q

With edema caused by heart failure, blood flow to the kidneys is reducedd and this reduced blood flow stimulates secretion of ______, causing increased formation of ____________ and increased secretion of _______, both of which cause additional salt and water ______ by the kidneys.

A

renin / angiotensin II / aldosterone / retention

78
Q

Capillary pressure can ______ before significant edema occcurs

A

double

79
Q

Three major factors that prevent edema

A

low interstitial compliance ( -3 mmHg), ability to increase lymphatic drainage, “wash down” of interstitial fluid proteins (as lymphatic flow increases proteins are WASHED AWAY)

80
Q

total safety factor against edema is about ______ mmHG

A

17 mmHg

81
Q

Kidneys are responsible for what?

A

regulation of fluid volume and body fluid composition, excretion of metabolic waste and foreign chemicals, secretion of certain hormones

82
Q

Plasma filtration happens in the _________

A

glomerulus

83
Q

The kidneys receive ____% of the cardiac output which is about ______ ml/min

A

22% / 1100 ml/min

84
Q

Renal blood flow path

A

Renal artery -> segmental arteries -> interlobar arteries -> arcurate arteries -> interlobular arteries -> afferent arterioles -> glomerular capillaries

85
Q

Oxygen consumption in the kidney varies directly with active transport of ____

A

Na+

86
Q

Highest metabolism is in the _____ ______

A

renal cortex

87
Q

On a per gram basis, renal blood flow is the _______ of any organ

A

highest

88
Q

A-V 02 difference gives information on oxygen uptake which is ____ml/L in the kidney, ___ml/L skeletal muscle and ___ml/L in heart

A

14 / 60 / 140

89
Q

The kidneys do not need a lot of oxygen but they do need a lot of _____ _____

A

blood flow

90
Q

The functional unit of the kidney

A

nephron

91
Q

Each kidney has _____ nephrons

A

1.25 million

92
Q

Two types of nephrons

A

cortical and juxtamedullary

93
Q

Cortical nephrons have short ____ ____ _____ and outnumber juxtamedullary nephrons __:___

A

loops of henle / 7:1

94
Q

Juxtamedullary nephrons extend deep into the ______ with LONG ____ ____ ______ and play a big role in ________ urine

A

medulla / loops of henle / concentrating

95
Q

LOH has a THIN ______ loop and THICK ________ loop

A

descending / ascending

96
Q

The bowman’s capsule is a funnel-like structure and considered the _____ of the nephron

A

beginning

97
Q

The glomerulus is a ____ pressure capillary bed and is the site of _____ ____

A

high / blood filtration

98
Q

Each nephron has it’s own indepenent ____ ______

A

blood supply (renal arterioles and veins)

Renal - Larmon (3 decks)

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