Renal: electrolytes and acid/base Flashcards
percent body fluid in
- males
- females
- infants
- nweborns
males= 60
females=50
kids=60-65
newborn=75-90
which part of the cell has largest amt of TBW
ICF—2/3 of TBW
aka most of the water in our body is INSIDE the cells
ECF contains (2)
interstitial fluid and plasma
water travels from a ____ to ____ solute [ ]
LOW TO HIGH
*establishes equillibrium this way
define osmotic pressure
is what drives osmosis—force that pulls water from areas of low [ ] to high [ ]
define:
- osmole
- osmolality
- osmolarity
osmole= unit of osmotic [ ]
osmolality= osmoles of solute/kg of solvent (osm/kg) AKA number of grams of sugar dissolved in kg of coffee
osmolarity=osmoles of solute/liter of solution (osm/L) aka number of grams of sugar dissovled in a liter of coffee
***osmolality is measured with osmometer— then use osmolality to calculate osmolarity
hydrostatic pressure
pressure exerted by the fluid aka water
oncotic pressure
sodium PULLS on water—-exerts pressure on water—oncotic pressure
*oncotic pressure pushes things towards it
list the forces favoring filtration
capillary hydrostatic pressure (BP)
interstitial oncotic pressure. (water pulling)
focres opposing filtration or forces favoring reabosortion
plasma oncotic pressure
interstitial hydrostaitc pressure
____ is required for water to move b/w ICF and ECF
osmotic gradient
location of high pressure baroreceptors
- role?
- overfilling leads to?
- underfiling leads to?
-bifurcation carotid artery
wall of internal cartoid artery
aortic arch
**respond quickly to changes in arterial cirucaltin and maintain pressure
overfilling leads to natriuresis–>NA+ excretion
underfilling leads to symp activation—NA+ retention
low pressure baroreceptors
- location
- responses ?
- right atrium
* renal response: to low ECF volume- cardiac wall stretch from increased venous return signals CNS to decrease renal sympathetic nerve
- humoral: inhibition of ADH and ACTH and release of ANP—-diuresis
- Cardiopulmonary
* receptors in L ventricle and pulm vasculature
* incr in CVP leads to natriuresis and diminshed symp tone
general causes for edema (5)
- incr capillary hydrostatic pressure (venous obstruction)
- decr plasma oncotic pressure (losses or dim prod of albumin)
- incr cap permeability
- lymph obstruction (lymphedema)
- na retention
cations and anions ICF
CATIONS: K+
ANIONS: phosphate, organic ions
ECF cations and anions
CATIONS: NA+
ANIONS: CL**, bicarb
role of aldosterone
increased reabsoprtion of NA at the distal tubule
natriuretic peptides rle
decrease tubular resoprtion and promotes urinary excretion of NA
RAAS–what activates and deactivates renin
- decrease in perfusion pressure causes the JGA to release RENIN
- Incrs in NACL causes JGA to inhibit RENIN
what regulates thirst
osmolality or osmoreceptors
—they are stim by hyperosmolality, plasma volume depletion—>increase H20 intake
Baroreceptors
–stim by depleted plasma volume—release ADH
when is ADH released
when plasma osmolality is increased OR decrease in circulating blood volume
***increased reabsortiption of water
**also called arginine vasopressin
things that regualte K+ balance
- kidneys
- aldosterone (excretes k+)
- insulin secretion (drive K+ into cell)
- changes in pH
**insulin, epinephrine and alkalosis drive K+ into cell
where is most CA located
-role of CA
bones
*as hydroxyapatite
- structure of bone/teeth
- blood clotting
- hormone secretion
- cell receptor function
- muscle contractions
Phosphate
- mostly located?
- roles
85% in bones
- necessary for high-energy bonds in creatinie phosphate and ATP
- anion buffer
- muscle contraction
what happens to CA levels if phosphate decrease? increase?
[ ] phos decrease—CA INCRS
[ ] phos increase—CA DECRS
*whenver ones goes up, the other will go down
which hormones regulate CA and PHOS
- PTH—>incrs plasma CA levles via kidney reabsorption
- VIT D—> increases Ca absoprtion from GI tract
- Calcitonin—>decrs plasma ca levels
high H+
acidic
low H+
alkaline
acids are formed as end prodcuts of?
proteins
CHO
fat
meabolism
ph below____ and above____= death
below 6.8
above 7.8
acid base equation
CO2+ H20 H2CO3 HCO3- + H+
LUNGS
acid base equation
CO2+ H20—>H2CO3—-> HCO3- + H+
LUNGS. KIDNEYS
bicarb decreases— what hapens to PH
decreases too– becomes acidic
proteins have ___ charge
negative charge
- act as buffers and take up H+ excess
- mainly IC buffer with HGB
normal blood ph
7.35-7.45
metabolic acidosis basic cause
depression of HCO3- or increase in noncarbonic acids
- lactic acidosis
- renal failure
- DKA
- diarrhea
- starvation
COMPENSATION= hyperventillation and renal excretion of excess acid
CM
- HA
- letargy
- kussmaul resps
TX
- ph significantly low— bicarb
- lactate-containing solutions: lactate converted into bicarb in liver
- tx underlying cause
metabolic alkalosis basic cause
elevation of HCO3- usualyl from an excessive loss of metabolic acids
- prolongd vomitting
- GI suctioning
- excessive bicarb intake
- hyperaldosteronism with hypokalemia
- diuretic tx
COMPENSATION
- hypoventilation
- kidneys conserve H+ and eliminate bicarb
CM
- weakness
- muscle cramps
- hyperactive reflexes with signs of hypocalcemia
tx
*cause
normal anion gap
10-12
***focus on 10 for exam
