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Physi CA1 Cram > Repeat Note > Flashcards

Repeat Note Flashcards

1
Q

What is % of TBW?

A

60%

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2
Q

What part of TBW is in ICF

A

2/3

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3
Q

What part of TBW is ECF

A

1/3

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4
Q

What are the compartments of ECF

A

Interstitial fluid = 75%
Plasma = 25%

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5
Q

What are the Physiological variations in total body water (TBW)

A

Age - TBW as % of body weight decreases with age.
At birth TBW - 80-85% of body weight.
Sex - male > female (adult male- 60-65% , female 40-45%)
Fat content - greater fat content lesser the TBW as a % of body weight.

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6
Q

Why infants are more prone to dehydrate than adults?

A

o Higher proportion of ECF water than adults - ECF is readily exchangeable
and relatively smaller fluid reserves in ICF
o Greater surface area relative to size and therefore more water loss
through skin
o Increased metabolic rate
o Immature kidney function - less concentration ability and requires more
fluid to excrete waste

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7
Q

Most abundant cation in ECF?

A

Na+

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8
Q

Most abundance cation in ICF?

A

K

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9
Q

Most abundant anion in ECF

A

Cl-
HCO3-

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10
Q

Most abundant anion in ICF

A

proteins
, organic phosphate

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11
Q

Explain tissue formation

A

Passage of substances across a capillary membrane occurs by,

  • diffusion
  • vesicular transport
  • filtration : the process by which fluid is forced through a membrane or other barrier because of a difference in pressure on the two sides.
    The amount filtered depends on,
    • Pressure difference
    • Surface area
    • Permeability
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12
Q

What is Starling Forces

A

Forces that maintain the movement of fluid across the capillary membrane.
 Hydrostatic pressure in capillary & interstitium
 Oncotic pressure in capillary & interstitium (mainly determined by
albumin)

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13
Q

What is oedema & 7 causes

A

Oedema is abnormal accumulation of fluid in interstitial space. It depends on,
• Capillary hydrostatic pressure
• Interstitial hydrostatic pressure
• Oncotic pressure
• Capillary filtration co efficient
• Number of active capillaries
• Lymph flow
• Total ECF volume

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14
Q

4 reasons for oedema

A
  1. Increase capillary pressure
    • Excessive kidney retention of salt and water
    • High venous pressure
    o Heart failure eg. Right ventricular disease, congestive cardiac failure
    o Local venous block
    o Failure of venous pumps
    • Decreased arteriolar resistance
    o Excessive body heat
    o Paralysis of the sympathetic nervous system o Effects of vasodilator drugs
  2. Decrease plasma proteins
    • Loss of proteins in urine eg. Nephrotic syndrome
    • Loss of proteins from denuded skin areas o Burns
    o Wounds
    • Failure to produce proteins
    o Liver disease eg. Cirrhosis
    o Malnutrition
  3. Increase capillary permeability
    • Immune reactions that cause release of histamine or other immune products eg. Bee stings
    • Toxins
    • Bacterial infections
    • Vitamin deficiency (vit c)
    • Prolonged ischemia
    • Burns
  4. Blockage of lymph return
    • Blockage of lymph nodes by cancer
    • Infections eg. Filariasis
    • Congenital absence of or abnormality of lymph vessels
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15
Q

2 types of Transport mechanism in the body.

A

Passive and active transport

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16
Q

3 types os passive transport

A

Passive transports - molecules are moved across plasma membrane along, down, or with their concentration gradients
- Energy is not necessary
• Diffusion - eg: non polar compounds, small molecules such as CO2 , H2O
• Facilitiated diffusion - cell membrane proteins working as carriers
• Osmosis

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17
Q

3 types of active transport

A

molecules are moved against their concentration gradient - need energy
 Primary active - eg. Na+/K+ ATPase, Ca2+ ATPase, H+/ K+ ATPase  Secondary active - eg. Na+ / Glucose cotransport
 Vesicular transport - eg. Exocytosis, endocytosis

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18
Q

5 factors affecting simple diffusion

A

• Cross sectional area of the membrane
• Permeability of the membrane to the substances
• Thickness of membrane
• Concentration gradient
• Temperature

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19
Q

4 comparisons of facilitated diffusion to simple diffusion

A
  1. Has higher rate of substance transfer
  2. Reaches saturation at higher substrate concentration 7. Has higher specificity
  3. Show competitive inhibition
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20
Q

What is plasma osmolality

A

Plasma osmolality = 280-295 mosm/L

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21
Q

What is osmolality

A

✓ Osmolality (Osm/L)- Number of osmoles per litre of solution.

Osmolality = 2Na+ + 0.055glucose + 0.36BUN

22
Q

What is BUN

A

BUN = [Blood Urea] * 28/60

23
Q

5 things osmolality depends on

A

Osmolality depends on,
• Na+ concentration
• Glucose concentration
• BUN level
• Temperature
• Volume

24
Q

What os mole

A

✓ Mole- The gram molecular weight of a substance.

25
Q

Wit is osmole

A

✓ Osmole- Gram molecular weight of a substance/No of freely moving
particles

26
Q

What is osmolarity

A

✓ Osmolarity (Osm/kg)- Number of osmoles per kg of solvent.

27
Q

What is tonicity

A

Tonicity- osmolality of a solution in relation to plasma.

28
Q

Wht is dehydration and 3 types

A

Dehydration - Loss of fluid from body.
1. Isotonic
2. Hypertonic
3. Hypotonic

29
Q

What is isotonic dehydration

A

Loss of water and electrolytes in equal proportion. Eg. Haemorrhage, vomiting, diarrhea

    Treatment- replace the loss of isotonic solution Eg. 0.9% saline, Hartmann's solution,5% dextros

Volume of ECF decreases but no change in ECF osmolality
No change in osmolality or volume of ICF
No H20 movement

30
Q

What is hypertonic dehydration

A

Loss of water excess of solutes. Eg. Fever, severe sweating

Treatment is infusion of hypotonic solution Eg. 5% dextrose (later become hypotonic), 0.45% saline

Volume of ECF and ICF decrease and their osmolality decreases
H2O moves from ICF to ECF

31
Q

What is ❖ Hypotonic dehydration:

A

Loss of electrolytes in excess water. Water moves into cells- swelling of cells. Eg. Excess use of diuretics

Treatment is hypertonic saline

Less vol in ECF and more in ICF so less osmolality
H2O moves from ECF to ICF

32
Q

Hw to measure volume of TBW

A
  • D2O/ heavy water, T2O
33
Q

Hw to measure volume of ECF

A

Inulin, sucrose, mannitol, Cl-/ Br-/SCN-

34
Q

Hw to measure plasma volume

A

Evans blue, serum albumin with labelled radioactive iodine

35
Q

How to measure ICF

A

TBW - ECF = ICF

36
Q

How to measure Interstital fluid volume

A

ECF - Plasma volume

37
Q

How to find Total blood volume

A

Plasma volume * 100/ ( 100 - hematocrit )

38
Q

Normal plasma pH

A

pH 7.35 -7.45

39
Q

What are 3 BLOOD BUFFERS

A

carbonic acid- bicarbonate
Proteins
Hb

40
Q

What are Interstitial fluid buffer

A

carbonic acid - bicarbonate

41
Q

What are 2 ICF buffers

A

proteins
Phosphates

42
Q

4 types of acid base imbalances and their names and consequences

A

Respiratory Alkalosis: deficit in carbonic acid in the ECF Eg. Alveolar hyperventilation
Respiratory Acidosis: excess in carbonic acid in the ECF
Metabolic Alkalosis: excess of bicarbonate in the ECF Eg. Vomiting
Metabolic Acidosis: deficit of bicarbonate in ECF Eg. Diarrhea

43
Q

Explain the physiological basis of giving normal saline to a patient with isosmotic dehydration

A

• Dehydration is a decrease in ECF volume due to loss of H2O and solutes. In isosmotic dehydration loss of H2O equal to loss of solutes.
• Causes for isotonic dehydration are hemorrhage, diarrhea, vomiting, and burns.
• Loss of isotonic fluid from plasma causes a loss of fluid from interstitium to plasma to maintain hydrostatic balance between the compartments. But there is no change in the osmolality of ECF compartment because of fluid lost is isotonic.
• Thus there is no fluid shift into or out of ICF as there is no change in ECF osmolality.
• Normal saline (0.9%NaCl) is given as treatment in isotonic dehydration as it is an isotonic solution itself.
• Infusion of 1L is remain in ECF. 1/4 in plasma & 3/4 in interstitium.
• In isotonic dehydration fluid is lost from ECF and normal saline is given
to replace the fluid loss as it will be distributed only in ECF.

44
Q

. If 1.5L of 5% dextrose is administered intravenously to a healthy adult. Outline its distribution in different body compartments.

A

 5% dextrose solution is initially isotonic but after glucose is metabolized becomes hypotonic solution.

 So hypotonic over hydration.
ECF
Volume inc
Osmolality dec.
1.5 L of 5% dextrose (hypotonic)
ICF
Volume inc
Osmolality dec.
Net movement ecf to icf
ICF (40%)
ECF (20%)
Plasma (5%)
Insterstitium ( 15%)

45
Q

. Explain why the children are more prone to be dehydrated compared to adult.

A

• Dehydration is reduction of body water level in the ECF sometimes accompanied with ICF due to excessive water loss or lack of water intake.
• TBW in adult 60% of body weight
• TBW in infant 80- 85% of body weight
• In adults ICF volume > ECF volume.
• But in children ICF volume = ECF volume
• So greater proportion in ECF compartment
• ECF is exchangeable. So the water content in ECF rapidly falls down in
dehydration state followed by ICF.
• Therefore in a dehydrated state the volume of water a children loss is
more compared to the TBW.
• Other reasons,
• Greater surface area relative to size and therefore more water loss
through skin.
• Increased metabolic rate.
• Immature kidney function.
- Less concentration ability and requires more fluid to excrete waste
- Inability to secrete sufficient ADH & aldosterone due to less efficiency of infant kidneys.

46
Q

Explain muscle composition of muscles

A

Fibers → Myofibrils→ Myofilaments-> Thin(actin) filaments ->Thick(myosin) filaments

47
Q

What is sarcomere

A

Portion of myofibril between two adjacent Z lines
Smallest contractile unit of a striated muscle

48
Q

What do sarcomeres consist of

A
  1. Thin actin filaments.- helical protein chains
    2.Thick/myosin filaments -Have a tail and two heads.The head acts as an actin binding site and a catalytic site( that bind to ATP)
49
Q

What does Thin/actin filaments consist of

A

Tropomyosin- rod like protein that covers the myosin binding sites of actin
Troponin-globular protein, 3 subunits
T- binds troponin to tropomyosin
I- inhibit the interaction between actin and myosin
C- binding site of Ca2+

50
Q

Wut r Transverse tubules(T-tubules)

A

Transverse tubules(T-tubules)- Tubular extensions of sarcolemma that facilitate p assage of nerve message directly to sarcoplasmic reticulum.(SR)Well developed T
tubules at A-I junctions with SR forms a triad.

51
Q

What is SR

A

Sarcoplasmic reticulum(SR) –Maintains a high Ca2+ level in SR and low Ca2+ in cy toplasm. Membrane has special Ca2+ channels for release and reuptake of Ca2+

Physi CA1 Cram (2 decks)

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