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Phys and Pharm > Water and Electrolyte Balance > Flashcards

Water and Electrolyte Balance Flashcards

1
Q

Total body water (TBW) is about 42L. ______ of body weight in healthy adult males. ______ of body weight in healthy adult females.

A

60%, 50%

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2
Q

________ have the highest percentage of TBW until the age of ______

A

infants, 2

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3
Q

TBW declines with ________

A

aging

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4
Q

TBW ______ as fat percentages ______

A

declines, increase

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5
Q

2/3 of TBW is ____________ which consists of fluid contained with all of the cells in the body. What is it regulated by?______% of body weight/28L

A

intracellular fluid volume (ICFV)
It is regulated by proteins and organic compounds in ICF and solutes that move between compartments.
40%

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6
Q

1/3 of TBW is ____________, all fluids outside of the cell. This is broken down into 3 additional categories which are what?

A

Extracellular Fluid Volume (ECFV)

  1. Interstitial fluid volume = 3/4 ECFV
    ***15% of body weight/10L
  2. Plasma/Vascular volume = 1/4 ECFV
    ***4% of body weight/3.5L
  3. Transcellular volume = typically inconsequential/1L
    ***Increases in this compartment called third-spacing
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7
Q

When looking at electrolytes/water we can only measure ________ most of the time.

A

plasma (1/4)

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8
Q

What are fluid requirements?

A

Usually require 35 ml/kg/day or 100mL per 100 kcal metabolized
Dissolving and eliminating metabolic wastes

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9
Q

Loss of fluid is relatively stable. It increases during which factors?

A
  1. fever states
  2. diarrhea
  3. sweating a lot
  4. certain renal diseases
  5. significantly increased respiratory rate
  6. wounds
  7. increases in metabolic rate
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10
Q

What are sources of fluid gain?

A

liquid, in food, water generated in metabolic processes

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11
Q

What are sources of fluid loss?

A

renal (obligatory urine output), GI tract, insensible losses (skin, lungs)

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12
Q

___________ is the primary barrier to movement between compartments. ________ substances pass directly by dissolving into the lipid layer.

A

cell membrane, lipid soluble

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13
Q

Water passes through by ________ through ______ protein channels

A

osmosis, aquaporin

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14
Q

Ions require active transport such as the _____________

A

Na+/K+ ATPase

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15
Q

Osmosis

A

movement of water across a semi-permeable membrane
Generates a pressure called osmotic pressure

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16
Q

Diffusion

A

movement of particles along a concentration gradient (charged or uncharged particles)
-Molecules are in constant motion
-Move from area of higher to lower concentration

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17
Q

Transfer of water between vascular space and interstitium occurs at a capillary level. It is controlled by 4 forces:

A
  1. Capillary filtration pressure/capillary hydrostatic pressure: pushes water out of capillary and into interstitial space
  2. Capillary colloidal osmotic (oncotic) pressure: pulls water back into capillary
  3. Interstitial fluid (hydrostatic) pressure: opposes movement of water out of capillary (pushing water into interstitium)
  4. Tissue colloidal osmotic pressure/interstitial oncotic pressure: pulls water out of capillary into interstitial spaces
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18
Q

_________ is the unit of measure for the amount of a substance. It is used as a way to express amounts of reactants and products in chemical reactions.

A

moles.
i.e. 2 H2 + 02 = 2 H20 (2 moles of H2 and 1 mole of O2 will react to form 2 moles of water)

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19
Q

What are osmoles?

A

-number of moles of solute that contribute to the osmotic pressure of a solution

-Depends on dissolution in solution

i.e. NaCl dissolutes in serum creating 1 mole of Na+ and 1 mole of Cl- where as glucose does not dissolve and remains one mole.

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20
Q

What is osmotic activity?

A

the force that nondiffusable particles exert in pulling water from one side of a membrane to another

-Expressed in osmolarity/osmolality

-Influenced by number of particles NOT size or weight

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21
Q

Osmolarity/osmotic concentration

A

measure of solute concentration, number of osmoles of solute per liter of solution
Osm/L
Allows the measurement of the osmotic pressure of a solution
Determines how the solvent will diffuse across a semipermeable membrane

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22
Q

Osmolality

A

measures the body’s water/electrolyte balance
Osm/kg

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23
Q

_______ is often used for fluids outside the body

A

osmolarity

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24
Q

slide 10 (look at notes section)

A
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25
Q

Tonicity

A

the effect that the osmotic pressure of a solution with impermeable solutes exerts on cell size due to water movement across the cell membrane

Determined by effective solutes that cannot penetrate the cell membrane
i.e. glucose

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26
Q

In water balance regulation, what does the need for increased volume stimulate?

A

stimulates thirst mechanism to increase water ingestion. Conscious sensation of the need to drink fluids high in water content

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27
Q

ADH Increases in water reabsorption by the kidneys controlled primarily by ___________: Antidiuretic hormone

A

ADH/Vasopression

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28
Q

ADH is produced by the ______ and released by ________

A

hypothalamus, posterior pituitary

29
Q

ADH controls ________ of water by kidneys

A

reabsorption

30
Q

What are the 2 vasopressin receptors ?

A

V1 in smooth muscle causes vasoconstriction

V2 in tubular cells of collecting ducts increases permeability of the collecting duct to water by influencing aquaporins

31
Q

What is ADH regulation stimulated by?

A
  1. Osmoreceptors that sense increases in serum osmolality
  2. Stretch receptors that sense decrease in blood volume
  3. Increased glucose levels in the absence of insulin (insulin allows glucose to enter osmoreceptors to make it ineffective osmole)
  4. Nausea, severe pain, surgery, trauma, and certain drugs (pain medications, anesthetics, and nicotine)
32
Q

What is ADH inhibited by?

A
  1. Decreases in serum osmolality
  2. Increases in blood volume
  3. Pregnancy and ovulation (resets the osmotic threshold and can increase ADH catabolism)
  4. Alcohol
  5. Certain drugs
33
Q

ADH is stimulated by?

A

Increases in ECF osmolality
Decreases in ECF volume to maintain fluid balance

34
Q

Increased ADH

A

influences distal tubule/collecting ducts to concentrate urine (water reabsorbed)

35
Q

Decreased ADH

A

sodium is reabsorbed but water is not, so large amounts of dilute urine is produced

36
Q

The amount of sodium excretion is determined by ____________

A

intravascular volume

37
Q

How does the RAAS system regulate water balance?

A

Renin-Angiotensin-Aldosterone System:

Renin is released by kidney in response changes in:
1. Arterial pressure
2. GFR
2. Decreased wall tension in afferent arteriole
3. Decreased salt to distal tubule

Once in circulation converts angiotensinogen to Angiotensin I
Angiotensin I converted to Angiotensin II
Angiotensin II acts on renal tubules to increase sodium resorption, constricts renal blood vessels (decreases GFR to reduce filtered Na and reabsorb more Na)
Regulates Aldosteroneproduced by the adrenal cortex
Aldosterone acts on collecting tubules to increase sodium reabsorption and increase potassium elimination

38
Q

Nonelectrolytes

A

substances that do not dissociate into ions
i.e. glucose and urea

39
Q

Electrolytes

A

substances that dissociate in solution to form charged particles

40
Q

Ions form when electrolytes dissolve. What are the 2 types?

A
  1. Cations have a positive charge (Na+)
    Due to attraction forces, cations are always accompanied by negatively charged ion
  2. Anions have a negative charge (Cl-)
41
Q

In the Extracellular space, _______ is the main electrolyte

A

Na+

42
Q

Electrolytes in the ECF

A

-Large amount of sodium, chloride
-Moderate amounts of bicarbonate
-Very little potassium, magnesium, calcium and phosphate

43
Q

Electrolytes in the ICF

A

large numbers of negatively charged intracellular proteins

-Large amounts of potassium
-Moderate amount of magnesium
-Small amounts of sodium, chloride, bicarbonate and phosphate
-Minimal or absent calcium

44
Q

__________ is the most abundant cation in the body. Mostly found in the _______ and scant amounts in the _______

A

NA+, ECF, ICF

45
Q

NA+ enters the body through the ___________

A

GI tract

46
Q

What eliminates NA+?

A

Kidneys (90%)
GI tract (10%)
Skin (insensible)

47
Q

What are the roles of sodium?

A

-Regulates extracellular and vascular volume

-Na+ and attendant anions (Cl- and HCO3-) account for 95% of osmotic activity in the cell

-As sodium bicarbonate it helps regulate acid-base balance

-Contributes to the function of nervous system as a current carrying cation

48
Q

_______ are extremely efficiency in regulating sodium

A

Kidneys

49
Q

Limited Sodium

A

reabsorbs almost all sodium leading to dilute urine

50
Q

Excess sodium

A

excretes more sodium leading to concentrated urine

51
Q

What are the systems that regulate sodium?

A
  1. SNS- responds to changes in arterial pressure and blood volume by adjusting glomerular filtration rate, regulates tubular reabsorption of sodium and renin release
  2. RAAS system- released by kidney in response to arterial pressure changes, through the pathway leads to aldosterone release which acts on collecting tubules to increase sodium reabsorption and increasing potassium elimination
  3. Atrial Natriuretic Protein (ANP) released by atria in response to atrial stretch and overfilling, leading to increased sodium excretion by the kidney
52
Q

_________Second most abundant cation in the body. Major cation in the _________. ________ concentration is much less.

A

Potassium, ICF, ECF

53
Q

90% of potassium is contained in body __________. Stores as related to ______ and _______. 70% is in _________ (declines with muscle mass)

A

cells, body size, muscle mass, muscle cells

54
Q

Potassium enters the body through the ___________

A

GI tract

55
Q

Potassium is normally eliminated by

A

Kidneys (90%)
Stool and sweat (10%)

56
Q

What is the role of potassium?

A
  1. Distribution between ECF and ICF regulates resting electrical membrane potentials
    **Excitability of nerve and muscle cells
    **    Contractility of skeletal, cardiac, and smooth muscle
  2. Acid-base balance
  3. Contributes to reactions necessary to transform carbohydrates into energy, glucose into glycogen, amino acids to proteins
57
Q

Renal mechanisms conserve or eliminate potassium. How is this done?

A

-Potassium filtered at glomerulus, reabsorbed at the proximal tubule and loop of Henle then secreted into collecting tubules for elimination

-Aldosterone secretion from adrenal is strongly controlled by potassium levels, if present it transports sodium back into blood and secretes potassium for elimination in the urine

-Transcellular buffers that remove potassium from the serum or release it into the serum as needed

-Potassium/Hydrogen ion exchange in collecting tubules
**High potassium leads to hydrogen being reabsorbed and decreasing pH
**Low potassium leads to hydrogen is excreted and pH increases

58
Q

Hypertonic solution

A

: increased concentration
Higher osmolality
Water moves out of cell and cell shrinks

59
Q

Isotonic solution

A

equal concentration
Equal osmolality
Water remains constant, cell is unchanged

60
Q

Hypotonic

A

decreased concentration
Lower osmolality
Water moves into cell and cell swells

61
Q

Water balance regulation is controlled by the thirst centers in the __________. How does it regulate thirst?

A
  1. Cellular dehydration caused by increase in serum osmolality
  2. Decrease in blood volume
  3. Angiotensin II (back up for typical thirst stimulators)
62
Q

Sodium ECF value

A

134-145

63
Q

Sodium ICF value

A

10-14

64
Q

Potassium ECF value

A

3.5-5.0

65
Q

Potassium ICF value

A

140-150

66
Q

Chloride ECF value

A

98-106 mEq/L

67
Q

Chloride ICF value

A

3-4 mEq/L

68
Q

Bicarb ECF value

A

24-31 mEq/L

69
Q

Bicarb ICF value

A

7-10 mEq/L

Phys and Pharm (16 decks)

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