Week 7 - Study Guide Flashcards
Ions in Intracellular
(inside of cells)
Intracellular
K+ ⬆
HPO4 (anion)
Proteins (anionic)
Mg2+
Ions in Interstitial Fluid
(in between the cells and plasma)
Interstitial
Na+
Cl-
HCO3-
Ions in the plasma
(fluid component of the blood)
Plasma
Na+
Cl-
HCO3-
Proteins – (albumin - buffering at bloodstream)
Sodium
Function:
1. Maintaining Blood Volume
2. Regulating ECF volume
3. Distribution
(Na+) is high in ECF
(Cl-) is high in ECF
Transmitting nerve impulses - sodium channels open - depolarization
Contracting muscles - during action potentials
Potassium
Intracellular Cation
a. Maintaining intracellular fluid osmolarity
b. Transmitting nerve impulses = repolarization during nerve impulses. (K+ opens and closes)
c. Skeletal and smooth muscle function. – contraction
Regulating Cardiac impulse transmission. = Heart contracts - K+ important
=Pacemaker cell – K+, Cl-, Na+
Regulating Acid-base Balance
Acidosis = pH⬇, H+⬆
H+ into the cell — K+ out of cell
Driving factor = H+ ⬆ in solution
H+ ➡exchange with K+
Alkalosis = pH⬆, H+⬇
H+ out of cell — K+ into cell
Calcium
- Retained in bones - forming bones and teeth
- Transmitting nerve impulses
Ca2+ allows vesicles to fuse with membrane
Release NT ➡ synapse to bind to receptors
- Regulating muscle contraction
- Blood clotting – cascade of events Ca2+
- Activating enzymes
Magnesium
- Maintaining intracellular metabolism
- Plays a role as a coenzyme in ATP formation
- OPerating Na+/K+ pump
- Mg2+ is bound to ATP to facilitate the breakdown to ADP + Pi
- Relaxing muscle contractions
(Myosin head release requires ATP)
(Ca2+ recycling @ SR requires ATP - active transport)
(Re-establishing resting membrane potential requires ATP)
(⬆Na+ outside, ⬆+ inside) - Transmitting Nerve impulses
(regulating cardiac function uses lots of ATP and magnesium)
Chloride
- producing hydrochloric acid
- In lumen of stomach to facilitate activation of enzymes that digest protein
- Regulating acid-base balance
- Critical to coupled reabsorption of HCO3- and secretions of H+ in the nephrons
- Regulating ECF balance and vascular volume
- Acting as a buffer in oxygen-carbon dioxide exchange RBCs
- Don’t forget the chloride shift
Want to move HCO3- out into bloodstream to act as a buffer at the bloodstream
H+ binds to Hb
Which causes an electrical deficit in RBC
Cl- needs to move in negative ion in/out exchange
Phosphate.
HPO4-
- Forming bones and teeth
- Function of muscle, nerve, and RBC formation
- Regulate acid-base balance (acidification of urine) get rid of excess H+
- Cellular metabolism (DNA & ATP)
- Regular calcium levels
(absorption - osteoclasts)
(Release - osteoblasts) - small % of Ca2+ binds to phosphate (forms of salt)
Bicarbonate
Major Buffer in acid-base regulation
CO2 + H2O ↔ H2CO3 ↔ (H+) + Hco3-
Important electrolytes in homeostasis
Na+, K+, Ca2+
For nervous system functions
Muscle contraction
Universal Solvent
Water
and essential for metabolism because…
Chemical processes occur here
Disruptions in composition impact metabolism
Fluids are …..
- Lubricants
- solvents
- pH regulators
- acid/base balance
- Transfer Route for everything we do
Hypervolemic Hyponatremia
- Feelings of impending doom
- decreased LOC
- Near freshwater drowning
Hypovolemic Hyponatremia
- Hypoaldosteronism
- ⬇Aldosterone
- Diuretics - abuse
- depressed cells
- digestive system not moving
SIADH
hormonal imbalance of ADH
—making ADH when you should not be – because you are well hydrated – not urinating
Hypovolemic hypernatremia
- Diarrhea
2 high fever/Resp Rate.
(constant loss of water associated with resp rate and sweating from fever) - Excitability
- Hallucinations & Delusions
Hypervolemic Hypernatremia
- Hyperaldosteronism
(vasoconstriction)
(hypersecretion from adrenal glands)
(Kidneys will retain Na+ & H2O) - Near drowning in salt water
What does Hypoaldosteronism cause?
Hypovolemic Hyponatremia
What does SIADH cause?
Hypervolemic Hyponatremia
What does diarrhea cause?
Hypovolemic Hypernatremia
What does hyperaldosteronism cause?
Hypervolemic Hypernatremia
What does diuretic abuse cause?
Hypovolemic hyponatremia
Most H+ is produced by…
metabolism
Hypokalemia
- Alkalosis ➡insulin not just glucose - move Glucose and K+ in cell
- Licorice aldosterone mimic (gets rid of K+)
- Cushing’s syndrome - hyperglycemia (cortisol)
(moves K+ and glucose out) - Hyperaldosteronism (lots of Na+ in and K+ out)
Hypokalemia
Depressed
three types of muscles ar affected:
1. Smooth muscle. - digestive slows down
2. Skeletal muscle. - weakness
3. Cardiac muscle - thready, weak pulse, ⬇BP
Hyperkalemia
- Acidosis - Way too much H+ in cell and K+ out of cell
- Transfusion of aged blood
- Crushing injures - pushes K+ out of cell
- Burns and infection – membranes fall apart more K+ out of cell
- Addison’s disease - hypoglycemia/insulin - inability to produce cortisol - ACTH not impacting Aldosterone
- Hypoaldosteronism - cannot hold onto Na+ and H2O; cannot get rid of K+
- Explosive diarrhea
- Paresthesia (tingling of the extremities)
- Ectopic foci - pacemaker - instead of SA node setting something else in the heart took over
What would Nasogastric suctioning cause?
Hypokalemia
What would acidosis cause?
Hyperkalemia
What would Hyperaldosteronism cause?
hypokalemia
What would crushing injury cause?
hyperkalemia
What would alkalosis cause?
Hypokalemia
What would hypoaldosteronism cause?
hyperkalemia
Hypocalcemia
- Inactive parathyroid gland
- Alkalosis (binds to protein plasma)
- carpopedal spasms
positive trousseau’s sign
Hypercalcemia
- hyperparathyroidism. (excessive bone breakdown due to releasing too much Calcium)
- Excessive Vitamin D intake (calcium and vitamin D work together)
- Acidosis - H+ binds Ca2+ unlocks -
- Cancer - cells can secrete substances that dissolve osteoclasts and cause release of calcium
- Calcium is a cotransport
- Depressed cells
Which imbalances would be most likely to cause lower levels of consciousness (LOC)?
a. Hyperkalemia
b. Hyponatremia
c. Hypermagnesmia
d. Hypokalemia
e. hyperphospatemia
f. Hypocalcemia
b. Hyponatremia
c. Hypermagnesmia
d. Hypokalemia
Hypomagnesemia
- Vitamin D and PTH levels are low
- Gastric suctioning
- Athetoid movements
- laryngeal stridor (pitch sound when breathing - so much muscle tension)
- cramping muscles
Hypermagnemsia
- Untreated DKA due to dehydration
- dysarthria
- hypotension
- Depression all over
Hypophosphatemia
- Tx DKA
- Anabolic effects of insulin shifts Mg, K, P, into cells
- Tissue anoxia (DPG not there) - chemical w/o phosphate cannot deliver O2 - reversible binding of O2
Hyperphosphatemia
- Rhabdomyolysis (muscles exploding)
- Chemotherapy for neoplastic disease
- Hyperreflexia due to secondary hypocalcemia
- Crystals in arteries and skin
