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Renal Exam 1 > (3) Physiology of Body Fluid (Walker) > Flashcards

(3) Physiology of Body Fluid (Walker) Flashcards

(54 cards)

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1
Q

What is the main function of the kidney?

A

Regulate the volume and composition of the body fluids within narrow limits

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2
Q

How do you calculate total body water (TBW)?

A

0.6 x Body weight (kg)

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3
Q

How do you calculate extracellular fluid (ECF)?

A

0.2 x body weight (kg)

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4
Q

How do you calculate intracellular fluid (ICF)?

A

0.4 x body weight (kg)

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5
Q

What is the 60-40-20 rule?

A

60% of body weight is total body water

40% of body weight or 2/3 of total body water is intracellular fluid (ICF)

20% of body weight or 1/3 of total body water is extracellular fluid (ECF)

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6
Q

How is extracellular fluid (ECF) further divided?

A

Interstitial fluid (75%)

Plasma (25%)

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7
Q

______ is an intermediary b/w cells and the external enviornment

All exchanges of H2O and other constituents b/w ICF and the external world must occur through the ________

Water added to the body fluids always enters the _____ compartment first, and fluid always leaves the body via the ______

A

Extracellular fluid (ECF)

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8
Q

What is third spacing?

A

Too much fluid shifts from the blood vessels (intravascular) into the non-functional area of the cells

***Third spacing is problematic, fluid is being lost from the intravascular space

*See in burn victims

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9
Q

Describe osmosis

A

Water moves from an area of higher concentration of water (more dilute solution, lower solute concentration)

TO

Area of lower concentration of water (more concentrated solution, higher solute concentration)

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10
Q

What is the major(s) ion in the extracellular fluid?

What is the major(s) ion in the intracellular fluid?

A

Extracellular = Na+ and Cl-

Intracellular = K+

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11
Q

Define:

Nonelectrolytes

A

Contain covalent bonds that prevent them from dissociating in solution and therefore have no electrical charge

egs: glucose, lipids, and urea

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12
Q

Define:

Electrolytes

A

Dissociate into ions (ionize) in water

egs: Mg+, Na+, Cl-, K+

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13
Q

T/F

Electrolytes have a lower osmotic power than nonelectrolytes

A

FALSE!!!

Electrolytes have a higher osmotic power than nonelectrolytes because each electrolyte molecule dissociates into at least two ions

*Electrolytes have a greater ability to cause fluid shift

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14
Q

Write out the normal ranges for the following values

*PAY ATTENTION TO NA+, Cl-, Creatinine, BUN, Serum osmolality

A
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15
Q

Define:

Osmolality

A

Measure of the number of osmotically active particles per kilogram of H2O

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16
Q

Define

Osmolarity

A

The number of osmotically active particles per liter of total solution

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17
Q

Disturbances in plasma

ECF volume loss will result in…

A

INCREASED total plasma protein (concentration)

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18
Q

Disturbances in plasma

ECF volume gain will result in…

A

DECREASED total plasma protein (dilution)

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19
Q

Disturbances in Hematocrit

ICF volume loss will result in:

A

DECREASED hematocrit

(Shrinkage of RBCs)

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20
Q

Disturbances in Hematocrit

ICF volume gain will result in:

A

INCREASED hematocrit

(swelling of RBCs)

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21
Q

What are the indicators used for determining:

Volumes of |

Extracellular Fluid

Plasma

A

Extracellular Fluid = Inulin

Plasma = Radio labeled albumin

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22
Q

*** PRACTICE QUESTION ***

Study These Flashcards
A

Intracellular volume = Increased

Intracellular osmolarity = Decreased

Extracellular volume = Decreased

Extracellular osmolarity=Decreased

Things to note:

Notice that the man is losing 3 L of SWEAT which contains electrolytes. That is different from the water!!!

23
Q

What is the Gibbs-Donnan Effect?

Study These Flashcards
A

The presence of a negatively charged protein on one side of a semipermeable membrane generates both osmotic and electrochemical gradients accross the membrane

24
Q

What would happen if gibbs-donnan effects were not countered?

Study These Flashcards
A

Intracellular proteins would result in an influx of water into the cell

CAUSING cell swelling and death

25
What **counteracts** the Gibbs-donnan effect?
**Na/K+ ATPase pump** _3 Na+ out, 2 K+ in_ Maintains a high Na+ concentration outside the cell
26
Sodium is responsible for the ____ osmotic balance Potassium maintais the ____ osmotic balance
Sodium is responsible for the **ECF** osmotic balance Potassium maintais the **ICF** osmotic balance
27
What is the pressure called that refers to: "the movement of fluids through capillaries as the result of blood pushing against the walls of the capillary"
Hydrostatisc pressure
28
When ______ pressure builds inside a capillary, it forces fluids and solutes out through the capillary walls into the interstitial fluid
When **hydrostatic pressure** pressure builds inside a capillary, it forces fluids and solutes out through the capillary walls into the interstitial fluid
29
"The pulling force of albumin in the intravascular space attracts water and holds it inside the blood vessel. This is referred to as \_\_\_\_\_\_\_\_\_\_"
Plasma colloid **oncotic pressure**
30
Describe with osmotic and hydrostatic pressures what is occuring with **Filtration**
Capillary blood pressure \> Plasma colloid osmotic pressure
31
Describe with osmotic and hydrostatic pressures what is occuring with **Absorption**
Capillary blood pressure \< Colloid osmotic pressure
32
What is **edema?**
Palpable swelling produced by expansion of interstitial fluid volume
33
What is **edema** caused by?
1. Alteration in **capillary hemodynamics** 2. **Renal retention** of dietary Na+ and water expansion of ECF volume
34
How would you calculate **net filtration?**
4 forces contribute (Starling forces) 1. Capillary hydrostatic pressure (blood pressure) 2. Capillary (plasma) oncotic pressure 3. Interstitial hydrostatic pressure 4. Interstitial oncotic pressure
35
What is the **tonicity of a solution?**
The effect the solution has on **cell volume** (Whether the cell remains the same size, swells or shrinks)
36
Cells have a normal NaCl concentration equal to?
0.85%
37
Describe what an **isotonic** solution is
Isotonic-cell enviornment has a NaCl concentration **equal to 0.85%** **\***If cells are placed in isotonic solution, there will be equal movement of water in and out of the cell
38
Describe what a **hypertonic** solution is
Hypertonic cells enviornment has a NaCl concentration **greater than 0.85%** \*If cells are placed in hypertonic solution, there will be a _net movement of water out of the cell_ which will cause the _cell to shrink_
39
Describe what an **hypotonic** solution is
Hypotonic: cells' enviornment has a NaCl concentration less than 0.85% \*If cells are placed in a hypotonic solution, there will be a net movement of water _into the cell_ which will cause the _cell to swell_
40
What are **replacement therapies** used for? What are the two categories?
It's a method for treating fluid and electrolyte alterations by _infusion of I.V. solutions_ 1. Crystalloids 2. Colloids
41
What are **crystalloids?** What are **colloids?**
**Crystalloids**: contains organic or inorganic salts dissolved in sterile water (egs, glucose, sodium chloride, normal saline (0.9% sodium choloride), DOES NOT CROSS PM -\> remains in ECF **Colloids:** contains large molecules that don't pass through semipermeable membranes (eg. albumin)
42
What is the equation for **plasma (serum) osmolarity?**
3 main solutes in the ECF are: Sodium, Glucose, Urea \*normal range = 275 -295 mOsm/kg
43
What are the two ways **dehydration** can be divided?
ACCORDING TO SERUM SODIUM CONCENTRATION Hypernatremic Hyponatremic
44
Describe the state of **hypotonic (hyponatremic) dehydration**
Loss of sodium \> loss of water in ECF Serum [Na+] in ICF \> ECF Water shifts from ECF to ICF to establish osmotic equilibrium \*Serum Na+ and Serum osmolality will be **less than** the normal range
45
Describe the **hypertonic (hypernatremic)** dehydration state
Loss of water \> Loss of Na+ in ECF Serum osmolality will exceed 300mOsm/kg Serum Na+ will be more than 150 mEq/L
46
Serum sodium = 150mEq/L What state are we in?
Hypernatremia Serum sodium above 147-150 mEq/L
47
Serum sodium = 125 mEq/L What state are we in?
Hyponatremia Serum sodium level below 130-135 mEq/L
48
What is a **Darrow-Yannet** diagram measuring?
Used to study the **effect** of **various clinical conditions** Such as (dehydration, shock, vomiting, diarrhea) On **osmolality and volume** of **extracellular** and **intracellular fluid** Solid line=normal values Dashed line=change in the volume and osmolality
49
What is occuring in this darrow-yannet diagram?
[Iso-osmotic volume contraction] ACUTE FLUID LOSS (**hemorrhage, diarrhea, vomiting)** _Decrease_ in ECF volume _No change_ in body osmolality and ICF volume
50
What is occuring in this Darrow-yannet diagram?
[Hyperosmotic volume contraction] HYPOTONIC FLUID LOSS (**dehydration, DM, alcoholism)** _Decrease_ in ECF and ICF volume _Increase_ in body osmolality
51
What is occuring in this Darrow-Yannet diagram?
[Isoosmotic volume expansion] Isotonic saline _Increase_ in ECF volume _No change_ in osmolality and ICF volume
52
What is occuring in this Darrow-Yannet diagram?
[Hypo-smotic volume expansion] Gain o hypotonic fluid (conditions like excess water-drinking and SIADH) _Increase_ in ECF and ICF _Decrease_ in Body osmolality
53
\*\*\* Practice Problem \*\*\*
See last few slides in lecture for long explanation lol
54
\*\*\* Practice Problem \*\*\*
C. 0.9% NaCl IV

Renal Exam 1 (8 decks)

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