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_Physiology Exam 5 > 4/8: I - Body Fluids > Flashcards

4/8: I - Body Fluids Flashcards

1
Q

What is essential for homeostasis?

A

Constant volume and stable composition of body fluid

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2
Q

Water in =

A

water out

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3
Q

Electrolytes in =

A

Electrolytes out

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4
Q

What are ways to gain water?

A

Food and drink
MEtabolism

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5
Q

What are ways to lose water?

A

Skin (sweat)
Lungs (evaporation)
Urine (varies to create balance)
Feces

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6
Q

What does an Na imbalance change?

A

Vascular and total body volumes

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7
Q

What does a K imbalance alter?

A

Cardiac and neural functions

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8
Q

What does a Ca imbalance alter?

A

Skeletal muscle, cardiac, neural function, and bone structure

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9
Q

What does H+ imbalance alter?

A

Multiple systems (mainly from metabolism)

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10
Q

What is total body water volume?

A

42L about 60% bod y weight
- 40% in intracellular fluid
- 20% in extracellular fluid

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11
Q

What is the extracellular fluid 20% comprised of?

A

ISF (75%)
Plasma (25%)
- composition of two are almost identical but plasma contains more protiens than ISF

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12
Q

What is the capillary membrane a barrier for?

A

Plasma and ISF

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13
Q

What is the cell membrane a barrier for?

A

ICF and ECF

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14
Q

What substance is high outside the cell? (extracellular conc.)

A
  • Sodium (Na)
  • Calcium (Ca)
  • Chlorine (Cl)
  • HCO3 (bicarbonate)
  • Glucose
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15
Q

What substance is high inside the cell (Intracellular concenration)

A

MAPPP
- magnesium
- amino acids
- potassium (K)
- phosphate
- proteins

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16
Q

What is the pH extracellularly?

A

pH: higher. 7.4 (more basic than intracellular, less H+)

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17
Q

What is the pH intracellularly?

A

pH: lower. 7.0 (more acidic than extracellular, more H+)

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18
Q

Describe how the plasma and ISF mix rapidly?

A

(except proteins will stay within the plasma)
- Movement of this fluid is down Starling forces: using Hydrostatic and colloid osmotic pressure via capillary pores is main force that will move fluid via bulk flow

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19
Q

How is fluid distribution between ICF and ECF determiend?

A

determined by osmotic effect of small solutes acting across cell membrane

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20
Q

What make up about 90% of total ECF osmolarity?

A

Na+ and Cl-

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21
Q

What makes up 90% of total ICF osmolarity?

A

K+ and other ions

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22
Q

What is cell membrane highly permeable to?

A

H2O

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23
Q

What is cell membrane impermeable to?

A

Small solutes (Na, Cl, and other electrolytes)

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24
Q

Describe the extracellular osmolarity and cell volume

A

Constantly challenged in our daily life (by food, drinks, lack of eating/drinking) and by conditions/illnesses (vomiting, diarrhea, burns and other skin loss, sweating, and renal disease)
- We have reflexes (in the kidney) that help eliminate any of the above changes so we can reestablish homeostasis in the resting state

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25
Q

What does the composition and volume of the ECF change determine?

A

composition and volume of fluid replacement

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26
Q

What happens when the cell is placed in a hypertonic solution?

A

Cell shrinks

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27
Q

What happens when the cell is placed in an isotonic solution?

A

No change in volume

28
Q

What happens when the cell is placed in a hypotonic solution?

A

Cell swells

29
Q

Describe IV infusion for when adding isotonic NaCl solution

A

fluid enters into the ECF and will expand ECF volume. Since it is isotonic, it will not change the osmolarity and will not have any volume shifts between ICF and ECF

30
Q

Describe IV infusion for when adding hypertonic NaCl solution

A

fluid would enter into the ECF and would expand ECF volume and tonicity. As tonicity increases, causes water to move from ICF to ECF (reduced ICF volume, making it more concentrated so raises osmolarity)
Increase ECF volume
Decrease ICF volume
Increase ECF osmolarity
Increase ECF osmolarity

31
Q

Describe IV infusion for when adding hypotonic NaCl solution

A

fluid would enter ECF and would expand ECF volume and dilute it therefore decreasing osmolarity. Causes water to shift into cells expanding ICF and diluting its concentration
Increase ECF volume
Increase ICF volume
Decrease ECF osmolarity
Decrease ICF osmolarity

32
Q

How would ECF and ICF volume and osmolarity change in an individual that has lost a hypotonic solution from ECF?

A

Now talking away volume. If we were to lose fluid from the body (plasma) this reduces ECF volume. The fluid left behind will become more concentrated (less water) because the fluid being taken out is hypotonic. ECF volume will reduce and osmolarity will increase, causing water to shift from ICF to ECF which reduced ICF volume and concentrating what’s left, increasing osmolarity

33
Q

What is the function of the kidneys?

A

regulate body fluid volume and composition by controlling ECF volume and composition

34
Q

What is edema?

A

Too much water in tissues

35
Q

What kind of edema is more common?

A

Extracellular

36
Q

What are causes of intracellular edema?

A
  1. Hyponatremia (lower than normal sodium levels. Sodium is the primary determinant of ECF osmolarity and tonicity)
    * Hyponatremia causes hypotonic and hyposmotic environments. This will cause water to travel into cells causing intracellular edema and will dilute cells and affect their function
  2. Decreased metabolism (blood flow): Na+/K+ pump failure (ATPase)
    * This ATPase pumps Na out and K into the cell. If you were to stop this pump, fluid of ions would move into the cell, pulling water with it (creating intracellular edema)
  3. Inflammation (infection, burns): increased membrane permeability and leakage
    * Will draw positive ions and substances into the cell, drawing water with it (creating intracellular edema)
37
Q

What is the most important cation in the body?

A

Na

38
Q

What do Na salts make up?

A

> 90% osmotically active solute in the ECF

39
Q

What is highly regulated?

A

Na+
anytime you want to move water, you need to move Na in order to do so

40
Q

What does too little ECFV lead to?

A

volume contraction, hypotension, and organ hypoperfusion

41
Q

What does too much ECFV lead to?

A

edema, ascites, pleural effusions, hypertension

42
Q

When does hyponatremia occur?

A

When Na+ is below normal (<142 mOsm/L)
Na+ input < Na+ output OR water input > water output

43
Q

What are the types of hyponatremia?

A
  1. Hyponatremia-dehydration
    - Increased NaCl loss
    - Vomiting, diarrhea; renal disease, diuretics; Addison’s disease
    (aldosterone deficiency).
  2. Hyponatremia-overhydration
    - Excess H2O retention
    - Inappropriate ADH secretion, H2O Toxicity
  3. Hyponatremia–low solute intake
    - Decreased NaCl intake
    - Extreme diets
44
Q

Describe normoatremia

A
45
Q

What happens in the ECF in chronic hyponatremia?

A

Concentration of Na goes down and water goes up (HYPOTONIC)

46
Q

What happens to the brain in chronic hyponatremia?

A

Brain actively pumps solutes out into the brain interstitial fluid which will raise solute concentration of brain interstitial fluid and will blunt the water movement into neurons
(this is why there is not much brain swelling with chronic hyponatremia because of this adaptation)

47
Q

Describe chronic hyponatremia

A

-Slow, gradual drop in [Na+]ECF which stimulates transport of Na+, K+, and organic solutes out of the cells
-This causes water diffusion out of the cells
-With chronic hyponatremia the brain swelling is attenuated (prevented) by the transport of solutes from the cells

48
Q

How do you fix chronic hyponatremia?

A

-Must correct [Na+]ECF slowly to avoid osmotic demyelination
-Reasoning: because hyponatremia was developing slowly over time, the brain interstitial fluid was accumulating electrolytes that were being pumped out by the cells. This raises tonicity in ECF and prevents water and swelling of the brain tissue
-If you were to raise Na quickly, it would create hypertonic ECF causing lots of water to exit cells by osmosis (drop in volume causes demyelination)

49
Q

What is an example of chronic hyponatremia?

A

Renal disease

50
Q

Describe acute hyponatremia

A

-Rapid decrease in [Na+]ECF
-Caused by loss of Na+ or excess H2O
-H2O rushes into the cells causing swelling of the brain tissue (creates pressure between brain and cranium and can cause herniation down through the foramen magnum)

51
Q

What is an example of acute hyponatremia?

A

Water toxicity

52
Q

What is extracellular edema?

A

increased interstitial fluid volume (swelling)

53
Q

What is extracellular edema caused by?

A

o Increased capillary filtration (most common cause = congestive heart failure)
o Failure of lymphatics to return interstitial fluid to circulation (lymphedema)

54
Q

Describe how to calculate filtration rate

A
55
Q

What is capillary pressure (Pc) determined by?

A

Blood pressure
* Regulated variable: we will increase it to increase overall net filtration and decrease it to decrease overall net filtration

56
Q

What is interstitial colloid osmotic pressure (PiIF) determined by?

A

Proteins in ISD
- Negligible, not much of a role in capillary filtration

57
Q

What is plasma colloid osmotic presure (PiC) determined by?

A

plasma proteins
Causes water to move into capillaries
* Shouldn’t change

58
Q

What is interstitial fluid pressure (PIF) due to?

A

pressure in the interstitial space
Causes water to move into capillaries
* Will only come into play if capillary is leaky and there is increased protein amount in the IF

59
Q

What are common causes of extracellular edema?

A
  • capillary permeability
  • increased capillary hydrostatic pressure
  • decreased capillary colloid osmotic pressure
60
Q

What happens with capillary permeability?

A

increase
Causes increase in fluid movement and possible protein leakage
- Inflammation, burns, ischemia

61
Q

What happens with increased capillary hydrostatic pressure?

A

Heart failure (generalized vs left heart failure)
Renal disease

62
Q

What happens with decreased capillary colloid osmotic pressure?

A

Renal loss (nephrotic syndrome, losing proteins), liver diseases (plasma proteins are made by liver)

63
Q

What is effusion?

A

build-up of fluid in potential spaces (another name/type of edema)

64
Q

What are potential spaces for effusion?

A

pleural, pericardial, peritoneal, synovial cavities, abdominal cavities
i.e. Ascites (build-up of fluid in the abdominal cavity)

65
Q

Describe lining membranes

A

Highly permeable

66
Q

What is lymph drainage important for?

A

Clearing fluid and proteins

67
Q

What are the changes in the following variables after giving 2.0 L of water IV?
Extracellular Fluid Volume
Extracellular Fluid Osmolarity
Intracellular Fluid Volume
Intracellular Fluid Osmolarity

A

If we give 2L of water, it would enter into the plasma and raise the ECF volume and lower the ECF osmolarity (because it is hypotonic). As the ECF volume goes down, it would cause water to rush into the ICF (raising ICF volume) and diluting the solute so lowering the ICF osmolarity.

_Physiology Exam 5 (10 decks)

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