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Renal > Body fluid compartments- Week 1 > Flashcards

Body fluid compartments- Week 1 Flashcards

1
Q

What are the ways the body looses water?

A

-insensible losses
-sweat
-feces
-kidneys

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2
Q

How much water is ingested in a day?

A

2100ml/day

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3
Q

how much water is synthesized by the body via oxidation of carbs?

A

200mL/day

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4
Q

What is the total water intake in a day?

A

2300ml/day

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5
Q

How much water is lost from evaporation during the day? (insensible water loss)

A

700mL/day

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6
Q

What is the most important means by which the body maintains a balance between water intake and output (and electrolytes)?

A

Controlling the rate the kidneys excrete these substances.

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7
Q

What is transcellular fluid?

A

The Compartment contains fluid in synovial, peritoneal, pericardial, CSF, and intraocular spaces

Considered a specialized type of extracellular fluid

Constitute 1-2L

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8
Q

In a 70kg man, what percentage of body weight is water?

A

60% or 42L
- dependent on age, gender and obesity

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9
Q

As a person gets older, the percentage of total body weight:

A

DECREASES

d/t increase fat

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10
Q

Is the protein level higher in the plasma or interstitial fluid?

A

plasma

(d/t low membrane permeability)

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11
Q

Is the capillary membrane separating the interstitial and plasma permeable or impermeable?

A

highly permeable

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12
Q

What separates the intracellular fluid from the extracellular fluid?

A

cell membrane

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13
Q

Is the cell membrane permeable or impermeable?

A

highly permeable to water NOT electrolytes= semipermeable

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14
Q

What is the composition of the extracellular fluid regulated by?

A

Kidneys

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15
Q
A
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15
Q

What is the Gibbs-Donnan Equilibrium?

A

When 2 solutions containing ions are separated by a membrane that is permeable to some ions and not to others, and electrochemical equilibrium is established

electrical and chemical energies on either side of the membrane are equal and opposite of eachother

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16
Q

Bc of the Gibbs donnan effect positively charges ions (cations) are slightly greater where?

A

PLASMA

-plasma proteins, sodium and potassium

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17
Q

Anions are higher where?

A

Interstitial fluid

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18
Q

What is the compartment volume measurement?

A

The principle of conservation of mass.

The total mass of a substance after dispersion in the fluid compartment will be the same as the total mass injected into the compartment

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19
Q

What determines the distribution of fluid between the intracellular and extracellular compartments? (across the cell membrane)

A

the osmotic effect of small solutes

Na+ and Cl-

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20
Q

What determines fluid distribution between interstitial and plasma compartments? (across the capillary membrane)

A

balance of hydrostatic and colloid osmotic forces across the capillary membrane

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21
Q

What is the rate of osmosis?

A

the rate of diffusion of water

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22
Q

What is a Mole?

A

defining specific quantity of molecules

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23
Q

What is an osmole?

A

of particles in a solution

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24
Q

What is osmolality?

A

Osmoles / kg of water

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25
Q

What is osmolarity?

A

Osmoles / liter of solution

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26
Q

What is osmotic pressure?

A

amount of pressure required to PREVENT osmosis

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27
Q

Molecules that disassociate when dissolved into a solution have more:

A

osmotic effect

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28
Q

What is Van’t Hoff’s Law?

A

Once can calculate the potential osmotic pressure of a solution, assuming that the cell membrane is impermeable to that solute.

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29
Q
A
30
Q

What electrolytes determine the osmolarity of the extracellular fluid?

A

Sodium and Chloride

31
Q

What electrolytes determine the osmolarity of the intracellular fluid?

A

Potassium

32
Q

Whats the total osmolarity of each compartment?

A

300 mOsm/L

33
Q

What is the effect if isotonic saline is added to the extracellular compartment?

A

the only effect is an increase in extracellular fluid volume

34
Q

If a hypertonic solution is added to the extracellular fluid what is the effect?

A

Increased extracellular osmolarity, fluid leaves cells to increase extracellular fluid.

Decreased intracellular volume, rise in osmolarity in both compartments

35
Q

If hypotonic solution is added to extracellular fluid what happens?

A

Water diffuses into the cells, and intravascular volume increases.

36
Q

What causes Hyponatremia?

A

Excess water
Loss of sodium
Diarrhea & vomiting
diuretic abuse
addison’s disease
excess water retention (ADH)

37
Q

What causes hypernatremia?

A

Loss of water
excess sodium
lack of ADH
DI
dehydration
Aldosterone secretion

38
Q

What happens of plasma sodium concentration falls below 115-120 mmol/L?

A

-brain swelling
-seizure
-coma
-perm. brain damage
-death

a rapid reduction in plasma sodium concentration can cause brain cell edema and neurological symptoms- headache, nausea, lethargy, disorientation

39
Q

Primary loss of water from extracellular fluid results in?

A

-Hypernatremia
-dehydration

40
Q

what kind of urine is excreted in central diabetes insipidus?

A

dilute urine

41
Q

What level of sodium willl you see symptoms related to hypernatremia?

A

158-160 mmol/L

42
Q

what are the effects of hypernatremia?

A

increased thirst, and secretion of antidiuretic hormone

43
Q

how would you correct hypernatremia?

A

hypo-osmotic sodium chloride or dextrose solutions

44
Q

where does edema occur?

A

EXTRACELLULAR FLUID COMPARTMENT

45
Q

when would you see intracellular edema?

A

-inflammation has a direct effect on increasing cell membrane permeability

-depression of cellular metabolic function

-lack of nutrition to the cell

-decreased blood flow: reduced o2 and nutrient supply

-ionic pumps of the cell membrane require oxidative metabolism (ATP) to remove intracellular sodium

46
Q

What causes extracellular edema?

A

1.) abnormal leakage from plasma

2.) lymphatic failure to return fluids to blood
-lymphatic blockage

47
Q

What causes an abnormal leakage from plasma?

A

-increase capillary filtration
-increased capillary hydrostatic pressure
-decreased plasma colloid osmotic pressure

48
Q

what causes increased capillary pressure?

A

1.) excessive kidney retention of sodium and water
2.) high venous pressure and venous constriction
3.) decreased arteriolar resistance

48
Q

What causes decreased plasma protein concentration?

A

-loss of proteins in the urine (nephrotic syndrome)**
-loss of protein from denuded skin areas
-failure to produce proteins

49
Q

What causes increase capillary permeability?

A

-immune system reactions (histamine release)
-toxins
-bacterial infections
-vitamin deficiency (esp. vit C deficiency)
-prolonged ischemia
-burns

50
Q

What causes a blockage of lymph return?

A

-cancer
-infections (filaria nematodes)
-surgery
-congenital absence or abnormality of lymphatic vessels

51
Q

What causes edema in heart failure?

A

blood flow to kidneys is reduced = secretion of renin–> angiotensin 2–> aldosterone= additional salt and water by kidneys

52
Q

summary of causes of extracellular edema:

A

1.) increased capillary pressure
2.) decreased plasma proteins
3.) increased capillary permeability
4.) blockage of lymphatic return

53
Q

What are the 3 main factors that prevent edema?

A

1.) low interstitial compliance (-3mmhg)
2.) ability to increase lymphatic drainage
3.) “wash down” of interstitial fluid proteins (as lymphatic flow increases proteins are washed away)

54
Q

6 major functions of the kidneys:

A

1.) maintenance of extracellular volume and composition

2.) blood pressure regulation (long and intermediate term)

3.) excretion of toxins and metabolites

4.) maintenance of acid-base

5.) hormone production (erythropoietin, calcitriol, prostaglandins)

6.) blood glucose homeostasis

54
Q

Why do we have kidneys?

A

-regulation of fluid volume and body fluid composition
-excretion of metabolic waste and foreign chemicals
-secretion of certain hormones

54
Q

what is the hilus?

A

vertical cleft where ureter and vein and artery enter/exit

lies at L1

54
Q

What is the total safety factor against edema?

A

17mmHg (3, 7, 7)

capillary pressure can double before significant edema occurs

55
Q

where do the kidneys lie?

A

paravertebral gutters, behind the peritoneum, with the right slightly lower d/t liver

56
Q

What is the functional unit of the kidney?

A

nephron

57
Q

Where does plasma filtration occur?

A

glomerulus

58
Q

what is the juxtaglomerular responsible for?

A

concentration of urine

59
Q

what percentage of the cardiac output does the kidney receive?

A

22% (1100ml/min)

60
Q

oxygen consumption in the kidney varies directly with:

A

active transport of Na+

60
Q

where does the highest metabolism take place in the kidney?

A

renal cortex

61
Q

on a per gram basis______

A

renal blood flow is the highest of any organ

makes up .4% of body weight - most highly perfused major organs in body

14mL/L kidney
60ml/L muscle
140ml/l hearty

62
Q

what are the cortical nephrons?

A

short loops of henle extend to outer medulla, glomeruli in outer cortex

  • MORE
63
Q

What are the juxtamedullary nephrons?

A

loops of henle extend deep into the medulla, glomeruli near the corticomedullary border, larger glomeruli, higher GFR

-PLAY A BIG ROLE IN CONCENTRATING URINE

  • kidney cannot regenerate new nephrones
64
Q

what is the glomerulus?

A

-high-pressure capillary bed
-the site of blood filtration

65
Q

what is the bowman’s capsule?

A

-funnel-like structure “beginning of nephron”

66
Q

each nephron has its own_____ _____ ____

A

independent blood supply (renal arterioles and veins)

67
Q

what is considered the beginning of the nephron?

A

bowman’s capsule

Renal (5 decks)

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