Body Fluids Physiology Flashcards
(192 cards)
1
Q
What percentage is the body is total body water?
A
About 55-60%
2
Q
What 4 factors make TBW have variations?
A
Body fat content, age, herbivores v. carnivores (diet), sex
3
Q
What are 5 basic functions of aqueous solutions in the body?
A
Glomerular filtration in the kidney
Establishment of a solute concentration gradient
Maintaining cell size
Excitability of cell membrane
Generation of a nerve impulse
4
Q
What percent of TBW is extracellular fluid? (as a whole)
A
33%
5
Q
What percent of TBW is intracellular fluid?
A
67%
6
Q
What percent of TBW is plasma?
A
8%
7
Q
What percent of TBW is interstitial fluid?
A
25%
8
Q
Sucrose is a marker for _______.
A
ECF
9
Q
tritium oxide is a marker for ____.
A
TBW
10
Q
Radioactive albumin (125- Albumin) is a marker for _____.
A
Plasma
11
Q
Can ICF be measured directly or indirectly?
A
Indirectly, by calculating TBW - ECF
12
Q
ICF is / of TBW
A
2/3
13
Q
ECF is / of TBW
A
1/3
14
Q
ISF & other transcellular fluid are / of TBW or _% of ECF
A
1/4, or 75% of ECF
15
Q
Plasma is / of TBW or _% of ECF
A
1/12.5, or 25%
16
Q
What is SID?
A
Significant/strong ion difference- The calculated difference between the concentration of positively charged “strong cations” and negatively charged “strong anions” (mainly chloride) in a solution.
17
Q
What is the most exchangeable ion?
A
K+
18
Q
What do electrolytes do?
A
They control the likelihood for a cell to be excited
19
Q
What are the major ICF electrolytes?
A
Potassium (K+), magnesium (Mg), and phosphorus (P)
20
Q
What are the major ECF electrolytes?
A
Sodium (Na), chloride (Cl-), and bicarbonate (HCO3-)
21
Q
Urine & feces are _____ routes of water loss
A
Sensible
22
Q
Insulin is a marker for_____.
A
ECF
23
Q
Deuterium oxide (D20) is a marker for ______.
A
TBW
24
Q
Evans blue is a marker for _______.
A
Plasma
25
What is the equation for total blood volume?
Plasma x 100/ 100- HCT (hematocrits)
26
What happens to blood when the significant ion difference decreases?
Blood becomes more acidic
27
What happens to blood when the significant ion difference increases?
Blood becomes more alkaline
28
The amount by which the strong positive ions (cations) are in excess of the strong negative ions (anions).
SID (significant/strong ion difference)
29
Diffusion, respiration, and sweat are ______ routes of water loss.
insensible
30
If the water content of the blood was **low** due to too much salt or sweating, what would happen to the brain and urine output?
The brain would produce **more** ADH, and a high volume of water is absorbed by the kidney, resulting in a **low** urine output.
31
If the water content of the blood was **high** due to overconsumption of water, what would happen to the brain and urine output?
The brain would produce **less** ADH, and a high volume of water is absorbed by the kidney, resulting in a **high** urine output.
32
What is edema?
The excessive accumulation of H2O in interstitial fluid. It is mostly extracellular and may develop due to factors like:
- Incr. of hydrostatic pressure in the capillaries
- Decr. colloidal osmotic pressure
- Failure of the kidney to excrete excess water
- Lymphatic obstruction
33
What are the 3 types of dehydration?
Isosmotic
Hyperosmotic
Hypoosmotic
34
Which dehydration occurs when proportionally the same amount of water and sodium is lost from the body?
Isosmotic dehydration
35
Which dehydration occurs when proportionally more water than sodium is lost from the body?
Hyperosmotic dehydration
36
Which dehydration occurs when proportionally more sodium than water is lost from the body?
Hypoosmotic dehydration
37
What causes hyperosmotic overhydration?
Oral or parenteral intake of large amounts of hypertonic fluid (high levels of solute, like salt)
38
What type of overhydration involves:
- Incr. of plasma osmolality
- Water shift from ISF to plasma
- Incr. of plasma volume
- Decr. in osmolality of the ECF (plasma), and incr. of osmolality of the ISF (2nd effect)
- Water shift from ICF to ECF
- Decr. in ICF volume
**Hyperosmotic** overhydration
39
What type of overhydration involves:
- Decr. in plasma osmolaliry
- Water shift from plasma to ISF
- Decr. in ISF osmolality
- Water shifts from ISF to ICF
**Hypoosmotic** overhydration
40
What is increased serum potassium concentration well above normal?
Hyperkalemia
41
What is the *false* state of increased serum potassium concentration, usually contributed by red cells?
**Pseudo**hyperkalemia
42
What is the increased serum potassium concentration well above normal, caused by factors that *regulate potassium balance*- renal and extrarenal factors?
**True** hyperkalemia
43
What is the function of diuretics (furosemide)?
increases potassium excretion
44
What is the increased serum potassium concentration well above normal?
Hyperkalemia
45
What is the *false* state of increased serum potassium concentration, usually contributed by red blood cells?
**Pseudo**hyperkalemia
46
What is the increased serum potassium concentration well above normal, caused by *factors that regulate potassium balance*- renal and extrarenal factors
**True** hyperkalemia
47
What is the function of **diuretics** (furosemide)?
To increase potassium excretion
48
What is the function of calcium **chloride**?
To antagonize the effect of hyperkalemia when given an IV
49
What is the function of glucose and insulin?
To control the situation in 10 minutes when given an IV
50
What is the function of sodium bicarbonate?
To stimulate cellular uptake of K+ when given an IV (same as calcium chloride)
(as well as treating metabolic acidosis)
51
What is the function of GIT potassium binders?
To reduce serum K+ levels via ion exchange mechanisms in the gastrointestinal tract
(cation exchange resins = polystyrene sulfonate)
52
What are some *extrarenal* causes of hypokalemia?
- Diarrhea
- Vomiting
- Potassium redistribution
- Insulin administration
- Acute alkalemia
- Folic acid and Epinephrine infusion
- Vitamin B (stimulates cell proliferation and produces hypokalemia)
53
What is the normal potassium level in dogs and cats?
3.5-5.5 mEq/L
54
What organs help maintain the water-salt balance?
Lungs, heart, blood vessels, kidneys, brain/pituitary, parathyroids, and adrenal cortex
55
What are some **extrarenal** causes of hypernatremia?
- Decreased fluid intake (dehydration)
- Increased skin loss (sweating)
- Increased GIT loss (vomiting, diarrhea)
56
What are some antidotes for hypernatremia?
- Free water intake
- Intravenous infusion of 5% dextrose solution
- Administration of Vasopressin (ADH)
- Use of thiazide diuretics and drugs that enhance the renal tubular effect of ADH
- Drugs that contribute to the stimulation of ADH release
57
What is hemolysis?
the breakdown of red blood cells; (RBCs) break down prematurely, releasing their hemoglobin into the bloodstream
58
hyperproteinemia decreases the amount of ____ in the blood while increasing the amount of ______.
water, proteins
59
hyperlipidemia decreases the amount of ____ in the blood while increasing the amount of ______.
water, lipids
60
What is the problem characterized by too much water but not necessarily too little sodium?
**hypo**natremia
61
What is the *false* increase of Na levels?
**pseudo**hypernatremia
62
What is pseudohyponatremia?
a condition in which the serum sodium concentration (the level of sodium in the blood) appears low, but the body's fluids are actually at a normal concentration
63
What is caused by a:
- decreased glomerular filtration rate
- Increased PT (proximal tubule) reabsorption of water seen in diseases with decreased renal perfusion pressure
- Drug-induced SIADH
**Hypo**natremia
64
What part of the kidney is responsible for resorption of water and electrolytes?
proximal tubule (65% resorption)
65
What does SIADH stand for?
Syndrome of Inappropriate Antidiuretic Hormone Secretion.
66
What is SIADH ?
It is a condition where the body produces too much antidiuretic hormone (ADH), leading to excessive water retention and low sodium levels in the blood (hyponatremia).
67
What is the drug chlorpropamide used to treat?
Type 2 diabetes mellitus, drug-induced SIADH
68
What is the drug clofibrate used to treat?
lower cholesterol and triglyceride (fat-like substances) levels in the blood, drug-induced SIADH
69
What are the normal sodium levels in dogs?
140-154 mEq/L
70
What are the normal sodium levels in cats?
145-158 mEq/L
71
What causes variations in NA levels?
age,
diet, hydration status, and health conditions
72
What is given to patients to combat hyperkalemia?
calcium chloride via IV
73
Which organs maintain a water-salt balance?
lung, blood vessels, heart, kidney, brain/pituitary, parathyroid glands, and adrenal cortex.
74
How do the lungs maintain a water-salt balance?
Gaseous exchange in the epithelium at the alveolar level
75
What hormone is PTH?
parathyroid hormone
76
How does the parathyroid maintain a water-salt balance?
PTH controls the calcium and phosphorus through;
1) release of calcium from bones into the bloodstream
2) absorption of calcium from the intestines
3) reabsorption of calcium in the kidneys
77
What are the 4 roles of electrolytes in the body?
1) Conduct electricity across cell membranes; they are needed for life processes to occur.
2) Maintain osmolality of body fluid compartments.
3) Regulate balance of acids and bases.
4) Aid in neurological and neuromuscular conditions.
78
What must be present for a homeostatic condition to exist?
Equal amounts of *anions* and *cations* must be present
on either side of the cell membrane
79
Where are extracellular electrolytes found?
The interstitial and intravascular fluids where there is a balance of anions and cations.
80
What are the kinds of IV fluids?
1) Colloids
2) Crystalloids
3) Blood and blood products
4) Oxygen-carrying solutions
81
What do colloid IV fluids help?
Improves the oncotic pressure in blood.
82
How do colloids maintain blood volume?
They contain proteins and molecules that are too large to pass through the capillary walls, so they have to stay in the blood stream for a long time, which increases the intravascular volume.
83
What nonclinical factors should be considered before using colloids for IV fluids?
They are expensive, have specific storage requirements, and have a short shelf life.
84
What strengths are available for albumin?
Albumin 5% and 25%
85
What is albumin made from?
Pooled human plasma
86
What do colloidal fluids treat or prevent by increasing the intravascular volume?
Edema
87
Describe Albumin 5%?
Slightly yellow tint, contains no preservatives, and slightly viscous.
(Albumin 5% is composed of 154 mEq’s of Sodium and 50 grams of albumin and has a pH level of 6.6 as well as an osmolarity of
290)
88
What is Albumin 25% used primarily to treat?
hypoproteinemia
89
What is another type of plasma expander that is similar in properties to Albumin.
Hetastarch (Hespan); It is composed of 154 mEqs of Sodium with a pH level of 5.5 as well as an osmolarity of 310
90
Name 3 conditions when you would want to use colloidal solutions?
1) Edema
2) Liver dysfunction
3) Low blood sugar
91
Name 3 plasma expanders?
Albumin, Hespan, and Dextran
92
What are the strengths (#) of Dextran?
Dextran 40 and 70
93
What are the 2 basic compounds that regulate osmotic pressure in plasma?
electrolytes and proteins
94
What type of solutions are primarily used in pre-hopsital therapy?
Crystalloids
95
Crystalloids contain electrolytes (e.g., sodium, potassium, calcium, chloride) and are classified according to their ________?
tonicity
96
What is crystalloid tonicity?
the concentration of electrolytes (solutes) dissolved in the water, as compared with that of body plasma fluid surrounding the cells
97
Give examples of crystalloids
normal saline, lactate ringers, dextrose 5% in water
98
What is the main solution of choice when administering a blood product?
Normal saline
99
Which crystalloid is considered isotonic in the bag before it is administered?
D5W (Dextrose 5% in water)
100
What are the most desirable/precious fluids for replacement for intravascular volume?
blood and blood products
101
Why use blood and blood products for intravascular volume replacement?
Because they carry oxygen to the cells
102
Which type of blood is universally compatible in humans?
0-negative
103
When considering blood typing and cross matching, what is special about ruminants?
They rarely require type and cross matching prior to receiving blood products.
104
Why does blood transfusion only briefly provide relief from signs of anemic anoxia in animals?
The erythrocytes have extremely short half-lives in the recipients.
105
Dogs that have __________can be considered to be universal recipients while ___________ are universal donors
DEA 1.1 positive ; DEA 1.1 negative
106
Why is it difficult to harvest plasma from ruminant blood without access to a large centrifuge or equipment for plasmapheresis?
Ruminant blood does not separate out naturally on standing, unlike equine blood.
107
What is the easiest way to give a plasma transfusion to ruminants?
Administer whole blood.
108
What are synthetic fluids that carry and deliver oxygen to the cells?
oxygen-carrying solutions
109
When would you use oxygen-carrying solutions if blood products are not available?
severe blood loss or hypovolemia
110
What are the 3 types of fluid classifications?
maintenance fluids, replacement fluids, and special fluids
111
What is the function of maintenance fluids?
replace insensible fluid losses
112
What is the function of replacement fluids?
correct body deficits due to gastric drainage, vomiting, diarrhea, infection, trauma, burns, etc.
113
What are 3 conditions and treatments with special fluids?
1) Hypoglycemia - 25 % dextrose
2) Hypokalemia ---- inj. KCl
3) Metabolic acidosis – inj. of sodium bicarbonate
114
Where do fluids distribute?
1) IV goes to → ________.
2) Subcutaneous goes to → ________, then → _______.
3) Oral goes to → _______ then → _____, and then ______.
1) plasma
2) interstitial space, blood
3) intestines, ISF, and blood
115
What 5 factors determine which IV solution to use?
1) Tonicity
2) Osmolarity
3) Osmolality
4) Type of dehydration
5) Type of electrolyte imbalance
116
What are the 6 routes of fluid administration?
1) Oral
2) Intravenous
3) Intraperitoneal
4) Subcutaneous
5) Intramedullary (IO or bone marrow)
6) Rectal
117
What are 4 advantages of oral rehydration?
Simple & inexpensive, owners can do this at home, large volumes can be administered, and most types of fluids can be used due to selective absorption.
118
What are 7 disadvantages of oral
rehydration
1) Slow absorption rate,
2) Not good for vomiting patients
3) Can't use for circulatory shock
4) Time consuming
5) Stressful if the patient is forced
6) Risk of aspiration pneumonia when forced by syringe
7) Only effective with mildly dehydrated animals.
119
What are the 2 advantages of
subcutaneous fluid therapy?
1) Simple, quick and inexpensive.
2) Useful in small animals such as hamsters where intravenous fluid therapy is impossible
120
What are the 7 disadvantages of
subcutaneous fluid therapy
1) Slow rate of absorption.
2) Can't use for circulatory shock.
3) Painful. Irritation and sepsis may result.
4) Contraindicated if the skin is devitalized.
5) Limited type of fluids, (isotonic only).
6) Only small volumes of fluid can be administered (10-12mls/kg per injection site).
7) Mild dehydration only.
121
What are the 2 main dangers associated with intraperitoneal fluid administration
Peritonitis and risk of puncturing an abdominal organ.
122
What are the 2 main risks associated with intravenous fluid therapy?
Thrombophlebitis (vein swells and forms a blood clot or thrombus) and over-transfusion if kidney damage exists
123
What are 9 conditions where IV fluids are administered?
* Coma
* Anesthesia
* Severe vomiting
* Diarrhea
* Dehydration
* Shock
* Hypoglycemia
* It is a vehicle for antibiotics, chemotherapy agents
* Critical problems (anaphylaxis, status asthmaticus (asthma)
or epilepticus (seizures), cardiac arrest, forced diuresis in drug overdose, poisoning etc.)
124
What things are considered to determine the appropriate IV fluid to administer?
* the pathology / histology
* the patient's underlying problem
* estimated fluid loss
* the primary fluid compartment involved
* the physiological and hemodynamic impact of the IV solution
125
Some complications of IV fluids are categorized into what 2 types?
local and systemic
126
What are the local complications of IV fluids?
hematoma (blood in the ISF) and phlebitis (inflammation of the veins)
127
What are 7 systemic complications of IV fluids?
1) Circulatory overload in large volumes
2) Hyper-coagulation due to reduction in AT3 (antithrombin III protein, natural defense)
3) Rigors (shivering due to large amounts of cold IV fluids)
4) Air embolism, delayed healing of anastomosis
5) Inhibition of GI motility (peristalsis)
6) Septicemia
7) Others: fluid contamination, mixing of incompatible drugs
128
What are the names of 4 types of isotonic IV fluids used all the time?
1) 9% NaCl, normal saline
2) LRS, lactate ringers
3) Plasmalyte
4) Normosol
129
How to calculate the daily metabolic water requirement?
mL/day=(30 x BWkg) + 70
130
How to calculate the amount of fluid deficit in liters (dehydration)?
BWkg x estimated % dehydration x 1,000 ml/L
131
How to calculate the percentage of dehydration (%)
Well wt (kg) - Current wt (kg) ÷ Well wt (kg) x 100
132
How to calculate the infusion rate or how fast (flow rate)?
total fluid volume x drop factor ÷ time (4 hrs? 6hr? 8hr?)
133
How to calculate infusion time or how long?
time = total quantity bag ÷ flow rate (ml/ hr)
134
what is the number of drops it takes to make up one milliliter (ml) of fluid called?
drop factor or IV drip rate
135
What are the 2 common sizes for drip rates? and for which fluids?
"gtts" is the medical abbreviation means drops
20 drops/mL for clear fluids
15 drops/mL for thicker substances such as blood.
136
What are the 2 types of tubing infusions?
microdrip and macrodrip
137
How is the IV fluid drip rate (gtt/min) calculated?
IV Drip Rate (gtt/min) = Total Volume
÷ Time (min) x Drop Factor (gtt/mL)
138
How to calculate the daily water intake?
Body wt x 2/3 (or 67%)
139
What is necessary for hydration to be calculated?
No ongoing losses
140
How to calculate the total fluid deficit?
Deficit (ml) = premorbid wt- current wt (kg) x 1000
141
For IV fluids, use the ______ diameter and the _______ catheter.
largest; shortest
142
What is the name of the physic law for pressure?
Poiseuille's Law
Delta p = pressure difference between the two ends
N = dynamic viscosity
L = length of tube
Q = volumetric flow rate
R = tube radius
143
What is the state of poor perfusion to tissues called?
shock
144
What 3 things are needed for perfusion?
pump (heart), tubes, (vessels) , fluid (blood)
145
Poor perfusion leads to what?
Organ dysfunction
146
What are the signs of shock?
Pallor (pallness), tachycardia, tachypnea, prolonged CRT (capillary refill time), hypothermia – Cats—bradycardia??
147
Signs of shock in dogs?
*Rapid heart rate and weak pulse*: The body is trying to pump more blood to vital organs.
*Rapid and shallow breathing*: The body is trying to get more oxygen to the tissues.
*Pale or bluish gums, lips, and tongue*: Reduced blood flow causes a lack of oxygen.
*Cold extremities*: The body is shunting blood away from non-essential areas to preserve vital organs.
*Low blood pressure*: The body is not circulating enough blood.
*Lethargy, confusion, or unresponsiveness*: The brain is not getting enough oxygen.
*Vomiting or diarrhea*: The body may try to expel toxins or reduce blood volume.
*Seizures or tremors*: In severe cases, shock can affect the nervous system.
148
What sign of shock might be different in cats?
bradycardia (slow heartrate)
149
What is the treatment for shock?
– Oxygen
– IV fluids (unless cardiogenic shock)
– Pain management
150
What is oedema (edema)? Special types?
Accumulation of fluid in the interstitial spaces
* Special types: ascites, hydrothorax
151
What is ascites?
a type of edema where the interstitial fluid is in the peritoneal cavity of the abdomen
152
What is hydrothorax?
a type of edema where there is a n abnormal accumulation of fluid in the pleural space between the lungs and chest wall
153
What are the causes of oedema?
* Increased Pcap (capillary
hydrostatic pressure)
* Decreased πcap (oncotic pressure)
* Blocked lymphatics
* Increased capillary permeability
(inflammation, histamine
154
What is Starlings' Law of capilllaries?
the movement of fluid between
the capillaries and interstitial fluid is due to the net effect of all four
pressures operational within and around the capillaries
155
What is the equation used to calculate the NFP (net filtration pressure) and determine the direction of movement?
NFP = (BHP + IFCOP) (favour filtration) –(BCOP + IFHP) (oppose
filtration).
156
What does NFP stand for?
net filtration pressure
157
What does BHP stand for?
blood hydrostatic pressure
158
What does BCOP stand for?
blood colloid osmotic pressure
159
What does IFHP stand for?
interstitial fluid hydrostatic
pressure
160
What does IFCOP stand for?
interstitial fluid colloid osmotic pressure
161
_______ and ________promote the movement of fluid out of the
capillaries or filtration. _______ and __________ promote the movement of fluid into the capillaries or reabsorption.
BHP and IFCOP
BCOP and IFHP
162
If the filtration pressure is greater than resorption pressure, then the NFP will be what
postive
163
If the resorption pressure is greater than the filtration pressure, then the NFP will be what?
negative
164
Under normal conditions physiologically, which factors of Starling's Law do not significantly vary?
IFHP, IFCOP, and BCOP
165
In most tissues, the rate of filtration and reabsorption comes down to ______?
BHP, blood hydrostatic pressure
166
What is condition in sheep characterized by a swelling of the submandibular lymph nodes, located under the jaw that is caused by a worm that destroy Albumin?
bottle jaw sheep, interstitial edema of the lower jaw
167
What condition is a painful swelling of the lymphatic vessels in a limb, usually in the horse's hind leg. It's often caused by a bacterial infection.
lymphangitis of the horse
168
How do you tell when an animal is dehydrated? (Initial Assessment and blood work?)
* Eyes
* Skin
* Mouth – CRT (capillary refill time)
* Hematocrit
* Range of dehydration– 5- 12%
169
What is the range of fluid loss to diagnose an animal with dehydration?
5% to 12% difference from their initial body weight
170
What do I have to consider when rehydrating an animal?
Replacement [90ml/kg/h in dogs; 45ml/kg/h in cats] *Severe*
* Maintenance [60-80ml/kg/day]
* Compensate for ongoing excess loss of fluids
171
What is the equation for Total Body Volume? (TBV)
TBV = ICF + EFC
172
What are some antidotes for hyperkalemia?
Calcium Chloride
Glucose & Insulin
Diuretics
Dialysis
173
What are some symptoms of hyperkalemia?
Arrhythmias and neuromuscular disorders
174
What kind of fluids would you give
a dog with hypernatremia?
3% sodium chloride (NaCl): 2 mL/kg of 3% NaCl IV over 10 to 60 minutes
Lactated Ringer's solution (LRS): A fluid and electrolyte replacement solution
Plasmalyte-A: A balanced isotonic crystalloid solution
Hypertonic saline: 3% or 5%
175
What kind of fluids would you give a cow with hypoalbuminemia?
Colloids
176
What kind of fluids would you give a dog with hyperosmotic dehydration?
Isotonic crystalloid
177
What kind of fluids would you give a cat with hypokalemia?
Hyperosmotic crystalloids
178
What kind of fluids would you give a hypoglycemic dog?
>5% dextrose solution
179
What are some examples of blood and blood products?
Plasma, platelets, Packed RBCs
180
What situations are oxygen-carrying solutions used in?
Severe blood loss or hypovolemia
181
What is the replacement fluid rate in dogs?
90 mL/kg/h
182
What is the replacement fluid rate in cats?
45 mL/kg/h
183
What is the maintenance fluid rate in cats?
60 mL/kg/day
184
What is the maintenance fluid rate in dogs?
60 mL/kg/day
185
What would happen if you give a DEA 1.1-negative dog more than one blood transfusion of DEA 1.1-positive blood?
The antibodies will attack the blood.
186
How is the hypothalamus stimulated during dehydration and why?
The osmoreceptors in the hypothalamus detect increased concentration of blood. It sends signals toincrease thirst and increase ADH to conserve water in the kidneys
187
If the solute concentration (osmolarity) in the extracellular fluid *increases*, what do osmoreceptors in the hypothalamus do?
generate an output signal to increase the release of ADH from the posterior pituitary.
188
If the solute concentration (osmolarity) in the extracellular fluid *decreases*, what do osmoreceptors in the hypothalamus do?
there is a decrease in the release of ADH.
189
Where is ADH released from?
The posterior pituitary in the brain
190
What is the most abundant cation in the extracellular fluid?
NA +
191
What is the most abundant cation inside the cell?
K+
192
Which water is produced by the mitochondria?
metabolic water
