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Physiology II - HLSC 128 > Chapter 15- Fluid and Acid-base balance > Flashcards

Chapter 15- Fluid and Acid-base balance Flashcards

1
Q

What is balance concept?

A

Input must equal output to maintain a stable balance in ECF

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2
Q

When does a positive balance exist?

A

When input exceeds output

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3
Q

When does a negative balance exist?

A

When output exceeds input

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4
Q

What is an example of input?

A

Ingestion
Metabolic consumption

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5
Q

What is an example of output?

A

Excretion
metabolic consumption

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6
Q

Why is input poorly controlled?

A

Eating habits are variable

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7
Q

Where do compensatory adjustments occur?

A

usually on output side by urinary excretion

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8
Q

What is the most abundant substance in the body?

A

Water
-Amount varies in different tissues
-Content remains fairly constant

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9
Q

What percent of body fluid is extracellular?

A

33%

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10
Q

what percent of body fluid is intracellular?

A

67%

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11
Q

What is extracellular fluid made from?

A

interstitial fluid- 75%
Plasma- 25%

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12
Q

What are the 2 major fluid compartments?

A

2/3 within the cells = ICF
1/3 in fluid surrounding the cells= ECF

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13
Q

What are the minor components of ECF?

A

Lymph and transcellular fluid

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14
Q

What is the barrier separating the ECF and ICF?

A

Cellular plasma membranes

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15
Q

What does the ICF contain that can’t leave the cells?

A

Proteins
-cant permeate cell membrane

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16
Q

Difference between ECF and ICF?

A

Unequal distribution of Na and K

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17
Q

What does the ECF serve as?

A

Intermediary between the cells and external environment?

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18
Q

What does kidney function do to ECF?

A

Regulates volume and osmolarity

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19
Q

Why is ECF volume regulated?

A

maintains blood pressure

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20
Q

What is important in long term regulation of ECF volume?

A

mainting salt NaCl balance

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21
Q

Why is ECF osmolarity regulated?

A

Prevent swelling or shrinking of cells

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22
Q

What is important in maiting ECF osmolarity?

A

Water balance

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23
Q

How does salt input occur?

A

through ingestion

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24
Q

How is salt balance maintained?

A

Outputs in urine
+lost in sweating and feces

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25
Q

How do the kidneys adjust the amount of salt excreted?

A

By controlling Glomerular filtration rate and Tubular reabsorption of sodium

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26
Q

What do deviations in ECF volume trigger?

A

Trigger renal compensatory responses that bring salt balance back into line

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27
Q

What is osmolarity?

A

Measure of the concentration of individual solute particles dissolved in a fluid

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28
Q

What do ECF and ICF have the same despite large chemical differences?

A

Same osmolarity
-no net movement of water

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29
Q

If fluid outside cell has same osmolarity?

A

isotonic

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30
Q

If fluid outside cell has higher osmolarity?

A

Hypertonic

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31
Q

If fluid outside cell has lower osmolarity?

A

Hypotonic

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32
Q

What accounts for the majority of the ECF’s osmotic activity?

A

Sodium and its attendant anions

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33
Q

What accounts for the majority of ICF’s osmotic activity?

A

Potassium and accompanying intracellular anions

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34
Q

What leads to changes in ECF osmolarity?

A

Circumstances that result in a loss or gain of free H2O

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35
Q

Examples of circumstances that alter ECF osmolarity?

A
  1. Deficit of free water in ECF
  2. Excess of free water in ECF
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36
Q

What is the osmolarity of when there is a water deficit?

A

Hypertonic
-too concentrated
-Dehydration

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37
Q

What is the osmolarity when there is a water excess?

A

Hypotonic
-too dilute
-overhydration

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38
Q

What happens to cells when they experience hypertonicity?

A

Cells shrink (ECF is too concentrated: water leaves cells)

39
Q

What causes hypertonicity?

A

Insufficient water intake
Excessive water loss
Diabetes insipidus

40
Q

What are the symptoms and effects of hypertonicity?

A

âš«Shrinking of brain neurons
-Confusion, irritability, delirium, convulsions, coma
âš« Circulatory disturbances
-Reduction in plasma volume, lowering of blood pressure, circulatory shock
âš« Dry skin, sunken eyeballs, dry tongue

41
Q

What happens to cells that experience hypotonicity?

A

Cells swell
-excess water usually excreted in urine

42
Q

What causes Hypotonicity?

A

Causes
âš« Patients with renal failure who cannot excrete a dilute urine become hypotonic when they consume more water than solutes
⚫ Can occur in healthy people when water is rapidly ingested and kidney’s do not respond quickly enough
âš« When excess water is retained in body due to inappropriate secretion of vasopressin

43
Q

Hypotinicity symtoms and effects?

A

âš« Swelling of brain cells
-Confusion, irritability, lethargy, headache, dizziness,
vomiting, drowsiness, convulsions, coma, death
âš« Weakness (due to swelling of muscle cells)
âš« Circulatory disturbances (hypertension and edema)
âš« Excess free water = Water intoxication

44
Q

How do you maintain stable water balance?

A

Water input must equal water output

45
Q

What are the two types of output loss?

A

Insensible loss
Sensible loss

46
Q

What is insensible loss?

A

Lungs, non-sweating skin

47
Q

What is sensible loss?

A

Sweating, feces, urine excretion
-controlled to keep balance

48
Q

Where is water excretion controlled in the kidney?

A

Collecting ducts and tubules of nephron

49
Q

What controls water excretion?

A

Vasopressin
-restores ECF osmolarity

50
Q

Where is vasopressin produced?

A

Hypothalamus

51
Q

Where is vasopressin released?

A

Posterior pituitary gland

52
Q

What is the hypothalamus the location of?

A

Thirst centre

53
Q

What are hypothalamic osmoreceptors?

A

Sense changes in osmolarity

54
Q

Where are hypothalamic osmoreceptors located?

A

Near vasopressin-secreting cells and thirst centre

55
Q

If osmolarity increases what occurs via hypothalamic osmoreceptors?

A

Increased vasopressin and thirst is stimulated

56
Q

If osmolarity decreases what occurs via hypothalamic osmoreceptors?

A

decreased vasopressin and thirst is suppressed

57
Q

What else stimulates vasopressin secretion and thirst?

A

left atrial receptor (reduction in arterial pressure)
Angiotensin II (when RAAS is activated to conserve Na)

58
Q

What does ECF fluid volume control?

A

Blood pressure

59
Q

What does ECF fluid osmolarity control?

A

Cell volume: The shape of the cell

60
Q

What is Acid-Base balance?

A

Precise regulation of free/unbound hydrogen concentration in ECF (body fluids)

61
Q

What are acids?

A

Group of H containing substances that dissociate in solution to release free H and anions

62
Q

What kind of acid has a greater tendency to dissociate in a solution?

A

Strong acids

63
Q

What is a base?

A

Substance that can combine with free H and remove it from solution

64
Q

What is pH?

A

A scale used to express the concentration of H+

65
Q

What is acidosis?

A

When blood pH falls below a 7.35
-Becomes acidic

66
Q

What is alkalosis?

A

When blood pH is above a 7.45
-Becomes basic

67
Q

What are consequences related to fluctuations in pH?

A

a) changes in excitability of nerve and muscle cells
b) marked decrease of H causes over excitability of nervous
c) influences enzyme activity
d) changes K levels in body (affects cardiac functions)

68
Q

What are some sources of H+ in the body?

A
  1. Carbonic acid formation
  2. Inorganic acids produced during breakdown of nutrients
  3. organic acids from intermediary metabolism (fatty acids)
69
Q

What are the body’s lines of defence for pH changes?

A
  1. Chemical buffer system
  2. Respiratory system
  3. Kidneys
70
Q

What is the chemical buffer system?

A

Fist line of defence with four systems. Minimises changes of pH by binding with or yielding free H+

71
Q

What are the four systems of the chemical buffer system?

A
  1. H2CO3-, HCO3 System
  2. Protein Buffer system
  3. Hemoglobin (CO2) system
  4. Phosphate system
72
Q

What is theH2CO3-, HCO3 System?

A

Primary ECF buffer for non carbonic acids

73
Q

What is carbonic acid?

A

Reaction of water with CO2
H2CO3

74
Q

What are inorganic acids?

A

Acids produced during the breakdown of nutrients
e.g; H2SO4, phosphoric acids found in meats

75
Q

What are organic acids?

A

acids resulting from intermediary metabolism
e.g; Fatty acids

76
Q

What is the protein buffer system?

A

Primary ICF buffer, it also buffers ECF

77
Q

What is Hemoglobin (CO2) system?

A

Primary buffer against carbonic acid changes

78
Q

What is the phosphate system?

A

Important urinary buffer, also buffers ICF

79
Q

What is the respiratory system’s role in the Chemical buffer system?

A

Second line of defence
Acts at moderate speed, regulates pH by control rate of CO2 removal

80
Q

What is the kidney’s role in the Chemical Buffer system?

A

Third line of defence
Takes hours to days to compensate for changes adjusts
a. H+ excretion
b. HCO3- excretion
c. Ammonia secretion

81
Q

What causes Acid-base imbalances?

A

Arise from either respiratory dysfunction or metabolic disturbances

82
Q

What is respiratory acidosis ?

A

Blood pH falls below a 7.35 because of abnormal CO2 retention arising from hypoventilation

83
Q

What are some possible causes of Hypoventilation —> respiratory acidosis?

A

Lung disease
e.g; emphysema, bronchitis, asthma
Depression of respiratory centre by drugs/disease
nerve, muscle disorders reducing respiratory muscle activity
Holding breath

84
Q

How does the body compensate for respiratory acidosis?

A

a. Chemical buffers immediately take uo additional H+
b.Kidneys conserve all filtered HCO3- and add new HCO3- to plasma, and excrete more H+

85
Q

What compensation inmost important during respiratory acidosis?

A

Kidneys

86
Q

What is respiratory alkalosis?

A

Blood pH rises above 7.45 primarily due to excessive loss of CO2 from body as a result of Hyperventilation
-its a loss of H+ and HCO3-

87
Q

What causes respiratory alkalosis?

A

Fever
Anxiety/other stressors
Aspirin poisoning
Physiologic mechanisms at high altitudes

88
Q

How does the body compensate for respiratory alkalosis?

A

a. Chemical buffer systems liberate H+
b. After a few days if it continues, kidneys conserve H+ and excrete more HCO3-

89
Q

What is metabolic acidosis?

A

Blood pH falls below a 7.35 due to any type of acidosis except those caused by excess CO2 in body fluids
Its a reduction in plasma HCO3 or accumulation of non-carbonic acids

90
Q

What causes metabolic acidosis?

A

-Severe diarrhoea
-Diabetes mellitus
-Strenuous exercise
-Uremic acidosis

91
Q

How does the body compensate for metabolic acidosis?

A

a. Buffers take up extra H+
b.Lungs blow off additional H+ generating CO2
c.Kidneys excrete more H+ and conserve more HCO3

92
Q

What is metabolic alkalosis?

A

Blood pH rises above a 7.45 due to a reduction in plasma H+ caused by relative deficiency of non-carbonic acids

93
Q

What causes metabolic alkalosis?

A

-Vomiting
-Ingestion of alkaline drugs

94
Q

How does the body compensate for metabolic alkalosis?

A

a. Chemical buffers immediately liberate H+
b. Ventilation reduces
c.If condition persists, kidneys conserve H+ and excrete excess HCO3- in urine

Physiology II - HLSC 128 (7 decks)

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