Chapter 21 Flashcards Preview

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Flashcards in Chapter 21 Deck (95):
0

Name 4 transcellular fliud

Vitreous humor, peritoneal fluid , mucus and serous fluid

1

What ion is relatively high in extracellular fluids.

Sodium

Because of selective membrane permeability, the concentrations of ions such as K+ are higher inside cells cells than Na+

2

What is the main force that causes water to move among the various fluid compartments

Osmosis

The concentration differences between cells and extracellular compartments create osmotic pressure differences

3

What is the main force that causes fluid to leave the plasma compartment

Hydrostatic pressure

Since the hydrostatic pressure component of blood pressure is always slightly higher than the plasma osmotic pressure, some water is constantly lost from the capillaries

4

What favors the development of edema

Decreased venous pressure

A drop in blood protein can result in a reduction of the osmotic pressure necessary to move fluids into the capillaries

5

Name 3 causes of hypoproteinemia

Glomerulonephritis, poor diet and liver disease

6

Name a direct cause of ascites

Hepatic disease

7

What causes the edema seen in inflammations

Histamine

8

Name 3 characteristics of Addison's disease

Sodium decreases, adrenal cortex failure, and low aldosterone

9

When a strong base reacts with the bicarbonate buffer system, ? Is formed from the base

Water

If one were to trace the OH- base in NaOH, it would end up as HOH or water and therefore, now as water, cannot effect pH alteration

10

When an acid reacts with the bicarbonate buffer system ? Is formed as an end product

Carbonic acid

11

What happens to HCl in the phosphate buffer reaction?

Forms a weak acid and salt

12

What reacts with excess acids in protein buffers?

NH3+

13

What buffers the addition of hydrogen in blood cells following the uptake of carbon dioxide

Hemoglobin

14

What Ions account for nearly 90% of the positively charged ions found in extracellular fliud?

Sodium

15

How is the excess tissue fluid returned to the blood?

Lymphatic vessels

16

About ?% of the total daily intake of water is derived from internal cell metabolism

10%

10% of daily water is an end product of cellular respiration as metabolic water; about 60% is obtained from drinking

17

As total body water decreases, the ? Of the extracellular fluid increases

Osmotic pressure

As fluid is lost, the concentration of particles increases, raising the osmotic pressure

18

The main factor that causes the kidney to conserve water is

ADH

Anti diuretic hormone increases the permeability and absorption of water at the distal convoluted tubules of the nephrons

19

ADH is secreted from the

Posterior pituitary

Although produced by the hypothalamus, ADH is stored and secreted into the blood from the posterior lobe of the pituitary

20

What has a diuretic affect

Drinking alcohol

21

Name 3 things ADH has a direct effect on

Blood pressure, water reabsorption, and blood concentration

22

Excessive vomiting usually results in the disorder of

Dehydration

23

The symptoms of dehydration result from the loss of ? Water

Intracellular

Although the loss may be caused by extracellular changes, the alteration in CNS activity such as confusion and coma, result from direct changes in the intra cellular compartment

24

The effects of water intoxication are usually related to

Low sodium

Water intoxication effects are related to ion concentrations

25

Where are most electrolytes normally lost

Urine

26

What is the most abundant extracellular cation

Sodium

27

What factor accounts for the ability of the body to conserve high levels of sodium?

Aldosterone

28

What ion is usually exchanged for sodium absorption

K+

29

What cells are most sensitive to electrolyte changes

Neurons

Nerve and muscle cells are most sensitive to ion changes and must be maintained at stable levels for normal conductivity or contraction

30

Name 3 effects of parathyroid hormone

Osteoclast stimulation, increase in blood Ca2+, and increase in intestinal absorption

PTH causes the kidneys to retain Ca2+; the net effect is to raise blood calcium levels

31

What ion is directly related to calcium homeostatis

Phosphate

32

Hyperparathyroidism usually causes an increase in

Calcium

33

Name 3 things that become involved with maintaining blood calcium balance

Bone, kidneys and intestine

34

Name 3 characteristics of hypocalcemia

Vitamin C deficiency, tetany, and cardiac arrhymia

35

What is the most important ion, which affects all of the functions of the others

H+

The H+ ion or acidity is the most important ion that has the capability of interacting with the other ions, pH balance is essential for proper enzyme functioning

36

Name 3 things that produce H+ ions?

Respiration of glucose, oxidation of fatty acids and oxidation of sulfur amino acids

The synthesis of proteins or other substances may not produce H+

37

Name 3 things associated with acidity

H3PO4, lactic, ketone

Glucose will not produce an acidic solution, but lactic acid, some ketones and phosphoric acids will produce H+

38

What is the likely cause of hypernatremia

Diabetes insipidus

The normal concentration of sodium in the blood plasma is 136-145 mM. Hypernatremia is defined as a serum sodium level over 145 mM.

39

Hypokalemia could result from what 3 things?

Vomiting, crushing's disease and renal failure

Hypokalemia is a lower-than-normal amount of potassium in the blood

40

Name a base in bodily fluids

NCO3-

41

Name 3 things that play a significant role in maintaining acid-base balance.

Blood buffers, kidneys, and respiration

Although the acidic pH of the stomach has a significant effect on blood pH, the stomach cannot maintain blood balance

42

What can act by itself as a buffer

Albumin

43

The purpose of a buffer system is to

Stabilize pH

44

What factor greatly increases the reaction between carbon dioxide and water

Carbonic anhydrase

Carbonic anhydrase is the enzyme found in the erythrocyte membrane which increases the reaction more than 100,000 times

45

Name an effect of acidosis

Mental confusion

Alkalosis tends to make neurons more excitable tending towards seizures while acidosis causes CNS depression leading to coma

46

What blood parameter is directly affected by breathing

Carbon dioxide

Breathing directly alters blood levels of carbon dioxide which then leads to changes in pH

47

During acidosis, the kidneys will secrete ? Into the urine

H2PO4

48

In an attempt to remove acid from the blood, the kidneys will secrete ? Into the urine compartment

NH4+

Ammonium (NH4+) were formed from a combination of ammonia and H+

49

What mechanism requires the most time to regulate pH

Renal function

The blood chemical buffers operate instantly while respiration may require several minutes to adjust pH; the kidneys require 12-24 hours to completely adjust pH

50

What condition is a generalized accumulation of body edematous tissues?

Anasarca

51

What is the normal pH of the blood

7.35-7.45

52

What is the pH range compatible with life?

6.8-8.0

Persons cannot survive long with pH values under6.8 or over 8.0

53

Hyperventilation from anxiety usually causes

Respiratory alkalosis

54

Name 3 things that can cause edema

Obstruction of lymphatic vessels
Increased capillary permeability because of inflammation
Increased venous pressure

55

The imbalance known as ? Can be caused by certain diuretic medications

Hypokalemia

Some diuretics conserve sodium ions at the expense of potassium

56

Name 3 things that occur as a result of a shift in the acid-base balance of the body

An alteration in the rate of enzyme-controlled metabolic reactions
A shift in the distribution of other ions
A modification in hormone actions

57

Name 3 factors that are major metabolic sources of hydrogen ions in the body

Aerobic and anaerobic respiration of glucose
Oxidation of amino acids that contain sulfur
Hydrolysis of phosphoprotiens

58

How is it possible for the rate and depth of breathing to affect hydrogen ion concentrations in body fluids?

During increased air exchange, more carbon dioxide is given off, returning hydrogen ion concentrations to normal

59

What is considered a secondary defense against changes in pH

Renal excretion of hydrogen ions

Physiologic mechanisms are secondary mechanisms

60

Of the following: metabolic water, water output , water in food or water in drinks, what value is the smallest?

Metabolic water

61

What condition leads to a severe, life threatening water loss?

Diabetes insipidus

Diabetes insipidus is a condition where ADH is ignored

62

An abnormal accumulation of interstitial fluid is termed

Edema

Edema or swelling is excess fluid in the interstitium

63

The most serious consequence of potassium imbalance is

Cardiac abnormalities

Cardiac muscle is very sensitive to potassium imbalance

64

What is the normal pH of blood

7.35-7.45

65

What is the most significant inorganic plasma buffer

Bicarbonate

Bicarbonate is very abundant in extracellular fluid

66

What is the most effective intra cellular inorganic buffer

Phosphate

Phosphate is in high intracellular concentration

67

Diabetic ketoacidosis is an example of which imbalance

Metabolic acidosis

Improper metabolism causes a pH less than 7.35

68

During drinking of water, the stretching of the stomach causes a hypothalamic reflex to send impulse to the nervous system causing the person to stop

T or F

True

The stretch receptors in the stomach often initiate a reflex that inhibits drinking, even before the absorption into the blood is complete

69

The osmoreceptors in the hypothalamus cannot detect the change in body fluids until e loss is decreased to around 20% of body water

T or F

False

The hypothalamus osmoreceptors are extremely sensitive to tonicity changes and will respond when the body loss is around 1%

70

The ability to sweat is the major method of regulating body water and concentration

T or F

False

Sweating is a major method of controlling body temperature; the usual loss of 6% is greatly outweighed by the regulatory capability of the kidneys

71

Loss of blood from trauma will usually reduce the amount do urine that is produced

T or F

True

One of the methods of conserving water, electrolytes and raising blood pressure is the inhibition of urine output from the increase in ADH secretion caused by a reduction in water and increase in tonicity sensed by the hypothalamus

72

Diuretics can have an effect of reducing blood pressure

T or F

True

Blood pressure is the main force governing the rate of urine production; high blood pressure can cause an increase in urine output, and diuretics can be used to reduce blood pressure

73

Drinking water can cause intoxication with symptoms similar to alcohol

T or F

True

Water intoxication results when the blood becomes hypotonic and results in the CNS delirium and muscle craps similar to alcohol intoxication

74

Edema caused by surgical procedures or inflammation is always serious and must be treated

T or F

False

Edema is not a disease but a symptom, and it only becomes a problem when it occurs in critical areas such as the lungs or brain (pulmonary or cerebral edema)

75

Diuretics could be used to reduce the edema seen in the legs or sacral regions

T or F

True

Diuretics cause the increase in urine output which will draw fliud from the blood and then the tissue spaces because they are in equilibrium with each other

76

Surgical removal of the breast can cause edema in the arm

T or F

True

Since lymphatic vessels drain ares, the loss of thoracic or pectoral tissue could prevent the return of water from distal areas

77

Most of the requirement for electrolytes can be adequately met by water drinking

T or F

False

Most drinking water is hypotonic and will not contain sufficient electrolytes to meet body demands

78

Cells attempt to maintain electrical charge stability by transporting ions such as sodium inward as soon as they are lost from a cell

T or F

False

Cells must maintain ionic balance which is usually achieved by causing the movement of ions that counterbalance the loss such as K+ for Na+

79

Breast, lung or bone cancers can cause hypercalcemia

T or F

True

Cancer cells can produce hormones similar to PTH or bone cancers can destroy bone tissue, either event causes rises in blood Ca 2+ levels

80

Increases in carbon dioxide production usually result in a decrease in acidity

T or F

False

Carbon dioxide from any source such as metabolism, readily combines with water to yield carbonic acid which ionizes to release H+

81

The oxidation of fatty or amino acids always must cause a decrease in pH

T or F

False

Some fatty acids produce acidic ketones and some amino acids result in acidic end products, but not all; most amino acids are amphoteric which means they have acidic and basic properties together in the same molecule

82

Factors that decrease the pH of a solution must always increase the acidity

T or F

True

The pH scale is a measurement of acidity and is inversely related to acid; the higher pH numbers means lower acidity

83

Diuretics have a higher probability of causing a sodium than a potassium depletion

T or F

False

The normal function of the kidney is to conserve sodium and excrete potassium, under the influence of aldosterone; factors which increase the rate of urination formation usually exaggerate this effect and cause a potassium depletion

84

Either hyperkalemia or hypokalemia could be associated with muscle paralysis or cardiac arrhythmias.

T or F

True

Either high or low levels of K+ are associated with nerve and muscle excitability disturbances; since the causative factors are complex, the resultant symptoms are also not directly related to either condition

85

Carbonated beverages usually have a higher pH than stomach secretions

T or F

True

Carbon dioxide forms the weak acid carbonic acid while the stomach produces the strong acid HCl, making its pH lower.

86

Both components of the phosphate buffer system are acids, which breaks the normal buffering rules

T or F

False

Both of the components are acids, but buffer rules are not broken because in physiologic solutions, the H2PO4 acts as the relative base, therefore enabling the system to buffer acids or bases

87

Holding one's breath tends to make the blood more acidic

T or F

True

Since carbon dioxide forms carbonic aci, the pH could decrease if carbon dioxide levels increase, assuming that the other buffers were not compensating

88

Renal secretion of phosphate acids is an example of renal compensation for respiratory acidosis

T or F

False

If the pH is restored to normal, the mechanism can be called compensation; only organs other than the one that is the cause of the imbalance can be said to compensate

89

A pH of 7.1 in a diabetic is caused by the production of compounds such as beta-hydroxybutyric acid

T or F

False

Ketoacidosis occurs when the production of acidic ketones exceeds the ability of all of the buffers to prevent acidosis; the production of some ketones occurs normally each day

90

The respiratory center in the pons and medulla are able to alter the pH of the blood

T or F

True

The respiratory centers react to the levels of H+ by altering breathing rate and depth; the effect is to facilitate the actions of the chemical bicarbonate blood buffers

91

A Person's blood may be alkaline at the same time they are considered to be in acidosis

T or F

True

The normal range is considered neutral physiologically but is chemically alkaline; a pH of 7.2 is alkaline but considered physiologically to be an indication of acidosis because it is less than 7.35

92

If blood plasma becomes more concentrated, the high osmotic pressure will cause neurons (osmoreceptors) to swell

T or F

False

High osmolarity in the blood would cause crenation.

93

The presence of sodium in the blood can be detected by the osmoreceptors of the hypothalamus

T or F

False

Osmoreceptors are not specific to one solute

94

The phosphate buffer system is more important in extracellular fluids

T or F

False

Phosphate is an intracellular buffer