chapter 24: body fluid homoeostasis

Question 1

2/3 of bodyfluid

Answer 1

intracellular

Question 2

1/3 of bodyfluid

Answer 2

extracellular

Question 3

extracellular comprised of (5)

Answer 3

interstitial compartment
vascular compartment
dense connective tissue
bone 
transcellular fluids

Question 4

interstitial compartment

Answer 4

between cells

Question 5

vascular compartment

Answer 5

blood vessels

Question 6

intracellular fluid rich in

Answer 6

potassium
magnesium
phosphates
proteins

Question 7

intracellular fluid low in

Answer 7

sodium

chloride

Question 8

extracellular fluid rich in

Answer 8

sodium
chloride
bicarbonate

Question 9

extracellular fluid low in

Answer 9

potassium
magnesium
phosphate

Question 10

fluid homeostasis net result of 4 subprocesses

Answer 10

intake
absorption
distribution
excretion

Question 11

capillary hydrostatic pressure

Answer 11

outward push of vascular fluid against the capillary walls

Question 12

osmotic pressure

Answer 12

inward pulling force of particles

Question 13

ADH released in response to

Answer 13

increases osmolality of extracellular fluid

decrease circulating volume

Question 14

ADH causes

Answer 14

reabsorption of water in kidneys

decrease fluid excretion

Question 15

aldosterone released in response to

Answer 15

decreased circulating blood

increased potassium ions in plasma

Question 16

aldosterone causes

Answer 16

reabsorption of sodium and water

expanding extracellular fluid

Question 17

ANP

Answer 17

stored in cardiac atrial cells, released when atria are stretched

Question 18

BNP:

Answer 18

released from ventricular cells when ventricular diastolic pressure is increase (stretch)

Question 19

ANP and BNP cause

Answer 19

natriuresis, sodium excretion accompanied by water

Question 20

abnormal fluid loss

Answer 20

GI tubes
emesis
hemorrhage
drainage; fistulas, wounds, open skin, paracentesis

Question 21

Extracellular ECV imbalance

Answer 21

concentration normal, but too much or too little volume.

Question 22

body fluid imbalance

Answer 22

concentration of fluid is abnormal

Question 23

deficit ECV causes

Answer 23

low extracellular volume
emesis, diarrhea, gastric suction, fistula drainage
extensive diuretic use, bed rest
hemmorhage, massive diaphoresis, third spacing, paracentesis, burns

Question 24

ECV deficit manifestations

Answer 24

wt. loss
postural BP decrease
tachycardia
flat neck veins when supine
prolonged capillary refill
lightheaded, dizzy
syncope
oliguria
dry mouth
hard stools
no tears or sweat

Question 25

ECV excess manifestations

Answer 25

wt gain edema circulatory overload: bounding pulse, neck vein distention upright, crackles, dyspnea, orthopnea

Question 26

ECV excess causes

Answer 26

``` Excessive IV infusion hyperaldosteronism CHF cirrhosis glomerulonephritis renal disease cushing disease corticosteroid therapy ```

Question 27

hyponatremia manifestations

Answer 27

``` <135 CNS dysfunction malaise anorexia nausea/vomiting headache confusion lethargy seizure coma ```

Question 28

hypernatremia manifestations

Answer 28

``` >145 CNS dysfunction neurons and glial cells shrivel confusion lethargy seizures coma ```

Question 29

ECV defici and hypernatremia

Answer 29

clinical dehydration vomiting and diarrhea unable to replace water and sodium s/s: same as hypernatremia and ECV deficit

Question 30

edema

Answer 30

excess fluid in interstitial compartment (between cells)

Question 31

causes of edema (4)

Answer 31

increased capillary hydrostatic pressure increased interstitial fluid osmotic pressure blockage of lymphatic drainage decreased capillary osmotic pressure

Question 32

Increased capillary hydrostatic pressure causes (3)

Answer 32

increased ECV increased local capillary flow associated with inflammation venous congestion

Question 33

increased interstitial fluid osmotic pressure cause

Answer 33

inflammation increases vascular permeability and proteins leak into interstitial fluid.

Question 34

blockage of lymphatic drainage cause

Answer 34

lymphatic drainage usually removes minute amounts of protein that enter interstitial fluid - blockage: tumor, parasites, fibrosis, surgical removal of lymphnodes - accumulation of protein in interstitial fluid

Question 35

decreased capillary osmotic pressure caused by

Answer 35

decrease concentration of plasma proteins

Question 36

aldosterone causes excretion of

Answer 36

potassium

Question 37

diarrhea causes excretion of

Answer 37

potassium and magnesium

Question 38

hypokalemia manifestations

Answer 38

``` <3.5 muscle dysfunction (membrane potential) hyperpolarized abd. distention dec. bowel sounds/ paralytic ileus postural hypotension muscle weakness flaccid paralysis respiratory paralysis ```

Question 39

hyperkalemia manifestations

Answer 39

``` >5.0 muscles hypopolarized mild intestinal cramping diarrhea -as worsens skeletal muscles hypopolarized to above resting potential, once discharged will not contract again muscle weakness flaccid paralysis cardiac arrest ```

Question 40

plasma calcium 3 forms

Answer 40

bound to protein (albumin) bound to small organic ions (citrate) unbound (free)

Question 41

hypocalcemia manifestations

Answer 41

``` <4.0 if caused by more binding, total serum normal increased muscle excitability positive: Trousseau and Chvostek signs parasthesias muscle twitching hyper reflexes spasms tetany seizure cardiac dysrhythmia ```

Question 42

hypercalcemia manifestations

Answer 42

``` >5.5 decreased neuro-muscular excitability anorexia nausea/vomiting constipation fatigue polyuria muscle weakness decrease reflexes HA confusion lethargy personality change cardiac dysrhythmia ```

Question 43

hypomagnesemia manifestations

Answer 43

``` <1.5 Mg depresses release of acetylcholine at neuromuscular junctions. inc. mg = dec. acetylcholine increase neuromuscular excitability insomnia increased reflexes muscle cramps grmacing positive: Trousseau and Chvostek nystagmus dysphagia ataxia seizures dysrhythmia ```

Question 44

hypermagnesemia manifestations

Answer 44

``` >2.5 dec. acetylcholine dec. deep tendon reflexes lethargy hypotension flushing diaphoresis drowsiness flaccid paralysis respiratory depression bradycardia dysrhythmia, arrest ```

Question 45

hypophostphatemia manifestations

Answer 45

``` <2.5 important component of ATP anorexia malaise paresthesias hemolysis dec. reflexes muscle aches/ weakness respiratory failure impaired cardiac function ```

Question 46

hyperphosphatemia manifestations

Answer 46

``` >4.5 (hypocalcemia) increased neuormuscular excitability positive: Trousseau, Chvostek paresthesias muscle twitches/ cramps increased reflexes spasms seizures cardiac dysrhythmia ```

Question 47

increased capillary permeability -> edema

Answer 47

burn, allergic inflammation reaction = inc. capillary permeability - > proteins can move through membrane/ loss of plasma proteins - > increased tissue oncotic pressue - > edema

Question 48

decreased production of plasma proteins -> edema

Answer 48

cirrhosis, malnutrition = dec. production of plasma proteins - > decrease in capillary oncotic pressure due to less proteins - > fluid build up in tissues - > edema

Question 49

increased capillary hydrostatic pressure -> edema

Answer 49

venous obstruction, Na & H2O retention, HF = inc. capillary hydrostatic pressure - > fluid moves into tissue due to hydrostatic pressure of capillaries > hydrostatic pressure of ECF - > edema