Disorders of Fluid, Electrolytes, Acid Base, and Blood Flashcards
(131 cards)
1
Q
This is the mechanical pressure exerted on one object by another
A
Fluid Pressure
2
Q
Pressure caused by the weight of fluid, and is exerted in the weight of a column
A
Hydrostatic pressure
3
Q
Where is hydrostatic pressure the largest?
A
The legs and feet
4
Q
What is a clinical example of failed hydrostatic pressure
A
Varicose veins
5
Q
This is the increment of pressure that is created by the resistance to the flow of a fluid in a closed system
A
Hydrodynamic pressure
6
Q
What is an example of hydrodynamic pressure?
A
The cardiovascular system
7
Q
This is the hydrodynamic pressure of moving blood
A
Blood pressure
8
Q
What is the equation of blood pressure?
A
Blood pressure= blood flow rate (cardiac output) * vascular resistance
9
Q
What % of water is intracellular?
A
2/3
10
Q
For fluid to flow, there must be ______
A
Pressure acting on that fluid
11
Q
Where is the pressure highest in the heart?
A
Left ventricle
12
Q
Where is the pressure lowest in the heart?
A
Right atrium
13
Q
Where is the area of the greatest resistance?
A
The arterioles (provided by the smooth muscle tone)
14
Q
The pressure gradient is driven by the ______ work for the left ventricle myocardial muscle
A
Mechanical
15
Q
What determines the flow into the arterial tree?
A
Cardiac output
16
Q
What determines flow out of the arterial tree?
A
Vascular resistance
17
Q
What is the equation for cardiac output?
A
CO= HR * SV
18
Q
What influences cardiac output?
A
Blood volume
19
Q
The lesser the blood volume, the ____ cardiac output and the _____ blood pressure
A
- Lesser cardiac output
- Lesser the Blood pressure
20
Q
What determines vascular resistance?
A
The collective size of the small peripheral arterioles
21
Q
The arterioles _____ to increase out flow
A
Constrict
22
Q
The arterioles _____ to decrease out flow
A
Dilate
23
Q
Where are the arterial blood pressures the highest?
A
The aorta
24
Q
What is the relative arterial blood pressure in the upper arm?
A
100 mmHg
25
What is the average blood pressure when it reenters the heart near the aorta?
0 mmHg
26
What triggers the RAA system?
Low Blood pressure
27
What secretes renin
Kidneys
28
Why is renin secreted?
To increase BP
29
What does renin do?
Acts on angiotensinogen and converts it to angiotensin 1
30
What makes angiotensinogen?
Liver
31
What converts angiotensin 1 to angiotensin 2
ACE
32
Where is acetylcholinesterase (ACE) made from?
The lungs
33
What does angiotensin 2 do?
Increases blood pressure by increasing peripheral resistance and cardiac output
34
Is angiotensin 2 a vasoconstrictor/dilator?
Vasoconstrictor
35
What does angiotensin 2 stimulate?
the secretion of aldosterone
36
Where is aldosterone secreted from?
The adrenal cortex
37
What does aldosterone do?
Acts on the kidney and tells it to hold onto water and Na to increase blood volume, to increase blood pressure, and to increase cardiac output
38
This is a mixture of a solvent and solute
Solution
39
This is what the solute is dissolved in
The solution
40
What is the bodies solvent?
Water
41
What is equivalent to blood concentration
0.9% NaCl (normal saline)
42
What does too much water cause?
Dilution of the solute concentration
43
What happens if the brain becomes hypervolumic?
It doesn't have anywhere to expand and when the cells swell it increases pressure and can cause swollen brain and seizures
44
What does the solute contain?
- Carbohydrates
- Proteins
- Salts
- Vitamins
- Hormones
45
Is fat a solute?
NOPE
46
What is the average solute concentration?
0.9% solution of NaCl
47
This is the concentration of the solute
Osmolarity
48
Under the normal conditions, ICF ___ ECF
ICF=ECF
49
Where does water go if there is a decrease in the ECF solute concentration?
ICF (water follows salt, so if salt is higher in the cell compared to the outside, water goes into the cells too)
50
A membrane that is permeable to the solvent but not the solute
Semipermeable membrane
51
This is the flow of water across a semipermeable membrane
Osmosis
52
Low osmolality=
Less stuff
53
High osmolarity=
Lots o stuff
54
What direction does water move?
Low osmolarity to high osmolarity (bc water wants to follow stuff)
55
This is the measure of the tenancy of water to move by osmosis from an area of high water (low solute) to low water (high solute)
Osmotic pressure
56
Lower pressure= ____ attraction
Lower
57
What is osmotic pressure mostly caused by?
Salt and Albumin
58
Low osmotic pressure tends to lose water and result in...
Third spacing
59
The inner most walls are...
endothelium
60
What drives water out of the vascular space?
Hemodynamic pressure
61
What vascular vessel has the highest hydrostatic pressure?
Veins
62
Describe what happens in varicose veins
The hydrostatic pressure is too large and the blood starts coming out
63
Treatment for varicose veins
- Exercise
- Compression socks
- Diuretics
- Collapse incompetent veins (surgery)
64
What 2 types of pressure combine to cause the flow of small amounts of fluid from blood to interstitial space
- Hydrodynamic Pressure
| - Osmotic pressure
65
What is responsible for forcing water out of the vascular space?
Blood pressure
66
This type of pressure tends to retain water within the vascular space
Osmotic pressure
67
What percentage of the body is solids?
45%
68
What percentage of the body is fluid?
55% (mostly water)
69
What is needed to move water?
Force
70
How is water maintained?
- Metabolic reactions
| - Food and drinks
71
How is water regulated?
Cells in the thirst center of the hypothalamus which sense osmolality
72
High osmolality= ____ water
Low water and signals to the thirst center that they need water
73
This works and acts on the kidney and causes you to retain water and concentrate the urine
ADH
74
What does alcohol do to ADH?
Inhibits ADH so you cant retain anything
75
How is water lost?
- Stool
- Urine
- Precipitation
- Respiratory Air
76
What are 3 mechanisms of water loss?
1. Antidiuretic hormone
2. Aldosterone
3. Atrial Naturetic hormone
77
Describe antidiuretic hormone
- Secreted by posterior pituitary
- Responds to osmoreceptors
- Osmoreceptors influence the kidney to retain water
78
Describe aldosterone
- Secreted by the adrenal cortex on command of renin
| - Influences the kidney to retain water
79
Describe atrial Naturetic hormone
- Secreted by the atrial cardiac muscles in response to increased blood volume
- Influences the kidney to release Na and water which lowers blood pressure by lowering blood volume
80
Where is the thirst center?
Hypothalamus
81
What is plasma made of?
-90% water and electrolytes
82
What is the normal kidney output?
1 liter per day
83
What is the sign of heart failure in a patient?
An increase in about 2 pounds in a day (1 liter= 2.2 lbs of fluid)
84
These are chemicals that separate into ions when they are dissolved in water
Electrolytes
85
What is the main determinant of volume shifts?
Salt
86
What is the relationship of between salt and water
Water follows salt
87
This is an abnormal accumulation of fluid in a tissue or body cavity
Edema
88
Is edema generalized or localized?
Generalized- it is hard to see
89
Causes of edema
- Lymphatic obstruction
- Back flow
- Low plasma osmotic pressure
90
What are the 3 types of edema?
1. Inflammatory edema
2. Lymphatic edema
3. Non-Inflammatory edema
91
Describe inflammatory edema
- AKA exudate
| - High protein
92
How does inflammatory edema occur
In response to increased vascular permeability of inflammation (bc of an inflammatory response)
93
Does inflammatory edema pit?
NOPE
94
Describe lymphatic edema
- Non-pitting
- High protein
- Bilateral
- Due to bad lymph absorption
95
What can help decrease lymph edema
Losing weight
96
Describe non-inflammatory edema
- Low protein
- AKA transudate
- caused by pressure imbalances
97
What happens to capillary fluid pressure in non-inflammatory edema
High capillary pressure
98
Describe the osmotic pressure in non-inflammatory edema
Low osmotic pressure (low attraction for water)
99
What is the definitive factor in osmotic pressure?
Albumin
100
Does non-inflammatory edema pit?
Yes aka pitting edema
101
Why does pitting occur in non-inflammatory edema?
- Pressure imbalance
- Increased capillary pressure
- Decreased osmotic pressure
102
Examples of non-inflammatory edema
- Liver failure
- Kidney failure
- CHF
- DVT
- Glomerular disease
- Venous Insufficiency
- Right side heart failure
103
This is a collection of fluid in body cavities
Ascites
| -seen in patients with liver failure
104
Body wide edema
Anasarca
105
Collection of edema in a space
Effusion
| -Ex. Pleural effusion- between lung and chest wall)
106
What are the 2 forms of edema
1. Localized
| 2. Generalized
107
Describe localized edema
- Swelling associated with tissue injury and inflammation
| - Easy to see
108
Describe generalized edema
-May be hidden
| Ex. Heart failure
109
Sign of pleural effusion
SOB
110
Signs of pericardial effusion
Heart is not as efficient
111
Describe venous stasis/chronic edema
- Lymph edema causes breakdown of melanocytes
| - Causes brown skin tone
112
What does chronic edema lead to?
- Atrophy
- Get ulcerations
- Due t skin breakdown
- Can lead to infection
113
Example of isotonic water loss
Sweating
114
Example of hypertonic fluid loss
GI loss/diarrhea
115
What is an example of hypotonic fluid loss
UTI
116
What can prolonged glucose in diabetes cause
Brain cell destruction and coma
117
2% dehydration=
Mild dehydration
118
5% dehydration=
Moderate dehydration
119
8% dehydration=
Severe dehydration
120
Who experiences the most severe dehydration?
- Infants
- Elderly
- Debilitated
121
Where does water shift in dehydration?
Out of the vascular space
122
Define third spacing
Shift of fluid out of blood into another body surface
123
Loss of fluid roughly eq to normal plasma
Normotonic dehydration
124
Loss of fluid with low electrolyte concentration
Hypotonic dehydration
125
Loss of fluid with high electrolyte concentration
Hypertonic dehydration
126
Signs of dehydration
- Dry mucus membranes
- Low BP
- Weak
- Rapid pulse
- Increased RBC (as a fraction of blood volume)
127
Does aldosterone and K have a direct or indirect relationship
Indirect
128
Do calcium and phosphate levels have an inverse relationship
Yes
129
How is Ca balance maintained?
By parathyroid hormone
130
What does parathyroid hormone do?
- Shifts Ca into blood
- Stimulates intestinal absorbtion of Ca
- Reduces urine Ca excretion
131
What causes hypocalcemia
- Low PTH
- Renal Failure
- Vitamin D deficiency
- Prolonged Alkalosis
