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ENDO > ENDO Week 10 > Flashcards

ENDO Week 10 Flashcards

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1
Q

where is body fluid found

A

flows in arteries, veins, lymph nodes

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2
Q

how is fluid distributed between interstitial and intracellular space

A

osmosis
water goes to higher osmolality compartment

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3
Q

what is the relationship between total body water and body fat

A

inverse relationship

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4
Q

what is ICF and ECF

A

ICF: all fluid inside all cells
ECF: all fluid outside of cells

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5
Q

what are the components of ECF

A

interstitial fluid: fluid surrounds cells
blood plasma: liquid part of blood
transcellular fluid: cerebrospinal fluid, pleural fluid, intraocular fluid, peritoneal fluid

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6
Q

what are the function of body fluids

A
  • electrolyte balance and osmoregulation
  • transportation
  • metabolic reaction
  • pH balance
  • temperature regulation
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7
Q

what are the major electrolytes of body fluids

A

sodium: mainly ECF
chloride: mainly ECF
potassium: mainly ICF
magnesium: ICF
calcium: ECF and ICF
Bicarbonate: buffer to maintain pH balance in blood

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8
Q

what are the constituents of body fluids and what do they include

A

organic and inorganic substances
inorganic substances are the electrolytes

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9
Q

how are fluid compartments measured

A

using the dilution method (measures ECF): Administer tracers that distribute in specific compartments and calculate based on amount excreted vs injected

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10
Q

how is TBW measured

A

dilution method: Tracers mix with body water, dilution reveals total water content

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11
Q

how is ECF volume measured

A
  • Can be measured directly via dilution method (injected inulin)
  • Plasma volume can be measured and is used to measure blood volume
  • Interstitial fluid: ECF – plasma volume
    (indirect method)
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12
Q

how is ICF volume measured

A

TBW - ECF
(indirect measurement)

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13
Q

what are some clinical assessment methods of determining change in body fluid

A

o Changes in body weight
o Urine and blood analysis (osmolality)

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14
Q

what is osmolarity

A

o Concentration of osmotically active particles per liter of solution

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15
Q

what is normal plasma osmolarity

A

o Normal plasma: 290 mOsm/L (no net movement)

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16
Q

what is tonicity

A

Impermeable solutes measured by osmolarity that cause water movement

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17
Q

what happens to a cell placed in a hypertonic solution

A

cell shrinkage

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18
Q

what happens to a cell placed in a hypotonic solution

A

cell swelling (edema)

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19
Q

what is the effect of isotonic solution IV fluid

A

(Saline 0.9%), no change in concentration

just increased ECF volume

osmolality is equivalent to plasma

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20
Q

what is the effect of a hypertonic IV solution

A

will draw water out of the cell (cell shrinks in size)

Higher osmolality than plasma

Increases ECF

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21
Q

what is the effect of a hypotonic IV solution

A

less osmotically active particles in solution), will draw water into the cell (cell increases increases)

Lower osmolality than plasma

Decreases ECF

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22
Q

what is the effect of hyponatremia on a cell and ECF

A
  • Hyponatremia induced cell swelling
  • Decreased ECF osmolality = water drawn into cells
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23
Q

what is the effect of hypernatremia on a cell and ECF

A

Hypernatremia induced cell shrinkage

Increased ECF osmolality = water drawn out of cell

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24
Q

what is the pathophysiology of clinical dehydration

A

Pathophysiology – decrease ECF volume, cell dehydration

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25
what are some causes of clinical dehydration
Inadequate intake, vomiting, diarrhea, polyuria, burns, hemmorage,
26
what are some S+S of mild dehydration
Thirst, dry mucous membranes, reduced urine output
27
what are some S+S of moderate dehydration
Tachycardia, orthostatic hypotension, oliguria
28
what are some S+S of severe dehydration
Hemodynamic instability, end-organ hypoperfusion
29
what do the Starling Forces determine
fluid movement between capillary and interstitial fluid
30
what are the 4 types of pressure
o Capillary hydrostatic pressure o Capillary colloid osmotic pressure o Interstitial hydrostatic pressure o Tissue colloid osmotic pressure
31
what is the direction in which hydrostatic and osmotic pressure move fluid
hydrostatic pushes fluid away osmotic pulls fluid in
32
what is the fluid movement along the capillary
arterial end - fluid exits capillary - filtration occurs mid capillary - no net movement venule end - fluid reenters capillary - reabsorption occurs
33
what is the function of the lymphatic system
- Prevents fluid accumulation in interstitial space - Returns excess filtered fluid from interstitum to circulation - returns osmotically active plasma proteins that may have leaked into intersitiaum due to increased permeability back into circulation
34
what are some consequences of lymphatic dysfunction
o Lymphedema: protein rich interstitial fluid accumulation, unable to put proteins back into circulation o Reduced clearance of pathogens
35
how is fluid balance regulated
* Renal system: water and sodium excretion * Thirst mechanism: regulate water intake * Cardiovascular adjustment: alter distribution of ECF * Regulatory hormones
36
what are the hormones which regulate fluid balance
ADH increases water reabsorption - Response to increase plasma osmolality or decreased blood volume Renin-angiotensin-aldosterone system - aldosterone II stimulates aldosterone (increase sodium reabsorption) and ADH and stimulates thirst ANP promotes sodium and water excretion
37
where is the thirst mechanism located
in the anterior hypothalamus
38
which receptors are responsible for triggering the thirst mechanism
osmoreceptor cells which are neurons
39
what are the two stimuli for thirst
osmotic thirst and hypovolemic thirst
40
what is osmotic thirst activated by and what does it cause
Activated by increase plasma osmolality. Causes dehydration of thirst centre neurons
41
what is hypovolemic thirst activated by
- activated by decrease in blood volume
42
what are 2 factors which inhibit thirst
- Oropharyngeal receptor, osmoreceptor is reduced before water is reabsorbed - Decreased plasma osmolality and restored blood volume
43
what is the osmoregulation mechanism
osmosensory transduction (turns changes in osmolality to neuronal signals 1. Neurons detect changes in osmotic pressure via mechanosensitive channels 2. Cell shrinkage during hypertonicity activated stretch-inhibited cation channels 3. Depolarization occurs, causing AP firing
44
which receptors detect changes in blood pressure/volume
baroreceptors
45
what are clinical disorders of osmoregulation
o Hypodipsia: reduced thirst o Polydipsia: excessive thirst o Osmoreceptor dysfunction: hypernatremia
46
what happens to osmoreceptors in a hypertonic environment?
Hypertonic causes cell shrinkage and increases stretch inhibited channels causes depolarization, causes AP firing to hypothalamus to increase thirst
47
what happens to osmoreceptors in a hypotonic environment?
Hypotonic causes cell swelling and inhibits stretch inhibited channels causes hyperpolarisation
48
when are stretch inhibited cation channels stimulated and inhibited by
stimulated by cell shrinkage in hypertonic environment inhibited by cell swelling in hypotonic environment
49
which hormones regulate the thirst mechanism
angiotensin II ADH ANP Aldosterone (does not act on thirst centre)
50
when does angiotensin II stimulate thirst
decrease in blood volume
51
what is ADH's action in the thirst centre
Stimulates water conservation
52
how does ANP affect thirst
Reduce thirst and block the release of ADH and aldosterone
53
what is aldosterone action
Controls Na+ absorption and K+ loss along the DCT (does not act on thirst center)
54
what are thirst's major stimuli
* Hypertonicity * Hypovolemia (low blood volume) * Hypotension * Angiotensin II: stims thirst when there is decreased blood volume
55
what is the primary determinant of ECF volume and major contributor to plasma osmolality
Sodium
56
is sodium permeable or impermeable across cell membrane
relatively impermeable
57
what are the regulatory mechanism of sodium balance
- glomeluar filtration and tubular reabsorption - hormonal regulation (renal): Aldosterone, ANP, renin
58
what can inadequate water intake or diabetes insipidus cause
hypernatremia
59
why is it important to maintain potassium balance
- RMP maintenance - Cardiac conduction and contractility
60
what are some regulatory mechanism of potassium balance
- renal excretion: principle regulatory mechanism - transcellular shifts
61
what is hypokalemia caused by
 Inadequate intake  Increase renal losses  Transcellular shifts
62
what is hyperkalemia caused by
 Excessive intake  Decrease renal excretion  Transcellular shifts
63
what can hypo and hyper kalmia cause
cardiac arrhythmias
64
what is edema and what is it caused by
* Increase in interstitial fluid volume * Disruptions in starling equation
65
what is pitting edema
- protein less fluid accumulation - can be caused by heart failure
66
what is non pitting edema
protein-rich fluid accumulation
67
what are some common causes of edema
o Lymphedema: impaired lymphatic drainage o Hypothyroidism, non-pitting, caused by mucopolysaccharides o Lipedema: abnormal subcutaneous fat deposition
68
what are the changes in starlings forces that contribute to edema
o Increased capillary hydrostatic pressure o Decreased plasma proteins, decreased capillary osmotic pressure o increased capillary permeability --> increased interstitial fluid osmotic pressure o Blockage of lymphatics
69
what is effusion
o Definition: Abnormal fluid in body cavity o Ex: closed body spaces (pleural, pericardial, peritoneal)
70
what is edema
o Definition: abnormal fluid in closed body spaces o Ex: tissues (legs, lungs, face)
71
how does insulin affect potassium
Insulin promotes potassium entry from ECF to ICF into the cell so low insulin like in diabetes, will cause hyperkalemia
72
how does heart failure cause edema
Increase accumulation of fluid in capillary system --> decrease venous return to heart --> increase capillary hydrostatic pressure --> increase fluid movement at arterial end --> fluid accumulates in interstitium --> edema
73
acidosis and hyperkalemia
acidosis means increased ECF H+ --> H+ moves into cell exchanged for K+ --> increased K+ outside cell
74
alkalosis and hypokalemia
alkalosis means decreased ECF H+ --> H+ moves out of cell exchanged for K+ --> increased K+ inside cell
75
how does Addisons disease (aldosterone deficiency) affect potassium
increases ECF potassium
76
what is Addisons disease affect on ECF volume and osmolarity
decreases ECF volume and osmolarity
77
what is diabetes insipidus's affect on ECF volume and osmolarity
decreases ECF volume and increases osmolarity

ENDO (8 decks)

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