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Physiology > Fluid, Electrolyte, and acid base balance > Flashcards

Fluid, Electrolyte, and acid base balance Flashcards

1
Q

What is the percentage of water in infants?

A

73% or more
(they have a low body fat and low bone mass)

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2
Q

What percentage of water do adult males hold?

A

60%

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3
Q

What percentage of water do adult females hold?

A

50%
(more fat and less skeletal muscle (that holds water)

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4
Q

What is the total body water volume?

A

40 Liters

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5
Q

What are the two main fluid compartments in the body?

A

Intracellular fluid
Extracellular fluid

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6
Q

What are the two parts of the extracellular fluid compartment?

A

Plasma (3L of water)
Interstitial fluid (12 L of water)

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7
Q

Water is a ____ solvent?

A

Universal

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8
Q

What are solutes?

A

What is dissolved in water

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9
Q

TF: Non electrolytes are mostly organic?

A

True (not soluble has many C’s)
Do not dissociate into water well

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10
Q

TF: Non electrolytes have a greater osmotic power than electrolytes

A

False
Electrolytes have the greatest ability to cause fluid shifts

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11
Q

What are the most abundant solutes in body fluids?

A

Electrolytes

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12
Q

What determines most chemical and physical reactions in the body?

A

Electrolytes

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13
Q

What two pressures regulate continuous exchange and mixing of fluids?

A

Osmotic
Hydrostatic

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14
Q

What causes net water flow?

A

Change in solute concentration of any compartment

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15
Q

Water intake must equal water _____

A

Output

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16
Q

How can the body intake water?

A

Beverages
Foods
Metabolic water

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17
Q

How can the body output water?

A

Urine
Insensible water loss (lost through skin and lungs)
Perspiration
Feces

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18
Q

What is osmolality usually maintained at in the body?

A

Around 280-300 mOsm

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19
Q

What happens when osmolality increases?

A

Stimulation of thirst
ADH release
(increase in osmolality means water is leaving)

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20
Q

What happens due to a decrease in osmolality?

A

Thirst inhibition
ADH inhibition

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21
Q

What is the main driving force for water intake?

A

Thirst mechanism

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22
Q

What is the thirst mechanism governed by?

A

Hypothalamic thirst center

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23
Q

What do hypothalamic osmoreceptors detect?

A

ECF osmolality

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24
Q

What is obligatory water loss?

A

Insensible water loss from lungs and skin
Feces

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25
Q

What is the daily minimum of sensible water loss volume?

A

500 mL in urine to excrete wastes

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26
Q

What is water reabsorption in collecting ducts proportional to?

A

ADH release

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27
Q

What senses ECF solute concentration?

A

Hypothalamic osmoreceptors

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28
Q

What factors may triggers ADH release?

A

Decrease in blood pressure
Large changes in blood volume
Factors lowering blood volume

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29
Q

What does dehydration cause?

A

Negative fluid balance
ECF water loss

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30
Q

What are the signs and symptoms of dehydration?

A

Cottony oral mucosa
Thirst
Dry flushed skin
Oliguria

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31
Q

What happens during hypotonic hydration?

A

Cellular over-hydration
water intoxication

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32
Q

What causes hypotonic hydration?

A

Renal insufficiency or rapid excess of water intake

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33
Q

How is hypotonic hydration treated?

A

With hypertonic saline

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34
Q

What is edema?`

A

Atypical accumulation of IF that causes tissue swelling (not cell swelling)

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35
Q

What causes edema?

A

Increase of fluid out of the blood or
Decrease of fluid in the blood

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36
Q

What causes an increase in fluid out of blood?

A

Increased capillary hydrostatic pressure or permeability
(incompetent venous valves, localized blood vessel blockage, congestive heart failure, increase in blood volume

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37
Q

What causes a decrease in fluid returning to blood?

A

Imbalance in colloid osmotic pressures
Fluid failes to return at venous ends of capillary beds

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38
Q

What is imbalanced colloid osmotic pressures a result of?

A

Protein malnutrition
Liver disease
Glomerulonephritis

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39
Q

What causes leaked proteins to accumulate in the interstitial fluid?

A

Blocked or surgically removed lymphatic vessel
Having more proteins (colloids) in the IF pulls fluids from the blood

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40
Q

What increases diffusion distance for nutrients and oxygen?

A

Edema

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41
Q

TF: Edema causes low blood pressure and severely impaired circulation

A

True

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42
Q

What does electrolyte balance usually refer to?

A

Salt balance

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43
Q

What do salts control?

A

Fluid movements

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44
Q

What do salts provide?

A

Minerals for excitability, secretory activity, and membrane permeability

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45
Q

What is the most abundant cation in the ECF?

A

Na+

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46
Q

What is the only cation that exerts significant osmotic pressure?

A

Na+

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47
Q

What determines osmolality of ECF?

A

Concentration of Na+

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48
Q

TF: there are many receptors that monitor Na+ levels in body fluids?

A

False
There are no known receptors `

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49
Q

What two control mechanisms are linked to Na+ water balance?

A

Blood pressure
Blood volume

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50
Q

What does aldosterone do?

A

Decrease urinary output
Increase blood volume

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51
Q

How does aldosterone increase blood volume and decrease urinary output?

A

Active reabsorption of remaining Na+ in distal convoluted tubule and collecting duct
(causes increased K+ secretion- remember if Na is going into blood K+ usually replaces it to keep the charge in the urinary system)

52
Q

What percent of Na+ is reabsorbed in proximal tubules

A

65%

53
Q

What percent of Na+ is reclaimed in the nephron loop?

A

25%

54
Q

TF: Na is never secreted into the filtrate

A

True

55
Q

What follows Na+ if ADH is present?

A

Water in the filtrate

56
Q

What mechanism is the main trigger for aldosterone release?

A

Renin-angiotensin- aldosterone mechanism

57
Q

What secretes renin in the kidneys?

A

Granular cells

58
Q

What activates granular cells to secrete renin in the juxtaglomerular caps?

A

Sympathetic nervous system stimulation
Decrease filtrate NaCl concentration
Decrease in stretch due to decreased blood pressure of granular cells

59
Q

What does renin catalyze?

A

production of angiotensin II

60
Q

What does renin cause Na+ to do?

A

Become more reabsorbed by kidney tubules

61
Q

What releases ANP?

A

Atrial cells in response to stretch (increase in blood pressure)

62
Q

What does ANP cause?

A

Increase of excretion of Na+ and water
Promotes vasodilation
Decrease in angiotensin II

63
Q

What female sex hormone increases salt reabsorption?

A

Estrogens
(H20 retention -bloating - during menstrual cycles and pregnancy

64
Q

What female sex hormone decreases Na+ reabsorption?

A

Progesterone
Promotes Na+ and H2O loss

65
Q

What do glucocorticoids do?

A

Increase sodium reabsorption and promote edema

66
Q

What do baroreceptors do?

A

Alert the brain of increases in blood volume and pressure
(Baro=pressure)

67
Q

What does potassium do for neurons and muscle cells?

A

Affect the resting membrane potential

68
Q

What happens when there is not enough potassium?

A

Hyperpolarization and nonresponsiveness

69
Q

What is hyperkalemia?

A

Too much K+

70
Q

What is hypokalemia?

A

Too little K+

71
Q

___ shifts in and out of cells in opposite direction of K+ to maintain cation balance?

A

H+

72
Q

TF: Kidneys have low ability to retain K+

A

True

73
Q

What is the most important factor affecting K+ secretion?

A

Its concentration in ECF

74
Q

What reduces K+ secretion?

A

Low K+ diet
Accelerated loss of K+

75
Q

What influence does aldosterone play for K+ secretion?

A

It stimulates K+ secretion and Na+ reabsorption
Through principal cells

76
Q

Where is 99% of the body’s calcium?

A

In the bones as calcium phosphate salts

77
Q

What is Ca2+ in the ECF important for?

A

Blood clotting
Cell membrane permeability
Secretory activities
Neuromuscular excitability

78
Q

What does hypocalcemia cause

A

Increased excitability and muscle tetany

79
Q

What does hypercalcemia cause?

A

Inhibition of neurons and muscle cells
Heart arrhythmias

80
Q

What controls calcium balance?

A

Parathyroid hormone

81
Q

What is the major anion in the ECF?

A

Cl-

82
Q

How much calcium in percent is reabsorbed under normal pH conditions?

A

99%

83
Q

What does pH affect?

A

All functional proteins and biochemical reactions

84
Q

How is most H+ produced?

A

Through metabolism

85
Q

H+ is liberated when CO2 is converted to _____ in the blood

A

HCO3-

86
Q

What regulates concentration of hydrogen ions in order?

A
  1. Chemical buffers (rapid and first line of defense)
  2. Brain stem respiratory centers (act within 1-3 minutes)
  3. Renal mechanisms (most potent but requires hours to days)
87
Q

What are three types of chemical buffer systems?

A

Bicarbonate buffer system
Phosphate buffer system
Protein buffer system

88
Q

What is contained in the bicarbonate buffer system?

A

Mixture of a weak acid (H2CO3) and salts of HCO3- (weak bases like NaHCO3)

89
Q

What does the bicarbonate buffer system actually buffer?

A

ICF and ECF

90
Q

What is the only important ECF buffer?

A

Bicarb buffer system

91
Q

What are the components of the phosphate buffer system?

A

Sodium salts of Dihydrogen phosphate which is a weak acid
and Monohydrogen phosphate which is a weak base

92
Q

TF: The phosphate buffer system is unimportant in buffering plasma

A

True

93
Q

What is an effective buffer in urine and ICF?

A

Phosphate buffer systems
(Where PO4 concentration is high)

94
Q

What are the components of a protein buffer system?

A

Intracellular proteins
Plasma proteins

95
Q

_____ molecules are amphoteric

A

Protein

96
Q

What does amphoteric mean?

A

Can function as both a weak acid and a weak base

97
Q

What releases H+ ions when pH rises (in the protein buffer system?

A

Organic acid
Carboxyl groups

98
Q

What binds to H+ when pH falls?

A

NH2

99
Q

What do respiratory and renal systems do as buffer systems?

A

Regulate amount of acid or base in the body
Act more slowly
Have more capacity than chemical buffers

100
Q

What do the lungs do for the Respiratory buffer system?

A

Eliminate volatile carbonic acid by eliminating CO2 (exhale)

101
Q

What do the kidneys do as a buffer system?

A

Eliminate nonvolatile (fixed) acids produced by cellular metabolism to prevent metabolic acidosis
Regulate levels of alkaline substances

102
Q

What are the most important renal mechanisms?

A

Conserving or generating new HCO3-
Excreting HCO3-

103
Q

TF: Generating or reabsorbing one HCO3- is the same as loosing one H+

A

True

104
Q

To reabsorb bicarbonate the kidneys must ____ H+

A

Secrete

105
Q

Where in the kidney does H+ secretion occur?

A

In the PCT
In the collecting duct Type A intercalated cells
Secretion means it is going INTO the filtrate

106
Q

Rate of H+ secretion changes with ECF _____ levels

A

CO2`

107
Q

What happens to the rate of H+ secretion when CO2 increases in the peritubular capillary blood

A

H+ secretion rate is increased

108
Q

What must the kidneys do the maintain the alkaline reserve?

A

Replenish bicarbonate

109
Q

Two mechanisms in the ___ and ______ generate new bicarb to be added to alkaline reserve

A

PCT and Type A intercalated cells

110
Q

Dietary __ must be balanced by generating new _____

A

H+
Bicarb

111
Q

What is the most important urine buffer?

A

Phosphate buffer

112
Q

H+ is secreted in the filtrate by what?

A

H+ ATPase pump

113
Q

In what form is H+ secreted and excreted in the urine?

A

H2PO4-

114
Q

What is the more important mechanism for excreting acid?

A

Ammonium ion excretion

115
Q

What does ammonium ion excretion involve?

A

Metabolism of glutamine in the PCT cells

116
Q

Each glutamine produces 2 ___and 2 new ____

A

NH4+
HCO3-

117
Q

____ moves to the blood and ___ is excreted in the urine (from glutamine use)

A

HCO3-
NH4+

118
Q

What replenishes alkaline reserve of blood?

A

Ammonium ion excretion

119
Q

What do type B intercalated cells do?

A

Secrete HCO3-
Reclaim H+ to acidify the blood

120
Q

What is the most important indicator for respiratory acidosis and alkalosis

A

Blood PCO2

121
Q

What is the key indicator of Metabolic acidosis and alkalosis?

A

HCO3- levels

122
Q

PCO2 above __mmHg represents respiratory acidosis

A

45

123
Q

PCO2 below ___ mmHg represents respiratory alkalosis?

A

35

124
Q

What is respiratory compensation?

A

Changes in respiratory rate and depth

125
Q
A

Physiology (17 decks)

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