Term
|
Definition
| Movement of fluids to a higher solute concentration (low osmotic pressure to high omsotic pressure (concentrated solution)) |
|
|
Term
|
Definition
| Movement away from a higher solute concentration away to balance molecules. |
|
|
Term
| What is the typical osmolality in plasma? |
|
Definition
|
|
Term
| How much fluid is in extracellular fluid? |
|
Definition
|
|
Term
| How much fluid is in intracellular fluid? |
|
Definition
|
|
Term
| Where does extracellular fluid usually come from when you lose water? |
|
Definition
|
|
Term
| What is the basic rule of thumb for water and sodium? |
|
Definition
| Where sodium goes, water follows. |
|
|
Term
| What happens to plasma volume when osmolality decreases? |
|
Definition
| The osmolality increases. (Higher concentration of molecules to water.) |
|
|
Term
| What is an early sign of dehydration in older adults? |
|
Definition
| Confusion. Less Cerebral Spinal Fluid can cause a variety of issues. |
|
|
Term
| What are some signs and symptoms of hypovolemia? (What happens when you have less water in your system?) |
|
Definition
| Hypotension, postural hypotension, weak thready pulse, confusion, tachycardia, weight loss, skin turger loss, low urine output. |
|
|
Term
| What is the Specific Gravity test for? |
|
Definition
| Measuring the volume of particles in the urine. |
|
|
Term
| What is the range for mild, moderate and severe fluid loss? |
|
Definition
Mild 2-4%
Moderate 5-7%
Severe 8% fluid loss or greater |
|
|
Term
| Where do you find third spacing show up frequently? |
|
Definition
|
|
Term
| What do you need to check when someone has low fluid volume? |
|
Definition
Specific Gravity
Sodium
Hematocrit (will be elevated)
BUN
Creatinine
Basic metabolic panel |
|
|
Term
| Why will hematocrit be elevated with low fluid volume? |
|
Definition
| Same reason osmolality increases. Less fluid for it to be compared with so relative concentration is higher. |
|
|
Term
| What is the causes of fluid volume excess? |
|
Definition
| CHF, kidney disease, too much water, bladder retention, excessive sodium intake. |
|
|
Term
| What are signs and symptoms of fluid volume excess? |
|
Definition
| High blood pressure, full bounding pulse, Orthopnea, dyspnea, crackles and wheezes, cough, weight gain, edema |
|
|
Term
| What sign is present in both low and high fluid volume issues? |
|
Definition
|
|
Term
| What are the 3 solutions that are isotonic in the body? |
|
Definition
| .9% saline, ringers and lactated ringers. |
|
|
Term
| What are the 5 solutions that are hypotonic in the body? |
|
Definition
| 5% dextrose in water, .45% Normal Saline, .224% Normal Saline and 5% dextrose in .45% Normal Saline, 5% dextrose in .224% Normal Saline. |
|
|
Term
| What are the 4 solutions that are hypertonic in the body? |
|
Definition
3% and 5% Normal Saline
10% and 50% Dextrose |
|
|
Term
| What solution type should you never use for brain injuries? |
|
Definition
|
|
Term
| How do Hypotonic solutions provide for free water in the body? |
|
Definition
| The dextrose triggers and insulin response and the sugar is pulled away, leaving water behind. |
|
|
Term
| What solution is isotonic in the bag but hypotonic in the body? |
|
Definition
|
|
Term
| What solutions are hypertonic in the bag but hypotonic in the body? |
|
Definition
5% dextrose in .45% Normal Saline (1/2 NS)
5% dextrose in .225% Normal Saline (1/4 NS) |
|
|
Term
| How much water of total body weight in percent |
|
Definition
|
|
Term
| How many liter of total body weight (70kg) |
|
Definition
|
|
Term
| Intracellular water how many liter |
|
Definition
|
|
Term
| Extracellular what subdivisions+L |
|
Definition
Plasma (3.5L)
Interstitial fluid(10L)
Transcellular (1L) |
|
|
Term
| What is transcellular fluid? |
|
Definition
| CSF, eye humors, synovial, pericardial |
|
|
Term
| What is interstitial fluid? |
|
Definition
| fluid in spaces between blood |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| amount of a substance that reacts with (or is equivalent to) an arbitrary amount of another substance in a given chemical reaction |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How are Plasma&ISF separated? |
|
Definition
|
|
Term
| How are ECF&ICF seperated? |
|
Definition
|
|
Term
| What forces controll the fluid movement across capillaries (plasma&ICF) |
|
Definition
capillary pressure, Plasma colloid osmotic pressure,
Interstitial fluid pressure, Interstitial fluid colloid osmsotic pressure |
|
|
Term
|
Definition
| number of solute particels/L solution |
|
|
Term
|
Definition
| number of solute particles/kg H20 |
|
|
Term
| Which cell membrane is not permeable to water? |
|
Definition
|
|
Term
| Cell membranes are mostly (im)permeable to ions? |
|
Definition
|
|
Term
| How do ions get across membranes? |
|
Definition
| facialted diffusion or active transport |
|
|
Term
|
Definition
| moves water across cell membranes and cause volume changes |
|
|
Term
Low osmotic pressure:
High or or Low water concentration? |
|
Definition
|
|
Term
|
Definition
| effect of concentraion of a solution on the VOLUME of a cell |
|
|
Term
|
Definition
| do not change volume, no exchange in water |
|
|
Term
Hypertonic
Hypotonic who shrinks/swells |
|
Definition
Hypertonic solutions cause cells to shrink
Hypotonic solutions caus cells to swell |
|
|
Term
| Body water content infant |
|
Definition
|
|
Term
| Body water content old age |
|
Definition
|
|
Term
| Who has higher total body water content- male or female? |
|
Definition
|
|
Term
| food and drink water intake? |
|
Definition
|
|
Term
|
Definition
0,3L
Glucose+O2-->CO2+H2O+ATP |
|
|
Term
|
Definition
| insensible water loss 0,9L |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Fluid balance maintaines by regulation of |
|
Definition
| ECF volume and osmolarity |
|
|
Term
| systems involved in fluid control? |
|
Definition
CNS (water&salt intake)
Endocrine system
Kindney (most impoertant)
Hydrostatic and osmotic pressure gradient |
|
|
Term
| Can kidneys restore lost volume? |
|
Definition
|
|
Term
| What happens if volume drops too low? |
|
Definition
|
|
Term
| Fluid balance is maintained by regulating? |
|
Definition
| ECf volume and ECF osmolarity |
|
|
Term
| Primary role of ECF/ICF osmolarity? |
|
Definition
|
|
Term
| By what is ICF volume maintained? |
|
Definition
| control of ECF (plasma) osmolality |
|
|
Term
| For what is ECF osmolarity important? |
|
Definition
| long term regualtion of ECFV ( Extracellular Fluid Volume) |
|
|
Term
| What determines ECFV ( Extracellular Fluid Volume)? |
|
Definition
|
|
Term
| Maintaining ECFV is critical for |
|
Definition
| maintaining blood pressure |
|
|
Term
| Volume regualtion is regulation of |
|
Definition
| NA+ balance (mainly renal) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Plasma osmolality sensors, effectors, what is affected? |
|
Definition
sensors: hypothalamic osmoreceptors
effectors: antidiuretic hormone, thirst
what is affected: urine osmolality via thirst: water intake |
|
|
Term
ECF volume regulation
sensors, effectors, what is affected? |
|
Definition
sensors: carotid sinus, afferent ateriole, atria
effectors: RAAS, SNS, atrail natriretic peptide, pressure natruresis, antidiuretic hormmone
what is affecetd? urine sodium excretion |
|
|
Term
| What does water determine (ICF or ECF volume? |
|
Definition
|
|
Term
| change of tonicity is synonymous with? |
|
Definition
|
|
Term
| Increased tonicity results in? |
|
Definition
| thirst and reduction of water excretion |
|
|
Term
| Reduced tonicity results in? |
|
Definition
| dimishes thist, increase water excretion |
|
|
Term
| Whatis major determinant of plasma osmolarity? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| normal plasma range (NA+) |
|
Definition
|
|
Term
| What is osmolality of ECF equal to? |
|
Definition
|
|
Term
| Intracellular osmolarity =ECF osmolarity=Plasma osmolarity |
|
Definition
|
|
Term
| What is clinical formula for P(osm) |
|
Definition
| 2*(NA)p + (glucose)p/18+ (BUN)p/2,8 |
|
|
Term
|
Definition
|
|
Term
| Is Plasma osmolalitynormallyaffected by glucose or BUN (urea) concentrations? |
|
Definition
|
|
Term
| What can raise plasma osmolality |
|
Definition
|
|
Term
| water balance is regualted by? |
|
Definition
| thirst mechanism+ ADH secretion |
|
|
Term
| What are the sensors for water balance? |
|
Definition
| Osmoreceptors in the hypothalamus |
|
|
Term
| When are Osmoreceptors in the hypothalamusare stimulated? |
|
Definition
| increased plasma osmolalit |
|
|
Term
| Response of Osmoreceptors? |
|
Definition
Stimulation of the thirst center => cognitive perception of thirst and increased water intake
Stimulation of ADH release=> higher water reabsorption in the distal nephron |
|
|
Term
| Central osmoreceptors? Organs, nucleus |
|
Definition
| organum vasculosum lamina terminalis (OVLT); subfornical organ (SFO); median preoptic n. (MnPO |
|
|
Term
|
Definition
|
|
Term
| The thirst center (lateral hypothalamus) is stimulated by |
|
Definition
▲pl.osmolality
▼▼ECF(blood) volume
Angiotensin II |
|
|
Term
| What is the role of the kidney in water excretion? |
|
Definition
| espondsto changes in ECF osmolarity by adjusting water excretion: small changes in ADH levels lead to a large changes in urine volume. |
|
|
Term
| Factors that affect water excretion |
|
Definition
1)GFR and delivery of glomerular filtrateto the LH and distal nephron
2)Medullary interstitium hypertonicity.(countercurrent mechanism)
3)ADH effects on DT& collecting ducts |
|
|
Term
| What is the hormonal response to cellular dehydration? |
|
Definition
| release of ADH(vasopressin) |
|
|
Term
| Location of synthesis of ADH(vasopressin)and way |
|
Definition
| ynthesized in the supraoptic nucleus (SON)and paraventricular nucleus (PVN)of the hypothalamus and transported along axons to the posterior pituitary |
|
|
Term
| Effects of ADH(vasopressin) |
|
Definition
increases the water permeabilityin the DT and CD
-->promotes reabsorption of water thus reducing ECF osmolarity; primär harn wird konzentrierter
-->helps expand the ECFV
Vasoconstrictor at high concentration |
|
|
Term
| What are the stimuli for regualtion of ADH |
|
Definition
higher ECF osmorality
Nonosmotic stimuli
-->severe volume depletion => ADH secreted to defend ECF volume, regardless of plasma osmolality(severe blood loss (8-10%); burns). In this situation, water is conserved at the expense of plasma osmolality, Stress(emotional, trauma, surgery), Nausea; , Drugs: morphine, nicotine, |
|
|
Term
| Wie wird das Blut bei Wassermangel? |
|
Definition
|
|
Term
| What are inhibitors for ADH release |
|
Definition
ANP Atrial natriuretic peptide, vasodialator
Drugs (alcohol, caffeine, etc. ) |
|
|
Term
| Are BaroR more or less sensitive then osmoR? |
|
Definition
| BaroR are less sensitive (& more potent) than the osmoR |
|
|
Term
| Hypertension (secondary to ECFV expansion) leads to? |
|
Definition
|
|
Term
|
Definition
| increases ADH for a given plasma osmolality. |
|
|
Term
| during life threatening reduction in blood volume and BP, what predomainates? |
|
Definition
| influence of volume/baroreceptorsover ADH secretion predominatesover the influence of the osmoreceptors |
|
|
Term
|
Definition
| Negative fluid balance: water loss exceeds water intake |
|
|
Term
|
Definition
Excessive loss of H2O from ECF,
ECF osmotic pressure rises
Cells lose H2O to ECF by osmosis; cells shrink |
|
|
Term
| Symptoms of dehdydration: |
|
Definition
dry mouth, sunken eye,
weak rapid pulse
rapid breathing, confusion
exhaustion coma |
|
|
Term
|
Definition
| describes a TBW increase. |
|
|
Term
| What are Disorders of ADH? |
|
Definition
Diabetes insipidus (DI)
Syndrome of inappropriate ADH (SIADH) |
|
|
Term
|
Definition
| Central DI-absence / deficiency of ADH•NephrogenicDI -tubular unresponsiveness to ADH |
|
|
Term
| Syndrome of inappropriate ADH (SIADH) |
|
Definition
| nonosmotic release or enhancement (mehr) of ADH action can cause water retention=> hyponatremia. zu niedrige Natriumkonzentration im Blutserum |
|
|
Term
| What does electrolyte balance usually refer to? |
|
Definition
|
|
Term
|
Definition
Neuromuscular excitability
Secretory activity
Membrane permeability
Control of fluid shifts |
|
|
Term
| What is the major determinant of the size of the ECF Volume |
|
Definition
| total amount of sodium (Na+)in ECF |
|
|
Term
| Sodium salts account for ____ of the total mOsm in the ECF |
|
Definition
| for 95% (~ 280 mOsm) of the total 290 mOsm |
|
|
Term
| What is linked to Na+ reabsorption |
|
Definition
| Reabsorption of water and other solutes |
|
|
Term
| What is coupled to Na+ transport? |
|
Definition
| Renal acid-base control mechanisms |
|
|
Term
| The total body content of Na+ determines |
|
Definition
|
|
Term
| Does Changes in the body Na+ content alter the ECF osmolality |
|
Definition
| do not normally alter ECF osmolality (as long as there is a minimal supply of salt and the thirst mechanism as well as the ability of the kidneys to excrete water are normal) |
|
|
Term
| Relationship between Na+ content, ECF volume & arterial BP: |
|
Definition
NA+ content
ECF volume
blood volume
venous return
cardiac output
Blood pressure |
|
|
Term
| IN which tubule segment is the highest sodium content reabsorbed |
|
Definition
|
|
Term
| IN which tubule segments is the lowest sodium content reabsorbed |
|
Definition
| Distal tube+ late distal tube to collecting duct |
|
|
Term
| Proxiaml tube way of apical entry of sodium |
|
Definition
Na/H exchange
Na/co transport with aa
sugar |
|
|
Term
| Loop of Henle way of apical entry of sodium |
|
Definition
|
|
Term
| Distal tube way of apical entry of sodium |
|
Definition
NA Cl symport
NHE3
Na channels |
|
|
Term
| Late Distal tube/collecting duct way of apical entry of sodium |
|
Definition
|
|
Term
| Proxiaml tube determinants |
|
Definition
all catecholamines
dopamines
hemodynamics |
|
|
Term
| Loop of Henle determinants |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Late distal tube/collecting duct determinants |
|
Definition
|
|
Term
|
Definition
| carbonic anhydrase inhibtor |
|
|
Term
|
Definition
loop diuretics
furosmeide |
|
|
Term
|
Definition
|
|
Term
| Late Distal tube inhibtors |
|
Definition
K spare diuretics
amiloride |
|
|
Term
|
Definition
| Principal cells in collecting duct |
|
|
Term
| What 3 systems regulate total body Na+ and ECFV? |
|
Definition
1)Renin -angiotensin -aldosterone system (RAAS) (JGA receptors)
2)Sympathetic nervous system (baroreceptors)
3)ANP (volume receptorsin the atria and great veins) |
|
|
Term
| Nictric Oxide Vasodilator or Constrictor |
|
Definition
|
|
Term
| ADH Vasodilator or Constrictor |
|
Definition
|
|
Term
| Where can you find A2 receptors |
|
Definition
Adrenal
uterus
CNS
heart
kidney |
|
|
Term
|
Definition
| mechanisms to increase Na+excretion are activated (to prevent ECFV overload); |
|
|
Term
|
Definition
| pathways are activated that promote Na+retention(to prevent ECFV depletion) |
|
|
Term
|
Definition
|
|
Term
| Salt apetite stimulated by: |
|
Definition
| Na+ deficit, hypovolemia, AT II |
|
|
Term
| What organ adjusts Na+ excretionto keep the ECFV within the normal range |
|
Definition
|
|
Term
| Factors affecting Na+ excretion |
|
Definition
| Glomerular Filtration(theamount of Na+ filtered)•Tubular Na+reabsorption rate (Na+ reabsorbed |
|
|
Term
|
Definition
Glomerulotubular balance
Tubuloglomerular feedback |
|
|
Term
| a+balanceis maintained by a negative/positive feedback loop |
|
Definition
|
|
Term
|
Definition
Low pressure receptors: stretch
Atria;
Pulmonary arteries & veins; other |
|
|
Term
| High pressure receptors (baroR) |
|
Definition
Caroid sinus Aortic arch
afferent arteriole |
|
|
Term
| Normally variations in ECV parallel to ECFV right wrong? |
|
Definition
|
|
Term
|
Definition
stretch(arterial baroR, volumeRin atria,pulm. vessels)=>increased Sympathetic output(increased RAAS)=>increased ADH,
decreased renal perfusion pressure(aff. a.)
=>increased Renin(RAAS) |
|
|
Term
|
Definition
| higher stretch of the atria=>hiher Atrial natriuretic peptide(ANP) & lower ADH |
|
|
Term
|
Definition
increases Na+ and water reabsorption
Adrenal gland : higher aldosterone secretion -higher NaClreabsorption (DT & CD)-more thirst and ADH secretion |
|
|
Term
| Whered does Renin comes from |
|
Definition
pericytes (mural cells) in the vicinity of the afferent arterioles in kindeys
+ juxtaglomerular cell |
|
|
Term
| Where does Angiotensinogen comes from |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| mineralcorticoid hormone secreted by the adrenal gland(cortex) |
|
|
Term
| Stimuli for release of Aldosterone |
|
Definition
AT II
•high K+ (ECF)
•low Na+affects aldosterone release indirectly,by RAAS |
|
|
Term
|
Definition
Na+ reabsorption& K+ secretion by principal cells in the lateDT and CD.
•H+ secretion( I-cell sof the CD) |
|
|
Term
| ▲Na+ reabsorptionis accompanied by |
|
Definition
|
|
Term
| Aldosterone ______the number of active Na+channels |
|
Definition
| increases and augments the action and number of the Na-K ATPase pumpsin the DT and CD |
|
|
Term
|
Definition
| RAAS when body Na+ content and/or ECF volume are decreased |
|
|
Term
| What converts Angiotensin 1 in2 |
|
Definition
|
|
Term
| Where is ANP released from |
|
Definition
| released from cells in the cardiac atria in response to high BP and ECF volume expansion (atrialstretch). |
|
|
Term
| What happens when decreased Na+ and H2O water reabsorption |
|
Definition
| Diuretic and natriuretic effects => reduces BP & blood volume |
|
|
Term
| Where is ANP is synthesized and secreted |
|
Definition
| by cardiac muscle cells in the walls of the atria in the heart |
|
|
Term
| Signs of Volume inbalance |
|
Definition
| BP, pulse, peripheral oedema, fluid chart |
|
|
Term
| abnormal ECF Volume are due to problems |
|
Definition
|
|
Term
| cases of abnormal ECF Na+ concentration are due to problem with |
|
Definition
|
|
Term
|
Definition
major intracellular solute(98%-in the cells
K+ gradient across cell membranes involved in membrane potential (MP |
|
|
Term
| Normal extracellular [K+] |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Both Hyperkalemia & Hypokalemia can: |
|
Definition
Decrease cardiac excitability
Lead to a sudden death |
|
|
Term
| K+ concentration affects cell’s |
|
Definition
| resting membrane potential |
|
|
Term
|
Definition
| decreases MP (depolarization) => inactivation of Na+ channels (arrhythmias); |
|
|
Term
|
Definition
| hyperpolarization, excitability of nerve & muscle cells (muscle weakness, rhythm abnormalities). |
|
|
Term
| H+ shifts in/out of cells (ABB disorders) lead to corresponding |
|
Definition
| shifts in K+ in the opposite direction |
|
|
Term
| Fluctuations in serum[K+]can cause |
|
Definition
| arrhythmias and be potentially fatal(cardiac arrest) |
|
|
Term
|
Definition
| K+ increase varies depending on the intensity of exercise |
|
|
Term
|
Definition
| H+ moves into cells, K+ moves out |
|
|
Term
|
Definition
| Severetrauma(burns) and other syndromes where celldestruction is prominent(hemolysis |
|
|
Term
|
Definition
| As plasma osmolality increases, water leaves cells,causing[K+] to rise; this drives K+ efflux from cells |
|
|
Term
| What organ is primarily responsible for maintaining K+content by adjustments of K+ excretion |
|
Definition
|
|
Term
| K+ transport in renal tubules |
|
Definition
Reabsorption in the PT & TALH (95%)
Secretionin the principal cells of DT & CD =>K+balance is controlled by changing the amount of secreted K+ |
|
|
Term
|
Definition
|
|
Term
| Basolateral leak K+ channels |
|
Definition
|
|
Term
|
Definition
muscle twitches / weakness,
diarrhea,
ECG: peaked T waves, flat P waves, prolonged PR, wide QRS, arrhythmias, irritability |
|
|
Term
|
Definition
muscle weakness, fatigue,
▼reflexes, ▼muscle tone,
arrhythmias,
ECG:T-wave flattening, constipation |
|
|
Term
| What are the solids (40%) |
|
Definition
| Proteins, Lipids, CArbs, Minerals |
|
|
Term
| Potassium concentraion in plasma |
|
Definition
|
|
Term
| CA2+ concentraion in plasma |
|
Definition
|
|
Term
| Chloride concentraion in plasma |
|
Definition
|
|
Term
| How many mmol/L Sodium inside cell |
|
Definition
|
|
Term
| How many mmol/L Potassium inside cell |
|
Definition
|
|
Term
| How many mmol/L Calcium inside cell |
|
Definition
|
|
Term
| How many mmol/L Chloride inside cell |
|
Definition
|
|
Term
| Where are protein to be found |
|
Definition
Extracellular fluid (Albumin)
and intracellular fluid but not intersitital fluid |
|
|
Term
| when is an AP send from osmoreceptors to hypothalmaus |
|
Definition
| when blood vessel is not stretched |
|
|
Term
| On what receptors acts ADH? |
|
Definition
| V2 receptors- mehr Wasserreabsoprtion in der Niere- weniger Urin |
|
|
Term
| What does macusa cells release at low blood presuure |
|
Definition
|
|
