Term
|
Definition
|
|
Term
|
Definition
| Interstitial fluid and plasma |
|
|
Term
| Does intra and extra cellular fluid have the same composition? |
|
Definition
| No they both have very different compositions |
|
|
Term
| What is the ECF and ICF's barrier? |
|
Definition
| The cell membrane is the barrier to their movement |
|
|
Term
| Which two compounds diffuse? |
|
Definition
|
|
Term
| Water crosses the membranes through which process |
|
Definition
|
|
Term
| What is osmosis driven by? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Movement of particles down a [] gradient |
|
|
Term
|
Definition
| movement of water x membrane in response to [solute particles] |
|
|
Term
| Water moves to which side of the gradient? |
|
Definition
| With the greater amount of solute particles |
|
|
Term
| Extent of osmosis pressure measured by what? |
|
Definition
|
|
Term
|
Definition
| mMol of non-diffusible particles |
|
|
Term
|
Definition
| Impact of osmotic pressure on a cell |
|
|
Term
| Hypertonic solutions have __ osmolality than cells |
|
Definition
|
|
Term
| Hypotonic solutions have __ osmolality than cells |
|
Definition
|
|
Term
| What do cells do in hypotonic solutions? |
|
Definition
|
|
Term
| What do cells do in hypertonic solutions? |
|
Definition
|
|
Term
| Distribution of body fluids: Total Body Water |
|
Definition
|
|
Term
| Distribution of body fluids: Intracellular fluid |
|
Definition
|
|
Term
| Distribution of body fluids: Interstitial Fluid |
|
Definition
| 2/3 of extracellular fluid |
|
|
Term
| Distribution of body fluids: Trans-cellular fluid consists of what parts? |
|
Definition
| CSF, peritoneal fluid, pleural fluid, etc. |
|
|
Term
| Where does the water move in the body? |
|
Definition
| between the EC and IC space |
|
|
Term
| Where is most of the total body water located? |
|
Definition
| In the intracellular fluid |
|
|
Term
| What is the major force out of the cell? |
|
Definition
| Capillary Filtration pressure |
|
|
Term
| Capillary filtration pressure |
|
Definition
| Blood pressure in capillary |
|
|
Term
| Where is the BP in capillaries higher and lower? |
|
Definition
| It is higher at the arterial end of capillaries and it is lower at the venous end of the capillaries |
|
|
Term
| What is the Interstitial fluid pressure like? |
|
Definition
| Low but normally negative |
|
|
Term
| Interstitial colloid osmotic pressure is usually? |
|
Definition
|
|
Term
| What is a major inward pressure? |
|
Definition
| Capillary colloid osmotic pressure |
|
|
Term
| Capillary colloid osmotic pressure is typically caused from what? |
|
Definition
| Albumin; mostly from proteins |
|
|
Term
| There is no net pressure for what particle in the body? |
|
Definition
| Electrolytes, they pass freely equal on both sides |
|
|
Term
| Exchange at arterial end of the capillary? |
|
Definition
| Out>In...... net filtration |
|
|
Term
| Exchange at venous end of capillary |
|
Definition
| In>out......Net reabsorption |
|
|
Term
| What happens when fluid or proteins do not get reabsorbed? |
|
Definition
| They return to circulation in the lymph |
|
|
Term
|
Definition
| When the same amount of water that is coming in, is going out |
|
|
Term
|
Definition
| Swelling caused by excess interstitial fluid |
|
|
Term
| Increased capillary filtration pressure |
|
Definition
| More fluid leaves capillary space |
|
|
Term
| Why is there an increase in capillary filtration pressure? |
|
Definition
| From increased venous pressure or from increased pressure at arterial end of capillary |
|
|
Term
| Decreased capillary colloid osmotic pressure |
|
Definition
| Less fluid returns to the capillary |
|
|
Term
| Why is there a decreased in capillary colloid osmotic pressure |
|
Definition
| Low albumin, liver failure or kidney disease |
|
|
Term
| Increased capillary permeability |
|
Definition
| Plasma proteins leak out of capillaries, can cause inflammation |
|
|
Term
|
Definition
| Prevents return of proteins and fluids to circulation |
|
|
Term
| Obstructed lymph flow can be from what? |
|
Definition
|
|
Term
|
Definition
| Determined by location- feet versus lung versus brain |
|
|
Term
|
Definition
| Weight, measurement of affected part, visual assessment |
|
|
Term
|
Definition
| Elevate lower extremities, support stockings, diuretics |
|
|
Term
| What are some other reasons for edema |
|
Definition
Increase capillary filtration pressure and increased capillary permeability
Decreased capillary colloid osmotic pressure, Obstructed lymph flow, manifestations |
|
|
Term
| Third space fluid accumulation |
|
Definition
| Trapping in trans-cellular space. Peritoneal. pleural or pericardial spaces and it may require drainage |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Urine, respiratory, skin, feces |
|
|
Term
| Total body water can change from adult to adult, why? |
|
Definition
| Because their body compositions can be different |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Atrial Natriuretic Peptide ANP |
|
Definition
| Peptide hormone which reduces an expanded extracellular fluid volume by increasing renal sodium excretion |
|
|
Term
| ANP does what to the sodium and water balance |
|
Definition
| increased blood volume stimulates ANP release which stimulates naturesis. |
|
|
Term
|
Definition
| Process of excretion of sodium in the urine via action of the kidneys. |
|
|
Term
| Blood volume can also be regulated by the |
|
Definition
|
|
Term
|
Definition
| decrease [Na=], blood volume, BP---> activation of RAA system. |
|
|
Term
| What is thirst controlled by? |
|
Definition
| Hypothalamus, which contains osmoreceptors |
|
|
Term
| Stimulation by low EFC volume or cellular dehydration does what? |
|
Definition
| Increases ADH release which caused water retention |
|
|
Term
| What else stimulates thirst? |
|
Definition
|
|
Term
|
Definition
| Decreased ability to sense thirst |
|
|
Term
|
Definition
| Lesions to the hypothalamus |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Accompanies dehydration from blood loss or Dry mouth |
|
|
Term
|
Definition
| CRF (chronic renal failure) or HF from high angiotensin |
|
|
Term
|
Definition
| compulsive drinking in psychiatric disorders |
|
|
Term
|
Definition
| Decrease in ADH; increases urinary output and dehydration. |
|
|
Term
|
Definition
| Trauma Rx: with ADH administration |
|
|
Term
|
Definition
| Renal response of ADH decreased |
|
|
Term
| Syndrome of inappropriate ADH secretion |
|
Definition
|
|
Term
| Syndrome of inappropriate ADH secretion causes what? |
|
Definition
|
|
Term
| Syndrome of inappropriate ADH secretion Rx: |
|
Definition
| diuretics and fluid restriction |
|
|
Term
|
Definition
| Diabetes insipidus, Neurogenic DI, Nephrogenic DI |
|
|
Term
| Diabetes Insipidus what color urine do they produce |
|
Definition
| The same exact color as whats in the IV bag, what goes in comes out |
|
|
Term
| Isotonic Fluid volume deficit |
|
Definition
| Loss of isotonic fluid from ECF |
|
|
Term
| Isotonic fluid volume deficit is caused from |
|
Definition
| Vomitting diarrhea, NG suction |
|
|
Term
| Isotonic fluid volume deficit Rx |
|
Definition
| Correct problem and replace loss with isotonic fluid |
|
|
Term
| Isotonic fluid volume deficit note on ICF |
|
Definition
|
|
Term
| Isotonic fluid volume excess |
|
Definition
| Gain of isotonic fluid into ECF |
|
|
Term
| Causes of Isotonic fluid volume excess |
|
Definition
| renal or heart failure, cortisol excess |
|
|
Term
| Manifestations of isotonic fluid volume excess |
|
Definition
| weight gain, edema, distended neck veins, pulmonary edema, and ascites |
|
|
Term
| RX of isotonic fluid volume excess |
|
Definition
| Sodium restriction and diuretics |
|
|
Term
| Is IFC impacted with isotonic fluid volume excess |
|
Definition
|
|
Term
|
Definition
| the body holds onto too much water. This dilutes the amount of sodium in the blood and causes levels to be low. |
|
|
Term
| Hyponatermia results from |
|
Definition
| Loss of sodium in excess of water loss. Gain of water without sodium |
|
|
Term
|
Definition
| SIADH, renal disease which causes water retention |
|
|
Term
| Manifestations of Hyponatermia |
|
Definition
| Neuro symptoms, muscle cramps weakness |
|
|
Term
|
Definition
| limit water intake, give hypertonic solutions if severe |
|
|
Term
|
Definition
| A high concentration of sodium in the blood. |
|
|
Term
| Hypernatremia results from |
|
Definition
| Gain of sodium and loss of water |
|
|
Term
|
Definition
| Lack of water access, hypodypsia, access sodium bicarb |
|
|
Term
| Hypernatremia manifestations |
|
Definition
| weight loss, polycythemia, thirst, neuro symptoms |
|
|
Term
|
Definition
| Give rehydration fluids, slowly avoid cerebral edema |
|
|
Term
|
Definition
Plasma has isotonic salt and albumin
Albumin creates COP which then holds fluids in vascular space |
|
|
Term
|
Definition
Fluid is isotonic
Distributes across ECF but does not enter the cells |
|
|
Term
| Give H2O (which you never do) |
|
Definition
Fluid lowers osmotic pressure of ECF
Distributes across TBW by osmosis |
|
|
Term
| Regulation of potassium balance |
|
Definition
|
|
Term
|
Definition
| Potassium filtered and partially reabsorbed |
|
|
Term
| Excretion is fine tuned by what? |
|
Definition
| By aldosterone-sensitive sodium reabsorption/ potassium secretion in DCT |
|
|
Term
|
Definition
| Sodium/potassium gradients across cell membrane maintained by active pump |
|
|
Term
| Cellular dehydration leads to |
|
Definition
| Increase in potassium shift out of cells |
|
|
Term
| Intracellular acidosis leads to |
|
Definition
| Increase in potassium shift out of cells |
|
|
Term
| Insulin and Epi stimulate pump which then.. |
|
Definition
| Leads to an increase in potassium movement into cells |
|
|
Term
| Resting membrane potential is determined by what? |
|
Definition
|
|
Term
| Hyperkalemia reduces ECF/ICF k+ ratio which means |
|
Definition
| Resting membrane potential closer to threshold for Action potential |
|
|
Term
| Hypokalemia increases ECF/ICF k+ ratio which means |
|
Definition
| Resting membrane potential is further from threshold for action potential |
|
|
Term
|
Definition
when blood's potassium levels are too low
K+<3.5 mEq/L |
|
|
Term
|
Definition
| Low intake of K, GI loss, renal loss, shifts into cells epi and insulin, seen during treatment of ketoacidosis |
|
|
Term
| manifestations of Hypokalemia |
|
Definition
| PR prolonged, T wave flattened, PVC's, weakness, fatigues, muscle cramps |
|
|
Term
|
Definition
| Replace IV if rapid replacement is needed |
|
|
Term
|
Definition
| potassium level in your blood that's higher than normal |
|
|
Term
|
Definition
| Decreased renal elimination, Increased movement from ICF (acidosis) |
|
|
Term
| Manifestations of Hyperkalemia |
|
Definition
| Peaked T wave, short QT, Wide QRS, weakness and muscle cramps |
|
|
Term
|
Definition
| CaCl2 to reverse ECG changes, beta agonists, insulin |
|
|
Term
| Parathyroid hormone increases Ca++ which then does what three things? |
|
Definition
| Increases absorption for gut (via vitamin D), decreases renal elimination, and stimulates osteoclasts |
|
|
Term
| Calcitonin does what to calcium |
|
Definition
| Decreases it, decreased absorption in gut, increased renal elimination |
|
|
Term
|
Definition
| PTH deficit. decreases Ca++ |
|
|
Term
| Hypoparathyroidism happens because |
|
Definition
| Congenital absence of gland, acquired through surgical removal or radiation |
|
|
Term
| Hypoparathyroidism manifestations |
|
Definition
|
|
Term
|
Definition
| IV calcium gluconate, Vitamin D |
|
|
Term
|
Definition
| Excess PTH with an increase in Ca++ |
|
|
Term
| Hyperparathyroidism cause |
|
Definition
|
|
Term
| Hyperparathyroidism may have what kind of abnormalities |
|
Definition
| Skeletal abnormalities, may be asymptomatic |
|
|
Term
| Most body calcium is where |
|
Definition
|
|
Term
| IN EFC how much calcium is bound to albumin and how much is free |
|
Definition
|
|
Term
|
Definition
| blood has too little calcium. |
|
|
Term
|
Definition
| Renal loss, and Hypoparathyroidism |
|
|
Term
| Hypocalcemia manifestations |
|
Definition
| Nerve and muscle elasticity |
|
|
Term
|
Definition
| Contracture of facial muscles from light tap |
|
|
Term
|
Definition
| Carpal spasms from inflating Bp cuff |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Too much calcium in the blood. |
|
|
Term
|
Definition
| Bone reabsorption, and hyperparathyroidism |
|
|
Term
| Hypercalcemia manifestations |
|
Definition
| Decreased neural excitability |
|
|
Term
| Regulation of magnesium balance |
|
Definition
| Reabsorption in DCT stimulated by PTH |
|
|
Term
|
Definition
| deficiency of magnesium in the blood |
|
|
Term
|
Definition
| diarrhea, malabsorption, laxative abuse |
|
|
Term
| Hypomagnesaemia manifestations |
|
Definition
| Tachycardia, hypertension |
|
|
Term
|
Definition
| Too much magnesium in the blood |
|
|
Term
|
Definition
| renal disease and magnesium containing meds antacids |
|
|
Term
| Hypermagnesaemia manifestations |
|
Definition
| Hypotension and cardiac arrest |
|
|
Term
|
Definition
| Many enzymes are sensitive to pH and cardiac and neural function decrease when pH decreases |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 10^-7 moles/L means that the pH is 7 |
|
|
Term
|
Definition
|
|
Term
| End prpoduct of aerobic metabolism |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Sulfuric and phosphoric acids |
|
|
Term
| Where are fixed acids produced |
|
Definition
| In metabolism of AA, nucleic acids and phospholipids |
|
|
Term
| Where are fixed acids secreted |
|
Definition
|
|
Term
|
Definition
| From pyruvic acid during anaerobic metabolism |
|
|
Term
|
Definition
| From fat and protein during catabolism |
|
|
Term
| An increase in acidosis is related to |
|
Definition
|
|
Term
| A decrease in alkalosis is related to an |
|
Definition
|
|
Term
| Carbon dioxide is produced in ___ and then does what |
|
Definition
| Produced in cells and then diffuses into the plasma |
|
|
Term
| Enzyme in CO2 production and transport |
|
Definition
|
|
Term
| 70% of CO2 is transported as |
|
Definition
|
|
Term
| 10% of CO2 is transported |
|
Definition
|
|
Term
| 20% of CO2 is transported |
|
Definition
|
|
Term
| Ratio of what determines pH levels? |
|
Definition
| Bicarbonate and carbon dioxide |
|
|
Term
| A low HCO3 with a normal CO2 means |
|
Definition
|
|
Term
| With acidosis what will compensate |
|
Definition
|
|
Term
| Decreased CO2 with a normal HCO3 means |
|
Definition
|
|
Term
| In alkalosis what will compensate |
|
Definition
|
|
Term
|
Definition
| The first defense against pH changes |
|
|
Term
|
Definition
| They resist changes in pH |
|
|
Term
| What are buffer systems composed of |
|
Definition
|
|
Term
| Bicarbonate Buffer system |
|
Definition
|
|
Term
| When pH increases thy system |
|
Definition
|
|
Term
| When PH decreases the system |
|
Definition
|
|
Term
|
Definition
| Depend upon proteins to consume small amounts of acid or base |
|
|
Term
| Protein buffer system; the proteins are capable of doing what |
|
Definition
| functioning as either an acid or a base |
|
|
Term
| Potassium Hydrogen Ion exchange |
|
Definition
| acidosis causes potassium to move from cells to extracellular fluid (plasma) in exchange for hydrogen ions |
|
|
Term
| Treatment of ketoacidosis often requires |
|
Definition
|
|
Term
| What is the second line of defense against pH |
|
Definition
| Respiratory control of CO2 |
|
|
Term
| Increased production of metabolic acids or CO2.. |
|
Definition
| Stimulates chemoreceptors |
|
|
Term
| respiratory centers are stimulated which |
|
Definition
|
|
Term
| what does a decreased CO2 do |
|
Definition
| Returns pH back to normal |
|
|
Term
| Kidneys change their excretion of acid or base for what reason |
|
Definition
| For compensation of pH changes |
|
|
Term
| Hydrogen ions are secreted into tubular fluid in exchange for what |
|
Definition
| in exchange for sodium and then bicarbonate gets reabsorbed back into the blood |
|
|
Term
| Hydrogen ion and bicarb exchange is stimulated by what |
|
Definition
|
|
Term
|
Definition
| Prevent urine from becoming extremely acidic then increasing ability to excrete hydrogen ions |
|
|
Term
| Two tubular buffer systems |
|
Definition
|
|
Term
| What determines if acidosis and alkalosis exist |
|
Definition
|
|
Term
| If abnormal CO2 is the problem then the problem is? |
|
Definition
|
|
Term
| If abnormal bicarb is the problem then the problem is? |
|
Definition
|
|
Term
| What system can adjust carbon dioxide to compensate for a metabolic disorder? |
|
Definition
|
|
Term
| What system can adjust bicarb to compensate for respiratory disorders |
|
Definition
|
|
Term
| There can also be mixed acidosis |
|
Definition
|
|
Term
|
Definition
| The serum concentration of unmeasured anions such as phosphate, sulfate, organic acids and proteins |
|
|
Term
| Anion gap is calculated how? |
|
Definition
|
|
Term
| Anion gap is increased in? |
|
Definition
| Acidosis and ketoacidosis |
|
|
Term
| In the anion gap what is present in abundance? |
|
Definition
| Lactate and ketones(anions) |
|
|
Term
|
Definition
| Metabolic acidosis from diarrhea because chloride is retained as bicarb is lost |
|
|
Term
| Anion gap is decreased in? |
|
Definition
|
|
Term
|
Definition
| pH is low, low bicarb is the cause. Increased MV, decrease CO2 may compensate |
|
|
Term
| Metabolic acidosis causes |
|
Definition
increased production of metabolic acids
increased anion gap
diarrhea bicarb loss
acid indigestion
poisoning
kidney disease |
|
|
Term
| Metabolic acidosis symptoms |
|
Definition
Kussmaul breathing
weakness fatigue
decreased cardiac function at pH of about 7.1 |
|
|
Term
| metabolic acidosis treatment |
|
Definition
| Correct cause NaHCO3 may be helpful |
|
|
Term
|
Definition
pH is increased, increased bicarb is the cause
decreased MV leads to increased CO2 may compensate |
|
|
Term
| Metabolic alkalosis causes |
|
Definition
Excessive intake of antacids
loss of H+
ECF loss, decreased GFR and RAA system activation which caused sodium and bicarb retention and an increase in alkalosis |
|
|
Term
| Symptoms of metabolic alkalosis |
|
Definition
| Hypoventalation, Excitability, may be asymptomatic |
|
|
Term
| Treatment of metabolic alkalosis |
|
Definition
| Correct underlying problem, correct fluid and electrolyte abnormalities |
|
|
Term
|
Definition
pH in decreased and increased CO2 is the cause
Bicrab increased to compensate |
|
|
Term
| Causes of respiratory acidosis |
|
Definition
| Decreased MV, chronic in COPD(bicarb is increased), acute in narcotic OD and neuromuscular disease (bicarb is normal) |
|
|
Term
| Respiratory acidosis symptoms |
|
Definition
May have hypoxia
Neuro symptoms, headache, blurred vision
Coma eventually |
|
|
Term
| Treatment for respiratory acidosis |
|
Definition
|
|
Term
|
Definition
Increased pH, decreased CO2 is the cause
Bicarb will decrease to compensate |
|
|
Term
| Causes of Respiratory alkalosis |
|
Definition
| Increased MV, central of peripheral stimulation, mechanical ventilation, anxiety, pain |
|
|
Term
| Symptoms of respiratory alkalosis |
|
Definition
Decreased brain blood flow which leads to dizziness
Increased pH which leads to increased calcium binding to protein which is tetany |
|
|
Term
| Treatment of respiratory alkalosis |
|
Definition
Correct cause (hypoxia)
Rebreathing for anxiety |
|
|
