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Chapter 27-Chetta
A & P Marieb 12th edition. BJU Chetta fall '12
| Question | Answer |
|---|---|
| How much of the body fluid is intracellular fluid(ICF)? | 2/3 |
| What is ICF? | fluid within cells. cytosol |
| How much body fluid is extracellular fluid(ECF)? | 1/3 |
| What is ECF? | the fluid outside cellls and all other body fluids. |
| What are the two types of ECF? | Interstitial and plasma |
| What percentage of ECF is interstitial fluid? | 80%. it occupies the microscopic spaces between tissue cells |
| What percentage of ECF is plasma? | 20%. it is the liquid portion of the bloood |
| What are the 2 general barriers that separate intracellular fluid, interstitial fluid, and blood plasma? | 1. plasma membrane of individual cells separates intracellular fluid from the surrounding interstitial fluid. 2. blood vessel walls divide the interstitial fluid from blood plasma. |
| Fluid balance | When the required amounts of water and solutes are present and are correctly proportioned among the various compartments |
| What is the largest single component of the body? | water. it makes up 45-75% of total body mass, depending on age and gender. |
| What are the main sources of body water? | Ingested liquids(1600 mL) and moist foods(700mL) absorbed in the GI tract |
| Metabolic water | is produced in the body when electrons are accepted by O2 during aerobic cellular respirations |
| Average daily water gain | 2500 mL |
| 4 Ways the body looses water | 1. urine 2. evaporation(sweat) 3. lungs(water vapor) 4. GI tract(feces) |
| Where is the thirst center located? | in the hypothalmus |
| Dehydration | water loss is greater than water gain. A decrease in volume and an increase in osmolarity of body fluids. |
| Signals that stimulate thirst | 1. production of renin-induced by low BP 2. neurons in the mouth that detect dryness 3. baroreceptors-detect loweerd BP in heart and blood vessels. |
| What types of people have a slower sensation of thirst? | Elderly, infants, confused mental state |
| What is the main factor that determines body fluid volume? | Extent of urinary salt(NaCl) loss |
| Two main solutes in extracellular fluid are | Sodium ions and chloride ions |
| The main factor that determines body fluid osmolarity is | urinary water loss |
| Three hormones that regulate the extent of renal Na and Cl reabsoption | 1. angiotensin II 2. Aldosterone 3. Atrial natriuretic peptied. |
| What do angiotensin II and aldosterone do when the body is dehydrated? | They promote urinary reabsorption of Na and Cl, decreasing urine output. |
| How does ANP respond when the body is dehydrated? | promotes natriuresse-elevated urinary excretion of Na(and Cl) followed by water excretion, decreasing blood volume. |
| What is the major hormone that regulates water loss? | Antidiuretic hormone(vasopressin) |
| How does ADH work? | it promotes the insetion of water-channel proteins(aquaporin-2) into the apical membranes of principal cells in the collecting duct of the kidnets. |
| What is the result of ADH? | The permeability of cells to water increases and less urine is put out. |
| What are the four general functions of ions that form with electrolytes dissolve and dissociate? | 1. control the osmosis of water between fluid compartments 2. Help maintain the acid-base balance 3. carry electrical current 4. Serve as cofactors needed for optimal activity of enzymes. |
| What is the most abundant extracellular cation? | Sodium(Na) |
| What is the most abundant extracellular anion? | Chloride(Cl) |
| What is the most abundant intracellular cation? | Potassium(K) |
| What is the most abundant intracellular anion? | Phosphate(HPO4) |
| what controls the level of sodium in the blood plasma? | aldosterone, ADH, and ANP |
| What regulates Cl balance in the blood plasma? | ADH, b/c it governs the extent of water loss in urine. |
| What regulates K levels in blood plasma? | Aldosterone |
| What are the main regulators of HCO3? | the kidneys |
| What is the second most prevalent extracellular anion? | Bicarb(HCO3) |
| What is the most abundant mineral in the body? | calcium |
| What roles does Ca play in the body? | blood clotting, neurotransmitter release, maintenance of muscle tone, excitability of nervous and muscle tissue, and hardness of bones and teeth |
| What is the main regulator of Ca con'c in the blood plasma? | PTH. low level of Ca-PTH stimulates osteoclasts in bone tissue to release CA from bone extracellular matrix. |
| What does PTH increase in relation to Ca? | Bone resorption |
| What regulates Phosphate levels in the blood plasma? | PTH and calcitriol |
| what does PTH do in relation to phosphate? | it inhibits reabsorption of phosphate ions while stimulating reabsorption of Ca ions. |
| Who are at risk for fluid/electrolyte imbalances? | infants, elderly, hospitalized, those receiving medical treatment, IVs, drainages, suctions, catheters, diuretics, athletes and military personnel in hot environments, post op pts, severe burn or trauma pts., pts. with chronic diseases, altered LOC. |
| What is critical to normal cellular function? | maintenance of acid-base balance |
| What is the normal pH of arterial blood? | 7.35-7.45 |
| What 3 mechanisms help maintain pH? | 1. buffer systems 2. exhalation of CO2 3. kidney excretion of H |
| How do buffer systems work? | acting quickly to temporarily bind H, removing the excessive H from the solution. they raise pH of body fluids, but do not remove H from the body. |
| How does exhalation of CO2 change pH | by increasing the rate and depth of breathing, more CO2 can be exhaled. This reduces the level of carbonic acid in blood which raises the blood pH |
| How does kidney excretion of H change pH? | by excreting acids through urine. it is the slowest mechanism. |
| What is the most abundant buffer system in intracellular fluid and blood plasma? | Protein buffer system. |
| What are 3 types of buffer systems? | 1. protein buffer system 2. Carbonic acid-bicarbonate buffer system 3. Phosphate buffer system |
| Where is the con'c of phosphates the highest? | intracellular fluid |
| Where is the phosphate buffer system an important regulator of pH? | in the cytosol |
| Carbonic Acid formula | CO2 + H2O = H2CO3 = H + HCO3 |
| At a pH of 7.4, the HCO3 blood level is | 24 mEq/L |
| How are nonvolatile acids created? | by metabolic reactions |
| What are the 2 places that large H load are excreted by the kidneys? | PCT and intercalated cells |
| What is acidosis? | pH lower than 7.35 |
| What level of pH is alkalosis? | blood pH higher than 7.45 |
| What is the major physiological effect of acidosis? | Depression of the central nervous system through depression of synaptic transmission. |
| What is compensation? | The physiological response to an acid-base imbalance that acts to normalize arterial blood pH |
| Respiratory compensation | Blood pH is brought back to normal through hyperventilation or hypoventilation. occurs in minutes and reaches its max in hours |
| Renal compensation | changes in secretion of H and reabsorption of HCO3 by the kidney tubules. may begin in minutes, but takes days to reach max effectiveness. |
| Normal pCO2 | 40mmHg; Range 35-45 |
| Normal HCO3 | 24 mEq/L; range 22-26 |
| Respiratory acidosis | Low pH; High pCO2; HCO3 normal or elevated if compensating |
| Conditions r/t respiratory acidosis | emphysema or any COPD; altered LOC (injury, drugs, alcohol), CHF, head injury, muscle impairment |
| Renal compensation for respiratory acidosis | increased H secretion; increased HCO3 reabsorption |
| Respiratory alkalosis | high pH; low pCO2; |
| conditions r/t respiratory alkalosis | : hyperventilation syndromes, CVA, anxiety, high altitude sickness, carop-pedal spasms |
| Renal compensation for respiratory alkalosis | decreased H secretion; decreased HCO3 reabsorption |
| Metabolic acidosis | pH decreases; HCO3 less than 22 mEq/L; Respiratory compensation-increased ventilatory rate, but can't comensapte |
| conditions r/t | Renal dysfunction, diarrhea (direct bicarbonate loss or lack of acid secretion) diabetes Accumulation of another acid (lactic acid; ketones)Kussmaul respirations |
| Metabolic Alkalosis | pH increases; HCO3-greater than 26 mEq/L |
| Conditions r/t metabolic acidosis | Loss of acid such as severe vomiting, gastric suctioning, antacids, licorice |
| Calculation for osmolarity | Osm= 2(Na)+ glu/18 + BUN/3-2 |
| Normal BUN/creatinine ratio | 20:1 |
| BUN for renal problems | Lower ratio. Ex 10:1. Renal Azotemia. |
| Dehydrated BUN | Higher ratio. Ex. 35:1 |
| Prerenal azotemia | build up of nitrogeonous wastes in the blood. High BUN |
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