fluid, electrolyte and acid/base balance

what percentage of body weight for average healthy adult male; infant; female makes is total water

60%; 75%; 50%

what are the three fluid compartments

intracellular fluid + extracellular fluid (interstitial fluid and plasma)

out of the entire 60% of body weight that water occupies, how much percentage is intracellular fluid? what about extracellular fluids?

40% and 20% (interstitial fluid makes up 80% of this)

more muscle =

more water

what is the medical condition that causes an abnormal accumulation of fluid in spaces where it doesn’t belong (normal spaces would be intracellular fluid or extracellular fluid), this includes thoracic, abdominal and cranial cavities

third spacing

what are examples of third spacing

burns, edema, ascites and post-surgery

where do we see large amounts of Na+ [intracellular or extracellular]; specify how much we find in intracellular vs extracellular

extracellular; 12mEq/L vs 140mEq/L

where do we see large amounts of K+ [intracellular or extracellular]; specify how much we find in intracellular vs extracellular

intracellular; 140mEq/L vs 4mEq/L

what is a homogenous mixture of 2 or more components/substances called

solution

what is a substance that is dissolved called

solute

what is a substance that is considered the dissolving medium

solvent

what are chemicals that dissociate/separate into ± charged ions in solutions called

electrolytes

what are some chemicals that do not dissociate in solution and instead retain their molecular forms (are considered nonelectrolytes)

lipids, glucose, urea, creatinine

what are chemicals that do not dissociate into +- charged ions in solutions called

non electrolytes

what are some chemicals that separate electrically (are considered electrolytes)

salts, acid, bases, some proteins

if H+ is one of the ions that a chemical separates into, then the electrolyte is considered an

acid

what is considered a strong acid

dissociates completely and gives all of its H+

what is considered a weak acid

does not dissociate completely and only some H+ are released

what is example of strong acid vs weak acid

HCl; H2CO3

what is the # of solutes dissolved in 1 liter/kg of H20 called

osmolality

what is the net flow of water

low to high (according to osmotic gradient)

300 mOsm is considered

normal osmolality

[electrolytes/non electrolytes] have greater ability to cause fluid shifts and why

electrolytes; contribute 2 or more solutes compared to nonelectrolytes that only contribute one

is glucose (C6H12O6) considered a chemical, electrolyte and acid (if so what type)

yes, no, no

is carbonic acid (H2CO3) considered chemical, electrolyte and acid (if so what type)

yes, yes, yes (weak)

is HCl considered chemical, electrolyte and acid (if so what type)

yes, yes, yes (strong)

is NaCl considered chemical, electrolyte and acid (if so what type)

yes, yes, no

is urea considered chemical, electrolyte and acid (if so what type)

yes, no, no

if a chemical is not an electrolyte then

it cannot be acid

with fluid movement among compartments, what is the pushing force called

Hydrostatic pressure

with fluid movement among compartments, what is the pulling force called

osmotic pressure

exchanges between plasma and interstitial fluid occur across

capillary wall

exchanges between interstitial fluid and intracellular fluid occur across

plasma membrane

so substances must pass through blood plasma (first) and then what are the next steps of fluid movement in order

interstitial fluid and intracellular fluid

what compartment does solute from stomach first pass through?

blood plasma

what compartment does solute from tissues cells first pass through?

interstitial fluid

the exception for fluid movement is lymph, what is the order from intestine to tissue cells?

lymph, blood plasma, interstitial fluid, intracellular fluid

the concentration of solutes in __ controls the intracellular fluid volume

interstitial fluid (part of extracellular fluid)

what is the solution called when there is a higher concentration of solute outside the cell (extracellular fluid osmolality is more than the normal which is 300 mOsm)

hypertonic solution

what is the solution called when there is a lower concentration of solute outside the cell (extracellular fluid osmolality is less than the normal which is 300 mOsm)

hypotonic solution

with isotonic solution there is equal concentration of solute intracellularly and extracellularly, what is h20 movement

both in and out of cell

what is movement of water with hypertonic solution (where the extracellular fluid osmolality is more than 300 mOsm)

out of the cell that causes it to shrink

what is movement of water with hypotonic solution (where the extracellular fluid osmolality is less than 300 mOsm)

inside the cell that causes it to swell and lyse

in order to remain hydrated (2500ml), input (from food, beverages and metabolic water) has to equal output; give me some examples of sensible (measurable) vs insensible (unmeasurable) losses

feces, sweat, urine; skin and lungs

thirst mechanism is regulated by which receptor in the hypothalamus that detects increase or decrease in osmolality (plasma membrane stretch)

osmoreceptor

if there is increase in osmolality (too concentrated and not enough water) what is the hypothalamic response

xerostomia that triggers polydipsia

if decrease in blood volume, then what pathway is triggered

RAA by baroreceptors that targets the thirst reflex

if decrease in osmolality (too dilute and too much water), then what two things are inhibited to increase urine output

thirst and ADH

obligatory water losses (occur from urine, lungs, skin and feces), but if it goes beyond this, output depends on

intake, diet and water loss

more sweat =

less urine

a 30 minute delay in eliminating excess water is required for

ADH inhibition

antidiuretic hormone functions to maintain correct extracellular fluid osmolality, therefore is released when there is high osmolality what does it target

aquaporins in collecting duct to reabsorb more h20

high osmolality refers to

too concentrated and not enough water

low osmolality refers to

too dilute and too much water

what are some examples of water balance disorders

dehydration, hypotonic hydration and edema

what water balance disorder is when individuals experience same symptoms as hypovolemic shock due to loss of water or loss of water and solutes together

dehydration

what water balance disorder is caused by sudden excess intake of h20 that may dilute intracellular fluid before kidney removal, with this type individuals may also experience hyponatremia

hypotonic hydration

what condition is associated with decreased sodium in blood and leads to nausea, vomiting, muscle cramps, and cerebral edema

hyponatremia

what water balance disorder is associated with swelling in interstitial space with extra fluid that increases distance nutrients like o2 have to travel across to get to cells

edema

what are some causes of dehydration

hemorrhage, severe burns, vomiting

with sweating, we lose water from extracellular fluid, what does this mean for osmolality of extracellular fluid? what is net movement of water? what type of solution is this?

high osmolality that causes water to leave cell (shrink); hypertonic

with increased water intake (overhydration) there is excessive water that enters the extracellular fluid, what does this mean for osmolality of extracellular fluid? what is net movement of water? what type of solution is this?

low osmolality that causes water to enter cell (swell); hypotonic

which disorder is linked to lack of aldosterone which causes sodium to leave via urine and water follows; associated with salty food cravings

addison’s disease

which disorder is linked to lack of minerals (iron) in which individuals crave abnormal substances like chalk, clay and burnt match tips

pica

which Na+ imbalance is due to inadequate water intake, fluid loss or increase in sodium intake (sodium is greater than 145mEq/L)

hypernatremia

which Na+ imbalance is when sodium is less than 145mEq/L

hyponatremia

which hormone is antagonist to aldosterone and is responsible for decreasing BP and blood volume by inhibiting Na+ reabsorption

atrial naturietic peptide

estrogen is chemically similar to __ that causes increase of water/sodium retention and bloating during cycling

aldosterone

which hormone produces opposite effects of aldosterone, water loss at end of cycle

progesterone

what disorder is the most common medically induced from corticosteroids and associated with excess amounts of gluocorticoids

cushing disease

baroreceptors, regulate blood volume and blood pressure but they indirectly also regulate

Na+ concentration

what is the most important intracellular ion

K+

what is the most important extracellular ion

Na+

hyper/hypo kalemia can cause

fatal arrythmias

acidosis is linked to what electrolyte balance

K+ (hyperkalemia)

all + ions must be electrically balanced by a - ion in fluids; which is the most common - ion? which is most common + ion?

cl-; na+