Week 11 Ch 22: Body Fluids

thirst mechanism, kidney activity, hormones, regulate pH

what are some factors of body fluid maintenance?

intracellular fluids

two-thirds to three-fourths of all body fluids

extracellular fluids

interstitial fluid, blood plasma, lymph, fluid in special compartments

sodium

main (+) ion in ECF; required for nerve impulse conduction. chiefly responsible for maintaining osmotic balance and body fluid volume; acid/base balance

potassium

main (+) in ICF; required for nerve impulse conduction; regulates chemical reactions by which carbs is converted to energy and amino acids are converted to protein

calcium

required for bone formation, muscle contraction, nerve impulse transmission and blood clotting

magnesium

required for muscle contraction

sodium, potassium, calcium, magnesium

what are the positive ions (cations)?

phosphate

found in plasma membrane, DNA, RNA and ATP; essential for carb metabolism, bone formation, acid/base balance

chloride

essential for formation of hydrochloric acid in the stomach; helps to regulate fluid balance and pH; most abundant anion in ECF

bicarbonate

important buffer in body fluids

phosphate, chloride, bicarbonate

what are the negative ions (anions)?

regulating fluid output, regulating fluid input, exchanging fluids btwn compartments and from place-to-place in body

what are 3 main factors that are mechanisms for balancing fluid volumes?

beverages, food, cellular respiration

what can you water gain from?

kidneys, skin, lungs, intestinal tract

what can you water loss from?

fluid homeostasis

maintained by water intake and urine output

thirst mechanisms, control center is hypothalamus

what controls need for water intake?

kidneys, sodium, hormones regulation

what controls need for water output?

aldosterone

high in sodium and low in water retention, low in potassium and high in BP - high potassium loss in urine

addison disease

low in aldosterone → sodium and water low and potassium excess

antidiuretic hormone (ADH)

high in water reabsorption in the kidney when blood sodium > normal range

angiotensin II

stimulates production of both aldosterone and ADH

atrial natriuretic peptide (ANP)

promotes low sodium and water thereby low blood volume and blood pressure

7.35-7.45

what is normal pH of body fluids?

acidosis

pH less than 7.35; depresses nervous system - mental confusion, coma

ketoacidosis

accumulation of ketone bodies; inadequate carb metabolism; uncontrolled diabetes mellitus; starvation; low carb diet

alkalosis

pH greater than 7.45; excites the nervous system - tingling, muscle twitches, paralysis; causes - hyperventilation (releasing too much CO2), ingestion of too much antacid, prolonged vomiting with loss of stomach acids

edema

accumulation of excessive fluid in the intercellular spaces

pulmonary edema

excess fluid in lungs; often results from congestive heart failure but can also occur with normal heart function

hyponatremia

swelling due to transport of water into cells; reduced by blood sodium concentration; swelling in brain may lead to convulsions, coma and death

effusion

escape of fluid into a space/cavity; difficult to inhale, difficulty expanding lung

ascites

fluid between abdominal cavity and organs; malnutrition, cancer, infection disorders of the liver, heart and kidneys

pleural effusion

within pleural space - tuberculosis, cancer, infection

pericardial effusion

encloses the heart - infections and autoimmune diseases

dehydration

deficit of body fluids; can reflect inadequate fluid intake or excessive fluid output

fluid therapy

fluid administered IV to correct specific imbalances; isotonic solution, hypertonic solution, hypotonic solution

isotonic

administered most often; will not alter blood cell volume; it has the same solute composition as cellular fluids

hypertonic

more concentrated than cellular fluid thus will draw water out of the cells

hypotonic

less concentrated than cellular fluid thus cells will absorb water and enlarge

ringer lactate solution

electrolyte concentrations = normal plasma; used for burn victims

serum albumin

draws fluid into circulation from tissues; corrects edema

kidneys

vital organs; essential for homeostasis and maintenance of life - adjust their output to equal the intake of the body; if this fails → nitrogenous waste products can accumulate and reach toxic levels

waste excretion, homeostasis of body fluids, BP homeostasis, hormone production, blood glucose control

what are the functions of kidney?

retroeritoneal space

under back muscles in the upper abdomen behind parietal peritoneum

renal pelvis

funnel-shaped basin, forms upper end of ureter; lies under kidney

calyces

extensions/divisions of the renal pelvis

renal cortex, renal medulla

what is the kidney divided into?

renal cortex

outer portion of the kidney

renal medulla

inner portion of the kidney; contains tubes in which urine is formed and collected

renal pyramids

cone shaped, formed from tubes and points toward renal pelvis

nephron

highly convoluted microscopic functional unit; renal corpuscle, renal tubule

renal tubule

tiny coiled tube; consists of proximal tubule, nephron loop, distal tubule collecting duct

proximal tubule

coiled portion leading from the Bowman capsule

nephron loop

extension of proximal tubule; dips into the medulla - descending limb, ascending limb, loop

peritubular capillaries

capillary network that surrounds the tubular portion of the nephron into which blood flows when it leaves the glomerulus

gomerular filtration

the movement of water and dissolved substances under pressure from the glomeruli blood into the Bowman capsule; occurs continuously

tubular reabsorption

occurs after the process of filtration; involves the movement of water and other needed substances from the filtrate back into the blood; urea and other waste products remain the tubule

tubular secretion

occurs before the filtrate leaves the body as urine; involves the movement of substances from the blood into the distal and collecting ducts

control of urine volume

ADH influences the amount of water that is eliminated with the urine

adh

pituitary gland; allows more water to be reabsorbed, less is excreted with the urine - concentrates urine

juxtaglomerular apparatus

consists of specialized cells in the kidney; regulates BP

ureters

long, slender, muscular tubes; entirely extraperitoneal; extend from kidney to urinary bladder; move urine by gravity and peristalsis

urinary bladder

elastic muscular organ, capable of great expansion; lined by mucous membrane; storage of urine before voiding, voiding

trigone

floor of the bladder; a triangle formed by the openings of the two ureters and the urethra

urethra

tube that extends from the bladder to the outside; carries urine

micturition

the release of urine from the urinary bladder through the urethra

urinary retention

is a condition in which no urine is voided - kidney produces urine but bladder does not empty

urinary suppression

kidneys do not produce any urine, bladder retains the ability to empty itself

hydronephrosis

abnormal fluid accumulation of the renal pelvis or in small sacs - kidney swelling

kidney stones

crystallized mineral deposits that develop in the renal pelvis or calyces; small stones will simply flow through the ureters and eventually be voided with urine

renal hypoplasia

abnormally small kidneys; normal form

renal dysplasia

malformed kidney in the womb; may be smaller and may have cysts; does not function normally → can lead to renal failure

ureteral stricture

constricted or narrow ureter

ureteral obstruction

ureter blockage

ureterocele

ureter end bulges into bladder

hypospadias

urethra opens under penis instead of at end

urethritis

inflammation of urethra; sexual activity or poor hygiene; bacteria - gonorrhea, chlamydia

cystitis

bladder infection/inflammation; more common in females; common cause bacteria - can be from calculi, tumors; antibiotic regime

interstitial cystitis

pelvic pain before and after urinating; almost exclusive to women; type of nonbacterial cystitis; may originate in autoimmune dysfunction; often associated with lupus

staghorn calculi

larger stones may obstruct the ureters, causing intense pain or renal colic

pyelonephritis

refers to inflammation of the renal pelvis and the kidney; usually caused by bacterial infection

acute glomerulonephritis

most common form of kidney disease; not related to UTI; caused by a delayed immune response to streptococcal infection; occurs 1-6 weeks after a strep infection; tx - antibiotics and bed rest

polycystic kidney disease

genetic disorder; usually asymptomatic in children; numerous fluid-filled cysts destroy kidney tissue as they grow resulting in chronic renal failure; tx - renal dialysis, kidney transplantation

acute renal failure

often occurs as a complication of another serious illness; caused by medical or surgical emergencies, toxins that damage the renal tubules

chronic renal failure

slow, progressive loss of nephrons caused by a variety of underlying diseases

renal insufficiency

beginning of chronic renal failure

stage 1 - early stage

healthy nephrons often compensate for damaged nephrons; asymptomatic; may last for years in this state

stage 2 - renal insufficiency

loss of kidney function ultimately results in uremia (high BUN levels) and its life-threatening consequences

stage 3 - uremia

complete kidney failure; results in death unless a new kidney is transplanted or an artificial kidney substitute is used

dialysis

the separation of dissolved molecules based on their ability to pass through a semipermeable membrane - hemodialysis, peritoneal dialysis

urinary incontinence

involuntary loss of urine

urge incontinence

a sudden and strong need to urinate; also referred as an unstable or overactive bladder or detrusor instability; associated with smooth muscle over-activity in the bladder wall

stress incontinence

often used to describe the type of urine loss associated with laughing, coughing or heavy lifting; common problem in women with weakened pelvic floor muscles following pregnancy

overflow incontinence

characterized by intermittent dribbling of urine; results from urine retention and over-distended bladder; common problem in men with an enlarged prostate gland

reflex incontinence

occurs in the absence of any sensory warning or awareness; common in nervous system disorders such as stroke, parkinson’s, spinal cord injury

nocturnal enuresis

bed wetting; often occurs in a child who is beyond the age when voluntary bladder control is expected