Pathophysiology: Disorders of Fluid and Electrolyte Balence

functions

body fluids assist in maintaining all body ___

-transport

-metabolic reactions

-temp regulation

-structure and shock absorber

-insulation

-lubrication

what are the 6 functions of body fluids

intracellular

___ fluids are fluids that are inside of the cell

2/3

___ of the body is intracellular fluids

extracellular

___ fluids are fluids that are outside of the body

1/3

___ of the body is extracellular fluid

"serum"

extracellular fluids is what they use for ___ blood test

vascular compartment

EFC is also known as the ___ compartment

60%

what is ___% of the bodys weight

age, gender, body fat

what are 3 things that influence total body weight

young, obese, and infants

who is at highest risk for dehydration

diffusion

___ is the movement of PARTICLES from an area of greater concentration to an area of lesser concentration

osmosis

___ is the movement of H2O across a semi- permeable membrane from an area of lesser concentration of particles to an area of greater concentration of particles

osmolality

___ is the concentration of solutes per weight of water and is often used with osmolarity

275-295 mOsm/kg

what are the normal values of osmolality

inside

osmolality is used to describe fluids ___ the body

dry (dehydrated)

in osmolality is increased, the patient is ___

hydrated

if osmolality is low, concentration of solutes has decreased and they are over ___

tonicity

___ is the movement of water that affects the cell size

pull

the osmolality of a solution may exert an osmotic ___

isotonic

___ the cell will experience no change and has the exact concentration inside and outside

hypotonic

___ the cell will swell

hypertonic

___ the solution is more concentrated and the cell will shrink

cell shrinks (hypertonic)

if the cell has an IFC of 280 mOsm/kg and the EFC has 300mOsm/kg, will the cell experience swelling or shrinking?

cell swelling (hypotonic)

if the cell has an IFC of 280 mOsm/kg and the EFC has 265 mOsm/kg, will the cell experience swelling or shrinking?

capillary

exchange of fluids between vascular and interstitial spaces occurs at the ___ level

-capillary filtration pressure: pushes water out of capillary and into interstitial space

-interstitial hydrostatic pressure: opposes the movement of water out of the capillary

-capillary colloidal osmotic pressure: pulls water back into the capillary

-tissue colloidal osmotic pressure: pulls water out of the capillary into the interstitial space

whata re the 4 factors that affect capillary/ interstitial fluid exchange?

-increase in capillary filtration pressure

-decrease in capillary colloidal osmotic pressure

what changes in the capillary causes fluid to "leak" out of the capillary and into the surrounding tissue?

decreased capillary colloidal osmotic pressure

___ occurs when blood vessels that has decreased in the amount of protein and the pull is loss. proteins can leak out of the capillary and into the interstitial space

nephrotic syndrome

what is an example of decreased capillary colloidal osmotic pressure

lymphatic system

due tot he 4 forces that regulate capillary / interstitial fluid exchange, only small amounts of fluid are in the interstitial compartment (under normal circumstances). the excess is removed by the ___ and is returned to the systemic circulation

edema

___ is an increase in interstitial volume

2-3 L

2-3 L

edema is evident when the interstitial volume is greater than ___

-increased capillary filtration pressure. Ex. excess fluid volume

-decreased capillary colloidal osmotic pressure. Ex. decrease in plasma proteins

-increased capillary permeability. Ex. inflammation, burns

-obstruction of lymph flow. Ex. malignancy of lymph system

what are the 4 causes of edema?

allergic/ inflammation

localized edema is usually related to ___

gravity

evidence of ___ are evident with edema

1

1 L of water = __ kg

-swelling

-pitting

-may be disfiguring

if edema is visible you will see what 3 things?

-impairs oxygen delivery to effected area

-increase risk of tissue damage

-may compress blood vessels

if edema is not visible, what three things could occur?

vascular volume

generalized edema (Anasarca) is usually related to excess ___

-brain

-lungs

-larynx

what are 3 circumstances where edema is life threatening?

lymph

___ edema has extreme swelling (anaphalactic reaction the larynx becomes edemisis)

third space accumulation

___ is the accumulation of fluids outside the vascular compartment that is NOT the interstitial space

metabolic

the fluids that are in the third space accumulation are fluids that not available for ___ processess

-pericardial sac

-peritoneal cavity (ascites-fluid build up in the stomach)

-pleural cavity

what are the 3 serous cavities that are third space accumulations (transcellular spaces)

2400-3200

what should be total daily intake and output of fluid in the body

pressure

we need ___ in our vessels in order to "perfuse" or deliver blood to cells

-SNS and RAAS

-vessel diameter

-volume

-resistance

what 4 things does pressure depend on?

perfusion

___ is the delivery of oxygen to the cells of our body

adequate "normal" pressure

"normal" vessel tone and "normal" fluid volume = ___

increased pressure and increased blood pressure

when vessels are constricted and there is no change in volume, this leads to ___

decreased pressure and decreased blood pressure

when vessels are dilated and there is no change in volume this leads to ___

-circulating volume

-thirst: hypothalamus

-baroreceptors

-SNS

-RAAS

-anti diuretic hormone (ADH)

-ANP

what are 7 mechanisms for fluid regulation

vascular compartment

the circulating volume is also known as ____

increase

when the body experiences thirst, there is cellular dehydration and an ___ in EFC osmolality

barareceptors

___ sense pressure changes in arterial vasculature (decrease in volume)

other regulatory mechanisms

baroreceptors activate other ___

decrease

baroreceptors are like guards who watch the pressure in blood vessels and they will alert when there is a ___ in pressure

SNS

___ is activated by baroreceptors

constriction

SNS results in the ___ of vessels and increase in HR (tachycardia= HR > 100)

flight or flight

SNS (sympathetic nervous system) is also referred to as the ___

renal blood flow (perfusion)

RAAS is activated by a decrease in ___

-renin (does nothing)

-Angiotension I (does nothing)

-Angiotension II --> potent vasoconstrition

-aldosterone --> retention of Na and H2O

what are the 4 steps of the RAAS systems and their functions

ADH

the opposite of RAAS is ___

K (Potassium)

Aldosterone promotes the excretion of ___

increase

aldosterone promotes the re-absorption of H2O by the kidneys and will ___ the volume which will ___ the pressure

antidiuretic hormone (ADH)

___ controls urination

osmolality

EFC

antidiuretic hormone (ADH) is activated by an increase in ___ and decrease in ___ volume

posterior pituitary

which gland is ADH secreted from

ANP

___ sense stretch in the atrial

-vasodilation

-fluids

When ANP is secreted, it results in ___ and excretion of ___ by the kidneys

heart

ANP is a peptide secreted from the ___ when there is excess fluid in the body

both atrial and ventricle

where is Atrial Natriatic Peptide located in the heart

Brain Natriuretic Peptide (BNP)

___ is located in the ventricle