Fluid, electrolyte, & acid-base balance

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44 Terms

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Intracellular fluid (ICF)

  • cytosol

    • Fluid within cells

    • 2/3 of fluid

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Extracellular fluid (ECF)

  • fluid outside of cells

  • 1/3 of body fluid

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Plasma membrane

  • separates intracellular fluid from surrounding interstitial fluid

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Blood vessels

  • divides interstitial fluid from blood plasma

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Water makes up ___% of total body mass

45-75%

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Body water gain/day

2500 mL

  1. Intestinal fluids- 1200

  2. Ingested foods- 700

  3. Metabolic water- 200

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Gain

Thirst center of hypothalamus (urge to drink)

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ADH reabsorbs__

Water

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Angiotensin II & Aldosterone reabsorb__

Na & Cl

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ANP excretes ___

Na & Cl

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Changes in osmolarity is the cause of

Fluid imbalance

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An increase in osmolarity of intestinal fluid will cause cells to __

Shrink (draws fluid out)

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A decrease in osmolarity of interstitial fluid will cause cells to

Swell (draw fluid out)

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Most common reason for changes in osmolarity is __

Changes in Na (this is why IV fluids have NaCl)

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Electrolyte balance (general functions):

  1. Control the osmosis of water between fluid compartments

  2. Help maintain the acid-base balance

  3. Carry electrical current (allows for action potentials & hormone secretion)

  4. Serves as cofactors for enzyme activity (important minerals)

    • Cation= (+)

    • Anion= (-)

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Sodium cation

  • most abundant cation ECF

    • 90% of ECF cations

    • Half of ECF osmolarity

    • Important in fluid/electrolyte balance

    • Needed for action potentials in muscle & nerve tissue

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Chloride anion

  • most abundant anion in ECF

  • Moves easily between ICF & ECF

  • Chloride shift to balance anions

  • Part of HCl in gastric juice

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Potassium cation

  • most abundance cation in ICF

  • Important in rest potentials & repolarization in neurons & muscle fibers

  • Exchanged for H+ to regulate pH

  • Aldosterone causes secretion of K

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Aldosterone causes secretion of __

K (potassium)

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Bicarbonate anion

  • abundant in ECF

  • Increases in capillary beds due to CO2 exchange

  • Concentration decreases as CO2 is exhaled

  • Kidneys regulated HCO3

  • Important in acid-base balance

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Calcium cation

  • MOST ABUNDANT MINERAL IN THE BODY DUE TO BONES!!

    • 98% is found in bones & teeth

  • Important roles in blood clotting & nerve & muscle tissue

  • Controlled by PTH & calcitriol

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What increases blood calcium levels?

  • PTH

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What lowers blood calcium levels

  • calcitonin

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Phosphate anion

  • Found with Ca in bones & teeth

  • Acts an important buffer

  • Binds in organic molecules (DNA, RNA, ATP)

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Magnesium cation

  • 50% in bone

  • 50% in iCF

  • Needed for neuromuscular activity

  • Cofactor for enzymes

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Buffer Systems

  • keeping H+ concentrations stable

  • Quickly binding to H+, but not removing it from the body

    • Uses a weak acid & its salt as a weak base to bind to hydrogen ions

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The 3 types of buffer systems

  1. Protein

  2. Carbonic acid-bicarbonate

  3. Phosphate

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Protein buffer system

  • very abundante

  • Works in both ICF & ECF compartments

  • Contains a (-COOH & -NH2)

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3 examples of protein buffer system

  1. Hemoglobin (RBCs)

  2. Albumin (plasma protein)

  3. Amino acids

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Carbonic acid-bicarbonate buffer system

  • Acts mostly on ECFs

  • HCO3= weak base

    • Binds to free H in low pH

  • H2CO3= gives up H in high pH

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Phosphate buffer system

  • H2PO4= weak acid

  • HPO4 will bind to free H

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Exhalation of CO2

CO2+H2O← → H2CO3→H + HCO3

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Decreases in pH→ breathing __

Faster

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Increase in pH→ breathing ___

Slows

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Kidney excretion of H+

  • ability to secrete H as Na is reabsorbed

  • Intercalates cells can secrete H against a concentration gradient, also HCO3 (when pH is high)

  • Kidney cells can also form H2PO4 (phosphate ion), NH4 (ammonia ion) to rid the body of H ions by passing in urine

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Normal body pH

7.35-7.45

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Below 7.35 is __

Acidosis

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Above 7.45 is __

Alkalosis

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Respiratory compensation

  • the use of the respiratory system to correct pH imbalance

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Renal compensation

  • using kidneys to secrete H+ or reabsorb HCO3 to correct pH imbalance

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Respiratory acidosis

**most common challenge

Decreases in pH (causes= hypoventilation, COPD)

Increase in CO2 (Corrections= excrete H+, reabsorb HCO3)

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Respiratory alkalosis

***not an emergency

Increase in pH (causes= hyperventilation, anxiety)

Decreases in CO2 (corrections= decrease less H+, reabsorb less HCO3)

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Metabolic acidosis

**2nd most common

Decrease in pH (Causes= loss of bicarbonate ion, renal dysfunction)

Increase in HCO3 (corrections: hyperventilation)

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Metabolic alkalosis

**rare

Increase in pH (causes= loss of acid, vomiting, anti acid drugs)

increase in HCO3 (corrections= hypoventilation)