Ch6 Fluid Electrolyte Acid-Base Blood Flow

_ moves large volumes of blood over long distance

blood pressure

blood pressure =

CO x vascular resistance

cardiac output =

HR x SV

_ moves small volumes of fluid over short distances

osmotic pressure

main determinant of osmotic pressure in plasma

albumin

main determinant of osmotic pressure in non-plasma body fluids

salts

what defines an electrolyte

a salt that separates into ions in water

important ions

Na+

Cl-

K+

Ca2+

HCO3-

_ is the major determinant of fluid shifts

sodium

RAAS pathway

renin made by kidney

renin acts on angiotensinogen

angiotensin I produced

ACE converts ang I to ang II

effects of angiotensin II

increase peripheral resistance (vasoconstriction)

increase CO, BP

stimulates secretion of aldosterone

what does lymph fluid carry

protein

fats

particulate matter

lymphatics ultimately drain into _

subclavian veins

term for an abnormal accumulation of fluid

edema

what causes exudate

inflammatory increase in vascular permeability

characteristics of exudate

inflammatory

high in protein

non-pitting edema

exudate is associated with _ edema

non-pitting

what causes transudate

increased capillary fluid pressure

decreased plasma osmotic pressure

transudate characteristics

non-inflammatory

low in protein

pitting edema

lymphedema is high in _

protein

early vs late lymphedema

early: pitting edema

late: non-pitting

transudate is a _ problem

pressure

exudate is a _ problem

permeability/inflammatory

abnormal fluid accumulation in a body cavity

effusion

ascites

effusion in the peritoneal cavity

generalized severe edema

anasarca

conditions that would lead to transudate production

heart failure

cirrhosis

low protein edema

transudate

left heart failure causes _

pulmonary edema

right heart failure causes _

peripheral edema

how does left heart failure cause edema

most common cause of right heart failure

left heart failure

primary extraceullar ion

Na

causes of hyponatremia

vomiting

diarrhea

sweating

causes of hypernatremia

dehydration

cause of hypokalemia

diarrhea

cause of hyperkalemia

renal failure

PTH has what effect

raises blood Ca++ and lowers phosphate

Cl- tends to follow _

Na+

is acidosis or alkalosis more common

acidosis

kidney eliminates _ for acid-base balance

fixed acids

kidney produces _ for acid-base balance

bicarbonate

hyperemia vs congestion

hyperemia is ACTIVE

congestion is PASSIVE

what causes hyperemia

inflammation

increased metabolic activity

hyperemia charateristics

actuve

inflammation

arterial

BRIGHT red

congestion is due to _

impaired VENOUS outflow

nutmeg liver is a form of _

chronic passive congestion

hemostasis in normal vessels

maintains blood in a fluid, clot-free state

hemostasis at site of injury

rapid, localized hemostatic clot

too much hemostasis can lead to _

thrombosis

pathologic formation of an intravascular clot

thrombosis

factors that can lead to thrombosis (3)

endothelial injury

abnormal blood flow

hypercoagulability

cells of normal hemostasis

endothelial cells

platelets

coagultion factors

coagulation factors lead to the production of _

fibrin

function of endothelial cells

attract platelets when injured while also having anti-coag properties

platelet main function

form the initial clot

hemorrhagic diathesis

excessive bleeding beyond what would be expected

causes of abnormal bleeding (4)

vascular problems

low platelet count

platelet dysfunction

coagulation factor deficiency

lab tests for hemostasis

PT

PTT

platelet count

platelet function analysis

causes of platelet dysfunction

bone marrow failure

immune thrombovytopenic purpura

hemophilia A is a deficiency of _

factor VIII

thrombophlebitis

inflamed thrombosed vein

venous thrombosis can lead to _

pulmonary thromboembolism

arterial thrombosis can lead to _

infarction

DIC stands for

disseminated intravascular coagulation

intravascular object TRAVELING in the bloodstream

embolism

types of embolisms

thromboembolism

pulmonary thromboembolism

bone marrow embolism

air embolism

amniotic fluid embolism

2 types of infarcts

white (anemic)

red (hemorrhagic)

white infarct involve _ tissue

dense tissue

red infarct involves _ tissue

spongy soft tissue

ischemic necrosis

infarction

organs affected by white infarct

heart

kidney

spleen

organ affected by red infarct

lung

4 types of shock

hypovolemic

cardiogenic

obstructive

septic

gram _ bacteria are associated with septic shock

positive

3 stages of shock

non progressive

progressive

irreveresible