Study Guide P (test 3)

What would cause “Water Retention”?

ADH hypersecretion

renin release

increased osmolarity of blood

What would cause “Water Loss”?

hemorrhage

Aldosterone hyposecretion

decreased renal tubular reabsorption of water

What is the result of ADH Release?

reduction in urine volume

increased water reabsorption from kidney tubules

increased aquaporin

drinking water

What stimulates the release of ADH?

reduction in total body water

increase blood osmolarity

What stimulates the release of Aldosterone?

higher concentration of K+ in the ECF

Hyponatremia

Hyperkalemia

Hypotension

What is the “result of Aldosterone release”?

increased production of DCT sodium-potassium ATPase pumps

increased potassium secretion

higher urine concentration of potassium

increased sodium reabsorption

What is the order for the homeostasis of Potassium ions?

Potassium ion concentration increases (stimulus)

Adrenal cortex is signaled (receptor)

Aldosterone is secreted (effector)

Renal tubules increase reabsorption of Na+ and increase secretion of K+ (action)

sodium ions are conserved and potassium ions are excreted (response)

What actions of the body would “Decrease” water levels in the body?

sweating, cutaneous transpiration, urinating, defecating, breathing

What actions of the body would “Increase” water levels in the body?

eating, drinking

Diarrhea and hemorrhage are an example of what type of fluid imbalance?

Volume depletion

Kidney’s decrease fluid loss is an example of what type of fluid imbalance?

volume excess

profuse sweating is an example of what type of fluid imbalance?

dehydration

Positive water balance is an example of what type of fluid imbalance?

Hypotonic hydration

Pleural effusion and Edema is an example of what type of fluid imbalance?

Fluid sequestration

“Increased interstitial fluid formation” is caused by?

increased Blood volume

increased hydrostatic blood pressure

increased capillary leakage

“Decreased reabsorption into capillaries” is caused by?

decreased blood colloid osmotic pressure

reduced ability of the liver to produce albumin

“Decreased lymph formation” is caused by?

surgical removal of tissue

following a mastectomy

What are the effects of Angiotensin II?

decreases urine output

What are the effects of ADH?

decrease urine output

What are the effects of Aldosterone?

decreases urine output

What are the effects of ANP?

increase urine output

decreased blood volume

decreases blood pressure

What are examples of Nonelectrolyes?

glucose, creatinine, urea

What are examples of Electrolytes?

sodium hydroxide, hydrochloric acid, sodium chloride

When blood pressure is low, angiotensin II acts on several organs to help raise blood pressure

How do “Blood vessels” respond?

increases peripheral resistance

When blood pressure is low, angiotensin II acts on several organs to help raise blood pressure

How do “Kidney’s” respond?

mesangial cells contract

vasoconstriction of afferent arterioles

decreases in GFR

When blood pressure is low, angiotensin II acts on several organs to help raise blood pressure

How does the “Hypothalamus” respond?

releases ADH

When blood pressure is low, angiotensin II acts on several organs to help raise blood pressure

How does the “Adrenal cortex” respond?

releases Aldosterone

What “decrease” respiratory rate?

increased H+

more CO2 in blood

less CO2 expired

decreased pH

What “increases” respiration rate?

decreased H+

Less CO2 in blood

more CO2 expired

increased pH

What are “Protein buffering system” characteristics?

does ¾ of chemical buffering in body fluids

buffers against pH changes in BOTH the blood and cells

Amine groups buffer acids

carboxylic acid buffers bases

What are “Phosphate buffering system” characteristics?

involved the most common anion within cells

buffers against pH changes ONLY in cells

What are “ Bicarbonate buffering system” characteristics?

buffers against pH changes ONLY in blood

Physiological buffering system involves?

respiratory + urinary system

may take minutes to days

Chemical buffering system involves?

phosphate buffering system

bicarbonate buffering system

protein buffers

works within seconds

Metabolic “Acidosis” involves?

blood H+ increases

causes increased respiration

blood (HCO3)- decreases

Metabolic “Alkalosis” involves?

blood H+ decreases

causes decreased respiration

blood (HCO3)- increases

What causes “ Metabolic Acidosis”?

excess consumption of alcohol

diabetes mellitus

renal dysfunction

diarrhea

What causes “ Metabolic Alkalosis”?

overuse of diuretics

vomiting

excess ingestion of antacid

Place the events of angiotensin II formation in the correct order from stimulus to response

1. low BP

2. sympathetic division stimulation

3. Juxtaglomerular apparatus releases renin into the blood

4. angiotensinogen activated

5. angiotensin I → angiotensin II

6. BP and volume increase

Place the events of ANP release in the correct order from stimulus to response

1. increase in BP or volume

2. stimulation of baroreceptor in atria

3. atria release ANP into blood

4. ANP binds to effectors

5. increase GFR and loss of Na+ in urine

6. decrease in BP or volume

a) diet

b) urine, feces, sweat

c) ALDO

d) ADH

e) ANP

a) normal blood K+ levels maintained

b) blood pH maintained

c) blood K+ levels maintained after eating

What promotes “increase” in BP?

vasoconstriction

increased activity of ACE

increasing levels of ALDO

increased release of renin

What promotes “decrease” in BP?

vasodilation

declining levels of ADH

decreased sodium reabsorption

When blood pH decreases, the kidneys help regulate blood pH by excreting _________ in the urine and by reabsorbing _________.

H+

bicarbonate

When fluid intake is equal to fluid output, and there is a normal distribution of water and solutes, the body is in a state of fluid _________

balance

T or F

On a hot day when fluid output exceeds fluid intake, the body is in danger of a fluid imbalance.

true

What are all of the sources of fluid intake?

ingesting performed water

production of metabolic water from cellular respiration

Urine that is always formed, regardless of the hydration state of the body, is an example of _________ water loss

obligatory

Drinking alcohol increases the production of dilute urine, dehydrating the body. Without the influence of alcohol, what would normally be happening if the body was dehydrated?

facultative water loss would be decreased

T or F

During volume depletion, fluid is lost but there is no net movement of water between intracellular and extracellular compartments.

true

Where is water sequestered in a tissue with edema?

in the interstitial space

Which stimulus for increasing thirst and water intake is monitored by the thirst center directly?

increased blood osmolarity

A decrease in blood pressure results in the

release of renin from the kidneys

What are the stimuli that will “inhibit” the thirst center?

increase salivary secretion

stretched stomach wall

When blood osmolarity drops?

ADH release is decreased

What substance will exert the greatest osmotic pressure?

CaCl2

Ingesting too much sodium may lead to

a hypertonic extracellular fluid

Sodium is an important electrolyte because

it contributes significantly to blood plasma osmolarity

What would “stimulate” angiotensin II formation?

sympathetic stimulation of the kidneys

low BP

What are the “effectors” of angiotensin II?

hypothalamus, kidneys, blood vessels

Angiotensin II stimulates _________release of the adrenal cortex

aldosterone

What are the “effects” of aldosterone?

increased blood volume

increased BP

increased plasma sodium levels

What are the “effects” of ANP?

systemic vasodilation

increased urine output

Lactic acid is an example of a _________ acid.

fixed

Carbonic acid is

regulated by the respiratory system

In response to decreasing blood pH, the kidneys will?

retain bicarbonate

As blood pH becomes too high, the kidneys will?

reabsorb H+

A protein in the blood plasma binds excess H+ after a meal. In this example, the protein is serving as a?

weak base

In response to an acid-base disturbance, the physiological buffering systems respond to bring pH back to normal. This response is known as _________

compensation

A patient has a chronically low blood pH (below 7.35), despite the response of the physiologic buffering systems.

What is happening to the patient?

the pH disturbance is uncompensated

the patient has an acid-base imbalance

After a traumatic event, a patient is hyperventilating.

What is happening?

the patient may reach a state of respiratory alkalosis

blood pH is increasing

After vomiting profusely, a patient has a decreased respiratory rate. This can be explained as

the respiratory response to metabolic alkalosis.

If there is a decrease in the pH of the ECF, which direction will the K+K+ ions move?

From the ICF to the ECF

Patients with a COPD, such as chronic bronchitis, cannot fully exhale causing their carbon dioxide levels to increase. Because of this they are often in a state of?

respiratory acidosis

What is fluid balance?

Exists when fluid intake is equal to fluid output, and a normal distribution of water and solutes is present in the two major fluid compartments.

Two categories of fluid intake

- Ingested water: includes the water absorbed from food and drink taken into the GI tract
- Metabolic water: includes the water produced daily from aerobic cellular respiration and dehydration synthesis

Fluid is lost from the body through the normal mechanisms of:

- Breathing
- Sweating
- Cutaneous transpiration (evaporation of water directly through the skin)
- Defecation
- Urination

What is sensible water loss?

measurable, includes fluid lost through feces and urine

What is insensible water loss?

no measurable; includes both fluid lost in expired air and fluid lost from the skin through sweat and cutaneous transpiration

What is obligatory water loss?

Loss of water that always occurs, regardless of the state of hydration of the body. It included water lost through breathing and through the skin (insensible water loss), as well as fluid lost in the feces and in the minimal amount of urine produced to eliminate wastes from the body.

What is facultative water loss?

Controlled water loss through regulation of the amount of urine expelled from the body. It is dependent upon the degree of hydration of the body and is hormonally regulated in the DCT, collecting tubules, and collecting ducts in the nephrons of the kidneys.

Fluid imbalance with constant osmolarity- When does this occur?

when isotonic fluid is lost or gained

What can lead to volume depletion?

When isotonic fluid loss is greater than isotonic fluid gain.

When does fluid imbalance with changes in osmolarity occur?

when fluid loss or gain that is not isotonic

What is dehydration?

water loss that is greater than solute loss

Causes of dehydration

profuse sweating, diabetes mellitus, intake of alcohol, hypersecretion of ADH, insufficient water intake, or overexpose to cold weather

In each case, the greater loss of water than the loss of solutes results in the blood plasma becoming hypertonic (relatively more concentrated).

What is hypotonic hydration?

water gain (retention) that is greater that solute gain

Causes of hypotonic hydration?

ADH hypersecretion or drinking a large amount of plain water following excessive sweating

The blood plasma becomes hypertonic to the other fluid compartments. Fluid moves from blood plasma into the IF, and then into the cells. Cells may look swollen with fluid.

What is fluid sequestration?

Total body fluid may be normal, but it is distributed abnormally. Fluid accumulates in a particular location, and it is not available for use elsewhere.

What is edema?

Fluid accumulates in the interstitial space around the cells and is characterized by swelling

What can lead to edema?

Either an increased formation of interstitial fluid or a decreased removal of interstitial fluid

What are some other examples of fluid sequestration?

Hemorrhage, ascites, pericardial effusion, and pleural effusion

What is directly measured to regulate fluid balance?

monitoring blood volume, blood pressure, and blood plasma osmolarity (concentration of solutes in blood plasma).

What occurs when fluid intake exceeds fluid output?

An increase in blood volume and increase in blood pressure

What occurs when fluid output exceeds fluid intake?

A decrease in blood volume and a decrease in blood pressure

What regulates fluid intake? Where is it located?

Thirst center located within the hypothalamus

What hormone stimulates the thirst center?

angiotensin II

When receptors in the thirst center detect an increase in osmolarity, they stimulate the release of which hormone?

ADH

What is another mechanism that stimulates the thirst center?

Decreased salivary secretions