Exam 1 patho

Intracellular fluid

Contained within the cell. 2/3 of total body water.

Extracellular fluid

Fluid outside of the cells. 1/3 total body water. Two compartments; interstitial fluid and intravascular fluid.

Interstitial fluid

Fluid between cells, outside of the blood vessels.

Intravascular fluid

Blood plasma or fluid within the blood vessels.

Osmolality

The number of particles of a solute in a unit of solution. Serum osmolality is 280-310 mOsm/kg.

Filtration

Movement of both water and smaller molecules through a semi-permeable membrane from an area of high pressure to an area of low pressure.

Hydrostatic Pressure

Pressure exerted by fluid within a closed system such as intravascular space. Leads to movement (filtration) of water through the capillary membranes into the interstitial space.

Osmotic pressure

Power of a solution to attract water due to concentration. The concentration is through solutes in the solution. In the bloodstream, the concentration is created by electrolytes, nutrients and proteins.

Oncotic pressure

Also called colloidal oncotic pressure. Refers to the force exerted specifically by albumin in the bloodstream. Good fact to know is that albumin is indicative of the protein nutritional status of the body so low albumin means poor nutritional status.

Edema

Accumulation of fluid within the interstitial space and intercellular fluid.

Isotonic solution

Same tonicity of the blood. We use 0.9% normal saline or 305 mOsm/kg.

Intake

The amount of fluid a person takes into their body within a day is about 2400-3200ml, generally >1500mL for normal kidneys to function and 500-1000mL from food.

Output

The amount of fluid that leaves the body within a day. Obligatory output should be 300-500mL/day or around 30-40mL/hr. Insensible water loss is about 100mL/day more if you have a fever.

Atrophy

decrease in cell size

Hypertrophy

increase in cell size

Physiologic hypertrophy

the enlarged muscle is adequately perfused and supplied with blood flow, oxygen, and nutrients because of angiogenesis

Pathological hypertrophy

Seen in hypertension or heart failure. An increase in cellular size without an increase in the supportive structures necessary for the enlarged cells increase in metabolic demand.

Hyperplasia

increase in number of cells

Metaplasia

replacement of one cell type with another

Dysplasia

abnormal size, shape, and organization of cell

Neoplasia

the new and abnormal development of cells that may be benign or malignant

Ischemia

Low blood flow to a tissue

Hypoxia

Low oxygen supply to a tissue (most common cause of cell death)

Infarction

Tissue death due to no oxygen

Oxidative stress

Imbalance between free radicals and antioxidants.

Free radicals

Unstable molecules that cause biochemical aging, especially wrinkling and sagging of the skin.

Apoptosis

Genetically programmed degenerative change that causes cell death. Cells degenerate at a specific time period with no adverse effects on the body. You get a reduction in cell size, intact plasma membrane but an altered structure, no adjacent inflammation.

Necrosis

Cellular death due to stressors of insults that overwhelm the cell's ability to survive, it is irreversible.

Gangrene

Occurs when a considerable mass of tissue undergoes necrosis. (can be dry or wet)

Allostasis

The dynamic state of balance that changes to exposure to stressors.

Allostatic load

The wear and tear on the body systems caused by stress reactions.

Somatic cells

46 chromosomes formed through mitosis.

Gametes

23 chromosomes and called haploid cells formed through meiosis.

Teratogens

Agents that may or may not cause mutations but can damage a developing fetus.

Penetrance

Ratio of how many persons have the phenotype as compared to those that have the genotype.

Expressivity

A disorder can be expressed by symptom severity, variation of a phenotype.

Aneuploidy

Abnormal number of chromosomes, a cell that does not contain 23 pairs of chromosomes.

Sex linked aneuploidy

Abnormal number of sex chromosomes.

Monosomy

Missing one chromosome from a pair. All autosomal monosomies are not compatible with life. Monosomy of the X chromosome is compatible with life.

7.35-7.45

Normal blood pH

35-45

pCO2 normal

22-26

HCO3

90-100

pO2

Solute

particles that are dissolved in liquid

Solvent

A liquid substance capable of dissolving other substances

interstitial, intravascular, transcellular

Types of extracellular fluids

transcellular

cerebrospinal fluid, synovial, digestive, pleural, peritoneal fluids

280-295 (mOsm/kg)

Normal osmolarity of blood

Hypotonic

Having a lower concentration of solute than another solution

increases concentration solutes

what does high osmolarity do mean for concentration of solutes ?

diffusion, osmosis, filtration

types of passive transport

filtration

movement of water and small particals through membrane from high to low pressure

osmosis

movement of water accross membrane from low solute to high solute concentrations

diffusion

Movement of molecules from an area of higher concentration to an area of lower concentration.

hydrostatic pressure + osmotic pressure

define filtration

osmotic pressure

power to draw/attract water (ex increase blood gluc = increasd h2o)

hydrostatic pressure

pressure exherted by fluid in closed system (ex blood pressure)

oncotic pressure

Pressure exerted by proteins (colloids) in blood plasma.

Colloids

important proteins in oncotic pressure

Na+/K+ pump

Active transporter that moves three Na+ out of a cell and two K+ into the cell against their respective concentration gradients.

ECF

is Na+ have a higher concentration ICF or ECF?

ICF

Does K+ have a higher concentration ICF or ECF?

The increased osmolarity of the blood

what can trigger thirst mechanism?

Hypothalamus

where is the thirst mechanism?

glycocorticoids

cortisol is a ______

mineralcorticoid

aldosterone is a _____

Aldosterone

Hormone that stimulates the kidney to retain sodium ions and water. Chief mineralcorticoid

adrenal glands

where is aldosterone released from?

decrease bp, decrease sodium (Na+), increase K+

what stimulates the release of aldosterone?

Renin-Angiotensin-Aldosterone System (RAAS)

Hormonal system regulating blood pressure and fluid balance.

afterload

Resistance heart must overcome to eject blood.

preload

The precontraction pressure in the heart as the volume of blood builds up.

renin

hormone secreted by the kidney that converts angiotensinogen to angiotensin I

ACE

enzyme that converts angiotensin I to angiotensin II

Angiotensin II

hormone that stimulaters vasoconstriction and the release of aldosterone

naturitic peptides (NPs)

promote sodium and water excretion (acting as a natural diuretic). Oppose RAAS

cells in aorta and ventricles

where are NP's secreted?

increased blood volume, increased blood pressure, stretched heart tissue

what triggers the secretion of NP's?

antidiuretic hormone (ADH)

Hormone that stimulates water reabsorption from kidney (not sodium absorption) and vasoconstriction

Vasopressin

Another name for ADH?

Posterior pituitary gland

where is ADH/vasopressin secreted?

True

T or F: ADH is regulated by pressure sensors in the vascular system?

increased osmolarity, decrease blood volume, hypotension, vomiting

When is ADH released?

alcohol, increased fluid volume

what inhibits ADH release?

from plasma to interstitial fluid

what happens to fluid when there is a decrease in colloid pressure?

excess

what happens to fluid volume when renal mechinism fails

increase hydrostatic pressure, decrease colloid pressure, increase cap memb perm, lymphedema

factors that cause edema

Third spacing

the movement of intravascular fluid to nonvascular fluid compartments, where it becomes trapped and useless. Example: pleural effusion, ascites

135-145

normal sodium levels

ECF

where is sodium in high concentration?

Sodium

What electrolyte functions to regulate osmolarirty, conduct nerve impulse, maintain ECF volume?

urine/kidneys

how is K+ excreted?

K+

whats electrolytes primary function is nerve impulse?

K+

An impalance in which electrolyte is a concern for cardiac changes/cardiac arrest

hypernatremia

high Na+ in the blood

hypernatremia

Lethargy, seizure, coma, thirst are some effects of ____

hyponatermia

Low Na+ in the blood

hyponatermia

how does adrenal insufficiency influence Na+ levels in the blood

water intoxication

hyponatremia causes _____ in the body

water intoxication (hyponatremia)

neurological symptoms due to cellular swealling (headache, irritability, confusion, lethergy),

Diarrhea and cramping

Symptoms for ___