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33 Cards in this Set
- Front
- Back
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Glomerular filtration |
The water and dissolved substances in the blood are filtered out at this point by hydro static pressure, arterial pressure is 55 fluid on the opposite side is 15, and osmotic forces in the artery are 30. There is net force of 10 pushing the fluid into bowmans capsule. |
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Tubular reabsorption |
The fluid pushed out during glomerular filtration is passed along next to a vessel and sugar, amino acids, water and sodium are reabsorbed. Electrolytes are reabsorbed as needed by the body. |
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Tubular secretion |
At this same point the vessels secrete potassium and hydrogen ions into the urine. |
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Urine concentration and volume |
Urine production 60 ml/hr |
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Regulation of body fluid |
Countercurrent. Selective permeability. |
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Countercurrent |
Increase in osmotic pressure in the vessels pulls the water and sodium back into the blood. |
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Selective permeability |
ADH regulated by baroreceptors in the left atrium and elsewhere, regulates fluid volume based on blood pressure. Increased blood pressure caused the ADH to go down and urine production to go up. |
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Soduim ions (Na+) |
135 to 145 mEq/L Increased Na cause the kidneys to retain water and body to crave water (thirst) |
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Potassium (K+) |
3.5 to 5 mEq/L Needed for normal muscle and nerve function. Too low hypokalemia. Metabolic alkalosis, muscle weakness and arrhythmias. Too high hyperkalemia. Metabolic acidosis, muscle weakness and deadly arrhythmias. When diuretics given the body loses potassium and chloride, need to be replace with KCI. |
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Acid base balance |
If the pH is low then H+ ions are excreted in the urine. If the pH is high then HCO3 is excreted in the urine. When HCO3 goes up the K+ and Cl- go down and vice versa. So a metabolic alkalosis is associated with a low potassium. |
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Blood volume |
Three places for fluid to be. Intracellular Extracellular: intravascular and interstitial. Increased blood volume will cause kidneys to excrete more urine and push fluid into the interstitial 3rd space. Low blood volume the kidneys will excrete less volume and the interstitial space will push fluid into the vessels. |
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Renal failure |
Congenital disorders Infections Obstructive disorders Inflammation and Immune response Neoplasms |
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Renal failure prerenal |
When the blood flow going into the kidneys is impaired, i.e. low blood pressure. |
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Renal failure renal |
Blood flow obstructed within the kidney. |
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Renal failure postrenal |
Obstruction to flow after kidney filtration. |
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Mechanical ventilation |
Postive pressure ventilated decreases urine output, stimulate ADH release. Negative pressure ventilation increases urine output. |
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Problem from renal failure |
As the kidneys fail water, nitrogen and electrolytes are retained. Increased fluid causes edema, both peripheral and pulmonary. Kidney function is sometimes assessed by blood urea nitrogen. |
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Hypertension |
Retained fluid and sodium lead to too much volume and high blood pressure and edema. |
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Metabolic acidosis |
Electrolytes are retained and increased K+ and Cl- lead to metabolic acidosis. |
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Anemia |
Suppress the ability of bone marrow to produce red blood cells. |
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Bleeding |
Platelet abnormalities, GI bleeding most serious |
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Cardiovascular |
Edema, CHF, pulmonary edema, pericarditis |
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Chapter 17 |
Chapter 17 |
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Sleep |
NREM (non REM) N1 and N2 light sleep N3 slow wave sleep and deep Sleep This is where you get your most sleep. REM (rapid eye movement) Muscle atonia except eyes and diaphragm, EEG similar to awake Most dreams and feeling of paralysis. Sleep stages repeat in cycles of 90 to 120 minutes. Circadian process, 24 hour cycle Infants 16 to 17 hours a day. Toddlers and preschoolers 14 hours a day. Hormonally drivenInfants 16 to 17 hours a day.Toddlers and preschoolers 14 hours a day. Children and adolescents 8 to 10 hours.Adults 6 to 8 hours. Children and adolescents 8 to 10 hours. Adults 6 to 8 hours. |
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Disorders |
Insomnia Hypersomnia Narcolepsy Periodic limb movement Restless leg syndrome Sleep apnea is a chronic disorder characterized by daytime hypersomnolence, snoring, disrupted sleep, hypoxemia, and repeated episodes of hypopnea or apnea, or both, during sleep |
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Three types of sleep apnea |
Obstructive: chest and abdominal efforts without airflow. Central: cessation of airflow and chest and abdominal efforts. Mixed: a combination of the two above. |
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Sleep disorders diagnosis |
Polysomnography EEG ECG Airflow nasal and oral (thermistor) Eye movement (electo-oculogram) Chest wall movement Abdominal movement Leg movement (electromyogram) Pulse oximerty |
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Autonomic nervous system |
Parasympathetic activity increases (stimulation of parasympathetic nerves cause bronchspasm) |
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Musculoskeletal system |
Muscle tone decreases. Paralysis during REM sleep. Loss of muscle tone in throat and tongue causing sleep apnea. |
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Thermal regulation |
Temperature falls |
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Renal function |
Renal perfusion decreases so less urine produced. |
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Cardiovascular |
Cardiac output changes with respiration. Increased number of arrhythmias during REM sleep. |
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Respiratory |
Non REM minute ventilation drops. Decreased metabolic rate Central chemoreceptors (medulla) does not respond to change in CO2. Peripheral chemoreceptors don't respond as fast. Increase airway resistance due to loss of muscle tone in upper airway. REM irregular respiratory pattern. |
