Physiology: Chapter 25 Body Fluid Compartments, Extra And Intracellular Fluid, Interstitial Fluid And Edema

Front 1

What source besides drinking do we get water from?

Back 1

oxidation of food stuff via the electron transport... approximately 200mL/day

Front 2

What is insensible water loss?

Back 2

sweating 300-400mL/day
respirations 300-400mL/day

Front 3

Is there are greater loss of fluid during respiration in hot or cold weather?

Back 3

Greater loss in cold because the air has very little moisture

Front 4

Where is transcellular fluid found?

Back 4

synovial, peritoneal, pericardial and intraocular spaces and cerebrospinal fluid

Front 5

What % of the body is water weight?

Back 5

60%

Front 6

As a person ages do they tend to lose or accumulate water?

Back 6

lose water possibly in part to a greater percentage of fat

Front 7

Is there more volume in interstitial or plasma compartments?

Back 7

interstitial

Front 8

Does plasma or interstitium have a higher concentration of proteins?

Back 8

plasma

Front 9

Is the concentration of cations greater in the interstitium or plasma? What causes this?

Back 9

1) plasma
2) donnan effect in which plasma proteins have a net negative charge and bind cations in the plasma

Front 10

What property of the interstitium allows it to repel proteins?

Back 10

it accumulates anions which repel plasma proteins which overall are negatively charged

Front 11

Is magnesium higher inside or outside the cell?

Back 11

inside

Front 12

What is the plasma concentration of Na, K, Ca, Cl, HCO3-?

Back 12

Na = 142 mOsm/L
K = 4.2
Ca = 1.3
Cl = 108
HCO3- = 24

Front 13

What element is used to measure plasma concentration? What about blood volume?

Back 13

1) Iodine labeled albumen
2) Cr labeled RBCs

Front 14

How is the interstitial volume measured?

Back 14

extracellular fluid - plasma volume

Front 15

How is intracellular fluid volume determined?

Back 15

total body water - extracellular volume

Front 16

How is total blood volume determined?

Back 16

plasma volume/ (1-hematocrit)

Front 17

What unit are the number of particles in a solution measured in?

Back 17

osmoles (osm)

Front 18

What is one osm equal to?

Back 18

1 mole which is 6.02x10^23

Front 19

1 mole of Na2SO4 is dissolved in 1 liter. How many osmoles are there?

Back 19

3osm/L

Front 20

What does the term osmole refer to?

Back 20

the number of particles that are dissolved

Front 21

What is osmolality?

Back 21

osmoles/kg water

Front 22

What is the pressure called that is needed to oppose osmosis?

Back 22

osmotic pressure. it is an indirect measurement of the water and solute concentrations of a solution.

Front 23

If the osmotic pressure is high what can be said about the water to solute ratio?

Back 23

there is less water and more solute

Front 24

What is the osmotic pressure proportional to?

Back 24

the number of particles and is independent of size of particle

Front 25

A blockage in the delivery of oxygenated blood to the cells

Back 25

Ischemia
pg 183

Front 26

What is osmolality?

Back 26

osmoles/kg water

Front 27

What is the pressure called that is needed to oppose osmosis?

Back 27

osmotic pressure. it is an indirect measurement of the water and solute concentrations of a solution.

Front 28

If the osmotic pressure is high what can be said about the water to solute ratio?

Back 28

there is less water and more solute

Front 29

What is the osmotic pressure proportional to?

Back 29

the number of particles and is independent of size of particle

Front 30

What is the equation of osmotic pressure?

Back 30

pi = CRT where C is concentration of solute, R is ideal gas constant and T is temp in kelvin. This is van't Hoffs law

Front 31

What is the assumption of van't hoffs law when calculating osmotic pressure of a solution?

Back 31

that the cell membrane is impermeable to the solute

Front 32

How can the osmotic pressure of a 0.9% NaCl solution be determined?

Back 32

0.9% means that the concentration is 9g/L. The molecular weight is 59g/mol so the molarity is 0.154mol/L. Because it dissociates into 2 ions it is 0.308osm/L or 308mosm/L. Then use pi=CRT

Front 33

For each mosm of an impermeant solute how much osmotic pressure is exerted across the membrane?

Back 33

19.3mmHg. This is how a small change in solute concentration can cause a large shift in volume across a impermeable membrane

Front 34

What is the osmolarity of a cell?

Back 34

282mosm/L

Front 35

What are examples of isotonic solutions administered in a hospital?

Back 35

0.9% NaCl and 5% glucose

Front 36

If a solution of 0.6% NaCl is given IV what will result?

Back 36

The cells will swell because they are hypertonic relative to the hypotonic solution

Front 37

What do the terms hyperosmotic and hypoosmotic refer to? Give an example!

Back 37

solutions that have a higher or lower osmolarity compared with normal extracellular fluid, without regard for whether the solute permeates the cell membrane. Urea can cause transient shifts in fluid volume between extracellular and intracellular fluids but will eventual become equal between compartments

Front 38

How long does it take to reach osmotic equilibrium after drinking water?

Back 38

30 minutes

Front 39

If an isotonic solution is added how does it settle in the different areas of the body? Does the osmolarity change in the intracellular compartment?

Back 39

1) in the extracellular fluid
2) no change in osmolarity in either the intracellular or extracellular compartment

Front 40

If a hypotonic solution is added how does it settle in the different areas of the body?

Back 40

1) settles in both the intracellular and extracellular compartments increasing volume in both
2) decreases the osmolarity in both the intracellular and extracellular compartments

Front 41

If a solution of 0.6% NaCl is given IV what will result?

Back 41

The cells will swell because they are hypertonic relative to the hypotonic solution

Front 42

What do the terms hyperosmotic and hypoosmotic refer to? Give an example!

Back 42

solutions that have a higher or lower osmolarity compared with normal extracellular fluid, without regard for whether the solute permeates the cell membrane. Urea can cause transient shifts in fluid volume between extracellular and intracellular fluids but will eventual become equal between compartments

Front 43

How long does it take to reach osmotic equilibrium after drinking water?

Back 43

30 minutes

Front 44

If an isotonic solution is added how does it settle in the different areas of the body? Does the osmolarity change in the intracellular compartment?

Back 44

1) in the extracellular fluid
2) no change in osmolarity in either the intracellular or extracellular compartment

Front 45

If an isotonic solution is added how does it settle in the different areas of the body? Does the osmolarity change in the intracellular compartment?

Back 45

1) settles in both the intracellular and extracellular compartments increasing volume in both
2) decreases the osmolarity in both the intracellular and extracellular compartments

Front 46

If an hypertonic solution is added how does it settle in the different areas of the body? Does the osmolarity change in the intracellular compartment?

Back 46

1) it decreases the intracellular volume and increases the extracellular volume
2) it increases the osmolarity of both the intracellular and extracellular compartments

Front 47

What type of dehydration does adrenal insufficiency cause? What happens to the Na, extra and intracellular fluid volumes?

Back 47

1) hypo osmotic dehydration
2) causes decreased Na, extracellular fluid and increased intracellular fluid

Front 48

What type of dehydration does diuretic use cause? What happens to the Na, extra and intracellular fluid volumes?

Back 48

1) hypo osmotic dehydration
2) causes decreased Na, extracellular fluid and increased intracellular fluid

Front 49

What type of dehydration does excess ADH or bronchogenic tumor cause? What happens to the Na, extra and intracellular fluid volumes?

Back 49

1) hypo osmotic overhydration
2) decreased Na, increased extra and intracellular volume

Front 50

What conditions cause hyperosmotic dehydration? What effect do they have on plasma Na, extra and intracellular fluid?

Back 50

1) diabetes insipidus, excessive sweating
2) increased Na, decreased extra and intracellular fluid

Front 51

What conditions cause hyperosmotic overhydration? What effect do they have on plasma Na, extra and intracellular fluid?

Back 51

1) cushings, primary aldosteronism
2) increased Na, and extracellular fluid and decreased intracellular

Front 52

what can vomiting and diarrhea do to the bodies fluid balance?

Back 52

cause hypoosmotic dehydration with decreased Na, and extracellular fluid but increased intracellular fluid

Front 53

What is Addison's disease?

Back 53

adrenal insufficiency

Front 54

what is hypo-osmotic overhydration?

Back 54

excessive fluid retention

Front 55

What conditions cause hyperosmotic dehydration? What effect do they have on plasma Na, extra and intracellular fluid?

Back 55

1) diabetes insipidus, excessive sweating
2) increased Na, decreased extra and intracellular fluid

Front 56

What conditions cause hyperosmotic overhydration? What effect do they have on plasma Na, extra and intracellular fluid?

Back 56

1) cushings, primary aldosteronism
2) increased Na, and extracellular fluid and decreased intracellular

Front 57

what can vomiting and diarrhea do to the bodies fluid balance?

Back 57

cause hypoosmotic dehydration with decreased Na, and extracellular fluid but increased intracellular fluid

Front 58

What is Addison's disease?

Back 58

adrenal insufficiency

Front 59

what is hypo-osmotic overhydration?

Back 59

excessive fluid retention with normal Na

Front 60

What 2 conditions cause intracellular swelling?

Back 60

1) depressed metabolic systems in tissues
2) lack of adequate nutrition

Front 61

With ischemia how does intracellular swelling result?

Back 61

deprivation of oxygen and nutrients impair the cells ability to maintain the concentration gradient and as a result Na concentration increases in the swell followed by water

Front 62

does inflammation cause intracellular edema?

Back 62

yes by having a direct effect to increase the permeability of the cell membrane to ions

Front 63

What are the 2 general causes of extracellular edema?

Back 63

1) abnormal leakage of fluid from the plasma to the interstitial spaces across the capillaries
2) failure of the lymphatics to return fluid to blood

Front 64

How is capillary filtration expressed mathematically?

Back 64

filtration = Kf x (Pc - Pif - pic + piif)
Kf=capillary filtration coefficient
Pc=cap hydrostatic pressure
Pif= interstitial hydrostatic pressure
pic=capillary plasma colloid osmotic pressure
piif=interstitial fluid colloid osmotic pressure

Front 65

Decreasing the plasma colloid osmotic pressure results in increased or decreased filtration?

Back 65

increased because less fluid is able to return at the distal capillary

Front 66

Why does lymphatic blockage cause edema?

Back 66

there is increased interstitial protein which raises intersitial colloid osmotic pressure and reduces the amount of fluid returned to plasma

Front 67

Does decreased arteriolor resistance result in edema or hypovolemia?

Back 67

edema from excessive body heat, insufficient sympathetic stim, or vasodilator drugs

Front 68

Do burns result in edema?

Back 68

yes

Front 69

Do children who develop acute glomerularnephritis have hypovolemia or edema?

Back 69

edema from decreased filtration

Front 70

What is one of the most common causes of decreased plasma proteins?

Back 70

loss of proteins in urine in conditions such as nephrotic syndrome

Front 71

At what point does serious edema result from plasma protein deficiency?

Back 71

when the protein level reaches 2.5g/100mL. norm is ~7g/dL

Front 72

What are the safety factors that prevent the accumulation of fluid in the interstitium?

Back 72

1) low compliance of the interstitium when the fluid pressure is in the negative pressure range
2) ability of lymph flow to increase 10-50 fold
3) washdown of interstitial fluid protein concentration which reduces interstitial fluid colloid osmotic pressure

Front 73

What is the interstitial fluid hydrostatic pressure in most loose subcutaneous tissues?

Back 73

negative that is why they easily accumulate fluid

Front 74

Interstitial tissue generally has a slight negative pressure. Does tissue have a low or high compliance while it is at this negative pressure?

Back 74

it has a low compliance so that even a small change in volume rapidly increases the tissue hydrostatic pressure

Front 75

When the interstitial fluid begins to develop a positive pressure will it have a high or low compliance?

Back 75

it will have a high compliance in that a lot of fluid can accumulate in the interstitium before the fluid hydrostatic pressure rises even a little

Front 76

Why is it important to have a negative interstitial hydrostatic pressure?

Back 76

It is better able to maintain equilibrium when the capillary hydrostatic pressure increases; that is by having a low compliance at negative pressure the interstitial fluid hydrostatic pressure can increase rapidly to overcome changes in capillary hydrostatic pressure

Front 77

When fluid enters the interstitium in the low compliance state what is the pressure? Where does the fluid accumulate?

Back 77

1) negative
2) accumulates in the proteoglycan mesh work "the gel formation"

Front 78

What is the function of the proteoglycan filaments in the interstitium?

Back 78

1) prevent fluid from flowing away from the site when it extravasates 2) prevent tissue collapse, for instance during dehydration, because the proteoglycan filaments are negatively charged and repel each other when compressed

Front 79

Interstitial tissue generally has a slight negative pressure. Does tissue have a low or high compliance while it is at this negative pressure?

Back 79

it has a low compliance so that even a small change in volume rapidly increases the tissue hydrostatic pressure

Front 80

When the interstitial fluid begins to develop a positive pressure will it have a high or low compliance?

Back 80

it will have a high compliance in that a lot of fluid can accumulate in the interstitium before the fluid hydrostatic pressure rises even a little

Front 81

Why is it important to have a negative interstitial hydrostatic pressure?

Back 81

It is better able to maintain equilibrium when the capillary hydrostatic pressure increases; that is by having a low compliance at negative pressure the interstitial fluid hydrostatic pressure can increase rapidly to overcome changes in capillary hydrostatic pressure

Front 82

When fluid enters the interstitium in the low compliance state what is the pressure? Where does the fluid accumulate?

Back 82

1) negative
2) accumulates in the proteoglycan mesh work "the gel formation"

Front 83

What is the function of the proteoglycan filaments in the interstitium?

Back 83

1) prevent fluid from flowing away from the site when it extravasates
2) prevent tissue collapse, for instance during dehydration, because the proteoglycan filaments are negatively charged and repel each other when compressed

Front 84

In the negative pressure range of interstitium does the volume or pressure change more readily?

Back 84

the pressure increases more easily with small increases in volume

Front 85

When does pitting edema occur?

Back 85

when excess free fluid accumulates and pulls the proteoglycan layer apart. The fluid flows freely through the tissue spaces

Front 86

What is nonpitting edema?

Back 86

when tissue cells swell instead of the interstitium or when the interstitium is infiltrated with fibrin clots which prevent free flow of fluid through the tissue

Front 87

What would result if the proteoglycan interstitium ceased to function?

Back 87

all the fluid would flow away and down to the feet while standing

Front 88

What pressure does the the lymphatic system reduce when it removes proteins from the interstitium?

Back 88

decreases colloid osmotic pressure which pulls fluid into the interstitium from the plasma

Front 89

What are the 3 safety factors that prevent edema?

Back 89

1) low compliance initially
2) lymph flow
3) wash down of proteins (high compliance stage)