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Chapter 27. Fluid, Electrolyte and Acid-Base Balance. Fluid basics. ≠. ECF. ICF. interstitial fluid blood plasma. cytoplasm. ~1/3. ~2/3. different ion compositions different fluid compartments same osmotic concentration. Fluid basics.

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Chapter 27

Fluid, Electrolyte and Acid-Base Balance


Fluid basics

ECF

ICF

interstitial fluid

blood plasma

cytoplasm

~1/3

~2/3

different ion compositions

different fluid compartments

same osmotic concentration


Fluid basics

all homeostatic mechanisms monitor the ECF, not the ICF

2. receptors can’t monitor [ion]

but can monitor:

plasma volume

osmotic concentration

3. cells cannot actively move H2O

“water follows salt”


Fluid basics

4. [water] and [electrolyte]

will rise if gains exceed losses

will fall if losses exceed gains


hormone basics

1. ADH (antidiuretic hormone)

high blood [osmotic]

release

H2O conservation in kidney

stimulates thirst


hormone basics

2. Aldosterone

released in response to:

rising [K+]

falling [Na+]

renin release

[Na+], Cl-, H2O

reabsorption in kidney


hormone basics

3. Natriuretic hormones

released cardiac/brain cells

block ADH release

block aldosterone release

[Na+] and H2O

lost to urine


Fluid movements

ECF

interstitial fluid

plasma

colloid

osmotic

pressure

hydrostatic

pressure


Fluid movements

fig 21-12


Fluid movements

ECF

ICF

interstitial fluid

plasma

rapid movement between ICF and ECF is called fluid shift

colloid

osmotic

pressure

hydrostatic

pressure


Fluid shift

ECF

ICF

If [osmotic] 

hypertonic

H2O


Fluid shift

ECF

ICF

If [osmotic] 

hypotonic

H2O


Fluid shift

  • net loss of water dehydration

    • sweating, vomiting, diarrhea

    • ICF and ECF become more concentrated

      • hypernatrimia

        • ADH, renin secretion

        •  thirst, …

give hypotonic fluids (H2O)


Fluid shift

  • net gain of water

    • into ECF

      • into ICF

         reduce ADH secretion

         increase fluid loss


Fluid shift

  • net gain of water

    water excess (overhydration)

drinking a lot

injection of hypotonic solution

kidney or liver failure

excess ADH production

 hyponatrimia

effects on CNS H2O intoxication


Electrolyte balance

electrolyte balance:

will affect H2O balance

will affect cell functions

Na+

most common electrolyte

balance problems

less common

more serious

K+


Electrolyte balance

Na+

too much

 ADH,  retain H2O

renin-angiotensinogen

 retain Na+, H2O

too little

 ADH,  lose H2O

ANP, BNP

 lose Na+, H2O


Electrolyte balance

K+

98% is in ICF

balance in ECF is small

maintained by secretion in kidney


Electrolyte balance

K+

too much

severe cardiac

arrhythmias

too little

 and




100 Keys pg. 1007

“Fluid balance and electrolyte balance are interrelated. Small water gains or losses affect electrolyte concentrations only temporarily. The impacts are reduced by fluid shifts between the ECF and ICF, and by hormonal responses that adjust the rates of water intake and excretion. Similarly, electrolyte gains or losses produce only temporary changes in solute concentration. These changes are opposed by fluid shifts, adjustments in the rates of ion absorption and secretion, an adjustments to the rates of water gain and loss.”


100 Keys pg. 1019

“The most common and acute acid-base disorder is respiratory acidosis, which develops when respiratory activity cannot keep pace with the rate of carbon dioxide generation in peripheral tissues.”


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