Fluid, Electrolyte, and Acid-Base Balance

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Water, Electrolyte, and Acid–Base Balance
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Presentation transcript:

Fluid, Electrolyte, and Acid-Base Balance Chapter 26

Body Water Content Varies with weight, age, and sex: Early embryo (97%) Newborn (77%) Adult male (60%) Adult female (54%) Elderly (45%) Adipose tissue versus skeletal muscle largely determines adult differences.

Body Fluids and Compartments

Composition of Body Fluids Electrolytes Cations: sodium, potassium, hydrogen, magnesium, and calcium Anions: chloride, bicarbonate, phosphate, and sulfate Non-electrolytes Glucose Urea Protein Lipids Creatinine

Comparison of Compartments

Fluid Movement Between Compartments

Fluid Movements Exchange between blood and interstitial spaces

Fluid Movements Exchange between extracellular fluids and cells

Water Balance

Regulation of Water Intake

Regulation of Water Output

Regulation of Water Output Obligatory Water Losses Skin and lungs Urine and feces Fluid intake Diet Levels of Anti-diuretic hormone (ADH)

Disturbances in Water Balance Dehydration Hypotonic hydration Edema

Electrolyte Balance Regulation of Sodium Balance Regulation of Potassium Balance Regulation of Calcium and Phosphate Balance Regulation of Magnesium Balance Regulation of Anions

Regulation of Sodium By Aldosterone

Regulation of Sodium By ANP

Regulation of Sodium By Baroreceptors

Regulation of Sodium Aldosterone ANP Baroreceptors Other hormones: Estrogen=enhances Na+ reabsorption Progesterone=decreases Na+ reabsorption Glucocorticoids=enhances Na+ reabsorption

Regulation of Potassium The regulatory site of potassium is in the renal tubules Influence of aldosterone Influence of plasma potassium concentrations

Regulation of Calcium Influence of Parathyroid Hormone Influence of Calcitonin

Regulation of Phosphate Influence of Parathyroid Hormone Decreases plasma phosphate concentrations while increasing calcium concentrations Influence of Calcitonin Increases plasma phosphate concentration while decreasing calcium concentrations

Regulation of Magnesium Balance and Anions PTH increases plasma magnesium concentrations by causing a decrease in the amount of magnesium excreted by the kidneys Anions Chloride is indirectly increased by Aldosterone because it passively follows sodium

Acid-Base Balances

Strong Acids versus Weak Acids

Three Types: Bicarbonate Buffers Phosphate Buffers Protein Buffers Chemical Buffers Three Types: Bicarbonate Buffers Phosphate Buffers Protein Buffers

Bicarbonate Buffers Major extracellular buffering system HCO3- functions as a weak base while H2CO3 functions as a weak acid. Example: HCl + NaHCO3- H2CO3 + NaCl

Phosphate Buffers Important in urine and intracellular buffering systems However NaH2PO4 acts as the weak acid and Na2HPO4 serves as the weak base. Example: HCl + Na2HPO4 NaH2PO4 + NaCl

Protein Buffers Most abundant buffering system in the body including intracellular and extracellular compartments. Carboxyl groups (COOH) and amine groups (NH3) act as either an acid or a base respectively.

Physiological Buffers Two Types: Respiratory Buffering System Renal Buffering System

Respiratory Regulation of H+ Rising plasma H+ causes deeper, rapid breathing which decreases CO2 blood thereby decreasing H+ ions.

Renal Buffering System Reabsorption of HCO3- is coupled to H+ secretion

Abnormalities in Acid-Base Balance Respiratory acidosis Increased CO2=increased H+=decreased pH Cause: Hypoventilation To compensate: Kidney function=increase excretion of H+ or by increased reabsorption of HCO3- Respiratory alkalosis Decreased CO2=decreased H+=increased pH Cause: Hyperventilation To compensate: Kidney function=decreased H+ excretion or by decreased reabsorption of HCO3-

Abnormalities in Acid-Base Balance Metabolic acidosis Decreased HCO3-=increased H+=decreased pH Cause: Diarrhea, ketosis, renal dysfunction To compensate: Hyperventilation and kidney function Metabolic alkalosis Increased HCO3-=decreased H+=increased pH Cause: Vomiting, diuretics, alkaline drug use To compensate: Hypoventilation and kidney function

Causes and Consequences of Acid-Base Imbalances

Causes and Consequences of Acid-Base Imbalances

Homeostatic Imbalances Hypernatremia Hyponatremia Hyperkalemia Hypokalemia Hyperphosphatemia Hypophosphatemia Hyperchloremia Hypochloremia Hypercalcemia Hypocalcemia Hypermagnesemia Hypomagnesemia Hyperproteinemia Hypoproteinemia

Homeostatic Imbalances

Homeostatic Imbalances

END TEST IV MATERIAL