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Fluid, Electrolyte, and Acid-Base Balance Chapter 26.

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Presentation on theme: "Fluid, Electrolyte, and Acid-Base Balance Chapter 26."— Presentation transcript:

1 Fluid, Electrolyte, and Acid-Base Balance Chapter 26

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

3 Body Fluids and Compartments

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

5 Comparison of Compartments

6 Fluid Movement Between Compartments

7 Fluid Movements Exchange between blood and interstitial spaces

8 Fluid Movements Exchange between extracellular fluids and cells

9 Water Balance

10 Regulation of Water Intake

11 Regulation of Water Output

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

13 Disturbances in Water Balance Dehydration Dehydration Hypotonic hydration Hypotonic hydration Edema Edema

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

15 Regulation of Sodium By Aldosterone

16 Regulation of Sodium By ANP

17 Regulation of Sodium By Baroreceptors

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

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

20 Regulation of Calcium Influence of Parathyroid Hormone Influence of Parathyroid Hormone Influence of Calcitonin Influence of Calcitonin

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

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

23 Acid-Base Balances

24 Strong Acids versus Weak Acids

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

26 Bicarbonate Buffers Major extracellular buffering system Major extracellular buffering system HCO 3 - functions as a weak base while H 2 CO 3 functions as a weak acid. HCO 3 - functions as a weak base while H 2 CO 3 functions as a weak acid. Example: Example: HCl + NaHCO 3 - H 2 CO 3 + NaCl

27 Phosphate Buffers Important in urine and intracellular buffering systems Important in urine and intracellular buffering systems However NaH 2 PO 4 acts as the weak acid and Na 2 HPO 4 serves as the weak base. However NaH 2 PO 4 acts as the weak acid and Na 2 HPO 4 serves as the weak base. Example: Example: HCl + Na 2 HPO 4 NaH 2 PO 4 + NaCl

28 Protein Buffers Most abundant buffering system in the body including intracellular and extracellular compartments. Most abundant buffering system in the body including intracellular and extracellular compartments. Carboxyl groups (COOH) and amine groups (NH 3 ) act as either an acid or a base respectively. Carboxyl groups (COOH) and amine groups (NH 3 ) act as either an acid or a base respectively.

29 Physiological Buffers Two Types: Respiratory Buffering System Renal Buffering System

30 Respiratory Regulation of H + Rising plasma H + causes deeper, rapid breathing which decreases CO 2 blood thereby decreasing H + ions.

31 Renal Buffering System Reabsorption of HCO 3 - is coupled to H + secretion

32 Abnormalities in Acid-Base Balance Respiratory acidosis Respiratory acidosis Increased CO 2 =increased H + =decreased pH Increased CO 2 =increased H + =decreased pH Cause: Hypoventilation Cause: Hypoventilation To compensate: Kidney function=increase excretion of H+ or by increased reabsorption of HCO 3 - To compensate: Kidney function=increase excretion of H+ or by increased reabsorption of HCO 3 - Respiratory alkalosis Respiratory alkalosis Decreased CO 2 =decreased H + =increased pH Decreased CO 2 =decreased H + =increased pH Cause: Hyperventilation Cause: Hyperventilation To compensate: Kidney function=decreased H+ excretion or by decreased reabsorption of HCO 3 - To compensate: Kidney function=decreased H+ excretion or by decreased reabsorption of HCO 3 -

33 Abnormalities in Acid-Base Balance Metabolic acidosis Metabolic acidosis Decreased HCO 3 - =increased H + =decreased pH Decreased HCO 3 - =increased H + =decreased pH Cause: Diarrhea, ketosis, renal dysfunction Cause: Diarrhea, ketosis, renal dysfunction To compensate: Hyperventilation and kidney function To compensate: Hyperventilation and kidney function Metabolic alkalosis Metabolic alkalosis Increased HCO 3 - =decreased H + =increased pH Increased HCO 3 - =decreased H + =increased pH Cause: Vomiting, diuretics, alkaline drug use Cause: Vomiting, diuretics, alkaline drug use To compensate: Hypoventilation and kidney function To compensate: Hypoventilation and kidney function

34 Causes and Consequences of Acid-Base Imbalances

35

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

37 Homeostatic Imbalances

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39 END TEST IV MATERIAL


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