Chapt21 fluid & electrolytes

Hole’s Human Anatomy and Physiology Twelfth Edition Shier w Butler w Lewis Chapter 21 Water, Electrolyte, and Acid-Base Balance 2 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

21.1: Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]

21.2: Distribution of Body Fluids ,[object Object],[object Object],[object Object]

Fluid Compartments ,[object Object],[object Object],Extracellular fluid (37%) Intracellular fluid (63%) 40 38 36 34 32 30 28 26 24 22 20 18 16 14 12 10 8 6 4 2 0 Liters Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Total body water Interstitial fluid Plasma Lymph Transcellular fluid Extracellular fluid (37%) Membranes of body cells Intracellular fluid (63%) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Body Fluid Composition ,[object Object],[object Object],Ion concentration (m Eq/L) 20 30 50 60 70 80 90 100 1 10 120 130 140 Relative concentrations and ratios of ions in extracellular and intracellular fluids 150 40 10 0 14:1 Ratio (Extracellular: intracellular) Na + 1:28 K + 5:1 Ca +2 1:19 Mg +2 26:1 Cl  3:1 HCO 3  1:19 PO 4  3 1:2 SO 4  2 Extracellular fluid Intracellular fluid Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Movement of Fluid Between Compartments ,[object Object],[object Object],[object Object],Interstitial fluid Capillary wall Transcellular fluid Lymph Plasma Serous membrane Intracellular fluid Cell membrane Lymph vessel Fluid leaves plasma at arteriolar end of capillaries because outward force of hydrostatic pressure predominates Fluid returns to plasma at venular ends of capillaries because inward force of colloid osmotic pressure predominates Hydrostatic pressure within interstitial spaces forces fluid into lymph capillaries Interstitial fluid is in equilibrium with transcellular and intracellular fluids Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

21.3: Water Balance ,[object Object],[object Object]

Water Intake ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Water in beverages (1,500 mL or 60%) Average daily intake of water Water lost in sweat (150 mL or 6%) Total output (2,500 mL) Average daily output of water (a) (b) Total intake (2,500 mL) Water in moist food (750 mL or 30%) Water of metobolism (250 mL or 10%) Water lost in feces (150 mL or 6%) Water lost through skin and lungs (700 mL or 28%) Water lost in urine (1,500 mL or 60%) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Water Output ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

21.4: Electrolyte Balance ,[object Object],Urine Electrolyte intake Fluids Feces Electrolyte output Foods Perspiration Metabolic reactions Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Electrolyte Intake ,[object Object],[object Object]

Regulation of Electrolyte Intake ,[object Object],[object Object]

Electrolyte Output ,[object Object],[object Object],[object Object]

Regulation of Electrolyte Output ,[object Object],[object Object],Aldosterone is secreted Adrenal cortex is signaled Potassium ion concentration increases Renal tubules increase reabsorption of sodium ions and increase secretion of potassium ions Sodium ions are conserved and potassium ions are excreted Calcium ion concentration decreases Calcium ion concentration returns toward normal Normal phosphate concentration is maintained Addition of phosphate to bloodstream Renal tubules conserve calcium and increase secretion of phosphate Parathyroid glands are stimulated Parathyroid hormone is secreted Intestinal absorption of calcium increases Activity of bone-resorbing osteoclasts increases Increased phosphate excretion in urine Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

21.1 Clinical Application Water Balance Disorders

21.2 Clinical Application Sodium and Potassium Imbalances

21.5: Acid-Base Balance ,[object Object],[object Object],[object Object],[object Object]

Sources of Hydrogen Ions Aerobic respiration of glucose Anaerobic respiration of glucose Incomplete oxidation of fatty acids Oxidation of sulfur-containing amino acids Hydrolysis of phosphoproteins and nucleic acids Carbonic acid Lactic acid Acidic ketone bodies Sulfuric acid Phosphoric acid H + Internal environment Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Strengths of Acids and Bases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Regulation of Hydrogen Ion Concentration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Acid-Base Buffer Systems

[object Object],[object Object],More CO 2 is eliminated through lungs Rate and depth of breathing increase Respiratory center is stimulated Cells increase production of CO 2 CO 2 reacts with H 2 O to produce H 2 CO 3 H 2 CO 3 releases H + Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Respiratory Secretion of Carbon Dioxide

[object Object],High intake of proteins Increased concentration of H + in urine Increased secretion of H + into fluid of renal tubules Increased concentration of H + in body fluids Increased metabolism of amino acids Increased formation of sulfuric acid and phosphoric acid Concentration of H + in body fluids returns toward normal Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Renal Secretion of Hydrogen Ions

[object Object],[object Object],[object Object],Phosphate buffer system Protein buffer system First line of defense against pH shift Second line of defense against pH shift Chemical buffer system Physiological buffers Bicarbonate buffer system Respiratory mechanism (CO 2 excretion) Renal mechanism (H + excretion) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Time Course of pH Regulation

21.6: Acid-Base Imbalances ,[object Object],[object Object],7.35 Survival range Normal pH range pH scale 7.45 8.0 7.0 6.8 7.8 Acidosis Alkalosis Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Acidosis ,[object Object],[object Object],pH rises pH drops Increased concentration of H + pH scale 7.4 Acidosis Alkalosis Decreased concentration of H + Accumulation of acids Loss of bases Loss of acids Accumulation of bases Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Acidosis ,[object Object],Accumulation of CO 2 Respiratory acidosis Decreased rate and depth of breathing Obstruction of air passages Decreased gas exchange Accumulation of nonrespiratory acids Metabolic acidosis Excessive loss of bases Kidney failure to excrete acids Excessive production of acidic ketones as in diabetes mellitus Prolonged diarrhea with loss of alkaline intestinal secretions Prolonged vomiting with loss of intestinal secretions Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Alkalosis ,[object Object],[object Object],Excessive loss of CO 2 Hyperventilation Decrease in concentration of H 2 CO 3 Decrease in concentration of H + Respiratory alkalosis • Anxiety • Fever • Poisoning • High altitude Loss of acids Net increase in alkaline substances Metabolic alkalosis Gastric drainage Vomiting with loss of gastric secretions Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Important Points in Chapter 21: Outcomes to be Assessed ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Important Points in Chapter 21: Outcomes to be Assessed ,[object Object],[object Object]

Chapt21 fluid & electrolytes

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