Fluid, Electrolyte and Acid-Base Dynamics

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Fluid, Electrolyte and Acid-Base Dynamics

• Human Anatomy and Physiology II
• Oklahoma City Community College

Dennis Anderson
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Concentration of Solutions

• Percent Salt
• 0.9 NaCl
• Milliosmoles
• 300 milliosmoles/Liter
• Milliequivalents
• 325 milliequivalents/Liter

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Osmosis
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Osmosis
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Hypertonic Solution
3 NaCl
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Cells Crenate in a Hypertonic Solution
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Hypotonic Solution
0.5 NaCl
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Cells in a Hypotonic Solution Swell and May Lyse
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Isotonic Solution
0.9 NaCl
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Which Way Will Fluid Move?
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Application Problem 1

• Michael has recently started working outdoors in
  the hot weather to earn money for his tuition.
  After a few days he experienced headaches, low
  blood pressure and a rapid heart rate. His blood
  sodium was down to 125 meq/L. The normal is 144
  meq/L. How do you explain this?

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Answer to Problem 1

• Michael lost sodium by perspiration. The low
  sodium in his blood allowed fluid to move into
  cells by osmosis. Lack of fluid lowered his
  blood pressure to give him a headache. The
  increased heart rate was his bodies way of trying
  to increase blood pressure.

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Application Problem 2

• Frank has hypertension. His doctor has advised
  Frank eat a low salt diet. Frank consumed a lot
  of salt the day before his last checkup. His
  blood pressure was up. Why?

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Answer to Problem 2

• The extra salt Frank ate made his blood
  hypertonic. Hypertonic blood will attract fluids
  from body cells by osmosis.

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Electrolyte vrs. Nonelectrolyte
NaCl Na Cl-
Glucose
Glucose
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Aldosterone

• Hormone secreted from the adrenal cortex
• Stimulates kidneys
• Retain sodium
• Retain water
• Secrete potassium

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Estrogen

• Female hormone from the ovaries
• Similar to aldosterone
• Stimulates the kidneys to retain sodium
• Increases fluid retention

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Cortisol

• Hormone from the adrenal cortex
• Converts lipids and protein to glucose
• Depress inflammation
• Stimulates the kidneys to retain sodium
• Increases fluid retention
• Elevated levels cause edema

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Antidiuretic HormoneADH
Collecting Duct
Hypertonic Interstitial Fluid
Urine
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Calcitonin
Calcium
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Estrogen
Calcium
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Parathormone
Calcium
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Blood pH 7.4(7.35-7.45)

• Blood pH regulated by
• 1. Kidneys
• 2. Lungs
• 3. Buffers in blood

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H Secreted HCO3- Rebsorbed
Blood
H
Kidney Nephron
Urine
HCO3-
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Kidneys Regulate pH

• Excreting excess hydrogen ions, retain
  bicarbonate
• if pH is too low
• Retaining hydrogen ions, excrete bicarbonate
• if pH is too high

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Lungs Regulate pH

• Breath faster to get rid of excess carbon dioxide
  if pH is too low
• Carbon dioxide forms carbonic acid in the blood
• Breath slower to retain carbon dioxide if pH is
  too high

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Carbon Dioxide and Acid
CO2 H2O H2CO3 H HCO3-
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More Carbon Dioxide More Acid Lower pH

• Breathing slower will retain CO2 , pH will
• decrease (more acid)
• Breathing faster will eliminate more CO2 pH will
• increase (less acid)

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Blood pH Drops to 7.3How does the body
compensate?

• Breath faster to get rid of carbon dioxide
• eliminates acid

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Blood pH Increases to 7.45How does the body
compensate?

• Breath slower to retain more carbon dioxide
• retains more acid

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John is Taking Narcotics for PainThe narcotics
have depressed his breathing rate. What will
happen to his blood pH?

• pH will decrease because he will retain excess
  carbon dioxide which will increase the amount of
  acid in the blood

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Buffers Regulate pH

• Chemicals that resist changes in pH
• Prevent large pH changes when an acid or base is
  added

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Strong Acid

• Acid that releases many hydrogen ions
• HCl

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Weak Acid

• Acid that releases only a few hydrogen ions
• Carbonic Acid

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Buffers Change Strong Acids to Weak Acids
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Bicarbonate Carbonic Acid

• 201 pH 7.4
• 211 pH more than 7.4
• 191 pH less than 7.4

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Acidosis

• pH below 7.35
• Depresses the nervous system
• coma

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Alkalosis

• pH above 7.45
• Overexcites the nervous system
• convulsions

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Respiratory Acidosis

• Any condition that impairs breathing
• Carbon dioxide increases in blood
• Excess carbon dioxide lowers pH

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Respiratory Alkalosis

• Hyperventilation
• Carbon dioxide decreases in blood
• Low carbon dioxide raises pH

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Metabolic Acidosis

• Not caused by breathing or carbon dioxide
  imbalance
• Excess acid in blood
• Renal disease, Diabetes or Starvation
• Deficiency of bicarbonate in blood
• Diarrhea

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Metabolic Alkalosis

• Not caused by breathing or carbon dioxide
  imbalance
• Deficiency of acid in the blood
• Vomiting, Diuretics
• Excess bicarbonate in the blood
• Ingesting sodium bicarbonate

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Sodium

• Attracts water into the ECF
• Nerve impulse
• Muscle contractions

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Hypernatremia

• Excess sodium in the blood
• Hypertension
• Muscle twitching
• Mental confusion
• Coma

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Hyponatremia

• Deficiency of sodium in the blood
• Hypotension
• tachycardia
• Muscle weakness

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Potassium

• Attracts water into the ICF
• Nerve impulse
• Muscle contractions

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Hyperkalemia

• Excess potassium in the blood
• Cardiac arrhythmias and cardiac arrest
• Elevated T wave
• Muscle weakness

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Hypokalemia

• Deficiency of potassium in the blood
• Cardiac arrhythmias and cardiac arrest
• Flatened T wave
• Muscle weakness

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Calcium

• Most in bones and teeth
• Blood clotting
• Nerve impulse
• Muscle contraction

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Hypercalcemia

• Excess calcium in the blood
• Kidney stones
• Bone pain
• Cardiac arrhythmias

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Hypocalcemia

• Deficiency of calcium in the blood
• Tetany
• Weak heart muscle
• Increased clotting time

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Aldosteronism

• Excess production of aldosterone
• Elevated sodium levels
• Depressed potassium levels
• Hypertension

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Addisons Disease

• Hyposecretion of the Adrenal Cortex
• Hyposecretion of Aldosterone
• Hyposecretion of Glucocorticoids
• Hormones that convert protein sugar
• Hypotension
• Sodium deficiency
• Low blood sugar
• Not enough glucocorticoids

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Cushings Syndrome

• Excess glucocorticoids
• Tumor of adrenal gland
• Side effect of steroid drugs
• cortisone
• Hyperglycemia
• Fat accumulation
• Abdomen
• Back of neck (buffalo hump)

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Insulin
Cell
Glucose
Blood
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Diabetes Mellites

• Hyposecretion or hypoactivity of insulin
• Hyperglycemia
• Glycosurea
• Polyurea
• Thirst
• Body burns more fat
• Ketone bodies
• Metabolic Acidosis
• Fat deposits in arteries
• Heart Attack, Stroke, Poor Circulation

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Antidiuretic HormoneADH
Collecting Duct
Hypertonic Interstitial Fluid
Urine
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Diabetes Insipidus

• Hyposecretion of ADH
• Increased urine volume

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THE END