Ch 24 Fluids and electrolytes Assignment

Select the ways in which the kidneys buffer hydrogen ions before they are eliminated via the urine. Check all that apply.

-Bicarbonate ions (HCO3-) in the tubular fluid neutralize H+.Bicarbonate ions (HCO3-) in the tubular fluid neutralize H+. -Na2PO4 (dibasic sodium phosphate) reacts with some of the H+, replacing one of the sodium ions in the buffering process.Na2PO4 (dibasic sodium phosphate) reacts with some of the H+, replacing one of the sodium ions in the buffering process. -Tubule cells catabolize certain amino acids and release ammonia (NH3) where it acts as a base to neutralize acid.

Place the correct word into each sentence to describe the action of aldosterone.

>Aldosterone plays a primary role in adjustment of sodium excretion. >Conditions such as hyponatremia, hypotension, and hyperkalamia stimulate the adrenal cortex to secrete aldosterone. >This in turn stimulates the renal tubules to increase reabsorption of sodium and secretion of potassium. >Both will result in the reabsorption of water.

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>Plasma sodium concentrations above 145 mEq/L represent hypernatremia, a condition that rarely occurs due to equal increases in water. >The consumption of massive amounts of water in a short time frame can produce hyponatremia, resulting from a dilution of sodium in the ECF. >When large quantities of potassium are released from the ICF following massive tissue trauma, hyperkalemia results, causing membrane potentials to be abnormally less negative due to a reduced concentration gradient. >Due often to excess sweating, diarrhea, or vomiting, hypokalemia causes the cell membrane to be hyperpolarized due to increased concentration gradients. >Hyperparathyroidism can result in hypercalcemia, a condition that reduces the membrane permeability to sodium and thus inhibits membrane depolarization. >Muscular tetanus can occur as a result of hypocalcemia brought on by illness or vitamin-D deficiency, whereby the muscle and nerve membranes are hyperactive.

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A buffer is any mechanism that resists changes in pH. A physiological buffer uses direct elimination of acids, bases, or carbon dioxide from the body in order to adjust systemic acidity. A substance that binds H+ during times of acidity and releases H+ during time of alkalinity is referred to as a chemical buffer. Carbon dioxide, when present in sufficient amounts, will bind with water to form carbonic acid, which is capable of dissociating into bicarbonate and hydrogen ions. The phosphate buffer system plays a significant role in the ICF because phosphates are capable of binding and unbinding H+, depending on current conditions of acidity or alkalinity. The carboxyl ends of protein chains are capable of buffering H+ as part of the protein buffer system.

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Antidiuretic hormone provides a means of controlling water output. The increased osmolarity of the blood stimulates the hypothalamus to stimulate the posterior pituitary to release ADH. ADH will work on the kidneys to reabsorb water into the blood stream. A negative feedback system is used until the blood volume and osmolarity return to normal levels.

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Dehydration can lead to increased blood osmolarity. This state will stimulate hypothalamic osmoreceptors. This stimulation will lead to reduced salivation and the sense of thirst. Through ingestion of water, a negative feedback system is completed.

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During periods of declining water levels, blood volume decreases, causing a decline in blood pressure. This is referred to as hypotension. Low blood pressure causes the kidneys to increase the secretion of renin from the JG cells. The activation of angiotensin II stimulates widespread vasoconstriction, release of ADH from the posterior pituitary as well as the adrenal cortex to release aldosterone. Aldosterone acts on the DCT of the kidney tubules to reabsorb greater amounts of sodium from the tubular fluid. The release of ADH directly stimulates the collecting ducts of the kidney to increase water reabsorption from the tubular filtrate. The net result of angiotensin II, aldosterone, and ADH cooperatively are an increase in blood pressure, resulting largely from increased blood volume.

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Electrolytes are physiologically important because they affect electrical potential across membranes and contribute to osmolarity of body fluids. Major cations of the body include sodium, potassium, and hydrogen. Oppositely, major anions include chloride, bicarbonate and phosphates. Concentrations of these anions and cations are needed in specific amounts to maintain normal metabolism of the body. Electrolyte concentration above or below the normal needed amounts can lead to disorders.

The extracellular fluid compartment includes what fluids? Check all that apply.

Interstitial fluid Blood plasma Cerebral spinal fluid Pleural and pericardial fluid

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The body is in a state of fluid imbalance if there is an abnormality of total volume, concentration, or distribution. There are three main factors affecting fluid balance; fluid deficiency, fluid excess and fluid sequestration. Fluid deficiency arises when output exceeds input. Fluid excess can be caused by volume excess or a condition called hypotonic hydration. Finally, fluid sequestration is when excess fluid accumulates in a particular location.

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The kidneys can permanently remove substances that affect pH balance by secreting them into the urine. Tubule cells can catabolize certain amino acids and release ammonia as a product. This product will diffuse into the tubular fluid where it can act as a base to neutralize the fluid. It will react with H+ and Cl-, which is passed in the urine. This action works as a buffer to reduce the strong acidity of the fluid.