Lecture Presentation - Fluid, Electrolyte and Acid Base Balance
Lecture Presentation - Fluid, Electrolyte and Acid Base Balance
Lecture Presentation - Fluid, Electrolyte and Acid Base Balance
Total body water declines throughout life with changes in muscle mass and fat Water occupies 2 main fluid compartments:
Water balance
water loss = water gain ~60% ingested liquids ~30% ingested in foods ~10% metabolic water (from oxidation) ~4% faeces ~28% insensible water loss (skin & lungs) ~8% perspiration ~60% urine
Water gain:
Water loss:
Regulation of body water gain depends mainly on regulating volume of water intake
Thirst centre in hypothalamus governs urge to drink Nerve impulses from osmoreceptors in hypothalamus
in PV or in plasma osmolality
Hypothalamic osmoreceptors lose water to plasma Increased transmission of nerve impulses to thirst centre
Regulation of body water (and solute) loss depends mainly on urinary excretion
Fluid movements
Sodium
water distribution
cells
ECF
angiotensin II increases Na+ absorption in PCT aldosterone increases Na+ absorption in collecting ducts
Na+ content of body may change, but concentration constant due to corresponding changes in water volume
Potassium
Acid-base balance
Biochemical reactions influenced by pH of surrounding fluids (pH = -log[H+]) pH of tissues regulated by:
respiratory compensation
Elimination of volatile acid (carbonic acid) by exhalation of CO2 Excretion of non-volatile acids (cannot be eliminated by exhaling CO2)
renal compensation
R-COOH R-COO- + H+
R-NH2 + H+ R-NH3+
H+ + HCO3- H2CO3
+ HPO42- H2PO4-
Acid-base imbalances
Acidosis
Alkalosis
Respiratory compensation
Rising or falling H+ from changes in metabolic acid production stimulate peripheral chemoreceptors increases or decreases ventilation to eliminate more or less CO2
Renal compensation
Can compensate for respiratory acidosis/alkalosis Also only means of eliminating nonvolatile acids (ie acids that cannot be converted to CO2)
PCT
secretes H+ into tubular fluid against concentration gradient using proton pumps (H+ATPases)