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Chapter 27
Kidneys (Continued)
100
Anatomy
Undergraduate 1
04/06/2014

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Term
Hypovolemia
Definition
Low (not enough) water volume

Dehydration

Decreases blood pressure
Term
Hypervolemia
Definition
High (excess) water volume

Increases blood pressure

Can cause edema
Term
Isotonic
Definition
Same concentration
Term
Hypotonic
Definition
Higher concentration of solutes outside the cell

RBC swells/may rupture
Term
Hypertonic
Definition
Higher concentration of solutes inside the cell

RBC shrivels
Term
Intracellular fluid
Definition
Contained inside cells
Term
Extracellular fluid
Definition
Fluid outside the PM of cells
Term
Interstitial fluid composes _____ of fluid in the body
Definition
3/4 (around 75%)
Term
Babies have a _______ concentration of water than adults
Definition
Higher
Term
Normal fluid loss from the kidneys
Definition
1500mL/day
Term
Normal fluid loss from evaporation (on the skin)
Definition
600mL/day
Term
Normal fluid loss from exhalation from the lungs
Definition
300mL/day
Term
Normal fluid loss from feces
Definition
100mL/day

Increases with diarrhea
Term
The greatest amount of water reabsoption occurs in:
Definition
The small intestine
Term
Renin converts
Definition
Angiotensin I to Angiotensin II
Term
Atrial natiruetic peptide (ANP)
Definition
Promotes excretion of Na and Cl
(water follows)

Decreases blood volume

Increases fluid loss
Term
ADH
Definition
Directly regulates water loss

Produces a concentrated urine

Stimulated by low water intake
Term
Vasopressin
Definition
Increases the permeability of the collecting ducts
Term
Tachypnea can cause
Definition
Increased fluid loss from the lungs
Term
Electrolytes
Definition
Control osmosis of water between body fluid compartments

Serve as cofactors for optimal activity of enzymes
Term
Proper sodium levels
Definition
135-145 mEq/L
Term
Proper potassium levels
Definition
3.5-4.5 mEq/L
Term
Hyponatremia
Definition
Under 135 mEq/L

Caused by overhydration/inadequate salt intake
Term
Hypernatremia
Definition
Over 145 mEq/L

Caused by dehydration
Term
Hypokalemia
Definition
Under 3.5 mEq/L
Term
Hyperkalemia
Definition
Over 4.5 mEq/L
Term
Sodium
Definition
Essential for normal membrane function and CNS (activate gate channels)
Term
Potassium
Definition
Major cation in cytoplasm

Essential for normal membrane function

Heart greatly depends on K for normal heart rate
Term
Chlorine
Definition
Major anion in bodily fluids

Forms HCl
Term
Calcium
Definition
Normal muscle and neuron function

Normal bone structure
Term
Phosphorus
Definition
High-energy compounds
Nucleic acids
Bone matrix
Term
Magnesium
Definition
Cofactor of enzymes/normal membrane functions
Term
Iron
Definition
Hb
Myoglobin
Cytochromes
Term
Zinc
Definition
Cofactor of enzymes
Term
Copper
Definition
Cofactor of Hb synthesis
Term
Cobalt
Definition
Mineral in Vitamin B12

Cofactor for transaminations
Term
High PTH levels is an indicator of
Definition
High calcium levels
Term
Chvostek's sign
Definition
Involuntary facial spasm

Due to low calcium levels
Term
Trousseau's sign
Definition
Hand spasm when the pt's blood pressure is being taken

Due to low calcium levels
Term
Increased sodium intake will increase
Definition
Blood pressure
Term
Release of natriuetic peptides causes
Definition
An increased Na and water loss in urine

Reduced thirst

Inhibition of ADH/aldosterone/NE
Term
Potassium is gained mainly by
Definition
Digestive tract reabsorption
Term
Potassium is lost mainly by
Definition
Excretion by the kidneys
Term
Low ECF levels can cause H+ to be substituted for
Definition
K+
Term
Aldosteronism
Definition
Excessive aldosterone secretion
Term
Hypothalamic osmoreceptor cells
Definition
Secrete ADH
Term
Angiotensin II
Definition
Secretes aldosterone
Term
Hypokalemia can cause
Definition
Muscle weakness and heart irregularities
Term
pH range
Definition
7.35-7.45
Term
Buffer system
Definition
Act quickly to temporarily bind excess H or OH

Quickest responders
Term
Sodium bicarbonate
Definition
Binds with HCl, forms carbonic acid and NaCl

Buffering system
Term
Sodium hydroxide
Definition
Increases blood pH

Reacts with carbonic acid to produce sodium bicarbonate and water
Term
Chloride shift
Definition
Concentration of Cl ions (in RBCs) increases as HCO3 ions diffuse out of the cell
Term
Volatile acids
Definition
Buffered mainly by potassium salts of Hb and oxyHb
Term
The base/acid ratio should be
Definition
20:1
Term
Compensation
Definition
Process of adjustment of pH balance to maintain ratio
Term
The amount of CO2 directly relates to the amount of
Definition
Carbonic acid and H+
Term
With increased respirations
Definition
Less CO2 remains in the blood

Less carbonic acid and fewer H+
Term
With decreased respirations
Definition
More CO2 remains in the blood

More carbonic acid and more H+
Term
Acidosis causes ______ to correct it
Definition
Hyperventilation
Term
Alkalosis causes _______ to correct it
Definition
Hypoventilation
Term
Secretion of NH3 in the urine occurs when
Definition
Blood H+ increases

Takes 2-3 days to occur
Term
Ketoacidosis is detected by
Definition
The adrenal glands in the kidneys
Term
Metabolic acidosis
Definition
Accumulation of non-respiratory acids from diabetic ketoacidosis/aspirin OD

Kidneys conserve HCO3 and eliminate H+ ions in acidic urine
Term
Metabolic alkalosis
Definition
Non-respiratory acids are lost due to vomiting

Kidneys conserve H+ ions and eliminate HCO3 in alkaline urine
Term
Respiratory acidosis
Definition
Too much CO2 from hypoventilation

Kidneys conserve HCO3 and eliminate H+ ions in acidic urine
Term
Respiratory alkalosis
Definition
Too little CO2 from hyperventilation

Kidneys conserve H+ ions and eliminate HCO3 in alkaline urine
Term
pO2 should be between
Definition
80mmHg to 100mmHg

Does not affect the pH
Term
pCO2 should be between
Definition
35mmHg to 45mmHg
Term
HCO3 should be between
Definition
22mEq/L to 26mEq/L
Term
Acidosis
Definition
pH < 7.35
PCO2 > 45mmHg
HCO3 < 22mEq/L
Term
Alkalosis
Definition
pH > 7.45
PCO2 < 35mmHg
HCO3 > 26
Term
Non-volatile acid
Definition
Acid produced from sources other than CO2
Term
Accumulation of acidic ketone bodies can be caused by
Definition
Diabetes mellitus
Term
If acidosis occurs during pregnancy, ______ is recommended so that:
Definition
Saline

Cl ions will replace HCO3 ions
Term
Respiratory acidosis
Definition
pH < 7.35 ↓
pCO2 > 45 ↑

Caused by CNS depression, COPD, pulmonary edema, pneumothorax, MI
Term
Respiratory alkalosis
Definition
pH > 7.45 ↑
pCO2 < 35 ↓

Caused by hyperventilation, anxiety/pain, respiratory distress, fever
Term
Metabolic acidosis
Definition
pH < 7.35 ↓
HCO3 < 22 ↓

Gain of acid: DKA, renal failure, lactic acid buildup (anaerobic), ingestion of ethanol & salicylates
Loss of base: diarrhea, pancreatic drainage
Term
Metabolic alkalosis
Definition
pH > 7.45 ↑
HCO3 > 26 ↑

Gain of base: excess HCO3 intake (Antacid)
Loss of acid: NG suction, vomiting, diuresis (excessive urination)
Term
If the lungs have a problem
Definition
The kidneys will compensate
Term
If the kidneys have a problem
Definition
The lungs will compensate
Term
Respiratory compensation takes _____, whereas metabolic compensation can occur in _________
Definition
Days

15 minutes
Term
Ventricular depolarization occurs during the
Definition
QRS complex
Term
Ventricular repolarization occurs during the
Definition
T wave
Term
Decrease in blood pressure stimulates
Definition
Renin secretion
Term
Renin is stored in the
Definition
Glomerulus
Term
The majority of CO2 in the blood is carried as
Definition
Bicarbonate
Term
Surfatant
Definition
Reduces surface tension in the alveoli
Term
Tidal volume
Definition
Volume of normal inhalation and exhalation
Term
Dead space
Definition
Air conduction from lungs to terminal bronchioles

No gas exchange occurs
Term
Residual volume
Definition
What is left in the lungs after expiration
Term
Sagittal
Definition
Between the two parietal
Term
If a substance is detected in the tubular fluid but not in the urine, it must have been
Definition
Filtered and reabsorbed
Term
Muscle fascile
Definition
Bundle of muscle fibers enclosed by a connective tissue sheath
Term
Anaerobic anabolism
Definition
Joining of creatine phosphate with ADP to produce ATP
Term
Third class lever system
Definition
Joint-muscle load

Most common
Term
Rectus femorus
Definition
Prime mover when extending the knee
Term
Soleus
Definition
Posterior side of the leg
Term
Intracellular contains the most
Definition
Fluid concentration
Term
If blood pressure is lowered, _________ will also be lowered
Definition
Blood hydrostatic pressure
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