Week 7 - Study Guide

Question 1

Ions in Intracellular
(inside of cells)

Answer 1

Intracellular

K+ ⬆
HPO4 (anion)
Proteins (anionic)
Mg2+

Question 2

Ions in Interstitial Fluid
(in between the cells and plasma)

Answer 2

Interstitial

Na+
Cl-
HCO3-

Question 3

Ions in the plasma
(fluid component of the blood)

Answer 3

Plasma

Na+
Cl-
HCO3-
Proteins – (albumin - buffering at bloodstream)

Question 4

Sodium

Answer 4

Function:
1. Maintaining Blood Volume
2. Regulating ECF volume
3. Distribution

(Na+) is high in ECF
(Cl-) is high in ECF

Transmitting nerve impulses - sodium channels open - depolarization

Contracting muscles - during action potentials

Question 5

Potassium

Answer 5

Intracellular Cation

a. Maintaining intracellular fluid osmolarity
b. Transmitting nerve impulses = repolarization during nerve impulses. (K+ opens and closes)
c. Skeletal and smooth muscle function. – contraction

Regulating Cardiac impulse transmission. = Heart contracts - K+ important
=Pacemaker cell – K+, Cl-, Na+

Regulating Acid-base Balance

Acidosis = pH⬇, H+⬆
H+ into the cell — K+ out of cell
Driving factor = H+ ⬆ in solution
H+ ➡exchange with K+

Alkalosis = pH⬆, H+⬇
H+ out of cell — K+ into cell

Question 6

Calcium

Answer 6

1. Retained in bones - forming bones and teeth
2. Transmitting nerve impulses

Ca2+ allows vesicles to fuse with membrane
Release NT ➡ synapse to bind to receptors

3. Regulating muscle contraction
4. Blood clotting – cascade of events Ca2+
5. Activating enzymes

Question 7

Magnesium

Answer 7

1. Maintaining intracellular metabolism
2. Plays a role as a coenzyme in ATP formation
3. OPerating Na+/K+ pump
4. Mg2+ is bound to ATP to facilitate the breakdown to ADP + Pi
5. Relaxing muscle contractions
   (Myosin head release requires ATP)
   (Ca2+ recycling @ SR requires ATP - active transport)
   (Re-establishing resting membrane potential requires ATP)
   (⬆Na+ outside, ⬆+ inside)
6. Transmitting Nerve impulses
   (regulating cardiac function uses lots of ATP and magnesium)

Question 8

Chloride

Answer 8

1. producing hydrochloric acid
2. In lumen of stomach to facilitate activation of enzymes that digest protein
3. Regulating acid-base balance
4. Critical to coupled reabsorption of HCO3- and secretions of H+ in the nephrons
5. Regulating ECF balance and vascular volume
6. Acting as a buffer in oxygen-carbon dioxide exchange RBCs
7. Don’t forget the chloride shift

Want to move HCO3- out into bloodstream to act as a buffer at the bloodstream

H+ binds to Hb

Which causes an electrical deficit in RBC
Cl- needs to move in negative ion in/out exchange

Question 9

Phosphate.

Answer 9

HPO4-

1. Forming bones and teeth
2. Function of muscle, nerve, and RBC formation
3. Regulate acid-base balance (acidification of urine) get rid of excess H+
4. Cellular metabolism (DNA & ATP)
5. Regular calcium levels
   (absorption - osteoclasts)
   (Release - osteoblasts)
6. small % of Ca2+ binds to phosphate (forms of salt)

Question 10

Bicarbonate

Answer 10

Major Buffer in acid-base regulation

CO2 + H2O ↔ H2CO3 ↔ (H+) + Hco3-

Question 11

Important electrolytes in homeostasis

Answer 11

Na+, K+, Ca2+

For nervous system functions
Muscle contraction

Question 12

Universal Solvent

Answer 12

Water

and essential for metabolism because…
Chemical processes occur here
Disruptions in composition impact metabolism

Question 13

Fluids are …..

Answer 13

1. Lubricants
2. solvents
3. pH regulators
4. acid/base balance
5. Transfer Route for everything we do

Question 14

Hypervolemic Hyponatremia

Answer 14

1. Feelings of impending doom
2. decreased LOC
3. Near freshwater drowning

Question 15

Hypovolemic Hyponatremia

Answer 15

1. Hypoaldosteronism
2. ⬇Aldosterone
3. Diuretics - abuse
4. depressed cells
5. digestive system not moving

Question 16

SIADH

Answer 16

hormonal imbalance of ADH
—making ADH when you should not be – because you are well hydrated – not urinating

Question 17

Hypovolemic hypernatremia

Answer 17

1. Diarrhea
   2 high fever/Resp Rate.
   (constant loss of water associated with resp rate and sweating from fever)
2. Excitability
3. Hallucinations & Delusions

Question 18

Hypervolemic Hypernatremia

Answer 18

1. Hyperaldosteronism
   (vasoconstriction)
   (hypersecretion from adrenal glands)
   (Kidneys will retain Na+ & H2O)
2. Near drowning in salt water

Question 19

What does Hypoaldosteronism cause?

Answer 19

Hypovolemic Hyponatremia

Question 20

What does SIADH cause?

Answer 20

Hypervolemic Hyponatremia

Question 21

What does diarrhea cause?

Answer 21

Hypovolemic Hypernatremia

Question 22

What does hyperaldosteronism cause?

Answer 22

Hypervolemic Hypernatremia

Question 23

What does diuretic abuse cause?

Answer 23

Hypovolemic hyponatremia

Question 24

Most H+ is produced by…

Answer 24

metabolism

Question 25

Hypokalemia

Answer 25

1. Alkalosis ➡insulin not just glucose - move Glucose and K+ in cell 2. Licorice aldosterone mimic (gets rid of K+) 3. Cushing's syndrome - hyperglycemia (cortisol) (moves K+ and glucose out) 4. Hyperaldosteronism (lots of Na+ in and K+ out)

Question 26

Hypokalemia

Answer 26

Depressed three types of muscles ar affected: 1. Smooth muscle. - digestive slows down 2. Skeletal muscle. - weakness 3. Cardiac muscle - thready, weak pulse, ⬇BP

Question 27

Hyperkalemia

Answer 27

1. Acidosis - Way too much H+ in cell and K+ out of cell 2. Transfusion of aged blood 3. Crushing injures - pushes K+ out of cell 4. Burns and infection -- membranes fall apart more K+ out of cell 5. Addison's disease - hypoglycemia/insulin - inability to produce cortisol - ACTH not impacting Aldosterone 6. Hypoaldosteronism - cannot hold onto Na+ and H2O; cannot get rid of K+ 7. Explosive diarrhea 8. Paresthesia (tingling of the extremities) 9. Ectopic foci - pacemaker - instead of SA node setting something else in the heart took over

Question 28

What would Nasogastric suctioning cause?

Answer 28

Hypokalemia

Question 29

What would acidosis cause?

Answer 29

Hyperkalemia

Question 30

What would Hyperaldosteronism cause?

Answer 30

hypokalemia

Question 31

What would crushing injury cause?

Answer 31

hyperkalemia

Question 32

What would alkalosis cause?

Answer 32

Hypokalemia

Question 33

What would hypoaldosteronism cause?

Answer 33

hyperkalemia

Question 34

Hypocalcemia

Answer 34

1. Inactive parathyroid gland 2. Alkalosis (binds to protein plasma) 3. carpopedal spasms positive trousseau's sign

Question 35

Hypercalcemia

Answer 35

1. hyperparathyroidism. (excessive bone breakdown due to releasing too much Calcium) 2. Excessive Vitamin D intake (calcium and vitamin D work together) 3. Acidosis - H+ binds Ca2+ unlocks - 4. Cancer - cells can secrete substances that dissolve osteoclasts and cause release of calcium 5. Calcium is a cotransport 6. Depressed cells

Question 36

Which imbalances would be most likely to cause lower levels of consciousness (LOC)? a. Hyperkalemia b. Hyponatremia c. Hypermagnesmia d. Hypokalemia e. hyperphospatemia f. Hypocalcemia

Answer 36

b. Hyponatremia c. Hypermagnesmia d. Hypokalemia

Question 37

Hypomagnesemia

Answer 37

1. Vitamin D and PTH levels are low 2. Gastric suctioning 3. Athetoid movements 4. laryngeal stridor (pitch sound when breathing - so much muscle tension) 5. cramping muscles

Question 38

Hypermagnemsia

Answer 38

1. Untreated DKA due to dehydration 2. dysarthria 3. hypotension 4. Depression all over

Question 39

Hypophosphatemia

Answer 39

1. Tx DKA 2. Anabolic effects of insulin shifts Mg, K, P, into cells 3. Tissue anoxia (DPG not there) - chemical w/o phosphate cannot deliver O2 - reversible binding of O2

Question 40

Hyperphosphatemia

Answer 40

1. Rhabdomyolysis (muscles exploding) 2. Chemotherapy for neoplastic disease 3. Hyperreflexia due to secondary hypocalcemia 4. Crystals in arteries and skin