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Water, Electrolytes, and

Acid-Base Balance

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Body Fluids
• Intracellular
– All fluids inside cells of body
– About 40% of total body weight
• Extracellular
– All fluids outside cells
– About 20% of total body weight
– Subcompartments
• Interstitial fluid and plasma; lymph, CSF, synovial
fluid
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Body Fluid Compartments

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Water Content Regulation
• Content regulated so • Sources of water
total volume of water in – Ingestion
body remains constant – Cellular metabolism
• Kidneys primary
regulator of water • Routes of water loss
excretion
– Urine
• Regulation processes
– Evaporation
– Osmosis
• Perspiration
– Osmolality • Respiratory passages
– Baroreceptors
– Feces
– Learned behavior

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Extracellular Fluid Osmolality

• Osmolality • Decreased osmolality


– Adding or removing – Inhibits thirst and
water from a solution ADH secretion
changes this

• Increased osmolality
– Triggers thirst and
ADH secretion

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Hormonal Regulation of
Blood Osmolality

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Regulation of ECF Volume
• Increased ECF results in
• Mechanisms – Decreased aldosterone secretion
– Increased ANH secretion
– Neural
– Decreased ADH secretion
– Renin-angiotensin- – Decreased sympathetic stimulation
aldosterone
• Decreased ECF results in
– Atrial natriuretic – Increased aldosterone secretion
hormone (ANH) – Decreased ANH secretion
– Antidiuretic hormone – Increased ADH secretion
(ADH) – Increased sympathetic stimulation

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Hormonal Regulation of
Blood Volume

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Hormonal Regulation of
Blood Volume

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Regulation of ECF Volume

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Regulation of ICF and ECF

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Regulation of Electrolytes in ECF
• Na+ Ions
• Electrolytes – Dominant ECF cations
– Molecules or ions with – Responsible for 90-95% of
an electrical charge osmotic pressure
• Water ingestion adds • Regulation of Na+ ions
electrolytes to body – Kidneys major route of
• Kidneys, liver, skin, excretion
lungs remove from – Small quantities lost in
body sweat
– Concentration changes • Terms
only when growing,
– Hypernatremia
gaining or losing
– Hyponatremia
weight

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Mechanisms Regulating Blood Sodium

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Mechanisms Regulating Blood Sodium

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Abnormal Plasma Levels of
Sodium Ions

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Regulation of Chloride,
Potassium, Magnesium Ions
• Chloride ions • Potassium ions
– Predominant anions in – Maintained in narrow
ECF range
• Magnesium ions – Affect resting membrane
– Capacity of kidney to potentials
reabsorb is limited – Aldosterone increases
– Excess lost in urine amount secreted
– Decreased extracellular • Terms
magnesium results in
greater degree of – Hyperkalemia
reabsorption – Hypokalemia

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Potassium Ion Regulation in ECF

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Abnormal Concentration of Potassium
Ions

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Abnormal Plasma Levels of
Magnesium Ions

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Regulation of Blood Magnesium

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Regulation of Calcium Ions
• Regulated within • PTH increases Ca2+
narrow range extracellular levels and
– Elevated extracellular decreases extracellular
levels prevent phosphate levels
membrane
depolarization • Vitamin D stimulates
– Decreased levels lead Ca2+ uptake in intestines
to spontaneous action • Calcitonin decreases
potential generation extracellular Ca2+ levels
• Terms
– Hypocalcemia
– Hypercalcemia
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Regulation of Calcium Ions

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Regulation of Phosphate Ions

• Under normal conditions, reabsorption of phosphate occurs


at maximum rate in the nephron
• An increase in plasma phosphate increases amount of
phosphate in nephron beyond that which can be reabsorbed;
excess is lost in urine
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Regulation of Blood Phosphate

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Acids and Bases
and Buffers
• Buffers: Resist changes in
• Acids pH
– Release H+ into – When H+ added, buffer
solution removes
• Bases – When H+ removed, buffer
replaces
– Remove H+ from
solution • Types of buffer systems
– Carbonic acid/bicarbonate
• Acids and bases
– Protein
– Grouped as strong or
– Phosphate
weak

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Regulation of Acid-Base Balance

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Regulation of Acid-Base Balance

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Buffer Systems

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Respiratory Regulation of
Acid-Base Balance
• Respiratory regulation of pH is achieved
through carbonic acid/bicarbonate buffer
system
– As carbon dioxide levels increase, pH decreases
– As carbon dioxide levels decrease, pH increases
– Carbon dioxide levels and pH affect respiratory
centers
• Hypoventilation increases blood carbon dioxide levels
• Hyperventilation decreases blood carbon dioxide levels

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Respiratory Regulation of
Acid-Base Balance

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Renal Regulation of Acid-Base
Balance
• Secretion of H+ into filtrate and reabsorption of
HCO3- into ECF cause extracellular pH to
increase
• HCO3- in filtrate reabsorbed
• Rate of H+ secretion increases as body fluid pH
decreases or as aldosterone levels increase
• Secretion of H+ inhibited when urine pH falls
below 4.5
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Kidney Regulation of
Acid-Base Balance

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Hydrogen Ion Buffering

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Acidosis and Alkalosis
• Acidosis: pH body fluids below 7.35
– Respiratory: Caused by inadequate ventilation
– Metabolic: Results from all conditions other
than respiratory that decrease pH
• Alkalosis: pH body fluids above 7.45
– Respiratory: Caused by hyperventilation
– Metabolic: Results from all conditions other
than respiratory that increase pH
• Compensatory mechanisms
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Acidosis and Alkalosis

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