(disturbances of water and electrolyte balance)

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(Disturbances of water and electrolyte balance). 水和电解质代谢紊乱. 体液 (body fluid). 第一节、体液的含量和分布 (Volume and distribution of body fluid). 体内的水和溶解在其中的物质。. 40 %. 细胞内液. Intracellular fluid (ICF). 细胞外液. Extra cellular fluid (ECF). 组织液. 组织间隙 15 %. Interstitial fluid(ISF). 5%. 血浆. Plasma. - PowerPoint PPT Presentation

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  • (Disturbances of water and electrolyte balance)

  • (Volume and distribution of body fluid)

  • Total body water (TBW) 60%

  • Body fluid TBW (%) Adult male TBW(%) Adult femaleTBW(%) InfantNormal605070Lean706080Obese504260

  • (Water and electrolytes balance)

  • () (Function of body water)

  • Daily intake (ml/day)Daily output(ml/day) Drinking 1200Urine 1500Water in food 1000Lungs 350Water of oxidation 300Skin 500Stool 150Total 2500Total 2500

  • ()140mmol/L50%10%40%

  • ()90%2%8%3.5-5.5mmol/L

  • (Regulation of water and sodium balance) --ADH-

  • 1.(antidiuretic hormone , ADH)ECF

  • 2.(aldosterone)

  • 3.(natriuretic hormone)

  • (Disturbances of water and sodium balance)

  • (dehydration) (water excess) Classification

  • hyponatremia) The serum sodium concentration150 mmol/L

  • (Dehydration) (>2%) body water deficit

  • 1.(concept) (hypovolemic hypernatremia)() (hypertonic dehydration) water losssodium loss serum[Na+] >150 mmol/L plasma osmotic pressure 310 mmol/L

  • 2. (causes) (1)(decrease of intake) (2)(lost from ECF)

  • >Na+3. (effects)

  • (dehydration fever)

  • ECF ICF

  • 4(pathophysiological basis of prevention and treatment)

  • 1.(concept) (hypovolemic hyponatremia)() (Hypotonic dehydration) sodium loss water loss serum[Na+]
  • 2. (causes) (lost from ECF) (gastrointestinal losses) (renal losses) (skin losses) (accumulate in third space)

  • Na+> 3. (effects)

  • ECF

  • 4(pathophysiological basis of prevention and treatment) (Na+) ()

  • 1.(concept) () (Isotonic dehydration) sodium loss water loss serum[Na+] 130150 mmol/L plasma osmotic pressure 280310 mmol/L

  • 2. (causes) (lost isotonic fluid) (gastrointestinal losses) (renal losses)(skin losses)(accumulate in third space)

  • 3. (effects)ECF[Na+](1)(2)(3)

  • 4(pathophysiological basis of prevention and treatment) Na+

  • ,,,,,,,,,,,>150mmol/L

  • (Water excess) Excess of body water.

  • 1.(concept) (hypervolemic hyponatremia) (water intoxication) serum[Na+] < 130 mmol/L plasma osmotic pressure < 280 mmol/L

  • 2. (causes) (1) (decrease of water excretion) (2) ADH ADH syndrome of inappropriate ADH secretion(3)

  • 3. (effects)

  • 4(pathophysiological basis of prevention and treatment) ()

  • Questions

  • (Potassium homeostasis and its disorders)

  • (Normal metabolism of potassium) 1. (intake) 2. (absorption):

  • 3. (distribution) 98% (ICF) 2% (ECF)4. (excretion) : urine 80%90 (feces 10) (sweat)serum [K+] 3.5~5.5mmol/L

  • (50mmol/Kg)Distribution and content of potassium within body

  • 5. (function)(Promoting the cell metabolism) (Maintenance of the resting membrane potential) (Regulating the osmotic pressure and acid-base balance)

  • 6. (Regulation of potassium balance)

  • 1. 2. K+3. 4.

  • : Na- K+K+: HNa-K

  • (Hypokalemia) (concept) Serum [K+] < 3.5mmol/L(potassium deficit)

  • ()(Causes and mechanisms)1. (decreased K+ intake)Hypokalemia

  • 2. (increased K+ excretion) Cusings disease

  • 3. (K shifts into the cells) (insulin therapy)

  • (alkalosis)H+[K+]

  • () (Effects) (effects on neuromuscular excitability)

  • K+(mechanism)

  • (hyperpolarized blocking)

  • (manifestations)CNS

  • 2. (effects on the heart)

  • T,UP-R

  • 3.(effect on renal function)4. (effect on acid-base balance)

  • () (Pathophysiological basis of prevention and treatment)

  • (Hyperkalemia)(Concept) Serum [K+] > 5.5mmol/L

  • ()(Causes and mechanisms)1. (decreased K+ excretion)(oliguria)

  • 2. K+(K+ shifts out of cells) (cell injury) (hyperkalemic periodic paralysis)

  • (acidosis)H+[K+]

  • ()(Effects) 1. (effects on neuromuscular excitability)

  • K+ (mechanism)

  • (hypopolarized blocking)

  • 2. (effects on the heart)

  • 3K+, T P-R QRS

  • 3.(effects on acid-base balance)

  • () (Pathophysiological basis of prevention and treatment)

  • ECF: Na+Cl- HCO3-ICF: K + Mg2 + HPO42- Pr-

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