MindMap Gallery Medicine-Water and Sodium Metabolism Disorders Mind Map
An article about medicine - a mind map of water and sodium metabolism disorders, including normal water and sodium metabolism, dehydration, etc. It’s full of useful information, friends in need should quickly collect it!
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Water and sodium metabolism disorders
Normal water and sodium metabolism
Body fluids concept
A liquid composed of water, electrolytes, low-molecular organic compounds, proteins, etc. that maintains the homeostasis of the body's internal environment
Solvent: water
solute
Small molecule
electrolyte
Glucose, amino acids, fatty acids
organic small molecule compounds
other
Macromolecules: proteins, enzymes, antibodies, etc.
Body fluid volume and distribution
60%
Adult men: 60%, women 50%, more men than women, more muscle and less fat, the older the less, newborns: 80%, infants 70%, children 65%.
Icf: 40%
Ecf: 20%
Plasma: 5%
Interstitial fluid: 15%
third interstitial fluid
Body fluid electrolyte composition
cation
In C: There is a lot of potassium, blood potassium, 3.5~5.5mmol/l
Except C: excessive sodium, blood sodium, 135~150mmol/l
Osmotic pressure of body fluids
The power of particle molecules to attract water molecules depends on the number of solute particles, and water seeps to higher places.
Serum sodium is the main factor that determines the osmotic pressure of Ecf.
Crystal osmotic pressure: maintains water balance inside and outside the cell
Colloidal osmotic pressure:. Blood vessel
Total plasma osmotic pressure: 290~310mmol/l
Water input and output
Relying on the neuro-endocrine system to maintain body fluid balance
Intake(ml)
Drinking water: 1000~1500
Food: 700
Metabolic water: 300
Total: 2000~2500
Discharge (ml)
Urine: 1000~1500
At least 500 per day to eliminate metabolic waste
Skin evaporation: 500
Respiratory evaporation: 350
Gut: 150
Total: 2500
Fluid balance regulation
Thirst sensing mechanism: Receptor: hypothalamus Thirst sensing center: cerebral cortex
Regulate water intake
Ecf⬆️
Circulating blood volume⬇️
ADH: Secreted, hypothalamus; promotes water reabsorption by renal distal tubules and collecting ducts
Regulate plasma osmotic pressure
Osmotic pressure ⬆️
blood volume ⬇️
ADS: secretion: zona glomerulosa of adrenocortex (zona fasciculata glucocorticoids, zona reticularis sex hormones)
Regulate blood volume
Low blood sodium and high blood potassium
Blood volume ⬇️, RAAS system
ANP: polypeptide secreted by atrial muscle
urination, excretion of sodium
blood volume ⬆️
Blood sodium ⬆️
Angiotensin ⬆️
dehydration
hypertonic dehydration
The key is less water; clinical classification (based on percentage of body weight)
轻
2~4%,口渴
中
4~6%,极度口渴,乏力尿少,尿比重高,皮肤弹性差,眼窝凹陷,唇舌干燥(失水体征)
重
极度口渴,CNS障碍,昏迷躁狂。
Features: Osmotic pressure is higher than 310, blood sodium is higher than 150, water loss is more than sodium loss
Causes and Mechanisms
Not enough water
Insufficient drinking water during high-temperature operations, cutoff of water source, coma, difficulty swallowing, nasal feeding of high-concentration nutrient solution, thirst disorder, etc.
Too much water loss
Kidney: Diabetes insipidus or large amounts of intravenous hypertonic fluids
Skin: Profuse sweating
Respiratory tract: tracheotomy; deep and fast breathing; high fever
Digestive tract: diarrhea in infants and young children
Infants do not have enough sodium in their gastrointestinal tract, adults are isotonic
Four major ways of losing water
Effect on the body
neuroendocrine changes
thirst center excitement
Thirsty
ADH⬆️
Little urine, high specific gravity
Severe blood volume ⬇️
ADS⬆️
Urine sodium⬇️
changes in body fluid distribution
Water moves from inside C to outside
Get up early to replenish part of the blood volume, and fail to replenish fluids in time, leading to signs of dehydration.
Icf⬇️
Brain cells are dehydrated, brain volume decreases, the distance between brain tissue and skull increases, and the tension of blood canalicles on the brain surface increases.
cerebral hemorrhage
serious pathological changes
Sweat gland cells are dehydrated, sweat⬇️, skin evaporates water⬇️, and heat dissipation is blocked
dehydration fever
Icf mainly decreases
Problem solving ideas
The cause and blood sodium concentration are key
clinical manifestations
strong thirst
signs of dehydration
Dehydration fever (children)
cerebral hemorrhage
CNS disorders
Prevention and control principles
Mainly hydrating
sugar first then salt
hypotonic fluid
Pediatric: 1/3 Tonic Sodium Solution GS: NS=2:1
Hypotonic dehydration (secondary dehydration)
Clinical classification, based on serum sodium concentration
轻:130~135,无口渴,尿多,比重低
中:120~130,尿量⬇️,比重⬇️,尿钠⬇️,脱水体征明显,血压低
重:小于120,神智不清,意识模糊,昏迷,休克
Features: Osmotic pressure is lower than 290, blood sodium is lower than 135, water loss is less than sodium loss, keywords: chronic, improper treatment, repeated, long-term.
Causes and Mechanisms
kidney loss of sodium
long-term natriuretic diuretics
renal failure polyuria stage
chronic interstitial renal disease
renal tubular acidosis
Adrenocortical insufficiency
extrarenal factors
Continuous loss of digestive juices
chronic diarrhea
sweating profusely
Chronic effusion from extensive trauma
Drain large amounts of thoracic and ascites fluid
Only replenishing water without replenishing salt will lead to hypotonic dehydration
Effect on the body
neuroendocrine changes
Thirst: No thirst in early stage
ADH⬇️: increased urine output. Severe blood volume decrease, ADH⬆️, decreased urine output.
Urine sodium
Extrarenal factors: ADS⬇️, urinary sodium⬇️
Kidney loss of sodium, urinary sodium⬆️
Changes in body fluid distribution: interstitial fluid moves into C, mainly losing Ecf
Obvious signs of dehydration
prone to shock
Brain cell edema
Cerebral herniation
Prevention and control principles
Mainly supplement salt
In principle isotonic
Severe hypertonicity
Pediatric: 2/3 isotonic sodium-containing solution
Isotonic dehydration (acute dehydration)
reason
Extrarenal losses from hypotonic dehydration, the most common of which are: gastrointestinal losses
body effects
neuroendocrine
Thirsty
Oligouria, low urine sodium
severe shock
body fluid distribution
Mainly missing Ecf
C internal and external osmotic pressure balance
Variety
No treatment
Hypertonic (no evaporation)
Replenish water without adding salt
Hypotonic
Prevention and control
Pediatric: 1/2 tonic sodium solution
Use balanced salt solution to avoid cl ion poisoning