MindMap Gallery Pathophysiology-Water and electrolyte metabolism disorders
Pathophysiology Water and electrolyte metabolism disorders refer to the disruption of the balance of water and electrolytes in the human body, resulting in abnormal composition and distribution of body fluids, which in turn causes physiological dysfunction. It is recommended to study by yourself along with the textbook.
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This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
Water and electrolyte metabolism disorders
Note
↑
increase/expand/activate/promote
↓
reduce/shrink/suppress
-
No change/little change
Normal water and sodium balance
water balance
Input amount 1500-2000
Drinking water 1000-1300
Food water 700-900
Metabolic water 300
Output>1500
evaporation
Skin 500
Breathe 350
excretion
Feces 150
Urine 1000-1500 (at least 500)
electrolyte balance
Blood Na135-145
adjust
ADH
Blood seepage↑
blood volume↓/blood pressure↓
ADH↑
Water reabsorption↑
Blood seepage↓
blood volume↑/blood pressure↑
aldosterone
Blood volume↓, blood Na↓-renin angiotensin↑-aldosterone↑-sodium and water retention, potassium excretion
water metabolism disorder
dehydration
hypotonic dehydration
Concept 4
Loss of Na>Water
Blood Na<135mmol/L
Blood infiltration <290mmol/L
ECF↓
reason
lost through kidneys
Diuretics-Urine Na↑
kidney disease
Adrenocortical insufficiency-aldosterone↓
parenchymal renal disease
Renal tubular acidosis-Na-H exchange↓
Extrarenal loss
Third space effusion-pleural effusion, ascites
Gastrointestinal fluid loss - only replenish water after vomiting or diarrhea
Skin loss - only hydration after heavy sweating/burn
Impact 3
changes in urine
urine output
Early stage - hematuria ↓ - ADH ↓, no sense of thirst - urine output -
Late stage - blood volume ↓ - ADH ↑ - urine output ↓
Indicates deterioration of condition
Na in urine
Transrenal loss-urinary Na↑
Extrarenal loss-urinary Na↓
prone to shock
Dehydration intracellular transfer-ECF↓-hypovolemic shock
signs of water loss
Interstitial fluid↓
Prevention and control
Replenish isotonic fluid
hypertonic dehydration
Concept 4
Water loss>Na
Blood Na>150mmol/L
Blood infiltration>310mmol/L
ECF, ICF↓
reason
Take water↓
Throw water↑
gastrointestinal tract
skin
Respiratory tract - hyperventilation
Renal-diabetes insipidus, dehydrating agents
Impact 4
Thirsty
body fluid
ECF↓
Hypertonic-extracellular transfer-ICF↓, ECF supplementation (auto-infusion)
changes in urine
Urine volume↓
Hypertonic-ADH↑
Na in urine
Mild (early stage) - blood volume - - aldosterone - - urine Na -
Severe (late stage) - blood volume ↓ - aldosterone ↑ - urine Na ↓
disease
Brain c dehydration-central disease
Sweating↓-heat dissipation↓-dehydration heat
Prevention and control
Replenish hypotonic fluid
Appropriate supplement of K
K is released with intracellular water, aldosterone↑-excretes K↑
isotonic dehydration
concept
Water loss≈Na
ECF↓
Influence
water intoxication
concept
water retention
Blood Na<135, but total Na amount-/↑
Plasma osmolarity <290
Edema
concept
Fluid retention in interstitial spaces/body cavities
Fluid retention in body cavities - hydrops
Mechanism 7
Inside and outside blood vessels - fluid exchange imbalance - interstitial fluid - production > reflux
Generate ↑
Capillary-Hydrostatic Pressure↑
Venous congestion - venous pressure ↑ - water column thickness ρVg - hydrostatic pressure ↑
Plasma-colloid infiltration↓
Microvessel-permeability↑-gel penetration↓
Return↓
Lymphatic drainage is blocked
Internal and external fluid imbalance—sodium and water retention
GFR↓
Proximal tubule - reabsorption of sodium and water↑
Atrial natriuretic peptide↓
FF↑
Glomerular filtration fraction = GFR/renal plasma flow
Heart failure/kidney disease
Renal blood flow↓-aldosterone↑
Small A shrinkage at outlet↑↑-GFR↑-plasma protein concentration↑-gel penetration↑-ADH↑
Distal convoluted tubule, collecting duct - reabsorption of sodium and water↑
Aldosterone, ADH↑
Electrolyte metabolism disorders
Potassium metabolism disorders
Hypokalemia
concept
Blood K<3.5
Influence
Abnormal membrane potential
Neuro-muscular (skeletal muscle/gastrointestinal smooth muscle)
Acute hypokalemia-K efflux↑-Em↓-(Em-Et)↑-hyperpolarization block state-excitability↓
Resting potential Em; threshold potential Et
钾外流—膜外+↑、膜内-↑—静息电位↑
|Em|rising
Chronic hypokalemia - not obvious
myocardium
Excitability↑
Serum potassium↓-myocardial c membrane-K permeability↓-Em↑-(Em-Et)↓
Self-discipline↑
Myocardial c membrane-K permeability↓-K outflow↓-Na influx relative↑-Phase 4 automatic depolarization↑
Arrhythmia
Conductivity↓
Em↑-Na inflow↓-0 period depolarization speed and amplitude↓
Contractibility
Mild-K inhibition of Ca influx↓-Ca influx↑-Contractility↑
Severe/chronic - myocardial potassium deficiency - metabolic disorder - degeneration and necrosis - contractility ↓
Digitalis toxicity↑
Cell metabolism disorder
skeletal muscle
Avascular necrosis, rhabdomyolysis
kidney
Distal curvature and collecting duct injury-ADH reactivity↓
Correct damage to the marrow-NaCl reabsorption↓-Water reabsorption↓
Concentration function↓-Urine volume↑
Abnormally acidic urine
Tissue c-K outflow↑, H inflow↑-alkali generation
Renal tubular epithelial c-H-Na exchange↑-Na-K exchange↓ (Na absorption and discharge K≠Na pump)-urine K↓, urine H↑-aciduria
bow your head alkali money
Prevention and control
Potassium supplement
Quiet pushing is prohibited
hyperkalemia
concept
Blood K>5.5
Influence
Abnormal membrane potential
neuromuscular
Acute mild-K efflux↓-excitability↑
Acute severe-K efflux↓↓-Em↑↑-(Em-Et)≈0-fast Na channel inactivation (depolarization block state)-cannot be excited
Chronic - not obvious
myocardium
Excitability
Acute mild-excitability↑
Acute Severe-Excitability↓
Same nerve-muscle—first ↑ and then ↓
Self-discipline↓
Myocardial c membrane-K permeability↑-K outflow↑-Na influx relative↓-Phase 4 automatic depolarization↓
Conductivity↓
Em↑
Shrinkage↓
K inhibits Ca influx↑-Ca influx↓
Acid substitution, abnormal alkaline urine
Tissue c-K inflow, H outflow-acid replacement
Renal tubular epithelial c-H-Na exchange↓-Na-K exchange↑-urinary K↑, urinary H↓-alkaline urine
treat
Prevent and treat primary disease
Intake↓
discharge↑
Potassium-depleting diuretics, dialysis
Enter the cell ↑
Insulin, PH↑
Anti-K-cardiotoxicity
Calcium, sodium salt