Professional Documents
Culture Documents
Electrolytes of importance
Sodium- osmolarity, action potential Potassium- RMP Calcium- second messenger, contractility Chloride Bicarbonate Magnesium Phosphate
Distribution of electrolytes
Basics
Osmosis- diffusion of water across a semipermeable membrane from region of high concentration to low concentration. Mole- gram molecular weight of a substance Osmole- mole / liter of water Osmolality- osmoles/Kg of water Osmolarity- osmoles/liter of solution Osmotic pressure- pressure required to prevent osmosis of water
Primary systems regulating ECF [Na+] : 1. Osmoreceptor-ADH feedback system 2. Thirst mechanism
Thirst mechanism
Thirst is a conscious for water Thirst center: AV3V and a small area in preoptic nucleus
Osmolar threshold for thirst- 2 mEq / L of Na+ One of the mechanisms is adequate to regulate osmolarity & [Na+]
Role of angiotensin II and aldosterone: Little effect on [Na+] Effective only in extreme conditions Salt appetite mechanism
Mechanisms of control: 1. Pressure natriuresis & diuresis 2. Nervous & hormonal factors(i) Sympathetic stimulation (ii) Role of Angiotensin II (iii) Role of Aldosterone (iv) Role of ADH (v) Role of ANP
Regulation of potassium
4.20.3 mEq/L 98% is intracellular Daily intake 50-200 mEq/day 5-10% excreted in feces
Renal K+ excretion
Secretion in distal tubule and cortical collecting duct is 1/3rd of intake Factors that control K+ secretion in principal cells: (i) Na+- K+ ATPase activity (ii) Electrochemical gradient for K+ (iii) Permeability of luminal membrane
K+ excretion is increased by: 1. Increased ECF K+ 2. Increased aldosterone 3. Increased tubular flow rate
Hyponatremia
Causes: Depletional & Dilutional c/f: nausea, malaise, lethargy, headache confusion, stupor, seizure, coma
Hypernatremia
Causes: central diabetes insipidus, hyperaldosteronism c/f- weakness, neuromuscular irritability, coma, seizures
Hypokalemia
Causes: insulin, alkalosis, hyperaldosteronism c/f- fatigue, muscular weakness, paralysis ECG changes- ST depression, prominent U wave, T inversion, prolonged PR interval
Hyperkalemia
Causes: insulin deficiency, hypoaldosteronism c/f- flaccid paralysis & hypoventilation ECG changes- tall T waves, prolonged PR & QRS