40 Questions
Which fluid compartment is located inside the cell?
Intracellular fluid
What is the term used to describe the fluid found in arteries and veins, carrying plasma, blood products, and nutrients?
Intravascular fluid
Which term is commonly used to refer to the fluid found in the interstitial spaces, often seen as edema?
Third-space fluid
Which of the following processes is responsible for the movement of water molecules across a semipermeable membrane from a region of higher concentration to a region of lower concentration?
Osmosis
Which of the following statements is true about the concentration or osmolarity of intracellular fluid (ICF) and extracellular fluid (ECF) in a healthy individual?
ICF and ECF should have the same concentration or osmolarity
What is the term used to describe the delicate membrane that separates the intracellular and extracellular fluid compartments and allows fluid to move in and out?
Permeable membrane
Which of the following statements is true about the total body water percentage in elderly patients?
It drops to around 45-40% estimated
Which process is responsible for the movement of molecules from a region of higher concentration to a region of lower concentration, without the need for energy input?
Diffusion
Which of the following statements is true regarding the movement of fluid and nutrients in the body?
The body moves fluid and nutrients in three ways: osmosis, diffusion, and a third process not mentioned in the text
Which of the following statements is true about the permeability of the membrane separating the intracellular and extracellular fluid compartments?
The membrane is selectively permeable
Which of the following is NOT a cause of increased capillary membrane permeability?
Dehydration
What is the primary cause of edema in end-stage renal disease?
Retention of salt and water
Which of the following is NOT a common cause of decreased plasma osmotic pressure?
Sepsis
What is the minimum pressure needed to prevent inward flow across a semipermeable membrane called?
Tonicity
Which of the following is NOT a sign or symptom of localized edema that can be deadly?
Pitting edema
What is the term used for the collection of water in the interstitial space?
Edema
Which of the following is NOT a common cause of increased capillary hydrostatic pressure?
Liver disease
What term is used to describe the increase in edema in a compartment, leading to decreased blood flow distal to the injury?
Compartment syndrome
Which of the following is NOT listed as one of the '5 P's' that are signs/symptoms of compartment syndrome?
Pericardial effusion
What term is used to describe edema that is measurable?
Pitting edema
What is the primary reason for calling 0.9% sodium chloride 'Normal Saline'?
Its osmolality is similar to that of circulating blood.
Which of the following is NOT a common hypotonic IV fluid?
3% sodium chloride
What is the primary treatment goal of using hypertonic IV fluids?
Pull excess fluid off to treat edema and prevent herniation in cases like traumatic brain injury.
Which of the following is NOT a mechanism of fluid movement across cell membranes discussed in the text?
Ultrafiltration
What is the primary function of measuring expired carbon dioxide (eTCO2)?
To monitor metabolic status, circulation, ventilation, and perfusion emergencies.
What is the primary difference between active transport and facilitated diffusion?
Active transport requires energy, while facilitated diffusion does not.
What is the primary difference between hydrostatic pressure and oncotic pressure in the capillary bed?
Hydrostatic pressure is higher on the arterial side, while oncotic pressure is higher on the venous side.
Which of the following is NOT a source of fluid replacement mentioned in the text?
Subcutaneous fluid administration
What is the approximate daily insensible fluid loss from the body?
1,600 mL
Which of the following statements about solute concentrations is TRUE according to the text?
The normal range for sodium in the extracellular fluid (ECF) is 135 to 145 mEq/dL.
What is the primary driving force behind the movement of fluids within the cardiovascular system?
Intravascular pressures
Which of the following best describes the relationship between arterial and venous hydrostatic pressures?
Arterial pressures are higher than venous pressures
What is the primary determinant of mean arterial pressure (MAP)?
Cardiac output, systemic vascular resistance, and right ventricular filling
Which of the following conditions is associated with low blood pressure, low cardiac output, low mean arterial pressure, and low systemic vascular resistance?
Overdose of blood pressure medications
What is the primary mechanism by which systemic vascular resistance is increased?
Constriction of blood vessels
Which of the following conditions is associated with high blood pressure, high cardiac output, high mean arterial pressure, and high systemic vascular resistance?
Compensated shock
What is the primary factor that determines the weight or hydrostatic pressure exerted by a fluid?
The pressure exerted by the pump and the diameter of the pipe
Which of the following is NOT a factor that can influence mean arterial pressure (MAP)?
Blood viscosity
What is the primary cause of low blood pressure associated with distributive shock?
Loss of vagal tone
Which of the following injuries or diseases is NOT mentioned in the text as potentially affecting blood pressure or hydrostatic pressures?
Myocardial infarction
Study Notes
Fluid Transport and Osmolality
- Mediated transport insensible fluid loss: approximately 1,600 mL in 24 hours from skin, respiratory tract, urine output, and fecal loss.
- Replacement comes from oral intake of fluids, metabolic water production, and medical interventions of intravenous (IV) fluids.
Concentrations and Osmolality
- Solute concentrations: the number of active particles in a kilogram or liter of water.
- Sodium (NA+) is the most abundant in extracellular fluid (ECF) with a concentration of 135-145 mEq/dL.
- Serum osmolality: 280-295 mEq/dL.
- Normal Saline (0.9% sodium chloride) has an osmolality of 308, similar to circulating blood (275-299).
Osmosis
- Movement of water between intercellular fluid (ICF) and extracellular fluid (ECF).
- Types of solutions:
- Isotonic: equal balance concentration between ICF and ECF (e.g., 0.9% Sodium Chloride, Lactated Ringers, D5W).
- Hypertonic: higher concentration in ECF than ICF (e.g., seawater).
- Hypotonic: lower concentration in ICF than ECF (e.g., distilled water).
Treatment Goals
- Hydration: increase preload in shock, treat hypoglycemia.
- Hypertonic: more solutes outside the cell, pull fluid from ICF to ECF (e.g., D5NS, D5LR, D5 0.45%, 10% Dextrose, 3.0% Sodium Chloride).
- Hypotonic: more solutes in the cell, pull fluid from ECF to ICF (e.g., D5W, 0.25% sodium chloride, 0.45% sodium chloride, 0.225% sodium chloride).
Diffusion and Active Transport
- Diffusion: spreading of molecules from a higher concentration to a lower concentration.
- Active transport: moving solutes against a concentration gradient, requiring energy (e.g., sodium/potassium pump, ATP production).
- Facilitated diffusion: uses a helper protein to move against the concentration gradient (e.g., insulin helps glucose into the cell).
Fluid Distribution and Edema
- Intracellular fluid (ICF): fluid inside the cell.
- Extracellular fluid (ECF): fluid outside the cell, includes intravascular and interstitial fluid.
- Edema: collection of water in the interstitial space, can be caused by:
- Increased capillary hydrostatic pressure.
- Decreased plasma oncotic pressure.
- Increased capillary membrane permeability.
- Histamine response.
- Lymphatic obstruction.
Complications and Management
- Localized edema can be deadly (e.g., cerebral edema, compartment syndrome).
- Signs and symptoms of edema: acute decrease in GCS, Cushing's triad, unequal or nonreactive pupils.
- EMS signs and symptoms: the 5 P's (pain out of proportion, paresthesia, paralysis, pallor, pressure).
Hemodynamics and Hydrostatic Pressure
- Hydrostatic pressure: pressure exerted by a fluid because of its weight.
- Oncotic pressure: pressure exerted by colloids in the fluid.
- Hemodynamics: dependent on cardiac output, right ventricular filling, and systemic vascular resistance.
- Mean arterial pressure (MAP): normal at 60-120 mmHg, measures end-organ perfusion pressures.
Test your knowledge on the functioning system responsible for distributing nutrients within the body. This quiz covers topics such as intracellular and extracellular fluids, intravascular fluid, interstitial fluid, and osmolarity.
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