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Questions and Answers
Which fluid compartment is located inside the cell?
Which fluid compartment is located inside the cell?
- Interstitial fluid
- Intravascular fluid
- Intracellular fluid (correct)
- Extracellular fluid
What is the term used to describe the fluid found in arteries and veins, carrying plasma, blood products, and nutrients?
What is the term used to describe the fluid found in arteries and veins, carrying plasma, blood products, and nutrients?
- Interstitial fluid
- Intravascular fluid (correct)
- Third-space fluid
- Intracellular fluid
Which term is commonly used to refer to the fluid found in the interstitial spaces, often seen as edema?
Which term is commonly used to refer to the fluid found in the interstitial spaces, often seen as edema?
- Interstitial fluid
- Intracellular fluid
- Third-space fluid (correct)
- Intravascular 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?
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?
Which of the following statements is true about the concentration or osmolarity of intracellular fluid (ICF) and extracellular fluid (ECF) in a healthy individual?
Which of the following statements is true about the concentration or osmolarity of intracellular fluid (ICF) and extracellular fluid (ECF) in a healthy individual?
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?
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?
Which of the following statements is true about the total body water percentage in elderly patients?
Which of the following statements is true about the total body water percentage in elderly patients?
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?
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?
Which of the following statements is true regarding the movement of fluid and nutrients in the body?
Which of the following statements is true regarding the movement of fluid and nutrients in the body?
Which of the following statements is true about the permeability of the membrane separating the intracellular and extracellular fluid compartments?
Which of the following statements is true about the permeability of the membrane separating the intracellular and extracellular fluid compartments?
Which of the following is NOT a cause of increased capillary membrane permeability?
Which of the following is NOT a cause of increased capillary membrane permeability?
What is the primary cause of edema in end-stage renal disease?
What is the primary cause of edema in end-stage renal disease?
Which of the following is NOT a common cause of decreased plasma osmotic pressure?
Which of the following is NOT a common cause of decreased plasma osmotic pressure?
What is the minimum pressure needed to prevent inward flow across a semipermeable membrane called?
What is the minimum pressure needed to prevent inward flow across a semipermeable membrane called?
Which of the following is NOT a sign or symptom of localized edema that can be deadly?
Which of the following is NOT a sign or symptom of localized edema that can be deadly?
What is the term used for the collection of water in the interstitial space?
What is the term used for the collection of water in the interstitial space?
Which of the following is NOT a common cause of increased capillary hydrostatic pressure?
Which of the following is NOT a common cause of increased capillary hydrostatic pressure?
What term is used to describe the increase in edema in a compartment, leading to decreased blood flow distal to the injury?
What term is used to describe the increase in edema in a compartment, leading to decreased blood flow distal to the injury?
Which of the following is NOT listed as one of the '5 P's' that are signs/symptoms of compartment syndrome?
Which of the following is NOT listed as one of the '5 P's' that are signs/symptoms of compartment syndrome?
What term is used to describe edema that is measurable?
What term is used to describe edema that is measurable?
What is the primary reason for calling 0.9% sodium chloride 'Normal Saline'?
What is the primary reason for calling 0.9% sodium chloride 'Normal Saline'?
Which of the following is NOT a common hypotonic IV fluid?
Which of the following is NOT a common hypotonic IV fluid?
What is the primary treatment goal of using hypertonic IV fluids?
What is the primary treatment goal of using hypertonic IV fluids?
Which of the following is NOT a mechanism of fluid movement across cell membranes discussed in the text?
Which of the following is NOT a mechanism of fluid movement across cell membranes discussed in the text?
What is the primary function of measuring expired carbon dioxide (eTCO2)?
What is the primary function of measuring expired carbon dioxide (eTCO2)?
What is the primary difference between active transport and facilitated diffusion?
What is the primary difference between active transport and facilitated diffusion?
What is the primary difference between hydrostatic pressure and oncotic pressure in the capillary bed?
What is the primary difference between hydrostatic pressure and oncotic pressure in the capillary bed?
Which of the following is NOT a source of fluid replacement mentioned in the text?
Which of the following is NOT a source of fluid replacement mentioned in the text?
What is the approximate daily insensible fluid loss from the body?
What is the approximate daily insensible fluid loss from the body?
Which of the following statements about solute concentrations is TRUE according to the text?
Which of the following statements about solute concentrations is TRUE according to the text?
What is the primary driving force behind the movement of fluids within the cardiovascular system?
What is the primary driving force behind the movement of fluids within the cardiovascular system?
Which of the following best describes the relationship between arterial and venous hydrostatic pressures?
Which of the following best describes the relationship between arterial and venous hydrostatic pressures?
What is the primary determinant of mean arterial pressure (MAP)?
What is the primary determinant of mean arterial pressure (MAP)?
Which of the following conditions is associated with low blood pressure, low cardiac output, low mean arterial pressure, and low systemic vascular resistance?
Which of the following conditions is associated with low blood pressure, low cardiac output, low mean arterial pressure, and low systemic vascular resistance?
What is the primary mechanism by which systemic vascular resistance is increased?
What is the primary mechanism by which systemic vascular resistance is increased?
Which of the following conditions is associated with high blood pressure, high cardiac output, high mean arterial pressure, and high systemic vascular resistance?
Which of the following conditions is associated with high blood pressure, high cardiac output, high mean arterial pressure, and high systemic vascular resistance?
What is the primary factor that determines the weight or hydrostatic pressure exerted by a fluid?
What is the primary factor that determines the weight or hydrostatic pressure exerted by a fluid?
Which of the following is NOT a factor that can influence mean arterial pressure (MAP)?
Which of the following is NOT a factor that can influence mean arterial pressure (MAP)?
What is the primary cause of low blood pressure associated with distributive shock?
What is the primary cause of low blood pressure associated with distributive shock?
Which of the following injuries or diseases is NOT mentioned in the text as potentially affecting blood pressure or hydrostatic pressures?
Which of the following injuries or diseases is NOT mentioned in the text as potentially affecting blood pressure or hydrostatic pressures?
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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.
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