Fluid, Electrolyte

& Acid-Base Balance

What will we learn?

n Fluids of the body

n Functions of body fluids
n Water Balance
n Electrolyte Balance
n Acid-Base Balance
n Includes your
body’s water and
all dissolved
substances
n 60 – 70% of body
weight
n Fluid Compartments
¡ Intracellular Fluid – located inside of cells

n High concentrations of potassium,

phosphate, and magnesium
¡ cytosol
¡ Extracellular Fluid – outside of cells
n High concentrations of sodium, chloride,
calcium, and bicarbonate
¡ Blood vessels = plasma
¡ Lymphatic vessels = lymph
¡ Tissue space = interstitial
 Functions of Bodily Fluids
n Carry nutrients and waste
n Medium for chemical reactions
 Keeping balance…

n Active
transport
¡ Na/K
pumps

n Facilitated
transport
¡ channels
 Water Balance
n Maintain plasma osmolarity – ratio of solutes to
water in blood plasma
¡ Intake – thirst stimulation
¡ Output – urine, perspiration, breathing, fecal matter

n Urine is primary regulator controlled by

n ADH – concentrates urine by retaining water
n Aldosterone – concentrates urine
High osmolarity causes:
Thirst à increased
water intake
ADH release à water
reabsorbed from urine

Low osmolarity causes:

Lack of thirst à
decreased water intake
Decreased ADH release
à water lost in urine
 Three types of dehydration
Hypotonic dehydration —primarily a loss of electrolytes, sodium in
particular. Hypotonic dehydration causes decreased plasma osmolarity.

Hypertonic dehydration —primarily a loss of water. Hypertonic

dehydration causes increased plasma osmolarity.

Isotonic dehydration —an equal loss of water and electrolytes.

Isotonic dehydration will not change plasma osmolarity, but it will
reduce overall plasma volume. Isotonic dehydration is the most
common type of dehydration.
 Water Intoxication
The result of an excess of extracellular water without having an excess
of solutes. Due to this imbalance, the extracellular fluid (ECF) becomes
diluted causing water to move into cells to equalize solute concentration
on each side of the cell. Hyponatremia, a potentially lethal situation, may
occur if high volumes of water are consumed without solute replacement.
 Electrolyte Balance
n physiological functions of electrolytes
¡ chemically reactive and participate in
metabolism
¡ determine electrical potential (charge
difference) across cell membranes

n major cations (positive charge)

¡ Na+, K+, Ca2+, and H+

n major anions (negative charge)

¡ Cl-, HCO3- , and PO43-
 Sodium
n Most abundant cellular cation
n Responsible for maintaining osmotic pressure
n Hyponatremia – low blood sodium, excessive water gain
n Caused by excessive sweating, vomiting, or diarrhea
n Dilution of sodium increases water entry into cells, which
can burst
n Hypernatremia – high blood sodium, lack of water
n Caused by water loss in blood or hormonal imbalance
 Potassium
n Abundant intracellular cation
n Usually moves in opposite direction of sodium

¡ Hypokalemia – low potassium levels

n Caused by vomiting, diarrhea or alkalosis
¡ Hyperkalemia – high potassium levels
n Abnormally excites muscle cells, including the
heart
n Causes mental confusion & weak respiratory
muscles
 Chloride
n Most abundant extracellular anion
n Follows sodium by passive transport
n required for the formation of stomach acid
n major role in regulating body pH

n Hypochloremia – low blood chloride

¡ Caused by vomiting, diarrhea, metabolic acidosis
n Hyperchloremia – high blood chloride
¡ Caused by dehydration, excessive intake of sodium,
aspirin intoxication
 Calcium
n Extracellular cation, 99% located in bone
n activates sliding filament mechanism of muscle contraction
n serves as a second messenger for some hormones and
neurotransmitters
n essential factor in blood clotting

n Hypocalcemia – low blood calcium

¡ Caused by abnormal thyroid
n Hypercalcemia – high blood calcium
¡ Caused by hyperparathyroidism
Phosphates
n inorganic phosphates (Pi) of the body fluids are
an equilibrium mixture of phosphate (PO43-),
monohydrogen phosphate (HPO42-), and
dihydrogen phosphate (H2PO4-)
n activates many metabolic pathways by
phosphorylating enzymes and substrates such
as glucose
n buffers that help stabilize the pH of body fluids

n Hypophosphatemia – low phosphate levels

¡ Caused by malnurishment or starvation
n Hyperphosphatemia – high phosphate levels
¡ Caused by decreased renal function or acute
lymphocytic leukemia
 Acid-Base Balance
pH

Normal Alk
osis 7.35 7.45
alo
sis
id
Ac
8.
0

De
8
h
6.
at

at
De

h
H2CO3 HCO3–
 Acid-Base Balance
n one of the most important aspects of homeostasis
¡ metabolism depends on enzymes, and enzymes are sensitive to
pH
¡ slight deviation from the normal pH can shut down entire
metabolic pathways

n 7.35 to 7.45 is the normal pH range of blood and tissue

fluid
n challenges to acid-base balance:
¡ metabolism constantly produces acid
n lactic acids from anaerobic fermentation
n phosphoric acid from nucleic acid catabolism
n fatty acids and ketones from fat catabolism
n carbonic acid from carbon dioxide
 Phosphate Buffer System
n reactions that proceed to the right liberating H+
and decreasing pH, and those to the left increase
pH
n more important buffering the ICF and renal
tubules
 Bicarbonate-Carbonic Acid
Buffer System
n major buffer system of body
n If body is acidic, bicarbonate reacts by binding to excess
H+ ions forming carbonic acid
n If body is basic, carbonic acid responds and breaks apart
into H+ and bicarbonate, then the H+ binds with OH-
forming water
 Protein Buffer System

n protein buffering ability is due to certain side groups of

their amino acid residues

n carboxyl (-COOH) side groups which releases H+ when

pH begins to rise

n amino (-NH2) side groups that bind H+ when pH gets too

low
n acidosis – pH
below 7.35
¡ Acids accumulate
in body
¡ H+ concentration
increasing

n alkalosis – pH
above 7.45
¡ Bases accumulate
in body
¡ Bicarbonates
increasing
 Respiratory Control of pH
n The lungs, under control of
the medulla oblongata, control
carbon dioxide and carbonic
acid content
¡ hypercapnia (excess CO2) -
stimulates pulmonary ventilation
eliminating CO2 and allowing pH to
rise
¡ hypocapnia (deficiency of CO2)
reduces ventilation and allows CO2
accumulate lowering pH
 Levels of Carbon Dioxide in Body
n Regulate pH by changing rate of breathing

n CO2 accumulating (body acidic)

¡ More carbonic acid produced
¡ More H+ released
¡ Respirations become faster
n CO2 decreasing (body basic)
¡ Less carbonic acid produced
¡ Less H+ released
¡ Respirations become slower
Renal Control of pH
n the kidneys can neutralize more acid or
base than either the respiratory system or
chemical buffers

n renal tubules secrete H+ into the tubular

fluid
¡ most binds to bicarbonate, ammonia,
and phosphate buffers
¡ bound and free H+ are excreted in the
urine actually expelling H+ from the body
¡ other buffer systems only reduce its
concentration by binding it to other
chemicals
Excretions to maintain pH

n Acids accumulating
¡ Kidney will eliminate H+ directly into urine
n Bases accumulating
¡ Kidney reabsorbs bicarbonate
¡ When OH- levels get high, kidney puts
bicarbonate into urine
Disorders of Acidosis & Alkalosis
 Metabolic Causes
n metabolic acidosis
¡ increased production of organic acids such as lactic
acid in anaerobic fermentation, and ketone bodies
seen in alcoholism, and diabetes mellitus
¡ ingestion of acidic drugs (aspirin)
¡ loss of base due to chronic diarrhea, laxative overuse

n metabolic alkalosis
¡ rare, but can result from:
¡ overuse of bicarbonates (antacids and IV bicarbonate
solutions)
¡ loss of stomach acid (chronic vomiting)
 Respiratory Causes

n respiratory acidosis
¡ occurs when rate of alveolar ventilation fails to keep
pace with the body’s rate of CO2 production
¡ carbon dioxide accumulates in the ECF and lowers
its pH
¡ occurs in emphysema where there is a severe
reduction of functional alveoli

n respiratory alkalosis
¡ results from hyperventilation
¡ CO2 eliminated faster than it is produced