水电解质和酸碱平衡失调.docVIP

Fluid Electrolyte and Acid-base of disturbances Part I Anatomy of Body Fluid Compartments Distribution and Conformation of Fluids Intracellular Fluid Female 35％BW, Male 40% Body Fluid (Water, Electrolyte) Extracellular Fluid(20%BW) Interstitial Fluid15％BW Plasma 5％BW Functioning Nonfunctioning Criteria for differentiation Function, Taking part in exchanging materials between tissue and microcirculation Nonfunction, Fluids in cavity in normal state Regulation of Body Fluid, Kidney Goal to regulation？Osmotic Pressure;Body fluid volume. Mechanism a. Regulation of Osmotic pressure, Osmotic pressure↑ Thirsty Hypothalamus Posterior hypophysis ADH↑ Reabsorption of Water Sodium↑ Osmotic pressure↓. Conversely, it is the same. b. Regulation of Volume ECF↓ Hypotension Sympathetic nerve+ ;Distal convoluted renal tubule Na+↓;Pressue receptor＋ Juxtaglomerular Cell＋ Renin↑ Angiotensinogen AngiotoninⅠ Lung AngiotensinⅡ Systemic Vasoconstriction Aldosterone↑ Absorption of Water Sodium↑ Maintaining the balance of acid-base. Organs：Lung and kidney Carbon dioxide is regulated through lung Mechanisms(HCO3-/H2CO3) Intrinsic acid and base excreted through kidney. Part II Disturbances of Body Fluid *Osmotic Pressure Definition, the number osmotically active particales per unit volume. 2.Osmotic pressure of ECF(mOsm/L) : 2Na+(mmol/L)+GS(mmol/L)+BUN(mmol/L) 3.Normal Range：290～310mOsm/L *体液失衡类型 细胞外液不足 等渗脱水 容量异常 细胞外液过多 水中毒 低钠血症 低渗