Assignment Prompt & Instructions
[>Anatomy homework help](https://www.sweetstudy.com/fields/biology-anatomy)
**files (3)**
– ## Chapter_020.rtf
– ## Chapter_019.rtf
– 20260410_231203.jpg
**## Chapter_020.rtf**
20-3
Audio Chapter Summaries
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
**Patton: Structure & Function of the Body, 17th Edition**
**Chapter 20: Acid-Base Balance**
****Audio Chapter Summaries****
****Welcome to the audio review of Chapter 20: Acid-Base Balance.****
**As a reminder, you see hydrogen ions in your text indicated by “H+”, but they are referred to as hydrogen ions in this audio script. Similarly, you have seen “OH−” to indicate hydroxide ions, but this audio program refers to them as hydroxide ions.**
**First, we will review information about the pH of body fluids.**
**pH is a number that indicates the relative hydrogen ion concentration (as compared with hydroxide ion concentration) of a fluid.**
**A pH of 7.0 indicates neutrality or a neutral solution.**
**A pH higher than 7.0 indicates alkalinity or an alkaline or basic solution; a base.**
**A pH less than 7.0 indicates acidity or an acid solution.**
**Typical range of blood pH is approximately 7.35 to 7.45.**
**Systemic arterial blood pH is about 7.4.**
**Systemic venous blood pH is about 7.37.**
**The pH scale is based on multiples of 10.**
**The hydrogen ion concentration changes**
**_by 10 times_ for each one pH unit.**
**The difference between pH 7 and pH 6 is a 10-**
**_fold_ increase in hydrogen ions. Moving from pH 7 to pH 5 is a**
**_100-_ _fold_ increase in hydrogen ion concentration.**
**Thus, large pH fluctuations may appear small on the pH scale.**
**Two coordinated homeostatic mechanisms act to maintain the normal pH of body fluids and prevent pH swings when excess acids or bases are present: chemical pH control mechanisms and physiological pH control mechanisms.**
**A chemical pH control mechanism, based on buffers in blood, red blood cells, and body fluids, acts immediately.**
**Physiological pH control mechanisms come from the respiratory and renal systems.**
**Changes in pH regulated by changes in respiratory rate that result in changes in blood carbon dioxide act within minutes.**
**Changes in pH regulated by altered renal activity act within hours.**
**Now we’ll discuss each of these mechanisms in more detail.**
**Chemical buffers are substances that prevent a sharp change in the pH of a fluid when an acid or base is added to it.**
**Buffers usually include two different chemicals; they are called a buffer pair.**
**“Fixed” acids are buffered mainly by sodium bicarbonate.**
**Changes in blood that result from buffering of “fixed” acids in the tissue capillaries include:**
**The amount of carbonic acid in the blood increases slightly; carbonic acid is indicated in your text as H2CO3.**
**The amount of sodium bicarbonate in the blood decreases; the ratio of the amount of sodium bicarbonate to the amount of carbonic acid does not normally change; that normal ratio is 20:1.**
**The hydrogen ion concentration of blood increases slightly.**
**Blood pH decreases slightly below the arterial level.**
**T The physiological pH control mechanisms influence pH by eliminating substances from the body or retaining substances in the body. There are two types of physiological pH control mechanisms: respiratory mechanism and the urinary mechanism.**
**The respiratory mechanism relies on ventilation to control pH in the body.**
**The amount of carbonic acid in blood is decreased and thereby its hydrogen ion concentration is decreased; this in turn increases blood pH.**
**Respiratory control centers in the brainstem react to dropping pH and promote increased respirations; when the pH increases, then breathing slows.**
**The urinary mechanism of pH control depends on the functioning of the kidneys.**
**The kidneys are the body’s most effective regulator of blood pH.**
**Usually urine is acidified by way of the distal tubules secreting hydrogen ions into the urine from blood, in exchange for bicarbonate being retained in the blood; much of the excess hydrogen ions are secreted as ammonia and ammonium ions.**
**Acidosis and alkalosis are the two kinds of pH, or acid-base, imbalances. Disturbances in acid-base balance depend on the relative quantities of sodium bicarbonate and carbonic acid in the blood.**
**The body can regulate both of the components of the sodium bicarbonate-carbonic acid buffer system.**
**Blood levels of sodium bicarbonate are regulated by the kidneys.**
**Carbonic acid levels are regulated by the lungs.**
**Metabolic and respiratory disturbances can alter the normal 20:1 ratio of sodium bicarbonate to carbonic acid in blood.**
**Metabolic disturbances affect the sodium bicarbonate levels in blood.**
**Metabolic acidosis is a bicarbonate deficit.**
**Metabolic alkalosis, a complication of severe vomiting, is a bicarbonate excess.**
**Respiratory disturbances affect the carbonic acid levels in blood.**
**Respiratory acidosis is a carbonic acid excess.**
**Respiratory alkalosis is a carbonic acid deficit.**
**Compensated acidosis or alkalosis occurs when the body’s pH-balancing mechanisms temporarily counteract an atypical shift in pH.**
**Uncompensated acidosis or alkalosis occurs when the body’s mechanisms have not yet normalized the pH.**
**This concludes the audio review of Chapter 20.**
**## Chapter_019.rtf**
19-4
Audio Chapter Summaries
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
**Patton: Structure & Function of the Body, 17th Edition**
**Chapter 19: Fluid & Electrolyte Balance**
****Audio Chapter Summaries****
****Welcome to the audio review for Chapter 19: Fluid** **&** **Electrolyte Balance.****
**Water is the most abundant body compound.**
**Listings of “average” body water volume in reference tables are based on a healthy, nonobese, 70-kg male.**
**Volume averages 40 L in a 70-kg male: 3 L of plasma; 12 L of interstitial fluid; and 25 L of intracellular fluid.**
**Total body water is distributed among fluid compartments, discussed later.**
**Total volume is related to:**
**The total body weight of an individual and the fat content of the body—the more fat in the body, the less the total water content per kilogram of body weight, because adipose tissue is low in water content.**
**Sex hormones influences total volume as well: the female body has about 10% less water than the male body.**
**Age affects total volume also. In a newborn infant, water may account for 80% of total body weight. In adult males, it is 60% and 50% in adult females. In the elderly, water per kilogram of weight decreases because muscle tissue—high in water—is replaced by fat which is lower in water.**
****The fluids of the body are contained within different “compartments” of the body.****
**The extracellular fluid is called the internal environment of the body; it surrounds cells and transports substances to and from them. This compartment contains plasma, interstitial fluid, and transcellular fluids:**
**Plasma is the liquid part of whole blood;**
**Interstitial fluid surrounds the cells; and**
**Transcellular fluids include lymph; joint fluids; cerebrospinal fluid; and eye humors.**
**Intracellular fluid is the largest fluid compartment.**
**Intracellular means it is located inside of the cells.**
**This fluid serves as solvent to facilitate intracellular chemical reactions.**
**Fluid balance is maintained between fluid intake and fluid output.**
**Sources of fluid intake include the liquids we drink, water in food that we eat, and metabolic water from cellular respiration.**
**Sources of fluid output include water vapor lost during respiration, sweating from the skin, urine from the kidneys, and water lost in the feces. The organs responsible for fluid output are the lungs, skin, kidneys, and large intestine.**
**Three main factors affect plasma, interstitial fluid, and intracellular fluid volumes:**
**Regulating fluid output;**
**Regulating fluid intake; and**
**Exchanging fluid among compartments and around the body.**
**Fluid output, mainly urine volume, adjusts to fluid intake.**
**Antidiuretic hormone (ADH) serves to decrease fluid output.**
**ADH is released from the posterior pituitary gland when extracellular fluid volume is low.**
**ADH promotes water reabsorption from the kidney tubules into the blood.**
**Water is thus retained by the body and less fluid is lost in urine.**
**An aldosterone mechanism decreases fluid output.**
**Aldosterone is released from the adrenal cortex.**
**It increases kidney tubule reabsorption of sodium.**
**Water follows sodium from the kidney tubules into the blood.**
**Water is retained by the extracellular fluid (and total body fluid) by decreasing urine volume.**
**Atrial natriuretic hormone (ANH) increases fluid output.**
**ANH is released from the heart’s atrial wall in response to high blood volume.**
**ANH promotes sodium loss from the blood into the kidney tubules.**
**Water follows sodium from the blood, thus increasing loss of water in urine.**
**Fluid intake is regulated by sensory receptors that detect change in volume and extracellular fluid concentration and send signals to the hypothalamus.**
**Signals from the hypothalamus cause the feeling of thirst, which triggers drinking of fluids to restore balance.**
**The constancy of internal fluid balance is also maintained by exchanging fluids between fluid compartments.**
**Increased capillary blood pressure transfers fluid from blood plasma to interstitial fluid—a fluid shift.**
**Blood plasma protein concentration contributes to osmotic pressure, thus attracting water and holding it in the plasma.**
**Fluid imbalances include dehydration, overhydration, and water intoxication.**
**In dehydration, the total volume of body fluids is below healthy levels.**
**Interstitial fluid volume shrinks first, and then if treatment is not given, intracellular volume and plasma volume decrease.**
**Dehydration occurs when fluid output exceeds intake for an extended period.**
**In overhydration, the total volume of body fluids is larger than needed for healthy survival.**
**Fluid intake exceeds output, and excess volume burdens the pumping action of the heart.**
**Water intoxication is a possibly life-threatening neurological impairment caused by severe overhydration and associated electrolyte imbalance.**
**It is important for you to understand the roles of electrolytes in body fluids.**
**First realize that nonelectrolytes are organic substances that do not break up or dissociate when placed in water solution (e.g., glucose).**
**Electrolytes are compounds that break up or dissociate in water solution into separate particles called ions. (An example is ordinary table salt or sodium chloride.)**
**Ions are the dissociated particles of an electrolyte that carry an electrical charge.**
**Cations are positively charged ions (such as, potassium and sodium ions that each carry one positive charge)**
**Anions are negatively charged ions (such as chloride and bicarbonate that each carry one negative charge, and anionic proteins).**
**Electrolytes are found within body fluids.**
**The extracellular fluid is dominated by sodium ions (which are positive) and chloride ions (which are negative).**
**Intracellular fluid is dominated by potassium ions (positive) and anionic proteins (which are negative)**
**Edema is swelling caused by high interstitial fluid volume.**
**Large volumes of sodium-containing internal secretions are produced daily.**
**Electrolyte imbalances include sodium imbalances, potassium imbalances, and calcium imbalances. Homeostasis of electrolytes is related to “intake” and “output” of electrolytes and also absorption and distribution of electrolytes in body fluids and availability for use by body cells.**
**Sodium imbalances are hypernatremia (high blood sodium) or hyponatremia (low blood sodium).**
**Hypernatremia is blood sodium more than 145 mEq/L.**
**It is characterized by relative deficit of water to salt in extracellular fluid.**
**Causes include overuse of salt tablets; dehydration; and prolonged diarrhea.**
**Hyponatremia is a blood sodium less than 136 mEq/L.**
**It results when there is relatively too much water in the extracellular fluid for the amount of sodium present.**
**Causes of hyponatremia include excessive secretion of antidiuretic hormone, massive infusion of sodium-free intravenous solution, burns, and prolonged use of certain diuretics.**
**Symptoms of both hypernatremia and hyponatremia are related to central nervous system malfunction and include headache, confusion, seizures, and coma.**
**Potassium imbalances are hyperkalemia (high blood potassium) or hypokalemia (low blood potassium).**
**Hyperkalemia is blood potassium more than 5.1 mEq/L.**
**Causes include increased intake, shift of potassium from intracellular fluid to blood caused by tissue trauma and burns, and renal failure.**
**Clinical signs of hyperkalemia are related to muscle malfunction and include skeletal muscle weakness, paralysis, and cardiac arrest.**
**Hypokalemia is blood potassium less than 3.5 mEq/L.**
**Causes include fasting, diets low in potassium, abuse of laxatives and certain diuretics, diarrhea, vomiting, and gastric suction.**
**Clinical signs include skeletal muscle and cardiac problems; smooth muscle weakness causing abdominal distention, and slow rate of passage of gastrointestinal contents.**
**Calcium imbalances are hypercalcemia (high blood calcium) or hypocalcemia (low blood calcium).**
**Hypercalcemia is a blood calcium level more than 10.5 mg/dL.**
**It is caused by excessive intake, increased absorption, shifts of calcium from bone to extracellular fluid, Paget disease and other bone tumors, and hyperparathyroidism.**
**Clinical signs are related to decreased neuromuscular activity, and include fatigue, muscle weakness, diminished reflexes, and cardiac problems.**
**Hypocalcemia is a blood calcium level less than 8.4 mg/dL.**
**It is caused by dietary deficiency, decreased absorption or availability, increased excretion, pancreatitis, hypoparathyroidism, rickets, osteomalacia, and renal insufficiency.**
**Clinical signs of hypocalcemia are related to increased neuromuscular irritability, such as cramping, muscle twitching, hyperactive reflexes, and abnormal cardiac rhythms.**
**This concludes the audio review of Chapter 19.**
**20260410_231203.jpg**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20260410-231203-jpg)
**20260410_231203.jpg**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20260410-231203-jpg)
**## Chapter_020.rtf**
20-3
Audio Chapter Summaries
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
**Patton: Structure & Function of the Body, 17th Edition**
**Chapter 20: Acid-Base Balance**
****Audio Chapter Summaries****
****Welcome to the audio review of Chapter 20: Acid-Base Balance.****
**As a reminder, you see hydrogen ions in your text indicated by “H+”, but they are referred to as hydrogen ions in this audio script. Similarly, you have seen “OH−” to indicate hydroxide ions, but this audio program refers to them as hydroxide ions.**
**First, we will review information about the pH of body fluids.**
**pH is a number that indicates the relative hydrogen ion concentration (as compared with hydroxide ion concentration) of a fluid.**
**A pH of 7.0 indicates neutrality or a neutral solution.**
**A pH higher than 7.0 indicates alkalinity or an alkaline or basic solution; a base.**
**A pH less than 7.0 indicates acidity or an acid solution.**
**Typical range of blood pH is approximately 7.35 to 7.45.**
**Systemic arterial blood pH is about 7.4.**
**Systemic venous blood pH is about 7.37.**
**The pH scale is based on multiples of 10.**
**The hydrogen ion concentration changes**
**_by 10 times_ for each one pH unit.**
**The difference between pH 7 and pH 6 is a 10-**
**_fold_ increase in hydrogen ions. Moving from pH 7 to pH 5 is a**
**_100-_ _fold_ increase in hydrogen ion concentration.**
**Thus, large pH fluctuations may appear small on the pH scale.**
**Two coordinated homeostatic mechanisms act to maintain the normal pH of body fluids and prevent pH swings when excess acids or bases are present: chemical pH control mechanisms and physiological pH control mechanisms.**
**A chemical pH control mechanism, based on buffers in blood, red blood cells, and body fluids, acts immediately.**
**Physiological pH control mechanisms come from the respiratory and renal systems.**
**Changes in pH regulated by changes in respiratory rate that result in changes in blood carbon dioxide act within minutes.**
**Changes in pH regulated by altered renal activity act within hours.**
**Now we’ll discuss each of these mechanisms in more detail.**
**Chemical buffers are substances that prevent a sharp change in the pH of a fluid when an acid or base is added to it.**
**Buffers usually include two different chemicals; they are called a buffer pair.**
**“Fixed” acids are buffered mainly by sodium bicarbonate.**
**Changes in blood that result from buffering of “fixed” acids in the tissue capillaries include:**
**The amount of carbonic acid in the blood increases slightly; carbonic acid is indicated in your text as H2CO3.**
**The amount of sodium bicarbonate in the blood decreases; the ratio of the amount of sodium bicarbonate to the amount of carbonic acid does not normally change; that normal ratio is 20:1.**
**The hydrogen ion concentration of blood increases slightly.**
**Blood pH decreases slightly below the arterial level.**
**T The physiological pH control mechanisms influence pH by eliminating substances from the body or retaining substances in the body. There are two types of physiological pH control mechanisms: respiratory mechanism and the urinary mechanism.**
**The respiratory mechanism relies on ventilation to control pH in the body.**
**The amount of carbonic acid in blood is decreased and thereby its hydrogen ion concentration is decreased; this in turn increases blood pH.**
**Respiratory control centers in the brainstem react to dropping pH and promote increased respirations; when the pH increases, then breathing slows.**
**The urinary mechanism of pH control depends on the functioning of the kidneys.**
**The kidneys are the body’s most effective regulator of blood pH.**
**Usually urine is acidified by way of the distal tubules secreting hydrogen ions into the urine from blood, in exchange for bicarbonate being retained in the blood; much of the excess hydrogen ions are secreted as ammonia and ammonium ions.**
**Acidosis and alkalosis are the two kinds of pH, or acid-base, imbalances. Disturbances in acid-base balance depend on the relative quantities of sodium bicarbonate and carbonic acid in the blood.**
**The body can regulate both of the components of the sodium bicarbonate-carbonic acid buffer system.**
**Blood levels of sodium bicarbonate are regulated by the kidneys.**
**Carbonic acid levels are regulated by the lungs.**
**Metabolic and respiratory disturbances can alter the normal 20:1 ratio of sodium bicarbonate to carbonic acid in blood.**
**Metabolic disturbances affect the sodium bicarbonate levels in blood.**
**Metabolic acidosis is a bicarbonate deficit.**
**Metabolic alkalosis, a complication of severe vomiting, is a bicarbonate excess.**
**Respiratory disturbances affect the carbonic acid levels in blood.**
**Respiratory acidosis is a carbonic acid excess.**
**Respiratory alkalosis is a carbonic acid deficit.**
**Compensated acidosis or alkalosis occurs when the body’s pH-balancing mechanisms temporarily counteract an atypical shift in pH.**
**Uncompensated acidosis or alkalosis occurs when the body’s mechanisms have not yet normalized the pH.**
**This concludes the audio review of Chapter 20.**
**## Chapter_019.rtf**
19-4
Audio Chapter Summaries
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
**Patton: Structure & Function of the Body, 17th Edition**
**Chapter 19: Fluid & Electrolyte Balance**
****Audio Chapter Summaries****
****Welcome to the audio review for Chapter 19: Fluid** **&** **Electrolyte Balance.****
**Water is the most abundant body compound.**
**Listings of “average” body water volume in reference tables are based on a healthy, nonobese, 70-kg male.**
**Volume averages 40 L in a 70-kg male: 3 L of plasma; 12 L of interstitial fluid; and 25 L of intracellular fluid.**
**Total body water is distributed among fluid compartments, discussed later.**
**Total volume is related to:**
**The total body weight of an individual and the fat content of the body—the more fat in the body, the less the total water content per kilogram of body weight, because adipose tissue is low in water content.**
**Sex hormones influences total volume as well: the female body has about 10% less water than the male body.**
**Age affects total volume also. In a newborn infant, water may account for 80% of total body weight. In adult males, it is 60% and 50% in adult females. In the elderly, water per kilogram of weight decreases because muscle tissue—high in water—is replaced by fat which is lower in water.**
****The fluids of the body are contained within different “compartments” of the body.****
**The extracellular fluid is called the internal environment of the body; it surrounds cells and transports substances to and from them. This compartment contains plasma, interstitial fluid, and transcellular fluids:**
**Plasma is the liquid part of whole blood;**
**Interstitial fluid surrounds the cells; and**
**Transcellular fluids include lymph; joint fluids; cerebrospinal fluid; and eye humors.**
**Intracellular fluid is the largest fluid compartment.**
**Intracellular means it is located inside of the cells.**
**This fluid serves as solvent to facilitate intracellular chemical reactions.**
**Fluid balance is maintained between fluid intake and fluid output.**
**Sources of fluid intake include the liquids we drink, water in food that we eat, and metabolic water from cellular respiration.**
**Sources of fluid output include water vapor lost during respiration, sweating from the skin, urine from the kidneys, and water lost in the feces. The organs responsible for fluid output are the lungs, skin, kidneys, and large intestine.**
**Three main factors affect plasma, interstitial fluid, and intracellular fluid volumes:**
**Regulating fluid output;**
**Regulating fluid intake; and**
**Exchanging fluid among compartments and around the body.**
**Fluid output, mainly urine volume, adjusts to fluid intake.**
**Antidiuretic hormone (ADH) serves to decrease fluid output.**
**ADH is released from the posterior pituitary gland when extracellular fluid volume is low.**
**ADH promotes water reabsorption from the kidney tubules into the blood.**
**Water is thus retained by the body and less fluid is lost in urine.**
**An aldosterone mechanism decreases fluid output.**
**Aldosterone is released from the adrenal cortex.**
**It increases kidney tubule reabsorption of sodium.**
**Water follows sodium from the kidney tubules into the blood.**
**Water is retained by the extracellular fluid (and total body fluid) by decreasing urine volume.**
**Atrial natriuretic hormone (ANH) increases fluid output.**
**ANH is released from the heart’s atrial wall in response to high blood volume.**
**ANH promotes sodium loss from the blood into the kidney tubules.**
**Water follows sodium from the blood, thus increasing loss of water in urine.**
**Fluid intake is regulated by sensory receptors that detect change in volume and extracellular fluid concentration and send signals to the hypothalamus.**
**Signals from the hypothalamus cause the feeling of thirst, which triggers drinking of fluids to restore balance.**
**The constancy of internal fluid balance is also maintained by exchanging fluids between fluid compartments.**
**Increased capillary blood pressure transfers fluid from blood plasma to interstitial fluid—a fluid shift.**
**Blood plasma protein concentration contributes to osmotic pressure, thus attracting water and holding it in the plasma.**
**Fluid imbalances include dehydration, overhydration, and water intoxication.**
**In dehydration, the total volume of body fluids is below healthy levels.**
**Interstitial fluid volume shrinks first, and then if treatment is not given, intracellular volume and plasma volume decrease.**
**Dehydration occurs when fluid output exceeds intake for an extended period.**
**In overhydration, the total volume of body fluids is larger than needed for healthy survival.**
**Fluid intake exceeds output, and excess volume burdens the pumping action of the heart.**
**Water intoxication is a possibly life-threatening neurological impairment caused by severe overhydration and associated electrolyte imbalance.**
**It is important for you to understand the roles of electrolytes in body fluids.**
**First realize that nonelectrolytes are organic substances that do not break up or dissociate when placed in water solution (e.g., glucose).**
**Electrolytes are compounds that break up or dissociate in water solution into separate particles called ions. (An example is ordinary table salt or sodium chloride.)**
**Ions are the dissociated particles of an electrolyte that carry an electrical charge.**
**Cations are positively charged ions (such as, potassium and sodium ions that each carry one positive charge)**
**Anions are negatively charged ions (such as chloride and bicarbonate that each carry one negative charge, and anionic proteins).**
**Electrolytes are found within body fluids.**
**The extracellular fluid is dominated by sodium ions (which are positive) and chloride ions (which are negative).**
**Intracellular fluid is dominated by potassium ions (positive) and anionic proteins (which are negative)**
**Edema is swelling caused by high interstitial fluid volume.**
**Large volumes of sodium-containing internal secretions are produced daily.**
**Electrolyte imbalances include sodium imbalances, potassium imbalances, and calcium imbalances. Homeostasis of electrolytes is related to “intake” and “output” of electrolytes and also absorption and distribution of electrolytes in body fluids and availability for use by body cells.**
**Sodium imbalances are hypernatremia (high blood sodium) or hyponatremia (low blood sodium).**
**Hypernatremia is blood sodium more than 145 mEq/L.**
**It is characterized by relative deficit of water to salt in extracellular fluid.**
**Causes include overuse of salt tablets; dehydration; and prolonged diarrhea.**
**Hyponatremia is a blood sodium less than 136 mEq/L.**
**It results when there is relatively too much water in the extracellular fluid for the amount of sodium present.**
**Causes of hyponatremia include excessive secretion of antidiuretic hormone, massive infusion of sodium-free intravenous solution, burns, and prolonged use of certain diuretics.**
**Symptoms of both hypernatremia and hyponatremia are related to central nervous system malfunction and include headache, confusion, seizures, and coma.**
**Potassium imbalances are hyperkalemia (high blood potassium) or hypokalemia (low blood potassium).**
**Hyperkalemia is blood potassium more than 5.1 mEq/L.**
**Causes include increased intake, shift of potassium from intracellular fluid to blood caused by tissue trauma and burns, and renal failure.**
**Clinical signs of hyperkalemia are related to muscle malfunction and include skeletal muscle weakness, paralysis, and cardiac arrest.**
**Hypokalemia is blood potassium less than 3.5 mEq/L.**
**Causes include fasting, diets low in potassium, abuse of laxatives and certain diuretics, diarrhea, vomiting, and gastric suction.**
**Clinical signs include skeletal muscle and cardiac problems; smooth muscle weakness causing abdominal distention, and slow rate of passage of gastrointestinal contents.**
**Calcium imbalances are hypercalcemia (high blood calcium) or hypocalcemia (low blood calcium).**
**Hypercalcemia is a blood calcium level more than 10.5 mg/dL.**
**It is caused by excessive intake, increased absorption, shifts of calcium from bone to extracellular fluid, Paget disease and other bone tumors, and hyperparathyroidism.**
**Clinical signs are related to decreased neuromuscular activity, and include fatigue, muscle weakness, diminished reflexes, and cardiac problems.**
**Hypocalcemia is a blood calcium level less than 8.4 mg/dL.**
**It is caused by dietary deficiency, decreased absorption or availability, increased excretion, pancreatitis, hypoparathyroidism, rickets, osteomalacia, and renal insufficiency.**
**Clinical signs of hypocalcemia are related to increased neuromuscular irritability, such as cramping, muscle twitching, hyperactive reflexes, and abnormal cardiac rhythms.**
**This concludes the audio review of Chapter 19.**
**20260410_231203.jpg**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20260410-231203-jpg)
**## Chapter_020.rtf**
20-3
Audio Chapter Summaries
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
**Patton: Structure & Function of the Body, 17th Edition**
**Chapter 20: Acid-Base Balance**
****Audio Chapter Summaries****
****Welcome to the audio review of Chapter 20: Acid-Base Balance.****
**As a reminder, you see hydrogen ions in your text indicated by “H+”, but they are referred to as hydrogen ions in this audio script. Similarly, you have seen “OH−” to indicate hydroxide ions, but this audio program refers to them as hydroxide ions.**
**First, we will review information about the pH of body fluids.**
**pH is a number that indicates the relative hydrogen ion concentration (as compared with hydroxide ion concentration) of a fluid.**
**A pH of 7.0 indicates neutrality or a neutral solution.**
**A pH higher than 7.0 indicates alkalinity or an alkaline or basic solution; a base.**
**A pH less than 7.0 indicates acidity or an acid solution.**
**Typical range of blood pH is approximately 7.35 to 7.45.**
**Systemic arterial blood pH is about 7.4.**
**Systemic venous blood pH is about 7.37.**
**The pH scale is based on multiples of 10.**
**The hydrogen ion concentration changes**
**_by 10 times_ for each one pH unit.**
**The difference between pH 7 and pH 6 is a 10-**
**_fold_ increase in hydrogen ions. Moving from pH 7 to pH 5 is a**
**_100-_ _fold_ increase in hydrogen ion concentration.**
**Thus, large pH fluctuations may appear small on the pH scale.**
**Two coordinated homeostatic mechanisms act to maintain the normal pH of body fluids and prevent pH swings when excess acids or bases are present: chemical pH control mechanisms and physiological pH control mechanisms.**
**A chemical pH control mechanism, based on buffers in blood, red blood cells, and body fluids, acts immediately.**
**Physiological pH control mechanisms come from the respiratory and renal systems.**
**Changes in pH regulated by changes in respiratory rate that result in changes in blood carbon dioxide act within minutes.**
**Changes in pH regulated by altered renal activity act within hours.**
**Now we’ll discuss each of these mechanisms in more detail.**
**Chemical buffers are substances that prevent a sharp change in the pH of a fluid when an acid or base is added to it.**
**Buffers usually include two different chemicals; they are called a buffer pair.**
**“Fixed” acids are buffered mainly by sodium bicarbonate.**
**Changes in blood that result from buffering of “fixed” acids in the tissue capillaries include:**
**The amount of carbonic acid in the blood increases slightly; carbonic acid is indicated in your text as H2CO3.**
**The amount of sodium bicarbonate in the blood decreases; the ratio of the amount of sodium bicarbonate to the amount of carbonic acid does not normally change; that normal ratio is 20:1.**
**The hydrogen ion concentration of blood increases slightly.**
**Blood pH decreases slightly below the arterial level.**
**T The physiological pH control mechanisms influence pH by eliminating substances from the body or retaining substances in the body. There are two types of physiological pH control mechanisms: respiratory mechanism and the urinary mechanism.**
**The respiratory mechanism relies on ventilation to control pH in the body.**
**The amount of carbonic acid in blood is decreased and thereby its hydrogen ion concentration is decreased; this in turn increases blood pH.**
**Respiratory control centers in the brainstem react to dropping pH and promote increased respirations; when the pH increases, then breathing slows.**
**The urinary mechanism of pH control depends on the functioning of the kidneys.**
**The kidneys are the body’s most effective regulator of blood pH.**
**Usually urine is acidified by way of the distal tubules secreting hydrogen ions into the urine from blood, in exchange for bicarbonate being retained in the blood; much of the excess hydrogen ions are secreted as ammonia and ammonium ions.**
**Acidosis and alkalosis are the two kinds of pH, or acid-base, imbalances. Disturbances in acid-base balance depend on the relative quantities of sodium bicarbonate and carbonic acid in the blood.**
**The body can regulate both of the components of the sodium bicarbonate-carbonic acid buffer system.**
**Blood levels of sodium bicarbonate are regulated by the kidneys.**
**Carbonic acid levels are regulated by the lungs.**
**Metabolic and respiratory disturbances can alter the normal 20:1 ratio of sodium bicarbonate to carbonic acid in blood.**
**Metabolic disturbances affect the sodium bicarbonate levels in blood.**
**Metabolic acidosis is a bicarbonate deficit.**
**Metabolic alkalosis, a complication of severe vomiting, is a bicarbonate excess.**
**Respiratory disturbances affect the carbonic acid levels in blood.**
**Respiratory acidosis is a carbonic acid excess.**
**Respiratory alkalosis is a carbonic acid deficit.**
**Compensated acidosis or alkalosis occurs when the body’s pH-balancing mechanisms temporarily counteract an atypical shift in pH.**
**Uncompensated acidosis or alkalosis occurs when the body’s mechanisms have not yet normalized the pH.**
**This concludes the audio review of Chapter 20.**
**## Chapter_019.rtf**
19-4
Audio Chapter Summaries
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
Copyright © 2025 by Elsevier Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies.
**Patton: Structure & Function of the Body, 17th Edition**
**Chapter 19: Fluid & Electrolyte Balance**
****Audio Chapter Summaries****
****Welcome to the audio review for Chapter 19: Fluid** **&** **Electrolyte Balance.****
**Water is the most abundant body compound.**
**Listings of “average” body water volume in reference tables are based on a healthy, nonobese, 70-kg male.**
**Volume averages 40 L in a 70-kg male: 3 L of plasma; 12 L of interstitial fluid; and 25 L of intracellular fluid.**
**Total body water is distributed among fluid compartments, discussed later.**
**Total volume is related to:**
**The total body weight of an individual and the fat content of the body—the more fat in the body, the less the total water content per kilogram of body weight, because adipose tissue is low in water content.**
**Sex hormones influences total volume as well: the female body has about 10% less water than the male body.**
**Age affects total volume also. In a newborn infant, water may account for 80% of total body weight. In adult males, it is 60% and 50% in adult females. In the elderly, water per kilogram of weight decreases because muscle tissue—high in water—is replaced by fat which is lower in water.**
****The fluids of the body are contained within different “compartments” of the body.****
**The extracellular fluid is called the internal environment of the body; it surrounds cells and transports substances to and from them. This compartment contains plasma, interstitial fluid, and transcellular fluids:**
**Plasma is the liquid part of whole blood;**
**Interstitial fluid surrounds the cells; and**
**Transcellular fluids include lymph; joint fluids; cerebrospinal fluid; and eye humors.**
**Intracellular fluid is the largest fluid compartment.**
**Intracellular means it is located inside of the cells.**
**This fluid serves as solvent to facilitate intracellular chemical reactions.**
**Fluid balance is maintained between fluid intake and fluid output.**
**Sources of fluid intake include the liquids we drink, water in food that we eat, and metabolic water from cellular respiration.**
**Sources of fluid output include water vapor lost during respiration, sweating from the skin, urine from the kidneys, and water lost in the feces. The organs responsible for fluid output are the lungs, skin, kidneys, and large intestine.**
**Three main factors affect plasma, interstitial fluid, and intracellular fluid volumes:**
**Regulating fluid output;**
**Regulating fluid intake; and**
**Exchanging fluid among compartments and around the body.**
**Fluid output, mainly urine volume, adjusts to fluid intake.**
**Antidiuretic hormone (ADH) serves to decrease fluid output.**
**ADH is released from the posterior pituitary gland when extracellular fluid volume is low.**
**ADH promotes water reabsorption from the kidney tubules into the blood.**
**Water is thus retained by the body and less fluid is lost in urine.**
**An aldosterone mechanism decreases fluid output.**
**Aldosterone is released from the adrenal cortex.**
**It increases kidney tubule reabsorption of sodium.**
**Water follows sodium from the kidney tubules into the blood.**
**Water is retained by the extracellular fluid (and total body fluid) by decreasing urine volume.**
**Atrial natriuretic hormone (ANH) increases fluid output.**
**ANH is released from the heart’s atrial wall in response to high blood volume.**
**ANH promotes sodium loss from the blood into the kidney tubules.**
**Water follows sodium from the blood, thus increasing loss of water in urine.**
**Fluid intake is regulated by sensory receptors that detect change in volume and extracellular fluid concentration and send signals to the hypothalamus.**
**Signals from the hypothalamus cause the feeling of thirst, which triggers drinking of fluids to restore balance.**
**The constancy of internal fluid balance is also maintained by exchanging fluids between fluid compartments.**
**Increased capillary blood pressure transfers fluid from blood plasma to interstitial fluid—a fluid shift.**
**Blood plasma protein concentration contributes to osmotic pressure, thus attracting water and holding it in the plasma.**
**Fluid imbalances include dehydration, overhydration, and water intoxication.**
**In dehydration, the total volume of body fluids is below healthy levels.**
**Interstitial fluid volume shrinks first, and then if treatment is not given, intracellular volume and plasma volume decrease.**
**Dehydration occurs when fluid output exceeds intake for an extended period.**
**In overhydration, the total volume of body fluids is larger than needed for healthy survival.**
**Fluid intake exceeds output, and excess volume burdens the pumping action of the heart.**
**Water intoxication is a possibly life-threatening neurological impairment caused by severe overhydration and associated electrolyte imbalance.**
**It is important for you to understand the roles of electrolytes in body fluids.**
**First realize that nonelectrolytes are organic substances that do not break up or dissociate when placed in water solution (e.g., glucose).**
**Electrolytes are compounds that break up or dissociate in water solution into separate particles called ions. (An example is ordinary table salt or sodium chloride.)**
**Ions are the dissociated particles of an electrolyte that carry an electrical charge.**
**Cations are positively charged ions (such as, potassium and sodium ions that each carry one positive charge)**
**Anions are negatively charged ions (such as chloride and bicarbonate that each carry one negative charge, and anionic proteins).**
**Electrolytes are found within body fluids.**
**The extracellular fluid is dominated by sodium ions (which are positive) and chloride ions (which are negative).**
**Intracellular fluid is dominated by potassium ions (positive) and anionic proteins (which are negative)**
**Edema is swelling caused by high interstitial fluid volume.**
**Large volumes of sodium-containing internal secretions are produced daily.**
**Electrolyte imbalances include sodium imbalances, potassium imbalances, and calcium imbalances. Homeostasis of electrolytes is related to “intake” and “output” of electrolytes and also absorption and distribution of electrolytes in body fluids and availability for use by body cells.**
**Sodium imbalances are hypernatremia (high blood sodium) or hyponatremia (low blood sodium).**
**Hypernatremia is blood sodium more than 145 mEq/L.**
**It is characterized by relative deficit of water to salt in extracellular fluid.**
**Causes include overuse of salt tablets; dehydration; and prolonged diarrhea.**
**Hyponatremia is a blood sodium less than 136 mEq/L.**
**It results when there is relatively too much water in the extracellular fluid for the amount of sodium present.**
**Causes of hyponatremia include excessive secretion of antidiuretic hormone, massive infusion of sodium-free intravenous solution, burns, and prolonged use of certain diuretics.**
**Symptoms of both hypernatremia and hyponatremia are related to central nervous system malfunction and include headache, confusion, seizures, and coma.**
**Potassium imbalances are hyperkalemia (high blood potassium) or hypokalemia (low blood potassium).**
**Hyperkalemia is blood potassium more than 5.1 mEq/L.**
**Causes include increased intake, shift of potassium from intracellular fluid to blood caused by tissue trauma and burns, and renal failure.**
**Clinical signs of hyperkalemia are related to muscle malfunction and include skeletal muscle weakness, paralysis, and cardiac arrest.**
**Hypokalemia is blood potassium less than 3.5 mEq/L.**
**Causes include fasting, diets low in potassium, abuse of laxatives and certain diuretics, diarrhea, vomiting, and gastric suction.**
**Clinical signs include skeletal muscle and cardiac problems; smooth muscle weakness causing abdominal distention, and slow rate of passage of gastrointestinal contents.**
**Calcium imbalances are hypercalcemia (high blood calcium) or hypocalcemia (low blood calcium).**
**Hypercalcemia is a blood calcium level more than 10.5 mg/dL.**
**It is caused by excessive intake, increased absorption, shifts of calcium from bone to extracellular fluid, Paget disease and other bone tumors, and hyperparathyroidism.**
**Clinical signs are related to decreased neuromuscular activity, and include fatigue, muscle weakness, diminished reflexes, and cardiac problems.**
**Hypocalcemia is a blood calcium level less than 8.4 mg/dL.**
**It is caused by dietary deficiency, decreased absorption or availability, increased excretion, pancreatitis, hypoparathyroidism, rickets, osteomalacia, and renal insufficiency.**
**Clinical signs of hypocalcemia are related to increased neuromuscular irritability, such as cramping, muscle twitching, hyperactive reflexes, and abnormal cardiac rhythms.**
**This concludes the audio review of Chapter 19.**
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