Body Fluids and Electrophysiology: Download A Copy of This Study Guide
Body Fluids and Electrophysiology: Download A Copy of This Study Guide
Body Fluids and Electrophysiology: Download A Copy of This Study Guide
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BODY FLUIDS
TOTAL BODY WATER: About 57%, in liters, of body weight in kilograms. Or 72% of lean mass.
EXTRACELLULAR: About 40% of total body water.
PLASMA: About 22.5% of extracellular water.
ECS: The remaining portion of extracellular fluids.
INTRACELLULAR: About 60% of total body water.
OBESITY lowers your total body water, because you have a smaller lean mass.
We want to know the concentration that would have been measured, if the indicator had been
distributed instantaneously. Therefore we extrapolate the linear part of the curve back to time zero.
TOTAL BODY WATER?
Tritiated Water. You have to use the extrapolation method to measure, though, as it takes a
long time for tritiated water to distribute to all body compartments.
If you use 3H2O, it takes a long time get results.
Radiosulfate: It will distribute into the extracellular space within an hour, so it is quicker. It
can also be used to measure plasma volume.
EXTRACELLULAR VOLUME?
Large molecules like inulin and mannitol tend to stay in the plasma, while small ions tend to
get into the intracellular spaces.
Mannitol is the best indicator we have for ECS, and was used in one of the problems.
Radiosulfate is used to determine extracellular volume.
TRANSCELLULAR WATER? These are special body compartments, separate from ICS, ECS,
and plasma.
EXAMPLES:
Cerebrospinal Fluid
Fluid in the GI Tract
Bladder
Intraocular Fluids
Fluid in potential spaces (pathological) such as the pericardial or pleural sacs.
This volume of fluid is small and is not normally considered in measurements, but should be
kept in mind, especially in cases of pathology.
PLASMA VOLUME?
Evans Blue Dye: It binds to serum proteins in bloodstream as soon as it is injected.
Radioiodinated Serum Albumin (RISA): RISA is also a large protein that stays in the
bloodstream.
INTRACELLULAR VOLUME?
Cannot be measured by any direct method, but can be determined by elimination.
Water flows from solution of low osmotic pressure to high osmotic pressure.
If you add an ISOTONIC solution to the body, all (most) the water will remain in the extracellular
spaces, as you have not changed the concentration gradient and there will be no net movement of
water after addition of the new fluid.
Add a HYPOTONIC solution, and water will move into the intracellular spaces.
Add a HYPERTONIC solution, and you will draw additional water out of the intracellular spaces
into the extracellular space.
Principles:
Over the whole body, water moves rapidly to equilibrate any osmolarity difference between
extracellular and intracellular spaces.
Unless solute is added or removed, the amount (but not necessarily concentration) of solute in
a compartment remains constant.
Sodium and Chloride are confined to the extracellular space.
In an equilibrated system, the movement of water will follow the movement of solute into or
out of cells.
At equilibrium, pure water is distributed to body compartment according to the total solute content
in each compartment.
So, if we have 50% of all impermeable solutes in the extracellular spaces and 50% in the
intracellular spaces. Then 50% of total volume after addition will be in each respective space
after equilibrium.
MEMBRANE PERMEABILITY:
Small ions (Na+ and K+) have very limited permeability through the membrane directly, i.e. through
small, transient, water-filled holes in the membrane. They are not completely impermeable.
DIFFUSION: Movement of a substance with its concentration gradient, due to random thermal
motion over time.
FLUX = the amount of solute that crosses a given area in a given amount of time, in millimoles
/cm2sec.
The flux is proportional to, and has the opposite sign of, the electrochemical gradient.
Fick Diffusion Equation: For a non-electrolyte, J = -P DeltaC = -(Permeability)
(Concentration Gradient).
So, flux is proportional to the permeability of a substance through the membrane, and the
concentration gradient.
THICKER MEMBRANE ------> Greater Area ------> Lower Permeability ------> Lower Flux
------> Lower Concentration Gradient
No energy required
With concentration gradient
There is a saturation point, when all channels are occupied
Competition among solutes. You can slow down glucose flux by adding galactose to the system
(assuming galactose can get through it).
The Na/K ATPAse creates the concentration gradient: three Na out for every two K in.
The Na gradient thus created, there is a Na/Glucose symport into the cell, to transport glucose into
the cell, against glucose's concentration gradient.
CHOLERA: Patient treated with glucose and sodium chloride in water. This allows patient to absorb
water along with the glucose and sodium.
RENAL GLYCOSURIA: Excretion of some glucose into urine, due to a defective (lower saturation point)
Na/Glucose symport in the kidneys.
OUABAIN: A cardiac glycoside that inhibits the sodium pump. Ouabain is used to treat "cardiac
insufficiency."
It blocks the Na+ pump ------> Na+ levels of inside of cell go up ------> More becomes available for
the Na+/Ca+2 Pump ------> Intracellular levels of Ca+2 go up as a result ------> Cardiac muscle
contractility increases
CELL VOLUME REGULATION: In the absence of active transport, cells tend to swell, due to
impermeable solutes in the cell.
The Sodium pump makes sodium behave as though it were an impermeable solute, as it constantly
restores any small amounts of Na+ that leak into the cell. This effect is important to maintain fluid /
volume homeostasis.
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ELECTROPHYSIOLOGY
Conc = Concentration of the ion (Molarity) inside and outside the membrane.
NERNST (CHEMICAL) POTENTIAL: An ions chemical potential. The energy an ion would generate if
it alone moved across the membrane with its concentration gradient.
K+ has a negative Nernst Potential (-90mV). It would generate a relative negative charge on the
inside if it moved across the membrane.
Positive charge would leave the cell.
Na+ has a positive Nernst Potential (+40mV). It would generate a relative positive charge on the
inside if it moved across the membrane.
Positive charge would enter the cell.
Cl- has a relative negative Nernst Potential. It would generate a relative negative charge on the
inside if it moved across the membrane.
Negative charge would enter the cell.
ELECTRICAL POTENTIAL: The energy an ion would create if it moved with its electrical gradient.
This is dependent on the volt potential of the membrane.
A positive volt potential means there is more positive charge on the inside of the membrane.
This would make positive ions want to leave the cell.
This would make negative ions want to enter the cell.
A negative volt potential means there is a negative charge on the inside of the membrane.
This would make positive ions want to enter the cell.
This would make negative ions want to leave the cell.
Electrochemical Potential:
Positive: There is relative positive electrochemical force on the inside, so positive charge
wants to move outward.
Negative: There is relative negative electrochemical force on the inside, so positive charge
wants to move inward.
Membrane Potential: The relative difference in charge on both sides of the membrane.
Positive: There is positive charge on the inside, so positive charge wants to move outward.
Negative: There is negative charge on the inside, so positive charge wants to move inward.
Chemical Potential: The membrane potential that would be created if an ion were to move with its
concentration gradient.
Positive: Positive charge would move inside to go with its concentration gradient, as that
would create a positive electric potential.
Negative: Positive charge would move outside to go with its concentration gradient, as that
would create a negative electric potential.
VOLT-CURRENT RELATIONSHIPS: Plot of voltage -vs- current for each type of ion. The X-Axis is
voltage and the Y-Axis is current.
Zero-current, i.e. when the line crosses the X-Axis, occurs at the Nernst Potential for the ion.
That is, when there is no current, the net voltage is equal to the Nernst Potential, DeltaE = 0 - E = E
Conductance is proportional to the slope of the ion-current relationship.
The higher the conductance, the steeper the slope.
Conductance is dependent on the permeability of the membrane -- i.e. on the number of open
channels for the particular ion.
CURRENT:
POSITIVE CURRENT: Means that net positive charge is leaving the cell.
NEGATIVE CURRENT: Means that net positive charge is coming in the cell.
The sign of an ion's current is always the same as its electrochemical potential.
EXAMPLE: Consider a membrane potential (Electrical Energy, V) of -70.
K+ Nernst Potential: EK = -90mV
K+ electrochemical potential = V - E = +20mV
K+ has positive current; it will go out of the cell
Na+ Nernst Potential: Ena = +40 mV
Na+ electrochemical potential = V- E = -110mV
Na+ has negative current; it will come in the cell strongly
Cl- Nernst Potential: Ecl = -50 mV
Cl- electrochemical potential = V- E = -20mV
Cl- has negative current: It will result in net positive charge coming into the cell.
The electrical energy of -70mV will drive Cl- out of the cell, and it stronger than the
counteracting chemical energy of -20mV to bring Cl- in the cell.
Hence more Cl- will leave the cell, against its chemical gradient (but not
electrochemical gradient)
Current Sum: The membrane potential of a cell will be equal to sum of the individual currents of a
cell, each one times its own fractional conductance:
When the current sum is negative, positive charge wants to enter the cell, so the cell's
membrane potential becomes more positive.
EXAMPLE: Increase extracellular level of potassium ------> more K+ enters the cell ---
---> resting potential goes up.
When the current sum is positive, positive charge wants to leave the cell, so the cell's
membrane potential becomes more negative.
EXAMPLE: Decrease extracellular level of potassium ------> more net K+ will leave
the cell ------> resting potential will go down.
SINGLE CURRENT: The membrane potential of a cell with only one type of ion channel is the
Nernst potential for that ion.
Corollary: When the membrane potential is equal to the Nernst potential for an ion, then there
is no net current.
Say we have a membrane, permeable only to K+, with a membrane potential (V) of
-70mV.
That means there is net negative charge on inside of cell, making K+ want to
come inside cell.
The K+ ion furthermore has a Nernst Potential (E) of -70mV.
That means that the K+ wants to leave the cell, leaving a net negative charge on
the inside if it left.
If Nernst Potential is equal to electrical potential, then electrochemical potential is zero
and the cell is balanced.
Math: DeltaE = -70mV - (-70mV) = 0
Sum current is inversely related to potential. When current becomes more positive, the
electrochemical potential becomes more negative, and vice versa.
CHANNEL-STATE CONSIDERATIONS:
ACTION POTENTIALS:
THRESHOLD
Threshold occurs when there is more sodium moving into the cell than there is potassium
moving out of the cell.
Both sodium and potassium are voltage-gated, but the voltage-level required to open
potassium channels is significantly more positive.
How to affect the threshold level:
If you make the membrane more permeable to potassium, then the threshold will go up
-- i.e. a higher starting voltage will be required so that a sufficient number of sodium
channels will be open to counteract the extra potassium conductance.
Value of Threshold Potential: It is generally 20mV to 30mV positive of the cell's resting
potential.
ALL-OR-NONE. The action potential is usually of uniform magnitude, but it can be affected by
various factors. Basically the factors that affect ionic current (i.e. conductance and electrochemical
potential), can affect action potential.
If you lower the sodium conductance of a membrane, three things will happen:
You will lower the rate of rise of the membrane potential, i.e. the frequency of potentials.
You will lower the overall magnitude or peak of the action potential.
You will raise the activation threshold for the action potential -- i.e. more voltage will be
required to start the potential.
TETRODOTOXIN: The above can be achieved with tetrodotoxin which blocks sodium-channels.
They lower sodium conductance and can kill ya.
Death occurs from respiratory failure.
PROCESS OF ACTION POTENTIAL:
UPSTROKE PHASE: There is a negative net current, such that net positive charge is
moving in the cell.
So, the sum of negative sodium current and positive potassium current is negative.
SPEED OF UPSTROKE PHASE depends on the following:
The magnitude of the stimulus. The great the stimulus, the greater the sodium
current, the faster the upstroke phase.
Sodium conductance. The greater the sodium conductance, the faster the
upstroke phase.
Potassium conductance: The lower the "background" potassium conductance,
the greater the speed of the upstroke phase.
THE LETHARGIC PATIENT: Patient had extracellular K+ levels of 10 mmolar (whereas normal is 3.5
mM).
PACEMAKER CHANNELS
Hyperpolarization-Activated Cation Current (Ih): This channel is responsible for
generating pacemaker potential. The more hyperpolarized a cell becomes, the more likely it is
to open.
At hyperpolarization levels (around -80mV), this channel opens, aiding in depolarizing
to a level high enough to generate action potential.
But the channel still inactivated normally -- as membrane potential becomes more
positive.
Delayed Rectifier Potassium Channels (IK): Primarily responsible for repolarization.
The cardiac K-Channel deactivates fairly slowly during the repolarization phase,
slowing down the process of repolarization.
This is the standard potassium channel, which is voltage-sensitive and therefore opens
during depolarization.
T-Type Calcium Channels (ICa,T): They are activated in the potential range that the h-
channels bring the cell to.
They continue carrying the cell along the "slow depolarization trajectory."
L-Type Calcium Channels (ICa,L): Kick in at a higher potential, giving rise to the full action
potential. The L-Type Calcium channels are the final channel to open, and they are
responsible for generation of the peak.
IK interplays with Ih during repolarization.
The K-Channels remain open for a while, as the membrane potential moves more and more
negative.
This negative potential causes the h-Channels to open, so that positive charges moves in. This
counteracts the K-Channels.
At a point, the h-channels and K-channels are equal to each other, then the h-channel current
takes over as the membrane begins to depolarize again.
NOREPINEPHRINE: It speeds heart rate. The ultimate target of modulation is the
hyperpolarization-activated h-channel.
It makes the h-channel activation threshold more positive.
This results in shorter action potentials, as h-channels start kicking in at a higher
membrane potential.
The faster h-channel activation also results in faster depolarization.
It makes the L-Type calcium activation threshold more negative.
This means a lower potential is required to activate the L-Type Calcium channels,
resulting in higher calcium conductance and a faster rate of rise.
This speeds the rate of depolarization.
It has no effect on T-Type calcium channels
It increases Ik ------> Faster hyperpolarization ------> Ih channels kick in quicker.
ACETYLCHOLINE: It slows heart rate. The ultimate target of modulation is the hyperpolarization-
activated h-channel.
It makes the h-Channel activation threshold more negative.
This results in longer action potentials, as h-channels don't start kicking in until a lower
repolarization potential.
It makes the L-Type Calcium channel activation threshold more positive
A higher potential is required before L-Type Ca channels open, resulting in a slower
rate of rise.
It has no effect on T-Type Calcium channels
It opens K-Channels, hyperpolarizing the cell.
It decreases Ik ------> Slower hyperpolarization
"Simple Encoding": The frequency of firing is directly proportional to the strength of the stimulus.
A-Type Potassium Channels: They help set the trajectory of slow depolarization in repetitive
firing models.
It behaves like a sodium channel: depolarization both activates and inactivates the channel.
Inactivation is a slower process than activation.
How A-Type Channels lead to a long duration of depolarization:
As cell begins to depolarize, the depolarization is held in check by the rapid activation
of A-Channels: K starts flowing out of the cell during depolarization.
This outward counter-current actually produces a hyperpolarizing notch close
to the time of maximal A-Channel current.
Then the A-Channels start to move into the inactive state, so the inward current starts
kicking in and the upstroke begins.
MODULATING FREQUENCY: The important thing to modulate is the frequency of the
action potential!!!
A strong stimulus will override A-Channel activation more quickly, resulting in a faster
action potential.
Calcium-Activated Potassium Channels: Afterhyperpolarization.
What they do:
An action potential often results in a rise in intracellular calcium. This activates these
potassium channels, which will then prolong the repolarization so that you get an
"afterhyperpolarization," following an action potential.
ABSENCE of Ca+2 gets rid of the afterhyperpolarization. Calcium is necessary for this
effect, and chelating it will speed up AP frequency and abolish the
afterhyperpolarization.
BK / Maxi Channel: One type of Ca-Activated Potassium channel.
It has a large fractional conductance.
It is primarily responsible for the early component of the afterhyperpolarization.
The name of the produced current is IC.
Scorpion Venom blocks these channels.
SK / Slow Channel: Second type of Ca-Activated Potassium channel.
Responsible for the late, slow phase of afterhyperpolarization.
Slow phase can last from 50 to 1000 milliseconds.
It has a smaller fractional conductance.
Name of the produced current is IAHP.
Honeybee Venom blocks these channels.
The (SK) Slow Calcium-Activated Potassium Channels are responsible for Spike Frequency
Adaptation.
The SK channel conductance slowly and continually increases, as the action potentials cease
to fire.
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