钾代谢紊乱chapter4 Disorders of Potassium metabolismPPT.pptVIP

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2018-06-09 发布于江苏
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钾代谢紊乱chapter4 Disorders of Potassium metabolismPPT.ppt

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钾代谢紊乱chapter4 Disorders of Potassium metabolismPPT

Chapter 4 Disorders of Potassium metabolism Osmotic pressure What-phenomena? Why - flux? How –balance? Concentration Osmotic pressure H2O H2O Na Na 1.Abnormally potassium concentration in the serum, 3.5 -5.5mmol/L introcellular fluid,140-160mmol/L 2.Physiology of K+ metabolism K+: 90%-- inside cells 7.6% in bone 1.4% in extracellular fluid 1% in transcellular fluid K+:the most important cation Homeostasis of potassium K+ K+ K+ PH [K+] Hormone …… Intake output Skin kidney 90% gastrointestinal tract 10% 50-200mmolin ECF 10mmol(1/4inECF) How to keep the balance in and out of the cell? Mechanism: pump-leak Pump:Na-K-ATPase move from low concentration to the higher Leak:K + channel move out of the cell b) Excretion of K+ by kidney (in distal convoluted tubule) aldosterone extracellular [K+] distal (tubular) flow rate acid-bace status Contex medulla Kidney glomerulus filter Initial urine Proximal convolute tubule medullaru loop reabsorption Intercalated cell Distal convoluted tubule collecting duct regulation I. maintains the stability of acid-base osmotic pressure II. influence protein and carbohydrates metabolisms - + + + + - - - III. control the tissue excitability The function of potassium hypokalemia Abnormally low potassium concentration in the serum, lesser than 3.5 mmol/L Why? K+ 3.5… intake? output ? distribution Can’t skin kidney gastrointedtinal tract in cell Kidney glomerulus filter through? Kidney tubules reabsorption ? excretion ? Influence-1:Neuromuscular excitability limbs Weak, respiratory muscle paralysis…… Excitability ? Em-Et ↑ Em ↑(-90to-110mV) K+I / K+e ↑ nernst equation ↑ ↑ ↑ influence-2:arrhythmia Excitability ↑ conductivity ? autorhythmicity ↑ Em-Et ?