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HBS109 Introduction To Anatomy And Physiology

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Question:

Case Study : Water Intoxication

Mika Rose Deloraine is a 34 year old women who is trying to fall pregnant. One morning she presents to her doctor with a suspected urinary tract infection. In addition to her usual antibiotics and pain killers, Mika's doctor suggests she increase her water intake to “flush her system”. Being overzealous Mika drinks roughly 500ml every half hour resulting in hospitalisation with her diagnosis as water intoxication.

In this case study you will describe the importance of maintaining homeostasis in regards to water and electrolyte balance for optimal health. Your focus should be on the kidneys and the cardiovascular system, in particular control from the renin-angiotensin system. Secondly, you will describe what effect ingesting large quantities of water has on:

- Fluid and electrolyte imbalances (blood tonicity).

- Renal function.

- Cardiac function (BP) including bradycardia and widened pulse pressure.

- Intracranial pressures and neurological effects of water intoxication.

By the end of this case study you should be able to:

  • Describe the anatomy and physiology of the cardiovascular system and its control of BP.

  • Describe the anatomy and function on fluid and electrolyte balance.

  • Describe the Renin-Angiotensin system in blood pressure regulation.

  • Describe cerebral oedema and its physiological complications on the CNS.
 

Answer:

Introduction

Water plays a critical role in the human body. From the case study provided it shows the health status of a 34 year old woman Mika Rose Deloraine. When she was suspected to have urinary tract infection she is given pain killers to calm the situation. However, apart from that Mika Rose Deloraine will have to increase her level of water intake. The role of water in this scenario is to help flush her system. Consequently after taking 500ml every hour for being overzealous, Mika is hospitalized with water intoxication. All these scenarios shows the impact of water in human body. For the purpose of this task, it will elaborate the importance of maintaining homeostasis in regards to water and electrolyte balance for optimal health. The focus will be on kidney and cardiovascular system, control from renin-angiotensin system. Apart from that, it will elaborate on effect of ingesting large quantities of water on renal function, cardiac function, intracranial pressure, and fluid and electrolyte imbalance.  

Importance of maintaining homeostasis in regards to water and electrolyte balance for optimal health.

An individual’s body is made up of millions of cells. However, for these cells to operate properly, the condition inside an individual’s body need to as favorable as possible. Anything that happens to the body, constantly tend to alter the conditions inside the body. For example, when an individual eats, he or she consumes new molecules to the body (Agrò et al, 2018, p.56). When these activities takes place, the amount of water that is taken and lost from the body constantly from time to time. There are also of waste that body produces.

Homeostasis illustrates the functions of one’s body that operate to keep the internal conditions constant. The first main organ that relates to homeostasis is the kidney. Kidney is one of the complex organs in human body that control the amount of water that is lost from the body. Apart of that it ensure that waste products such as urea are removed from the body system.  The waste materials contain things such as amino acids. The body needs at least 8 glasses of water every day. However, only one and half liters leaves the organs inform of urine (Begg, 2017, p.30).

On the other hand, water balance is important in the body. Every cell inside one’s body carry chemicals that are in partially permeable membrane. With this membrane, water together with other tiny particles can move into and out of the cell with a given concentration gradient. However, there are some chemicals including proteins, glucose and amino acids that cannot be able to pass through the cell membrane. Therefore there is need for the concentration of substances within the tissues have the same concentration as the cell content. Maintaining water level helps in hypertonic solution, hence water moves out through the process of osmosis. However, change in concentration brings hypotonic solution, thus water moves into the cells. The following is a good example of a diagram that is used to maintain concentration in cells (Agrò et al, 2018, p.56).

Electrolytes plays a critical role in maintaining homeostasis. In the human body.  Electrolytes assist in regulating neurological and myocardial functions, delivery of oxygen, and acid balance among other biological functions.  The human cells make us of electrolytes to control voltages across the cell membranes. Apart from that, electrolytes are important in carrying the electrical impulses from one cell to another.

However, it is important to balance the amount of electrolytes within the body since the cells from heart, muscles and nerve use it to control voltages across the cell membranes. Electrolyte imbalance can come from diminished ingestion or when there is diminished elimination of a given electrolyte.  For example, most instance of electrolyte disturbance happens when there is renal failure. Apart from that, abnormalities from the amount of potassium or sodium can result to electrolyte imbalance (Smoll et al, 2020, p.6). The main organ that work to maintain the state of electrolyte in the body is kidney. For instance, when one is doing heavy exercise, several electrolytes get lost through sweating. It therefore calls for increase electrolyte balance. Kidney works to restore the amount of potassium and sodium in the body. Kidney make use of osmotic transport to restore the status the tubes transport water osmotically. The solutes get diluted between the tubules and capillaries. The following diagram shows the correction of the status of the ions to improve the level of electrolyte (Begg, 2017, p.30),

When it comes to cardiovascular system, it helps in maintaining homeostasis through provision of adequate blood to the tissues. The cardiovascular system continuously redirect the flow of blood.  However, renin angiotensin II, helps in inducing thirst in the body. The re renin- angiotensin system forms the complex pathway for homeostasis that regulate volume of blood (Verschuren et al, 2020, p.11). Angiotensin II works on the hypothalamus to create the sensation of thirst in the body. The release of aldosterone hormone from the renin- angiotensin hormone result to increase reabsorption of water. These activities bring balance in the level of water in the body.

 

The effect of ingesting large quantities of water on:

Fluid and electrolyte imbalances

The amount of electrolytes in one’s body may be become too high or low depending on the amount of water intake in the body. When one is having electrolyte imbalance, the level of salt and other electrolytes are either too low or too high.  Drinking a lot of water has an impact to fluid and electrolyte imbalance. Toxicity result to overloading of the kidney.  The situation forces kidney to excrete the extra amount of water. The outcome is hyposmolarity. The situation is always rare in a healthy adult.  Too much water in the body dilute important electrolytes in body. The kidney needs to excrete the extra water to bring fluid and electrolyte balance in the body (Van Regenmortel et al, 2017, pp.892). Continuous ingestion of water beyond the body required amount can lead to coma or eve death. Sodium is the key controller of extracellular fluid volume. In many occasion, the sodium content and other fluid concentration are always under homeostasis control. Sodium also plays a critical role in controlling osmolality.  And the content in the membrane cells. In normal body functioning, the sodium is always pumped in the cell membranes in exchange of potassium. The activity ensures that there is normal body function. Consequently, when there is low sodium intake, it is the responsibility of the aldosterone hormone to increase its activities so that the body attains normal excretion.  

Renal function

Intake of high volume of water increases the rate of hydration in an individual.  The kidney always adjust its function to the ingestion of too much water in the body.  The first renal change is the production of excess urine (Nriagu et al, 2016, p.200).  The process of releasing excess urine from the body begins immediately thirty minutes after ingestion of excess water in the body.  However, antidiuretic hormone plays a critical role in controlling the level of water absorbed from kidney tubules and collecting duct. High intake of water increases the concentration of the plasma.  The excess water in the blood mainly dilute important electrolytes in the body especially sodium (BAk and Tsiami, 2016, p.5). The kidney must respond by reducing the amount of water being reabsorbed from the capillaries.  The situation can be dangerous to other parts of the body. The body cells continue to swell due to intake of too much water. Swelling of the cell increases the pressure in the skull. Some severe effect can include increase in blood pressure.

Cardiac function

Drinking a lot of water have several impact to the human cardiovascular system. Ingestion of high amount of water lead to increase in muscle sympathetic nerve activity. The other issues include vascular resistance among other effects.  In a healthy individual, the effect is not severe.  The change in blood pressure is moderate. However, sick or elderly people may register increase in pressure by 12mmHg immediately after consuming more water (Menni et al, 2019, p.7).  Other ailing individual may have increase in pressure by more than 25mmHg. The pressure increases for over forty five minutes.  The severe cardiovascular activities are the ones that result to increase in blood pressure within the body.  Some of the activities to restore the situation include increase in pumping of blood.  It increases dilution of mineral to the minerals to the excess water.

Intracranial pressures and neurological effects of water intoxication

Intracranial pressure is the pressure within the brain as a result of fluids. When water is ingested in high amounts cells swell including those within the brain. The increase in the volume results to high pressure in the brain. Consistent effect of the pressure can lead to other damages include brain damage.  However, neurological effects of water intoxication include prolonged dilution of body fluid. Retention of water result to hyponatremia.

Linking to the case study

From the case study, the woman took high volume of water. Water intoxication lead to swelling of cells. Important minerals such as sodium would have been diluted in her body. From the incident, the kidney needs to work to increase removal of the excess water. The removal can be through sweating and urination. However, the woman’s blood pressure would increase immediately after consumption of high volume of water.

In conclusion, water plays an important role in human body. However intake of excess amount triggers other organs including kidney to increase removal of excess water.  Many cells can swell leading to increased blood pressure within the body.

 

References

Agrò, F.E., Vennari, M. and Benedetto, M., 2018. Fluid management and electrolyte balance. In Postoperative Critical Care for Adult Cardiac Surgical Patients (pp. 419-493). Springer, Cham.

BAk, A. and Tsiami, A.A., 2016. Review on mechanisms, importance of homeostasis and fluid imbalances in the elderly. Current Research in Nutrition and Food Science, 4(S3), pp.1-7.

Begg, D.P., 2017. Disturbances of thirst and fluid balance associated with aging. Physiology & behavior, 178, pp.28-34.

Menni, C., McCallum, L., Pietzner, M., Zierer, J., Aman, A., Suhre, K., Mohney, R.P., Mangino, M., Friedrich, N., Spector, T.D. and Padmanabhan, S., 2019. Metabolomic profiling identifies novel associations with Electrolyte and Acid-Base Homeostatic patterns. Scientific reports, 9(1), pp.1-8.

Nriagu, J., Darroudi, F. and Shomar, B., 2016. Health effects of desalinated water: Role of electrolyte disturbance in cancer development. Environmental research, 150, pp.191-204.

Smoll, L.I., Beard, L.A. and Lanyon, J.M., 2020. Osmoregulation and electrolyte balance in a fully marine mammal, the dugong (Dugong dugon). Journal of Comparative Physiology B, pp.1-10.

Van Regenmortel, N., De Weerdt, T., Van Craenenbroeck, A.H., Roelant, E., Verbrugghe, W., Dams, K., Malbrain, M.L.N.G., Van den Wyngaert, T. and Jorens, P.G., 2017. Effect of isotonic versus hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers. BJA: British Journal of Anaesthesia, 118(6), pp.892-900.

Verschuren, E.H., Castenmiller, C., Peters, D.J., Arjona, F.J., Bindels, R.J. and Hoenderop, J.G., 2020. Sensing of tubular flow and renal electrolyte transport. Nature Reviews Nephrology, pp.1-15.

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