Body Fluid and Electrolyt

8/13/2019 Body Fluid and Electrolyt

1/36

DISORDERS OF

CIRCULATION, BODYFLUID AND

BASIC ACIDBy

Taufik Rahman, M.D


2/36

Body Fluid

Human body

60%, water

40 %, intracellular 20 %, extracellular

5 %, interstitial 15 %, intravascular


3/36

Electrolyt

Intracellular

Na + 142 mEq/L

K + 4 mEq/L

Ca ++ 2,4 mEq/L

Mg ++ 1,2 mEq/L

Cl - 103 mEq/LHCO3 - 28 mEq/L

Extracellular

Na + 10 mEq/L

K + 140 mEq/L

Ca ++ 0,0001 mEq/L

Mg ++ 58 mEq/L

Cl - 4 mEq/LHCO3 - 10 mEq/L


4/36

Classification of circulation

disorders

1. Disorders of body fluid and electrolyt

Edema, dehydration, electrolytdeficiensi and electrolyt excess

2. Disorders of volume

Hiperemia, bleeding and shock

3. ObstructionsTrombosis, emboli, ischemia, infarc andother obstruction


5/36

Oedema

Collected of body fluid in interstitial orbody cavity.

Oedema : - transudat (BJ < 1,15)

- exudat (BJ > 1,20)

Oedema : - local

- generalOedema in serous cavity : hidrothorac,hidropericard, hidroperitoneum ( acites ).


6/36

Cont

Causes of oedema

Noninflamation oedema :

1. Increase of hidrostatic pressure

2. Decrease of osmotic pressure3. Obstruction of limphatic canal

Inflamation oedema :

Increase of vascular permeubelityOther causes : disorder of natrium exchange orelectrolyt balance


7/36

Change of morphology as

consequence of oedema Pulmonary oedema

increase of weight

fluid around septum capiler

fluid that content edema fluid, air, and erytrocyt.

disorders of gas exchange that cause asfixia or anoxia.

Brain oedema

constriction of sulcus

dilation of gyrus

substansia alba being soft like gelatin

dilation of substantia grisea


8/36

Hyperemia and congestion

Hyperemia ( active hyperemia )

Dilatation of arteriol and artery causesincrease of blood flow to capiler tissuewith opening inactive capilers.

Dilatation of vascular caused by vasoactiveagent.

Example : fever

shy


9/36

Cont

Congestion ( pasive hyperemia )

Blood flow to vena have a disorders.

Vena blood flow decrease in spesific areaand dilatation of vena and capiler.


10/36

Change of morphology as

consequence of hyperemia

Wet apperanace and full of erytrocyt

Pulmo : full of erytrocyt in alveoli capiler


11/36

Shock

Syndrome that caused by circulation failure

Inbalance of volume and vascular space.

Shock primer :Vascular space increase, but the body fluid

volume constant

Shock secunder :Vascular space constant, but the body fluid

decrease


12/36

Cont

Shock ( characteristic ) :

- Reversible

- Irreversible

Shock ( cause ) :

- Anaphylactic

- Cardiogenic

- Septic

- Neurogenic


13/36

Cont

Sign and symptom :

Paleness and weak

Cold extremity Pulseness weak and quick

Very low blood pressure

Oliguria Decrease of consciousness


14/36

Dehydration

Deficiency of fluid

Inbalance of input and output

Causes :- water loss

- natrium loss

- combination of both


15/36

Cont

Water loss :

Long comatosa

Hydrophobia Exercise

Consequnce of dehydration

Release of ADH by Hypopise, and thenoliguria


16/36

Cont

Sign and symptom of dehydration (waterloss) :

- thirsty

- decrease of saliva secret

- dry throat

- oliguria

- weakness

- consciousness disorders


17/36

Cont

Natrium Loss : Proggresive vomiting Progressive diarrhea

Sign and symptom of dehydration ( natrium loss ):- Nausea- Weakness

- Cephalgia- Vomiting- seizure


18/36

Bleeding

Release of blood from vascular

Internal bleeding

Blood release to interstitial, serous cavity,or body organ.

External bleeding

Blood release to out of body


19/36

Cont

Inner body bleeding

Skin and mucous : petiche, echimosis, purpura,hematoma.

Body cavity : hemothorac, hemoperitoneumhematopericardium

Uterus, vagina and tuba : hematometrium

hematokolpos, hematosalphink

Testis : hematochele

Articulatio cavity : hemarthrosis


20/36

Cont

Outter body bleeding

Respiratory tract : Epistaksis, Hemoptisis,

Gastrointestinal tract : Hematemesis,Hematokezia, Melena

Uterus : Menorargia, Metrorargia


21/36

Cont

Local effect of bleeding

Brain : increase of ICP

Pulmo : decrease of pulmonary volume Heart : tamponade

fibrosis


22/36

Cont

Systemic effect of bleeding

Anemia

Circulation colaps Death


23/36

Trombosis

Solidfication of blood that content bloodelement in vascular of human life.

Factors that contibute to make trombus :

1. Change of vascular wall

2. Change of blood flow

3. Change of blood composition


24/36

Cont

Trombus ( form ) :

- Occlution trombus

- Propagating trombus

- Saddle or riding trombus

- Mural or parietal trombus

- Pedunculated trombus

- Ball trombus

Trombus ( colour ) :

- Red trombus

- White trombus

- Mixed trombus


25/36

Cont

Trombus ( making time ) :- Fresh trombus- Old trombus

Trombus ( bacteria ) :- Septic trombus- Sterile trombusTrombus ( site ) :

- Vena trombus- Arteria trombus- Car trombus


26/36

Cont

Effect of trombus :

- Ischemia

- Necrosis- Infarction

- Gangren


27/36

Embolus

Foreign bodies that follow blood flow from theirsites and can trapp in other sites causesobstruction.

Embolus ( substance ) :

- Fatty emboly- Air emboly

- Tumor cell emboly

- Aterom emboly

Embolus ( sites) :- Arteria emboly

- Vena emboly


28/36

Vascular disorders

Ischemia : Decrease or loss of blood supplyto part of body.

Effect of ischemia :

- degeneration

- Loss of parenchym cell

- Cell death


29/36

Cont

Infarc : vascular obstruction by specificmaterial (trombus), that causes ischemiaand anoxia necrosis of tissue in distal of

obstruction.

Infarc :

- Hemorargic infarc

- Paleness infarc


30/36

Cont

Gangren : death of tissue that caused by loss ofblood supply and followed saprophyt bacteriainvasive.

Gangren :

Wet gangren :- body organ that content lots of fluid

- places that no evaporation

Dry gangren :

- Body organ that content few of fluid- Places that evaporation

- Places that good drainage


31/36

Basic acid Balance

Human body inclined acid, caused :

- carbon dioxide production in aerobic respiration

- lactat acid in glikolisis

- Fatty acid in lipolisis

pH level :

- Artery : 7,4

- Interstitial fluid : 7,35

- Intracellular fluid : 7,0


32/36

Cont

Henderson-Hasselbach

pH = pK + log HCO3 -H2CO3

pK = 6,1


33/36

Mechanism

Renal mechanism

Balancing hidrogen ion and bicarbonat

H2CO3 H + + HCO3 -


34/36

Cont

Pulmonary mechanism

H20 + CO2 H2CO3


35/36

Cont

Acidosis : decreasing pH level

Acidosis : - respiratoric

- metabolicAlcalosis : increasing pH level

Alkalosis : - respiratoric

- metabolic


36/36

Any question ?

Please!!!

Body Fluid and Electrolyt

Documents