Bodyfluids New 101020230204 Phpapp02

8/19/2019 Bodyfluids New 101020230204 Phpapp02

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BODY FLUIDS


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• In average young adult male:

Body composition

Body composition % of body weight

Protein, & related substances 18%

Fat 15%

Mineral 7%

Water !%


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Body F"#ids

• Water content in body is divided into 2 compartments:

1$ &t'(ce""#"(' f"#id )*F+, )internal environment or the milieu intérieur

! "luid outside the cells# ≈ $% volume o" "luids in body '≈ ( o" total body )ater#

! contains ions & nutrients needed "or cellular li"e#

-$ Int'(ce""#"(' f"#id )I*F+,

! "luid inside the cells#

≈ 2% volume o" "luids in body '≈ *+( o" total body )ater#


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Fluid ompartments

≈ !% of body weight

ExtracellularExtracellular

fuidfuid

((≈≈ 1/3)1/3)≈ ( o" -.W( o" -.W ≈ 20% of body wt

IntracellularIntracellular

fuidfuid

((≈≈ 2/3)2/3)≈ *+( o" -.W*+( o" -.W≈ 40% of body wt

InterstitialInterstitial

fuidfuid≈75% o ECF75% o ECF

≈ 15% of bodywt

PlasmaPlasma

≈ 25% o ECF25% o ECF≈ 5% of body wt

ranscellular ranscellularfuidfuid

C!FC!F

IntraoculaIntraocula

rr

PleuralPleural

PeritonealPeritoneal

PericardiaPericardia

ll

!"no#ial!"no#ial

$iesti#e$iesti#e


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&(mp"e,

.ow to c("c#"(te tot(" body w(te' )/B0+

/# alculate -.W "or a +0 1g man#

-.W *0( o" body )eight -.W *0( 3 +0 42 5 o" )ater


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Diffe'ences between *F 2 I*F

*F*(tions,

3(4 '$42mmol%5

6 4 '4#2

Mg-4 '0#7

nions,*"6 '$07

.*O6 '24

3#t'ients,

8-, glucose, "atty acids, &

amino acids#

0(stes,

8-, 9rea, uric acid,

ecess )ater, & ions#

I*F

*(tions, ;a4 '$4

4 '$40

9g-4 '20

nions,l6 '4


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*O9:OSI/IO3 OF BODY FLUIDS

*/IO3S )mmo";"+ :"(sm( Inte'stiti(" Int'(ce""#"('3( 19g !$8 !$7 -!

3IO3S )mmo";"+

*" 1!8 1!8


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=tracellular and Intracellular Fluids

• =ach "luid compartment o" the body has adistinctive pattern o" electrolytes

• =tracellular "luids are similar 'ecept "or the high

protein content o" plasma > ?odium is the chie" cation

> hloride is the ma@or anion

• Intracellular "luids have lo) sodium and chloride > Potassium is the chie" cation

> Phosphate is the chie" anion


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I9:O>/3*

• 9(int(ining *F ?o"#me is c'itic(" to

m(int(ining b"ood p'ess#'e

• *F osmo"('ity is of p'im('y impo't(nce

in "ong6te'm 'eg#"(tion of *F ?o"#me

> *F osmo"('ity m(int(ined m(in"y by 3(*"

b("(nce,• int(@e, 1!$5g;d o#tp#t, 1!g;d in #'ine


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&asic $e'nitions&asic $e'nitions

smolalit"( *FFECE$ &+ ,E -.0E F !.E! I !.I)

umer o osmoles er unit o total ei4t o sol#ent (msm/ ,2)

smolalit" 6 28 msm/28 msm/

smolarit"

umer o osmoles er unit o total #olume o sol#ent (msm/ l ,2)

mOsm/kg = mOsm/ LmOsm/kg = mOsm/ L P Osmolality = 280 - 310 mOsm/kgP Osmolality = 280 - 310 mOsm/kg P Osmolarity = 280 - 310 mOsm/P Osmolarity = 280 - 310 mOsm/ll

8ncotic Pressure: the "raction o" plasma osmolarity that is due to plasma proteins


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Basic DenitionsBasic Denitions

onicit" smolalit"

P4"sioloical term(e9ecti#e s P relati#e to lasma)

!olutes t4at do not crosst4e cell memrane onl"counts

C4emical term

*ll solutes contriutes tosmolalit"

2 x a: : ;lucose 2


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AOLU9 OF BODY FLUIDS I3 7! @g 93

/O/L AOLU9

*LLU> FLUID-8 L)>OU.LY -; OF /B0+

C/> *LLUL> FLUID

1< L)>OU.LY 1; OF /B0+

:LS9

< L )>OU.LY OF *F+


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M=- .A /O SL*/ SUI/BL DY O>

>DIO6ISO/O:• D D859M= 8F F59IA

• B -8-B5 BM89;- 8F AE= 9?=A

• = BM89;- 8F AE= =3C=-=A 8C58?- #

• 8;=;-CB-I8;

I3DI>*/ 9/.OD E

I3DI*/O> )DY+ DILU/IO3 /*.3IU

F8CM95B

DB!=%


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D859M= M=B?9C=M=;- 8F DBCI89?

F59IA? 8MPBC-M=-;?

I3/>S/I/IL FLUID

*F E :"(sm( Ao"#me

I3/>*LLUL> FLUID

/B0 E *F


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*>I/>I FO> SUI/BL DY$

• 9US/ 9IC A3LY /.>OU.OU/ /.*O9:>/9/3

• 3O3 /OCI*

• 9US/ .A 3O FF*/ OF I/S O03 O3 /.DIS/>IBU/IO3 OF 0/> O> O/.>SUBS/3*S I3 /. BODY

• I/.> I/ 9US/ B U3*.3D DU>I3 /.

C:>I93/ O> IF I/ *.3S G /. 9OU3/*.3D 9US/ B 3O03$

• /. 9/>IL S.OULD B >L/IALY SY/O 9SU>$


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D859M= M=B?9C=M=;- 8F DBCI89?

F59IA? 8MPBC-M=-;?

• Aye Ailution Principle

/O/L BODY 0/> )/B0+ SUBS/3* USD

• DU/>IU9 OCID )D-O+• />I/I/D 0/>• 3/I:Y>I3• 9I3O:Y>I3


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• C/>*LLU> FLUID

• SUBS/3*S USD , /0O 9HO>/Y:S,

> S**.>IDS e$g$ SU*>OSG I3ULI3G

933I/OL

> DIFFUSIBL I3O3S e$g$ SUL:./G SODIU9G

/.IOSUL:./G B>O9IDG *.LO>ID

D859M= M=B?9C=M=;- 8F DBCI89?

F59IA? 8MPBC-M=-;?


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BLOOD :LS9$

• A3S BLU

• >DIO*/IA LBLD 1-5 I LBU9I3

AOLU9 9SU>93/ OF

A>IOUS FLUIDS *O9:>/9/3S

/O/L BLOOD AOLU9 :LS9 AOL C 1!!

1!! 6.*/


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F*/O>S FF*/I3

• :hysio"ogic("

> dipose /iss#e

> Se&

> ge

• :(tho"ogic("

> Dehyd'(tion

> O?e'hyd'(tion


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Dehyd'(tion

• 5oss o" )ater "rom the body,

e#g# vomiting, diarrhea, s)eating, & polyuria#

• 5eads to ↓ in both =F & IF volumes#

∀ ↑ osmolarity in both =F & IF#

• eneral signs:

! Ary tongue

! loss o" s1in elasticity

! so"t eyeballs 'due to lo)ering o" intraocular tension

! ↓ blood pressure 'i" ≥ 4!*5 loss

! ↑


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Aisorders o" Water .alance:


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Aisorders o" Water .alance: =dema

• Btypical accumulation o" "luid in the interstitial

space, leading to tissue s)elling• Factors that accelerate "luid loss include:

> Increased blood pressure, capillary permeability

> Incompetent venous valves, localiHed blood vessel bloc1age

> ongestive heart "ailure, hypertension, high blood volume#

> lo) levels o" plasma proteins


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Cegulation o" =F Dolume

• Mechanisms

> ;eural

> Cenin!angiotensin!aldosterone

> Btrial natriuretic

hormone 'B; Bntidiuretic hormone'BA Aecreased aldosterone secretion

> Increased B;< secretion

> Aecreased BA< secretion

> Aecreased sympathetic

stimulation

• Aecreased =F results in > Increased aldosterone secretion

> Aecreased B;< secretion

> Increased BA< secretion

> Increased sympathetic stimulation


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=F volume receptors

• entral vascular sensors > Low pressure (very important)

• ardiac atria

• Pulmonary vasculature

> High pressure (less important)• arotid sinus

• Bortic arch

• Jutaglomerular apparatus 'renal a""erent arteriole

• ?ensors in the ;? 'less important

• ?ensors in the liver 'less important

;#.# Cegulation o" =F volume Cegulation o" body ;aK# -hus,

regulation o" ;aK also dependent upon baroreceptors#

< l C l i "


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2+!2*


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2+!2+


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2+!27

Cegulation o" =F Dolume


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Cegulation o" Water Inta1e

Figure 27.5

Bodyfluids New 101020230204 Phpapp02

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