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Title : Body Fluids

Teacher: Edyta Mdry MD PhD Coll. Anatomicum, wi cic!i "treet #, De$t. o% Physiolo&y

'ntroduction to Body Fluids

1. General function of water in the body: a) temperature regulation b) protective cushion c) lubricant d) reactant e) solvent f) transport 2. Percentage of water in the body . The percentage of water in the person depends on the amount of fat tissue which has only about 20 water compared to the muscle mass which has about !" of water. #. $luid compartments a) intacellular fluid %&'$)(appro)imately #() b) e)tracellular fluid %*'$) (interstitial fluid(appro)imately *+) (plasma(appro)imately ,) +. 'omposition of body fluids a) water %solvent) b) electrolytes c) proteins d) blood cells +. ,a-or ions of *'$ a) .ation ( /a0 b) anion ( 'l 1 ". ,a-or ions of &'$ a) .ation ( 20 b) anion ( proteins and phosphate !. $unctions of electrolytes (cofactors for en3ymes

(action potentials in neurons and muscle cells (secretion and action o hormones and neurotransmitters (muscle contraction (acid4base balance (secondary active transport (osmosis

-ater .omeostasis
1. Total 5ody 6ater % T56 ) 1 about +07 (water inta.e %food and drin. ( 2#00ml8 cell metabolism( 200ml8 total( 2"00) (water output %.idneys 1 1"00ml8 s.in( !00ml8 lungs( #00ml8 G& tract(100ml8 total 1 2"00ml) 2. 9isturbances of 6ater :omeostasis (hypervolemia %infusion of isotonic i.v. fluid) (hypovolemia %blood loss) (overhydration %drin.ing too much water) (dehydration %sweating) #. $our Primary ,echanisms ;egulate $luid :omeostasis (<9: (thirst mechanism (aldosterone (sympathetic nervous system

Electrolyte homeostasis
/a0 and 20 balance are maintained by the .idney through the hormone aldosterone. 1. ;oles of sodium in the body %/*#0/12 mE345 ): (nerve impulse conduction and muscle contraction ( regulation of water movement %water follows sodium by osmosis)

.y$ernatremia %/a0 plasma concentration above 1+" m*=47)(symptoms: non(specific signs of central nervous system dysfunction such as confusion and lethargy> in severe cases sei3ure and death. 2. ;oles of potassium in the body %*, 202, / mE345): ( is responsible for intracellular fluid volume> through osmosis ( plays .ey role in maintaining resting membrane potential> nerve impulse conduction> muscle contraction and maintenance of normal cardiac rhythm. ( plays important role in acid 4 base balance .y$o!alemia %20 plasma concentration bellow #> " m*=47) cause: decrease neuromuscular e)citability> s.eletal muscle wea.ness> cardiac dysrhythmias ?ever hypo.alemia may cause respiratory arrest. .y$er!alemia %20 plasma concentration above ".1 m*=47) can cause intestine cramps> diarrhea> restlessness> changes in *2G. ?ever hyper.alemia cause muscle wea.ness progressing to paralysis> slowed heart conduction> cardiac arrest. +. 'alcium homeostasis %6, +0//, + m&4dl ) is crucial to normal body function. *ven small changes in 'a concentration can be deadly. 'a00 balance is maintained by PT., clcitonin and 7itamin D. .y$ercalcemia %plasma 'a00 concentration above 11> 0 ml4dl) leads to heart dysrhythmias> fatigue> confusion> coma> cardiac arrest> calcification of soft tissue .y$ocalcemia %'a00 concentration below @> 0 mg4dl) leads to muscle spasm. 6hen the 'a00 level is very low a person can go into tetanus and breathing will stop.

Acid4Base .omeostasis
1. p: of body fluids: (arterial blood0 $. 8, *208, 12 (venous blood(p: A> #" (intracellular fluid(p: A> 0 (gastric -uice( $. (, + (small intestine -uice( $. ,, + (urine( p: +> "(B >0 based on diet and metabolic state

2. The body has # ways of maintaining a normal p: range: (chemical buffer system %acts within seconds) a) carbonic acid 4 bicarbonate b) phosphate buffer c) protein buffer (respiratory controls a) acts within minutes b) important in compensating for metabolic acidosis or al.alosis c) permits elimination of the volatile acid % bicarbonate acid ) (renal mechanisms a) acts within hours or days b) compensate for respiratory acidosis or al.alosis c) eliminate fi)ed acids from the body %metabolic acids generated in the body that are eliminated only in the urine).

De%initions
The Base E9cess %(2> " C 02> " mmol4l) the amount of acid %in mmol) re=uired to restore 1 later of blood to its normal p:> at a p'D2 of ".#.Pa %+0mm:g). The "tandard Bicar:onate %22(2! mmol4l)is the bicarbonate concentration of a sample when the p'D2 has been ad-usted %or EstandardisedF) to +0 mm:g at a temperature of #A'.

Blood &as norms

p: p'D2 pD2 5* A>#"(A>+" #"(+" mm :g B0(100 mm :g (2>" C 02>" mmol4l

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:'D#

22(2! mmol4l

pH-bicarbonate diagram help you to identify type of acid-base disturbance.

Metabolic alkalosis

HCO - (mmol!")

Acute respiratory alkalosis Chronic respiratory alkalosis

Metabolic acidosis

pH

Acid Base distur:ances

/. ;es$iratory acidosis %G p: H < p'D2 )

(impaired gas e)change % 'D79 ( chronic obstructive lung diseases> severe asthma> pneumothora)) ( impaired activity of diaphragm muscle % spinal cord trauma> nerve in-ury) ( impaired respiratory control in the brain stem %brain in-ury> stro.e)
(. ;es$iratory al!alosis %< p: H G p'D2 )

( hyperventilation

O2

Acute respiratory acidosis

m mH g)

( high altitude

*. Meta:olic acidosis %= p: H negative 5*)

a) e)cess acid production (diabetic .etoacidosis (starvation .etosis (lactic acidosis % intensive e)ercise) (.idney disease (hyper.alemia
b) loss of bases (diarrhea (e)cessive vomiting +.Meta:olic al!alosis %I p: H positive 5*) a) loss of acids ( vomiting of stomach contents (hypo.alemia b) to much bases (ingesting too much :'D# (