Body Compartments

Physiology
-Dr. Tiara Calvo
Fluid Compartments
% of Body Weight Fraction of TBW

Total Body water 60 1.0

Intracellular fluid volume 40 2/3

Extracellular fluid volume 20 1/3

Plasma 5 1/12 (1/4 of ECF)

Interstitial fluid 15 ¼ (3/4 of ECF)

Fluid Compartments
Markers used to Primary cation and
measure volume anion
Total Body water Tritiated H2O, D2O none

Intracellular fluid volume TBW – ECF (indirect C: K

measure) A: Organic phosphate,
proteins
Extracellular fluid volume Inulin, Mannitol C: Na
A: Cl, HCO3
Plasma RISA, Evans blue C: Na
A: Cl, HCO3, Plasma
proteins
Interstitial fluid ECF-plasma volume C: Na
(indirect measure) A: Cl, HCO3
Total Body Water
ICF: 2/3 of TBW CO: Cardiac Output
ECF: 1/3 of TBW
ISF: 2/3 of ECF
The “60, 40, 20 rule” for body fluid volumes

Total body water ~60% of body weight (~40 L)

Intracellular volume
~40% of body weight (~25 L)

ECF Volume
~20% of body weight (~15 L)
ICF vrs ECF
The two compartments are
separated be the cell
membranes.
Have two main
characteristics:
Freely permeable water
Impermeable to sodium
chloride
Plasma osmolality
POsm: is the number of solutes in plasma (tonicity of
plasma)

Plasma osmolality (mOsm/kg) =

2([Na+] + [K+]) + ([BUN]/2.8) + ([Glucose]/18)

POsm approximates serum [Na]

Urea shifts through ICF and ECF freely so it will not
cause any movement of H2O
Changes in RBC volumes
300 lower mOsm: cell swells
300  higher mOsm: cell shrinks
300  same mOsm: no change

Examples:
A- 400 mOsm NaCl?
B- 200 mOsm NaCl?
C- 300 mOsm NaCl
D- 150 mM Nacl?
Isotonic fluid disorders
Isotonic Loss:
equal loss of Na & H2O
= Body Osm
Serum Na Normal:
TBNa /  TBW
No Osm gradient
ECF contracts
= ICF
 CO due to decrease of
plasma vol

Ej. Adult Diarrhea,

Vomiting, Hemorrhage,
isotonic urine
Isotonic Gain:
equal gain of Na & H2O
= Body Osm
Nl serum Na:  TBNa /
TBW
No Osm gradient
ECF expanded
= ICF
 CO

Ej. Excessive isotonic

fluid or normal saline
0.9% Normal saline
Isotonic crystalline solution
Approximates plasma tonicity
Used to:
maintain BP in volume loss conditions
 bleeding
To replace isotonic loss of fluid
 diarrhea
Hypotonic fluid disorders
1- Always due to hyponatremia
2- Osmotic gradient: H2O shifts into ICF compartments
(expands)
HypoNa + Hypertonic Loss Salt:
more loss of salt than H2O  hyponatremia  serum Na 
 Body Osm
 TBNa /  TBW
ECF contracted
 CO
ICF expanded

Ej. Loop Diuretics,

Addison’s disease, 21-
OHase deficiency
HypoNa + Gain Pure H2O:
with no gain of Na
 Body Osm
TBNa /  TBW
Increase plasma volume
due to:
ECF expanded
ICF expanded
 CO

Ej: Syndrome of
inappropiate secretion of
ADH (Rx H2O
restriction)
HypoNa + Hypotonic Gain of Salt
 Body Osm
 TBNa /  TBW
ECF expanded
 CO :Sterling’s force
alter
ICF expanded

Ej. Congestive heart

failure, Cirrhosis,
Nephrotic Syndrome
Pitting Edema
Gain a little more of H2O than Na  hyponatremia 
pitting edema states (transudates).
NOTE: always when there is an  TBNa it will cause
pitting edema.
Hypertonic fluid disorders
1- due to hypernatremia or hyperglycemia
2- Osmotic gradient: H2O shifts out of ICF (contracts)
HyperNa + Hypotonic Loss of Salt:
loss more H2O than salt
 Body Osm
 TBNa /  TBW
ECF contracted
ICF contracted
Decrease of plasma
volume
 CO

Ej. Osmotic diuretics

(glucose), Sweating,
Infant diarrhea
Hypotonic Loss of Salt
Infant diarrhea loss of H2O causing hyponatremia 
if given pure H2O, it will lower the serum Na more 
Rx Pedialyte (hypotonic salt solutions) they have
glucose or galactose to Na to be reabsorbed in the GIT
(cotransport pump).
HyperNa + Loss of Pure H2O
 Body Osm
TBNa /  TBW
ECF mild contracted
ICF contracted
Nl CO (no loss of salt)

Ej. Insensible H2O loss

(fever), Diabetes
Insipidus
Hypertonic Gain of Salt
 Body Osm
 TBNa / TBW
ECF expanded
ICF contracted
Increase of plasma
volume
 CO

Ej. 3% hypertonic saline,

Na antibiotic, NaHCO3
Diabetic Ketoacidosis:
 Body Osm
 Glucose,  serum Na
 TBNa /  TBW
(dilutional effect ICF
H2O)
ECF contracted
 CO
ICF contracted
Ej. Osmotic diuresis