BODY FLUIDS
DR. MOSAB GHNIMAT
DR. NISREEN MOUSA
PHYSIOLOGY DEPARTMENT
PPU
OBJECTIVES
1. Volumes & Compartments of body fluids
2. Composition of body fluids
3. Measurement of each compartment
4. Significance of body fluids
5. Water balance – positive and negative
water balance
6. Oedema , Dehydration.
BODY COMPOSITION
Daily Intake of Water:
• It is ingested in the form of liquids or water in the
food, about 2100 ml/day
• It is synthesized in the body as a result of oxidation
of carbohydrates,
15% adding about 200 ml/day.
• Total water intake of about 2300 ml/day
18%
Daily Loss of Body Water:
60%
• Evaporation from the respiratory tract and
diffusion through the skin, about 700ml/day
• Sweating about 100 ml/day.
• Water Loss in Feces about 100ml/day.
• Urine excretion about 1400ml/day
• Total water loss of about 2300 ml/day
TOTAL BODY WATER
BODY FLUID COMPARTMENTS
DISTRIBUTION OF TOTAL BODYY
WATER
COMPARTMENTS VOLUME (L) PERCENTAGE
BODYWEIGHT BODYWATER
TOTALBODY 42 60 100
WATER
ICF 28 40 67
ECF 14 20 33
PLASMA(25%) 3.5 5 8
INTERSTITIAL 10.5 15 25
FLUID,
TRANSCELLULAR
FLUID,
MESENCHYMAL
TISSUE(75%)
PERCENTAGE OF WATER IN THE BODY
Total Body Water
varies depending on
body fat:
infant: 73%
male adult: 60%
female adult: 40-50%
effects of obesity
Old age 45%
% of total body water is affected by sex
age and fat proportion :
•Lower in female than male .
•Lower in old age than adult .
•Decreased total body water with
increased fat content.
Infants are prone to dehydration i.e.,
infants are more vulnerable for water loss due
to:
• Absolute ECF volume is lesser.
• Increased body surface area compared to
mass .
• Higher metabolic rate .
• Physiologic inability of the infant’s kidneys to
concentrate urine.
WATER CONTENT IN DIFFERENT TISSUES
BLOOD VOLUME
MEASUREMENT
Hematocrit
the ratio of the volume of red blood cells to the
total volume of blood.
MOVEMENT OF BODY FLUIDS
IMPORTANT CONCEPT
Body fluids are not
static.
Fluids & electrolytes
shift from
compartment to
compartment.
Emphasis is always on
maintaining
homeostasis
COMPOSITION OF BODY FLUIDS
Body fluids contain water
and solids. Solids are
organic and inorganic
substances.
ORGANIC SUBSTANCES:
Glucose, amino acids,
fatty acids, hormones
and enzymes.
COMPOSITION OF BODY FLUIDS
INORGANIC SUBSTANCES:
Extracellular fluid contains
large quantity of sodium,
chlorides, bicarbonate,
and oxygen.
Intracellular fluid
contains large quantities
of potassium, magnesium,
phosphates, sulphates and
proteins.
PH of ECF is 7.4
PH of ICF is 7
SIGNIFICANCE OF BODY FLUIDS
In Homeostasis: Body
cells survive in the fluid
medium called internal
environment or milieu
interior.
For growth and functions of
cells
Glucose, amino acids,
lipids, vitamins, ions,
oxygen etc., in proper
quantities in the internal
environment.
SIGNIFICANCE OF BODY FLUIDS
In Transport mechanism:
Body water forms the
transport medium by
which nutrients and
other essential
substances enter the cells
and wastes come out of
the cells.
SIGNIFICANCE OF BODY FLUIDS
In Metabolic reactions:
water inside the
cells forms the
medium for various
metabolic reactions,
which are necessary
for growth and
functional activities
of the cells.
SIGNIFICANCE OF BODY FLUIDS
In Texture of tissues : water
inside the cells is
necessary for the
characteristic form and
texture of various tissues.
In Temperature
regulation : body water
plays a vital role in the
maintenance of normal
body temperature.
REGULATORY MECHANISMS
Hypothalamus –Thirst
mechanism
KIDNEYS
Kidney Function
HORMONES
Renin-Angiotensin-
Aldosterone
Anti-Diuretic Hormone
MEASUREMENT OF BODY FLUIDS
DILUTION PRINCIPLE
the process of adding additional
solvent to a solution to decrease its
concentration.
This process keeps the amount of solute
constant, but increases the total amount
of solution, thereby decreasing its final
concentration.
INDICATOR DILUTION METHOD:
V= M
C
V = volume of fluid in the compartment
M = Mass or total quantity of marker substance
injected
C= Concentration of the marker substances in the
sample of fluid
CORRECTED FORMULA:
Volume = [Link] subs. Amt. of subs.
Injected - excreted
Conc. of subs. in sample of fluid.
PRE-REQUISITE FOR ACCURATE BODY
FLUID MEASUREMENTS
Non-toxic.
Mix-evenly.
Relatively easy to
measure.
No effect on
distribution of water.
Must be unchanged & if
changed must be
known.
MEASUREMENT OF TOTAL BODY WATER.
By injecting marker
which evenly distribute
in all compartment of
body.
Markers used
Deuterium Oxide (D2O)
Tritium Oxide (T2O)
Aminopyrine.
Value :42 liters.
MEASUREMENT OF ECFVOLUME.
Marker should not enter the
cell but freely pass through
capillary membrane.
Radioactive substances –
Na, Cl, Bromide sulphate,
Thiosulphate
NON-METABOLIZABLE
saccharides – Inulin (Most
accurate) Mannitol, Sucrose
Value : 14 liters.
WHAT ARE THE LIMITATIONS OF
MEASURING THE EXTRACELLULAR
FLUID COMPARTMENT???
MEASUREMENT OF PLASMA VOLUME
Marker should bind
strongly with plasma
proteins & should not
diffuse into Interstistium.
Radioactive iodine (I121)
Evan’s blue dye
Radioactive isotopes of
Chromium (Cr51)
Value : 3.5 liters.
MEASUREMENT OF ICF
Cannot be measured
directly.
So ICF = TBW – ECF
42 - 14 = 28 liters.
MEASUREMENT OF
INTERSTITIAL FLUID VOLUME
Interstitial fluid volume =
ECF – Plasma volume.
= 14 - 3.5 = 10.5 liters
WATER BALANCE
Body fluid levels are maintained at normal
levels when the intake and output of
water are balanced.
INTAkE OUTPUT
Drinking – 1300 Urine – 1500
Food – 850 Sweat through skin - 500
Metabolic origin – 350 Feces – 100
------------ Expired air - 400
2500 ml 2500 ml ----------
When the intake is more than the output then
a positive water balance develops.
PHYSIOLOGICAL POSITIVE WATER
BALANCE
Growth
Convalescence
Pregnancy
PATHOLOGICAL POSITIVE WATER BALANCE
This is referred to as oedema.
Abnormal accumulation of
water in normally existing
space in the body is called
Oedema.
Oedema develops in
Heart Failure
Renal failure
Malnutrition
Inflammation of tissue
OEDEMA
Oedema is mostly extracellular and may develop
due to:
Increase in capillary hydrostatic pressure
Decreased colloidal osmotic pressure
Increased permeability of the capillary
Lymphatic obstruction
Failure of kidney to excrete excess water
NEGATIVE WATER BALANCE
PHYSIOLOGICAL NEGATIVE WATER BALANCE:
occurs during exercise, working in hot sun.
PATHOLOGICAL NEGATIVE WATER BALANCE:
is seen in dehydration, burns, hemorrhage,
vomiting, diarrhea
when the output is more than input,
negative water balance develops.
DEHYDRATION
Excessive loss of body
water leading to a
decline in body
water level iscalled
dehydration.
Dehydration may
be due to :
Simple water loss
Loss of both water
and electrolytes
DEHYDRATION -- EXCESSIVE LOSS OF BODY WATER
IS SEEN IN
Excess body water loss as
in diarrhea
Severe vomiting
Excessive sweating
Fluid loss in burns
Addison’s disease
Diabetes mellitus and
Diabetes insipedus
Renal disease
The clinical symptoms associated with
severe dehydration are:
Low cardiac output
Rapid pulse rate
Low blood pressure
Decreased skin turgor
Acidosis
Sunken eye
Lethargy, confusion and
coma
Intracellular
dehydration may lead
to death.
Severe Dehydration
TREATMENT:
The replenishment
of body with water
and electrolytes.
Electrolytes and pH
should be monitored
carefully.
BODY ELECTROLYTE
Distribution of ions inECF & ICF
IONS ECF ICF
CATIONS
Na+ 142 14
K+ 5.5 150
Ca+ 5 <1
Mg+ 3 58
ANIONS
Cl- 103 4
HCO3 28 10
PO4 4 75
Proteins 5 40
INFERENCE
In ICF major Cations
are K+ & Mg and
major anions PO3 &
Proteins.
In ECF major Cations
is Na+ and major
anions are Cl-& HCO3
EXCHANGEABLE IONS
All body K+is
exchangeable
65-70% of Na is
Exchangeable.
All Ca & Mg Non-
exchangeable.
Only exchangeable
solutes – Osmotically
active.
FUNCTIONS OF ELECTROLYTES
Main solutes for acid-
Base maintenance
balance.
Maintain proper
osmolality & volume of
body fluids.
Concentration of certain
ions determine their
physiological function.
Thank you.