BODYFLUIDS
dr. Winarsi
The body fluid compartement:
Total body water (TBW) makes up about 60% of body weight
in men and about 50% in women.
Approximately 2/3 of TBW is located in the intracellular
compartement and constitutes the intracellular fluid volume
(ICV).
About 1/3 of TBW is located in the extracellular
compartement and comprises the extracellular fluid volume
(ECFV).
The interstitial fluid volume comprises about ¾ of ECFV and
the plasma volume is about ¼ of ECFV.
Water passes freely and rapidly between all these
compartements in response to changes in solute
concentration to maintain osmotic equilibrium between the
compartements.
Therefore the osmolalities in all compartements are equal.
The availibility of water.
A Preformed water: liquid about 1200 ml., water in
food about 1000 ml.
B Water of oxidation: about 300 ml. (or ‘metabolic
water’) derived from the combustion of food staffs in
the body:
the oxidation of 100 grams of fat yields 107 grams
of water;
the oxidation of 100 grams of carbohydrates yields
55 grams of water;
the oxidation of 100 grams of protein yields 41
grams of water.
Losses of water.
Water is lost from the body by 4 routes:
the skin (as sensible and insensible
perspiration): 75-200ml.
the lung as water vapour in the expired air;
the kidney as urine : 800-1000 ml.;
the intestine as feces : 100 ml.
Total is 1500-2000 ml.
There are 3 categories of solutes:
1.Organic compound of small molecular size
(glucose, urea, amino acid efc.).
2.Organic substances of large molecular size,
mainly the protein.
3.The inorganic electrolytes. Because of the
relatively large quantities of these materials in
the body, the inorganic electrolytes are by far
the most important, both in the distribution and
the retention of body water.
Electrolyte composition of blood plasma and of intracellular
fluid.
Sodium is the major extracellular cation and
is responsible for most of the osmotic driving
force that maintains the size of the ECFV.
Potassium is the major intracellular cation.
Because of the large potassium excretory
capacity of the normal kidney, hyperkalemia
generally does not develop unless a renal
excretory defect is also present.
Chloride is the major extracellular anion and
phosphate is the major intracellular anion.
Blood
Blood, including red cells, white cells, platelets, and a
collection of specialized proteins and various
electrolytes , serves an essential physiologic function
as it carries molecules from one part of the body to
another.
Major functions of blood:
1.Respiration: transpor t of oxygen from the lung to the
tissues and of CO2 from the tissues to the lungs.
2.Nutrition: transport of absorbed food materials.
3.Excretion: transport of metabolic waste to the kidney,
lungs, skin and intestines for removal.
4.Maintanance of the normal acid-base balance in the
body.
5. Regulation water balance through the effects
of blood on the exchange of water between
the circulating fluid and the tissue fluid.
6. Regulation of body temperature by the
distribution of body heat.
7. Defense against infection by the white blood
cells and circulating antibodies.
8. Transport of hormones and regulation of
metabolism.
9. Transport of metabolites.
10.Coagulation.
The concentration of protein in plasma is
important in determining the distribution fluid
between blood and tissues.
Most plasma proteins are synthesized in the
liver. Albumin is the major protein in human
plasma.
Plasma immunoglobulins play a major role in the
body’s defense mechanisms.
The complement system comprises some 20
plasma protein and is invloved in cell lysis,
inflammation.
Vascular hemostasis (coagulation) has four
phases.
1.Constriction of the injured vessel.
2.Formation of a loose and temporary platelet
aggregation at the site of injury.
3.Formation of a fibrin mesh, a more stable
hemostatic plug.
4.Partial or complete dissolution of the
hemostatic plug by plasmin.
SEKIAN
