Body Fluids

60% OF HUMAN BODY IS WATER!

How to Determine The Volume of Body Fluids Compartments??

Oedema

Dehydration

1. Body Fluids “MohmmadRjab” S. Seder

2. ≈ 60% OF HUMAN BODY IS WATER ! AND WE HAVE MADE FROM WATER EVERY LIVING THING Quran 21:30

3. Total Body Water

4. 40% is intracellular fluid (ICF) i.e. fluid inside the cells. 20% is extracellular fluid (ECF) i.e. fluid outside the cells. Further divided into: Interstitial Fluid (ISF)- 15% Plasma- 5% ≈ 60% OF HUMAN BODY IS WATER !

5. ≈ 60% OF HUMAN BODY IS WATER ! 40% is intracellular fluid (ICF) i.e. fluid inside the cells. 20% is extracellular fluid (ECF) i.e. fluid outside the cells. Further divided into: Interstitial Fluid (ISF)- 15% Plasma- 5%

6. Distribution of Total Body Water COMPARTMENTS VOLUME (L) PERCENTAGE % BODY WEIGHT BODY WATER TOTAL BODY WATER 42 60 100 ICF 28 40 67 ECF 14 20 33 PLASMA (25%) 3.5 5 8 INTERSTITIAL FLUID 10.5 15 25 TRANSCELLULAR FLUID MESENCHYMAL TISSUE (75%)

7. Percentage of Water in The Body Total Body Water varies depending on body fat: I nfant: 73% M ale adult: 60% F emale adult: 40-50% E ffects of obesity Old age 45%

8. Water content varies in different body organs and tissues, from as little as 8 percent in the teeth to as much as 85 percent in the brain. Body Water Content

9. Body Fluid Compartment

10. ECF Vs ICF ECF Most abundant cation: Na + Most abundant anion: Cl - ICF Most abundant cation: K + Anions are protein and phosphates (HPO 4 -2 ) Also called internal environment or m ilieu interior ICF ECF Volume 40% 20% Major ions K+ Proteins Na+ Cl- pH 7.0 7.4

11. Movement of Body Fluids Body fluids are not static . Fluids and electrolytes shift from compartment to compartment . Emphasis is always on maintaining homeostasis .

12. Composition of Body Fluids Body fluids contai n water and solids. Solids are organic and inorganic substances.

13. Composition of the ICF, IF, and plasma The graph shows the composition of the ICF, IF, and plasma. The compositions of plasma and IF are similar to one another but are quite different from the composition of the ICF

14. You're looking at Plasma, a typical body fluid

15. Significance of Body Fluids I n t ransport mechanism : b ody water forms the transport medium by which nutrients and other essential substances enter the cells and wastes come out of the cells .

16. 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

17. 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.

18. Regulatory Mechanisms Hypothalamus Thirst mechanism Kidneys Kidney Function Hormones R e n i n A n g i o te n s i n Aldosterone Anti-Diuretic Hormone

19. How to Determine The Volume of Body Fluids Compartments??

20. Measurements of Body Fluids INDICATOR DILUTION METHOD Fick's Principle Dilution Principle 1- A known amount of indicator is injected intravenously. The indicator should be inert, non-toxic and not used by tissue. 2- Enough time is allowed for even distribution of indicator. 3- A sample is taken to determine concentration (dilution) of indicator volume. Volume of distribution = V = M / C

21.   C 1 x V 1 = C 2 x V 2

22. Prerequisite 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.

23. Measurement of fluid volume

24. Measurement of Total Body Water By injecting marker which evenly distribute in all compartment of body. Markers used Deuterium Oxide (D 2 O) / ( 2 H 2 O) Tritium Oxide ( 3 H 2 O) Aminopyrine Antipyrine

25. Measurement of ECF Volume Marker should not enter the cell but freely pass through capillary membrane. Markers used: Radioactive substances _ Na, Cl, Bromide sulphate, Thiosulphate Non-Metabolizable saccharides _ Inulin (Most accurate) , Mannitol , Sucrose

26. Unfortunately, some bromine -82 also distributes into the cells. Thus, bromine measurements of the ECF volume frequently over-estimate the ECF volume

27. Measurement of Plasma Volume Marker should bind strongly with plasma proteins and should not diffuse into Interstistium. Markers used: Radioactive iodine (I 121 ) Evan’s blue dye Radioactive isotopes of Chromium (Cr 51 )

28. Measurement of ICF Volume Cannot be measured directly. So, ICF = TBW - ECF

29. Measurement of Interstitial Fluid Volume Interstitial F luid V olume = ECF – Plasma volume

30. Estimating the blood volume on the basis of the measured plasma volume Hematocrit: is the volume percentage of red blood cells in blood, measured as part of a blood test.

31. Water Balance Body fluid levels are maintained at normal levels when the intake and output of water are balanced . When the intake is more than the output then a positive water balance develops .

32. Physiological Positive Water Balance Growth Convalescence Pregnancy

33. Pathological Positive Water Balance OEDEMA Oedema: Abnormal accumulation of water in normally existing space in the body . Oedema develops in Heart Failur e Renal failure Malnutrition Inflammation of tissue

34. 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

35. Oedema Edema is the accumulation of excess water in the tissues. It is most common in the soft tissues of the extremities. The symptoms of edema include swelling of the subcutaneous tissues, an increase in the normal size of the limb, and stretched, tight skin.

36. Negative Water Balance Physiological Negative Water Balance: occurs during exercise , working in hot sun. Pathological Negative Water Balance: I s seen in dehydration , burns , hemorrhage , vomiting , diarrhea . W hen the output is more than input, negative water balance develops.

37. Dehydration Excessive loss of body water leading to a decline in body water level is called dehydration . Dehydration may be due to : Simple water loss . Loss of both water and electrolytes .

38. 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

39. The clinical symptoms associated with severe dehydration are: Low cardiac output Rapid pulse rate Low blood pressure Decreased skin turgor Acidosis Sunken eye balls Lethargy, confusion and coma excessive sleepiness lessened urine output Intracellular dehydration may lead to death

40. Treatment of Dehydration The replenishment of bod y with water and electrolytes. Electrolytes and pH should be monitored carefully.

41. Exchangeable Ions All body K + is exchangeable 65-70% of N a i s Exchangeable. All Ca & Mg Non- exchangeable. Only exchangeable solutes – Osmotically active

42. THANK YOU