bodyfluids- COMPARTEMENTS PPT 2022.ppt1w

Fluids

1. BODY FLUIDS
02/27/25

2. OBJECTIVES
Thursday, December 10,
2015
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.
02/27/25

3. Introduction:
Stability in the volume and composition of body fluid
in body fluid compartments is essential for
homeostasis.
 Functions of cells depend on fluids present both
outside and inside the cells.
 Therefore, maintenance of fluid volume of the body is
an important aspect of patient management in clinical
medicine.
Appropriate fluid replacement in dehydration and
removal of fluid in overhydration, hypervolemia and
edema are mainstay of treatment in fluid volume
disorders.

4. Body Fluid Content:
The body composition of a normal adult
male on average consists of 15% fat, 18%
proteins, 7% minerals and 60% water.
The total body water (TBW) as percentage
of body weight on average is about 60% in
adult males, which is about 10% more than
adult females .
In infants and children, though TBW as
percentage of body weight is more than in
adults, their absolute water content is
significantly less.
BODY COMPOSITION

5. In elderly people in both the sexes, TBW is
about 10% less than their adult
counterparts.
In females, TBW is less than males due to
relatively greater amount of adipose tissue
(subcutaneous fat) in them
Of total body water, about two-third is
present in intracellular compartment and
one-third in extracellular compartment

6. TOTAL BODY WATER
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7. BODY FLUID COMPARTMENTS
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8. 02/27/25

9. DISTRIBUTION OF TOTAL
BODY WATER
Thursday, December 10,
2015
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,
TRANSCELLULAR
FLUID,
MESENCHYMAL
TISSUE (75%)
10.5 15 25
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10. 02/27/25

11. 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%
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12. MOVEMENT OF BODY FLUIDS IMPORTANT
CONCEPT
■Body fluids are not
static.
■Fluids & electrolytes
shift from
compartment to
compartment.
■Emphasis is always
on maintaining
homeostasis
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13. 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.
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14. COMPOSITION OF BODY FLUIDS
■
■
INORGANIC SUBSTANCES:
Extracellular fluid contains
large quantity of sodium,
chlorides, bicarbonate,
glucose, fatty acids 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
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15. 02/27/25

16. SIGNIFICANCE OF BODY FLUIDS
■
■
In Homeostasis: Body
cells survive in the fluid
medium called internal
environment or
milieu interior.
Growth and functions of
cellsGlucose, amino
acids, lipids, vitamins,
ions, oxygen etc., in
proper quantities in the
internal environment.
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17. 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.
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18. 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.
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19. 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.
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20. REGULATORY MECHANISMS
■Hypothalamus –Thirst
mechanism
■KIDNEYS
■Kidney Function
■HORMONES
■Renin-Angiotensin-
Aldosterone
■Anti-Diuretic Hormone
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21. 02/27/25

22. A1 = Amount of indicator injected in the
fluid,
A2 = Amount of indicator removed by
excretion and
metabolism, and
C = Concentration of the indicator in the
fluid.
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23. For example, if 150 mg of sucrose (A1) is injected
into a
70 kg man, 10 mg sucrose (A2) has been excreted or
metabolized and the concentration of plasma
sucrose (C) measured is 0.01 mg/mL; then the
volume distribution ofsucrose is
150 mg – 10 mg/0.01 mg/mL
= 14,000
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24. DILUTION PRINCIPLEDILUTION PRINCIPLE
Inject x gm x gm of marker into compartment
measure concentration at equilibrium (y gm/L) (y gm/L)
Since concentration = mass/ volume
Volume = mass / concentration Volume = mass / concentration
= x/y L= x/y L
C1V1=C2V2
Principle of mass conservationPrinciple of mass conservation
Based on using a marker whose concentration can be
measured.

25. Measuring Compartment Measuring Compartment Size Size
Indirect METHOD Indirect METHOD – INDICATOR (DYE) DILUTION TECHN– INDICATOR (DYE) DILUTION TECHNIQUE
(Law of Mass Conservation) (Law of Mass Conservation)
Concentration = Amount Injected
Volume of Distribution
Amount of Tracer Remained in Compartment = A - E
Compartment Volume = (A – E)/C
Compartment
Volume (V)
Tracer Concentration (C)
Amount of
Tracer Added
(A)
Amount of
Tracer Lost
From
Compartment
(E)
Based on concentration in a well-mixed substance that distributes
itself only in the compartment of interest.

26. 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.
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27. MEASUREMENT OF TOTAL BODY
WATER.
■By injecting marker
which evenly
distribute in all
compartment of body.
■Markers used
■Deuterium Oxide.
■Tritium Oxide.
■Aminopyrine.
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28. MEASUREMENT OF ECF VOLUME.
■
■
■
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
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29. Most accurate method of measuring the
volume of ECF is by using inulin
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30. MEASUREMENT OF PLASMA
VOLUME
■Marker should bind
strongly with plasma
proteins & should not
diffuse into Interstistium.
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31. Plasma volume is measured by two
dilution methods:
First Method: In the first method,
the substance used neither leaves
the vascular system nor penetrates
red cells.
•Examples are: Evans Blue Dye (T-
1824), Radio-iodinated human
serum albumin (RISA), and Radio-
iodinated gamma globulin and
fibrinogen.
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32. Second Method: In the second method,
radio-isotopes of phosphorus (
32
P), iron
(
55,59
Fe) and chromium (
51
Cr) are used that
penetrate and bind to red cells.
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33. Commonly used tag is
51
Cr, which is
attached to the red cells by incubating
in a suitable ‘Cr’ solution. Then, plasma
volume is calculated by using the
formula:

34. MEASUREMENT OF ICF
■Cannot be measured
directly.
■So ICF = TBW - ECF
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35. ■Interstitial fluid
volume =
ECF – Plasma volume.
MEASUREMENT OF INTERSTITIAL
FLUID VOLUME
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36. The ECF volume/intracellular fluid
volume ratio is larger in infants and
children as compared to adults, but
absolute volume of ECF in children is
smaller than in adults.Therefore,
dehydration develops rapidly, more
frequently and severe in children than in
adults.
02/27/25

37. Indicators used for measuring plasma volume, Indicators used for measuring plasma volume,
ECF volume and total body HECF volume and total body H
22OO
CompartmentCompartmentCriterionCriterion IndicatorsIndicators
1.1.PlasmaPlasma Substance Substance
should not cross should not cross
capillariescapillaries
1.1.Evans blue dye; Evans blue dye;
2.2.radioiodinated fibrinogen; radioiodinated fibrinogen;
3.3.radioiodinated albuminradioiodinated albumin
1.1.ECF ECF
volumevolume
Substance Substance
should cross should cross
capillaries but capillaries but
not cross cell not cross cell
membranesmembranes
Isotonic solutions of sucrose, Isotonic solutions of sucrose,
inulin, mannitol, NaClinulin, mannitol, NaCl
1.1.Total Total
body Hbody H
22O O
(TBW)(TBW)
Substance Substance
distributes distributes
evenly in ICF & evenly in ICF &
ECFECF
Heavy H2O, tritiated H2O, Heavy H2O, tritiated H2O,
aminopyrine, antipyrineaminopyrine, antipyrine

38. Blood volume /Markers usedBlood volume /Markers used
1.1.Obtained from plasma volume and hematocritObtained from plasma volume and hematocrit
2.2.Total blood volume = Plasma volume/1- Total blood volume = Plasma volume/1-
HematocritHematocrit
3.3.Example: If the plasma volume is 4 liters and the Example: If the plasma volume is 4 liters and the
hematocrit is 0.45, total blood volume is ?hematocrit is 0.45, total blood volume is ?
4.4.=PLASME VOL X 100=PLASME VOL X 100
100 -HCT100 -HCT

39. 
The electrolytes constitute about 7% of The electrolytes constitute about 7% of
the total body weight.the total body weight.

40. BODY ELECTROLYTE
■Distribution of ions in ECF & 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
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41. 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
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42. EXCHANGEABLE IONS
■All body K+ is
exchangeable
■65-70% of Na is
Exchangeable.
■All Ca & Mg Non-
exchangeable.
■Only exchangeable
solutes – Osmotically
active.
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43. FUNCTIONS OF ELECTROLYTE.
■Main solutes for acid-
Base maintenance
balance.
■Maintain proper
osmolality & volume of
body fluids.
■Concentration of certain
determine their
physiological function.
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44. 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
------------
2500 ml
Expired air -
400
--------
--
2500ml
When the intake is more than the output then
a positive water balance develops.
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45. ❖
❖
❖
Growth
Convalescence
Pregnancy
PHYSIOLOGICAL POSITIVE WATER
BALANCE
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46. 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
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47. 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
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48. 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.
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49. 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
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50. 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 02/27/25

51. 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
■Intracellular
dehydration may lead to
death.
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52. Severe Dehydration
TREATMENT:
The replenishment of
body with water and
electrolytes.
Electrolytes and pH
should be monitored
carefully.
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53. MCQ
The volume of distribution of
intravenously administered sucrose in a
healthy 70-kg man is about:
A.3.5 liters
B.10.5 liters
C.14 liters
D.28 liters
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54. MCQ
The volume of distribution of
intravenously administered sucrose in a
healthy 70-kg man is about:
A.3.5 liters
B.10.5 liters
C.14 liters
D.28 liters
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55. Which of the following markers
administered intravenously distributes
exclusively in plasma?
A.Evans blue dye
B.Heavy water
C.Sucrose
D.None of the above
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56. Which of the following markers administered
intravenously distributes exclusively in plasma?
A.Evans blue dye
B.Heavy water
C.Sucrose
D.None of the above
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57. 100 mg of sucrose is injected intravenously into
an adult male weighing 70 kg. The plasma
concentration of sucrose after mixing is 0.01
mg/ml. If 5 mg of sucrose has been metabolized
during this period, the ECF volume in this
individual is approximately:
A.6 liters
B.9.5 liters
C.14 liters
D.17.5 liters
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58. 100 mg of sucrose is injected intravenously into
an adult male weighing 70 kg. The plasma
concentration of sucrose after mixing is 0.01
mg/ml. If 5 mg of sucrose has been metabolized
during this period, the ECF volume in this
individual is approximately:
A.6 liters
B.9.5 liters
C.14 liters
D.17.5 liters
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59. Indicator-dilution principle:
Volume of distribution of the indicator equals the amount
injected (A) divided by the concentration (C) in plasma (of
the indicator) after mixing.
In the above example,
First, sucrose distributes throughout ECF. Amount of
sucrose injected = 100 mg Amount metabolized = 5 mg
Amount remaining in ECF = 95 mg Concentration after
mixing = 0.01 mg/ml Volume of distribution of sucrose
= 95 mg / 0.01 mg/ml = 9500 ml = 9.5 L
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60. Thank you.
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