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BODY FLUIDS

BODY FLUIDS. FACTORS AFFECTING. Total Body Water varies depending on body fat: infant: 73% male adult: 60% female adult: 40-50% effects of obesity Old age 45%. FLUIDS and ELECTROLYTES. ICF. ECF. P. ISF. FLUID EXCHANGE BETWEEN BODY FLUID COMPARTMENTS. Osmotic Pressure Gradient.

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BODY FLUIDS

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  1. BODY FLUIDS

  2. FACTORS AFFECTING Total Body Water • varies depending on body fat: • infant: 73% • male adult: 60% • female adult: 40-50% • effects of obesity • Old age 45%

  3. FLUIDS and ELECTROLYTES ICF ECF P ISF FLUID EXCHANGE BETWEEN BODY FLUID COMPARTMENTS Osmotic Pressure Gradient Oncotic P (Colloid osmotic P) Capillary P (Hydrostatic P)

  4. FLUIDS and ELECTROLYTES Control of Osmotic Pressure, Volume & Electrolyte Concentration • OBLIGATORY Reabsorption • occurs in the proximal tubules • 178 L/day of glomerular filtrate (80% reabsorbed) • 2 to solute reabsorption • independent of the water requirement • FACULTATIVE Reabsorption • occurs in the distal & collecting tubules • independent of the active solute transport • dependent of body’s need of water • under the control of ADH

  5. IMPORTANCE • Maintaining ECF volume is critical to maintaining blood pressure • ECF osmolarity is of primary importance in long-term regulation of ECF volume • ECF osmolarity maintained mainly by NaCl balance:

  6. FLUID COMPARTMENTS EXTRA CELLUAR FLUID INTRA CELLULAR FLUID INTERSTITIAL FLUID • PLASMA TRANSCELLULAR FLUID • CSF • Intra ocular • Pleural • Peritoneal • Synovial • Digestive Secretions

  7. VOLUME OF BODY FLUIDS IN 70 kg MAN TOTAL VOLUME 42 L INTRA CELLUAR FLUID 28 L(ROUGHLY 2/3 OF TBW) EXTRA CELLULAR FLUID 14 L(ROUGHLY 1/3 OF TBW) PLASMA 4 L (ROUGHLY ¼ OF ECF)

  8. INTERSTITIAL FLUID ECF – Plasma Volume VOLUME MEASUREMENT OF VARIOUS FLUIDS COMPARTMETNS INTRACELLULAR FLUID TBW – ECF

  9. TOTAL BODY WATER(TBW) • 60% OF THE BODY WEIGHT IN ADULT MALE • 50% OF THE BODY WEIGHT IN ADULT FEMALE

  10. FLUIDS and ELECTROLYTES IV FLUID REPLACEMENT THERAPY • Types of Solutions • Isotonic • 0.9% sodium chloride (NSS) • Lactated Ringer’s sol’n • Hypotonic • 5% dextrose and water (D5W) • 0.45% sodium chloride • 0.33% sodium chloride • Hypertonic • 3% NaCl • Protein sol’ns • Colloids • Salt pour albumin Plasmanate, Dextran

  11. Factors affecting ADH release

  12. REGULATION OF FLUID INTAKE (THIRST) decreased salivation decreased blood volume increased blood osmotic pressure dry mouth and throat decreased blood pressure stimulation of hypothalamic osmoreceptors stimulation of tactile receptors increased angiotensin II stimulation of hypothalamic thirst center conscious awareness of thirst increased water intake

  13. REGULATION OF FLUID OUTPUT ANTIDIURETIC HORMONE ALDOSTERONE ATRIAL NATRIURETIC PEPTIDE increased blood volume dehydration dehydration increased blood osmolarity increased angiotensin II stretch of right atrium stimulation of hypothalamic osmoreceptors increased aldosterone secretion of ANP secretion of ADH from posterior pituitary gland increased Na+ reabsorption decreased Na+ reabsorption increased water reabsorption decreased water reabsorption increased water reabsorption increased thirst rehydration rehydration decreased blood volume

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