BODY FLUIDS

QUENTENE O. OIDARE
(TUTOR)
 Learning objectives
2

At the end of discussion, students should be able to;

1. Describe the organization of the body fluid and its
components.
2. Understand the measurement of the various body
fluid compartments.
3. Describe how fluid moves from one compartment
to another compartment?
4. Able to appreciate applied physiology of body fluids
in clinical areas.
 Body fluids cont.….
3

Body is formed by solids and fluids. Fluid part is more than two
third of the whole body. Water forms most of the fluid part of
the body. In human beings, the total body water varies from
45% to 75% of body weight.
In a normal young adult male, body contains 60% to 65% of
water and 35% to 40% of solids.
In a normal young adult female, the water is 50% to 55% and
solids are 45% to 50%. In females, water is less because of more
amount of subcutaneous adipose tissue. In thin persons, water
content is more
than that in obese persons.
In old age, water content is decreased due to increase in
adipose tissue.
Total quantity of body water in an average human being
weighing about 70 kg is about 40 L.
 Functions of body fluids
4

1. In homeostasis
2. In transport mechanism
3. In metabolic reactions
4. In maintaining the normal texture of tissues
5. In temperature regulation
COMPARTMENTS OF BODY FLUIDS –
DISTRIBUTION OF BODY FLUIDS
5

Total water in the body is approximately 40

litres.
 Body fluid has been divided into two
compartments –
 Intracellular fluid (ICF)
 Inside the cells
 55% of total body water
 Extracellular fluid (ECF)
 Outside the cells
 45% of total body water
 Body Fluids
6

Extracellular fluid includes

 Interstitial fluid
Present between the cells
Approximately 80% of ECF
 Plasma
Present in blood
Approximately 20% of ECF
 Also includes
Lymph
synovial fluid
aqueous humor
cerebrospinal fluid
Body fluids cont.
7
 Barriers separate ICF, interstitial fluid and
plasma
8

 Plasma membrane
 Separates ICF from surrounding interstitial fluid
 Blood vessel wall
 Separate interstitial fluid from plasma
 Organic substances
i. Glucose
ii. Amino acids
iii. Fatty acids
iv. Hormones
v. Enzymes
 MEASUREMENT OF
FLUID VOLUME
9

• Volume of interstitial fluid cannot be measured

directly. It is calculated from the values of ECF volume
and plasma volume
Interstitial fluid volume =
ECF volume – Plasma volume
 Volume of ICF cannot be measured directly. It is
calculated from the values of total body water and
ECF.
ICF volume = Total fluid volume – ECF volume.
 Internal Environment and Homeostasis

Total body water = 60 % BW

Extracellular fluid
Blood Plasma 1/5
1/3 Interstitial fluid 4/5

Intracellular fluid
2/3
= 40 % BW

10
 Internal environment
Intracellular
fluid

Plasma

Interstitial fluid

Extracellular fluid directly baths body cells

Internal environment = Extracellular fluid
11
 Extracellular fluids
Intracellular
fluid
2. Plasma

1. Interstitial fluid
3. Fluid of special compartments:
pericardial fluid, pleural fluid, cerebrospinal fluid
12
 Fluid Compartments
13
 60% of body weight

Extracellular fluid Intracellular fluid

( 1/3) ( 2/3)
 33% of TBW  67% of TBW
 20% of body wt  40% of body wt

Plasma Interstitial fluid Transcellular fluid

 25% of ECF 75% of ECF CSF
 5% of body wt  15% of body wt Intraocular
Pleural
Peritoneal
Pericardial
Synovial
Digestive
secretions
 Example:
How to calculate total body water (TBW)?
14

Q. Calculate TBW for a 70 kg man.

TBW = 60% of body weight

TBW = 60% X 70 = 42 L of water
Differences between ECF & ICF
15

ECF ICF
Anions: Cations: Anions: Cations:
Cl- (108) Na+ (142mmol/L) Cl-
(4)
Na+ (14)
HCO3- (24) K+ (4.2) HCO3- (10)
K+ (140)
Mg2+ (0.8) Phosphate ions
Mg2+ (20)
Nutrients:
Nutrients:
O2, glucose, fatty acids, &
High concentrations of proteins.
amino acids.
Wastes:
CO2, Urea, uric acid,
excess water, & ions.
 Factors affecting body fluids
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1. Water intake & output

2. Age:
- infant: 73%
- elderly: 45%
3. Sex:
- adult male: 60%
- adult female: 40-50%
4. Obesity
5. Climate
6. Habits
7. Level of physical activity
 Body composition
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 In average young adult male:

% of body weight Body composition

18% Protein, & related substances

15% Fat

7% Mineral

60% Water
 Daily intake & output of water (ml/day)
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Prolonged, heavy exercise Normal
Intake:
? 2100  Fluids ingested

(Drinking/in food)
200 200  From metabolism

? 2300 Total intake

Output:
350 350  Insensible – skin

650 350  Insensible – lungs

5000 100  Sweat

100 100  Feces

500 1400  Urine

6600 2300 Total output

In steady state, water intake = water loss
Body Fluid Compartments
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 Water Content Regulation
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 Content regulated so  Sources of water
total volume of water in  Ingestion
body remains constant  Cellular metabolism
 Kidneys primary
regulator of water
 Routes of water loss
excretion
 Urine
 Regulation processes
 Evaporation
 Osmosis
 Perspiration
 Osmolality
 Respiratory passages
 Baroreceptors
 Learned behavior  Feces
 Concentration of body fluids
21

Expressed in terms of 3 ways

I. Osmolality
II. Osmolarity
III. tonicity
 OSMOLALITY
22

Measure of a fluid’s capability to create osmotic pressure is

called osmolality or osmotic (osmolar) concentration of a
solution. In simple words, it is the concentration of
osmotically active substance in the solution. Osmolality is
expressed as the number of particles (osmoles) per kilogram
of solution (osmoles/kg H2O).

Also its a measurement of the amount of osmotically

effective solute per 1000grams of solvent
 It is the molar equivalent of the no. of molecular particles
in a litre of water.
 calculation
23

 Serum osmolality = 2 x Na⁺ (meq/L) +

BUN(mg/dl) + glucose(mg/dl)
2.8 18

Normal serum osmolality is 280 to 295 mOsm/L

 OSMOLARITY
24

Osmolarity is another term to express the osmotic

concentration. It is the number of particles (osmoles) per
liter of solution (osmoles/L).
Osmotic pressure in solutions depends upon osmolality.
However, in practice, the osmolarity and not osmolality is
considered to determine the osmotic pressure because of
the following reasons:
i. Measurement of weight (kilogram) of water in solution is a
difficult process
ii. Difference between osmolality and osmolarity is very
much negligible and it is less than 1%.
 Osmolarity cont.
25

Often, these two terms are used interchangeably.

Change in osmolality of ECF affects the volume of
both ECF and ICF. When osmolality of ECF increases,
water moves from ICF to ECF. When the osmolality
decreases in ECF, water moves from ECF to ICF.
Water movement continues until the osmolality of these
two fluid compartments becomes equal.
 tonicity
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Expressing effective osmolality

 Large molecules like Na and glucose which cross the
cell membrane slowly influences the movement of
water from one compartment to another.
 These molecules are responsible for effective
osmolality.
In terms of tonicity, the solutions are classified into three
categories:
i. Isotonic fluid
ii. Hypertonic fluid
iii. Hypotonic fluid
 Isotonic Fluid
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Fluid which has the same effective osmolality

(tonicity) as body fluids is called isotonic fluid.
Examples are 0.9% sodium chloride solution
(normal saline) and 5% glucose solution.
Red blood cells or other cells placed in isotonic fluid
(normal saline) neither gain nor lose water by
osmosis.
This is because of the osmotic equilibrium
between inside and outside the cell across the cell
membrane.
 Hypertonic Fluid
28

Fluid which has greater effective osmolality than the

body fluids is called hypertonic fluid.
Example is 2% sodium chloride solution.
When red blood cells or other cells are placed in
hypertonic fluid, water moves out of the cells
(exosmosis) resulting in shrinkage of the cells
(crenation).
 Hypotonic Fluid
29

Fluid which has less effective osmolality than the body

fluids is called hypotonic fluid.
Example is 0.3% sodium chloride solution.
When red blood cells or other cells are placed in
hypotonic fluid, water moves into the cells (endosmosis)
and causes swelling of the cells. Now the red blood cells
become globular (sphereocytic) and get
ruptured (hemolysis).
 CONT…
30
 ISOTONIC (0.9%Nacl sol  Osmotic equilibrium
and 5% glucose sol. Fluid Is maintained between inside
which have same effective and outside of the cell
osmolality as body fluids

 Exosmosis
 Hypertonic(2% Nacl sol)
shrinkage of the cell

 Hypotonic(0.3% Nacl sol)

 Endosmosis
swelling and rupture of the
cell (hemolysis)
CONT…

31
 Extracellular Fluid Osmolality
32
 Osmolality  Decreased osmolality
 Adding or removing water  Inhibits thirst and ADH
from a solution changes secretion
this

 Increased osmolality
 Triggers thirst and ADH
secretion
Hormonal Regulation of
Blood Osmolality
33
 Regulation of ECF Volume
34

 Increased ECF results in

 Mechanisms  Decreased aldosterone secretion
 Increased ANH secretion
 Neural
 Decreased ADH secretion
 Renin-angiotensin-  Decreased sympathetic
aldosterone stimulation
 Atrial natriuretic  Decreased ECF results in
hormone (ANH)  Increased aldosterone secretion
 Antidiuretic hormone  Decreased ANH secretion
(ADH)  Increased ADH secretion
 Increased sympathetic
stimulation
Hormonal Regulation of
Blood Volume
35
Hormonal Regulation of
Blood Volume
36
Regulation of ECF Volume
37
Regulation of ICF and ECF
38
 DEHYDRATION
39

Dehydration is defined as excessive loss of water from

the body.
Body requires certain amount of fluid intake daily for
normal functions. Minimum daily requirement of water
intake is about 1 L. This varies with the age and activity
of the individual.
The most active individuals need 2 to 3 L of water intake
daily. Dehydration occurs when fluid loss is more than
what is consumed.
 Basically, dehydration is of three types:
40

1. Mild dehydration: It occurs when fluid loss is about

5% of total body fluids. Dehydration is not very
serious and can be treated easily by rehydration.
2. Moderate dehydration: It occurs when fluid loss
is about 10%. Dehydration becomes little serious
and immediate treatment should be given by
rehydration.
3. Severe dehydration: It occurs when fluid loss is
about 15%. Dehydration becomes severe and
requires hospitalization and emergency treatment.
When fluid loss is more than 15%, dehydration
becomes very severe and life threatening.
 CAUSES OF DEHYDRATION
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1. Severe diarrhea and vomiting due to gastrointestinal

disorders
2. Excess urinary output due to renal disorders
3. Excess loss of water through urine due to endocrine
disorders such as diabetes mellitus, diabetes
insipidus and adrenal insufficiency
4. Insufficient intake of water
5. Prolonged physical activity without consuming
adequate amount of water in hot environment
6. Excess sweating leading to heat frustration
(extreme loss of water, heat and energy). Severe
sweating and dehydration occur while spending
longer periods on regular basis in the saunas
7. Use of laxatives or diuretics in order to lose weight
quickly. This is common in athletes.
 Regulation of Electrolytes in ECF
42
 Na+ Ions
 Electrolytes  Dominant ECF cations
 Molecules or ions with  Responsible for 90-95% of
an electrical charge osmotic pressure
 Water ingestion adds  Regulation of Na+ ions
electrolytes to body
 Kidneys major route of
 Kidneys, liver, skin, excretion
lungs remove from body
 Small quantities lost in
 Concentration changes sweat
only when growing,  Terms
gaining or losing weight
 Hypernatremia
 Hyponatremia
 Control of body fluids
43

 Thirst
 Sweating
 Renal control (aldosterone)
 Neuronal (osmoreceptors, baroreceptors)
44