Fluid, Electrolyte, and

Acid-Base Balance
Prof. Yasmeiny Yazir
Dr. Eka Roina Megawati
Dept. Physiology
University of Sumatera Utara

Introduction to Body Fluids

Body

fluids is the fluids in the body

that is composed of water &
dissolved substances, including
electrolytes, which are crucial for
body function.

Body Water Content

Infants

have low body fat, low bone

mass, and are 73% or more water
Total water content declines
throughout life
Healthy males are about 60% water;
healthy females are around 50%
This difference reflects females:
Higher

body fat
Smaller amount of skeletal muscle
In

old age, only about 45% of body

weight is water

Functions of Body Water

Regulating

body temperature
As protective cushion & lubricant
As reactant
As solvent
As transporter

Fluid Compartments
Water

occupies two main fluid

compartments
Intracellular fluid (ICF) about two
thirds by volume, contained in cells
Extracellular fluid (ECF) consists of
two major subdivisions
Plasma the fluid portion of the
blood
Interstitial fluid (IF) fluid in spaces
between cells

Other

ECF lymph, cerebrospinal

fluid, eye humors, synovial fluid,
serous fluid, and gastrointestinal
secretions

Fluid Compartments
The

plasma and the cellular elements

of the blood, principally red blood
cells, fill the vascular system, and
together they constitute the total
blood volume.
The interstitial fluid is that part of
the ECF that is outside the vascular
system, bathing the cells.

About

a third of the total body

water (TBW) is extracellular;
the remaining two-thirds are
intracellular (intracellular
fluid).

Body fluid
compartme
nts

Body Composition
The

intracellular component of the

body water accounts for about 40% of
body weight and the extracellular
component for about 20%.
Approximately 25% of the extracellular
component is in the vascular system
(plasma = 5% of body weight) and 75%
outside the blood vessels (interstitial
fluid = 15% of body weight).

 The

total blood volume is about 8%

of body weight.

Fluid Compartments

Figure 26.1

Composition of Body Fluids

Water

is the universal solvent

Solutes are broadly classified into:
Electrolytes inorganic salts, all
acids and bases, and some
proteins
Nonelectrolytes examples include
glucose, lipids, creatinine, and urea

 Electrolytes

have greater osmotic

power than nonelectrolytes
Water moves according to osmotic
gradients

Units for Measuring

Concentration of Solutes
Moles
A

mole is the gram-molecular weight of

a substance, ie, the molecular weight of
the substance in grams.
Each mole (mol) consists of
approximately 6 1023 molecules.
The millimole (mmol) is 1/1000 of a
mole, and the micromole (mmol) is
1/1,000,000 of a mole.

 Thus,

1 mol of NaCl = 23 + 35.5 g =

58.5 g, and 1 mmol = 58.5 mg.
The mole is the standard unit for
expressing the amount of substances
in the SI unit system

Units for Measuring

Concentration of Solutes
Equivalents
The

concept of electrical equivalence

is important in physiology because
many of the important solutes in the
body are in the form of charged
particles.
One equivalent (eq) is 1 mol of an
ionized substance divided by its
valence.

 One

mole of NaCl dissociates into 1

eq of Na+ and 1 eq of Cl-. One
equivalent of Na+ = 23 g; but 1 eq of
Ca2+ = 40 g/2 = 20 g.
The milliequivalent (meq) is 1/1000
of 1 eq.

Electrolyte Concentration
Expressed

in milliequivalents per liter

(mEq/L), a measure of the number of
electrical charges in one liter of solution
mEq/L = (concentration of ion in
[mg/L]/the atomic weight of ion) number
of electrical charges on one ion
For single charged ions, 1 mEq = 1 mOsm
For bivalent ions, 1 mEq = 1/2 mOsm

Extracellular and Intracellular

Fluids
Each

fluid compartment of the body

has a distinctive pattern of
electrolytes
Extracellular fluids are similar
(except for the high protein content
of plasma)
Sodium is the chief cation
Chloride is the major anion

 Intracellular

and chloride
Potassium

fluids have low sodium

is the chief cation

Phosphate is the chief anion

Extracellular and Intracellular

Fluids
Sodium

and potassium concentrations

in extra- and intracellular fluids are
nearly opposites
This reflects the activity of cellular
ATP-dependent sodium-potassium
pumps
Electrolytes determine the chemical
and physical reactions of fluids

Extracellular and Intracellular

Fluids
Proteins,

phospholipids, cholesterol,
and neutral fats account for:
90% of the mass of solutes in
plasma
60% of the mass of solutes in
interstitial fluid
97% of the mass of solutes in the
intracellular compartment

Electrolyte Composition of Body

Fluids

Figure 26.2

Major functions of
electrolytes :
Cofactors

for enzymes
Action potential in neuron and
muscle cells
Secretion & action of hormones &
neurotransmitters
Muscle contraction
Acid/base balance
Osmosis

Fluid Movement Among

Compartments
Compartmental

exchange is
regulated by osmotic and hydrostatic
pressures
Net leakage of fluid from the blood is
picked up by lymphatic vessels and
returned to the bloodstream

 Exchanges

between interstitial and

intracellular fluids are complex due
to the selective permeability of the
cellular membranes
Two-way water flow is substantial

OSMOSIS
When

a substance is dissolved in
water, the concentration of water
molecules in the solution is less than
that in pure water, since the addition
of solute to water results in a solution
that occupies a greater volume than
does the water alone.

 If

the solution is placed on one side

of a membrane that is permeable to
water but not to the solute and an
equal volume of water is placed on
the other, water molecules diffuse
down their concentration gradient
into the solution.

Diagrammatic representation of
osmosis

Water

molecules are represented by small

open circles, solute molecules by large solid
circles.
In the diagram on the left, water is placed on
one side of membrane permeable to water but
not to solute, and an equal volume solution of

Diagrammatic representation of
osmosis

Water molecules move down their concentration gradient

into the solution, and, as shown in the diagram on the right,
the volume of the solution increases.
As indicated by the arrow on the right, osmotic pressure is
the pressure that would have to be applied to prevent the
movement of the water molecules.

OSMOSIS
This

processthe diffusion of
solvent molecules into a region in
which there is a higher concentration
of a solute to which the membrane
is impermeableis called osmosis.
It is an important factor in
physiologic processes.

OSMOTIC PRESSURE
The

tendency for movement of

solvent molecules to a region of
greater solute concentration can be
prevented by applying pressure to the
more concentrated solution.
The pressure necessary to prevent
solvent migration is the osmotic
pressure of the solution.

 The

osmolarity is the number of

osmoles per liter of solutioneg,
plasmawhereas the osmolality is
the number of osmoles per kilogram
of solvent. Therefore, osmolarity is
affected by the volume of the various
solutes in the solution and the
temperature, while the osmolality is
not.

 Osmotically

active substances in the

body are dissolved in water, and the
density of water is 1, so osmolal
concentrations can be expressed as
osmoles per liter (osm/L) of water.

OSMOSIS
Diffusion

of water trough a
semipermeable membrane from
higher water concentration (lower
solute concentration) to a lower
water concentration (higher solute
concentration)
Tonicity: a measure of the ability of a
solution to cause a change in cell
shape by promoting osmotic flow

 Osmotic

pressure is defined as the

external pressure applied to the top
of the fluid to prevent osmosis from
occuring

Osmolal Concentration of
Plasma: Tonicity
The

term tonicity is used to describe

the osmolality of a solution relative
to plasma. Solutions that have the
same osmolality as plasma are said
to be isotonic; those with greater
osmolality are hypertonic; and
those with lesser osmolality are
hypotonic.

 All

solutions that are initially

isosmotic with plasmaie, that have
the same actual osmotic pressure or
freezing-point depression as plasma
would remain isotonic if it were not
for the fact that some solutes diffuse
into cells and others are metabolized.

 Thus,

a 0.9% saline solution remains

isotonic because there is no net
movement of the osmotically active
particles in the solution into cells and
the particles are not metabolized.
On the other hand, a 5% glucose
solution is isotonic when initially
infused intravenously, but glucose is
metabolized, so the net effect is that
of infusing a hypotonic solution.

Osmosis & IV fluids

Hypotonic

IV solutions if too much

water enters the cells eventually it
coud undergo hemolysis or break
open
Hypertonic IV solutions there is a
net flow of water out of the cell and
that cause the cell to shrink

Extracellular and Intracellular

Fluids
Ion

fluxes are restricted and move

selectively by active transport
Nutrients, respiratory gases, and
wastes move unidirectionally
Plasma is the only fluid that
circulates throughout the body and
links external and internal
environments

 Osmolalities

of all body fluids are

equal; changes in solute
concentrations are quickly followed
by osmotic changes

Movements of fluids in the

body
Absorption;

Fluids are absorbed into

the plasma in the intestine
Circulation; The fluids circulate within
the plasma bathing the cells in the
body
Excretion; The kidney remove excess
ions and water from the body
through urine

Continuous Mixing of Body

Fluids

Water Homeostasis
The body maintains a balance of water
intake and output by a series of
negative feedback loop involving the
endocrine system and autonomic
nervous system

Water Balance and ECF

Osmolality
To

remain properly hydrated, water

intake must equal water output
Water intake sources
Ingested fluid (60%) and solid food
(30%)
Metabolic water or water of
oxidation (10%)

Water Balance and ECF

Osmolality

Water output

Urine (60%) and feces (4%)

Insensible losses (28%), sweat (8%)

Increases in plasma osmolality trigger thirst

and release of antidiuretic hormone (ADH)

Water Intake and Output