BMS130

Physiological Sciences 2
School of Biomedical Sciences, Charles Sturt University

Topic: Water and electrolyte balance

Reference: Saladin, CH 24 pp 925-936
Lecturer: Drs James Wickham & Brian Spurrell

1 Images provided by Saladin, K. (2012). Anatomy & Physiology: the unity of formSchool
and function
of Biomedical Sciences
 Learning Objectives

1. Name the major fluid compartments & explain how water moves
from one to another
2. List the body’s sources of water and routes of water loss
3. Describe the mechanisms of regulating water intake and output
4. State some conditions where there is a fluid deficiency or a fluid
excess amongst fluid compartments
5. State the physiological roles of sodium and potassium
6. State the term for an excess or deficiency of sodium and describe
consequences of these imbalances
7. State the term for an excess or deficiency of potassium and
describe consequences of these imbalances
8. Describe the hormonal and renal mechanisms that regulate the
concentrations of sodium and potassium

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1. Name fluid compartments & explain how water moves between them
Fluid compartments
•65% Intracellular Fluid (ICF)
•35% Extracellular Fluid (ECF)
25% tissue (interstitial)
fluid
8% blood plasma, lymph
2% transcellular fluid
(CSF, synovial fluid)
Porth, 2007

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1. Name fluid compartments & explain how water moves between them

Water movement between compartments

• Water movement and distribution mainly occurs due to osmosis
except with capillary filtration from blood to tissue fluid

Saladin, Figure 24.1

Note that the net movement of water is determined by

the concentration of solutes in each compartment
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1. Name fluid compartments & explain how water moves between them

Your water content

• Total body water for 70K male = 40L (55-60%)
• Women average less (as a %), because they hold more
adipose tissue which is nearly free of water
• At birth, a baby has more than 75% water weight , and at death we might
only be at 50%.

Image: allaboutim.webs.com

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 2. List the body’s sources of water and routes of water loss

Water Gain
• Preformed water
• ingested in food and drink
• Metabolic water
• by-product of aerobic
metabolism and dehydration
synthesis

E.g. Glycogen formation

Glycogenesis
Saladin, Figure 26.7

Saladin, Figure 2.15

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 2. List the body’s sources of water and routes of water loss
Water Loss
• Routes of loss
• urine, faeces, expired breath, sweat,
cutaneous transpiration
• Loss varies greatly with environment and
activity
• respiratory loss : with cold, dry air or
heavy work
• perspiration loss : with hot, humid air
or heavy work
• Insensible water loss
• breath (300 ml/day) and cutaneous
transpiration (400 ml/day)
• Obligatory water loss (unavoidable)
• breath, cutaneous transpiration, sweat,
faeces, minimum urine output (400
ml/day)
• We gain and lose 2.5L of water/day Saladin, Figure 24.2

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 3. Describe the mechanisms of regulating water intake and output
Regulation of Fluid Intake
• Dehydration
•  blood volume and pressure
•  blood osmolarity
• Thirst mechanisms
• stimulation of thirst center (in hypothalamus)
• hypothalamic osmoreceptors: signal in response to  ECF osmolarity
• ADH: produced in response to  blood osmolarity
• ADH initiates aquaporin synthesis in collecting duct
Leads to 

inhibition of salivation Increased Water reabsorption

thirst center sends
sympathetic signals to
salivary glands.
Mouth feels dry.
from the distal collecting duct in
the renal tubule.
Reduced urine volume, increased
concentration.

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 3. Describe the mechanisms of regulating water intake and output
Neurons sensitive to ECF osmolarity are activated
and release ADH (Vasopressin) with dehydration

(ADH)

Saladin, Figure 24.4

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 3. Describe the mechanisms of regulating water intake and output
Reduced water volume also leads
to reduced plasma volume and
hypotension.
Hypotension stimulates the release of
renin from the kidney. Renin activates
the angiotensin system, causing
aldosterone release from the adrenal
gland.
Aldosterone increases sodium
reabsorption and hence also water
reabsorption in the distal convoluted
tubule and collecting duct
Angiotensin II also directly stimulates
water reabsorption in the proximal
convoluted tubules
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 4. State some conditions of fluid deficiency and also fluid excess
Disorders of Water Balance
Fluid deficiency
1. volume depletion (hypovolemia)
• total body water , osmolarity normal
• hemorrhage, severe burns, chronic vomiting or diarrhea
2. dehydration
• total body water , osmolarity rises
• lack of drinking water, diabetes, profuse sweating,
diuretics
• infants more vulnerable
• high metabolic rate demands high urine excretion,
kidneys cannot concentrate urine effectively, greater
ratio of body surface to mass
• affects all fluid compartments
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 4. State some conditions of fluid deficiency and also fluid excess

Water Loss & Fluid Balance

• profuse sweating

• produced by capillary filtration

• blood volume and pressure drop,

osmolarity rises

• blood absorbs tissue fluid to

replace loss

• fluid pulled from ICF

Saladin, Figure 24.5

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 4. State some conditions of fluid deficiency and also fluid excess
Fluid Excess
• Volume excess
• both Na+ and water retained,
ECF isotonic
• aldosterone hypersecretion
• Hypotonic hydration - more water
than Na+ retained or ingested, ECF Google images “isotonic sports
drinks”
hypotonic - can cause cellular
swelling
• Most serious effects - pulmonary
and cerebral edema (e.g.
hyponatremia) Google images “cerebral edema”

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 4. State some conditions of fluid deficiency and also fluid excess
Fluid Sequestration
• Excess fluid in a particular location
• Most common form: oedema
• accumulation in the interstitial spaces
• Hematomas
• hemorrhage into tissues;
• blood is lost to circulation
• Pleural effusions
• several liters of fluid may
• accumulate in some lung infections

Images: lymphoedema.com.au (top)

casereports.bmj.com (bottom)

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 Learning Objectives

1. Name the major fluid compartments & explain

how water moves from one to another
2. List the body’s sources of water and routes of
water loss
3. Describe the mechanisms of regulating water
intake and output
4. State some conditions where there is a fluid
deficiency or a fluid excess amongst fluid
compartments

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 5. State the physiological roles of sodium and potassium

• Sodium
• The major cation of the ECF accounting for 90-95% of osmolarity of ECF
• Most significant solute in determining total body water and its distribution
• One of the principal ions responsible for RMP and nerve functioning
• Responsible for cell membrane depolarisation in an action potential
• Its gradient is used to co-transport other solutes (glucose, potassium and
calcium)across cell membranes
• Has a major role as a buffer of the pH in ECF (NaHCO3)
• Potassium
• The most abundant cation of the ICF
• Greatest determinant of intracellular osmolarity & cell volume
• One of the principal ions responsible for RMP and nerve functioning
• Responsible for cell membrane repolarisation in an action potential
• Important for proper heart functioning

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 5. State the physiological roles of sodium and potassium
Ionic Basis of Resting Membrane Potential

Saladin, Figure 12.11

• Na+ concentrated outside of cell (ECF)

• K+ concentrated inside cell (ICF)
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 5. State the physiological roles of sodium and potassium

Na+- K+ pump
Sodium is concentrated in ECF and
excluded from ICF

•Exchanges intracellular Na+ for

extracellular K+
•Membrane potential generated by
Na/K exchange & balanced by K
leakage
•generates body heat

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6. State the term for excess/deficiency of Na+ & list their consequences
Sodium - Imbalances
• Hypernatremia
• associated with dehydration
• plasma sodium > 145 mEq/L
• from administration of IV saline
• Results in water retention,
hypertension and edema Google images “hypernatremia”

• Hyponatremia
• plasma sodium < 130 mEq/L
• result of excess body water, drinking
too much too quickly (marathon
runners, Jennifer Strange)
• can result in death from cerebral
edema Google images “hyponatremia”

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7. State the term for excess/deficiency of K+ & list their consequences
Potassium - Imbalances
• Most dangerous electrolyte imbalances occur
with potassium
• Hyperkalemia - effects depend on rate of
imbalance
• if concentration rises quickly, (crush injury) the
sudden increase in extracellular K+ makes
nerve and muscle cells abnormally excitable,
cardiac arrythmias may result in cardiac arrest
• Hypokalemia
• from sweating, chronic vomiting or diarrhea
• nerve and muscle cells less excitable Google images
• muscle weakness, loss of muscle tone,  reflexes, “hyperkalemia”
cardiac arrthymias
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7. State the term for excess/deficiency of K+ & list their consequences
Potassium - Imbalances

Saladin, Figure 24.9

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8. Describe hormonal & renal mechanisms that regulate Na+ & K+ levels
Sodium and potassium homeostasis
• Aldosterone - “salt retaining hormone”
•  # of renal Na+/K+ pumps in distal convoluted tubule and
cortical collecting duct, →  Na+ reabsorption and  K+
reabsorbed but  secretion of K+
• hypernatremia/hypokalemia inhibits release
• ADH -  blood Na+ levels stimulate ADH release
• kidneys reabsorb more water (without retaining more Na+)
• ANP (atrial natriuretic peptide) – from stretched atria
• kidneys excrete more Na+ and H2O, thus  BP/volume
• Others - estrogen retains water during pregnancy
• progesterone has diuretic effect

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8. Describe hormonal & renal mechanisms that regulate Na+ & K+ levels

Sodium and potassium homeostasis

Saladin, Figure 23.21

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8. Describe hormonal & renal mechanisms that regulate Na+ & K+ levels

Sodium and potassium homeostasis

If water follows Na+ through the
kidneys then potassium goes the
opposite way. Secretion is stimulated
by high extracellular concentrations of
potassium (causing the release of
aldosterone), however decreased
sodium concentrations also do this to
increase sodium reabsorption.
Hypotension also does this. The result
of all of these is increased K+ secretion
and decreased water and sodium loss.

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 Learning Objectives

5. State the physiological roles of sodium and

potassium
6. State the term for an excess or deficiency of
sodium and describe consequences of these
imbalances
7. State the term for an excess or deficiency of
potassium and describe consequences of these
imbalances
8. Describe the hormonal and renal mechanisms
that regulate the concentrations of sodium and
potassium
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