The document summarizes the pathophysiology of several body fluids. It describes how urine is formed through glomerular filtration and tubular reabsorption in the kidneys. Cerebrospinal fluid is produced by the choroid plexuses at a rate of 0.3-0.4 mL/min and circulates through the ventricular system and subarachnoid space. Synovial fluid is an ultrafiltrate of plasma combined with hyaluronic acid in synovial joints. Pleural, pericardial and peritoneal fluids are plasma filtrates that lubricate body cavities, and accumulations result in effusions.
The document summarizes the pathophysiology of several body fluids. It describes how urine is formed through glomerular filtration and tubular reabsorption in the kidneys. Cerebrospinal fluid is produced by the choroid plexuses at a rate of 0.3-0.4 mL/min and circulates through the ventricular system and subarachnoid space. Synovial fluid is an ultrafiltrate of plasma combined with hyaluronic acid in synovial joints. Pleural, pericardial and peritoneal fluids are plasma filtrates that lubricate body cavities, and accumulations result in effusions.
The document summarizes the pathophysiology of several body fluids. It describes how urine is formed through glomerular filtration and tubular reabsorption in the kidneys. Cerebrospinal fluid is produced by the choroid plexuses at a rate of 0.3-0.4 mL/min and circulates through the ventricular system and subarachnoid space. Synovial fluid is an ultrafiltrate of plasma combined with hyaluronic acid in synovial joints. Pleural, pericardial and peritoneal fluids are plasma filtrates that lubricate body cavities, and accumulations result in effusions.
Dept. of Clinical Pathology Faculty of Medicine - Hasanuddin University URINE Normal Adult ±1200 ml/min of blood perfuses the kidney (25% of CO). Blood afferent arterioles ultrafiltrate on Glomeruli Bowman’s space tubules reabsorption or secretion and concentration on collecting ducts. Original glomerular filtrate vol. = 180 L in 24hrs reduced 1-2L, depending on status of hydration. Urine formed in the kidney passes from collecting ducts renal pelvis ureters bladder urethra voided. Through glomerular filtration and tubular secretion, numerous waste products are eliminates from body, including : – Nitrogenous products – Organic acids and bases – Inorganic acids and bases. The kidney provide important hormonal regulation with erythropoietein and renin prod., as well as vitamin D activation. Derangement of renal function chemically or cytologically alteres urine. Cerebrospinal Fluid (CSF) In adults, ±500ml of CSF produced each day (0.3- 0.4 mL/min). Total vol. = 90-150mL 25mL in ventricles and the remainder in subaracnoid space (SAS). Total CSF vol. replaced every 5-7hrs. 70% of CSF derived by ultrafiltration and secretion through the choroid plexuses. Ventricular ependymal lining and cerebral SAS account for the remainder. CSF leaves the ventricular syst. Through medial and lateral foramina, flowing over the brain and spinal cord surface within SAS. Arachnoid villi CSF resorption, along the superior sagittal sinus. Blood-brain barrier (BBB) derived from dye-exclusion studies. Consists of 2 morphologically distinct comp. : – A unique capillary endothelium held together by intercellular tight junctions – The choroid plexus, a single layer of specialized choroidal ependyma cells connected by tight junctions overlies fenestrated capillaries. CSF Major functions : – Provides physical support – Confers a protective effect against sudden changes in acute venous and arterial blood pressure – Provides an excretory waste function – Pathway whereby hypothalamus releasing factors are transported to the cells of median eminence – Maintains central nervous system ionic homeostasis. CSF ionic components (e.g. H+, K+, Ca2+, Mg2+ , bicarbonate, etc) tightly regulated by specific transport systems, whereas glucose, urea, and creatinine diffuse freely but require 2 or more hours to equilibrate. Proteins cross by passive diffusion at a rete proportional to their molecular weight and hydrodinamic vol. BBB maintains the relative homeostasis of the central nervous systems environment during acute perturbations of plasma comp. SYNOVIAL FLUID (SF) Synovium tissue lining synovial tendon sheaths, bursae, and disarthrodial joints except articular surface. Composed 1-3 cell layers form discontinuous surface overlying fatty, fibrous, or periosteal joint tissue.
SF is an imperfect ultrafiltrate of blood
plasma combined with hyaluronic acid produced by synovial cells. Small ions and molecules readily pass into the joint space and similar concentration to plasma.
Resorption by lymphatics and is not size
dependent.
SF acts as a lubricant and adhesive, and provide
nutrients for the avascular articular cartilage. PLEURAL FLUID The pleural cavity is a potential space lined by mesothelium of the visceral and parietal pleura.
The pleural cavity normally contains a small
amount of fluid that facilitates movement of 2 membranes against each other.
This fluid is a plasma filtrate derived from capillary
of the parietal pleura. It’s produced continuously at a rate dependent on capillary hydrostatic pressure, plasma oncotic pressure, and capillary permeability. Pleural fluid is reabsorbed through the lymphatics and venules of visceral pleura. An accumulation of fluid effusion imbalance of fluid production and reabsorption. This fluid accumulation in the pleural, pericardial, and peritoneal cavities known as serous effusion. PERICARDIAL FLUID From 10-50 mL of fluid is normally present in the pericardial space, produced by transudative process ≈ pleural fluid. Pericardial effusions are most often caused by viral infection, enterovirus being the most common. They may also develop as a result of bacterial, tuberculous or fungal infections, autoimmune disorders, renal failure, myocardial infarctions, mediastinal injury, the effects of various drug or idiopathic. PERITONEAL FLUID Ascites is the pathologic accumulation of excess fluid in the peritoneal cavity. Up to 50 mL of fluid is normally present in the mesothelial-lined space. As with pericardial and pleural fluids, it’s produced as an ultrafiltrate of plasma dependent on vascular permeability, and hydrostatic and oncotic starling forces.