BODY FLUID

&
HOMEOSTASIS

DR MOHD SALEH
 Learning Outcome

At the end of this session, the student should be able to:

1. Describe body compositions body fluids & its compartments
2. Differentiate ECF, ICF and interstitial fluid; and relate to its
clinical importance
3. Discuss the factors affecting and controlling body fluids
4. Discuss about homeostasis and its clinical importance in
acidosis and alkalosis
5. Regulation of pH of body fluids by buffering mechanism by
lungs and kidney

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 Approximate Composition of the Body
• The body as an organized “Solution”
• The chief constituent of living tissue is……..
(Water).
• The percentage of water varies with sex, age and lean
body mass
Average total body water (TBW) = 60% of total body weight in 70Kg man
Normal Normal
adult adult
man women
Water % 65- 70 55- 60

Fat % 5 18
Lean (Fat free) body mass 25 22

Other components such as few percentages of Minerals, Protein & Related Substances

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 Is total body water (TBW) same?

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 Body Fluid Distribution

 In 60% of TBW

40%

20%

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 (BFC = ICF + ECF)

 60%

 40%  20%

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 Electrolytes Distribution
TBW 60%

ECFV 20% ICFV 40%

Plasma 5% ISF 15%

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 Solute composition of fluid compartments -
Intracellular fluid
• potassium is abundant in the ICF
• mnemonic: HIKIN = HIgh K+ INtracellularly
- Extracellular fluid
• sodium and chloride is abundant in the ECF

• "60-40-20 Rule"
• 60% of body weight is total body water
• 40% of body weight, or 2/3 of total body water,
is intracellular fluid (ICF)
• 20% of body weight, or 1/3 of total body water,
is extracellular fluid (ECF)

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22.11.22
 Osmosis describes the movement of water through a
semipermeable membrane
• water moves from an area of high water concentration (or low
solute concentration) to an area of low water concentration (or
high solute concentration)

 Osmolarity, Osmolality &Units

• osmolarity ( SI unit - mOsm/L)
• solute concentration per liter of solvent (e.g., water)
• osmolality (mOsm/kg)- 280-295 mOsmol/kg
• solute concentration per kilogram of solvent

 Effective osmole
• a solute that does not cross the cell membrane (e.g., protein)

• this creates an osmotic force that "pulls" water into its

compartment

In body fluids, two terms(osmolarity & osmolality )can be used

synonymously because the differences are small
 Clinical relevance of osmolality
As cell membranes in general are freely permeable to water, the osmolality of the
extracellular fluid (ECF) is approximately equal to that of the intracellular fluid (ICF).
Therefore, plasma osmolality is a guide to intracellular osmolality.
This is important, as it shows that changes in ECF osmolality have a great affect on
ICF osmolality - changes that can cause problems with normal cell functioning and
volume (may even induce cytolysis).
• In normal people, increased osmolality in the blood will stimulate secretion of
antidiuretic hormone (ADH). This will result in increased water reabsorption, more
concentrated urine and less concentrated blood plasma. A low serum osmolality will
suppress the release of ADH, resulting in decreased water reabsorption and more
concentrated plasma.
• An increase of only 2% to 3% in plasma osmolality will produce a strong desire to
drink. A change of 10% to 15% in blood volume and arterial pressure is required to
produce the same response.
22.11.22
 pH

• Is the negative logarithm of the H+ concentration

• In the plasma of healthy individuals, pH is slightly
alkaline, maintained in the narrow range of 7.35 to
7.45
• For each pH unit less than 7.0, the
[H+ ] is increased tenfold; for each
pH unit above7.0, it is decreased
tenfold

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Some features of different fluid compartments

% Major Major Osmolarit pH

Body cation anion y
weight (mosm/L)
TBW 60 - -
= -
ICF 40 K +
PO4 , Prot 290±5 7.3

ECF:ISF 15 Na+ Cl- 290±5 7.4

ECF:IVF 5 Na+ Cl- 290±5 7.4

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 The Internal Environment
• The fluid environment of the cells
• Thus, ECF constitutes …..
‘the internal environment’

The state of relative constancy of the internal

environment, as result of dynamic equilibrium …..
“Homeostasis”

Mechanisms have evolved in the body to keep the

internal environment relatively constant …..
“Homeostatic mechanisms”

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 HOMEOSTASIS

 Maintenance of a nearly constant conditions in the

internal environment – homeostasis
 Essential for survival and normal functioning of all the cells
 Contributed by the functions performed by each body
system

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 HOMEOSTATIC CONTROL SYSTEM
 A functionally interconnected network of body components
that operate to maintain a given chemical or physical state
in the internal environment relatively constant around an
optimal set level

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 HOMEOSTATIC CONTROL SYSTEM

 Can be grouped into two classes:

1. Intrinsic (local) controls
 Inherent compensatory responses of an organ
to a change
2. Extrinsic controls
 Responses of an organ that are triggered by
factors externally to the organ
 Accomplished by nervous and endocrine
systems
 Permit coordinated regulation of several
organs toward a common goal

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 HOMEOSTATIC CONTROL SYSTEM

 The control system consists of

1. Sensor/ Receptor
 Detects the deviations from normal
(change in the internal environment,
stimulus)
2. Integrator
 Receives information from the detector
and integrate it with other relevant
information and send out impulses to
the effector
3. Effector
 Make appropriate adjustments to
reduce the deviation to its desired
value

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 HOMEOSTATIC CONTROL SYSTEM

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 HOMEOSTATIC CONTROL SYSTEM

Regulated Variable Sensor Effector(s)

Arterial blood pressure Carotid baroreceptors Heart, blood vessels

Chemoreceptors in carotid
Arterial PO2and PCO2 Respiratory muscles
sinus and brainstem

Hypothalamic Collecting ducts of the

Osmolarity of body fluids
osmoreceptors renal tubules

Thermoreceptors in Muscle, sweat glands,

Body core temperature
hypothalamus and skin cutaneous circulation

Plasma potassium
Cells of the adrenal cortex Kidney tubule cells
concentration

Plasma glucose Liver, muscle, and adipose

Beta cells in the pancreas
concentration cells

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 HOMEOSTATIC MECHANISM

 Primarily operate on the principle of negative feedback

 Negative feedback
 A change in a homeostatically controlled variable triggers a response that
drives the variable in the opposite direction of the initial change, thus
opposing the change

 A control system’s output is regulated to resist change, so that the

controlled variable is maintained at a set-point value

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 NEGATIVE FEEDBACK

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 NEGATIVE FEEDBACK
(EXAMPLE: BP CHANGES)

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 POSITIVE FEEDBACK

 A change in a controlled variable triggers a

response that drives the variable in the same
direction as the initial change, thus amplifying the
change

 Positive feedback loops are not

homeostatic mechanisms

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 2 3

POSITIVE
FEEDBACK
1
4

5
EXAMPLE: CHILD BIRTH

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 POSITIVE
FEEDBACK

EXAMPLE:BREAST FEEDING

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 HOMEOSTATIC DISRUPTION

 When one or more of the body systems fail to

function properly,
 Homeostasis is disrupted
 An optimal internal environment can not be maintained
 Lead to various pathophysiological states
 May lead to death

 Diseases that result from a homeostatic imbalance

include Heart Failure, Diabetes, …….

 Diabetes occurs when the control mechanism for insulin

becomes imbalanced, either because there is a deficiency of
insulin or because cells have become resistant to insulin.
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 Respiratory Acidosis
-Hypoventilation
-INCREASED of Carbon dioxide
-INCREASED of carbonic acid
-INCREASED of hydrogen ion and
bicarbonate.
-DECREASED pH

-multiple causes including chronic

obstructive pulmonary disease, opiate
abuse/overdose, severe obesity, and brain
injury.

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 Respiratory Alkalosis
-Hyperventilation
-DECREASED of Carbon dioxide
-DECREASED of carbonic acid
-DECREASED of hydrogen ion and
bicarbonate.
-INCREASED pH

-multiple causes including panic attacks with

hyperventilation, pulmonary embolism,
pneumonia, and salicylate intoxication.

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 Metabolic Acidosis
-acid-base imbalance
-INCREASED of organic acids
-abnormal metabolic processes
-INCREASED of lactic acid, ketoacids
and uric acid
-lactic acid (anaerobic glycolysis)
-ketoacids (diabetes mellitus)
-uric acid (kidney problem)

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 Metabolic Alkalosis
-acid-base imbalance
-DECREASE of excess H+
-INCREASED HCO3 concentration and pH

Some of the endocrine disorders, renal

tubular disorders, etc. cause metabolic
disorders
leading to loss of H+

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 Regulation of Acid-Base
Balance

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