L4) blood fluids and electrolytes .pdf

Physiology Team 445 4 Body fluids &...

Physiology Team 445 4 Body fluids & electrolytes OBJECTIVE EDITING FILE: Identify daily intake and output of water and - Main Text maintenance of water balance. - Important describe of body fluid compartments as (ICF), (ECF), interstitial fluid, trans-cellular fluid and total body water (TBW). - Dr’s notes - Girls' Slides Describe the composition of each fluid compartment, in terms of volume and ions and represent them in graphic forms. - Boys' Slides Physiology factor influencing body fluid: age, sex, adipose tissue,etc. - Extra Pathological factors: Dehydration, fluid infusion. [email protected] File editing  Body Water Content In general Human body contain 50%-70%, 40%- 70% water Example: 70 kg man has 42 L of water (Kg of water = Liter of water) So he has 42 kg of water Percentage of Factors affecting clarification body 70-73% or Low body fat Infants more Low bone mass Low body fat Healthy males larger amount of 60% adult skeletal muscle Higher body fat Healthy females Smaller amount of 40% - 50% adult skeletal muscle Total body water Older age 45% declines throughout life. In general Higher body fat Means Obese 45% less body water  Regulation of water intake depends on : 1- Climate 2- Habits 3- Level of physical activity The hypothalamic thirst center is stimulated : By increases in plasma osmolality of 1%–2% By a decline in plasma volume of 10%–15% Decline in plasma volume stimulates hypothalamic thirst center, but not as strongly as increased in plasma ‫ لكن لو حدث نقص في‬Thirst center ‫ بالمية وهي نسبة عالية بيتحفز الـ‬١٥ ‫ إلى‬١٠ ‫إذا حدث نقص في حجم البالزما بنسبة‬ ‫ بالمية مارح يتحفز‬٢ ‫ الى‬١ ‫حجم البالزما بنسبة‬ ‫ بيتحفز‬plasmas osmolality ‫ لو حصلت ف الزيادة في‬٢ ‫ الى‬١ ‫ في المقابل نفس هذه النسبة البسيطة‬Thirst center ‫الـ‬ Thirst center ‫الـ‬ So that is why the hypothalamic thirst center is more sensitive to plasma osmolality Factors that affect the TBW Physiological factors : Pathological factors : Age and Sex Vomiting Body fat Diarrhea Climate Blood loss Diseases with excessive Physical activity loss of water DM, excessive sweating  Fluid Compartment Intracellular fluid (ICF) Extracellular fluid (ECF) transcellular fluids Two main fluid compartment Location: inside the cell Location: outside the cell membrane Amount: 2/3 of Total body water Amount: small amount high concentrations of protein Amount: 1/3 of total body water Example: Plasma Interstitial fluid Location: TBW: 42L CSF Location: Fluid bathing the cell Location: Fluid circulating GIT fluid ECF= 14L in the blood vessels Source: Ultra filtration of plasma biliary fluid ICF= 28L Amount: 1/4 of ECF synovial fluid plasma= 3.5L Amount: 3/4 of ECF Intrapleural fluid interstitial= 10.5L intraperitoneal fluid intrapericardial fluid intraocular fluid Plasma and interstitial fluid have almost the same composition. BUT Plasma has a higher protein concentration because proteins cannot pass through the capillary walls during filtration due to their large size. Hence, proteins stay in the plasma (blood) rather than moving into the interstitial fluid. Dr.Nervana Mostafa notes these pictures is Very very Important Cell membrane capabilities Helpful video Daily intake of water The amount of water taken = The amount of water lost These numbers are average numbers so if there is a little changes in exams no problem. For Example : The urine output in normal status equals: 1500 ✔️ 200 100 350  Composition of Body fluids Water Solutes Is the universal fluid Amount= in moles, osmoles Electrolytes Nonelectrolytes (e.g. inorganic salts, all (e.g. glucose, acids, bases, some lipids,creatinine, proteins) urea These substances dissociate into ions in These substances do not dissociate in water and conduct electricity. water and do not conduct electricity. Concentration The number of moles of a substance per liter of Molarity= solution (moles/Liter or M/L) In biological solutions: moles/Liter Millimoles per Liter (mM/L): A measure of the (M/L) concentration of solutes in a solution where 1 mM = 1/1000 M, Dr.Nervana says that “she has no Osmolarity‫(‏‬Osm): The number of osmoles of solute business with these Osmolarity = per liter of solution (osmoles/Liter or Osm/L) values and In biological solutions: definitions, as these Osmoles/Liter Milliosmoles per Liter (mOsm/L): A measure of the are things concerned with (Osm/L) concentration of solute particles in a solution where biochemistry”. 1 mOsm = 1/1000 Osm. Dr.Aldrees says that “all i need you to know is the definitions of these values”. Osmolality = The number of osmoles of solute per Osmoles/kilogram kilogram of solvent (osmoles/kilogram (Osm/kg) or Osm/kg).  Electrolyte Concentration Expressed in milliequivalents per liter ( mEq/L) , measure of number of electrical charges in one liter of solution. -mEq/L = ( concentration of ion in [mq/L]/ the atomic weight of ion ) x number of electrical charges on one ion -For single charged ions —> 1 mEq=1 mOsm -For bivalent ions —> 1 mEq = 1⁄2 mOsm Girls slides Each fluid compartment of the body has a distinctive pattern of electrolytes ECF (Extracellular Fluid): ICF (Intracellular Fluid): Main Cation: Sodium (Na⁺) Main Cation: Potassium (K⁺) Main Anion: Chloride (Cl⁻) Main Anion: Phosphate (PO₄³⁻) Has a low concentration of Has a low concentration of potassium (K⁺) and phosphate sodium (Na⁺) and chloride (Cl⁻). (PO₄³⁻). Both compartments must maintain electroneutrality, meaning the total concentration of cations (positive charges) equals the total concentration of anions (negative charges).  Dr.Aldrees Notes “Na and Cl are the most abundant in the ECF, While Potassium & Phosphate are the dominating cation and anions respectively”. Dr.Nervana Notes “Save this graph in your photo album” While elaborating this graph she asked questions about the Main anions and cations of ECF and ICF. “What are the most important ICF anions? Phosphate and some proteins” said Dr.Nervana. But pay attention that Phosphates are more abundant Dr.Nervana said “ 1-Sodium (Na) is more abundant in ECF. 2- chloride(Cl) is more abundant in ECF. 3-Potassium (K) is more abundant in ICF. You don’t need to memorize proteins and phosphates concentration, just remember where it’s more concentrated ”. Dr.Aldrees said “Plasma fluids have more proteins than Interstitial fluids otherwise they are very similar”. That makes sense because in a later lecture we will learn that we need more proteins inside blood vessels to increase their osmolarity and “suck” back or absorb the fluids that once left the capillaries(left the capillaries into the interstitial fluid) back into them(from the interstitial fluid back into the capillaries). Dr.Aldrees also focused on the same four cations and anions he mentioned in the last slide  Abnormalities in Electrolyte Concentrations: Potassium (K⁺) Sodium (Na⁺): Hypokalemia: Abnormally low Hyponatremia: Abnormally low potassium levels in ECF (1-2 mEq/L sodium levels in ECF. below normal). Hyperkalemia: Abnormally high Hypernatremia: Abnormally high potassium levels in ECF (60-100% sodium levels in ECF. above normal). Normal Ranges: 3.5-4.5 mEq/L Normal Ranges: 135-145 mEq/L Regulation of fluid exchange Intracellular: Cell membrane 1- Highly permeable to water 2-Relatively impermeable to small ions (only water is moving) Extracellular 1-Osmotic effect of electrolytes (e.g. Na,K,Cl) Boys slides  MCQs 1- Composed of ultrafiltration of plasma A) Intracellular B) interstitial C) Transcellelar D) Both A and B fluid fluid Fluid 2- What is the cheif cation in the ECF? A) Phosphate B) Sodium C) Chloride D) Potassium 3- When someone s thirsty the plasma osmolality: A) increase B) declines C) doubled D) tripled 4- Which of these fluids have high concentration of protein? A) Intracellular B) plasma C) Interstitial fluid D) Both A and B fluid 5- which of the following is considered “internal Environment of the body? A) Capillary B) Extracellular C) interstitial D) Transcellular walls fluid fluid fluid 1-B, 2-B, 3-A, 4-D, 5-B Jood Alqosi Bandar Alqahtani Aljoharah Algazlan Abdulaziz Alowaid Dana Alanazi Naser Alnukhylan Maha alghamdi Khalid Alangari Rehad Almutairi Turki Alanazi Danah Alrabiah Rayan Alshahrani Rahaf Metlea Mohammed Almutairi Renad Bin Sanad Faris Aldawood Horia alotaibi Abdullah Alnami Latifah Al-Dossary Yazeed Alqarni Aryam Almotairi Ibrahim Almugrin Jory Alturki Abdulaziz Ibrahim Nada Almuhawwis Shahad alotaibi Basma Al-Bahkly Retaj Alosaimi