Body

Fluids


M Aryadi Arsyad

Study Objec2ves
Understand what is body uid and its
components
Be able to explain how the body maintain uid
balance
Be able to explain consequences of body uid
imbalance

Homeostasis
Internal factors need to be maintained:
1. Concentra?on of nutrients
2. Concentra?on of O2 & CO2
3. Concentra?on of waste products
4. pH
5. Concentra?ons of water, salt & other
electrolytes
6. Volume & pressure
7. Temperature

Homeostasis is essen?al for the survival of each cell, and each cell,
through its specialized ac?vi?es, contributes as part of a body system
to the maintenance of the internal environment shared by all cells

Body uids
Total body water (TBW) comprises 45-75%
(60%) of body weight
TBW fairly constant due to Kidney regulates H2O
balance but varies amongst people
Inuenced by: sex, age and obesity degree
H2O >90% in plasma, 70-80% in skin, muscle and
internal organs, 20% in bones but 10% in fat
Divided into: extracellular uid (ECF) and
intracellular uid (ICF)

Fluid compartments
Intracellular : inside cell, 30-40% of body weight
(28L)
Extracellular : outside cell
Inters??al uid: 16% (11L)
Plasma: 4-5% (3L)
Transcellular: 1-3% (1-2L) (synovial, peritoneal,
pericardial, intraocular space & cerebrospinal uid)

Body uid movement

Extracellular Fluid
Important as intermediary between
intracellular uid and outside environment
Fluid balance is controlled by regula?ng ECF
volume and osmolarity
Plasma is the only uid that its volume &
composi?on can be regulated
Plasma changes en?re ECF ICF

Extracellular Fluid
1. ECF volume is crucial for blood pressure
Salt balance inuence the volume

2. ECF osmolarity can cause the cell swelling or

shrinking
H2O volume determine osmolarity

Video of osmosis process

ECF volume maintenance

Short term control
Baroreceptor reex aects cardiac output & total
peripheral resistance
Fluid transfers between plasma & inters??al
space

Long term control

Kidneys trough urine produc?on
Thirst mechanism that aects uid intake
Na+ intake

Na+ role in ECF volume

Distribu2on of ions in body uids

ECF osmolarity maintenance

Non penetra?ng solutes determine osmolarity
of ECF
Decit free H2O, solutes too concentrated,
increase osmolarity (hypertonic)
Excess free H2O, solutes too diluted, decrease
osmolarity (hypotonic)
Vasopressin (ADH) is important in regula?ng
ECF osmolarity

BODY FLUID REGULATION

Body uid maintenance

Water gain & loss

1. Water gain:
Intake trough inges?on
Water from metabolism

2. Water loss:

Insensible loss trough skin

Insensible loss trough lungs
Sweat
Feces
urine

Vasopressin/ADH

Renin-Angiotensin-Aldosteron (RAA)
System

RAA system

SUHU
NORMAL
(ml/hari)
Insensible Water Loss :
-kulit
350
-Pernapasan
350
Sensible Water Loss :
-urine
1400
-keringat
100
-tinja
100
total

2300

SUHU
PANAS
(ml/hari)

LATIHAN BERAT
DAN LAMA

(ml/hari)

350
250

350
650

1200
1400
100

500
5000
100

3300

6600

Dehydra2on (hypertonic)
1. Water loss trough gastrointes?nal
Vomit
Diarrhea
Fistula & peritoni?s

2. Water loss trough kidney

Diabetes insipidus
Insuciency adrenal
Diure?c osmo?c

3. Water loss trough skin & lungs

Burn trauma
Excessive swea?ng
Lung cancer

Overhydra2on (hypotonic)
Renal failure
Excessive water inges?on
Massive vasopressin release

Edema
Presence of excess uid in body ?ssues
Mainly in extracellular compartment but can
also happen intracellular
The cause of extracellular edema:
1.
2.
3.
4.

Increased capillary pressure

Decreased plasma proteins
Increased capillary permeability
Blockage of lymph return

References
Human physiology, Laura lee Sherwood, 7th
ed.
Human anatomy and physiology, Elaine N
Marieb, 9th ed.
Textbook of medical physiology, Arthur C.
Guyton, 11th ed.