1/16/2017 FluidPhysiology:2.

3OsmolalityandTonicity

FluidPhysiology
2.3OsmolalityandTonicity

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Somedefinitionsarenecessaryfirsttohelpusinourdiscussionoffluidandelectrolyteconditions.

UsefulDefinitions

MoleAmoleistheamountofasubstancethatcontainsthenumberofmoleculesequalto
Avogadro'snumber.Themassingramsofonemoleofasubstanceisthesameasthenumber
ofatomicmassunitsinonemoleculeofthatsubstance(iethemolecularweightofthe
substanceexpressedasgrams).Themole(symbol:mol)isthebaseunitintheSIsystemfor
theamountofasubstance
Avogadro'snumberthisisthenumberofmoleculesinonemoleofasubstance(ie6.022x
1023)
Molalityofasolutionisthenumberofmolesofasoluteperkilogramofsolvent
Molarityofasolutionisthenumberofmolesofsoluteperlitreofsolution
OsmoleThisistheamountofasubstancethatyields,inidealsolution,thatnumberof
particles(Avogadrosnumber)thatwoulddepressthefreezingpointofthesolventby1.86K
Osmolalityofasolutionisthenumberofosmolesofsoluteperkilogramofsolvent
Osmolarityofasolutionisthenumberofosmolesofsoluteperlitreofsolution

Osmolalityisameasureofthenumberofparticlespresentinsolutionandisindependentofthesizeorweightofthe
particles.Itcanbemeasuredonlybyuseofapropertyofthesolutionthatisdependentsolelyontheparticle
concentration.Thesepropertiesarecollectivelyreferredtoasthecolligativeproperties.

ColligativeProperties

vapourpressuredepression
freezingpointdepression
boilingpointelevation
osmoticpressure

Theosmoticpressureisthehydrostatic(orhydraulic)pressurerequiredtoopposethemovementofwaterthrougha
semipermeablemembraneinresponsetoan'osmoticgradient'(iedifferingparticleconcentrationsonthetwosides
ofthemembrane).

Serumosmolalitycanbemeasuredbyuseofanosmometeroritcanbecalculatedasthesumoftheconcentrations
ofthesolutespresentinthesolution.Thevaluemeasuredinthelaboratoryisusuallyreferredtoastheosmolality.
Thevaluecalculatedfromthesoluteconcentrationsisreportedbythelaboratoryastheosmolarity.TheOsmolargap
isthedifferencebetweenthesetwovalues.Thetwovaluesusuallydon'tmatchexactlyforvarious:therearea
numberofformulasthatcanbeusedandtheyallgiveslightlydifferentresultstheformulastypicallyusethe
concentrationsofonly3solutes(Na,glucose,urea)inthecalculationsocontributionsfromabnormalsmallMW
unchargedsubstanceswillbemissedsothecalculatedvaluewillbelowuseofosmometersthatusethevapour
pressuremethodareunreliableinthepresenceofvolatilechemicals.

Tonicityisatermusedfrequentlyinamedicalcontext.Itisalsoatermwhichisfrequentlymisunderstoodasitis
definedinatleastthreedifferentways.Themostrigorous&usefuldefinitionis:

Tonicityistheeffectiveosmolalityandisequaltothesumoftheconcentrationsofthesoluteswhichhavethecapacity
toexertanosmoticforceacrossthemembrane.

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Thekeypartsareeffectiveandcapacitytoexert.Theimplicationisthattonicityislessthenosmolality.Howmuch
less?Itsvalueislessthenosmolalitybythetotalconcentrationoftheineffectivesolutesitcontains.Whyaresome
soluteseffectiveandothersineffective?

Considerthisexperiment:ImagineaglassUtubewhichcontainstwosodiumchloridesolutionswhichare
separatedfromeachotherbyasemipermeablemembraneinthemiddlelowestpartoftheUtube(seefigurebelow).
Themembraneispermeabletowateronlyandnottothesolutes(Na +andCl)present.Ifthetotalparticle
concentration(osmolality)ofNa +andClononesideofthemembranewashigherthantheotherside,waterwould
movethroughthemembranefromthesideoflowersoluteconcentration(oralternatively:higherH2Oconcentration)
tothesideofhighersoluteconcentration.Water(thesolvent)movesdownitsconcentrationgradient.

UTubeExperimentalSetup

coming...

IfthewaterlevelsweredifferentinthetwolimbsoftheUtubeatthestartoftheexperimentthen:

Whatwouldbetheequilibriumsituationasregardsparticle(iesolute)concentrationonthetwosidesofthe
membrane?
Whatwouldthedifference(ifany)beintheheightsofthewaterlevelsonthetwosidesofthemembrane?
Istheequilibriumconditionreachedwhentheparticleconcentration(ieosmolality)isequalonthetwosidesof
themembrane?

Theanswertothelastquestionisnobecausethisneglectstheprobabledifferenceintheheightofthewatercolumns
inthetwolimbs.Thisheightdifferenceisahydrostatic(orhydraulic)pressuredifferenceandthisprovidesan
additionalforcewhichmustbeaccountedforinthebalancingofforcesneededtoreachanequilibrium.(An
equilibriumispresentwhenthereisnonetwatermovementacrossthemembrane.)

Theequilibriumwouldoccurwhenthisnethydrostaticpressureisbalancedbytheremainingdifferenceinosmolality
betweenthetwosolutions.Thisosmolalitydifferenceresultsinanosmoticforcewhichtendstomovethewaterinthe
oppositedirectiontothehydrostaticpressuregradient.Equilibriumiswhentheseopposingforcesareequal.

Nowconsiderwhatwouldhappenintheabovesituationifthemembranewaschangedtoonewhichwasfreely
permeablebothtothewaterandtotheions(sodium&chloride)present.Nownoneoftheparticlespresenthasthe
capacitytoexertanosmoticforceacrossthemembrane.Atequilibriumthereisnodifferenceinthefluidlevelsinthe
twolimbsoftheUtubebecausetheparticlespresentwillmoveacrossthemembraneuntiltheconcentration
gradientsforNa +orClareeliminated.Theosmolalityisnowthesameonbothsidesofthemembrane.At
equilibriumtherewillbenohydrostaticgradienteither.

Theconclusionisthatifthemembraneallowscertainsolutestofreelycrossit,thenthesesolutesaretotally
ineffectiveatexertinganosmoticforceacrossthismembraneandthismustbecorrectedforwhenconsideringthe
particleconcentrationsacrossthemembrane.Tonicityisequaltotheosmolalitylesstheconcentrationofthese
ineffectivesolutesandprovidesthecorrectvaluetouse.

OsmolalityandTonicity:RelationshiptoMembrane

Osmolalityisapropertyofaparticularsolutionandisindependentofanymembrane.

Tonicityisapropertyofasolutioninreferencetoaparticularmembrane.

Itisstrictlywrongtosaythisorthatfluidisisotonicwithplasmawhatshouldbesaidisthattheparticularfluidis
isotonicwithplasmainreferencetothecellmembrane(iethemembraneshouldbespecified.)Byconvention,this
specificationisnotneededinpracticeasitisunderstoodthatthecellmembraneisthereferencemembraneinvolved.

Fromacellsviewpoint,itisnetosmolargradientacrossthecellmembraneatanymomentthatisimportant.Tonicity
(andnotosmolality)isimportantforpredictingtheoverallfinaloutcome(theequilibriumstate)ofachangein
osmolalitybecauseitallowsforthosesoluteswhichwillcrossthemembrane.Allthecellsinthebody(withafew

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exceptionsegcellsinthehypertonicrenalmedulla)areinosmoticequilibriumwitheachother.Movementofwater
acrosscellmembranesoccurseasilyandrapidlyandcontinuesuntilintracellularandextracellulartonicitiesare
identical.Ifwatercancrossthemembranefasterthantheineffectivesolutecancrossthentheeffectofanabrupt
changeinextracellularosmolalitymaybeinitiallyandtemporarilydifferentfromthatpredictedfromtheacute
tonicitychangealone.

Ifahyperosmolarsolutionwasadministeredtoapatient,thiswouldtendtocausewatertomoveoutofthecell.
Howeverifthesoluteresponsibleforthehyperosmolalitywasalsoabletocrosscellmembranesitwouldenterthe
cell,increaseintracellularosmolalityandpreventthislossofintracellularfluid.Thisisthesituationwith
hyperosmolalityduetohighureaconcentrationsasureacrossescellmembranesrelativelyeasily.

HyperglycaemiainuntreateddiabeticsresultsinECFwhichisbothhyperosmolarandhypertonic(ascomparedtothe
normalsituation)asglucosecannoteasilyentercellsinthesecircumstances.Watermovesoutofthecellsuntilthe
osmolargradientisabolished.

Insomesituations,amoreoperationaldefinitionoftonicityisusedtoexplaintheterm:thoughnotincorrectthis
explanationislessversatileandrigorousthantheonediscussedabove.Thisisbasedontheexperimentof
immersingredcellsinvarioustestsolutionsandobservingtheresult.Iftheredcellsswellandrupture,thetest
solutionissaidtobehypotoniccomparedtonormalplasma.Iftheredcellsshrinkandbecomecrenated,thesolution
issaidtobehypertonic.

Iftheredcellsstaythesamesize,thetestsolutionissaidtobeisotonicwithplasma.Theredcellmembraneisthe
referencemembrane.Redcellsplacedinnormalsaline(ie0.9%saline)willnotswellsonormalsalineissaidtobe
isotonic.Haemolysisdoesnotoccuruntilthesalinesolutionislessthen0.5%.Thepointaboutthisdefinitionof
tonicityisthatitisqualitativeandnotquantitative.Itdoesimplythatpermeantsoluteswillbeineffectivebecauseitis
essentiallyatestagainstarealmembrane.

Amajorphysiologytext(Ganong16thed.,1993)definestonicityasatermusedtodescribetheosmolalityofa
solutionrelativetoplasma(asinhypotonic,isotonicorhypertonic).Thislessrigorousdefinitioniswrongasitdoes
notcoverthefullsenseinwhichthetermtonicityisused.Ganongarguesthataninfusionof5%dextroseisinitially
isotonicbutthatwhentheglucoseistakenupandmetabolisedbycells,theoveralleffectisofinfusingahypotonic
solution.Thisisreallyaproblemwithhisdefinition.Morecorrectly,onewouldsaythatthe5%dextroseisinitially
isosmolarwithplasma(andthisavoidshaemolysis).Glucoseisapermeantsoluteinthenondiabeticandcaneasily
entercells.Wheninfused,the5%dextroseisveryhypotonic(withreferencetothecellmembrane)despitebeing
isosmolar.Waterdoesnotleavethecellsinitially(andhaemolysisdoesnotoccur)becausethereisnoosmolar
gradientacrossthecellmembrane.Thesolutionishoweverhypotonicandwhentheglucoseenterscellswaterdoes
also.Ifinsulinisnotpresent,thismovementofglucosedoesnotoccur.Inthislattercase,thesolutionisisosmolar
beforeinfusionandcanbeconsideredisotonicafterinfusionaswell.

Theparticularproblemwiththisdefinitionisthatitdoesnotdistinguishtonicityfromosmolalityasitmakesno
recognitionofwhethertheavailablesolutesarepermeant(andthus'ineffective')ornonpermeant(andthus
'effective')withrespecttoaparticularmembraneasintheexampleofthe5%glucosewhichisisosmolarbut
hypotonic.Thedefinitionreallydoesn'taddmuchmorethencouldbeachievedbythetermshypoandhyper
osmolality.Ofcourse,thereferencingtoactualplasmaosmolalitymeansthisdefinitioniseffectivelythesameasthe
'redcelltest'definition,whileobscuringthefactthattonicityisreferencedtothecellmembrane.

Notethattonicityisdefinedinseveralwayswhichdontallhaveexactlythesamemeaning.Thisisconfusing.The
definitionbasedontonicityastheeffectiveosmolalityisbest.

ComparisonofDifferentDefinitionsofTonicity

EffectiveosmolalityThebestdefinitionasitaccountsforpermeantsolutesandis
quantitative.
TheredcelltestApracticalqualitativedefinitionthatemphasisestherequirement
thattonicityisdefinedinreferencetoamembrane.
ComparisonwithosmolalityofplasmaDoesnotaccountforpermeantsolutes,and
notquantitative.

Afinalpointhereregardingthemeaningoftheterm"osmoticpressure".

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ConsideragaintheUtubeexperimentbutpurewaterononesideandatestsolutionofunknownosmolalityonthe
othersideofasemipermeablemembranewhichispermeableonlytowater.Waterwillmoveintothetestsolution.
Whatwouldhappeniffurtheramountsofthetestsolutionwereaddedbeforeanymovementofwaterhadoccurred?
Anequilibriumsituationwouldbereachedatwhichthehydrostaticpressure(iedifferenceinfluidheightsinthetwo
limbsoftheUtube)onthetestsolutionsideofthemembranewouldbalancetheosmotictendencyforwatertomove
acrossthemembraneintothetestsolution.

Atthisequilibriumpoint,thehydrostaticpressureisameasureoftheosmotictendencyinthetestsolution:indeed
theopposinghydrostaticpressureneededtobalancetheosmoticforcesisusuallyreferredtoastheosmotic
pressure.

Therewouldbepracticaldifficultiesinperformingthisexperimentwithbodyfluidsasthetestsolutionastheosmotic
pressuretobemeasuredisover7atmospheresandanextremelylonglimbedUtubewouldbenecessary!
Alternatively,thepressurecouldbesuppliedfromapistonoracompressedgassourceratherthanacolumnoffluid.

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'FluidPhysiology'byKerryBrandisfromhttp://www.AnaesthesiaMCQ.com

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