Unit Five: The Body

Fluids and Kidneys

Chapter 25: The Body
Compartments: Extracellular and
Intracellular Fluids; Edema
Guyton and Hall, Textbook of Medical Physiology, 12th edition

Balance of Fluid Intake and Output

Steady-State Balance
a.
b.
c.
d.
e.

Daily intake of water

Daily loss of water-insensible water loss
Fluid loss in sweat
Water loss in feces
Water loss by the kidneys

Table 25.1 Daily Intake and Output of Water (ml/day)

Normal

Prolonged
Heavy
Exercise

2100

From
metabolism

200

200

Total Intake

2300

Insensible-skin

350

350

Insensible-lungs

350

650

Sweat

100

5000

Feces

100

100

Urine

1400

500

Total Output

2300

6600

Intake
Fluids ingested

Output

Body Fluid Compartments

Fig. 25.1 Summary of body fluid regulation, including the major body fluid compartments

Compartments (cont.)

Body Fluid Compartments

a. Intracellular
b. Extracellular-interstitial fluid and blood plasma
c. Transcellular-fluids in the synovial, peritoneal,
pericardial, intraocular spaces, and the CSF
d. Total body water for men is about 60% and 50%
for women
e. Varies with age, gender, and degree of obesity

Compartments (cont.)

Intracellular Fluid Compartment

a. Constitutes about 40% of the fluid in the average
person
b. Concentration of substances is similar from cell
to cell

Compartments (cont.)

Extracellular Fluid Compartment

a. Interstitial fluid-makes up about 75% of the fluid
b. Blood plasma-makes up 25% of the fluid
c. Only real difference between the two types is the
protein composition of the plasma

Blood Volume

Blood Volume

a. Makes up about 7% of the body weight (5 L)

b. 60% plasma and 40% cells
c. Percentages vary according to gender, weight, etc.

Hematocrit
a. Red blood cell fraction of the blood
b. 96% accurate because you cannot pack the cells
completely
c. Males (o.40) and females (o.30)

Constituents of Extra- and Intracellular Fluids

Fig. 25.2 Major cations and anions of intracellular and

extracellular fluids.

Fig. 25.2 Nonelectrolytes of the plasma

Constituents of Extra- and Intracellular Fluids

Table 25.2 Osmolar substances in extracellular and intracellular fluids
Plasma (mOsm/L
of Water

Interstitial
(mOsm/L of
Water

Intracellular
(mOsm/L of
Water

Sodium

142

139

14

Potassium

4.2

4.0

140

Calcium

1.3

1.2

Magnesium

0.8

0.7

20

Chlorine

108

108

24

28.3

10

11

0.5

0.5

Bicarbonate
Phosphate
Sulfate
Phosphocreatine

45

Carnosine

14

Amino acids

Constituents of Extra- and Intracellular Fluids

Table 25.2 Osmolar substances in extracellular and intracellular fluids
Plasma
(mOsm/L of
Water

Interstitial
(mOsm/L of
Water

Intracellular
(mOsm/L of
Water

Creatine

0.2

0.2

Lactate

1.2

1.2

1.5

ATP

Hexose
monophosphate

3.7

Glucose

5.6

5.6

Protein

1.2

0.2

4.8

3.9

10

301.8

300.8

301.2

Corrected
osmolar activity

282

281

281

Total Osmotic
Pressure (37 C)

5443

5423

5423

Urea
Others
Total mOsm/L

Basic Principles of Osmosis and Osmotic Pressure

Osmosis is the net diffusion of water

across a selectively permeable
membrane from a region of high water
concentration to one
that has a lower
water concentration.
Rate of diffusion of water is called the
rate of osmosis.

Moles vs. Osmoles

Osmoles-the total number of particles in a
solution
One osmole is equal to 1 mole of solute
particles
Osmole refers to the number of
osmotically active
particles in a solution rather than to the
molar
concentration

Osmolality vs. Osmolarity

Osmolality = osmoles/kg of water

Osmolarity = osmoles/L of solution

Osmotic Equilibrium
Isotonic-occurs if the water concentration of
both intracellular and extracellular fluid is the same; cells
do
shrink or swell
Hypotonic-occurs if the water concentration is
lower
inside the cell (solutes are higher inside) and
the cell will swell and possibly lyse

Hypertonic-occurs if the water concentration is

higher inside the cell (solutes are lower inside)

Fig. 25.5 Effects of isotonic, hypotonic, and hypertonic solutions on cell volume

Equilibrium (cont.)

Isosmotic-solutions with an osmolarity the same as the c

Hyperosmotic-solutions with a higher osmolarity

Hyposmotic-solutions with a lower osmolarity

Volume and Osmolality in Abnormal States

Effect of adding saline to extracellular fluid

Hyponatremia

Hyperantremia

Edema

Intracellular Edema
a. Hyponatremia
b. Depression of metabolic systems of tissues
c. Lack of adequate nutrition to the cells

Extracellular Edema
a. Abnormal leakage of fluid from plasma
b. Failure of the lymphatics to return the fluid
(lymphedema)