Body Fluid Compartments Flashcards

1
Q

Extracellular Fluid

A
  • includes the blood plasma and interstitial fluid.
  • 1/3 total body water
  • Major cation: Na+
  • Major anions: Cl- and HCO3-
  • Plasma 1/4th of ECF
    • 1/12 TBW
    • Major plasma proteins are albumins and globins
    • Major cation: Na+
    • Major anion: Cl-, HCO3-, plasma protein
  • Interstitial Fluid 3/4 of ECF
    • 1/4 TBW
    • same as plasma w/ little protein (ultrafiltrate of plasma)
    • Major cation: Na+
    • Major anion: Cl-, HCO3-
  • 60-40-20 rule
    • TBW is 60% body weight
    • ICF is 40%
    • ECF is 20%
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2
Q

Intracellular Fluid

A
  • sum of the fluid contents of all cells of the body.
  • 2/3 of total body water
  • Major cations: K+ & Mg2+
  • Major anions: protein and organic phosphates
  • intracellular water constitutes 30-40% of body weight
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3
Q

Transcellular Fluid

A
  • specialized fraction of extracellular fluid
  • includes cerebrospinal, intraocular, pleural, peritoneal, and synovial fluids plus the digestive secretions.
  • Each of the several discontinuous fractions is separated from blood plasma by the capillary endothelium & also a continuous layer of epithelial cells.
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4
Q

Measurement of Total body water

A
  • Two isotopes of water, deuterium oxide (D2O) and tritiated water (HTO) may be used.
  • D2O is quantified by specific gravity techniques
  • HTO quantified by measurement of the radioactivity of tritium.
  • The drug antipyrine may also be employed.
    • measured by chemical means.
    • Several hours are allowed for mixing before taking samples.
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5
Q

Measurement of Plasma volume

A
  • measured as volume of distribution of a substance confined w/in the vascular bed.
  • Evans-blue dye and radioiodinated human serum albumin (RISA) are commonly used.
  • Evans-blue dye binds with plasma albumin
  • RISA is administered precombined with albumin.
  • In either instance, the volume is that of plasma albumin
  • The concentration of Evans blue is determined colorimetrically
  • The concentration of RISA concentration is determined by scintillation counting.
  • Also estimated by the distribution of RBCS tagged w/ radioactive phosphorus (32P) or chromium (51Cr).
    • From the hematocrit, the blood volume can be calculated.
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6
Q

Measurement of Extracellular fluid volume

A
  • Less precisely than total body water or plasma volume measure
  • No ideal substance is known.
  • Some substances used are inulin, sucrose, and radioisotopes of sulfate and mannitol.
  • Inulin and sucrose do not diffuse into far places of the extracellular compartments
  • tend to underestimate the extracellular volume
  • sodium, chloride, bromide and thiocyanate tend to penetrate cells to some extent and overestimate
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7
Q

Calculation of intracellular and interstitial water

A
  • Intracellular water is calculated as the difference between total body water and extracellular water.
    • Intracellular = total body water - extracellular water
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8
Q

Extracellular vs. Intracellular Solute Distribution

A
  • Predominance of sodium, chloride and bicarbonate in the ECF
  • Predominance of potassium, phosphates, and magnesium in ICF
  • Substances are transported through the cell membrane by two major processes, diffusion and active transport.
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9
Q

Simple diffusion

A
  • Random molecular motion requiring an electrochemical gradient for net movement to occur
    • net diffusion is always “downhill”)
  • Lipid solubility is a major determinant of the diffusibility of any substance
  • only very small non-polar substances pass through the membrane by simple diffusion.
  • involves no specific interaction between the moving molecule and the proteins of the membrane.
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10
Q

Simple facilitated diffusion

A
  • produce net movement of a substance only down its electrochemical gradient (thus the term “diffusion”).
  • Transport depends on interaction w/ specific membrane proteins that “facilitate” its movement.
  • This is an important mechanism for accelerating the movement of non-lipid-soluble molecules
  • membrane proteins involved are frequently termed “carriers.”
  • exhibits the characteristics of specificity, saturability, and competition. (Not seen in simple)
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11
Q

Primary active transport

A
  • Molecule interacts w/ membrane carriers and may exhibit specificity, saturability, and competition.
  • Hallmark is net uphill transport
  • Energy for “active” transport comes directly from splitting ATP or another source of chemical energy.
  • “primary” denotes that chemical energy is the direct source of energy for the process
  • some cases, ATPase not only splits the ATP but is a component of the actual carrier mechanism.
  • Active transport of Na+ is an example of primary active transport.
    • Na+ moves across the luminal (apical) membrane into the cell mainly by simple facilitated diffusion.
    • Then actively transported across the basolateral membrane into the interstitial fluid.
    • This “pump” is primary active involving Na/K-dependent ATPase found only in the basolateral membrane.
    • Na+ & water, moves into peritubular capillaries by bulk flow
    • final step in the reabsorption of all substances.
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12
Q

Coupled facilitated diffusion of two or more substances (Secondary Active Transport)

A
  • 2+ substances interact simultaneously w/ the same specific membrane carrier and are transported across the membrane by “facilitated diffusion”.
  • This co-transport exhibits specificity, saturability, and competition, just like simple facilitated diffusion.
  • Net movement of one of the substances can occur uphill (against its electrochemical gradient).
  • The energy liberated by downhill diffusion of one co-transported substance drives the other substance uphill against its electrochemical gradient.
  • Sodium is frequently the substance moving downhill in coupled facilitated diffusion systems
  • co-transported substance being simultaneously moved uphill undergoes secondary active transport.
  • Glucose moves across the luminal membrane by coupled facilitated diffusion w. Na+
  • The energy derived from the simultaneous downhill movement of Na+.
  • After entering the cell the glucose crosses the basolateral membrane by simple facilitated diffusion
  • Overall glucose reabsorption depends upon the primary active Na+ pump in the basolateral membrane.
  • This pump maintains the electrochemical gradient for net Na+ diffusion across the luminal membrane,
  • Provides the energy for the simultaneous uphill movement of glucose.
  • Amino acids, phosphate, and a variety of organic substances undergo secondary active reabsorption by being co-transported with Na+ in this same manner.
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13
Q

Osmosis

A
  • net movement of water caused by a concentration difference is called osmosis.
  • Requires a semipermeable membrane that allows water but not solutes to cross the membrane
  • Osmotic pressure is the amount of pressure required to stop osmosis completely.
  • The osmotic pressure of nondiffusible particles in a solution is determined by the number of particles per unit volume and not the mass of the particle.
  • One osmol is the number of particles in one-gram molecular weight of undissociated solute.
  • Two osmols are in each gram of a substance that completely dissociates into two ions, (e.g., NaCl.)
  • Osmolality and osmolarity: Two terms that are used almost interchangeably
  • The osmolar concentration expressed as osmols per kilogram is referred to as osmolality
  • expressed as osmols per liter it is referred to as osmolarity.
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14
Q

Addition of water (hypo-osmotic overhydration) effects in ICF and ECF

A
  • oral ingestion of a large volume of water or SIADH
  • Osmolarity of ECF decreases b/c excess water dilutes
  • ECF volume increases b/c water retention
  • Water shifts into cells
    • ICF osmolarity decreases
    • ICF volume increases
  • Plasma protein concentration decrease b/c increase ECF volume
  • Hematocrit unchanged b/c water enters RBC offsetting diluting effects of increased ECF volume
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15
Q

Addition of sodium chloride (hyperosmotic overhydration) effects on ICF and ECF

A
  • Hypertonic solution of NaCl IV infusion (or ingestion of sea water)
  • Osmolarity of ECF increases b/c osmoles (NaCl) added
  • Water shifts from ICF to ECF
  • Osmolarity of ICF increases until equal to ECF
  • Water shifts so ECF volume increases and ICF decreases
  • Plasma protein concentration and hematocrit decrease
    • b/c increase in ECF volume
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16
Q

Infusion of Isotonic Saline Solution (isosmotic overhydration) effects on ICF and ECF

A
  • ECF volume increases
  • No change in osmolarity of ECF or ICF
  • b/c osmolarity unchanged, no water shift b/t compartments
  • ICF volume unchanged
  • Plasma protein concentration and hematocrit decrease
    • Fluid dilutes ECF proteins and RBCs
    • RBCs don’t shrink/swell b/c osmolarity unchanged
  • Arterial BP increases b/c ECF volume increases
17
Q

Loss of water (hyperosmotic dehydration) effects on ICF and ECF

A
  • Loss of water w/o loss of isotonic sodium chloride
  • Occurs w/ sweating b/c sweat is hyposmotic
    • More water than salt lost
  • It may also be seen in persons where no water is available to replace obligatory water losses.
  • Osmolarity of ECF increases
  • ECF volume decreases b/c loss of volume in sweat
  • Water shifts out of ICF
    • ICF osmolarity increases to meet ECF
    • ICF volume decreases
  • Plasma protein concentration increase b/c decrease ECF volume
  • Hematocrit unchanged b/c water shifts out of RBCs
18
Q

Removal of sodium chloride (hypo-osmotic dehydration) effects on ICF and ECF

A
  • Removal of NaCl from the ECF without loss of water
  • Results from adrenal insufficiency
  • Osmolarity of the ECF decreases
  • ECF volume decreases
    • Water shifts into cells
  • ICF osmolarity decreases until equal with ECF
  • ICF volume increases
  • Plasma protein concentration increase b/c decrease ECF volume
  • Hematocrit increases b/c decreased ECF volume and RBCs swell from water entry
  • Arterial BP decreases b/c decrease in ECF volume
19
Q

Loss of isotonic saline solution (isosmotic dehydration) effects on ICF and ECF

A
  • Abnormal loss of water and NaCl in isotonic concentration
  • This may occur with hemorrhage, plasma loss through burned skin, vomiting and diarrhea.
  • ECF volume decreases
  • No change in osmolarity of ECF or ICF
  • B/c osmolarity unchanged, no water shift b/t compartments
  • Plasma protein concentration and hematocrit increases
    • loss of ECF concentrates proteins and RBCs
    • No RBC shrink/swell b/c osmolarity constant
  • Arterial pressure decreases b/c ECF volume decreases
20
Q

Outline the movement and distribution of fluid between blood and interstitial fluid.

A
  • Pressure in the capillaries forces fluid and dissolved substances thru capillary pores into interstitial spaces.
  • fluid filters out at arteriolar end of the capillary, circulates, and returned to the capillary at the venular end.
  • caused by near-equilibrium of the mean forces tending to move fluid through the capillary membrane.
  • The components generating the pressures are:
    a) capillary hydrostatic pressure (Pc)
    b) plasma colloid osmotic pressure (πp)
    c) interstitial fluid hydrostatic pressure (Pif)
    d) interstitial fluid colloid osmotic pressure (πif).
  • Sum of the forces at the venular end of the capillary is equivalent to a net inward or absorbing pressure almost equivalent to the outward pressure of the arteriolar end.
  • There is slightly more filtration of fluid into the interstitial spaces than reabsorption.
  • This slight excess of filtration is called the net filtration
  • balanced by fluid return to the circulation through the lymphatics.
  • About one-tenth of the fluid enters the lymphatic capillaries and returns to the blood through the lymphatic system rather than through the venous capillaries.