Test 2 Flashcards
phrenic nerves
C3-C5 innervates diaphragm (phrenic motor nucleus) and comes out of the spinal cord
internal and external intercostal skeleton
between ribs, movement helps move ribs
intercostal nerves
innervates internal and external intercostal skeleton and originates from the spinal cord. T1 - L1
external intercostal skeleton
contributes to inhalation with diaphragm
abdominal nerves (rectus abdominus)
innervates abdominal muscles, T7-L1: contribute to respiration by helping expel air from the lungs during exhalation. Only contracts on forced expiration,
exhalation/expiration
usually passive without muscle contraction, diaphragm doms up as air flows out.
inhalation/inspiration
active -> contraction of muscles at rest (diaphragm flattens) thorax increases in vol as inspiratory muscles, diaphragm and external intercostal muscles expands in three directions.
Where is the diaphragm
base of the thoracic cage
how much of the inspiratory effort does the diaphragm partake in
70% in contraction
ribs during exhalation
move down and in
lung volume at rest (litres)
tidal volume, which is 0.5L (500mL).
ribs during inhalation
move up and out
tidal volume
500 mL.
Atmospheric pressure and intrapleural pressure
negative intrapleural pressure to create a diffusion gradient that allows air to move in upon inhalation (inspiration).
how many lobes in the lung
5
how many lobes on the right side of the lung
3, no cardiac notch leaves space for a third lobe.
how many lobes on the left side of the lung
2 with a cardiac notch to accommodate for the heart
lungs surrounded by
visceral pleura
parietal pleura
lines thorax and covers lung (outer layer)
pulmonary pressure in inspiration
Pulmonary pressure begins at 0 cm H₂O, equal to atmospheric pressure, when the lungs are at rest (before inhalation begins). Diaphragm contracts and thoracic cavity expands -> lungs expand -> lower pressure in alveoli creating a negative pressure relative to the atmosphere.
pneumothorax
chest is open to the atmosphere, pleural pressure is equal to the atmosphere -> deflated lung as air rushes into the chest
pulmonary pressure in expiration
The decrease in lung volume increases the pressure inside the alveoli, causing pulmonary pressure to rise above atmospheric pressure. This positive pressure forces air out of the lungs into the atmosphere as gases flow from areas of higher pressure (lungs) to lower pressure (outside air).
pleural pressure in expiration and inspiration.
is always negative to keep the lungs inflated by being more negative from atmosphere. Becomes less negative during expiration.
What does a spirometer measure
tidal breath (Vt), respiratory frequency (f), minute ventilation (tidal x frequency), inspiratory and expiratory reserve vol.
what cant you measure with a spirometer
residual volume, total lung capacity, functional residual capacity.
hyperventilation
> 6L/min
hypoventilation
minute ventilation
Vt x f= 0.5L x 12 (breaths) = 6L/min
Va
alveolar ventilation
dead space
Vd = 22ml/kg -> 150 mL
deadspace ventilation
150 x 8 = 1.8 L
vitalographs
measures gas volume dynamics and measures the efficiency of lungs such as obstructions/stiffness and can serve as an early diagnostic test. Can diagonise COPD and asthma
FEV1/FVC healthy lung
80% is a healthy lung.
FEV1
forced expiratory volume in one sec = 4 L
FVC
forced vital capacity, 5L and usually less than during a slower exhalation.
Diffusion distance in human lung
0.5 micrometers in diameter
external respiration full def
process in the lungs by which O2 is absorbed from the atmosphere into the blood within pulmonary capillaries, CO2 is excreted
internal surface of the lung is about
100m2
upper class anatomical boundary
nose and larnyx
internal/tissue respiration
exchange of gases between blood and systemic capillaries and the tissue fluid and cells which surrounded.
lower class
trachea and alveoli
pulmonary ventilation
breathing, the bulk movement of air flow into and out of lungs, the ventilatory pump comprises the rib cage with its associated muscles and the diaphragm
what is part of the conducting part of the respiratory system
nasal cavities, pharynx, larynx, trachea, bronchi and bronchioles
function of the conducting part of the respiratory system
the bulk movement of air into and out lungs which conduct air between the nose and deepest recesses of lungs. Humidify and clean the air.
function of the respiratory part of the respiratory system
comprises the tiny, thin-walled airways where gases are exchanged between the air and blood. Transport of gases to various parts of the system.
what structures are part of the Respiratory part of the respiratory system
respiratory bronchioles, alveolar sac, alveolar ducts and alveoli.
nasal cavity
tall narrow chamber lined with mucous membrane which humidifies and warms inspired air
for gas exchange, the air has to be:
clean, free of dust and bacteria, warm and saturated with 100% H2O
What is in the nasal cavity (cellular/small)
thick hairs that help filter and ciliated epithelium to allow particles to stick to mucus. Under this, is a very rich blood supply with large vessels that allow heat exchange.
structure of nasal cavity
conchae which increases the SA of the nasal cavity and slows down air by creating turbulence.
What lines the conducting zone
the respiratory epithium: pseudo-stratified ciliated columnar epithelium + goblet cells and basal cells
sinuses
air filled spaces in the skull which is also lined with respiratory epithelium and mucus. They lighten the face and add resonance to the voice
sinusitis
buildup of mucus/ infection of sinuses
glands under epithelium
secrete water secretions and constantly supplying the layer for humidity
mucociliary clearance
cilia beating -> moving particles down mucocilary escalator till the end of the conducting site.
smoking effects on cilia
paralyses cilia
the pharynx is an airway but also
a food way -> primarily part of the gastrointestinal system.
Three parts of the pharynx (throat) each have an anterior opening
nasopharynx, oropharynx and larngopharynx
epiglottis
protects the airway from food and closes to push food posterior to airways.
trachea main features
has to stay open -> C-shaped cartilage and mainly to get air into lungs, 12 cm long windpipe.
esophagus position relative to the trachea
posterior to trachea and lying in the shallow groove formed by the trachealis msucle.
the trachea is lined with
pseudo-stratified columnar ciliated epithelium and transport a mucous sheet upwards to the nasopharynx
respiratory zone branching starts at
20-23
alveolar sacs branching position
28
bronchus structure (cells)
columnar ciliated epithelial cells with goblet cells, contain smooth muscle and mucus glands, cartilage to keep tube open.
terminal bronchiole
no gas exchange
bronchus function
keep airways open, conditioning air, saturated with water and mucus for defence
Bronchiole vs bronchus
bronchus have cartilage, goblet cells and mucus glands whereas bronchiole has club cells and mainly uses smooth muscle to direct blood flow.
wall of bronchiole
club cells for watery secretion (antimicrobial properties) and not as sticky as mucus, ciliated cuboidal epithelium, smooth muscle to constrict and relax.
capillaries and alveolus
alveolar sacs greatly increase SA and capillaries are wrapped around to maximise gas exchange.
Cells in the alveolar wall
Red blood cells and capillaries, type I pneumocyte, alveolar macrophage and type II pneumocyte
type I pneumocyte
squamous cells that a flat and thin
what are the three types of cells found in the alveolus
macrophage for defence, type II squamous cells and type II cuboidal cells.
type II pneumocyte
secretes surfactant to break surface tension between air and liquid layer of alveolus. Keeping the air sac nice and open and stops alveoli from collapsing.
alveolar macrophage
ingests bacterial and particles if something is wrong/clean up
movement of ribcage and ventilation
responsible for 25% of the air movement into and out of the lungs.
The diffusion barrier
blood barrier, 0.5 um thick, the squamous pneumocyte, basement membranes are all fused as one.
exercise and intercostal muscles
active, externals for inspiration and internals for expiration.
ventilation division with diaphragm and ribs
ribs: 25%, diaphragm: 75%
How does expiration occur at rest? (deflation to remove Co2)
recoil force
the two forces required to deflate the lung are
elasticity and surface tension in the lungs
recoil force and elasticity of the lungs
allows lungs to return to resting position -> residual capacity following inhalation.
elasticity
the ability to recover original size and shape after deformation, we have collagen and elastin in our lungs. Inspiration dependent on the elasticity.
compliance
ability of the lungs and the chest wall to stretch and expand in response to changes in pressure, change in volume/change in pressure
surface tension
enhancement of the intermolecular attractive forces at the surface is called surface tension.
elasticity and compliance
elasticity decreases as compliance increases
Laplaces law
P = 2T(surface tension)/R(radius of alveolus). The smaller the alveolus, the higher the pressure required to keep it open. Surfactant reduces the surface tension, preventing small alveoli from collapsing and ensuring efficient lung function.
increased compliance
smoking caused, reduction in elastic fibers and much less pressure to inflate -> more compliant.
decreased compliance
fibrosis: lungs become fibrotic and stiff with increased effort (more pressure) to inflate lungs
COPD lung
increased compliance -> massively expanded lungs and flatted diaphragm with mid-sternal space reduced.
Fibrosis lung
deflated lungs, mid sternal space widened and fluffy areas of fibrotic tissue present
Where is the area of the highest resistance in the respiratory airway
in the trachea
high resistance airflow in trachea
is fast and turblent
alveoli air flow
slow and laminar which helps gas exchange and has the lowest resistance.
Control of airway diameter and resistance via autonomic control of airways in the bronchiole
it is full of smooth muscle that is affected by hormones which can dilate and constrict when needed to direct airflow
parasympathetic nerves and the autonomic nervous system control of airway smooth muscle
contained within vagus nerve and causes bronchoconstriction via the muscarinic receptor of acetylcholine.
sympathetic nerves and the autonomic nervous system control of airway smooth muscle
from the thoracic spinal segements that cause broncholdilation and via beta-adrencepetors for noradrenaline
sympathetic nerves that cause
bronchodilation via beta-adrenoceptors of noradrenaline
parasympathetic nerves cause the
bronchoconstriction via vagus nerves and muscarinic receptors of acetylcholine.
Hering-Breuer reflex
activated by sensory mechanical receptors and activated as lungs inflate -> triggers reflex response to increase sympathetic outflow. This reflex is especially important in maintaining normal tidal volume and avoiding potential damage from overinflation.
asthmatics meds
inhale directly into airway:salbutamol binds to beta receptors and immediately dilates bronchioles- B2- adrenoceptor agonist (stimulant)
asthma
bronchioles constrict
pulmonary circulation pressure
low pressures system as right ventricles only need to pump to one system and dont need to go against gravity.
pressure in pulmonary circuit
22/10 mmHg with a mean of 14 mmHg
sheet flow around alveoli
many capillaries on the sides of the walls merge to form a sheet flow around alveoli which helps increase contact between blood and alveoli and increase in gas exchange.
two circulations to the lungs
pulmonary circulation and bronchial circulation, as it has a venous drainage.
distension and recruitment
controls pressure to prevent oedema 0< prevent fluid forced outside vessel wall/ fluid accumulation.
Chemical control of pulmonary blood vessels - pulmonary hypoxic vasconstriction
low alveolar PO2 -> hypoxia, causes regional vasoconstriction to cause blood to go over to another alveoli with better O2.
uneven blood flow in lungs
due to gravity and structure of the lungs, blood flow is greater in the lower regions of the lungs and less in the upper regions. This can lead to ventilation-perfusion mismatches, influencing how efficiently oxygen is delivered to the blood and carbon dioxide is removed.
best perfusion is when
pulmonary arterial pressure > pulmonary vein pressure and gravity > pulmonary alveoli pressure
why is V/Q not one
it is 0.86 -> gravity not fully perfusing the lung as ventilation occurs more at the base of the lung than the top.
In exercise how may we increase perfusion? think abt the un even blood flow in lungs
in exercise, CO2 increases to generate pressure sufficient to force more blood into the top of the lung -> added capacity of the lung increases extraction of O2.
Ideal ventilation
is when the ventilation and perfusion ration = 1 A V/Q ratio of 1 indicates that the amount of oxygen entering the lungs and reaching the alveoli (ventilation) is equal to the blood flow available for gas exchange (perfusion).
Pulmonary hypertension
hypoxia = vasoconstriction and can cause right heart failure as this strains the right ventricle.
Factors regulating movement of gas across respiratory surface
area, thickness, partial pressure differential across tissue, solubility of gas in blood and molecular weight of gas.
pulmonary oedema
left heart failure due to systemic hypoxia -> breathlessness (dyspnoea).
Area of alveoli
~300 alveoli in human lung -> 0.3 mm in diameter which increases and shrinks due to inflation and deflation.
Thickness of tissue
all alveoli lined with surfactant to help decrease surface tension. Only 0.5 um between air and blood which is prone to infection…
Partial pressure differential across tissue
O2 100mmHg and CO2 40 mm Hg, O2 has a big driving force (10x more)
Solubility of gas in blood and molecular weight of gas
solubility is more important than MWt of gas and CO2 is 25x more soluble in blood than O2, movement of both gases across alveolar membrane are balanced.
O2 transport
binds with haemoglobin and some in plasma, also dissolved in solution.
movement of O2 and Co2 across alveolar membrane
are balanced
oxygen dissociation curve
Percent of O2 saturation of hemoglobin -> lower affinity for O2 at lower PO2’’s encourages O2 release at tissues and a higher affinity for O2 at higher PO2’s to encourage O2 uptake in lungs.
oxygen dissociation curve
sigmoidal relationship, this is due to co-operative binding.
Hemoglobin changes affinity for O2
due to pH change -> there is less affinity when there are more protons.
In acidic environment the hb
has less affinity for O2, at tissues there is more CO2 which is lower pH so O2 is released
At lungs less CO2 -> higher pH
so O2 is taken up.
For a given PO2, more O2 taken up =
a higher binding affinity of Hb for O2.
Bohr shift
changes in pH and carbon dioxide (CO₂) concentration affect the affinity of hemoglobin for oxygen (O₂). When tissues produce more CO₂ and H⁺, hemoglobin’s affinity for oxygen decreases, making it easier to deliver oxygen to where it’s needed most.
Myoglobin affinity
high affinity at low PO2 and binds O2 in muscles (good for exercise)
Fetal haemoglobin
has a greater affinity for O2 for a given PO2 -> drags O2 across placenta.
Anaemia oxygen dissociation curve
reduced hb by 50% , pulse oximeter will be inacurate as it measures saturation not content.
CO2 transport in blood
dissolves in solution, chemical in form of HCO3- (mostly), combines to amine groups (plasma proteins) Co2 solubility is 20-25% times higher than O2.
peripheral chemoreceptors
located near major blood vessels -> connected to carotid sinus nerve then to medulla oblongata. CAROTID BODY senses blood gases and is at the highest blood flow and density of capillaries.
Most Co2 is transported by bicarbonate in plasma
70%
chloride shift
in red blood cells (RBCs) during the transport of carbon dioxide (CO₂) from the tissues to the lungs. It involves the exchange of chloride ions (Cl⁻) for bicarbonate ions (HCO₃⁻) across the RBC membrane to maintain electrical neutrality during CO₂ transport.
central chemoreceptors
located within medulla oblongata, respond only to CO2, the chemosensitive regions on the ventral surface of the medulla oblongata.
what stimulates peripheral chemoreceptors
reduced and increased PaO2 (hypoxia and hypercapnia), hemorrhage, acidosis and increased sympathetic activity
Ventilatory response to hypoxia - peripheral chemoreceptors only
ventilation inc to peak ventilatory response then falls -> gasping is the last attempt to stimulate breathing -> maximal inspiratory effort and auto resuscitation mechanism.
how fast are peripheral chemoreceptors
very fast -> within a breath
Charged ions
How fast are central chemoreceptors
slow ~3-seconds as there is a limited carbonic anhydrase in CSF -> takes a while for H ions to build up and not much carbonic anhydrase in CSF. (Charged ions cannot cross blood brain barrier so CA makes HCO3).
Ventilatory response to hypercapnia (TOO MUCH CO2) - peripheral and central chemoreceptors
response mediated by 80% central and 20% peripheral. Ventilation goes up with inc PaCO2 mm Hg.
Ondines curse -> congenital central hypoventilatory syndrome
no central chemoreceptors and you can die in the sleep
Renal capsule
thin outercasing of the kidney which protects the kidney against trauma and maintains the shape of the kidney.
adipose capsule
the second layer(middle layer) that acts as padding and maintains the position of the kidneys
what are medullary pyramids seperated by
renal columns
renal fascia
anchors the kidneys to surrounding structures and the outermost layer.
renal cortex
the layer under the renal capsule
blood vessels in the kidneys
found all throughout kidneys as blood is important substrate for the kidney to function
the large structures of the kidney
renal capsule, renal cortex, medullary pyramids which are separated by renal columns.
what is a lobe in the kidney
consists of a triangular like section of the medullary pyramid, the renal cortex and capsule etc.
What do we call the region between two kidney lobes
interlobar
how many lobes does an average human kidney have
~8-12 as we are considered to be multilobar
lobules
multiple subdivisions within each lobe which are lobules.
where are the papillary ducts located
in the papillar/papillary region, central kidney the with the white stuff.
structurally, where are the nephrons
cortex of the kidney
where is the collecting duct located (kidney)
they descend through the renal cortex and medullary region toward the papillary duct.
where does urine get collected into small cup-like structures
calyces - Calyx.
minor and major calyx
minor calyces go into major calyces
where does urine flow from the renal pelvis
to the ureter
renal pelvis
as the major calyces feed into this area called the renal pelvis -> basin
where does the ureter then pass urine
to the urinary bladder
what is the papillar/papillary region, where is it located?
the pointy bit of the medullary pyramid by the calyces.
blood vessels in between two lobes in the kidney are called
interlobar artery
juxtamedullary nephrones are responsible for
enabling us to make a concentrated urine.
Where is the juxta-medullary nephron
located lower in the cortex and deeper down near the medulla which is close to the cortical medullary junction.
the interlobar artery marks the boundary between what
one renal pyramid and its neighboring renal pyramid.
where does the interlobar artery arch around
as it comes up to the cortex at the cortical medullary junction, which make these arcuate arteries.
arcuate arteries in the kidney lobe.
arch when reaching cortical medullary junction
what does the arcuate arteries give rise to in kidney lobes
these supply blood to the lobules, each lobule has these which are called interlobular arteries
interlobular arteries
within each lobe that are subdivisions of arcuate arteries from interlobar arteries
afferent arteriole in the kidney
feeds toward the important filtration unit of the glomerulus (golmerular capillaries) from the interlobular artery
vasa recta (descending) purpose is to
feed the cells that make up the tubular parts of the nephron in the medulla, this blood is oxygen rich.
Efferent arteriole
the blood vessel moving from the glomerulus (glomerular capillaries) to either the descending vasa recta or stay in the cortex to feed the tubular cells in the cortex near the glomerulus via peritubular capillaries of the cortex
peritubular capillaries of the medulla
from the vasa recta (but these are horizontal)-> gas exchange occurs. O2 is absorbed by the cells of the nephron and CO2 is transported back into the blood. This is where the blood goes from arterial to venous.
where does the blood go from arterial -> venous in the kidney? (where gas exchange occurs) -> specifically in the medulla
peritubular capillaries of the medulla
Glomerulus
one part of the renal corpuscle -> the blood component containing a specialised network of capillaries. The input is the afferent arteriole and the output is the efferent arteriole.
where does the venous blood go from the peritubular capillaries in the cortex?
to the interlobular vein -> arcuate vein -> interlobar veins -> renal vein -> inferior vena cava and returns to the right side of the heart.
ascending vasa recta
ascending toward the cortex from the medulla which carries venous blood after gas exchange.
peritubular capillaries of the cortex
where gas exchange occurs between the blood in the capillaries and the cells that make up the convoluted tubules of the nephron in the cortex (arterial -> venous)
structure and location of the renal corpuscle
golf ball looking structures found in only the renal cortex of the kidney, where filtration begins. it contains two components.
the renal corpuscle has two components
a blood component (glomerulus) and an epithelial capsule component (Glomerular (bowman’s) capsule).
what will be expected to be found in the wall of efferent arterioles
endothelial cells as it is a blood vessel and lots of smooth muscle to modulate resistance and control blood pressure which is characteristic of blood pressure.
Glomerular (bowman’s) capsule
the second part of the renal corpuscle -> epithelium and consists of two layers. The visceral layer of podocytes (modified epithelium) tightly attached to glomerular capillaries and parietal layer that forms the outer wall of the capsule which are squamous epithelium
what are the cells of the parietal layer of the glomerular bowmans capsule
the parietal layer that surrounds the outer wall of the capsule and contains specialised epithelium which are simple squamous.
what are the cells of the visceral layer of the glomerular bowmans capsule
specialised podocytes that are modified epithelium that covers the innermost wall of the capsule (capillaries)
what do the podocytes of the visceral layer of the glomerular bowmans capsule do?
the interaction between the podocytes and the underlying glomerular capillaries that enable filtration to take place and allows the blood to be filtered -> forming the filtration barrier
the visceral epithelium is continuous with….
the parietal epithelium but the parietal epithelium is just filled with simple squamous cells that do not contribute to filtration membrane or barrier.
what is the space between the podocytes (visceral epithelium) and parietal squamous epithelium
the capsular/urinary space.
where does filtrate accumulate in the renal corpuscle
the urinary/capsular space
what does the urinary/capsular space do
between the parietal and visceral layers, collects filtrate and accumulates it until it flows out into the tubular portion.
The filtration membrane
consists of three membranes, the fenestration of the glomerular endothelial cell, the basal lamina of the glomerulus and the slit membrane between pedicels.
the cytoplasm of the endothelial cells of our glomerular capillaries
the endothelium here, are fenestrated (porous in the membrane). Small enough to stop red blood cells from exiting but large enough for components of blood plasma to pass through. The endothelial cells secrete a basement membrane.
Basal lamina of the glomerulus
is the basement membranes combined from the podocyte basement membrane and basement membrane of the endothelial cells of the blood vessels. The second layer of filtration membrane.
where is the slit membrane
forms the webbed structure between foot pedicels (interdigitating feet of the podocytes), making up the third layer of our filtration barrier.
slit membrane function
prevents filtration of medium sized proteins
basal lamina function
prevents filtration of larger proteins.
route of the filtrate from the urinary space
leave renal corpuscle -> proximal convoluted tubule -> thick descending loop of henle -> thin descending loop of henle -> thin ascending loop of henle -> thick ascending loop of henle -> distal convoluted tubule -> collecting duct.
proximal convoluted tubule
the start of the convoluted tubules of the nephron which is closest to the renal corpuscle. These have microvilli for transport.
distal convoluted tubule
in the cortex, of many nephrons combine and feed into a single collecting duct. Next to afferent and efferent arterioles. Monitors how things are going and provides feedback to influence the beginning of the process.
cells in the distal convoluted tubule can..
regulate filtration and tell the afferent arteriole to vasoconstrict when filtration occurs too fast and vice versa.
key function of the kidney
maintaining homeostasis: eg water and electrolyte balance, blood osmolarity, blood volume and pressure.
Osmolarity
measure of the osmotic pressure exerted by a solution across a perfect semi-permeable membrane compared to pure water
molarity x dissociation factor
unit of osmolarity
mOsm/L
NaCl osmolarity
fully dissociates: eg 150 milimolar (mM) + 1L water dissociates to give 150 mM/L Na+ and 150 mM/L Cl- = 300 mOsm/L
glucose and urea osmolarity
dont dissociate, 300 mM urea + 1L water -> 300 mOsm/L.
molarity x dissociation factor
osmolarity, eg. glucose doesnt (1), NaCl does (2)
hyperosmotic
a solution with a higher osmolarity than another (eg. 300 mM/L NaCl vs 300 mM/L urea).
iso-osmotic
two solutions with the same osmolarity being compared: 150 mM/L NaCl vs 300 mM/L Urea
tonicity
effective osmolarity -> takes into account the conc of a solute and ability of the particle to cross a semi-permable membrane
hyposmotic
a solution having a lower osmolarity than another eg: 150 mM/L urea vs 150 mM/L NaCl.
tonicity of NaCl
NaCl has a low permeability, eg in solution with a cell cytosol of ~300 mOsm, and 150 mM NaCl -> the cell does not shrink or enlarge -> isotonic
hypertonic
when a solution has a higher POsm than another -> water will leave the cell and cause cell shrinkage.
Urea tonicity.
Has high permeability into cell: its isosmotic but not isotonic. When putting cell cytosol into urea, the urea will move into the cell as there is little urea in the cell causing the cell to swell.
hypotonic solution
eg cell swells and rbc can eventually burst -> urea moving into cell. A solution with a lower POsm than another, water will move into the cell.
isotonic
two solutions with the same POsm -> no net water movement
dehydration
the loss of water via sweat or something, the extracellular fluid and cells lose water -> to maintain osmolarity the cells lose water to dilute conc of extracellular fluid to mantain isotonicity.
Hydration
gain of water -> decrease osmolarity in extracellular fluid and water will move into the cell which causes the cell to swell.
fluid distribution in the bodu (70kg male)
60% fluid = 42 L, 2/3 intracellular = 28 L, 1/3 = 14 L.
20% plasma = 2.8
80% interstitial: 11.2 L
water intake and output
average output of water is matched with average intake per day of about 2.5 L
How much of blood is plasma
55% = 2.8 L of plasma and 5L blood.
