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49
S. Faubel and J. Topf3 Starling’s Law
3
3Starling’s Law
50
The Fluid, Electrolyte and Acid-Base Companion
Weightofwater
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o
l
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e
Introduction
Three factors affect the movement of water be-tween body water compartments.
The previous chapter took a brief look at the factors which influence thedistribution of water between compartments. These factors are hydrostaticpressure, osmotic pressure and membrane characteristics.
Hydrostatic pressure
is a force generated by water. Hydrostatic pres-sure pushes water out of a compartment.
Osmotic pressure
is a force exerted by solutes. Osmotic pressure drawswater into a compartment. This force is dependent only on the concentra-tion of particles (osmolality) in solution.
Membrane characteristics
affect the ability of water and solute to movebetween compartments.This chapter focuses on how these factors are incorporated into Starling’slaw. Starling’s law governs fluid shifts between compartments and can beused to understand all fluid accumulations, including peripheral edema,pleural effusions and ascites.
There are two forces governing the movement of water betweencompartments: __________ pressure and osmotic pressure.Osmotic ___________ is the ability of a solute to cause the move-ment of _______. Aaahydrostaticpressurewater
1
Hydrostatic pressure
2
Osmotic pressure
3
Membrane characteristics
51
S. Faubel and J. Topf3 Starling’s Law
Starling’s law
Net hydrostatic pressure and net osmotic pressuredetermine the movement of water between compartments.
To determine where water will flow between the plasma and interstitialcompartments, it is necessary to look at the
net
hydrostatic pressure and
net
osmotic pressure of each compartment.
Net hydrostatic pressure
is the difference between the hydrostatic pres-sure in the capillary and the hydrostatic pressure in the interstitium. Wa-ter flows out of the compartment with the greater hydrostatic pressure. Inthe diagram above, the capillary hydrostatic pressure is greater than theinterstitial hydrostatic pressure; the net hydrostatic pressure causes move-ment of water out of the capillary.
Net osmotic pressure
is the difference between the osmotic pressuresin the capillary and interstitium. Water flows into the compartment withthe higher osmotic pressure. In the diagram above, the capillary osmoticpressure is higher; the net osmotic pressure causes the movement of waterinto the capillary.
___________ pressure pushes water out of a compartment.___________ pressure draws water into a compartment.______ hydrostatic pressure is the capillary hydrostatic pressureminus the interstitial hydrostatic pressure.Net osmotic pressure is the ________ osmotic pressure minus theinterstitial osmotic pressure.HydrostaticOsmoticNetcapillary
(capillary
hp
– interstitial
hp
)(capillary
op
– interstitial
op
)net hydrostatic pressurenet osmotic pressure
capillarycapillaryinterstitiuminterstitium
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