Body

 Fluids    

M Aryadi Arsyad

 Study  Objec2ves  

•  Understand  what  is  body  fluid  and  its  

components  
•  Be  able  to  explain  how  the  body  maintain  fluid  
balance    
•  Be  able  to  explain  consequences  of  body  fluid  
imbalance  
 Homeostasis  
 Internal  factors  need  to  be  maintained:  
1.  Concentra?on  of  nutrients  
2.  Concentra?on  of  O2  &  CO2  
3.  Concentra?on  of  waste  products  
4.   pH  
5.  Concentra?ons  of  water,  salt  &  other  
electrolytes  
6.  Volume  &  pressure  
7.  Temperature  
Homeostasis  is  essen?al  for  the  survival  of  each  cell,  and  each  cell,  
through  its  specialized  ac?vi?es,  contributes  as  part  of  a  body  system  
to  the  maintenance  of  the  internal  environment  shared  by  all  cells  
 Body  fluids  
•  Total  body  water  (TBW)  comprises  45-­‐75%  
(±60%)  of  body  weight  
•  TBW  fairly  constant  due  to  Kidney  regulates  H2O  
balance  but  varies  amongst  people  
•  Influenced  by:  sex,  age  and  obesity  degree  
•  H2O  >90%  in  plasma,  70-­‐80%  in  skin,  muscle  and  
internal  organs,  20%  in  bones  but  10%  in  fat    
•  Divided  into:  extracellular  fluid  (ECF)  and  
intracellular  fluid  (ICF)  
 Fluid  compartments  

•  Intracellular  :  inside  cell,  30-­‐40%  of  body  weight  

(28L)  
•  Extracellular  :  outside  cell  
–  Inters??al  fluid:  16%  (11L)  
–  Plasma:  4-­‐5%  (3L)  
–  Transcellular:  1-­‐3%  (1-­‐2L)  (synovial,  peritoneal,  
pericardial,  intraocular  space  &  cerebrospinal  fluid)  
   
Body  fluid  movement  
 Extracellular  Fluid  
•  Important  as  intermediary  between  
intracellular  fluid  and  outside  environment  
•  Fluid  balance  is  controlled  by  regula?ng  ECF  
volume  and  osmolarity  
•  Plasma  is  the  only  fluid  that  its  volume  &  
composi?on  can  be  regulated  
•  Plasma  changes  è  en?re  ECF  è  ICF  
 Extracellular  Fluid  

1.  ECF  volume  is  crucial  for  blood  pressure  

–  Salt  balance  influence  the  volume  
 
2.  ECF  osmolarity  can  cause  the  cell  swelling  or  
shrinking  
–   H2O  volume  determine  osmolarity  
Video  of  osmosis  process  
 ECF  volume  maintenance  
•  Short  term  control  
–  Baroreceptor  reflex  affects  cardiac  output  &  total  
peripheral  resistance  
–  Fluid  transfers  between  plasma  &  inters??al  
space  
•  Long  term  control  
–  Kidneys  trough  urine  produc?on  
–  Thirst  mechanism  that  affects  fluid  intake  
–  Na+  intake  
Na+  role  in  ECF  volume  
Distribu2on  of  ions  in  body  fluids  
 ECF  osmolarity  maintenance  
•  Non  penetra?ng  solutes  determine  osmolarity  
of  ECF    
•  Deficit  free  H2O,  solutes  too  concentrated,  
increase  osmolarity  (hypertonic)  
•  Excess  free  H2O,  solutes  too  diluted,  decrease  
osmolarity  (hypotonic)  
•  Vasopressin  (ADH)  is  important  in  regula?ng  
ECF  osmolarity  
BODY  FLUID  REGULATION  
Body  fluid  maintenance  
 Water  gain  &  loss  
1.  Water  gain:  
–  Intake  trough  inges?on  
–  Water  from  metabolism  

2.  Water  loss:  

–  Insensible  loss  trough  skin  
–  Insensible  loss  trough  lungs  
–  Sweat  
–  Feces  
–  urine  
Vasopressin/ADH  
Renin-­‐Angiotensin-­‐Aldosteron  (RAA)  
System  
RAA  system  
 SUHU SUHU LATIHAN BERAT
NORMAL PANAS DAN LAMA
(ml/hari) (ml/hari) (ml/hari)

Insensible Water Loss :

-kulit 350 350 350
-Pernapasan 350 250 650
Sensible Water Loss :
-urine 1400 1200 500
-keringat 100 1400 5000
-tinja 100 100 100

total 2300 3300 6600

 Dehydra2on  (hypertonic)    
1.  Water  loss  trough  gastrointes?nal  
–  Vomit                                            
–  Diarrhea  
–  Fistula  &  peritoni?s  
2.  Water  loss  trough  kidney  
–  Diabetes  insipidus  
–  Insufficiency  adrenal  
–  Diure?c  osmo?c  
3.  Water  loss  trough  skin  &  lungs  
–  Burn  trauma  
–  Excessive  swea?ng  
–  Lung  cancer  
 Overhydra2on  (hypotonic)    

•  Renal  failure  
•  Excessive  water  inges?on  
•  Massive  vasopressin  release  
 Edema      
•  Presence  of  excess  fluid  in  body  ?ssues  
•  Mainly  in  extracellular  compartment  but  can  
also  happen  intracellular  
•  The  cause  of  extracellular  edema:  
1.  Increased  capillary  pressure  
2.  Decreased  plasma  proteins  
3.  Increased  capillary  permeability  
4.  Blockage  of  lymph  return  
 References    

•  Human  physiology,  Laura  lee  Sherwood,  7th  

ed.  
•  Human  anatomy  and  physiology,  Elaine  N  
Marieb,  9th  ed.  
•  Textbook  of  medical  physiology,  Arthur  C.  
Guyton,  11th  ed.