BODY FLUIDS

GENERAL CHARACTERISTICS AND

COMPARTMENTS
 DEFINITION OF BODY FLUIDS AND
BODY FLUID COMPARTMENTS
• Body fluids are liquids within the human body.
• The exact percentage of fluid relative to body
weight is inversely proportional to the percentage
of body fat.
• Water is the major constituents of body fluid in
human body.
• It ranges from about 75% of body mass in infants
to about 50–60% in adult and as low as 45% in
old age.
• The percentage of water depends on age, gender
and degree of obesity.
Fig 1: Water Content of the Body’s
Organs and Tissues
 Contd.
• In order to maintain normal fluid volume in the
body, an individual's water input must match the
water output.
• Water input occurs through ingestion and
metabolic reactions.
• Water output results from urination,
defecation, sweat, and evaporation from
the skin (not including from sweat) and the
respiratory surface during ventilation (specifically
during exhalation).
 Significance of Water Content in the
Body
• It provides a fluid environment for
extracellular communication and molecular
transport throughout the body.
• It is a key component of biochemical reactions
such as hydrolysis.
• Many organ systems depend on the physical
properties of water such as the surface
tension of water in the alveoli of the lungs.
 Body Fluid Compartments
• The total body fluid is distributed mainly between two
compartments: the extracellular fluid and the intracellular
fluid.
Intracellular Fluid (ICF)
• It is the fluid found inside cells.
• It is separated into compartments by membranes that
encircle the various organelles of the cell. For example, the
mitochondrial matrix separates the mitochondrion into
compartments.
• The contents of a eukaryotic cell within the cell membrane,
excluding the cell nucleus and other membrane-bound
organelles is referred to as cytoplasm.
 Contd.
• The cytosol is a complex mixture of substances
dissolved in water. Although water forms the
large majority of the cytosol, it mainly
functions as a fluid medium for intracellular
signaling (signal transduction ) within the cell,
and plays a role in determining cell size and
shape.
 Extracellular Fluid (ECF)
• It usually denotes all the body fluid that is
outside of the cells.
• The pH of extracellular fluid is tightly
regulated by buffers and maintained around
7.4.
• The extracellular fluid is divided into the
interstitial fluid, blood plasma and
transcellular fluid.
 Interstitial Fluid (ISF)
• Interstitial fluid (or tissue fluid) is a solution that bathes
and surrounds the cells of multicellular animals.
• It is found in the interstitial spaces (tissue spaces).
• On average, a person has about 10L of interstitial fluid
that provide the cells with nutrients and a means of
waste removal.
• It contains a great deal of connective tissue and
proteins (e.g. collagen) that are involved in blood
clotting and wound healing.
 Blood Plasma
• It is a straw-colored/pale-yellow liquid component of
blood that normally holds the whole blood cells in
suspension.
• It makes up about 55% of total blood volume.
• It is mostly water and contains dissolved proteins
(fibrinogens, globulins and albumins), glucose, clotting
factors, mineral ions, hormones and carbon dioxide.
• It plays a vital role in intravascular osmotic effects that
keep electrolyte levels balanced and protects the body
from infection and other blood disorders.
 Transcellular Fluid
• It is the portion of total body water contained within
the epithelial-lined spaces.
• It is the smallest component of extracellular fluid.
• It is often not calculated as a fraction of the
extracellular fluid, but it is about 2.5% of the total body
water.
• Transcellular fluids include; cerebrospinal, synovial,
peritoneal, pericardial and intraocular fluids.
• It provide lubrication of these cavities and sometimes
electrolyte transport.
 IONIC COMPOSITION OF BODY FLUIDS
(mEq/l)
Substance ICF ISF Plasma
Cations
Na+ 14 140 142
K+ 150 5 5
Ca2+ 2 5 5
Mg2+ 30 2 2
Anions
Cl- 10 113 113
HCO3- 10 27 27
HPO4-/H2PO4- 113 2 2
SO42- 20 1 1
Protein 74 2 16
 Contd.
• The distribution of a solute depends on its
size, electrical charge and how it is
transported across a cell membrane.
• The overall solute concentration is the same in
the ECF and ICF because water moves freely
between the body water compartments, the
compositions of the solutes may however
differ.
 Contd.
• Cells have semi permeable membranes which
allow some particles to move between
compartments but not others.

• Water moves freely in and out of cells, so if the

solute concentration increases in one
compartment, water will flow from the more
dilute area to the area with a higher
concentration. Thereby keeping the fluids in
equilibrium (same concentration).
 MEASUREMENT OF BODY FLUID
• Directly by indication dilution principle
• Indirectly by calculation obtained from known volume.
• Total body potassium (40K) for determining total cell mass
and ICFV.
• Bio Impedance Analysis (BIA)
 Non-invasive procedure
 Clinically preferred
 Simple to use
 By checking the current passing through 2 different point in
the body with known quantity of current, then measuring
the resistance of impedance in the 2 point.
 The TBW is then calculated using prediction formula
 Contd.
TBW = 3.75 + 0.45 (Height)2 + 0.11 (weight)
R50
• Where R is the resistance
Types of BIA
i. Single Frequency Bio Impedance Analysis
(SFBIA)
ii. Multiple Frequency Bio Impedance Analysis
(MFBIA)
iii. Bio impedance spectroscopy
• Dual Energy Xray Absorptiometry (DEXA)
• Magnetic Resonance Spectroscopy (MRS)
 Magnetic Resonance Spectroscopy
Dual Energy Xray Absorptiometry
 DIRECT MEASUREMENTS
• Directly by injecting known substances
(indicators) that will stay in one compartment,
then calculate the volume of fluid in which the
test substance is distributed (volume of
distribution of injected material).

Volume of distribution = amount of substance injected- amount excreted

Metabolized concentration of the substance in the sample
 Example
• A 70kg male is injected with 1.5 g of mannitol. During the
equilibration period, 5% of the mannitol was excreted/hour.
After two hours of equilibration, the plasma concentration
of mannitol was measured as 9 mg/100 ml. What is the
volume of distribution of mannitol?

Volume = 1500mg – 150mg

9 mg/ 100ml
Volume = 1350mg
90 mg/ml

Volume =15L
 CHARACTERISTICS OF MARKER
SUBSTANCE/INDICATOR
• Must be non-toxic.
• Must mix evenly throughout the compartment
being measured.
• Must have no effect of its own on the distribution
of water or other substances in the body.
• It must be unchanged by the body during mixing
period, or the amount changed must be known.
• It must be easy to measure.
 MEASUREMENT OF TOTAL BODY WATER
• The volume of TBW can be determined using a
substance that can rapidly permeate cell membranes
and distribute itself uniformly throughout the ECF and
ICF compartments.
• Indictors commonly used include antipyrine and
isotopic form of water such as tritium (3H2O) or
deuterium (2H2O).
• These substances are lost from the body via every
route open for the loss of water. Approximately 2 hours
are needed for them to achieve a uniform distribution
in the TBW and, during that period, the amount of
water lost by the body is less than 1% of the TBW.
 MEASUREMENT OF ECF VOLUME
• To determine the volume of the ECF
compartment, a substance is used that can
readily permeate capillary walls but not cell
membranes. Such substance include;
Radioactive sodium, radioactive chloride,
thiosulphate ion, inulin, mannitol and sucrose
• The substances mix almost completely
throughout ECFV within 30-60mins.
MEASUREMENT OF PLASMA VOLUME
• The simplest of all of the body fluid
compartments to measure is the plasma
volume (PV).By using indicator dilution
method.
• Indicators used include; Evan’s blue (T-1824)
and radioactive iodine(131I).
• The substance binds strongly with plasma
proteins.
• Diffuses into ISF in small quantity or not at all.
 Contd.
Example
• An amount of 131 I-albumin having 350,000 counts per minute
(cpm) is injected intravenously. One hour later, 10 mL of whole
blood are withdrawn and centrifuged. The whole blood consisted of
5.5 mL of plasma and 4.5 mL of packed blood cells. Then, 1 mL of
the plasma is removed and found to contain 100 cpm.
Solution
PV = Q
Q/V
PV = 350,000cpm
100cpm/L

PV = 3.5L
 Contd.
• Total Blood Volume (TBV) can also be
calculated from the data using the hematocrit
(fraction of the total blood volume comprised
of cells, mainly red blood cells).
• In this case, the hematocrit (Hct) is
Hct = 4.5
10
Hct = 0.45
 Contd.
TBV = PV
1- Hct

TBV = 3.5
1 – 0.45
TBV = 3.5
0.55
TBV = 6.4L
 Indirect Measurements
• ICFV and ISFV are determined by indirect method
• ICFV = TBW – ECFV
• ISFV = ECFV – PV
• Where ICFV – Intracellular Cell Volume
ECFV - Extracellular Cell Volume
ISFV – Interstitial Fluid Volume
TBW – Total Body Water
PV – Plasma Volume
REGULATION OF BODY FLUID VOLUME
• The volume and distribution of body fluids are
determined ultimately by the amounts of
body water and sodium in the body.
• Body fluid volume is controlled by;
Thirst control mechanism
ADH mechanism
Hormonal and neutral factors
 THIRST MECHANISM
• Thirst centre in the hypothalamus contains
osmoreceptors.
• When ECFV decreases then osmolarity
increases, osmoreceptors are stimulated and
this activate the thirst centre thus initiating
thirst.
• The person feels thirsty and drink water
• Then ECFV increases and ECF osmolarity
decreases.
 ADH MECHANISM
• The homeostatic control of water balance, ECFV
and osmolarity depends on Antidiuretic Hormone
(ADH).
• When ECFV decreases , ECF osmolarity increases.
• ADH is release from the neurohypophysis of the
hypothalamus.
• ADH causes retention of water by facultative
reabsorption.
• ECFV increases and osmolarity decreases.
 RAAS SYSTEM
• Sodium depletion accompanied by reduced
ECFV and hypovolemia activates the renin-
angiotensin system and induces
hypersecretion of sodium retaining
aldosterone. Thereby increasing sodium
reabsorption, water reabsorption and vascular
tone.
• This process is known as the Renin-
Angiotensin-Aldosterone (RAAS) System.
 Disorders of Body Fluid Balance
• Keeping body water and solutes balanced is essential
for all body functions.
• This is because all body processes rely on molecular
movements and chemical reactions.
• Deviations in water levels and concentrations of
solutes can;
1. affect muscle and nerve function.
2. affect protein structures making them nonfunctional.
3. disrupt blood pressure.
4. cause edema (swelling).
5. result in cellular damage.
 Contd.
• Edema is the accumulation of excess water in the tissues.
• It is most common in the soft tissues of the extremities.
• The physiological causes of edema include water leakage from
blood capillaries.
• Edema is almost always caused by an underlying medical condition,
use of certain therapeutic drugs, pregnancy, localized injury and
allergic reaction.
• In the limbs, the symptoms of edema include swelling of the
subcutaneous tissues, an increase in the normal size of the limb,
and stretched, tight skin.
• One quick way to check for subcutaneous edema localized in a limb
is to press a finger into the suspected area.
• Edema is likely if the depression persists for several seconds after
the finger is removed (“pitting”).
 Contd.
• Therapy for edema usually focuses on elimination
of the cause.
• Activities that can reduce the effects of the
condition include appropriate exercises to keep
the blood and lymph flowing through the
affected areas.
• Other therapies include elevation of the affected
part to assist drainage, massage and compression
of the areas to move the fluid out of the tissues,
and decreased salt intake to decrease sodium and
water retention.