Body Fluid: Distribution and Measurement oo ontent BODY COMPOSITION (AS % OF BODY WEIGHT) Human body is composed of the following: (enone wee RES eee eee ‘Oxygen 60% si Water 60% skeletal muscle 36% (GEReR 20% | Protein 18% Non-skeletal 29% Hydrogen 15% Fat 15% Adipose tissue 2504 Sain 4% Mineral 6% Bone 10% ates 4% Glycogen 1% @Boay Water as % Body Weight ° TBW=60% MG ICF = 40% (2/3rd of TBW) /*. ; ECF = 20% (1/3rd of TBW) 1. Plasma = 5% (1/4th of EGR) 2. Interstitial fluid = 15% (3/4th of ECF). It includes lymph also, total body weight. 3. Transcellular fluid = ~1.5% * Total blood volume = and blood cell volume which is 2-3% of 8% of body weight (Since, plasma volume = 5% of body weight =3% of body weight) Total blood volume: Plasma volume (1-Hematocrit) Transcellular Fluid This compartment inchides fluid in the synovial, peritoneal, pericardial, and intraocular spaces, as well as the cerebrospinal fluid; itis usually considered to be a specialized type of ECF, although in some cases, its composition may differ markedly from that of the plasma or ISF. All the transcellular fluids together constitute about 1 to? liters (1% to 3% of body weight). Pericardial fluid: 50 mi * Pleural fluid: 10-20 m14 Re iew of Physiolo, ay y luteal phase) and 5 ml (ate leg Je-20 ml (ear © Peri Peritoneal fluid: Male-no fluid, Fema phase). Synovial fluid: sant He = About Iml of fluid is present in each large joint ett ety elbow and wrist. (Range 0.5 ml to 15™ )- aE a i th the or lular fluid environmen: Volume bow osmolality * Y-axis: solute concentration ", ECF (1/3) * X-axis: Volume of ICF 2/9) 2° sity of ICF and ECF is equal. = nnormal control tte OST Gr, Jost from body, its changes the ECF yo, Volu - nis [ Whenever any s0ltion Orting to the type credits Geto . 'YPotonic o, or, osmolality of bo! = we one varies with ECF osmolality and ICF osmolality changes ae : volume change- ; Now Carefully Check the Following Diagrams (Broken line indicates shifts from normal). { osmolality meu ICF a Volume Volume ‘Volume Volume Gain of Isotonic Fluid (B) Infusion of isotoni¢ solution will lead f0 Because there is no change in osmolalitY, mncrease ECF volume but no change i ein HGR volume remains games fr. ft ity. Loss of Isotonic Fluid (C) ‘Will only decrease the ECF volume. ‘Osmolality Osmolatity < a Volume Volume VolumeFei Body Fluid: Distribution and Measurement 7 —— gain of Hypotonic Fluld (D) x ineroases the ECF volume, bitt because ofits hypotonicity, the final osmolality of ECF {cross Waler shits from ECF to ICF (osmosis), hich Fads to increase ICF volume, ime its only shift of water from ae ine cits ar equilibrium reached Loss of Hypotonic Fluid (E) ypotonic loss leads to decrease volume but increase osmolalit JCF to ECF (osmosis), which decrease ICF volume. Osmolality y of ECF. Water shifts from Osmoalty Gain of Hypertonic Fluid (F) Increase in effective volume and osmolalit 'y of ECF. Water shifts from ICF to ECE, wh; leads to decrease ICF volume and increase osmolality until new equilibrium, rade Loss of Hypertonic Fluid (G) Decrease ECF volume and tonicity because of hy Yypertonic fluid loss. Decrease t ECF, shifts the fluid from ICF to ECF (osmosis) So, ICF volume increases and tony creases. (Prmaae OF DARROW-YANNET DIAGRAM pote) Gain of isotonic —_Isotonic NaCl infusion Increased No change No change fluid (B) {Loss of isotonic Hemorthage Decreased No change No change fluid (C) Diarrhea | 7 Vomiting Gain of hypotonic’ — SIADH Increased Increased Decreased fluid (02) —— Drinking of tap water Loss of hypotonic Sweating, Decreased Decreased Increased fluid (E) Diabetes insipidus Gain of Hypertonic Excessive NaCl intake, Increased Decreased Increased fluid (F) mannitol ¢ Loss of Hypertonic Adrenocortical insufficiency Decreased Increased Decreased. ‘fluid (6) i aber fie | Hypotonl Example: If there is loss of 1 L of body, calculate amount of ECF loss In + Water loss: If 1 L of water is ost all three conditions. ¢ fuld distributed both In ECF and ice water (hypotonic), isotonic NaCl, or haltisoton volume will fall by only 333 me eco eee + Isotonie loss: ECF volume Wil mL of isotonic saline. ot eo) ml be lost from ECF only. Thers itd ICF volumes by 667 mL and 393 mL, 'esPo ly. 3 “Composition oF DIFFE ECF Tonic composition of ples * The most important diffe! _ concentration of protein In He plasm: * Because of the Donnan effect (-2%) cations in the plasma nd ints IcF* Only small quantities of Na amounts of K* and phospha! Qn in, cells contain large amounts of protei fore, the 1oss of 1 Lof hal-Isotonie saline decreas RENT FLUID COMPARTMENT erstitial fluid (ISF) is similar. rence between these two compartments is the high er half-isotonic NaCl Is equivalent to 500 mL of + Half-isotonic loss: One liter © 1 water will be lost from ECF and ICF. And anot egatively charge plasma protein holds a sli rin the interstitial fluid. + and C'ions and almost no Ca" ions. Instead, it conta te jons plus moderate quantities of Mg” and sulfate ig almost four times as much as in the plasm; aed Fe NOC the IGF volume will docreaso by 657 mL, viereas the : Cr Water plug ther 500 my $25 the ECF ang wit Bhtly greater ins large NS. Also, a. ee 4 “TYPICAL IONIC CONCENTRATION OF MAMMALIAN CELL Mogae (ete TE Yeas mOsmiL 140 (max cation) 4 42 ic Fuze ig 38) 145 (max cation) / cr 3 108: 108 (max anion) / RCO: 10 28 Ng "7 Tes +H,PO, 11 (max anion) 2 a Protein a 02 | ca® <0,0002 12 18 “ge 20 o7 15 1 Corrected osmolar activity (mOsmi/L) 281 281 282 j t Total osmotic pressure at 37°C (mm Hg) 5423 5423 5443 q * Concentration gradient between ECF and ICF is maximum for Ca’* (~12000:1)‘a ribution and Measurement 9 Body Fluid: Di erage 70-kg adult, the whole-body: in an average tent 2500 to 5000 mEq (mol) > Sodlun the ECF comparimen and 10% I in the (CF compartment ( “0% Is in B: a Saat is ~53 mEq/kg body weight. Of this ich Is ~S8MEq/kg body weight. Of this amount, ine! imarily in the Bone). Ds + Potal mou! ‘compart total body js important to note that: Tis im Entially all of the body K* is in the exchangeable pool. 1 Gnly 65-70% of the body Na* is exchangeable. Almost all of the body Ca** and ‘Mg* are non-exchangeable. Only the exchangeable solutes are osmotically, active. ITS OF MEASUREMENTS. Moles A mole is the molecular weight of the substance in grams. Each mole (mol) consists of 6 +10 molecules. The millimole (mmol) is 1/1000 of a mole, and the micromole (mol) is 1/1,000,000 of a mole. Example: 1 mol of NaCl = 23 g + 35.5 g = 58.5 g, and 1 mmol = 58.5 mg. (Atomic weight of Na=23 and CL = 35.5) EQUIVALENTS. One equivalent (Eq) is 1 mol of an ionized substance divided by its valence. Examples: One mole of NaCI dissociates intolEq of Na’ and1Eq of Cl-. One equivalent of Nat = 23g, but 1 Eeq of Ca** = 40 g/2 = 20 g. a a of N: OSMOLE It expresses concentration of osmotically active particles. 1 Osmole = Mol /Number of freely moving particular each molecule liberates in solution Examples: * 1 mol of NaCl = 2 osmoles because each NaCI molecule given one Na‘ and one Cl Particle is solution. 1 mol of Na,SO, = 3 osmoles because each Na,SO, molecule gives 2 Na* and 10, in solution 1 mol of, CaCl2 =3 osmoles, because each molecule of CaC 2 give 3 particles (I calcium and 2 Cl) in solution.r | 10 Review of Physiology Converting WEIGHT TO OSMOLALITY weight of the substance (B/D) attnber of ene Molecular weight (8) CONVERTING WEIGHT TO. MILLIEQUIVALE! ROsmol/L . NTS mg x valence. molecular of, formula weight . Example A: Conver the expression 10 mg% of Ca to mEq/L and mOsmol, 1. 10mg% of Ca*means, 10 mg/100 m= 100 mg/L mEq= yn: mEq/L = me =5 mEq/L 0.1 (g/L) . According to equation: mOsmol/l = 79 (g) Eq of KCl are in 1.5 g of KCI = 39 +35.5= 745 BL . According to the above equattio «1 1000=2.5 mOsmol/L, :mple B: How many ™ 1. Molecular weight of KC 2. According to equation: | 7A Example C:100mgeach of NaCl, CaCl, and FeCl,in 1Lof water. Determine the con, in percent, cia milliequivalent (mEq) and milliosmolarity (mOsmol), ‘centration mEq _ 1so0mgt re Percent (g/volume) {NaCl in IL solution = 0.1g/1000 ml= 0.01 g/100 mi = 0.01% NaCl: 100 mg o! : aC; 100 mg of CAC, i 1L solution = 018/1000 m= 0.01g/100 mi = 0.01% @ mg of FeCl, in IL solution =0.1g/1000 ml= 0.01g/100 ml = + FeCl, 100 mg of 0 ey y Motcity NaCl: Motecular weight = 585 g (so, IMol = 58.5 g) 0.018/585 g=cooi7y 1.7 mMol + CaCl; Molecular weight= 111g (so, IMol = 11 g) 0.01g/111g = 0.0009 M=09 mi ‘© FeCl: Molecular weight = 162.2 g (s0, IMol = 162.2 g) 0.01g/162.2 g = 0.00062M=0.69 ate Milliequivalent © NaCl: Molecular weight = 58.5g valence 1 + CaCl: Molecular weight = 111g and valence 2 © FeCl,: Molecular weight = 162.2g and valence 3 mg x valence $0 according to formula: mEq = —— molecular or, formula weight 100x1 NaCl: mEq = —y5~ = 1.7 mEq/L CaCl: mEq= a“ *2 18 mEq/L 11 FeCl: mEq = as =1.85 mEq/L= Body Fluid: Distribution and Measurement 11 Me aay discussed, that 1 mol of NaCl = wetely 1 mol FeCl,= 4 osmoles. S mM of NaCl = (2 « 1.7) mOsmol = 3.4 mOsmol/L 0,9 mM of CaCl, =@ * 0.9) mOsmol = 2.7 mOsmol/L, 0.62 mM of FeCl, = (4 « 0.62) = 24.8 mOsmol/L on directly using the formula 2 osmoles, 1 mol of, CaCl, = 3 osmoles. weight of the substance (g/L) : et ot mOsmol/L = "Molecular weight (@) number of species x 1000 will give the same result Relation of Osmolality to Osmotic Pressure + At 37°C, a concentration of 1 osmole per liter will cause 19,3 2 ation of 1. i 00 mm Hg (25.4 atm) osmotic Pressure in the solution. Likewise, 1 mOsmol per liter concentration is equivalent te 19.3 mm Hg ‘osmotic pressure, “Multiplying this value by the 300 mOsmel (concentration of the body fluids — ® calculated mye of the body fluids of 5790 mm Hg. ) gives a total TONICITY Definition: This is the osmolality of a solution with res; pect to plasma osmolality. Example: 0.9% NaClis isotonic; 5% glucose is isotonic initially; later has become hypotonic. Calculated Osmolarity (CO)/Osmolality : When unit of Na and K are in mEq/L or, mmol/L, and unit of Glucose and BUN ate way) “Plasma Osmolality = 2(Na+ K) + Glucose , BUN Or, 18 2.8 Plasma Osmolality = 2(Nq) + Glucose 18 —~ When all units arefin mmol, Plasma Osmolali (Na + K) + Glucose + BUN. Or, Plasma Osmolality = 2(N4+ K) + Glucose + BUN12 i Measured osmolal ity (MO) molality leche: nding out the osmolali 1s by freezing poi 7 a GAP [mo itis called esmolal gap, Osmo CO and MO, ir oily a toxic alcohol such 35 fe Mol, If there is a difference between the V indicates the presence of a foreign substance like us methanol or isopropyl alcohol. i. Aad the patient has ingested et So, sometime a different equation is used when the P' thanol, os mannitol therapy: thanol , Mannitol Glucose BUN , E Plasma Osmolality = 2(Na)+ “7g at 37 7 290-290 mOsm kg. In the plasm, 8 of CF fluids is sip Osm. The remaining 20 B20 M0sm ar, te 270 mi nce lesser number of particles plasma osmolality. ” Plasma CF and It olality of the ECF and HCO, contribu The normal osm the total osmolality Nat, Cl-and contributed by glucose and urea. molecular weight and hei Because of the large proteins (70g/L) contribute y. olality calculation!!! «There are altogether, around 36 y cal ‘The best equation is: Zander’s optimized equation, which is not commonly useg © The best method for measurement is: freezing point depression. i TONICITY OF DIFFERENT SOLUTION Dextrose solution Provide 170 Cal 5% Isotonic but 278 50 physiologically hypotonic [10% ‘Hypertonic 556 100 Provide 340 Cal. Saline solution n | 0.45% Hypotonic 154 0 No Calories 0.9% i mi Isotonic 308 0 ony solution that may be = administered with blood 3% Hypertonic 1026 0 No Calories = Dextrose in saline S| 5% in 0.225% Isotonic 355 50 Provide 1 g = rovide 170 Call. I “ in 0.45% Hypertonic 432 50 Provide 170 Call. i p al 1% in 0.9%. Hypertonic 586 50 fide 170 Provide 170 CallBody Fluid: Distribution and Measurement 13 SE racer ae " similar in composition to plasma ae 308 o except it has excess Cand No jg soution ce Mg‘*,no HCO; ee 5 ‘Similar in composition to plasma | isotonic 274 ithhas No Mg** xe Ringe’ ‘eee a Gtion) Ee aes 4, Major cation in ECF: peceNT MCOS a.Nat b. K f ICF in body: c. Ca d. Mg* 1. Volommrody wt. b, 04 x body wt 5. Most osmotically active intracellular a jexbody wt. d. 08 x body wt. cation: ee OCF i art of total body a. Kt Nat 2 Ea how much Mg? . Protein eight: a One third b. Half 6. True regarding Na‘ ion cTwothird d. None a. Responsible for Donnan effect 3, ICFis: b. Responsible for Resting membrane al4L Wwe potential b.20% of body weight ~~ ¢. Responsible for Depolarization c. 28L w) s) {Does not help other ions in trans 4. 33% of body weight or. ery 7. The following are true about body water b. Most intracellular water is the mus- a. Water constitutes 60% of the body culoskeletal system weight - [PGI Dec 07] c. Extracellular water constitutes about b. Plasma volume constitutes 10% of 40% of body weight the total body water d. Total plasma constitutes about 10% c. ECF volume can be determined by body weight dilution methods e. Extracellular fluid can be measured d. 10% is intracellular water by dilution method 8. ECF forms what percentage of body 49, Which of the following methods is weight [ar97] not used for measurement of body a. 10% b. 25% fluid volumes? [AIMS May 05] ©. 33% d. 60% a. Antipyrine for total body water 9. True statements are: [PGI Dec 04] b. Inulin for extracellular fluid a. Total body water constitutes about c. Evans blue for plasma volume 60% of body weight d. 15 albumin for blood volume14_Review of Physiology 1 Most accurate measurement of extea- cellular fluid volume (ECF) can be done by using: [AIMS May 03] eae b, Mannitol Inulin d. Aminopyrine 12. Predominant extracellular ions are: a. Nat b. K och d. HCO, e.PO, 13. True statements about ions composi- Hon in body: [PGI June 06] @. Intracellular & Extracellular ions compositions aresame b. Phosphorus and Mg"* are major ions intracellularly ©. Na’, Cr principal ions in ECF d. Kidney tightly regulates Na‘, composition Kt, Cr f 18. One person has ingested 1500 ml © water. Calculate the amount fi be present in ISF after equilibrium? a. 1000 ml b. 500 ml 1 .375 ml d. 125 ml ‘Answer questions number 19 and 20 from the following diagram (dashed lines represent original conditions and solid lines the final steady-state situation). 15. 46. Osmotic pressure of 1 jount that will | os 14, About sodium, true; jpg —~ a, Normal serum level i 135, ote b, Daly intake 8150 mmot of SE, , Major portion is extraelignn I dl Major Feserve is skeletal my Total body water differences by : male and female is Tot seen at ‘a een [pt ygp8_ | 60 years“! 25 years mB f &. Above 60 years b, 49. 10-18 years d. 1g. i Mole of ; solute relative to pure watey io! [PGi b. 224 atm V0) a. 6.5 atm c. 4atm d. latin e, 2atm 17, Ineffective osmolsis yp a. Na* b. ke PMER og, c. Urea d@. All 7 19. Which of the diagram best j “the fluid shifts resulting peu ~Sion! of IL of distilled wa “bloodstream: Sa A . Cc dD 20. Which best illustrates the status of person who received 1 Lof a yet tonic saline solution intravenously, aA b.B (xe aD 21. A 60 kg patient has a hematoctit read ing of 40 and a plasma volume of 3, ters. What is his total blood volume? a. 4.0 liters b. 5.0liters c. 6.0 liters d. 7.0 liters 22. What is the calculated osmolarity of a solution containing 12 mmol NaCl, 4 mmol KCl and 2 millimolar CaC? 7 infy. er into the (mOsmol/L)? a.16 b. 26 ©. 38 d. 32y. ! Body Fluid: Distribution and Measurement 15 ing complete dissociation of all . Assan ch of the following solu- a would be hyperosmotic to 1 mM. Ne glucose b. 1.5 mM glucose a TmMCaCl2 d. 1mM sucrose which of the following best describes the changes in cell volume that will txeur when red blood cells (previous- fy equilibrated in a 280-mOmol solu- on of NaCl are placed in a solution $4140 mmol NaCl containing 20 mmol Grea, a relatively large but permeant molecule? 2. Cells shrink initially, then swell over time and lyse b, Cells shrink transiently and return to their original volume over time ¢. Cells swell and lyse d. No change in cell volume will occur The diagram below illustrates possible . Initial volume 70 Time (seconds) 25. Which curve best illustrates the vol- ume caused by immersion of the cell into an aqueous solution of 300 mOsm caciz aA bB c 4D 26. Which curve best illustrates the vol- ume change caused by immersion of the cell into a mixture of aqueous so- lution of 200 mOsm/L NaCl and 200 changes in. RBC volume resulting from nea - aoe a change in ECF composition for a cell ie q equilibrated in 150 mM/L NaCl solution at & aD time 0. Answer questions number 25 and 26 below: ANSWERS: 1. Ans. b. 0.4 x body wt (Ref: Ganong’s Physiology 24th ed. pp 2) ICF is 40% of total body weight. 2. Ans. d. None (Ref: Ganong’s Physiology 24th ed. pp 2) ECF is 20% of total body weight, so, its 1/5th of body weigth and 1/3" of total body water (33%) 3. Ans. c.28L (Ref: Ganong’s Physiology 24th ed. Pp 2) ICF is 40% of total body weight. Adult person with 70 Kg body weight, total body water is 42 Land ICE (2/3") volume is 28L 4. Ans. a. Nat (Ref: Ganong’s Physiology 24th ed. pp 3) a In ECF Major cation is Na* and anion is Cl . In ICF major cation is K* and anion is phosphate. 5. Ans. a. K (Ref: Ganong’s Physiology 24th ed. pp 2) Osmolality depends on number of molecules. As K* concentration is maximum, in cell, most osmotically active particle is K* 6. Ans. c. Responsible for Depolarization (Ref: Ganong’s Physiology 24th ed. pp 6) Donnaneffectis distribution ofall permeable ions due to presents of non-permeable ions. K’ is responsible for RMP. 7. Ans. a, Water constitutes 60% of the body weight (Ref: Ganong’s Physiology 24th ed. pp 2)16 i Review of Physiology extracellular © ECF vot ? 1 dilution Tena can be determined by Plasm: ‘ Dia Ae teal body weight. and akg person, plasma volume is 3.5L weight), ao water is 42L (60% of body . So, plasma is 8.3% 1 bod: water [@5/Ae00h 3% of total body 8. Ans, b. 25% ed. pp 2) (Ref: Ganong’s Physi 4 24th ‘ 1g’s Physiology ECF is 20% of total body weight: So, close , ovided options: answer is 25% with the Pr 9. Ans. a. Total body water constitutes about 60% of body weight, b. Most intracellular Ww oskeletal syste™ e. Extracellular fluid ean Pe measured bY dilution method (Ref: Ganons’s Prysilosy 2 ECE constitute 20% of total bo eal plasma is 5% of body weight qo Ans. 4.7% albumin for blood v' (Ref: Cuiyton- Physiology 13th edn.pp £9) 12% albumin is used for plasma volume not blood volume. ‘Ans, ¢. Inulin (Ref: Guy" gy-13th edn.pp 49) Inulin is best for ECF measurement. 2. Ans.a.Na‘e. CI'd. HCO; ‘Ref. Ganong’s Physiology 24th ed. Pp3) sy Predominant ECF: Na”-Cl, HCO," and Ca’ Predominant ICF: K* Mg", phosphate and protein. 43, Ans. b. Phosphorus and Mg” ar jor ions intracellularly, . Na’, Ci principal ions in ECF 4. Kidney tightly regulates Na’, K’, Cr composition ie ae Ganong's Physiology 24th ed. pp 3) . ane Normal serum level is 135-145 b. Daily i : aily intake is 150 mmol of NaCl ter is the muscu 4th ed. pp 2) dy weight. lume 1. on-Physiolo- e ma- | Major portion c. i nef Fiend’ physiology 24th ed. pp 3) Major reserve rena is bones Mot muscle, Ans: & (Ref; Fluid jd Estectrolyte Balartce By Nor ¢ M. Metheny pifference jsnotseen uPfo the age of Dube ig, b. 22-4 atm ty ji Physiology 12th ed.pp. 209 g, 13th edn, y a "4 oc aconcentration of 1osmole 51) “At37" e 19,300 mm Hg osmotic Perle i the solution: Likewise, 1 mOsmol ae matration is equivalent to 19,3 Per aii liter cone e enotic Pressure: Urea Physiology 12th edn. pp. 299 13th ednyp 5 mpighly permeating absence 52) ‘yee’ can cause transient shifts j ich as urjume between the ICF and ECE, ad fluid enough time, the concentrations "ut given substances eventually become equal these substampartments and have litle effect intracellular osmolality and volum fect on steady-state conditions.” That's aie Under an ineffective osmoles. WAY urea is 18. Ans. Cc. Water is a hypotonic fluid so, i distributed equally in both’ Een ibe Tce acosidltinsia theltorchinnates< 0 years. 46. Ans: Be (Refi Guy? So,» : « 2/3 of 1500 ml wil istril 2 of 1500 will be distributed in e 1/3" of 1500 ml wi istril eee will be distributed in ¢ ISF is 3/4th of ECF = ISE ie 3 3/4th of 500 ml = 19. Ans. b. Infusion of distilled wi s ater would de OO ae eis increase the vlan . The decreased ECF it would cause water to diffuse ileal raise ICF volume. eat70. Ans Novertonic saline will increase yriasins NYFTty. Since fluid is given, the y osmelsthe ECF compartment will vol The increased osmolarity of the inere*S"" cquse water to diffuse out of fereasing ICF volume. None of the calls, ¢U* 5 matching. diag .b. a eatocrt (Het) = 40% = 0.4 Fipod volume = Plasma volume/(I-Het) = 3/ (-0.4)=5L sc. mel solution has ImOsmol when the 1 Me does not dissociate. NaCl and KCI ‘oth dissociate into two molecules and cacl2: dissociae into 3 molecules. So, 12mmol {acl has an osmolality of 24 mOsmol, mmol of KCl = 8 mOsmol and 2 mmol of Gacl2 = 6 mOsmol. Total 38 mOsmol. 23, Ans. ¢. : The 1 mM CaCl, solution (osmolarity = 3 mOsm/L) is hyperosmotic to 1 mM NaCl (osmolarity = 2 mOsm/L). The 1 mM glucose, 1.5 mM glucose, and 1 mM sucrose solutions are hyposmotic to 1 mM NaCl. 24. Ans. b. Cell is placed in a solution of 140 mmol NaCl with 20-mmol urea. A solution of 140 mmol NaCl has an osmolarity of 280 mOsmol, which is iso-osmotic relative to “normal” intracellular osmolarity. If RBC Body Fluid: Distribution and Measurement _17 were placed in 140 mmol NaCl alone, there would be no change in cell volume. But the additional presence of 20-mmol urea, however, increases the solution’s osmolari and makes it hypertonic relative to the ICF solution. Water will initially move out of the cell, but because the plasma membrane is permeable to urea, urea will diffuse into the cell and equilibrate across the plasma membrane. As a result, water will re-enter the cell, and the cell will return to its original volume. So, B better answer>>D. 25. Ans. c. * The RBC was equilibrated in 150 mM NaCl (means 300 mOsmol NaCl) that is an isotonic saline solution. A 300 mOsm CaCl, solution is also an isotonicfolution of a nonpenetrating solute, thus, there will be no change in RBC volume. 26. Ans. b. * 200 MOsm NaCl is nonpenetrating but the 200 mOsm glycerol penetrates slowly. Initially the effective osmolarity of the solution is 400 mOsm (200 Nacl+ 200 glycerol), thus the cell shrinks. With time the glycerol penetrates and the final effective osmolarity of the solution is only 200 mOsm due to the NaCl. Thus, as the glycerol penetrates, water moves into the red blood cell and final volume will be greater than at time zero. Curve B, which shows an initial shrinkage then overall swelling, is the best answer.