BODY FLUID COMPARTMENT

AND
OSMOREGULATION

DR. F.L MASIKA MD.

FEBRUARY,2023.
 OBJECTIVES
DESCRIBE BODY FLUID COMPARTMENTS.
DESRIBE REGULATION OF FLUID EXCHANGE AND
OSMOTIC EQUILBRIUM BETWEEN INTRACELLULAR AN
EXTRCELLULAR FLUID COMPARTMENTS.
DESCRIBE CONTROL OF EXTRACELLULAR FLUID
OSMOLALITY AND SODIUM CONCENTRATION.
 INTRODUCTION
HUMAN BODY IS FORMED BY SOLIDS AND FLUIDS.
 FLUID PART IS MORE THAN TWO THIRD OF THE WHOLE
BODY.
WATER FORMS MOST OF THE FLUID PART OF THE BODY.
IN HUMAN BEINGS, THE TOTAL BODY WATER VARIES FROM
45% TO 75% OF BODY WEIGHT.
 IN A NORMAL YOUNG ADULT MALE, BODY CONTAINS
60% TO 65% OF WATER AND 35% TO 40% OF SOLIDS.
 CONTIN…
 IN A NORMAL YOUNG ADULT FEMALE, THE WATER IS 50% TO 55%
AND SOLIDS ARE 45% TO 50%.
 IN FEMALES, WATER IS LESS BECAUSE OF MORE AMOUNT OF
SUBCUTANEOUS ADIPOSE TISSUE.
 IN THIN PERSONS, WATER CONTENT IS MORE THAN THAT IN OBESE
PERSONS.
 IN OLD AGE, WATER CONTENT IS DECREASED DUE TO INCREASE IN
ADIPOSE TISSUE.
 TOTAL QUANTITY OF BODY WATER IN AN AVERAGE HUMAN BEING
WEIGHING ABOUT 70 KG IS ABOUT 40 L
 SIGNIFICANCE OR FUNCTIONS OF BODY FLUIDS
1. HOMEOSTASIS:
 BODY CELLS SURVIVE IN THE FLUID MEDIUM CALLED INTERNAL
ENVIRONMENT .
 INTERNAL ENVIRONMENT CONTAINS SUBSTANCES SUCH AS GLUCOSE,
AMINO ACIDS, LIPIDS, VITAMINS, IONS, OXYGEN.
 WHICH ARE ESSENTIAL FOR GROWTH AND FUNCTIONING OF THE CELL.
2. TEMPERATURE REGULATION:
 WATER PLAYS A VITAL ROLE IN THE MAINTENANCE OF NORMAL BODY
TEMPERATURE.
 CONTIN…
3. IN TRANSPORT MECHANISM:
 BODY WATER FORMS THE TRANSPORT MEDIUM BY WHICH NUTRIENTS,
ENZYMES, HORMONES, VITAMINS, ELECTROLYTES AND OTHER SUBSTANCES
ARE CARRIED FROM ONE PART TO ANOTHER
4.METABOLIC REACTIONS:
 WATER INSIDE THE CELLS FORMS THE MEDIUM FOR VARIOUS METABOLIC
REACTIONS, WHICH ARE NECESSARY FOR GROWTH AND FUNCTIONAL
ACTIVITIES OF THE CELLS.
5.TEXTURE OF TISSUES:
 WATER INSIDE THE CELLS IS NECESSARY FOR CHARACTERISTIC FORM AND
TEXTURE OF VARIOUS TISSUES.
 COMPARTMENTS OF BODY FLUIDS
DISTRIBUTION OF BODY FLUIDS
• TOTAL WATER IN THE BODY IS ABOUT 40 L.
• IT IS DISTRIBUTED INTO TWO MAJOR COMPARTMENTS:
1. INTRACELLULAR FLUID (ICF):
ITS VOLUME IS AND IT FORMS 55% OF THE TOTAL BODY WATER.

2. EXTRACELLULAR FLUID (ECF):

ITS VOLUME IS AND IT FORMS 45% OF THE TOTAL BODY WATER.
 CONTIN…
• ECF IS DIVIDED INTO 5 SUBUNITS:
I. INTERSTITIAL FLUID AND LYMPH (20%).
II. PLASMA (7.5%).
III. FLUID IN BONES (7.5%).
IV. FLUID IN CONNECTIVE TISSUES (7.5%).
V. TRANSCELLULAR FLUID (2.5%).
 CONTIN…
TRANSCELLULAR FLUID INCLUDES:
• A. CEREBROSPINAL FLUID.
• B. INTRAOCULAR FLUID.
• C. DIGESTIVE JUICES.
• D. SEROUS FLUID.
• E. SYNOVIAL FLUID IN JOINTS.
• F. FLUID IN URINARY TRACT.
 COMPOSITION OF BODY FLUIDS
• BODY FLUIDS CONTAIN 1. ORGANIC AND 2. INORGANIC SUBSTANCES.
• ORGANIC SUBSTANCES: ARE GLUCOSE, AMINO ACIDS AND OTHER
PROTEINS, FATTY ACIDS AND OTHER LIPIDS, HORMONES AND ENZYMES.
• INORGANIC SUBSTANCES: ARE SODIUM, POTASSIUM, CALCIUM,
MAGNESIUM, CHLORIDE, BICARBONATE, PHOSPHATE AND SULFATE.
• ECF CONTAINS LARGE QUANTITY OF SODIUM, CHLORIDE, BICARBONATE,
GLUCOSE, FATTY ACIDS AND OXYGEN.
• ICF CONTAINS LARGE QUANTITIES OF POTASSIUM, MAGNESIUM,
PHOSPHATES, SULFATES AND PROTEINS.
• THE PH OF ECF IS 7.4 AND THE PH OF ICF IS 7.0.
 CONCENTRATION OF BODY FLUIDS
CONCENTRATION OF BODY FLUIDS IS
EXPRESSED IN THREE WAYS:
1. OSMOLALITY.
2. OSMOLARITY.
3. TONICITY.
 OSMOLALITY
• OSMOLALITY IS A MEASURE OF A FLUID’S CAPABILITY TO
CREATE OSMOTIC PRESSURE.
• SOMETIMES IS CALLED OSMOTIC CONCENTRATION OF A
SOLUTION (OSMOLAR) .
• IT IS THE CONCENTRATION OF OSMOTICALLY ACTIVE
SUBSTANCE IN THE SOLUTION.
• IS EXPRESSED AS THE NUMBER OF PARTICLES (OSMOLES)
PER KILOGRAM OF SOLUTION(OSMOLES/KG H2 O).
 OSMOLARITY
• OSMOLARITY IS THE NUMBER OF PARTICLES (OSMOLES)
PER LITER OF SOLUTION (OSMOLES/L).
• OSMOLARITY IS ANOTHER TERM TO EXPRESS THE OSMOTIC
CONCENTRATION.
• IN PRACTICE, THE OSMOLARITY IS CONSIDERED TO
DETERMINE THE OSMOTIC PRESSURE.
• OFTEN, THESE TWO TERMS OSMOLALITY AND OSMOLARITY
ARE USED INTERCHANGEABLY.
 TONICITY.
• TONICITY IS THE MEASURE OF EFFECTIVE
OSMOLALITY.
• IN TERMS OF TONICITY, THE SOLUTIONS ARE
CLASSIFIED INTO THREE CATEGORIES:
1. ISOTONIC SOLUTIONS.
2. HYPERTONIC SOLUTIONS.
3. HYPOTONIC SOLUTIONS.
 I. ISOTONIC FLUID (SOLUTION).
• IS AN EXTERNAL SOLUTION THAT HAS THE SAME SOLUTE
CONCENTRATION AND WATER CONCENTRATION
COMPARED TO BODY FLUIDS.
• EXAMPLES: 0.9% SODIUM CHLORIDE SOLUTION (NORMAL
SALINE) AND 5% GLUCOSE SOLUTION.
• CELLS PLACED IN ISOTONIC FLUID NEITHER GAIN NOR LOSE
WATER BY OSMOSIS.
• THIS IS BECAUSE OF THE OSMOTIC EQUILIBRIUM BETWEEN
 II. HYPERTONIC FLUID
• IS AN EXTERNAL SOLUTION THAT HAS A HIGH SOLUTE
CONCENTRATION AND LOW WATER CONCENTRATION
COMPARED TO BODY FLUID.
• EXAMPLE: 2% SODIUM CHLORIDE SOLUTION.
• CELLS PLACED IN HYPERTONIC FLUID, WATER MOVES OUT
OF THE CELLS (EXOSMOSIS) RESULTING IN SHRINKAGE OF
THE CELLS (CRENATION).
 III. HYPOTONIC FLUID
• IS AN EXTERNAL SOLUTION THAT HAS A LOW SOLUTE
CONCENTRATION AND HIGH WATER CONCENTRATION
COMPARED TO BODY FLUIDS.
• EXAMPLE: 0.3% SODIUM CHLORIDE SOLUTION.
• CELLS PLACED IN HYPOTONIC FLUID, WATER MOVES INTO
THE CELLS (ENDOSMOSIS) AND CAUSES SWELLING OF THE
CELLS.
• IT BECOMES GLOBULAR AND GET RUPTURED (HEMOLYSIS).
 BODY FLUID IMBALANCE.
• BODY FLUID IMBALANCE CAN ARISE DUE TO
HYPOVOLEMIA, NORMOVOLEMIA WITH MALDISTRIBUTION
OF FLUID, AND HYPERVOLEMIA.
• COMMON CAUSES OF FLUID IMBALANCE ARE:
 DEHYDRATION, WHICH IS A LOSS OF PLASMA.
 TRAUMA DUE TO BLOOD LOSS.
 DEHYDRATATION
• DEHYDRATION IS DEFINED AS EXCESSIVE LOSS OF WATER
FROM THE BODY.
• DEHYDRATION OCCURS WHEN FLUID LOSS IS MORE THAN
WHAT IS CONSUMED.
• BODY REQUIRES CERTAIN AMOUNT OF FLUID INTAKE
DAILY FOR NORMAL FUNCTIONS.
• MINIMUM DAILY REQUIREMENT OF WATER INTAKE IS
ABOUT 1 L.
 CLASSFICATION OF DEHYDATRATION

• DEHYDRATION CAN BE CLASSFIED ON THE BASIS OF:

1. AMOUNT OR PARCENTAGE OF WATER LOSS.

2. RATIO BETWEEN WATER LOSS AND SODIUM LOSS.
 1. BASE ON AMOUNT OF WATER LOSS
• IS CLASSFIED INTO THREE TYPES:
1. MILD DEHYDRATION: OCCURS WHEN FLUID LOSS IS ABOUT 5% FLUID.
IS NOT VERY SERIOUS AND CAN BE TREATED EASILY BY REHYDRATION.
2. MODERATE DEHYDRATION: OCCURS WHEN FLUID LOSS IS ABOUT 10%.
IT IS LITTLE SERIOUS AND IMMEDIATE TREATMENT SHOULD BE GIVEN BY
REHYDRATION.
3. SEVERE DEHYDRATION: OCCURS WHEN FLUID LOSS IS ABOUT 15%.
IT IS SEVERE AND REQUIRES HOSPITALIZATION AND EMERGENCY
TREATMENT.
 BASED ON RATIO BETWEEN WATER AND SODIUM
• ON THE BASIS OF RATIO BETWEEN WATER LOSS AND SODIUM LOSS,
DEHYDRATION IS CLASSIFIED INTO THREE TYPES:
1. ISOTONIC DEHYDRATION: BALANCED LOSS OF WATER AND SODIUM.
E.G IN THE CASE OF DIARRHEA OR VOMITING.

2. HYPERTONIC DEHYDRATION: LOSS OF MORE WATER THAN SODIUM.

E.G IN THE CASE OF FEVER.

3. HYPOTONIC DEHYDRATION: LOSS OF MORE SODIUM THAN WATER.

E.G IN THE CASE OF EXCESS USE OF DIURETICS.
 MAINTENANCE OF WATER BALANCE
• WATER ENTERS THE BODY VIA THE DIGESTIVE TRACT.
• WATER IS ALSO ADDED TO THE TOTAL FLUID VOLUME
FROM FOOD METABOLISM OF CELLS.
• WATER LEAVES THE BODY VIA FOUR EXITS:
1.URINE THROUGH THE KIDNEY.
2.WATER IN EXPIRED AIR THROUGH THE LUNGS.
3.SWEAT THROUGH THE SKIN.
4.FAECES FROM THE INTESTINE.
 CONTIN
• BODY HAS SEVERAL MECHANISMS WHICH WORK TOGETHER TO
MAINTAIN THE WATER BALANCE.
• THE IMPORTANT MECHANISMS INVOLVE HYPOTHALAMUS AND
KIDNEYS.
• UNDER NORMAL CONDITIONS HOMEOSTASIS OF THE TOTAL
VOLUME OF THE WATER IN THE BODY IS MAINTAINED BY
ADJUSTING:
1.OUTPUT URINE VOLUME.
2. FLUID INTAKE.
 1.REGULATION OF URINE VOLUME
TWO FACTORS DETERMINE URINE VOLUME
I. GLOMERULAR FILTRATION RATE
EXCEPT UNDER ABNORMAL CONDITIONS REMAIN FAIRLY
CONSTANT.
II. RATE OF TUBULAR REABSORPTION OF WATER.
 FLUCTUATES CONSIDERABLY.
 NORMALLY ADJUSTS URINE VOLUME TO FLUID INTAKE
INFLUENCED BY HORMONAL •
 2. REGULATION OF FLUID INTAKE
• MECHANISMS REGULATION OF FLUID INTAKE;
WHEN DEHYDRATION BEGINS TO DEVELOP, SALIVARY
SECRETION DECREASES.
THIS PRODUCING THE SENSATION OF THIRST;
SUBSEQUENTLY INDIVIDUAL INCREASED FLUID INTAKE TO
OFFSET INCREASED OUTPUT TENDS TO RESTORE FLUID
BALANCE.
 MAJOR MECHANISMS THAT REGULATE
EXTRACELLULAR FLUID VOLUME
1. NEURAL MECHANISM
IT CHANGES THE FREQUENCY OF ACTION POTENTIALS CARRIED BY
SYMPATHETIC NEURONS TO THE AFFERENT ARTERIOLES OF THE
KIDNEY IN RESPONSE TO CHANGE IN BLOOD PRESSURE.
 WHEN BARORECEPTORS DETECT AN INCREASE IN ARTERIAL AND
VENOUS PRESSURE, THE FREQUENCY OF ACTION POTENTIAL
CARRIED BY SYMPATHETIC NEURON TO THE AFFERENT ARTERIOLE
DECREASES.
 CONTIN…

CONSEQUENTLY THE AFFERENT ARTERIOLE DILATES.

THIS INCREASES GLOMERULAR CAPILLARY PRESSURE, RESULTING
IN AN INCREASE IN THE GLOMERULAR FILTRATION RATE, AN
INCREASE IN FILTRATE VOLUME AND AN INCREASE IN URINE
VOLUME.
WHEN THE BARORECEPTORS DETECT A DECREASE IN ARTERIAL
AND VENOUS PRESSURE THE ACTION POTENTIAL CARRIED BY
SYMPATHETIC NEURON CAUSES CONSTRICTION OF AFFERENT
ARTERIOLE AND THE OPPOSITE OCCURS.
 CONTIN…
2. RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
THE RENIN ANGIOTENSIN-ALDOSTERONE MECHANISM RESPONDS
TO SMALL CHANGES IN THE BLOOD VOLUME.
INCREASED BLOOD PRESSURE RESULTS FROM INCREASED BLOOD
VOLUME.
JUXTAGLOMERULAR CELLS DETECT INCREASE IN BLOOD PRESSURE
IN THE AFFERENT ARTERIOLE AND DECREASE THE RATE OF RENIN
SECRETION.
THE DECREASE IN RENIN SECRETION RESULTS IN A DECREASED
CONVERSION OF ANGIOTENSINOGEN TO ANGIOTENSIN II.
 CONTIN…
REDUCED ANGIOTENSIN II CAUSES A DECREASE IN THE RATE OF
ALDOSTERONE SECRETION FROM THE ADRENAL CORTEX.
 DECREASED ALDOSTERONE LEVEL REDUCES THE RATE OF SODIUM (NA+ )
REABSORPTION FROM THE DISTAL RENAL TUBULES AND COLLECTING DUCTS.
CONSEQUENTLY MORE NA+ REMAINS IN THE FILTRATE AND FEWER ARE
REABSORBED.
 THE WATER REMAINS WITH THE EXCESS NA IN THE FILTRATE.
THUS THE VOLUME OF URINE PRODUCED INCREASES AND EXTRACELLULAR
FLUID VOLUME DECREASES.
THE OPPOSITE OCCUR IN CASE OF DECREASED IN BLOOD VOLUME.
 CONTIN…
3. ATRIAL NATRIURETIC HORMONE (ANH) MECHANISM.
 THE ANH MECHANISM IS MOST IMPORTANT IN RESPONDING TO INCREASES
IN EXTRACELLULAR FLUID VOLUME.
 AN INCREASE IN PRESSURE IN THE ATRIA OF THE HEART, WHICH USUALLY
RESULTS FROM AN INCREASE IN BLOOD VOLUME, STIMULATES THE
SECRETION OF ANH, WHICH DECREASES NA+ REABSORPTION IN THE DISTAL
AND COLLECTING DUCTS.
THIS INCREASE THE RATE OF NA+ AND WATER LOSS IN THE URINE .
THUS INCREASED ANH SECRETION DECREASES EXTRACELLULAR FLUID
VOLUME.
 CONTIN…
4. ANTIDIURETIC HORMONE (ADH) MECHANISM .
THE ADH MECHANISM PLAYS AN IMPORTANT ROLE IN
REGULATING EXTRACELLULAR FLUID VOLUME IN RESPONSE TO
LARGE CHANGES IN THE BLOOD PRESSURE .
AN INCREASE IN BLOOD PRESSURE RESULTS IN A DECREASE IN
ADH SECRETION.
 AS A RESULT, THE REABSORPTION OF WATER FROM THE LUMEN
OF THE DISTAL TUBULE AND COLLECTING DUCTS DECREASES,
RESULTING IN A LARGE VOLUME OF DILUTE URINE.
 CONTIN…

THIS RESPONSE HELPS TO DECREASE EXTRACELLULAR

FLUID VOLUME AND BLOOD PRESSURE.
A DECREASE IN BLOOD PRESSURE RESULTS IN AN
INCREASE IN ADH SECRETION AND THE OPPOSITE
OCCURS. •
 REFERENCES

• GUYTON AND HALL TEXTBOOK OF MEDICAL

PHYSIOLOGY 13TH EDITION 2015.
• ROSS AND WILSON ANATOMY AND
PHYSIOLOGY IN HEALTH IN HEALTH AND
ILLNESS 13TH EDITION 2018.
• ESSENTIALS OF MEDICAL PHYSIOLOGY
SEMBULINGAM 6TH EDITION IN 2012.