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Body fluid and electrolyte: About 46 to 6o % of the average adult weight is water.
The proportion of water decreases with aging because fat, age and sex effect of total body water. (Infant 70 80%).
b) Extracelluar fluid (ECF): is found out side of cell and account 1/3 of the total body fluid. its subdivided into three compartments: 1) Intravascular fluid or plasma: is found within vascular system. 2) Interstitial fluid: is found surrounding the cell and includes lymph. 3) Transcellular: includes cerebrospinal fluid, pleural, peritoneal and synovial fluid.
Composition of Fluids
Cations Na K Ca Mg Anions Cl HCO SO4 HPO4 Protein plasma interstitial intracellular
140 4 5 2
103 24 1 2 16
146 4 3 1
104 27 1 2 5
12 150 10 7
3 10 116 40
Function of ICF & ECF: ICF: is vital to normal cell function, its contain solutes such as oxygen, electrolytes and glucose. It provides a medium to metabolic process. ECF: it is the transport system that carries nutrients and waste product from the cell.
Solutes are substance dissolved in liquid. Crystalloid: salts that dissolved readily in to true solution. Colloids: substance such as large protein molecules that do not dissolved in true solution.
2. Diffusion: Is the continual intermingling of molecules in liquid, gases by random movement of the molecules.
3. Filtration: Is the process where by fluid and solutes moved together across a membrane from one compartment to another.
4. Active transport: substance can move across cell membranes from a less concentrated solution to amore concentrated one by active transport.
The average adult drinks about 1500ml per day, but need to 2500ml per day, this added volume is acquired by the food. The thirst center is located in the brain, this center trigger by osmotic pressure and angiotensin II .
Hormonal regulation
Regulation of ECF
Obligatory losses: approximately 500ml of fluid must be exerted through the kidney to eliminate metabolic waste product and feces, respiration and perspiration to maintain body temperature. The average daily fluid out put for an adult 2500ml/ day.
Diet: in nutritional deficiency, the body preserved the protein by breaking down the fat and glycogen. Stress: water retention and increase the production antiduritic hormone. Illness: burn, renal disorder
Disturbances in fluid and electrolyte: Hypovolemia: decrease blood volume Hypovolemic shock when intravascular fluid is depleted. Hypervolimia: increase blood volume.
Edema: is collection of fluids in the tissue. Type of edema: Dependent edma: found in the lowest part body. Pitting edma: edema that leaves a depression or pit after finger pressure is applied on the swollen area.
Pitting odema
Sodium (Na): Is the most abundant cation in the extracelluar fluid and major contributor to serum osmolality. Function of sodium: controlling and regulating water balance. Maintaining blood volume Transmitted nerve impulses.
Normal level is 135 145 mg/dl. Hyponatremia: sodium deficit in the blood. Hypernatremia: sodium excess in the blood. Sodium is found in many foods, such as processed cheese, table salt.
Potassium: Is the major cation in intracellular fluid. Function of potassium: Maintain ICF osmolality. Transmitting nerve impulses. Regulate cardiac impulses. Skeletal and smooth muscle function. Regulate acid base balance
Potassium is found in many fruits and vegetables, meat, fish, milk. Normal level of potassium is 3.5 5.3meq/l. Hypokalemia: potassium deficit in the blood. Hyperkalemia: potassium excess in the blood.
Hypocalcemia: calcium deficit in the blood. Hypercalcemia: calcium excess in the blood.
Decreased urine out put. Increased hematocrit. Thirst. Flat neck vein.
Clinical manifestation:
Weight gain. Fluid intake greater than out put. Moist mucous membrane. Tachycardia. Increased blood pressure. Distended neck vein. Dyspnea and crackles. Mental confusion.