You are on page 1of 36


By Taufik Rahman, M.D

Body Fluid
Human body 60%, water

40 %, intracellular

20 %, extracellular

5 %, interstitial

15 %, intravascular


Na + K+ Ca ++ Mg ++ Cl HCO3 -

142 mEq/L 4 mEq/L 2,4 mEq/L 1,2 mEq/L 103 mEq/L 28 mEq/L

Na + K+ Ca ++ Mg ++ Cl HCO3 -

10 mEq/L 140 mEq/L 0,0001 mEq/L 58 mEq/L 4 mEq/L 10 mEq/L

electrolyt deficiensi and electrolyt excess 2. Obstructions Trombosis. infarc and other obstruction 1. bleeding and shock 3. emboli.Classification of circulation disorders Disorders of body fluid and electrolyt Edema. ischemia. . dehydration. Disorders of volume Hiperemia.

hidroperitoneum ( acites ).general Oedema in serous cavity : hidrothorac.Oedema Collected of body fluid in interstitial or body cavity.local .exudat (BJ > 1.transudat (BJ < 1. Oedema : . .20) Oedema : .15) . hidropericard.

Obstruction of limphatic canal Inflamation oedema : Increase of vascular permeubelity Other causes : disorder of natrium exchange or electrolyt balance . Decrease of osmotic pressure 3. Increase of hidrostatic pressure 2.Cont… Causes of oedema Noninflamation oedema : 1.

disorders of gas exchange that cause asfixia or anoxia. and erytrocyt. Brain oedema constriction of sulcus dilation of gyrus substansia alba being soft like gelatin dilation of substantia grisea . air.Change of morphology as consequence of oedema   Pulmonary oedema increase of weight fluid around septum capiler fluid that content edema fluid.

Dilatation of vascular caused by vasoactive agent. Example : fever shy .Hyperemia and congestion Hyperemia ( active hyperemia ) Dilatation of arteriol and artery causes increase of blood flow to capiler tissue with opening inactive capilers.

Vena blood flow decrease in spesific area and dilatation of vena and capiler.Cont… Congestion ( pasive hyperemia ) Blood flow to vena have a disorders. .

Change of morphology as consequence of hyperemia   Wet apperanace and full of erytrocyt Pulmo : full of erytrocyt in alveoli capiler .

Shock Syndrome that caused by circulation failure Inbalance of volume and vascular space. Shock primer : Vascular space increase. but the body fluid decrease . but the body fluid volume constant Shock secunder : Vascular space constant.

Septic .Reversible .Cont… Shock ( characteristic ) : .Cardiogenic .Irreversible Shock ( cause ) : .Anaphylactic .Neurogenic .

Cont… Sign and symptom :  Paleness and weak  Cold extremity  Pulseness weak and quick  Very low blood pressure  Oliguria  Decrease of consciousness .

combination of both .Dehydration Deficiency of fluid Inbalance of input and output Causes : .natrium loss .water loss .

Cont… Water loss :  Long comatosa  Hydrophobia  Exercise Consequnce of dehydration Release of ADH by Hypopise. and then oliguria .

decrease of saliva secret .oliguria .consciousness disorders .Cont… Sign and symptom of dehydration (water loss) : .weakness .thirsty .dry throat .

Vomiting .seizure .Weakness .Cephalgia .Nausea .Cont… Natrium Loss :  Proggresive vomiting  Progressive diarrhea Sign and symptom of dehydration ( natrium loss ) : .

External bleeding Blood release to out of body . or body organ.Bleeding Release of blood from vascular Internal bleeding Blood release to interstitial. serous cavity.

Cont Inner body bleeding Skin and mucous : petiche. Body cavity : hemothorac. purpura. hemoperitoneum hematopericardium Uterus. echimosis. hematosalphink Testis : hematochele Articulatio cavity : hemarthrosis . vagina and tuba : hematometrium hematokolpos. hematoma.

Gastrointestinal tract : Hematemesis. Hematokezia.Cont… Outter body bleeding Respiratory tract : Epistaksis. Hemoptisis. Metrorargia . Melena Uterus : Menorargia.

Cont… Local effect of bleeding  Brain : increase of ICP  Pulmo : decrease of pulmonary volume  Heart : tamponade  fibrosis .

Cont… Systemic effect of bleeding  Anemia  Circulation colaps  Death .

Factors that contibute to make trombus : 1. Change of vascular wall 2. Change of blood flow 3. Change of blood composition .Trombosis Solidfication of blood that content blood element in vascular of human life.

Ball trombus Trombus ( colour ) : .White trombus .Occlution trombus .Mural or parietal trombus .Pedunculated trombus .Saddle or riding trombus .Cont… Trombus ( form ) : .Mixed trombus .Red trombus .Propagating trombus .

Septic trombus .Arteria trombus .Vena trombus .Old trombus Trombus ( bacteria ) : .Fresh trombus .Sterile trombus Trombus ( site ) : .Cont… Trombus ( making time ) : .Car trombus .

Infarction .Ischemia .Necrosis .Gangren .Cont… Effect of trombus : .

Embolus Foreign bodies that follow blood flow from their sites and can trapp in other sites causes obstruction. Embolus ( substance ) : .Vena emboly .Aterom emboly Embolus ( sites) : .Air emboly .Arteria emboly .Fatty emboly .Tumor cell emboly .

Effect of ischemia : .Cell death .degeneration .Vascular disorders Ischemia : Decrease or loss of blood supply to part of body.Loss of parenchym cell .

Paleness infarc .Hemorargic infarc .Cont… Infarc : vascular obstruction by specific material (trombus). Infarc : . that causes ischemia and anoxia necrosis of tissue in distal of obstruction.

places that no evaporation Dry gangren : .Cont… Gangren : death of tissue that caused by loss of blood supply and followed saprophyt bacteria invasive. Gangren : Wet gangren : .Places that good drainage .Body organ that content few of fluid .Places that evaporation .body organ that content lots of fluid .

caused : .0 .Intracellular fluid : 7.Basic acid Balance Human body inclined acid.lactat acid in glikolisis .Fatty acid in lipolisis pH level : .4 .Artery : 7.carbon dioxide production in aerobic respiration .35 .Interstitial fluid : 7.

1 .Cont… Henderson-Hasselbach pH = pK + log HCO3 H2CO3 pK = 6.

Mechanism Renal mechanism Balancing hidrogen ion and bicarbonat H2CO3 H + + HCO3 - .

Cont… Pulmonary mechanism H20 + CO2 H2CO3 .

respiratoric .Cont… Acidosis : decreasing pH level Acidosis : .respiratoric .metabolic Alcalosis : increasing pH level Alkalosis : .metabolic .

Any question ? Please!!! .