BODY FLUIDS

JAY ANDREA VEA D. ISRAEL, RMT, MPH

JINKY T. CHUA, RPh, MPH
JENNIFER LUYUN, MSc
Objectives
● Identify the important body fluids and discuss
their functions
● Enumerate the functions and determine the
composition of blood
● Summarize how blood serves as carrier of
Oxygen and transporter of CO2
● Correlate the roles of the Kidneys in blood
cleansing, buffer system and maintenance of
water and salt
● Discuss other body fluids, its biochemistry and
clinical significance.
2
Snake and Ladder activity
● The class will be divided into 5
groups
● Each player must put their counter
on the spaces that says “start”
● Each group must choose a
representative to role a dice
● Move the counter forward the
number of spaces shown on the
dice
3
Snake and Ladder activity
● There will be questions on each
space landed
● The player will choose 1 color to
answer
● If the answer is “correct” the
group will be given 3 points
● If the counter landed at the
bottom of the ladder, the group
will move up to the top of the
ladder 4
Snake and Ladder activity
● At the top of the ladder will be a
question to answer (5 points)
● If the counter lands on the head of
the snake, the player must slide
down the bottom of the snake
● The first player to finish will be
given an extra 10 points

5
6
Give 2 functions of Blood

Note; Discussions will follow when all

groups have passed this space
7
Give 1 composition of blood, it
percentage composition and
importance

Note; Discussions will follow when all

groups have passed this space
8
Name 1 blood composition and give
the disorder or condition when it
becomes abnormal (clinical
significance)

Note; Discussions will follow when all

groups have passed this space
9
How many molecules of Oxygen can
be bound to one hemoglobin?

Note; Discussions will follow when all

groups have passed this space
10
Give 1 way how CO2 is transported
from tissues to the lungs

Note; Discussions will follow when all

groups have passed this space
11
Give 1 way how CO2 is transported
from tissues to the lungs

Note; Discussions will follow when all

groups have passed this space
12
How can the kidney function in the
cleansing of blood?

13
BONUS (3 points)

14
Bonus (3 points)

15
Give 2 composition of urine and its
percentage

Note; Discussions will follow when all groups have

passed this space
16
Give 1 chemical compound that can
be abnormally found in the urine and
give name the condition

Note; Discussions will follow when all

groups have passed this space
17
Describe the mechanism of water
retention in the kidneys

Note; Discussions will follow when all groups have

passed this space 18
Describe the mechanism of salt
retention in the kidneys

Note; Discussions will follow when all groups have

passed this space 19
Describe the role of hormones in the
regulation of water and salt

Note; Discussions will follow when all groups have

passed this space 20
Cerebrospinal Fluid:
- Location
- Normal Amount
- Function

21
Give 2 biochemical compounds that
are mostly tested for CSF and give
their normal reference Range

22
What is the clinical significance of
Protein and Glucose for CSF?

23
What disease can be associated
with increase ammonia in the CSF

24
Pleural Fluid
- Location
- Normal Amount
- Function

25
Give 2 biochemical compounds that
are mostly tested for Pleural Fluid
and give their normal reference
Range

26
Give one difference and cause of
Transudate and Exudate origin of
Pleural Effusion

27
Pericardial Fluid
- Location
- Normal Amount
- Function

28
Peritoneal Fluid
- Location
- Normal Amount
- Function

29
Give 2 biochemical compounds that
are mostly tested for Peritoneal Fluid
and give their normal reference
Range

30
Give one cause of Transudate and
Exudate origin of Pleural Effusion

31
Synovial Fluid
- Location
- Normal Amount
- Function

32
Give 2 biochemical compounds that
are mostly tested for Synovial Fluid
and give their normal reference
Range

33
Give 1 cause of the following
conditions seen for Synovial Fluid
- non-inflammatory
- Inflammatory

34
Give 1 cause of the following
conditions seen for Synovial Fluid
- Hemorrhagic
- Septic

35
Sweat
- Description
- Function

36
When is sweat tested? What is the
diagnostic value of the biochemical
compound tested for this condition?

37
● Explain the function of blood as
carrier of Oxygen and Carbon
Dioxide

38
● Explain the role of kidneys in the
acid base balance

39
● Explain the role and importance of
other body fluids’ biochemistry

40
Body Fluid
Composition

Body Fluid Composition in the body

(taken from https://image.slidesharecdn.com/bodyfluids-new-101020230204-
phpapp02/95/body-fluids-new-5-728.jpg?cb=1287615794) 41
Blood
● Blood is essential in human life because it carries out
numerous functions

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43
Functions
• It carries O2 from the lungs to the tissues.
• It carries CO2 from the tissues to the lungs.
• It carries nutrients from the digestive system to the tissues.
• It carries waste products from the tissues to the excretory organs.
• With its buffer systems, it maintains
the pH of the body (with the help of
the kidneys).
• It maintains a constant body
temperature.
• It carries hormones from the endocrine
glands to wherever they are needed.
• It transports infection-fighting blood
cells (leukocytes) and antibodies.
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Blood as Oxygen
carrier

https://www.proishunting.com/wp-content/uploads/2018/08/normal-
hemoglobin-levels.jpg

https://previews.123rf.com/images/designua/designua1411/designua141100029/34138132-gas-exchange-
in-humans-path-of-red-blood-cells-oxygen-transport-cycle-both-oxygen-and-carbon-dioxide.jpg
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 46
https://d1yboe6750e2cu.cloudfront.net/i/f5d3bd6e3b5077750acbeebfaa583a850317e84b
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Kidney and its
function
● Kidneys are superfiltration
machine
● Cleanses blood through
filtration and reabsorption of
waste products

https://i.pinimg.com/originals/de/fc/58/defc58bd458eaab
115113971f5e9ccb2.jpg 48
Urine
● Urine is very useful in the
diagnosis of disease
because of its biochemical
components
● Under certain pathological
conditions, other
substances can appear in
the urine.

49
 50
https://slideplayer.com/slide/5071629/16/images/29/Composition+of+Urine+Normal+Urea+Uric+acid+Creatinine+Na+K+Phosphates.jpg
 https://image.slidesharecdn.com/roleofkidneyinacidinmaintai
ningphbydr-141019234819-conversion-gate02/95/role-of-
kidney-in-maintaining-acid-base-balance-ph-by-dr-ashok-
kumar-j-2-638.jpg?cb=1414322770

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https://upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Renin-angiotensin-
aldosterone_system.png/700px-Renin-angiotensin-aldosterone_system.png 52
 Cerebrospinal
Fluid (CSF)
● CSF produced in
choroid plexuses of the
four ventricles from
plasma
○ 20 mL/min produced in
adults
○ Volume adults 90-150
mL, neonates 10-60 mL

53
Copyright © 2008 F.A. Davis Company
 Common Chemistry Test
● Total Protein ● Glucose
 15-45 mg/dL  Approx. 60-70%
 TAU (carbohydrate- plasma glucose
deficient transferrin) (65mg/dL)
seen in CSF not in
blood
 transferrin is major
beta globulin
 IgG major gamma
globulin

54
Copyright © 2008 F.A. Davis Company
 Clinical Significance
● Total Protein ● Glucose
 Decrease – fluid  Low levels
leakage  Bacterial
 Elevated meningitis
 Damage to blood  Altered transport
brain barrier  TB meningitis
 Meningitis (low
 hemorrhage lymphocytes)
 Ig production in  Viral and Fungal
CNS meningitis
 Decreased (normal glucose
clearance and
lymphocytes)

55
Copyright © 2008 F.A. Davis Company
 Other Chemistry Test
● CSF Lactate ● LD isoenzymes
 Diagnosis and ○ Helps diagnose
management of meningitis by
meningitis confirming the
presence of
 Bacterial >35mg/dL
PMN and
 Viral <25mg/dL lymphocytes
 LD1 and LD2 – brain
tissue destruction
 LD2 and LD3 – viral
meningitis
 LD4 and LD5 –
bacterial meningitis

56
Copyright © 2008 F.A. Davis Company
 Other Chemistry Test
● Glutamine
 Produced by brain cells from
ammonia and α-ketoglutarate to
remove toxic ammonia
 Elevated in liver disease
 Determines increase ammonia in
CSF
 >35 mg/dL – disturbance of
consciousness
 Seen in children with Reye
syndrome

57
Copyright © 2008 F.A. Davis Company
 CSF biochemistry
(taken from
https://i.pinimg.com/originals/c0/43/55/c04355d0bfa9b1acb9b9bbcd8a4d401e.jpg

58
Serous Fluid
● Fluids in the serous membrane
that line the closed body cavities
○ Pleural
○ Pericardial
○ Peritoneal
● Serous membrane can be parietal
(lines cavity wall) or visceral (lines
organs in the cavity)

59
● Ultrafiltrate of plasma
● Abundant fluid collected = >100mL
● Disruption in the formation and absorption of serous fluid causes
fluid build up - EFFUSION

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 Pleural Fluid
● Pleural fluid (less than 10mL) is found
between the space in the chest wall
and the lungs,
https://healthengine.com.au/info/uploads/VMC/DiseaseImages/598_Normal_L_Pleura.jpg

https://healthengine.com.au/info/uploads/VMC/DiseaseImages/599_Pleural_Effusion.jpg
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EFFUSION can be classified as
● Transudate ● Exudate
○ systemic ○ conditions
disorder affecting
disrupts membranes
filtration and ○ Inflammation
reabsorption ○ infection
○ congestive ○ malignancy
heart failure
○ nephrotic
syndrome

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https://66.media.tumblr.com/d28f7a229edd126edabce4449fdae15c
/tumblr_pfjatzaNa01uybg0co1_1280.png 63
 Transudate Exudate

Appearance Clear Cloudy

Fluid:serum protein ratio <0.5 >0.5

Fluid:serum LD ratio <0.6 >0.6

White blood cell count <1000/µL >1000/µL

Spontaneous clotting No Possible

Pleural fluid cholesterol <45-60 mg/dL >45-60 mg/dL

Pleural fluid:serum cholesterol ratio <0.3 >0.3

Pleural fluid:bilirubin ratio <0.6 >0.6

Serum-ascites albumin gradient >1.1 <1.1

Pericardial Fluid
● Pericardial Fluid (15-
50mL), an ultrafiltrate of
plasma, originates from
the visceral pericardium

https://www.healthlinkbc.ca/sites/default/libraries/healthwise/media/medical/hw/h9991645_001.jpg

65
Peritoneal Fluid
● Free Fluid that
accumulates in the
peritoneal cavity is called
Ascites.
● Normally, the volume
does not exceed 5mL

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https://st2.depositphotos.com/2852841/9536/v/950/depositphotos_95368066-stock-illustration-fluid-in-
peritoneal-cavity.jpg
 https://www.biochemia-
medica.com/assets/images/upload/Clanci/24/24_1/BM-2014-
014/24-1_Milevoj_Kopcinovic_L_Culej_J.-
Tablica2.jpg?1534318161384

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 Synovial Fluid
● Ultrafiltrate of plasma
across synovial
membrane
● Provides lubrication for
the movable joints

Copyright © 2008 F.A. Davis Company 68

 Chemistry Test
● Normal knee fluid – 3.5mL
● Clear and pale yellow
● Normal values are similar to plasma
● Glucose – normal is not <10mg/dL of
plasma glucose (decreased in
inflammatory and septic)
● Protein – normal is <3g/dL (increased
in inflammatory and hemorrhagic)
● Uric acid – confirms diagnosis of gout

Copyright © 2008 F.A. Davis Company 69

 Clinical Significance
● Non-inflammatory ● Inflammatory
 Degenerative  Immunologic
 osteoarthritis  LE
 Rheumatoid arthritis
 Lyme Disease
● Hemorrhagic
 Gout
 Trauma
 Tumors
 Coagulation ● Septic
deficiencies  Microbial Infection

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Copyright © 2008 F.A. Davis Company
Sweat
● Sweat is a watery fluid
secreted by glands in the
skin to help regulate an
increase in body
temperature.
● It is produced as an isotonic
ultrafiltrate of plasma

71
Clinical Significance
● Used to diagnose Cystic
Fibrosis
● Chloride with ≥60mmol/L
is indicative of cystic
fibrosis

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/15313014-cystic-fibrosis.jpg 72