Human Physiology

MULUGETA G (BSc )

DEPARTMENT OF
SCHOOL OF MEDICINE & HEALTH SCIENCE
WOLLO UNIVERSITY,
2018
 CHAPTER :
General Introduction to
Human Physiology
 Learning Objectives
At the end of this session students will be able to:

Define the subject matter of physiology

Define the principles of homeostasis

Identify homeostatic values and regulatory mechanisms of the human body

Describe the functional structures of cell membrane and cell organelles

Describe the transporting mechanisms across cell membrane

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 What is Physiology?
The study of the functioning of the normal body

It also deals with the integrated activities of different

organs and organ systems, and the conditions which
determine normal functions of body parts.

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 Historical Background
Physiology is an experimental science

1. Aristotle (384 - 322 B.C.) : Was

-the father of natural history
- the 1st person to coin the term physiology.
According to Aristotle, Physiology means the study of nature-
“Physi - nature, ology - study.
This means studying practically everything in the Universe
and in the human body.

2. William Harvey (1628):

Correctly described the direction of circulation of blood.

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3. Claud Bernard:
Described that every cell in body is bathed with the fluid
environment called extracellular fluid (ECF).
ECF contains all the needed substances for cells.
He called ECF is the internal environment of the body, Mileue
interieor.
4. Walter cannon:
Another great physiologist of the 1st half of 19th century
Termed the maintenance of constant conditions in the ECF as
homeostasis.

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 Level of structural organization of the body

• The human body has different structural levels of organization, starting

with atoms molecules and compounds and increasing in size and
complexity to cells, tissues, organs and the systems that make up the
complete organism
• A. CHEMICAL LEVEL - includes all chemical substances (atoms,
ions, & molecules) • At its simplest level, the body is composed of atoms.

The most common elements in living organism are carbon, hydrogen,

oxygen, nitrogen, phosphorus and sulfur.
• Atoms → Molecule → Compounds
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 Level of structural organization of the body
B.CELLULAR LEVEL
• cells are the basic structural and functional units of the human body – there
are many different types of cells (e. All life depends on the many chemical
activities of cells.
••Some of the basic functions of cell are: Production of Bio-Energy ,
Storage ,Multiplication , Specific function according to locationg., muscle,
nerve, blood, and so on)

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 C.TISSUE LEVEL

• A tissue is a group of cells that perform a specific function

•The various tissues of the body are divided in to four groups.
•These are epithelial, connective, nervous and muscle tissu

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 THYPES OF TISSUE
• Epithelial tissue: - Found in the outer layer of skin, lining of
organs, blood and lymph vessels and body cavities.
• Connective tissue: - Connects and supports most part of the
body. They constitute most part of skin, bone and tendons.
• Muscle tissue: - Produces movement through its ability to
contract. This constitutes skeletal, smooth and cardiac muscles. •
• Nerve tissue: - Found in the brain, spinal cord and nerves. It
responds to various types of stimuli and transmits nerve impulses. 7 7

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 General Objectives
At the end of teaching, the students are expected to understand
that :

a. The cell serving as the basic unit of the living body, has vital
functions to perform.
b. There is great specialization of cells in various organs
c.Functions of organ systems are derived from functions of cells
d.Lipid bilayer membrane encompasses the cell and its organelles
e. protein- mediated transport processes regulating the
flow of water and solutes across biomembrane are essential to all
physiological functions.

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• The Cell theory
Is the idea that all organisms are composed of cells.
In its modern form, the cell theory includes four principles:
1. All organisms are composed of one or more cells
2. Cells are the smallest living things
3. Evolution of life:
. Prokaryotes (single cell animals with no nucleus,
e.g. bacteria) evolved 3.5 billion years ago.
. Eukaryotes (nucleated cell animals ), evolved 1.5 billion years ago
4. Cells arise only by division of a previously existing cell
5. Cells are constructed of the same basic elements and share the same basic materials
and biosynthetic machinery but differ by shapes and molecular structures

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 FUNCTION OF CELLS
- 1. the basic unit of living things
2. humans are multicellular
3. several basic functions of all cells
a. obtain nutrients and O2
b. make usable energy, Food + O2 ➝ CO2 + H2O + energy
c. eliminate wastes
d. synthesize needed molecules
e. respond to environmental changes
f. control exchange of materials with the environment
g. transport molecules h. reproduce
4. in multicellular organisms, cells specialize

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 Fluid Environment of the Cells
• About 60% of human body is made up of fluid
• 2 main fluid compartments
– Intracellular fluid (ICF) – about two thirds by volume

– Extracellular fluid (ECF): Plasma and Interstitial fluid (IF)

• A cell is the basic structural as well as functional unit of life

• These cells are bathed with the fluid called ECF.
• This fluid contains an optimum amount of nutrients, gasses, hormones, enzymes, water
and electrolytes

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 Fluid compartments

ICF ECF contains:

• Nutrients: glucose, amino acids, lipids
•Water
• Gases: O2, CO2
•High K+, Po43-,
Mg2+ • Hormones
•Nutrients, gases • Enzymes
•Hormones • Water
• Minerals (High Na+, Cl- , Ca2+ and
HCO3-

Figure 1: Body Fluid Compartments and Their Major Content

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 Composition of Human Body
• The approximate composition of an average adult human per body weight is
that:
– Water = 60%
– Proteins = 18%
– Minerals = 7%
– Fats = 15%

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 Homeostasis
• The term homeostasis is used by physiologists to mean that maintenance of static or
constant conditions in the internal environment (ECF).
• Essentially all organs of the body perform their functions to maintain constant
conditions in the ECF.
For example
• Lungs maintain the normal concentration of respiratory gases in blood.
• The CVS transports required substances and removes waste products
• The kidneys maintain constant ionic concentration and
• The GIT provides nutrients.

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 Normal Ranges of Some Important Parameters (1)
1. Body fluid volume = 40 L
ECF = 15L
ICF = 25L
2. Osmolality = 300 mosm/L, (285 – 300 mosm/L)
3. Body T. = 36.3 – 37.1OC
4. pH = 7.35 – 7.45
5. Blood Gases
PCO2 = 35 – 45 mm Hg
PO2 = 40 – 104 mm Hg
6. Electrolytes (ECF)
Ca2+ = 10 mg/dL or 5 meq/L
K+ = 4 meq/L
Na+ = 142 meq/L
Cl- = 103 meq/L
HCO3- = 27 meq/L 18
 Normal Ranges of Some Important Parameters (2)
7. Waste Products
Bilirubin = 0.5 mg/dl
Creatinine = 0.6 – 1.5 mg/dL
Blood urea nitrogen (BUN) = 8 – 25 mg/dL
Uric acid (s): Women = 2.3 – 6.6 mg/dL
Men = 3.6 – 8.5 mg/dL
8. Blood Glucose level (fasting): 70 – 110 mg/dL
9. Arterial Blood pressure (systemic circulation).
Systolic pressure = 120 mm Hg (90 – 140 mm Hg)
Diastolic pressure = 80 mm Hg (60 – 90 mm Hg)
Pulse pressure = 40 mm Hg
Mean BP = 96 mm Hg
Pulmonary AP = 25/10
Cardiac output = 5 L/min
Blood Flow = 5 L /min
10. RBC count = 4-6 millions/mm3
WBC count = 4000-11,000/mm3 19
Hemoglobin (Hb) = 12-18 g/dl in Females, 14-20 g/dl in Males
Normal values
 Disturbances of homeostasis

• Deviations in normal ranges = pathology

• Hypo- or hyperthermia, hypo- or hypercapnea
• Acidosis or alkalosis,
• Hypoxia or hyperoxia
• Hypo- or hypercalemia
• Hypo- or hyperglycemia
 Feedback control mechanisms of the homeostasis
There are two types of feed back mechanisms:
a. The Negative Feedback Mechanism (NFM)
b. The Positive Feedback Mechanism (PFM)
1. NFM: It works by producing an effect which opposes the previous condition (the
initiating stimulus) of the organ.
– For example: if the PCO2 is increased in the blood, the NFM stimulates PVR, which
has an effect on decreasing PCO2 in blood to normal.
– Most homeostatic values of the body are controlled by NFM.
1. Control of ABP
2. Control of BGL
3. Control of BT
PVR=pulmonary ventilation rate

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2. PFM
• It works by producing an effect which enhances or repeats the same action like that of
the starting stimulus.
• Also called viscous circle. Most of the action of this mechanism disturbs the internal
environment and cause disease and death.
• E.g. - Blood clotting

- Generation and propagation of the action potential

- Labor during child birth

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STRUCTURAL LEVELS OF ORGANIZATION OF HUMAN
BODY
Muscle cells
Nerve cells
Cells: 4 types Epithelial cells
Cells in the connective tissues
Muscle tissue
Tissues 4 types Nerve tissue
Epithelial tissue
connective tissues
Organs: Example: Heart, lungs

Organ system: Example: Respiratory system, CVS

Organism: Human organism

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A GENERALIZED CELL

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 Generalized cell
Components of cells:
 A typical cell has two parts: nucleus and cytoplasm.
 The nucleus is separated from the cytoplasm by a nuclear membrane
 The cytoplasm is separated from the surrounding fluid (ECF) by the plasma
membrane
 The different substances that make up the cell are collectively called protoplasm.
Protoplasm:
 Composed mainly of five basic substances: water, electrolytes, proteins, lipids and
carbohydrates.

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 The plasma membrane:
A sheet-like structure that surround (enclose) the cell, separating the cellular contents from
the ECF.

Entirely composed of proteins and lipids in a ratio of 55:42 respectively, and 3% of

carbohydrates.
Percent proportion:
1. Proteins: 55 %
Phospholipids 25 %
2. Lipids: 42 % Cholesterol 13 %
Neutral fats 4%
3. Carbohydrate: 3%
 The level of cholesterol determines rigidity of the membrane

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 Function of plasma membrane:
 Separates cellular contents from the ECF

 Regulates the passage of substances in and out.

 It provides receptors for NTs, hormones and drugs.

 It is a means of cell to cell contact.

 Plays role in the generation and transmission of electrical impulse in

nerves and muscles.
 Involved in the regulation of cell growth and proliferation.

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 A. Lipid component of the cell membrane
• A plasma membrane is a fluid in its nature, according to the fluid Mosaic model of the
membrane
• The cell membrane consists of an organized arrangement of proteins, lipids and CHOs
• Lipids form the basic structure of the membrane.
• The lipid molecules are arranged in two parallel rows, forming a lipid bilayer.

Figure: Lipid bilayer Component

of the cell membrane. Polar head
faced the fluid compartments and
non-polar tails hide themselves in
the interior.

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 Lipid …cont’d
• The lipid molecules (primarily phospholipids) contain a polar phosphate heads, soluble in
water (hydrophilic) and a non-polar tails that does not mix with water (hydrophobic).
• The physical orientation of the lipid bilayer structures is that the hydrophilic ends of the
lipid molecules line up facing the ICF and ECF.
• The hydrophobic tails of the molecules face each other in the interior of the bilayer.
• The lipid bilayer portion of the cell membrane is impermeable to water and water soluble
substances such as ions, glucose, urea and others.
• On the other hand, fat soluble substances such as O2, CO2, alcohol and drugs can penetrate
this portion of the membrane.

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Figure: Functional structure of the cell membrane
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 B. Protein component of Cell Membrane (1)
• According to fluid Mosaic model, the plasma membrane are also composed of globular
proteins embedded in the lipid bilayer
• Membrane proteins are two types:

A. Integral or intrinsic proteins:

– Interdingitated in the hydrophobic center of the lipid bilayer
i. Transmembrane proteins: are integral proteins that span the entire bilayer.
– It serve as: - Channels through which ions pass
- Carriers which actively transports material
- Pumps which actively transport ions
- Receptors for NTs and hormones

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 B. Protein component of Cell Membrane (2)
ii. Integral proteins that are present only on one side of the membrane, serve
primarily as enzymes.
• Example: Adenylate cyclase

B. Peripheral or extrinsic proteins:

– Bind to the hydrophilic polar heads of the lipid or on integral proteins.
– Peripheral proteins that bind to the intracellular surface contribute to the
cytoskeleton.
– Peripheral proteins that bind to the external surface contribute to the glyco-
calyx
 i.e. a cell coat that is composed of glycol-lipids and glycol-proteins to cover
the cell membrane
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Plasma Membrane

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 C. Carbohydrates components of PM
• Attached invariably on the outside surface of the membrane, binding with protruded
integral proteins and lipid, they form glyco-proteins and glyco-lipid (glycocalyx)
respectively.
• They play a role in:

1. Immune reaction (antigenical importance),

2. Cell to cell attachment and

3. Act as receptors for NTs, hormones and drugs

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 The nucleus
• The control center for the cells.
• Contains the genes, which are units of heredity.
– Chemically each gene consists of a highly compressed DNA in the form of
chromosomes
– Genes control cellular activity by determining the type of proteins, enzymes, and other
substances that are made by the cell.
• The site of RNA synthesis.

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 The nucleus…cont’d
• There are three kinds of RNA
– Messenger RNA (mRNA): carries the instruction from DNA for protein synthesis to
the cytoplasm
– Ribosomal RNA (rRNA): moves to the cytoplasm where it becomes the site of protein
synthesis
– Transfer RNA (tRNA): serves as an amino acid bases purine (A, G) and pyrimidin (C,
T) as well as deoxyribose sugar conjugated by phosphate. transporter system within the
cell for protein synthesis.
• DNA and RNA are made up of nucleotides
– In DNA, nucleotides are composed of nitrogen containing

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 The nucleus (cont’d)
• In RNA, the pyrimidin base T is replaced by U and the 5-carbon sugar is ribose.
• In addition to the chromatin, the nucleus contains one or two round bodies called
nucleoli.
 It is here that rRNA is synthesized.
• The nuclear contents are surrounded by a double walled nuclear membrane.
• The pores present in this membrane allow fluids, electrolytes, RNA, and other materials
to move between the nuclear and cytoplasmic compartments.

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 The Cytoplasm
The cytoplasm surrounds the nucleus and it is here the work of the cell takes place.
It is essentially a colloid solution that contains water, electrolytes, suspended proteins,
neutral fats, and glycogen molecules
Major intracellular electrolytes: K+, Mg2+, PO43-, SO42-
Smaller quantities: Na+, Cl- and Ca2+ and HCO3-

These electrolytes facilitate the generation and transmission of electrochemical impulses

in nerve and muscle.
Intracellular electrolytes are also participate in reaction for cellular metabolism
Inner organs of the cell or organelles: Ribosome, ER, Golgi Apparatus, Mitochondria,
lysosomes, and cytoskeletal system

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Ribosome:
• Sites of protein synthesis in the cell
Endoplasmic reticulum (ER):
 An extensive membranous structure that connects various parts of the inner cell.
 It also connected with the nuclear membrane
• es composed of rRNA and proteins
• Found in two forms: scattered in the cytoplasm and clustered (joined) to form
functional units called poly ribosome
Endoplasmic There are two types of ER: rough ER and smooth ER.

rER: sER:
Studded with ribosomes  Free of ribosomes
Segregate proteins that are being exported from  Glycogen storage
the cell  Lipid biosynthesis
The site of protein synthesis  Calcium ion storage
 Drug metabolism (detoxify)

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rER and sER
Golgy complex

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Golgi Complex:

 Consists of flattened membranous saccules and cisterns that communication with the ER
 Acts as a receptacle for hormones and others substances that the ER produces.
 It then modifies and packages these substances into secretary granules.
 These secretary granules make out of the Golgi Complex into the cytoplasm
 It is though to produce large CHO molecules which is needed to combine with protiens
to form Glyco-protiens
 Many pro-hormones and inactive enzymes produced in the rER are converted into active
hormones and enzymes in the Golgi Complex by proteolytic enzymes.

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Mitochondria:
Are literally the “power house” of the cell, capable of producing the energy rich
compound ATP, which is required for various cellular activities.
Require oxygen to produce energy (ATP) from food stuffs
It is encased in a double membrane
An outer membrane encloses the periphery
An inner membrane is enfolded to form the cristae, which aid in the production
of ATP

Mitochondria
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Lysosomes:
 Membraneous tructures in the cytoplasm that contains
aggregates of enzymes.
 Well developed in macrophages.
Function:
• Degrade old dead cells and phagocytosis of microrganisms

Lysosomes

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 Cytoskeletal system of the cell
• They are microfilament and microtubules, rigid
threadlike structures dispersed through out the
cytoplasm.
Function of cytoskeletal system:
1. Maintain shape of the cells. eg. Neurofibrils in
axone
2. Serve as a transport system for the movement of
compounds and organelles within the cell. eg
axoplasmic transport
3. Construct the mitotic spindle eg. Centroils (9+3
triplets)
4. Provide for the support and movement of cilia
and flagella (9+2 doublets)
5. Cell to cell contact: to fasten cell membranes
together
Microtubules organized as 9+2 doublets46
 Transport through the cell membrane
Substances are transported through the cell membrane by:
1. Simple diffusion
2. Osmosis
3. Facilitated diffusion
4. Active transport (1O and 2O) and
5. Vesicular transport mechanisms.

ECF

ICF 47
 1. Simple Diffusion
 It is the passive movement of substances down their concentration gradient.
 Factors affecting the net rate of diffusion
a. Lipid solubility of the subs
b. Membrane permeability
c. Concentration difference
d. Pressure difference
e. Electrical potential difference of ions

 Membrane permeability is affected by

– Membrane Thickness
– Lipid solubility
– No of ion channels per unit area
– Temperature: T =  thermal motion of molecule permeability
– Molecular weight
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 Simple Diffusion cont’d…
Rate of diffusion is determined by the following factors summarized in the formula shown
below.
S. A. T. C
Rate of diffusion =
D MW

Where, C = Change of concentration

S = Solubility in lipid
A = Surface area of the membrane
T = Temperature
D = Distance or membrane thickness
MW = Molecular wt of substances

• Examples: Substances that are transported by simple diffusion are CO 2, O2, alcohol, lipid
soluble drugs and ions through specific channels.
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 2. Osmosis (1)
 ) in diameter, so that they can not traverse the lipid bilayer simply. IIt is the power of
movement of H2O from an area of higher amount of water to an area of lower
amount of water through the semi permeable membrane.
 The direction of movement of water is governed by the amount of osmoticaly active
particles (solutes).
 The pressure that opposes osmosis of water is called osmotic pressure
 H2O molecules have very small (0.3 nmnstead they pass through specific water
channels called aquaporins:
 Five aquapurins (AQ1….AQ5) have been identified in the body.
2. Osmosis (2)

Figure: Osmosis: Mechanism of

Transport of Water through the
Cell Membrane

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 3. Facilitated diffusion
 Carrier mediated transport
 Carriers are saturable, do not need energy
 Transports substances down their concentration gradient
 Examples: transport of glucose, proteins (Macromolecules)
Glucose

ECF
Cell membrane
ICF

Carrier protein

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 4. Active transport

• Substances are transported against

Common examples 1O AT
concentration, electrochemical gradient, 1. Na+ - K+ ATPase
up hill direction. 2. H+ - K+ ATPase
• Used for the transport of Na+, K+, Ca2+, 3. Ca2+ ATPase
Fe2+, H+, Cl-
• Consumes energy in the form of ATP
1. Primary active transport
• Carrier protein is involved
• Consumes energy from ATP
• Carrier protein is anti-porter

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 Na+ - K+ ATPase
• It pumps 3Na+ outward and 2K+ inward
• It maintains Na outside and K+ inside
• It maintains electropositive outside and electronegative inside.
• Na+ - K+ pump is a carrier protein that is made up of two subunits. It has 3 binding sites
for Na+ inside
• It has 2 binding sites for K+ on the outside
• It has ATPase activity inside.
ATP = ADP + ---P + energy.
• Energy brings conformational change of the pump so that Na+ pumped outward and K+
inward.

Figure: Primary active

transport, Na+ - K+
ATPase
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 2. Secondary active transport
• Carrier protein is involved
• Consumes energy
• Carrier protein is symporter

Figure: Secondary active

transport, Na+ - Glucose Co-
transport Mechanism

Uniport carriers: Carry single substance to one direction

Antiport carriers: Carry two substances in opposite directions
Symport carriers: Carry two substances in the same direction

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5. Vesicular transport (1)
There are two types:
1. Endocytosis:
 It is the process of intake of substances
by the cells
 2 types:
a. Pinocytosis: the process of intake of
fluid and also called cell drinking
b. Phagocytosis: intake of solids, also
called cell eating

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Vesicular transport (2)
2. Exocytosis:
 It is the process of release of cell secretory products

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CHAPTER II:
BODY FLUID
 Learning Objectives
At the end of this chapter, students should be able to:

Describe body fluid compartments

Identify composition of body fluid

Define important terms involving in body fluid

Describe the tonicity of a solution

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 What is Body Fluid?
 The term refers to the body water + its dissolved substances

 BF comprises an average of 60% of total body weight

 The total body water in adult averages about 40 L

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Fluid Compartments

Figure 26.1
Trans-cellular Spaces
 Are potential spaces containing small volume of body fluid
 Lymph in the lymphatic vessels

 CSF in the brain ventricles and central canal of spinal cord

 Synovial fluid in Joints

 Aqueous humor and vitreous body in the eye (intraocular fluid)

 Endo-lymph and perilymph in the inner ears

 Pleural, pericardial, peritoneal fluids

 Glomerular filter in the body

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 Importance of Water in the body

 As a solvent: to electrolytes and dissolve nutrients

 Digestion and absorption requires fluid medium

 Transportation

 Temperature regulation

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 Composition of the Body Fluid
 Water is the universal solvent

 Solutes
– Electrolytes: inorganic salts, all acids and bases, and some proteins
– Non-electrolytes: examples include glucose, lipids, creatinine, and urea

 Electrolytes have greater osmotic power than non-electrolytes

 BF composed of electrolytes, nutrients, respiratory gases, hormones and vitamins in

different proportion.

 Water moves according to osmotic gradients.

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Electrolyte Composition of Body Fluids

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 Factors Affecting Total Body Water (TBW)

 Water is by far the largest single component of body that makes up

60% TBWt.

1. Age: Infants > Adults → the percentage ↓ with the age

2. Obesity: Lean people > Fat People

3. Sex: Male (60%) > Female (55%) since females have more
subcutaneous fat than males
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 Water Homeostasis
Water Balance: To remain properly hydrated, water intake must equal water output, so
the body maintains a constant volume
•Water intake sources
– Ingested liquids (1600ml/day) and solid foods (700ml/day) that have been
absorbed from GIT.
This water called performed water (amounts 2300ml/day)
– Metabolic water or water of oxidation (200ml/day): water produced through
dehydration synthesis reactions of anabolism
•Water output
– Kidney excrete (Urine) = 1500ml/day
– Skin = 500ml/day
– Lungs = 300 ml/day
– GIT = 200 ml/day 67
 Regulation of Water Homeostasis (1)
a. The Thirst Mechanism
•Thirst is a powerful regulator of fluid consumption
•When water loss is greater than water gain, the resulting dehydration stimulates thirst
in at least 2 ways:
a. Dehydration =↑s blood osmotic pressure → stimulates osmoreceptors in HT
• These receptors also stimulate the thirst center in the HT
b. Dehydration= ↓s BP → stimulates the release of Rennin by JG-cells of the
Kidneys
• Rennin promotes formation of Ang-II, an effect of which is to stimulate the
thirst center in HT
•Thus, when the thirst center stimulated, the sensation of thirst is increased, fluid
intake is initiated and normal fluid volume is restored.
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Regulation of Water Intake: Thirst Mechanism

Figure6926.5
 Regulation of Water Homeostasis (2)

b. The Antidiuretic Hormone (ADH)

•Normally, fluid loss is adjusted by ADH and aldosterone
•ADH and Aldosterone → ↓s fluid loss
•ANP → causes diuresis

c. The Renal System

•Renal tubules control water balance by:
– Producing concentrated urine when there is a shortage of water in the body; and
– Producing diluted urine when there is excess water in the body
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 Influence and Regulation of ADH
• Water reabsorption in collecting ducts is proportional to ADH release
• Low ADH levels produce dilute urine and reduced volume of body fluids
• High ADH levels produce concentrated urine (preserve body water)
– Hypothalamic osmoreceptors trigger or inhibit ADH release
– Factors that specifically trigger ADH release include
 prolonged fever;
 excessive sweating,
 vomiting, or diarrhea;
 severe blood loss; and
 traumatic burns

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72
 Disturbances of Water Balance

• Hypovolemia: caused by blood loss

• Hypervolemia: caused by excessive fluid infusion

• Dehydration

• Overhyderation (Hypotonic hydration): caused by water intoxication

• Edema

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 Dehydration
• Water loss exceeds water intake
– Negative fluid balance
• Causes by: hemorrhage, severe burns, prolonged vomiting or diarrhea, profuse
sweating, water deprivation, and diuretic abuse
• Signs and symptoms
– Prolonged dehydration may lead to weight loss, fever, and mental confusion
• Rx.: a replacement therapy with oral rehydration solution (ORS) is usually practiced.
 During dehydration, BP ↓ → GFR ↓ → water is conserved
 Excess fluid volume in blood → ↑ BP →↑ GFR → ↑ Urine Output

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 Disorders of Water Balance: Dehydration

1 Excessive loss of H2O from 2 ECF osmotic 3 Cells lose H2O

ECF pressure rises to ECF by
osmosis; cells
shrink

(a) Mechanism of dehydration

Figure 75
26.7a
 Hypotonic Hydration
• Renal insufficiency or an extraordinary amount of water ingested quickly can lead to
cellular overhydration, or water intoxication
• ECF is diluted – sodium content is normal but excess water is present
• The resulting hyponatremia promotes net osmosis into tissue cells, causing swelling

• These events must be quickly reversed to prevent severe metabolic

disturbances, particularly in neurons

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 Disorders of Water Balance: Hypotonic Hydration

1 2 ECF osmotic 3 H2O moves into

Excessive H2O enters the
ECF pressure falls cells by osmosis;
cells swell

(b) Mechanism of hypotonic hydration

Figure 77
26.7b
 Edema
• A typical accumulation of fluid in the interstitial space
– tissue swelling
• Caused by anything that increases flow of fluids out of the bloodstream or
hinders their return
• Factors that accelerate fluid loss from the blood include:
– increased capillary permeability
– incompetent venous valves, localized blood vessel blockage
– congestive heart failure
– high blood pressure
– high blood volume
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 Concentrations of solutions
• There are several ways to express concentrations of chemicals dissolved in body fluids:
a. Concentrations may be expressed as the amount of solute in solution or %
 E.g. 0.9%NaCl solution (0.9g of NaCl in 100ml of solution) is isotonic to
RBC. It is called isotonic saline.
 5% glucose (5g in 100ml) = isotonic to plasma
b. Concentrations can be expressed as the total number of cations and anions in
meq/l or mmol/l
 Single positive or negative charge e.g. Na+, K+, HCO3- No. of meq/l = No. of
mmol/l
 Two positive or negative charge e.g. Ca2+, HPO42-
No. of meq/l = Twice no. of mmol/l

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 Definition of Important Terms
1. Osmosis: is the power of a solution to dray the solvent through a semi-permeable
membrane.
2. Osmotic pressure: is the pressure needed to prevent the mov’t of solvent across a semi-
permeable membrane into a solution.
3. Osmoles: the ability of solutes to cause osmosis and osmotic pressure. Measured in
‘osmoles’. An osmole = the gram substance of the molecule dividing by the number of
freely moving particles on solution e.g. NaCl (58.5g0/2 = 29.23g
4. Osmolarity: is the concentration of osmoticaly active particles per liter of solution
(Osmoles/l). One osmole of a solute added to one liter of solvent.
5. Osmolality: is the conc. Of osmotically active particles per Kg of solution (Osmoles/Kg).
One osmole of a solute and one Kg of solvent are added together.

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 Tonicity of Solution
• It is the osmolality of a solution relative to osmolality of plasma.

1. An Isotonic solution: has the same osmolality as plasma

E.g. 0.9% NaCl given for hypotension

5% glucose given for dehydration

1.8% urea

2. A Hypertonic solution: has a higher osmolality than plasma.

E.g. 9% NaCl

8% glucose
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 Tonicity of Solution
3. A Hypotonic solution: has a lower osmolality than plasma.

E.g. 0.6% NaCl,

3% glucose
• Na+ is the most abundant electrolyte in the ECF and it determines ECF osmolality
• Plasma osmolality can be calculated using plasma concentration of Na+.
• Plasma osmolality = 2.1 x [Na+] ECF = 2.1 x 142 mg/L = 298.2 mosm

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