DOCSLIB.ORG

Body Fluids Bruce M

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Faculty version with model answers Body Fluids Bruce M. Koeppen, M.D., Ph.D. University of Connecticut Health Center Introduction By weight, water comprises approximately 60% of the adult human body (this percentage varies with the amount of adipose tissue (as the amount of adipose tissue increases the percentage of body weight attributed to water decreases). This total body water (TBW) is contained within two major compartments; the intracellular fluid (ICF – 40% of body weight) and the extracellular fluid (ECF – 20% of body weight). Fluid within the ECF is further subdivided into plasma and the fluid surrounding cells (interstitial fluid). Water readily moves between these various fluid compartments. Water movement between the ICF and ECF is driven by differences in osmotic pressure, whereas movement between the vascular compartment (i.e., plasma) and the interstitial fluid compartment is driven by Starling forces across the wall of the capillaries. In this conference we will examine the volumes and composition of the various body fluid compartments, and how fluid shifts occur under a number of conditions. Recommended Reading: Pg. 1 - 15: Renal Physiology, 3rd ed., Koeppen & Stanton, C.V. Mosby, 2001. ___________________________ Capillary Fluid Movement Fluid movement across the wall of a capillary is driven by the sum of the Starling forces; two of which favor (Pc and Πis) and two of which oppose (Pis and Πc) fluid movement out of the capillaries. • Pc: hydrostatic pressure in the capillary • Pis: hydrostatic pressure in the interstitium • Πc: oncotic pressure of proteins in the capillary • Πis: oncotic pressure of proteins in the interstitium Fluid movement across the capillary can be quantitated as: Fluid Flow = Kf [(Pc - Pis) - σ(Πc-Πis)] Where: Kf is the filtration coefficient and takes into consideration the intrinsic permeability of the capillary wall to fluid movement (also called the hydraulic conductivity), as well as the surface area available for fluid flow; and σ is the reflection coefficient for proteins, which varies from 0 (i.e., the capillary wall is freely permeable to proteins) to 1 (i.e., the capillary wall is impermeable to proteins). Fluid Movement Between the ICF and ECF Water can move between the ICF and ECF under a number of important clinical situations. The effects of these shifts on the volumes of the body fluid compartment can be approximated using the following principles: ©Bruce M. Koeppen, M.D., Ph.D., University of Connecticut Health Center -1- • The volumes of the various body fluid compartments can be estimated in the normal adult as: Total Body Water (TBW) = 0.6 x body weight Extracellular Fluid Volume (ECF) = 0.2 x body weight Intracellular Fluid Volume (ICF) = 0.4 x body weight Plasma Volume (P) = 0.25 x ECF volume Interstitial Fluid Volume (IF) = 0.75 x ECF volume • All exchange of water and solutes with the external environment occur through the ECF (e.g., intravenous infusion and intake or loss via the gastrointestinal tract). Changes in the ICF are secondary to fluid shifts between the ECF and ICF. Fluid shifts only occur if the perturbation of the ECF alters its osmolality. Note: the osmolality of the ECF can be quickly estimated by doubling the plasma [Na+], because Na+ and its attendant anions are the major osmoles of the ECF. • Except for brief periods of seconds to minutes, the ICF and ECF are in osmotic equilibrium. A measurement of plasma osmolality will provide a measure of both ECF and ICF osmolality. • For the sake of simplification, it can be assumed that equilibration between the ICF and ECF occurs only by movement of water, and not by movement of osmotically active solutes. • Conservation of mass must be maintained, especially when considering either addition of water and/or solutes to the body or their excretion from the body. ____________________________ 1. Use the following Starling forces for questions 1A and 1B. Arterial End Venous End Pc 35 mmHg 10 mmHg Pis - 3 mmHg -3 mmHg Πc 26 mmHg 26 mmHg Πis 5 mmHg 5 mmHg A. On the following graph, plot: (Pc - Pis) and σ(Πc - Πis). Assume that plasma proteins cannot cross the capillary wall (i.e., that σ = 1). 50 40 30 Pc-Pis mmHg 20 σ(Πc-Πis) 10 ©Bruce M. Koeppen, M.D., Ph.D., University of Connecticut Health Center -2- 0 Arterial Venous End End Note that proteins cannot exert an oncotic pressure if they freely cross the capillary wall. Accordingly, the reflection coefficient (σ) takes into account the permeability of the capillary to proteins. A capillary that is essentially impermeable to proteins (e.g., glomerular capillary of the kidney) will have σ = 1 as in this example. If the capillary is freely permeable to protein (e.g., liver sinusoid) σ = 0. What can you conclude from this graph about the movement of fluid into and/or out of the capillary? The Starling forces are such that there will be net movement of fluid out of the lumen of the capillary at the arterial end, and net movement into the capillary lumen at the venous end. B. Replot (Pc - Pis) and σ(Πc - Πis) on the following graph assuming that the capillary wall has a significant permeability to plasma proteins (i.e., σ = 0.4). 50 40 30 Pc-Pis mmHg 20 10 σ(Πc-Πis) 0 Arterial Venous End End This clearly emphasizes the importance of considering the permeability of the capillary to proteins. With a significant permeability (i.e., σ = 0.4) there is a much reduced effect of protein on the movement of fluid across the capillary. In the extreme where σ = 0, as in the liver sinusoids, the only driving forces for movement of fluid across the capillary wall would be the capillary and interstitial hydrostatic pressures. What can you conclude from this graph about the movement of fluid into and/or out of the capillary under this condition? As noted above, because σ is less than 1, the protein within the capillary lumen and interstitium will not exert the full oncotic pressure (in this example it is reduced by 60%). As a result of this, fluid leaves ©Bruce M. Koeppen, M.D., Ph.D., University of Connecticut Health Center -3- the capillary lumen along its entire length. This overall net movement of fluid into the interstitium will result in formation of lymph. Recent studies indicate that σ in muscle capillaries is in the range of 0.8 - 0.9, and given the estimated Starling forces, fluid is probably filtered along the entire length of the capillary. In liver sinusoids, σ is near 0, and fluid is filtered through out the sinusoid driven by hydrostatic pressure only. 2. Edema is the abnormal accumulation of fluid in the interstitial fluid compartment. Edema can be localized or generalized. The formation of edema requires an alteration in the Starling forces across the capillary wall, or a change in the permeability of the capillary wall such that there is increased movement of fluid out of the capillary into the interstitium. As the terms imply, localized edema is confined to a particular portion of the body or vascular bed, whereas generalized edema results from increased movement of fluid out of the capillaries into the interstitum in vascular beds through out the body. Give an example of localized edema, and an example of generalized edema. Explain the pathogenesis of each in terms of the Starling forces across the capillary wall. Localized edema: A bee sting is an example of localized edema. In the case of the bee string, inflammatory and vasoactive mediators (e.g., histamine, cytokines, etc.) at the sting site increase both capillary permeability and cause local vasodilation. This increases permeability of the capillary wall to protein (i.e., reduces σ), and increases capillary hydrostatic pressure. The net effect of these two changes is illustrated below (compare to graph shown in 1A). These changes in capillary permeability and capillary hydrostatic pressure will result in more fluid moving out of the capillary with localized edema formation. 50 40 Pc-Pis 30 mmHg 20 10 Πc-Πis 0 Arterial Venous End End Generalized edema: The classic example of generalized edema is that seen with congestive heart failure. Hydrostatic pressure within the capillary lumen is an important driving force for the movement of fluid out of the capillary; this pressure is determined by precapillary and postcapillary resistances. Most capillary beds have a well developed precapillary sphincter that helps maintain a relatively constant capillary hydrostatic pressure in the face of changes in arterial pressure. In most capillary beds there is not an effective postcapillary sphincter (the exception is the glomerulus of the kidney). Therefore changes in venous pressure can have important effects on capillary hydrostatic pressure. With congestive heart failure there is an increase in venous volume and pressure. The increased venous pressure is transmitted down to the level of the capillary resulting in an increase in capillary hydrostatic pressure. This increased pressure will in turn cause excess accumulation of fluid in the interstitial ©Bruce M. Koeppen, M.D., Ph.D., University of Connecticut Health Center -4- space (i.e., edema). Because the change in venous pressure effects the Starling forces in capillaries throughout the body the formation of edema is generalized. Edema is most easily detected in the lower extremities, this occurs because gravity acting on the column of blood in the veins further increases the hydrostatic pressure in the capillaries. The following graph depicts the changes in Starling forces that would be seen in this situation. In this example σ = 1(compare to graph shown in 1A). 50 40 30 Pc-Pis mmHg 20 Πc-Πis 10 0 Arterial Venous 3. Patients with generalized edema are frequently treated with low salt diets, or diuretics.
Recommended publications
  • BIPN100 F15 Human Physiology 1 (Kristan) Lecture 15. Body Fluids, Tonicity P

    BIPN100 F15 Human Physiology 1 (Kristan) Lecture 15. Body Fluids, Tonicity P

    BIPN100 F15 Human Physiology 1 (Kristan) Lecture 15. Body fluids, tonicity p. 1 Terms you should understand: intracellular compartment, plasma compartment, interstitial compartment, extracellular compartment, dilution technique, concentration, quantity, volume, Evans blue, plasma volume, interstitial fluid, inulin, total body water, intracellular volume, diffusion, osmosis, colligative property, osmotic pressure, iso-osmotic, hypo-osmotic, hyperosmotic, tonicity, isotonic, hypotonic, hypertonic, active transport, symporter, antiporter, facilitated diffusion. I. Body fluids are distributed in a variety of compartments. A. The three major compartments are: 1. Intracellular compartment = total volume inside all body cells. 2. Plasma compartment = fluid volume inside the circulatory system. 3. Interstitial compartment = volume between the plasma and intracellular compartments. 4. Extracellular compartment = plasma + interstitial fluid B. Slowly-exchanging compartments include bones and dense connective tissues, fluids within the eyes and in the joint capsules; in total, they comprise a small volume. C. Cells exchange materials with the environment almost entirely through the plasma. Fig. 15.1. The major fluid compartments of the body and how water, ions, and metabolites pass among them. D. Under normal conditions, the three compartments are in osmotic equilibrium with one another, but they contain different distributions of solutes. 1. There is a lot of organic anion (mostly proteins) inside cells, essentially none in interstitial fluid, and small quantities in the plasma. 2. Na+ and K+ have inverse concentration profiles across the cell membranes. 3. The total millimolar concentration of solutes is equal in each of the three compartments. 4. Materials that exchange between compartments must cross barriers: a. Cell membranes separate the intracellular and interstitial compartments. b.
  • Body Fluid Compartments Dr Sunita Mittal

    Body Fluid Compartments Dr Sunita Mittal

    Body fluid compartments Dr Sunita Mittal Learning Objectives To learn: ▪ Composition of body fluid compartments. ▪ Differences of various body fluid compartments. ▪Molarity, Equivalence,Osmolarity-Osmolality, Osmotic pressure and Tonicity of substances ▪ Effect of dehydration and overhydration on body fluids Why is this knowledge important? ▪To understand various changes in body fluid compartments, we should understand normal configuration of body fluids. Total Body Water (TBW) Water is 60% by body weight (42 L in an adult of 70 kg - a major part of body). Water content varies in different body organs & tissues, Distribution of TBW in various fluid compartments Total Body Water (TBW) Volume (60% bw) ________________________________________________________________ Intracellular Fluid Compartment Extracellular Fluid Compartment (40%) (20%) _______________________________________ Extra Vascular Comp Intra Vascular Comp (15%) (Plasma ) (05%) Electrolytes distribution in body fluid compartments Intracellular fluid comp.mEq/L Extracellular fluid comp.mEq/L Major Anions Major Cation Major Anions + HPO4- - Major Cation K Cl- Proteins - Na+ HCO3- A set ‘Terminology’ is required to understand change of volume &/or ionic conc of various body fluid compartments. Molarity Definition Example Equivalence Osmolarity Osmolarity is total no. of osmotically active solute particles (the particles which attract water to it) per 1 L of solvent - Osm/L. Example- Osmolarity and Osmolality? Osmolarity is total no. of osmotically active solute particles per 1 L of solvent - Osm/L Osmolality is total no. of osmotically active solute particles per 1 Kg of solvent - Osm/Kg Osmosis Tendency of water to move passively, across a semi-permeable membrane, separating two fluids of different osmolarity is referred to as ‘Osmosis’. Osmotic Pressure Osmotic pressure is the pressure, applied to stop the flow of solvent molecules from low osmolarity to a compartment of high osmolarity, separated through a semi-permeable membrane.
  • Water Requirements, Impinging Factors, and Recommended Intakes

    Water Requirements, Impinging Factors, and Recommended Intakes

    Rolling Revision of the WHO Guidelines for Drinking-Water Quality Draft for review and comments (Not for citation) Water Requirements, Impinging Factors, and Recommended Intakes By A. Grandjean World Health Organization August 2004 2 Introduction Water is an essential nutrient for all known forms of life and the mechanisms by which fluid and electrolyte homeostasis is maintained in humans are well understood. Until recently, our exploration of water requirements has been guided by the need to avoid adverse events such as dehydration. Our increasing appreciation for the impinging factors that must be considered when attempting to establish recommendations of water intake presents us with new and challenging questions. This paper, for the most part, will concentrate on water requirements, adverse consequences of inadequate intakes, and factors that affect fluid requirements. Other pertinent issues will also be mentioned. For example, what are the common sources of dietary water and how do they vary by culture, geography, personal preference, and availability, and is there an optimal fluid intake beyond that needed for water balance? Adverse consequences of inadequate water intake, requirements for water, and factors that affect requirements Adverse Consequences Dehydration is the adverse consequence of inadequate water intake. The symptoms of acute dehydration vary with the degree of water deficit (1). For example, fluid loss at 1% of body weight impairs thermoregulation and, thirst occurs at this level of dehydration. Thirst increases at 2%, with dry mouth appearing at approximately 3%. Vague discomfort and loss of appetite appear at 2%. The threshold for impaired exercise thermoregulation is 1% dehydration, and at 4% decrements of 20-30% is seen in work capacity.
  • Everything You Need to Know About Whole House Water Filtration

    Everything You Need to Know About Whole House Water Filtration

    EVERYTHING YOU NEED TO KNOW ABOUT WHOLE HOUSE WATER FILTRATION Whole house water filter, this in short is the way to ensure that you entire WHOLE HOUSE WATER FILTER home, and everyone within it, is getting pure safe water you desire. From every faucet. YOU NEED TO PROTECT YOUR FAMILY AND YOUR HEALTH BY Water is essential to life. ENSURING YOU ONLY HAVE You know this, so well. You also know that clean, pure water is important for your health. You have checked this, and you know some of the issues, SAFE PURE WATER COMING especially health issues, that come from water that has contaminants. FROM EVERY FAUCET IN YOUR With skin conditions, like eczema, being greatly affected by water quality. ENTIRE HOME. THINGS LIKE THAT ROTTEN EGG SMELL, CHLORINE There are of course other reasons for getting a whole house water filter installed. Around the US, many people are living in areas where lead, AND OTHER CONTAMINANTS mercury and other contaminants are a problem. Different contaminants AFFECT YOUR HEALTH. A GOOD affect your health in various ways, they also affect your piping and WATER FILTRATION SYSTEM plumbing, in a big way. THROUGHOUT YOUR HOME So, getting a water filtration system fitted, throughout your entire home, is HELPS YOU GET TRULY HEALTHY. a great thing to do. Especially when, you wish for your whole family to live long, happy lives. Whole House Water Filter Facts To Help You Best Protect Your Family ¦ What’s A Water Filter? ¦ Water Filtration System And Pure Water What You Need To Know! ¦ Contaminants Filtered Out By Your AquaOx Water Filtration System.
  • Regulation of Water and Electrolyte Metabolism During Dehydration and Rehydration in Camels Ali Abdullah Al-Qarawi Iowa State University

    Regulation of Water and Electrolyte Metabolism During Dehydration and Rehydration in Camels Ali Abdullah Al-Qarawi Iowa State University

    Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1997 Regulation of water and electrolyte metabolism during dehydration and rehydration in camels Ali Abdullah Al-Qarawi Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Animal Sciences Commons, Physiology Commons, and the Veterinary Physiology Commons Recommended Citation Al-Qarawi, Ali Abdullah, "Regulation of water and electrolyte metabolism during dehydration and rehydration in camels " (1997). Retrospective Theses and Dissertations. 11766. https://lib.dr.iastate.edu/rtd/11766 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly fi'om the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be fi'om any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper aligxmient can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion.
  • Kidney: Body Fluids & Renal Function

    Kidney: Body Fluids & Renal Function

    Kidney: Body Fluids & Renal Function Adapted From: Textbook Of Medical Physiology, 11th Ed. Arthur C. Guyton, John E. Hall Chapters 25, 26, & 27 John P. Fisher © Copyright 2012, John P. Fisher, All Rights Reserved Overview of The Kidney and Body Fluids Introduction • The maintenance of volume and a stable composition of body fluids is essential for homeostasis • The kidneys are key players that control many functions • Overall regulation of body fluid volume • Regulation of the constituents of extracellular fluid • Regulation of acid-base balance • Control of fluid exchange between extracellular and intracellular compartments © Copyright 2012, John P. Fisher, All Rights Reserved 1 Balance of Fluid Intake and Fluid Output Introduction • Water intake comes from two sources • Ingested in the form of liquids or within food Normal Exercise • Synthesized as a result of the Intake oxidation of carbohydrates Ingested 2100 ? Metabolism 200 200 • Water loss occurs in many forms Total Intake 2300 ? • Insensible water loss • Evaporation through skin Output • Humidification of inspired air Insensible - Skin 350 350 • Sweat Insensible - Lungs 350 650 • Feces Sweat 100 5000 • Urine Feces 100 100 • The kidneys are a critical Urine 1400 500 mechanism of controlling water Total Output 2300 6600 loss © Copyright 2012, John P. Fisher, All Rights Reserved Balance of Fluid Intake and Fluid Output Body Fluid Compartments • Total body fluid is divided between extracellular fluid, transcellular fluid, and intracellular fluid • Extracellular fluid is again divided between blood plasma and interstitial fluid • Transcellular fluid includes fluid in the synovial, peritoneal, pericardial, and intraocular space • A 70 kg person contains approximately 42 liters of water (60%) and varies with significant physical parameters • Age • Sex • Obesity Guyton & Hall.
  • Chapter 25: Fluid, Electrolyte, and Acid / Base Balance

    Chapter 25: Fluid, Electrolyte, and Acid / Base Balance

    Chapter 25: Fluid, Electrolyte, and Acid / Base Balance Chapters 25: Fluid / Electrolyte / Acid-Base Balance Body Fluids: 1) Water: (universal solvent) Body water varies based on of age, sex, mass, and body composition H2O ~ 73% body weight Low body fat Low bone mass H2O (♂) ~ 60% body weight H2O (♀) ~ 50% body weight ♀ = body fat / muscle mass H2O ~ 45% body weight Chapters 25: Fluid / Electrolyte / Acid-Base Balance Body Fluids: 1) Water: (universal solvent) Total Body Water Volume = 40 L (60% body weight) Plasma Intracellular Fluid (ICF) Interstitial Volume = 3 = Volume Volume = 25 L Fluid (40% body weight) Volume = 12 L L Extracellular Fluid (ECF) Volume = 15 L (20% body weight) 1 Chapters 25: Fluid / Electrolyte / Acid-Base Balance Body Fluids: 2) Solutes: A) Non-electrolytes (do not dissociate in solution – neutral) • Mostly organic molecules (e.g., glucose, lipids, urea) B) Electrolytes (dissociate into ions in solution – charged) • Inorganic salts • Inorganic / organic acids • Proteins Although individual [solute] are different between compartments, the osmotic concentrations of the ICF and ECF are usually identical… Marieb & Hoehn – Figure 25.2 Chapters 25: Fluid / Electrolyte / Acid-Base Balance Body Fluids: 2) Solutes: What happens to ICF volume if we increase osmolarity of ECF? IV bags of varying osmolarities allow for manipulation of ECF / ICF levels… Marieb & Hoehn – Figure 25.2 Chapters 25: Fluid / Electrolyte / Acid-Base Balance Water Balance: ICF functions as a reservoir For proper hydration: Waterintake = Wateroutput Water Output Water Intake Feces (2%) < 0 Metabolism (10%) Sweat (8%) Osmolarity rises: • Thirst Solid Skin / (30%) (30%) foods lungs • ADH release > 0 Ingested Urine liquids Osmolarity lowers: (60%) (60%) • Thirst • ADH release 2500 ml/day 2500 ml/day = 0 2 Chapters 25: Fluid / Electrolyte / Acid-Base Balance Water Balance: Thirst Mechanism: osmolarity / volume (-) of extra.
  • WATER REQUIREMENTS, IMPINGING FACTORS, and RECOMMENDED INTAKES Ann C

    WATER REQUIREMENTS, IMPINGING FACTORS, and RECOMMENDED INTAKES Ann C

    3. WATER REQUIREMENTS, IMPINGING FACTORS, AND RECOMMENDED INTAKES Ann C. Grandjean The Center for Human Nutrition University of Nebraska Omaha, Nebraska USA ______________________________________________________________________________ I. INTRODUCTION Water is an essential nutrient for all known forms of life and the mechanisms by which fluid and electrolyte homeostasis is maintained in humans are well understood. Until recently, our exploration of water requirements has been guided by the need to avoid adverse events such as dehydration. Increasing appreciation for the impinging factors that must be considered when attempting to establish recommendations of water intake presents us with new and challenging questions. This paper, for the most part, will concentrate on water requirements, adverse consequences of inadequate intakes, and factors that affect fluid requirements. Other pertinent issues will also be mentioned. For example, what are the common sources of dietary water and how do they vary by culture, geography, personal preference, and availability, and is there an optimal fluid intake beyond that needed for water balance? II. ADVERSE CONSEQUENCES OF INADEQUATE WATER INTAKE, REQUIREMENTS FOR WATER, AND FACTORS THAT AFFECT REQUIREMENTS 1. Adverse Consequences Dehydration is the adverse consequence of inadequate water intake. The symptoms of acute dehydration vary with the degree of water deficit (1). For example, fluid loss at 1% of body weight impairs thermoregulation and, thirst occurs at this level of dehydration. Thirst increases at 2%, with dry mouth appearing at approximately 3%. Vague discomfort and loss of appetite appear at 2%. The threshold for impaired exercise thermoregulation is 1% dehydration, and at 4% decrements of 20-30% is seen in work capacity.
  • Fluids, Electrolytes and Acid-Base Balance

    Fluids, Electrolytes and Acid-Base Balance

    Fluids,Fluids, ElectrolytesElectrolytes andand AcidAcid--BaseBase BalanceBalance Todd A. Nickloes, DO, FACOS Assistant Professor of Surgery Department of Surgery Division of Trauma/CriticalTrauma/Critical Care University of Tennessee Medical Center - Knoxville ObjectivesObjectives DefineDefine normalnormal rangesranges ofof electrolyteselectrolytes Compare/contrastCompare/contrast intracellular,intracellular, extracellularextracellular,, andand intravascularintravascular volumesvolumes OutlineOutline methodsmethods ofof determiningdetermining fluidfluid andand acid/baseacid/base balancebalance DescribeDescribe thethe clinicalclinical manifestationsmanifestations ofof variousvarious electrolyteelectrolyte imbalances.imbalances. NormalNormal PlasmaPlasma RangesRanges ofof ElectrolytesElectrolytes Cations Concentration Sodium 135-145 mEq/L Potassium 3.5-5.0 mEq/L Calcium 8.0-10.5 mEq/L Magnesium 1.5-2.5 mEq/L Anions Chloride 95-105 mEq/L Bicarbonate 24-30 mEq/L Phosphate 2.5-4.5 mEq/L Sulfate 1.0 mEq/L Organic Acids (Lactate) 2.0 mEq/L Total Protein 6.0-8.4 mEq/L NormalNormal RangesRanges ofof ElectrolytesElectrolytes SodiumSodium (Na(Na+)) RangeRange 135135 -- 145145 mEqmEq/L/L inin serumserum TotalTotal bodybody volumevolume estimatedestimated atat 4040 mEqmEq/kg/kg 1/31/3 fixedfixed toto bone,bone, 2/32/3 extracellularextracellular andand availableavailable forfor transtrans--membranemembrane exchangeexchange NormalNormal dailydaily requirementrequirement 11--22 mEqmEq/kg/day/kg/day ChiefChief extracellularextracellular
  • Consumption of Low Tds Water

    Consumption of Low Tds Water

    International Headquarters & Laboratory Phone 630 505 0160 WWW.WQA.ORG A not-for-profit organization CONSUMPTION OF LOW TDS WATER Since the beginning of time, water has been both praised and blamed for good health and human ills. We now know the real functions of water in the human body are to serve as a solvent and medium for the transport of nutrients and wastes to and from cells throughout the body, a regulator of temperature, a lubricator of joints and other tissues, and a participant in our body's biochemical reactions. It is the H2O in water and not the dissolved and suspended minerals and other constituents that carry out these functions. Total dissolved solids (TDS) is a measure of the combined content of all inorganic and organic matter which is found in solution in water. Water low in TDS is defined in this paper as that containing between 1-100 milligrams per liter (mg/l) of TDS. This is typical of the water quality obtained from distillation, reverse osmosis, and deionization point-of-use water treatment of public or private water supplies that are generally available to consumers in the world. Worldwide, there are no agencies having scientific data to support that drinking water with low TDS will have adverse health effects. There is a recommendation regarding high TDS, which is to drink water with less than 500mg/L. Some people speculate that drinking highly purified water, treated by distillation, reverse osmosis, or deionization, "leaches" minerals from the body and thus causes mineral deficiencies with subsequent ill health effects.
  • Renal Physiology Question

    Renal Physiology Question

    Med Phys 2011 4/18/2011 Lisa M Harrison-Bernard, PhD Associate Professor Department of Physiology Renal Physiologist MEB Room 7213; 568-6175 [email protected] Please Use the Subject Line – Renal Physiology Question Posted on Medical Physiology Schedule of Classes: Learning Objectives, Reading AiAssignmen tHdtPblStts, Handouts, Problems Sets, Tutorials, Review Article Renal Lecture 1 – Harrison-Bernard 1 Med Phys 2011 4/18/2011 Renal Physiology - Lectures 1. Physiology of Body Fluids – Problem Set Posted – 4/19/11 2. Structure & Function of the Kidneys 3. Renal Clearance & Glomerular Filtration – Problem Set Posted 4. Regulation of Renal Blood Flow – Review Article Posted 5. Transport of Sodium & Chloride – Posting of Tutorials A & B Renal Physiology - Lectures 6. Transport of Urea, Glucose, Phosphate, Calcium & Organic Solutes 7. Regulation of Potassium Balance 8. Regulation of Water Balance 9. Transport of Acids & Bases 10. Integration of Salt & Water Balance Renal Lecture 1 – Harrison-Bernard 2 Med Phys 2011 4/18/2011 Renal Physiology - Lectures 11. Clinical Correlation - 5/4/11 12. Problem Set Rev iew – 5/9/11 13. Exam Review – 5/9/11 14. Exam IV – 5/12/11 15. Final Exam – 5/18/11 THE END OF PHYSIOLOGY!! Renal Physiology Lecture 1 Physiology of Body Fluids Chapter 1 - Koeppen & Stanton Renal Physiology 1. Terminology 2. Body Fluid Compartments 3. IditDiltiPiilIndicator Dilution Principle 4. Clinical Examples Renal Lecture 1 – Harrison-Bernard 3 Med Phys 2011 4/18/2011 Three Emergency Room Patients • 80 yo - over medicated - no drinking
  • Dehydration: a Hidden Risk to the Elderly Adapted From

    Dehydration: a Hidden Risk to the Elderly Adapted From

    Dehydration: A Hidden Risk to the Elderly Adapted from https://www.parentgiving.com/elder-care/dehydration-a-hidden-risk-to-the-elderly/ It's important for caregivers to be more aware of ways to prevent dehydration, recognize signs of dehydration in the elderly, and to treat it promptly. Sudden shifts in the body’s water balance can frequently result in dehydration, and the physical changes associated with aging expose the elderly in particular to the risks of dehydration. One serious danger to the elderly is that they may not know about their dehydrated condition, which could lead to it not being treated and result in more serious consequences. In one study of residents in a long-term care facility, author Janet Mentes reported that 31 percent of patients were dehydrated. In a related study, researchers found that 48 percent of older adults admitted into hospitals after treatment at emergency departments actually had signs of dehydration in their laboratory results. Dehydration: The Causes, The Health Risks Dehydration in seniors is often due partly to inadequate water intake, but can happen for many other reasons as well including diarrhea, excessive sweating, loss of blood, diseases such as diabetes, as well as a side effect of prescribed medication like diuretics. Aging itself makes people less aware of thirst and gradually lowers the body’s ability to regulate its fluid balance. Elders may not feel thirst as keenly Scientists warn that the ability to be aware of and respond to thirst is slowly blunted as we age. As a result, older people do not feel thirst as readily as younger people do.