1. body fluids
    • intercellular is about 28 liters
    • extracellular is 14 liters; 11 interstitial and 3 plasma
    • blood volume is around 5 liters
  2. HCT
    • volume of blood that is red cells
    • true value is 96% of measured since some plasma stays between red cells
  3. plasma vs interstitial compostion
    • about the same
    • plasma has more preteins
  4. Donnan effect
    • the proteins in the plasma carry a negative change so the plasma will have a slightly higher concentration of cations
    • Anions have a slightly higher concentration in the interstitial fluid
    • clinically the ion concentrations are said to be equall
  5. Fat body water
    • the fatter a person is the less of there body weight is water
    • women have higher body fat percent so less of there weight is water
  6. Ion distrabution
    • higher intercellular; protein, K, Mg, PO4
    • Higher extracelluar; Na, Cl, HCO3, Ca
  7. Mass equally volume x concentration
    a solution injected into a compartment will have the same mass after injection. You can use this equation to calculate the volume of the compartment
  8. What is used to measure total body water
    radioactive water
  9. Measure plasma volume
    • tagged albumin
    • stays in vasculiture
    • Evans blue dye binds albumin
  10. Measure extracellular volume
    labelled Na
  11. Blod volum =
    plasma volume/1-HCT
  12. What do you label RBCs with
  13. Osmosis
    movement of water from a high concentration to a low
  14. Osmole
    • the number of osmotically active particles in a volume
    • Different then molar concentration. 1 Mol of NaCl in a liter of solution has an osmolarity of 2osm/L
  15. Osmolality
    osmoles per kilogram of water
  16. osmolarity
    osmoles per L of water
  17. Osmotic pressure
    • the pull from solutes of water
    • directly proportional to osmolarity
    • if given grams of a solution, 0.9% saline=9gNaCl / L, divide grams by molar weight of compound to get molar concentration. then find osmolarity
  18. Plasma is slightly higher osmolarity then interstitial fluid
    • due to proteins
    • 282 mOsm/L
  19. Each moms
    19.3 mmHg
  20. Isotonic solutions
    • 5% glucose
    • .9% saline
  21. Hypotonic solution
    cell swells
  22. hypertonic solution
    cell shrinks
  23. cell membranes and Na
    behave as they are impermeable
  24. clinical measurement of fluid balance
    Na concentration
  25. Primary loss of NaCl
    • hypo osmotic dehydration
    • decrease in extracellular fluid volume
    • diarrhea and vomiting and overuse of diuretics
    • pylonephritis, causes disruption of counter current exchanger
    • Addisons disease
  26. Hyper-osmotic dehydration
    • diabetes insipidus
    • dehydration from sweating
  27. Two conditions that cause intercellular edema
    • loss of metabolic systems; Na/K pumps
    • lack of adequate nutrition
    • Ischemic area will have non pitting edema
    • Inflammation can also lead to intercellular edema
  28. Two main causes of extracellular edema
    • abnormal leakage of fluid from the plasma to the interstitial space
    • failure of lymphatics , dangerous because proteins have no way to be removed
    • infections or tumor of lymph nodes, filaria nematodes
  29. paralysis of muscles will cause venous congestion and edema
  30. Liver cirrosis
    • produce less proteins
    • cause portal hypertension leading to ascities, can hold up to 20 L
  31. Interstitial gel
    • most interstitial fluid is in the gel form.
    • bound to proteoglycans
    • no free space for fluid to go
  32. Interstitial safty factor
    • low compliance as long is pressure is negative
    • safety factor of 3mmHg
  33. Collagen and proteoglycans add space
    • without space waste ane electrolytes could not move in tissue to become excreted by the capillaries
    • stops fluid from flowing to easy, without when yo stood up all fluid would flow to feet
    • diffusion of waste is not compromised
  34. Lymphatic edema saftly factor
    • can increase flow 50 fold
    • about 7 mmHg
  35. Washout safty factor
    • lymph flow increases and washes out proteins
    • this decreases osmotic pressure
    • safety factor of 7mmHg
  36. Total body safety factor
    • about 17 mmHg
    • low tissue compliance, 3
    • increased lymph flow, 7
    • washout of interstitial proteins , 7
  37. potential space
    • pleura, pericardial, peritoneal cavity, synovial cavities
    • joints and bursa
  38. effusion
    • edema of potential spaces
    • caused by lymph blockage, excessive filtration
  39. lymph usually removes proteins from interstitial and potential space
  40. body weight
    • 60% fluid
    • 40% is intercellular
    • 20% is extracellular
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