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Body Compartments Regulation of Fluid & Electrolyte Balance Volume Osmolarity Disturbance Potassium Balance Acid-Base Balance OUTLINE

Fluid Electrolyte Pengampuan SY 1213

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Page 1: Fluid Electrolyte Pengampuan SY 1213

Body CompartmentsRegulation of Fluid & Electrolyte

Balance Volume Osmolarity Disturbance Potassium Balance

Acid-Base Balance

OUTLINE

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Body Compartments

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Body Compartments

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Fluid compartments are separated by membranes that are freely permeable to water

Movement of fluids due to: hydrostatic pressure osmotic pressure Starling forces

Fluid Movement

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Starling Forces

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Swelling of tissues due to excess interstitial fluidCauses:

Increased venous pressure (e.g. heart failure) Increased capillary permeability leak of plasma

proteins to interstitial fluid (e.g. anaphylactic shock)

Decreased plasma proteins (e.g. liver disease, malnutrition)

Inadequate lymph drainage (e.g. filariasis)

Edema

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Body Compartments

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All homeostatic mechanisms that monitor and adjust composition of body fluids respond to changes in ECF, not ICF

No receptors directly monitor fluid or electrolyte balance plasma volume & osmotic concentration

Cells cannot move water by active transport “water follows salt”

Regulation of Fluid & Electrolyte Balance

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Osmolarity Tonicity Through water balance

Volume Blood Pressure Through salt balance

Regulation of ECF

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Tonicity

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Water Balance

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Water Output

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Regulation of Fluid Intake – Thirst

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Regulation of Fluid Output – Urine

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Kidneys conserve water by regulating urine concentration/osmolarity: 50-1200 mOsM

Countercurrent mechanism producing vertical osmotic gradient

Vasopressin/Antidiuretic Hormone (ADH) controls water reabsorption

Obligatory urine volume: 500 mL

Regulation of Fluid Output – Urine

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Countercurrent Mechanism

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Countercurrent Mechanism

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Vasopressin/ADH

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Vasopressin/ADH

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Vasopressin/ADH

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Short-term: Baroreceptor reflex cardiac output and

total peripheral resistance Fluid shifts due to Starling forces

Long-term: ECF volume salt balance

Regulation of Blood Pressure

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Sodium account for >90% of ECF’s osmotic activity conservation of salt = conservation of water (“water follows salt”) primary determinant of ECF volume

Salt Balance

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Intake: Poorly regulated; usually >>

Output: Obligatory loss in sweat and feces (0.5

g/day) Urine: controlled, very precise

Filtration: GFR Reabsorption: Renin-Angiotensin-Aldosterone

(RAA) system; Atrial Natriuretic Peptide (ANP)

Salt Balance

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Salt Balance

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RAA System

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RAA System - Aldosterone

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RAA System - Aldosterone

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ANP

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Integration of Fluid & Electrolyte Balance

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Integration of Fluid & Electrolyte Balance

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Disturbances of Fluid and Electrolyte Balance

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98% in ICF

Intake: DietaryOutput: Urine

Disturbances in Potassium balance are less common than sodium balance, but significantly more dangerous

Potassium Balance

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Factors affecting rate of K+ tubular secretion: K+ concentration in ECF (from dietary

intake) Aldosterone levels (promotes secretion) pH of ECF (acidosis: decreases secretion,

vice versa)

Potassium Balance

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Potassium Balance

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Acid-Base Balance

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Buffer System

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Buffer SystemLungs

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Buffer System - Renal

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Buffer System - Renal

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Buffer System - Renal

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Buffer System - Renal

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Acid-Base Balance

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Disturbances of Acid-Base Balance

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SUMMARY

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Guyton AC, Hall JE. Textbook of medical physiology.11th ed. Philadelphia. Elsevier, Inc. 2006.

Martini FH, Nath JL, Bartholomew EF. Fundamentals of anatomy & physiology. 9th ed. Boston. Benjamin Cummings. 2012

Sherwood L. Human Physiology from cells to system, 7th ed. Australia. Brooks/Cole Cengange Learning. 2011.

Silverthorn DU. Human physiology: an integrated approach. 5th ed. San Francisco. Pearson Education, Inc. 2010.

Tortora GJ, Derrickson B. Principles of anatomy and physiology. 12th ed. USA. John Wiley & Sons, Inc. 2009.

REFERENCES

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THANK YOU