ASSIGNMENT

MEDICAL
PHYSIOLOGY


Title

MEASUREMENTS OF THE
DIFFERENTS BODY FLUIDS



BY: IRFAN MUHAMMAD
ROLL NO # 2012013025
CLASS: F2012 (1)
Measurement of Fluid Volumes in the Different
Body Fluid Compartmentsthe Indicator-
Dilution Principle
In this Principle, a small amount of dye or other
substance contained in the syringe is injected
into a chamber and the substance is allowed to
disperse throughout the chamber until it
becomes mixed in equal concentrations in all
areas. Then a sample of fluid containing
Then a sample of fluid containing
the dispersed substance is removed
and the concentration is analyzed
chemically, photoelectrically, or by
other means. If none of the
substance leaks out of the
compartment.
The volume of a fluid compartment in
the body can be measured by placing an
indicator substance in the compartment,
allowing it to disperse evenly throughout
the compartments fluid, and then
analyzing the extent to which the
substance becomes dilute this indicator-
dilution method of measuring the
volume of a fluid compartment.
This method is based on the
conservation of mass principle, which
means that the total mass of a
substance after dispersion in the fluid
compartment will be the same as the
total mass injected into the
compartment.
The total mass of substance in the
compartment (Volume B
Concentration B) will equal the total
mass of the substance injected (Volume
A Concentration A). By simple
rearrangement of the equation, one can
calculate the unknown volume of
chamber B as demonstrate in followings
Body as an open sytem
Body exchanges materials and energy
with its surroundings
Route Range
(l/day)
Regulatory
influences
Insensible -
lungs
0.3-0.4 Atmospheric
vapor
pressure
(temperature)
Insensible -
skin
0.35-0.4 10x increase
in burn
victims
Sweat 0.1-2 (per
hour)
Temperature,
exercise
Feces 0.1-0.2 Diarrheal
disease
Urine 0.5-1.4-20 Body fluid
composition
FACTORS AFFECTING
Total Body H
2
O

varies depending on body fat:

1. Infant: 73-80%

2. Male adult: 60%

3. Female adult: 40-50%

4. Effects of obesity

5. Old age 45%

6. Climate Level of physical activity

PERCENTAGE OF H2O IN TISSUES
FLUID COMPARTMENTS

EXTRA CELLUAR INTRA CELLULAR
FLUID (cytosol)FLUID





PLASMA INTERSTITIAL TRANSCELLULAR
FLUID FLUID



1. CSF
2. Intra ocular
3. Pleural
4. Peritoneal
5. Synovial
6. Digestive Secretions


TISSUE % WATER % BODY Wt. L of H
2
O
Skin 72 18 9.1
Muscle 76 41.7 22.1
Skeleton 22 16 2.5
Brain 74.8 2.0 1.0
Liver 68.3 2.3 1.0
Blood 83.0 8.0 4.65
Intestine 74.5 1.8 1.0
Adipose Tissue 10.0 10+ 0.7

Average 70 kg person total body weight
42 litres total H
2
O 60%
28 l. Intracellular fluid (ICF) 40%
14 l. Extracellular fluid (ECF) 20%
% is important in fluid therapy
divided into ISF and plasma water
10.5 l. Interstitial fluid (ISF) 15%
3.5 l. Plasma water 5%
PERCENTAGE OF WATER IN TISSUES
Regulation of H
2
O Intake
The hypothalamic thirst center is stimulated:

1. By a decline in plasma volume of 10%15%

2. By increases in plasma osmolality of 12%

3. Via baroreceptor input, angiotensin II, and other
stimuli

1. Semipermeable membrane

2. Movement some solute obstructed

3. H
2
O (solvent) crosses freely

4. End point:

1. H
2
O moves until solute concentration on
both sides of the membrane is equal
2. OR, an opposing force prevents further
movement
Solutes dissolved particles

1. Electrolytes charged particles
1. Cations positively charged ions
Na
+
, K
+
, Ca
++
, H
+
2. Anions negatively charged ions
Cl
-
, HCO
3
-
, PO
4
3-

2. Non-electrolytes - Uncharged
1. Proteins, urea, glucose, O
2
, CO
2
20
APPROXIMATE IONIC COMPOSITION OF THE
BODY H2O COMPARTMENTS

Interstitial Skeletal
Plasma, fluid, muscle cell,
Ion mmoles/L mmoles/L mmoles/L
Cations
Na
+
142.0 145.1 10.0
K
+
4.3 4.4 140.0
Ca
2+
(ionized) 2.5 2.4 1.0
Mg
2+
(ionized) 1.1 1.1 17
Others 4.0
Total 154 153 168

Anions
Cl
-
114.0 117.4 4.0
HCO
3
-
24.0 27.1 7.0
HPO
4
2-
, H
2
PO
4
-
1.0 1.2 40.0
Proteins 1.5 0.1 3.0
Other 10.0 6.2 84.0
Total 154 153 138


Interstitial
H
2
O
Plasma
H
2
O
Cell
H
2
O
Balance of Starling Forces acting across the capillary
membrane
1. osmotic forces
2. hydrostatic forces

Plasma vs Interstitial Space
-Balance between Hydrostatic and Colloid Osmotic
forces across the capillary membranes

Intracellular vs Extracellular
1. Osmotic effect (e.g. electrolytes)
2. ICFV is NOT altered by: iso-osmotic changes in
extracellular fluid volume.





Plasma is clinically accessible
Dominated by [Na
+
] and the associated
anions
Under normal conditions, ECF osmolarity
can be roughly estimated as:

P
OSM
= 2 [Na
+
]
p
270-290 mOSM
Net Osmotic Force Development
1. Semipermeable membrane.
2. Movement some solute obstructed.
3. H
2
O (solvent) crosses freely.
4. End point:
H
2
O moves until solute concentration on both sides of
the membrane is equal.
OR, an opposing force prevents further movement.
Ionic composition very different
-Total ionic concentration very similar
-Total osmotic concentrations virtually identical
Disorders of H
2
O Balance: Dehydration
Excessive loss of H
2
O from
ECF
1
2
3 ECF osmotic
pressure rises
Cells lose H
2
O
to ECF by
osmosis; cells
shrink
(a) Mechanism of dehydration
ECF Osmolarity ?
1. H
2
O moves out of
cells
2. ICF Volume decreases
(Cells shrink)
3. ICF Osmolarity
increases

4. Total body
osmolarity remains
higher than normal
ECF Osmolarity ?
1. H
2
O moves into the
cells
2. ICF Volume increases
(Cells swell)
3. ICF Osmolarity
decreases

4. Total body osmolarity
remains lower than
normal

CRITERIA FOR A SUITABEL DYE.

BODY FLUID MARKER

1. Must mix evenly throughout the compartment

2. Non toxic, no physiological activity

3. Even mixing

4. Must have no effect of its own on the distribution of H2O
or other substances in the body

5. Either it must be unchanged during the experiment or if
it changes , the amount changed must be known.

6. The material should be relatively easy to measure.
DILUTION PRINCIPLE
Inject x gm of marker into compartment
measure concentration at equilibrium (y gm/L)
Since concentration = mass/ volume
Volume = mass / concentration
= x/y L
C1V1=C2V2
Principle of mass conservation
Based on using a marker whose concentration can be
measured.
Measuring Compartment Size
Indirect METHOD INDICATOR (DYE) DILUTION TECHNIQUE
(Law of Mass Conservation)
Concentration = Amount Injected
Volume of Distribution
Amount of Tracer Remained in Compartment = A - E
Compartment Volume = (A E)/C



Compartment
Volume (V)
Tracer Concentration (C)
Amount of
Tracer Added
(A)
Amount of
Tracer Lost
From
Compartment
(E)
Based on concentration in a well-mixed substance that distributes
itself only in the compartment of interest.


Indicators used for measuring plasma volume, ECF
volume and total body H
2
O
Compartment Criterion Indicators
1. Plasma Substance
should not cross
capillaries
1. Evans blue dye;
2. radioiodinated fibrinogen;
3. radioiodinated albumin
1. ECF
volume
Substance
should cross
capillaries but
not cross cell
membranes
Isotonic solutions of sucrose,
inulin, mannitol, NaCl
1. Total
body H
2
O
(TBW)
Substance
distributes
evenly in ICF &
ECF
Heavy H2O, tritiated H2O,
aminopyrine, antipyrine
Total Body H
2
O (TBW)

1. Deuterated H2O (D
2
O)


2. Tritiated H2O (THO)


3. Antipyrine
Blood volume /Markers used
1. Obtained from plasma volume and hematocrit
2. Total blood volume = Plasma volume/1-
Hematocrit
3. Example: If the plasma volume is 4 liters and the
hematocrit is 0.45, total blood volume is ?
4. =PLASME VOL X 100
100 -HCT


1.T-1824 (Evans blue dye) attaches to plasma proteins and is removed
by the liver. Measures plasma volume
2. Radioactive labeled 125 i albumin
3. Cr
51
(radioactive chromium) is incubated with red blood
cells then injected
Measures total blood volume
Take this problem:
100 mg of sucrose is injected into a 70 kg
man. The plasma sucrose level after
mixing is 0.01 mg/ml. If 5 mg has been
metabolized during this period, then,
what is the ECF volume?
9.5 L
14 L
17.5 L
10 L
If 1mL of solution (10mg/mL) of
dye is dispersed in chamber B
and final concentration is the
chamber is 0.01mg/mL. What is
the volume in chamber B?
1000ml or 1L
Compartments with
no Compartment-Specific Substance
1. Determine by subtraction:
2. How would you measure ICF volume?
3. Cannot be measured; it is calculated
(estimated)..
4. ICF volume = Total body H
2
O ECF volume


5. Interstitial volume
1. Can not be measured directly
6. Interstitial Fluid Volume (ISFV).
ISFV = ECFV - PV
Measurement of other spaces
Extracellular volume
Na
24

Cl
35

Inulin
Sucrose
Mannitol
Sulfate
I
125
iothalamate
Disperse in plasma and interstitial fluid, but not
permeable to cell membrane
30-60 min for dispersion to extracellular fluid
Determining body fat:
Technique: bioelectric impedance technique

Principle:
1. Body fluids conduct electricity well;
2. But fat is anhydrous and therefore is a poor
conductor of electricity;
3. The resistance to flow of a small current
between points on the body is proportional
to fat mass.
Lean body mass (LBM)
Definition: LBM is fat free mass
Total body mass = fat mass + fat free mass
Note: fat is relatively anhydrous
Note: the H
2
O content of LBM is constant
H
2
O content of LBM is constant - 70 ml /100 g
tissue