Sistem

Limfatik
M. Rasjad Indra
Laboratorium Ilmu Faal
FK. UNIBRAW
Berkaitan dengan:

• Keseimbangan cairan tubuh

• Pertahanan tubuh
Body Fluid Compartment
Body Fluid Volume
Body fluid
60% (45-75)
water

Intracellular Extracellular
40 % 20 %
(42 liter in 70 kg (14 liter in 70 kg
young adult) young adult)

Interstitial Plasma Transcellular

15 % 5% 1-3 %
(10.5 liter in 70 kg (3.5 liter in 70 kg (Cerebrospinal)
young adult) young adult) (Aqueous humor)
Electrolyte Composition of Body Fluid

Electrolytes Plasma Interstitial Fluid Intracellular

(mEq/L) (mEq/Kg H2O) Fluid (mEq/Kg
H2O)
Cation:
Na+ 142 145 10
K+ 4 4 159
Ca2+ 5 3 1
Mg2+ 2 2 40
Total 153 154 210
Anion:
Cl- 103 117 3
HCO3- 25 28 7
Protein 17 - 45
Others 8 9 155
Total 153 154 210
Daily Intake and Output of Water
(in ml/day)
Normal Prolonged
Heavy Exercise
Intake
Fluid ingested 2100 ?
From metabolism 200 200
Total intake 2300 ?
Output
Insensible-Skin 350 350
Insensible-Lungs 350 650
Sweat 100 5000
Feces 100 100
Urine 1400 500
Total output 2300 6600
 Add pure water
• Normal • Add pure water

ICF ECF
ICF ECF
 Add isotonic saline
• Normal • Add isotonic saline

ICF ECF ICF ECF

 Add pure NaCl
• Normal • Add pure NaCl

ICF ECF ICF ECF

 Decreased ADH
release from
posterior
pituitary
Decreased
plasma ADH
Cardiovascular
stretch receptor
Osmoreceptor

Decreased
Increased collecting duct
extracellular water
Ingestion of 1L
fluid volume permiability
of water
Decreased
plasma
osmolarity

Decreased water
Normal fluid reabsorption
volume
Increased water
excretion
 Increased ADH
release from
posterior
pituitary
Increased plasma
ADH
Cardiovascular
stretch receptor
Osmoreceptors

Increased
Decreased collecting duct
extracellular water
Thirst permiability
Dehydration fluid volume

Increased
plasma
osmolarity
Increased
water intake Increased water
reabsorption
Normal fluid
volume

Decreased water
excretion
 Angiotensinogen
Liver

Kidney Renin

Angiotensin I
Decreased
effective
arterial blood Lungs
volume
Converting
enzyme

Angiotensin II

Blood vessels Adrenal cortex Brain

Vasoconstrictor Aldosteron secre. ADH secretion Thirst

Blood pressure > Sodium reabs. H2O reabsorption Water intake

Normal effective arterial blood volume

 Increased plasma
[K+] Increased [K+] in body cell
Direct effect on adrenal (including kidney cells)
cortex

Increased Increased aldosterone

Potasium intake secretion

Normal potasium
level Increased plasma
aldosterone

Increase luminal membrane permiablility to

Na+ and K+ & Increase basolateral
membrane Na+/K+-ATPase activity in
collecting duct principal cells.

Increased potasium
secretion

Increased potasium
excretion
 Starling Hypothesis
The balance of hydrostatic and oncotic pressures across the
capillary endothelium
Mean capillary hydrostatic pressure (Pc): 25 mmHg (40 10)
Interstitial fluid hydrostatic pressure (PIF): 0 mmHg
Capillary oncotic pressure (Пc): 28 mmHg
Interstitial fluid oncotic pressure (ПIF): 3 mmHg

Arterial end of capillary: Venous end of capillary:

Pc= 40 mmHg; PIF= 0 mmHg Pc= 10 mmHg; PIF= 0 mmHg
Пc= 28 mmHg; ПIF= 3 mmHg Пc= 28 mmHg; ПIF= 3 mmHg
Net Filtration= 40-0-28+3= 15 Net Absorption= 10-0-28+3= -15
Definition of Edema:

An increase in the interstitial compartement of extracellular

fluid volume (Harrison’s).

Causes of Extracellular Edema

1. Increased capillary pressure
2. Decreased plasma proteins
3. Increased capillary permiability
4. Blockage of lymph return
• 1. Increased capillary pressure
– Excessive kidney retention
– High venous pressure
– Decreased arteriole resistance
• 2. Decreased plasma proteins
– Loss of protein in urine
– Loss of protein from denuded skin
– Failure of produce protein
• 3. Increased capillary permiability
– Immune reaction
– Toxin
– Bacteria infection
– Vitamin deficiency (exp. Vit C)
• 4. Blockage of lymph return
– Cancer
– Paracyte infection (Filaria)
– Surgery
– Congenital absence or abnormal of
Lymphatic vessels