Fluid & Electrolytes
Fluid & Electrolytes
Fluid & Electrolytes
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Body Fluids: Water and Solutes
The term fluid' refers to water and the components it contains
Solution: liquid containing a dissolved substance (fluid)
Solvent: liquid part of a solution (water)
Solute: substance that can be dissolved in a solution (electrolyte)
Cell Membrane
Membrane
Permeability
Selective permeability
Impermeability
Controls differences in fluid and electrolyte composition in the different body compartments
Fluid Compartments
Water
Electroneutrality: total sum of cations must equal total sum of anions (pluses and minuses must equal)
Movement
Exchange: Water and Solutes
Constant movement of water and solutes between different fluid spaces
Goal: maintain homeostasis
Selective permeability: controls solute movement
Small particles (ions, 02, C02, H20) pass easily
Larger molecules (glucose, proteins) have more difficulty passing between fluid compartments
Sodium controls water distribution (water follows sodium)
Passive vs Active Transport
Gradient: difference in concentration, pressure, or electrical charge between two compartments
Passive transport: no energy expended
Flows down the concentration gradient
Only from high concentration to low
Passive Transport
Types of Passive Transport
Diffusion
Facilitated diffusion
Osmosis
Filtration
Simple Diffusion
Random movement of solutes across a permeable membrane down a concentration gradient
High conc. low conc.
Result: equal solute distribution (equilibrium)
No ATP energy
Example: smaller, fat-soluble molecules (02, C02)
Diffusion in Action
Facilitated Diffusion
Diffusion of large, lipid-insoluble solutes across a membrane, with the help of transport proteins
High conc. low conc.
Integral membrane protein acts as carrier
No ATP energy
Faster than simple diffusion
Example: glucose
Osmosis
Diffusion of water across a selectively permeable membrane (permeable to water, not to solute)
High water conc. low water conc.
Low solute conc. high solute conc.
No ATP energy
Examples: water movement from interstitium to cells, from interstitium to plasma
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Osmotic Pressure
Fluid-pulling power
Exerted by all particles in a solution
Driving force for movement of water across a cell membrane
Solute = Osmotic pressure
Osmotic pressure = water in
Osmotic pressure = water out
Osmolarity
Number of solute particles per 1L of body fluid
Measures osmotic pressure (fluid-pulling power)
Expressed as milliosmoles per liter (mmol/L)
Normal osmolarity = 270-300 mmol/L
Electrolyte molecules exert greater effect on osmosis than nonelectrolytes
Sodium is greatest determinant of ECF osmolarity
Water follows sodium
Tonicity
Effect of osmotic pressure on cellular volume
Concentration of solutes determines direction of water flow
Isotonic: 270 300 mmol/L
Equal solute and waterexact same number of particles in both solutionsno net movement (same)
Hypertonic: > 300 mmol/L
Greater solute, less waterwater pulled out of cells (shrinks)
Hypotonic: < 270 mmol/L
Less solute, more waterwater moves into cells (swells)
Tonicity of IV Fluids
Isotonic: same osmolarity (270 300 mmol/L)
Normal saline (NS or 0.9% NaCl), Lactated Ringers (LR)
Hypotonic: fewer solutes (< 270 mmol/L)
Water, NS (0.45% NaCl), and D5W (5% dextrose in water, after the dextrose is used up)
Filtration
Fluid-pushing power
LARGE AMOUNTS (bulk flow) of water & solutes together are forced through capillary membranes by
pressure in the blood
High hydrostatic pressure low hydrostatic pressure
Filtration
Filters out formed elements of blood and colloid proteins (no protein in interstitial fluid)
Opposes osmosis (fluid-pulling power)
No ATP energy
Examples: capillary bed, glomerulus (kidneys)
Colloids: Plasma Proteins
Large molecules unable to pass through membrane because of their size
Albumin, globulin, fibrinogen
Exert osmotic pull: colloid osmotic pressure, oncotic pressure
Pull water back into the vascular system
Colloid IV solutions:
Albumin, Dextran, Hetastarch
Remain in vascular compartment
Starlings Forces
Pressure differences in venous and arterial ends of capillaries influence direction of fluid movement
Filtration (arterial end): fluid out (due to higher hydrostatic pressure)
Reabsorption (venous end): fluid back in (due to higher colloid osmotic pressure)
Capillary Dynamics
Interplay of 4 forces:
Capillary hydrostatic pressure (CHP): MAJOR
ISF hydrostatic pressure (IFHP): MINOR
Capillary oncotic pressure (COP): MAJOR
ISF oncotic pressure (IFOP): MINOR
Capillary Dynamics
Arterial end: fluid out
Plasma ISF
Filtration prevails
(CHP + IFOP) (COP + IFOP) ~ 16 mm Hg
Venous end: fluid in
ISF Plasma
Osmosis prevails
(COP + IFHP) (CHP + IFOP) ~ 9 mm Hg
More fluid out than back in
Excess tissue fluid returned to vascular space by lymphatic vessels
Lymphatic System: Returns Excess ISF to Vascular System
Active Transport
Movement of solutes across a cell membrane against a concentration gradient, with the help of carrier
molecules (pumps)
Low conc. high conc.
Requires ATP energy
Example: sodium-potassium pump
Sodium-Potassium Pump
Transport protein pumps in cell membrane
Powered by ATP
3 Na+ ions transported to ECF against gradient
2 K+ ions transported to ICF against gradient
Maintains ECF, ICF homeostasis
Can You Name the Process?