Body Fluids
The human body is about 60% water by weight. Body fluids are blood
plasma, lymph, interstitial fluid (tissue fluid) which consist mainly water.
They contain many different substances including nutrients, gases, water,
hormones, and inorganic salts, acids and bases. All the chemical reactions in
the body take place in a watery medium.
The body
fluid is distributed in two principal compartments. The intracellular
compartment and the extracellular compartments. Two-thirds of the body fluid is
found within cells called intracellular
fluid. The remaining is outside the cells in the extracullar compartment
called the extracellular fluid (ECF).
The
movement of fluid from one compartment to another depends on blood pressure and
osmotic concentration, decided by plasma proteins.
Water Balance
Fluid
intake must equal fluid output, so that the total amount of fluid in the body
remains constant. Water is taken in through the alimentary tract and a small
amount is formed by the metabolic processes. Water is excreted in expired air
and in faeces, through the skin as sweat and mainly as urine.
The
balance between fluid intake and output is controlled by the kidneys.
Dehydration occurs when fluid output is greater than the intake. e.g. through
vomiting, sweating, diarrhea. The Anti-diuretic Hormone released into the blood
by the posterior pituitary gland regulates the kidneys to reabsorb more water.
Electrolyte
balance and fluid balance are interdependent. Electrolytes are compounds such
as inorganic salts, acids and bases that form ions in solution. The electrolyte
composition varies among body fluids in different compartments. The ECF
contains high levels of sodium ion. Potassium ion concentration is higher in
the ECF. Sodium ion concentration is adjusted mainly by regulating the amount
of water in the body, as well as, by the hormone aldosterone secreted by adrenal cortex. Potassium ions are also
important in maintaining fluid volume and helps to regulate acid-base levels.
Acid-Base balance
Acid-base
balance depends on the concentration of hydrogen ions and its regulations is
critical to health. pH is a measurement of the H+ ion concentration
of a solution. A neutral pH is 7. Lower pH indicates acidity. Higher pH
indicates alkalinity.
Blood is slightly alkaline at pH 7.4. Change in pH can affect rate of
chemical reactions and structure and function of proteins.
The term acidosis refers to
any condition in which the hydrogen ion concentration of plasma is elevated
above normal. There are 2 types of acidosis:
Metabolic acidosis : This can be due to excessive loss of
bicarbonate ion as in diarrhea or large accumulation of lactic acid as in
exercise.
Respiratory acidosis :
This develops when CO2 is produced more rapidly than it is excreted by the lungs. This occurs during
respiratory diseases.
The term alkalosis is any condition where the
hydrogen ion concentration is below the normal range. There are 2 types of
alkalosis.
Metabolic alkalosis : When there is loss of hydrochloric acid from stomach as in excessive vomiting it can result in muscle
twitches and convulsions.
Respiratory alkalosis
: This occurs when the respiratory system excretes CO2 more
quickly than it is produced. Hyperventilation of lungs due to high altitude or
stress can cause this. The kidneys help regulate the pH by excreting or
conserving certain ions.
Renal failure : This can be acute renal failure / chronic renal failure.
Acute Renal failure : There is a sudden and severe reduction in the glomerular filtration rate and function of the kidney due
to traumatic injury to normal kidneys, such as loss of blood, loss of fluid as
in burns, diarrhoea etc.
Chronic renal failure
: This occurs when the nephrons are progressively and irreversibly damaged
and can be the end result of kidney stones or high BP or Diabetes mellitus.
Kidney ( Renal Calculi) : Calculi form in the kidneys and bladder when urinary constituents normally in solution are precipitated.
The solutes involved are oxalates, phosphates, urates and uric acid. They are
more common in males and after 30 years of age. Dehydration, Infection,
hyperparathyroidism etc can lead to stone formation.
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