Kompartemen cairan tubuh.ppt

8/10/2019 Kompartemen cairan tubuh.ppt

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BODY FLUIDBODY FLUIDCOMPARTEMENTSCOMPARTEMENTS

(KOMPARTEMEN CAIRAN TUBUH)(KOMPARTEMEN CAIRAN TUBUH)

FAKULTAS KEDOKTERAN GIGIFAKULTAS KEDOKTERAN GIGI

UNIVERSITAS ANDALASUNIVERSITAS ANDALAS



2



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Water Intake and OutputIntakeIntake = Ou

tput = Ou

tput



4

Flu ! C"#pa$t#ent%Flu ! C"#pa$t#ent%

• Water occupies 2 main fluid compartments• Intracellular fluid (ICF) – about two t irds

b! "olume# contained in cells

• $%tracellular fluid ($CF) & – 'lasma – t e fluid portion of t e blood – Interstitial fluid (IF) – fluid in spaces between

cells

• Ot er $CF – l!mp # cerebrospinal fluid#e!e umors# s!no"ial fluid# serous fluid#and astrointestinal secretions



Flu ! C"#pa$t#ent%Flu ! C"#pa$t#ent%

Total Body Water: varies with fat

ICF high in K and Mg; ECF high in Na, Cl

Plasma high in protein, but interstitial fluid low in protein

Smallest compartment (plasma) most important (intravascular volume that’s controlled by kidney)



*

C"#p"% t "n "& B"!' Flu !%C"#p"% t "n "& B"!' Flu !%

• Water is t e uni"ersal sol"ent• +olutes are broadl! classified into&

– $lectrol!tes – inor anic salts# all acids andbases# and some proteins

– ,onelectrol!tes – lucose# lipids# creatinine#and urea

• $lectrol!tes a"e reater osmotic powert an nonelectrol!tes

• Water mo"es accordin to osmoticradients



Fun t "n% "& B"!' ate$ Fun t "n% "& B"!' ate$

• -i"e structure to t e bod!• .edium / 'articipates in biolo ical r%ns• .edium for transportation• 0ubricant• 1emp control (* kcal / 0 perspiration)



T*e +"lu#e an! D %t$ ,ut "n "&T*e +"lu#e an! D %t$ ,ut "n "&T"tal B"!' ate$ (TB )T"tal B"!' ate$ (TB )

Extracellular Fluid (ECF)~1/3 TBW or 20% body mass

!tracellular Fluid ( CF)~2/3 TBW or "0% body mass

!tra#ascularFluid (~1/" ECF)

!terstitialFluid (~3/" ECF)

cell membra!e

ca$illary e!dot elium2& ' 20

10 * ' 20

+lasma , ~3 * ' 20

TBW , ~-0% total body mass

.da$ted rom C . Burtis ed et. al. Tiet Textboo o Cli!ical C emistry 3rd

ed + iladel$ ia WB 4au!dersCom$a!y 1555 $6 105-



E-t$a ellula$ an! Int$a ellula$E-t$a ellula$ an! Int$a ellula$

• $%tracellular fluids are similar (e%cept fort e i protein content of plasma) – +odium is t e c ief cation – C loride is t e ma5or anion

• Intracellular fluids a"e low sodium andc loride – 'otassium is t e c ief cation – ' osp ate is t e c ief anion



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E-t$a ellula$ an! Int$a ellula$ E-t$a ellula$ an! Int$a ellula$

• +odium and potassium concentrations ine%tra7 and intracellular fluids are nearl!

opposites• 1 is reflects t e acti"it! of cellular 81'7

dependent sodium7potassium pumps

• $lectrol!tes determine t e c emical andp !sical reactions of fluids



66

.ec anisms Controllin Fluid and.ec anisms Controllin Fluid and$lectrol!te .o"ement$lectrol!te .o"ement

• 9iffusion – molecules mo"e from i to low concentration

• Facilitated diffusion – in"ol"es carrier molecules

• 8cti"e transport – mo"ement a ainst concentration radient – re:uires ener ! – $; ;& keepin ,a out and < in t e cells (re:uires 81')



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Flu ! M".e#ent A#"n/Flu ! M".e#ent A#"n/C"#pa$t#ent%C"#pa$t#ent%

• Compartmental e%c an e is re ulated b!osmotic and !drostatic pressures

• ,et leaka e of fluid from t e blood ispicked up b! l!mp atic "essels andreturned to t e bloodstream

• $%c an es between interstitial andintracellular fluids are comple% due to t eselecti"e permeabilit! of t e cellularmembranes



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ate$ Balan e an! ECFate$ Balan e an! ECF

O%#"lal t'O%#"lal t'

• 1o remain properl! !drated# water intake

must e:ual water output• Water intake sources

– In ested fluid (* =) and solid food (3 =)

– .etabolic water or water of o%idation (6 =)



6

ate$ Balan e an! ECFate$ Balan e an! ECFO%#"lal t'O%#"lal t'

• Water output – >rine (* =) and feces (4=)

– Insensible losses (2 =)# sweat ( =)• Increases in plasma osmolalit! tri er

t irst and release of antidiuretic ormone

(89?)



6*

Re/ulat "n "& ate$ IntakeRe/ulat "n "& ate$ Intake

• 1 e !pot alamic t irst center isstimulated& –

@! a decline in plasma "olume of 6 =–6 = – @! increases in plasma osmolalit! of 6–2= – Aia baroreceptor input# an iotensin II# and

ot er stimuli



6B

Re/ulat "n "& ate$ IntakeRe/ulat "n "& ate$ Intake

• 1 irst is :uenc ed as soon as we be in todrink water

• Feedback si nals t at in ibit t e t irstcenters include& – .oistenin of t e mucosa of t e mout and

t roat – 8cti"ation of stomac and intestinal stretc

receptors



6

Re/ulat "n "& ate$ OutputRe/ulat "n "& ate$ Output

• Obli ator! water losses include& – Insensible water losses from lun s and skin – Water t at accompanies undi ested food

residues in feces

• Obli ator! water loss reflects t e fact t at& – <idne!s e%crete 762 mOsm of solutes

to maintain blood omeostasis – >rine solutes must be flus ed out of t e bod!

in water



6

In&luen e an! Re/ulat "n "& ADHIn&luen e an! Re/ulat "n "& ADH

• 0ow 89? le"els produce dilute urine andreduced "olume of bod! fluids

• ?i 89? le"els produce concentratedurine

• ?!pot alamic osmoreceptors tri er orin ibit 89? release

• Factors t at specificall! tri er 89?release include prolon ed fe"er e%cessi"esweatin # "omitin # or diarr ea se"ereblood loss and traumatic burns



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D %"$!e$% "& ate$ Balan e0D %"$!e$% "& ate$ Balan e0De*'!$at "nDe*'!$at "n

E- e%% .e l"%% "& H1O &$"#ECF

2 1 3ECF "%#"tp$e%%u$e $ %e%

Cell% l"%e H 1Ot" ECF ,'"%#"% %4 ell%

%*$ nk

(a) Me *an %# "& !e*'!$at "n



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D %"$!e$% "& ate$ Balan e0D %"$!e$% "& ate$ Balan e0H'p"t"n H'!$at "nH'p"t"n H'!$at "n

E- e%% .e H 1O ente$%t*e ECF

2 1 ECF "%#"tp$e%%u$e &all%

3 H1O #".e% nt"ell% ,' "%#"% %4ell% %5ell

(,) Me *an %# "& *'p"t"n *'!$at "n



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S"u$ e%S"u$ e%

6; @eaudoin# 9; $lectrol!tes and ion sensiti"eelectrodes; ''1; 2 3;

2; I"ko"ic# 8 ;# 9a"e# D; Denal re"iew; ''1

3; <ersten; Fluid and electrol!tes; ''1;4; .arieb# $,; Fluid# electrol!te# and acid7base

balance; ''1; 'earson $ducation# Inc; 2 4

Kompartemen cairan tubuh.ppt

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