Renal Physiology (V) - Body Fluid Compartments(Clinical Correlation)

4,385 views
4,007 views

Published on

by dr Mohammed Abel Gawad (drgawad@gmail.com): Nephrology Specialist at Kidney & Urology Center - Alexandria - Egypt. website: www.nephrotube.blogspot.com

Published in: Health & Medicine
0 Comments
29 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
4,385
On SlideShare
0
From Embeds
0
Number of Embeds
26
Actions
Shares
0
Downloads
70
Comments
0
Likes
29
Embeds 0
No embeds

No notes for slide

Renal Physiology (V) - Body Fluid Compartments(Clinical Correlation)

  1. 1. 1 RENAL PHYSIOLOGY (V) mBODY FLUID COMPARTEMENTS (CLINICAL CORRELATION) Mohammed Abdel Gawad
  2. 2. OBJECTIVES2  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
  3. 3. OBJECTIVES3  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure (factors affecting)  Body Water – Clinical Correlation
  4. 4. Total Body Water (TBW)
  5. 5. TBW is affected by: Gender and Age
  6. 6. TBW is affected by body fatThe ideal weight is only accurate in thin patients while the adjusted weight is accurate in both thin and obese patients.
  7. 7. OBJECTIVES9  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
  8. 8. Total body water Compartments
  9. 9. Total body water Compartments
  10. 10. Intravascular Compartment
  11. 11. Intravascular Compartment
  12. 12. OBJECTIVES14  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
  13. 13. Electrolytes and Non-Electrolytesdissolved in the TBW
  14. 14. Total body water Compartments
  15. 15. Osmolality is the number of particles (mmol) contained in one liter of water, so measured in mmol/L. i.e. it is the concentration by number
  16. 16. Water, Electrolytes & Non-ElectrolytesDistribution (1)
  17. 17. Water, Electrolytes & Non-ElectrolytesDistribution (2)
  18. 18. Osmolality of all three compartments  Osmolality of all three compartments is the same, because water is able to move freely among all three compartments
  19. 19. OBJECTIVES21  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
  20. 20. Movement of water: Starling’s Forces & Membrane Permeability22 The amount of water in each body compartment is dependent on:  1- osmotic pressure  2- hydrostatic pressure  + Membrane characteristics
  21. 21. Osmolality is the number of particles (mmol) contained in one liter of water, so measured in mmol/L. i.e. it is the concentration by number
  22. 22. Starling’s Forces – Osmotic pressure
  23. 23. Starling’s Forces – Osmotic pressure
  24. 24. Starling’s Forces – Hydrostatic pressure
  25. 25. Starling’s Forces
  26. 26. Body Fluid Exchange 1- Osmosis 2- Filtration 3- Diffusion (the most important)
  27. 27. Membrane Factors Membrane permeability (s) is clinically relevant in disorders which disrupt membrane integrity (e.g., sepsis). Permeability of a membrane ranges from zero, completely permeable, to one, completely impermeable.
  28. 28. OBJECTIVES30  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
  29. 29. Starling’s Forces – Net Filtration Pressure
  30. 30. Starling’s Forces – Net Filtration Pressure
  31. 31. Factors Affecting Net Filtration Pressure:1- Hydrostatic Pressure Changes
  32. 32. Factors Affecting Net Filtration Pressure:2- Osmotic Pressure Changes  Increased net filtration pressure can be due to decreased net osmotic pressure.
  33. 33. Factors Affecting Net Filtration Pressure:3- Membrane Permeability Changes  Increased net filtration pressure can be due to increased membrane permeability.  Capillary membrane damage (s rises) may be caused by infection, inflammation, sepsis, trauma, malignancy and adult respiratory distress syndrome (ARDS).
  34. 34. OBJECTIVES36  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure (factors affecting)  Body Water – Clinical Correlation
  35. 35. Factors Affecting Net Filtration Pressure:Clinical Correlation  All fluid accumulations in the body are due to a change in one of the components of Starlings Forces: hydrostatic pressure, osmotic pressure or capillary permeability.  Determining amount of protein and other factors contained in the fluid → help to determine fluid collection is due to a change in which factor
  36. 36. Factors Affecting Net Filtration Pressure:Clinical Correlation (transudate & exudate)  Determining amount of protein and other factors contained in the fluid → help to determine fluid collection is due to a change in which factor:  1- change in hydrostatic pressure → collection with a low protein content and is called a transudate.  2- change in osmotic pressure → collection with a low protein content and is called a transudate.  3- change in membrane permeability (capillary damage) such as inflammation, infection and malignancy → collection with a high protein & LDH content and is called an exudate.
  37. 37. Factors Affecting Net Filtration Pressure:Clinical Correlation (transudate & exudate)
  38. 38. Factors Affecting Net Filtration Pressure:Clinical Correlation (Ascities albumin gradient)
  39. 39. Follow Onwww.nephrotube.blogspot.com & Facebook Group NephroTube
  40. 40. Gawad

×