WATER METABOLISM
WATER <ul><li>Most abundant compound in the body  (65-95%of body weight) </li></ul><ul><li>Special properties – polarity <...
UNIQUE PROPERTIES OF H 2 O <ul><li>Powerful solvent for ionic & neutral molecules. </li></ul><ul><li>Dissociation of macro...
BODY FLUIDS <ul><li>Extra cellular fluid: fluid outside the body cells (heterogeneous) </li></ul><ul><ul><ul><li>Plasma </...
Daily intake of water <ul><li>2500 ml /day (average) </li></ul><ul><ul><li>Water & other fluids - 1200-1500 ml </li></ul><...
<ul><li>Distribution of body water is affected by the  osmotic forces  that direct the water movement between body compart...
ELECTROLYTES <ul><li>The most important substances that influence the distribution & retention of body water. </li></ul><u...
<ul><li>60-80% inorganic material of the body comprise with main mineral elements. </li></ul><ul><ul><li>Sodium </li></ul>...
Sodium <ul><li>Daily intake – 4g </li></ul><ul><li>95% of ingested Na excreted in urine. </li></ul><ul><li>Distribute main...
Hyponatremia Severe   Na depletion from the extracellular body fluids <ul><li>Extracellular body fluids become hypotonic a...
Hypernatremia Excess of Na in body fluid <ul><li>Due to excess intake of NaCl (mainly intravenous), Cushing’s syndrome & h...
Potassium <ul><li>Daily intake – 4g </li></ul><ul><li>Important </li></ul><ul><ul><li>in maintenance of acid-base balance ...
Hyperkalemia ( Elevated serum K) <ul><li>Causes:  renal failure, advanced dehydration, shock, in Addison’s disease and int...
Hypokalemia Low level of serum K   by quick removal of extracellular K by kidneys (intracellular K is transferred to extra...
Chlorine <ul><li>Importance: </li></ul><ul><ul><li>Water balance </li></ul></ul><ul><ul><li>Osmotic pressure regulation </...
Metabolic alkalosis <ul><li>Increase in serum bicarbonate due to the loss of chloride in excess of Na. </li></ul><ul><li>C...
Calcium <ul><li>The most abundant mineral element. </li></ul><ul><li>99% of body Ca present in teeth & bone (skeleton) as ...
<ul><li>About 15% of dietary Ca is absorbed in SI (facilitated by vit D) and rest is recovered in feces. </li></ul><ul><li...
Phosphorus <ul><li>About 80% total P: combined with Ca in bones &teeth. </li></ul><ul><li>About 10%: combined with protein...
Hormones affect for Ca & P metabolism <ul><li>Parathyroid hormone </li></ul><ul><li>Calcitonin </li></ul><ul><li>Thyroxin ...
Question <ul><li>a) What are the important trace elements  of the body?  </li></ul><ul><li>b) Briefly explain the importan...
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Mineral metabolism

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Mineral metabolism

  1. 1. WATER METABOLISM
  2. 2. WATER <ul><li>Most abundant compound in the body (65-95%of body weight) </li></ul><ul><li>Special properties – polarity </li></ul><ul><li> - H bonding </li></ul>
  3. 3. UNIQUE PROPERTIES OF H 2 O <ul><li>Powerful solvent for ionic & neutral molecules. </li></ul><ul><li>Dissociation of macromolecules of the celll along with dilute salt solutions. </li></ul><ul><li>Influence on the structural & functional components of the cell </li></ul><ul><li>Cooling of the body by evaporation of moisture in the lungs &from the skin </li></ul>
  4. 4. BODY FLUIDS <ul><li>Extra cellular fluid: fluid outside the body cells (heterogeneous) </li></ul><ul><ul><ul><li>Plasma </li></ul></ul></ul><ul><ul><ul><li>Interstitial & lymph fluid </li></ul></ul></ul><ul><ul><ul><li>Dense connective tissue, cartilage & bone </li></ul></ul></ul><ul><ul><ul><li>Transcellular fluid : salivary gland, pancreas, liver, billiary tree, kidneys, CSF etc. (in organs) </li></ul></ul></ul><ul><li>Intracellular fluid: fluid within the body cells (fairly constant in composition) </li></ul>
  5. 5. Daily intake of water <ul><li>2500 ml /day (average) </li></ul><ul><ul><li>Water & other fluids - 1200-1500 ml </li></ul></ul><ul><ul><li>Foods - 770-1000 ml </li></ul></ul><ul><ul><li>Metabolic water - 200- 300 ml </li></ul></ul><ul><li>Routes of water loss </li></ul><ul><li>Skin (sensible & insensible perspiration) </li></ul><ul><li>Lungs (water vapor in the expired air) </li></ul><ul><li>Kidneys (urine) </li></ul><ul><li>Intestine (feces) </li></ul>
  6. 6. <ul><li>Distribution of body water is affected by the osmotic forces that direct the water movement between body compartments. </li></ul><ul><li>Factors that affect the production & control of osmotic forces </li></ul><ul><ul><li>Electrolytes : the most important substances </li></ul></ul><ul><ul><li>Organic substances of large molecular weight & size (serum proteins) : maintain the osmotic balance between circulating blood & the tissue spaces </li></ul></ul><ul><ul><li>Organic compounds of small molecular weight (glucose, urea, amino acids etc.) : diffuse relatively free across cell membranes & not important </li></ul></ul>
  7. 7. ELECTROLYTES <ul><li>The most important substances that influence the distribution & retention of body water. </li></ul><ul><li>The most important osmotically effective electrolytes: </li></ul><ul><ul><li>Na+ :main cation of extracellular fluid </li></ul></ul><ul><ul><li>K+ : main cation of intracellular fluid </li></ul></ul>
  8. 8. <ul><li>60-80% inorganic material of the body comprise with main mineral elements. </li></ul><ul><ul><li>Sodium </li></ul></ul><ul><ul><li>Potassium </li></ul></ul><ul><ul><li>Chlorine </li></ul></ul><ul><ul><li>Calcium </li></ul></ul><ul><ul><li>Magnesium </li></ul></ul><ul><ul><li>Phosphorous </li></ul></ul><ul><ul><li>Sulfur </li></ul></ul>MINERAL METABOLISM
  9. 9. Sodium <ul><li>Daily intake – 4g </li></ul><ul><li>95% of ingested Na excreted in urine. </li></ul><ul><li>Distribute mainly in plasma, whole blood, cells, nerve & muscle tissues. </li></ul><ul><li>Metabolism is influenced by the adrenocortical steroids. </li></ul><ul><li>All active Corticosteroids, except androgens increase the absorption of Na & Cl - by renal tubules and excretion by the sweat gland, salivary gland and intestinal tract </li></ul><ul><li>Increase excretion of K is required for the retention of Na by kidneys (by exchange of intracellular K with extracellular Na) </li></ul>
  10. 10. Hyponatremia Severe Na depletion from the extracellular body fluids <ul><li>Extracellular body fluids become hypotonic as water leaves to restore plasma osmotic pressure. </li></ul><ul><li>More water is lost from tissue fluid </li></ul><ul><li>When the Pt has lost Na equivalent of 4Lof isotonic saline symptoms begins </li></ul><ul><ul><li>Vasoconstrictive shock </li></ul></ul><ul><ul><li>Nausea, vomitting, cramps –intestinal dilation </li></ul></ul><ul><ul><li>Cause of death due to circulatory failure </li></ul></ul>
  11. 11. Hypernatremia Excess of Na in body fluid <ul><li>Due to excess intake of NaCl (mainly intravenous), Cushing’s syndrome & head injury with water depletion. </li></ul><ul><li>Symptoms: </li></ul><ul><ul><li>Raised central venous pressure </li></ul></ul><ul><ul><li>Peripheral edema </li></ul></ul><ul><ul><li>Pulmonary edema with eventual respiratory failure </li></ul></ul>
  12. 12. Potassium <ul><li>Daily intake – 4g </li></ul><ul><li>Important </li></ul><ul><ul><li>in maintenance of acid-base balance </li></ul></ul><ul><ul><li>in maintenance of osmotic pressure </li></ul></ul><ul><ul><li>for water retention </li></ul></ul><ul><ul><li>for some metabolic reactions catalyzed by enzymes (intracellular K) </li></ul></ul><ul><ul><li>influences the muscle activity, mainly cardiac (intracellular K) </li></ul></ul><ul><li>Distribute in muscle tissue, cells, nerve tissue, whole blood and plasma in increasing order. </li></ul><ul><li>Mineralcorticoids maintain the K metabolism. </li></ul><ul><li>Mainly excreted by the kidneys. </li></ul>
  13. 13. Hyperkalemia ( Elevated serum K) <ul><li>Causes: renal failure, advanced dehydration, shock, in Addison’s disease and intravenous administration of K at an excessive rate. </li></ul><ul><li>Symptoms: </li></ul><ul><ul><li>Cardiac & CNS depression </li></ul></ul><ul><ul><li>Mental confusion </li></ul></ul><ul><ul><li>Weakness, numbness </li></ul></ul><ul><ul><li>Weakness in respiratory muscles. </li></ul></ul>
  14. 14. Hypokalemia Low level of serum K by quick removal of extracellular K by kidneys (intracellular K is transferred to extracellular K) <ul><li>Causes: gastrointestinal losses, chronic wasting disease with malnutrition, metabolic alkalosis, in prolonged IV administration of solutions without K and in Cushing’s syndrome </li></ul><ul><li>Outcome: severe damage to the kidneys. </li></ul><ul><li>Symptoms: </li></ul><ul><ul><li>Muscle weakness with irritability & paralysis </li></ul></ul><ul><ul><li>Tachycardia and dilation of the heart with ECG changes </li></ul></ul>
  15. 15. Chlorine <ul><li>Importance: </li></ul><ul><ul><li>Water balance </li></ul></ul><ul><ul><li>Osmotic pressure regulation </li></ul></ul><ul><ul><li>In acid base balance </li></ul></ul><ul><ul><li>Production of HCl acid in gastric juice </li></ul></ul><ul><li>Abnormalities always associated with abnormalities of Na metabolism as Cl - intake occurs as NaCl </li></ul><ul><li>Cl - deficit occurs when losses of Na are excessive </li></ul><ul><ul><li>Diminished intake of NaCl </li></ul></ul><ul><ul><li>Burns, severe exudative skin lesions and excessive sweating </li></ul></ul><ul><ul><li>Addison’s disease </li></ul></ul><ul><ul><li>Prolonged vomiting and diarrhea </li></ul></ul>
  16. 16. Metabolic alkalosis <ul><li>Increase in serum bicarbonate due to the loss of chloride in excess of Na. </li></ul><ul><li>Cause: Loss of HCl acid in prolonged vomiting. </li></ul>
  17. 17. Calcium <ul><li>The most abundant mineral element. </li></ul><ul><li>99% of body Ca present in teeth & bone (skeleton) as CaPO 4 deposits in a soft fibrous matrix. </li></ul><ul><li>In body fluids: small concentrations as ionized Ca +2 . </li></ul><ul><li>Ionized Ca +2 is important in </li></ul><ul><ul><li>Blood coagulation </li></ul></ul><ul><ul><li>Maintaining the normal excitability of the heart, muscles and nerves </li></ul></ul>
  18. 18. <ul><li>About 15% of dietary Ca is absorbed in SI (facilitated by vit D) and rest is recovered in feces. </li></ul><ul><li>Urinary excretion: about 200mg/day </li></ul><ul><li>Factors affect the Ca absorption: </li></ul><ul><ul><li>Phytic acid (forms insoluble Ca phytate) </li></ul></ul><ul><ul><li>Oxalates forms Ca oxalates. </li></ul></ul><ul><ul><li>Intestinal P H (acidic P H promotes Ca absorption) </li></ul></ul><ul><ul><li>Phosphate (reduces the absorption forming a phosphate) </li></ul></ul><ul><ul><li>Presence of free fatty acids (form insoluble Ca soaps) </li></ul></ul><ul><ul><li>Presence of Vit D </li></ul></ul>
  19. 19. Phosphorus <ul><li>About 80% total P: combined with Ca in bones &teeth. </li></ul><ul><li>About 10%: combined with proteins, lipids& CHO and other cpds in blood and muscle </li></ul><ul><li>Remining 10%: widely distributed in various chemical cpds. </li></ul><ul><li>Daily adult intake: 1.5 – 3.0g </li></ul><ul><li>Factors affect for the absorption and the metabolism of P is much similar to Ca. </li></ul>
  20. 20. Hormones affect for Ca & P metabolism <ul><li>Parathyroid hormone </li></ul><ul><li>Calcitonin </li></ul><ul><li>Thyroxin </li></ul><ul><li>The estrogen & androgens </li></ul><ul><li>Glucocorticoids </li></ul><ul><li>Other factor: Action of Vit D </li></ul><ul><li>Ref: </li></ul><ul><li>How do the above factors affect for the metabolism of Ca & P? </li></ul><ul><li>Serum Ca and serum inorganic P </li></ul>
  21. 21. Question <ul><li>a) What are the important trace elements of the body? </li></ul><ul><li>b) Briefly explain the importance of above elements </li></ul>

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