The document discusses body water and fluid compartments. It describes that total body water is about 42L in healthy adults. Water is contained within two main fluid compartments - intracellular fluid and extracellular fluid. Extracellular fluid is further divided into plasma and interstitial fluid. Various indicator dilution methods are used to measure the volumes of these fluid compartments. Fluid movement between compartments is regulated to maintain osmotic equilibrium and water balance in the body. Disruptions can lead to edema, an excess accumulation of fluid in tissues.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS#CELL MEMBRANE TRANSPORT#PHYSIOLOGY#BODY FLUIDS#RENAL PHYSIOLOGY#
The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste and other unwanted materials. The primary function of the lymphatic system is to transport lymph, a fluid containing infection-fighting white blood cells, throughout the body.
Lymph is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to the central circulation.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS#CELL MEMBRANE TRANSPORT#PHYSIOLOGY#BODY FLUIDS#RENAL PHYSIOLOGY#
The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste and other unwanted materials. The primary function of the lymphatic system is to transport lymph, a fluid containing infection-fighting white blood cells, throughout the body.
Lymph is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to the central circulation.
The lymphatic system is part of the immune system. It also maintains fluid balance and plays a role in absorbing fats and fat-soluble nutrients.
The lymphatic or lymph system involves an extensive network of vessels that passes through almost all our tissues to allow for the movement of a fluid called lymph. Lymph circulates through the body in a similar way to blood.
There are about 600 lymph nodes in the body. These nodes swell in response to infection, due to a build-up of lymph fluid, bacteria, or other organisms and immune system cells.
A person with a throat infection, for example, may feel that their "glands" are swollen. Swollen glands can be felt especially under the jaw, in the armpits, or in the groin area. These are, in fact, not glands but lymph nodes.
The lymphatic system is part of the immune system. It also maintains fluid balance and plays a role in absorbing fats and fat-soluble nutrients.
The lymphatic or lymph system involves an extensive network of vessels that passes through almost all our tissues to allow for the movement of a fluid called lymph. Lymph circulates through the body in a similar way to blood.
There are about 600 lymph nodes in the body. These nodes swell in response to infection, due to a build-up of lymph fluid, bacteria, or other organisms and immune system cells.
A person with a throat infection, for example, may feel that their "glands" are swollen. Swollen glands can be felt especially under the jaw, in the armpits, or in the groin area. These are, in fact, not glands but lymph nodes.
Professor Mridul M. Panditrao, deals with this basic, complicated but very important topic for not only post- graduates but also for under-graduates. Various complicated issues have been discussed in detail, mainly from clinical point of view.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. Outline
• Total body water
• Fluid intake and output
• Fluid compartments and composition
• Tonicity, osmolarity and osmolality of fluids
• Overview of edema
3. Body water content
• TBW -Total amount of water in body
• 42L in a 70kg health adult
• varies with age and sex
• Infants: 73% (low body fat, low bone mass)
• Adult males: ~60%, females: ~50% water
• Water content declines to ~45% in old age
4. Fluid intake and output
Source: Guyton and Hall(2015); Textbook of medical Physiology, P306
6. Fluid compartments
Total body water = 42 L
Two main fluid compartments
–Intracellular fluid (ICF) compartment: 2/3 in cells
–Extracellular fluid (ECF) compartment: 1/3 outside cells
•Plasma: 3L (20%)
•Interstitial fluid (IF): 11L (80%) in spaces btn cells
–Usually considered part of IF: lymph, CSF, humors of
the eye, synovial fluid, serous fluid, and gastrointestinal
secretions
7. ECF
Fluid outside cells may be;
• Intravascular;
in blood vessels. Contains electrolytes and a protein-rich fluid (plasma) esp.
albumin.
• Interstitial:
surrounds cell. Is the location of most ECF; ¾. Contains little or no protein
• Transcellular :
within specialized body cavities e.g. CSF, synovial, pleural.
8. Composition of body fluids
• Water and solids
• Solids; organic and inorganic substances
• Organic; Glucose, amino acids and other proteins, fatty acids and
other lipids, hormones and enzymes
• Inorganic; Na, K, Ca, Mg, Cl, HCO3, phosphate and sulfate
9. ECF Vs ICF composition
ICF
Cations:
Na+ (14)
K+ (140)
Mg2+ (20)
Anions:
HPO4 (50)
HCO3
- (10)
SO4 (10)
Cl- (4)
Nutrients:
High concentrations of proteins.
10. Movement of fluid btn compartments
• Difference btn relative osmolarity →fluid shifts
• Fluid shifts end at eqbm
• At eqbm, a new steady-state is achieved
• Changes in osmolarity typically affect the ECF first;
- compartment directly in contact with outside envt
- Solutes and water can be added to it from GI tract
- can be subtracted from it by action of kidneys
- loss from perspiration, breathing, and the feces
11. Water balance and ECF Osmolarity
• Water intake must = water output = ~ 2500 ml/day
• Water intake: beverages, food, and metabolic water
• Water output: urine (60%), insensible water loss (lost through skin
and lungs), perspiration, and feces
12. Measurement of fluid volume
• TBW and the volume of different compartments of the body fluids are
measured by indicator dilution method or dye dilution method.
13. Indicator dilution method
• A known quantity of a substance such as a dye is
administered into a specific body fluid compartment.
• These substances are called the marker substances or
indicators.
• After administration into the fluid compartment, the
substance is allowed to mix thoroughly with the fluid.
• Then, a sample of fluid is drawn and the
concentration of the marker substance is determined.
• Radioactive substances or other substances whose
concentration can be determined by using
colorimeter are generally used as marker substances
14. Formula of IDM
• Quantity of fluid in the compartment is measured using the formula;
V=
𝑴
𝑪
Where;
• V = Volume of fluid in the compartment.
• M = Mass or total quantity of marker substance injected.
• C = Concentration of the marker substance in the sample fluid
• However this is not so accurate (some fluid is lost in urine)
15. Fomula for IDM
• Correction factor, (to cater for loss in urine)
V =
𝑀 −𝐴𝑚𝑜𝑢𝑛𝑡 𝑜𝑓 𝑚𝑎𝑟𝑘𝑒𝑟 𝑠𝑢𝑏𝑠𝑡𝑎𝑛𝑐𝑒 𝑒𝑥𝑐𝑟𝑒𝑡𝑒𝑑
𝐶
16. X-tics of a marker substance for IDM
• Must be nontoxic
• Must mix with the fluid compartment thoroughly within reasonable
time
• Should not be excreted rapidly
• Should be excreted from the body completely within reasonable time
• Should not change the color of the body fluid
• Should not alter the volume of the body fluid.
17. Applications of IDM
• There are 3 main applications;
i-measurement of plasma volume
ii-measurement of ECF volume
iii-measurement of volume of TBW
18. Indicators used
Fluid compartment Marker substances used
Total body water 1. Deuterium oxide (D2O)
2. Tritium oxide (T2O)
3. Antipyrine
Extracellular fluid 1.Radioactive sodium, chloride,
bromide, sulfate and thiosulfate.
2.Non-metabolizable saccharides
like inulin, mannitol, raffinose
and sucrose
Plasma 1. Radioactive iodine (131I)
2. Evans blue (T-1824)
19. Applications of IDM
i-Measurement of TBW
• Volume of TBW (fluid) is measured by using a marker substance which is
distributed through all the compartments of body fluid
• Deuterium oxide and tritium oxide mix with fluids of all the compartments
within few hours after injection.
• Since plasma is part of TBW, the concentration of marker substances can be
obtained from sample of plasma.
• The formula for IDM is applied to calculate total body water.
• Antipyrine is also used to measure TBW.But as it takes longer time to
penetrate various fluid compartments, the value obtained is slightly low.
20. Applications of IDM..
ii-measurement of ECF volume
• Substances which pass through the capillary membrane but do not
enter the cells, are used to measure ECF volume.
• These substances remain only in ECF and do not enter the cell (ICF).
• When any of these substances is injected into blood, it mixes with the
fluid of all subcompartments of ECF within 30 minutes to 1 hour.
• Indicator dilution method is applied to calculate ECF volume
• Also here, a sample of plasma is used (its part of ECF)
21. Example of ECF volume measurement
Consider the following results;
• Quantity of sucrose injected (Mass) : 150 mg
• Urinary excretion of sucrose : 10 mg
• Concentration of sucrose in plasma: 0.01 mg/mL
ECF volume =
𝑀 −𝐴𝑚𝑜𝑢𝑛𝑡 𝑜𝑓 𝑚𝑎𝑟𝑘𝑒𝑟 𝑠𝑢𝑏𝑠𝑡𝑎𝑛𝑐𝑒 𝑒𝑥𝑐𝑟𝑒𝑡𝑒𝑑
𝐶
=
150−10𝑚𝑔
0.01𝑚𝑔/𝑚𝐿
= 14,000mL
= 14L
22. Applications of IDM…
iii-measurement of plasma volume
• The substance which binds with plasma proteins strongly and diffuses
into interstitium only in small quantities or does not diffuse is used to
measure plasma volume
23. Procedure;
-known volume of dye is injected intravenously
- after 10mins a blood sample is collected
-also 4 samples may be collected at 10min interval
-all samples are centrifuged and plasma is separated
- concentration of dye is measured in each plasma
sample
- average concentration is calculated
- urine is collected and amount of dye excreted is
measured.
25. Applications of IDM…
iv- measurement of interstitial fluid
• Volume of interstitial fluid cannot be measured directly.
• It is calculated from the values of ECF volume and plasma volume.
• Interstitial fluid volume = ECF volume – Plasma volume
26. Applications of IDM
v. Measurement of ICF
• Volume of ICF cannot be measured directly. It is calculated from the
values of total body water and ECF.
• ICF volume = Total fluid volume – ECF volume.
27. Concentration of body fluids
• Concentration of body fluids is expressed in three ways:
1. Osmolality
2. Osmolarity
3. Tonicity.
28. Osmolality
• Measure of a fluid’s capability to create osmotic pressure or
• Its also the osmotic (osmolar) concentration of a solution.
• Simply; it is the concentration of osmotically active substance in the
solution.
• Osmolality is expressed as the number of particles (osmoles) per
kilogram of solution (osmoles/kg H2O).
29. Osmolarity
• Osmolarity is another term to express the osmotic concentration.
• It is the number of particles (osmoles) per liter of solution
(osmoles/L).
• Osmotic pressure in solutions depends upon osmolality.
30. In practice, the osmolarity and not osmolality is used to determine the
osmotic pressure because of the following reasons:
i. Measurement of weight (kilogram) of water in solution is a difficult
process
ii. Difference between osmolality and osmolarity is very much
negligible and it is less than 1%.
31. • Change in osmolality of ECF affects the volume of both ECF and ICF.
• When osmolality of ECF increases, water moves from ICF to ECF.
• When the osmolality decreases in ECF, water moves from ECF to ICF.
• Water movement continues until the osmolality of these two fluid
compartments becomes equal.
32. Mole and osmole
• mole (mol) is the molecular weight of a substance in gram.
• Millimole (mMol) is 1/1000 of a mole.
• One osmole (Osm) is the expression of amount of osmotically active
particles.
• It is the mw of a substance in grams divided by number of freely
moving particles liberated in solution of each molecule.
• One milliosmole(mOsm) is 1/1000 of an osmole.
33. Tonicity
• Larger molecules sodium and glucose, which cross the cell membrane
slowly, can influence the movement of water
• Such molecules are; effective osmoles
• Osmolality that causes movement of water from one compartment to
another is called effective osmolality and the effective osmoles are
responsible for this.
34. Tonicity …
• Tonicity is the measure of effective osmolality.
• In terms of tonicity, the solutions are classified into three;
i. Isotonic fluid
ii. Hypertonic fluid
iii. Hypotonic fluid.
35. Tonicity…
i-isotonic fluid;
• Fluid which has the same tonicity as body fluids.
• Examples are; 0.9% NaCl solution (normal saline) and
5% glucose solution.
• RBCs or other cells placed in isotonic fluid (normal
saline) neither gain nor lose water by osmosis
• This is because of the osmotic equilibrium between
inside and outside the cell across the cell
36. Tonicity…
ii- Hypertonic fluid;
• Has greater tonicity than the body fluids.
• Example is; 2% NaCl solution.
• When RBCs or other cells are placed in hypertonic
fluid, water moves out of the cells (exosmosis)
resulting in shrinkage of the cells (crenation).
37. Tonicity …
iii- Hypotonic fluid
• Has less tonicity than the body fluids.
• Example is; 0.3% sodium chloride solution.
• When RBCs or other cells are placed in hypotonic
fluid, water moves into the cells (endosmosis)
• This causes swelling of the cells
• The RBCs become globular (sphereocytic) and get
ruptured (hemolysis).
40. Edema
• Edema refers to the presence of excess fluid in the body tissues.
• It may be generalized or local.
• Edema that involves the entire body is called generalized edema.
• Local edema – occurs in specific areas of the body such as
abdomen, lungs and extremities like feet, ankles and legs.
• occurs mainly in the ECF compartment; may involve ICF as well.
• Thus; two types;
i) Intracellular edema
ii) Extracellular edema
41. Intracellular edema
• Due to accumulation of fluid inside the cell
• Mainly caused by;
(1) depression of the metabolic systems of the tissues (due to
poor blood supply hence lack of O2)
(2) lack of adequate nutrition to the cells
(3) in inflamed tissues.
• Inflammation usually has a direct effect on the cell
membranes to increase their permeability, allowing sodium
and other ions to diffuse into the interior of the cell, with
subsequent osmosis of water into the cells.
42. Extracellular edema
• Excess fluid accumulation in the extracellular spaces
(outside the cell).
• 2 general causes:
(1) abnormal leakage of fluid from the plasma to the
interstitial spaces across the capillaries, and
(2) failure of the lymphatics to return fluid from the interstitium
back into the blood.
• The most common clinical cause of interstitial fluid
accumulation is excessive capillary fluid filtration.
43. Conditions that lead to extracellular edema
• two main abnormalities stated earlier:
1. Heart failure
2. Renal failure
3. Decreased amount of plasma proteins.
4. Lymphatic obstruction.
5. Increased endothelial permeability.