The document discusses the regulation of body water and electrolyte balance through various homeostatic mechanisms. It describes how water comprises 60-70% of total body weight in humans and is obtained through drinking water, beverages, cooked foods, and metabolic water. Key factors that regulate fluid balance include thirst, antidiuretic hormone, the renin-angiotensin system, aldosterone, atrial natriuretic peptide, and kinins. The kidneys play an important role in excreting excess water or electrolytes to maintain balance. Imbalances can disrupt the normal fluid distribution between intracellular and extracellular compartments.
water and electrolyte balance and imbalance.pdfDhoofOfficial
The Importance Of water and Electrolyte Balance and Imbalance Our health To Maintenance Minerals and Fluid Balance inside and Outside The Cells It is Main Role of Health balanced.
This topic Prepare Dr Ibrahim And Thank About Suggesting to Prepared And To choose Lecture Water and Electrolyte balance and Imbalance
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
water and electrolyte balance and imbalance.pdfDhoofOfficial
The Importance Of water and Electrolyte Balance and Imbalance Our health To Maintenance Minerals and Fluid Balance inside and Outside The Cells It is Main Role of Health balanced.
This topic Prepare Dr Ibrahim And Thank About Suggesting to Prepared And To choose Lecture Water and Electrolyte balance and Imbalance
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.
Follow us on: Pinterest
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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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
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
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
11. • In an adult of 70 kg body
• Total Body Water -60- 70% /36-49 Lt
• Intracellular Fluid -65 % - 35 L
• Extracellular Fluid -35% -14 L
–Interstitial Tissue Fluid -25% -11L
–Plasma /Intra Vascular Fluid -8% -3L
–Transcellular Fluid- 2%
18. • Involved in Biochemical reactions
–Water act as reactant in many hydration
Hydrolytic reactions of metabolic
pathways.
• Transporting media of body:
–Transportation of nutrients and waste
metabolites through aqueous media of
blood and tissue floods.
• Regulates body temperature
19. • Water transports Hormones, Enzymes,
blood platelets, and red and white
blood cells
• Water act as a solvent for Electrolytes
and Non electrolytes
• Water Facilitates Digestion and
promoting Elimination of ingested
food
• Water serve as a tissue Lubricant
21. Body Water Input
• Body can gain water by
–Ingestion of liquids and moist
foods (2300mL/day)
–Metabolic synthesis of water
during cellular respiration
(200mL/day)
22. Body Water Output
• Body losses water through:
–Kidneys (1500mL/day)
–Evaporation from Skin (600mL/day)
–Exhalation from Lungs (300mL/day)
–Feces (100mL/day)
25. What Are Electrolytes?
•Substance when dissolved
in solution dissociates into
ions
•These ions are able to
carry an electrical current
26. •An Electrolyte is a
substance
•Which develops an
electrical charge when
dissolved in water
27. Body Electrolytes
• Salts like NaCl and KCl in aqueous
solutions gets dissociated to
• Charged ions Na+ and Cl- called as
Electrolytes.
• The concentration of these
Electrolytes is expressed as mEq/L.
40. • Electrolytes are well
distributed in the body
compartments.
• Electrolytes in the
medium/compartments
produce osmotic pressure.
• This osmotic pressure helps in
maintaining water balance.
41. ELECTROLYTES
• Na+: Most abundant electrolyte in
the ECF.
• K+: Essential for normal membrane
excitability for nerve impulse
• Cl-: Regulates osmotic pressure
and assists in regulating acid-base
balance
42. • Ca2+: Promotes nerve impulse and
muscle contraction/relaxation
• Mg2+: Plays role in carbohydrate and
protein metabolism, storage and use
of intracellular energy and neural
transmission. Important in the
functioning of the heart, nerves, and
muscles
43. •For more detail functions
of Electrolytes
•Refer Minerals Chapter.
45. Diffusion – movement of
particles down a concentration
gradient.
Diffusion: the random
movement of particles in all
directions through a solution
46. • Osmosis: movement of water
across a membrane from a less
concentrated solution to a more
concentrated solution
• Osmosis – diffusion of water
across a selectively permeable
membrane
47. •Osmolarity: The number of
moles per liter of solution
•Osmolality: The number of
moles per Kg of Solvent.
48. • Sodium and its associated
ions in plasma make the
largest contribution (90%) for
plasma Osmolality.
• Osmolality is measured by
Osmometer
50. •Osmolality: concentration
of a solution determined by
the number of dissolved
particles per kilogram of
water.
• Osmolality controls water
movement and distribution
in body fluid compartments
51. •Active transport: Movement
of solutes across
membranes;
•Requires transporters and
expenditure of energy
•Movement of particles is up
a concentration gradient
52. •Filtration: transfer of
water and solutes
through a membrane
•From a region of high
pressure to a region of
low pressure
53. Normal Fluid and Electrolytes
Exchanges In Body
Water And Electrolytes Movement
INN and OUT of Cells.
54. Remember
•Normally in a healthy body
there is osmotic
equilibrium maintained in
each compartment.
55. •In a healthy body the
semipermeable cell membrane
•Allows only passage of Water
but not Electrolytes through it.
56. • Disturbance in osmotic equilibrium
of compartments
• Draws water from the compartment
with lower osmotic pressure
(Hypotonic)
• Into the compartment with higher
osmotic pressure (Hypertonic)
• Until equilibrium is restored.
58. •During difference in electrical
potential
•For example in relative
negativity inside the cells
•There tend to keep Cl - out and
K + inn.
59. Remember
• Cells do not allow accumulation
of Na +
• Na rapidly enters in the cells
• By the Sodium pump, Na is
effectively extrudes out from ICF
• By active transport of Na out of
cells.
60. •However in case of Na +
diffusion into cells
•It is favored by both the
concentration gradient
and electrical potential.
63. Water Balance
• An healthy adult individual
always try
• To maintain water balance by the
homeostatic mechanisms.
• Since Water balance is vital for
human body
64. •A body is said to be in water
balance In a day
•When the amount of water
intake in the body is equal
•To the amount of water
output by that body.
65. •A healthy body tries to
regulate the body water
•Proportionately
distribute the water in
ICF and ECF
66.
67. Water Input = Water Out put
2100ml 2100 ml
Sensible loss
Drinking Water 1000 ml Urine 1000 ml
Cooked Foods 700 ml Feces 100 ml
Metabolic Water 400 ml
Insensible loss
Skin 600 ml
Lungs 400 ml
68. Electrolyte Balance
• Healthy body obeys the law of
electrical neutrality.
• Fluid in any body compartment
contain, equal number of
Cations and Anions.
69. • Specific concentrations of
Electrolytes in the body
compartments are of most
important
• In distribution and retention
of body water.
70. • In healthy state the Osmotic
pressure due to Cations is equal
to the osmotic pressure due to
Anions.
• Which is predominantly due to
equal concentrations of Cations
and Anions in each compartment.
72. • In human body Water and
Electrolytes go togetherly.
• That means the osmotic
equilibrium created by
Electrolytes help in maintaining
water balance.
• If there is imbalance in
Electrolytes it directly affects
Water balance.
73. • Since the Electrolytes and
Water balance go hand in
hand in human body.
• Hence factors regulating the
water and electrolytes are
same.
75. –Ion transport
–Water movement
–Kidney function
These functions act to keep body fluids:
–Electrically neutral
–Osmotically stable
Solute Homeostasis Maintained by:
78. • A body consume fluids and food
items variably depending upon
habits and climatic condition.
• Intake of water and electrolytes
is rarely proportional.
79. •Kidneys play a predominant
role
•In regulating water and
electrolyte balance in the
body normally.
80. –Kidneys play role to excrete
–Excess water through urine
(Dilute form of Urine)
OR
–Excess Electrolytes through
urine
(Concentrated form of Urine)
84. • When the body water is lowered
due to:
–No intake of fluids
–Body fluids lost through obligatory
losses (Urine and Feces).
• This leads to decrease in volume of
body fluids with respect to solutes
and rise in osmotic pressure.
88. • In response to the stimulus to
thirst center
• There occurs dryness of mouth
and Pharynx .
• Feeling of thirst makes drink water
• Water ingested orally quench the
thirst to regulate the body water.
92. •An increase in Osmolality
(Na+ conc) of plasma
•Promotes ADH secretion
and vice versa.
93. •ADH is water conservation
hormone
•It acts on renal collecting
tubule
•For reabsorption of water
by renal tubules.
94. Role Of Anti Diuretic Hormone (ADH)
•When the body water
is depleted
•ADH exerts
Antidiuretic effect.
95. • ADH affects renal tubules
• Provides for the facultative
reabsorption of water from
distal tubules.
•Urine output will be lower
•Urine concentration will be
increased
•Body water will be
maintained
103. • Angiotensin II then stimulates
adrenal gland to release
Aldosterone
• Aldosterone then increase the
peripheral vasoconstriction
104. • Renin Angiotensin System
regulates Aldosterone
hormone from Adrenal gland
• During homeostatic
mechanism of Water and
Electrolyte Balance.
105. • Fall in E.C.F volume
• Decreases blood pressure
• Sensed by Juxtaglomerular apparatus
of Nephrons of Kidneys to secrete
Renin
• Renin then stimulate Liver
Angiotensinogen to produce
Angiotensin –I
106. •Angiotensin I is converted to
Angiotensin
•By Lung produced enzyme
Angiotensin Converting
Enzyme(ACE).
110. Aldosterone
• Aldosterone is a Steroid Hormone.
• It is a Mineralocorticoid produced
by Zona Glomerulus of Adrenal
Cortex.
• It has most important effect on
Mineral Metabolism.
112. •The hormone Aldosterone by
its action:
–Increases the rate of
reabsorption of Na+ (95 %)
and Cl-
–Increases K+ loss through
Urine
113. Role Of Aldosterone
• Aldosterone increases Sodium
uptake from the tubular fluid
• Regulates water reabsorption by
renal tubules and add into the
blood
• Makes excretion of Potassium
114. • Thus Aldosterone maintain
Water and Electrolyte Balance by
its action on renal tubules:
•Reabsorbs Sodium
•Retains Water
•Looses Potassium
117. Atrial Natriuretic Peptide or Factor
(ANP)/ (ANF)
–ANP is a Cardiac hormone
–Secreted by right Atrium of
Heart.
– Chemically ANP is a
Polypeptide hormone
118. ANP
–ANP is released in response to
increased blood pressure in the
atria ( due to increased blood
volume)
–ANP opposes the Renin-
Angiotensin-Aldosterone system
119. ANP suppresses Renin level
Decreases the release of
Aldosterone
Decreases ADH release
ANP stimulates excretion of Na
and H2O
Reduces vascular resistance by
causing vasodilation.
120. Role Of Atrial Natriuretic Peptide
(ANP)
•ANP increases the
urinary excretion of Na+
and regulates the
electrolytes balance.
122. •Kinins are proteins in the
blood
•Kinins cause inflammation
and affect blood pressure
(especially lowers the blood
pressure).
•Kinins increases Salt and
Water excretion.
124. Osmolarity of Solutions
• Isotonic Solution— Same concentration
of solutes as plasma
• Hypertonic Solution— Greater
concentration of solutes than plasma
• Hypotonic Solution— Lesser
concentration of solutes than plasma
125. Example Of
ISOTONIC SOLUTIONS
• 0.9% Sodium Chloride Solution / Normal Saline
• Ringer’s Solution typically contains
•Sodium Chloride
•Potassium Chloride
•Calcium Chloride
•Sodium Bicarbonate
•Lactate Ringer’s Solution
– Contains additionally Lactate
126. • 1 mol NaCl weighs 58.44g
NaCl
• 1 mmol NaCl weighs 0.058 g
NaCl
• One mmol of NaCl contains
•58.3 mg NaCl
133. •In a human body water
distribution in compartments
•Is due to osmotic pressure
produced by Electrolytes
134. • Since Water and Electrolytes
balance in the body go together
• Hence imbalance in any one of it
,affects both.
• In simple words if there is
Electrolyte imbalance, it directly
affects and causes Water Imbalance.
148. Types Of Dehydration
• Primary Dehydration /Due to pure water
depletion
• Mixed Type Dehydration /Due to both
Water and Salt depletion
• Secondary dehydration/Due to pure salt
depletion
150. Causes Of Primary Dehydration
• Very weak or very ill patients
unable to ingest Water.
• Mental Patients who refuses to
drink water
• In Coma Condition
• Person lost in desert or
Shipwrecked
152. Biochemical Alterations
•Pure Water depletion occurs
almost always:
•Because of lack of Water intake
•Rather than because of excess
looses from the body.
153. • Body water stores get depleted
because of:
– Continuing obligatory losses of
water through
– Urine and Feces to excrete
metabolic waste.
154. •The only source of water
supply in this condition is
•Metabolic water obtained
from oxidation of food
stuffs.
155. •The volume of ECF is
maintained almost to normal
in this condition.
•At the expense of I.C.F which
is grossly reduced in volume
•Causing intracellular
dehydration.
157. Clinical Manifestations
• Dry tongue and pinched facies
(Due to intense thirst)
• Oligouria- ADH secreted causes
reabsorption of water from kidney
tubules
• Causing a gradual diminution of
Urine volume.
158. Management
• Give water to drink by mouth
• 5% Glucose by I.V (Hypotonic Soln)
• To correct intracellular dehydration.
• Note: Never give Isotonic Saline.
(0.9 % w/v NaCl solution).
160. •This is the most common
type of dehydration
condition.
161. Causes of Mixed Type
Dehydration
•Severe Vomiting
•Severe Diarrhea
162. Biochemical Alterations
• Mixed dehydration has both low
volume of both water and
electrolytes.
• Here the volume of fluids in both
E.C.F and I.C.F is reduced.
• The patient appears dehydrated
and complains of thirst.
166. Pure Salt Depletion
Secondary Dehydration
•This occurs when fluids of
high Na/Cl content are lost
from the body
• And body is replaced by
Salt deficient fluids.
167. Causes
• Excessive Sweating
• GIT loss of fluids during vomiting and
diarrhea
• Continuous aspirations of G.I fluids
• In Addisons disease (Insufficiency of
Adrenal Cortex)
• Vigorous use of diuretics
169. • In pure salt depletion E.C.F becomes
hypotonic.
• The lowered osmotic pressure
inhibits the release of ADH
• In this response Kidneys excrete
water in an attempt to maintain
normal extracellular Na
concentration
170. • This decreases plasma and
interstitial fluids .
• The water from ECF (hypotonic)
flows into the I.C.F of cells
(hypertonic soln).
• This further reduces the volume
of ECF.
171. •In this condition there is no
cellular dehydration.
•No response to thirst
centre.
172. Copyright 2009, John Wiley & Sons, Inc.
Series of Events in Secondary Dehydration
173. Manifestations Of Secondary
Dehydration
• Absence of Thirst (No intracellular dehydration)
• Patient is apathetic, listless
• Hallucinations and Confusions are common
• Anorexia and Nausea
• Cramps in thigh, abdominal and respiratory
muscles.
• Sunken eyes, inelastic skin
• Low BP, decreased GFR and excretion
176. Primary Dehydration Secondary Dehydration
Caused due to pure
Water Depletion
when water in take is
stopped.
Caused due to pure Salt
depletion
when fluids of high salt content
lost and replaced by salt deficient
fluids
Noted in patients with
dysphagia
Comatose and Mental
patients, Lost in deserts
Patients with excessive
sweating,vomiting ,diarrhea in
CCF, with no electrolytes
replenished.
Feels Thirst , Cramps
absent ,Pulse and B.P
normal.
Thirst absent , cramps present,
rapid and thready
pulse with low B.P.
177. Primary Dehydration Secondary Dehydration
Scanty Urine Normal or increased
Urine
ECF Hypertonic ECF Hypotonic
Cellular Dehydration
present
Cellular Edema present
Management by Water
intake and Hypotonic soln
By infusing Isotonic
solution
182. Over Hydration / Water Intoxication
•Due to excess water intake
•Due to water retention
183. Causes Of Water Excess
• Excessive administration of parenteral
fluids.
• Renal Failure (No/Less excretion of Urine)
• Hypersecretion of ADH
• Administration of Narcotics ,Anaesthesia
causes secretion of ADH
• Excess of Aldosterone (Conn’s Syndrome)
192. Causes Of Edema
• Increased Hydrostatic Pressure
• Small blood vessels become leaky and releases
fluid into nearby tissues.
• Venous obstruction, Lymphedema, CHF, Renal
failure
• Lowered Plasma Osmotic pressure (Protein loss)
• Liver failure, Malnutrition, Burns
• Increased capillary membrane permeability
• Inflammation, Sepsis
193. Types Of Edema
•Generalized Edema
•Organ specific Edema
[cerebral, ascites , pleural)
•Cutaneous Pitting Edema
•Non Pitting Edema
194.
195. Consequences Of Edema
• Imbalance in Water and Electrolyte
distribution.
• Impaired blood flow
• Slow healing
• Increased risk of infections
• Pressure sores over bony prominences
• Impaired organ function
(Brain, Liver, Gut, Kidney)
196. Treatment Of Edema
• Treat the underlying cause of
Edema.
• Defect in heart/Lungs/Liver
/Kidney should be treated
• Reducing amount of salt
199. Diabetes insipidus
• Diabetes insipidus (DI) is
a condition characterized by:
–Excretion of large amounts
of severely dilute urine
–With excessive thirst
202. Central Diabetes Insipidus
• Central Diabetes insipidus
(CDI)
•Involves a deficiency
of Vasopressin /
Antidiuretic hormone
203. Nephrogenic Diabetes insipidus
• The second common type of DI
is Nephrogenic Diabetes insipidus
(NDI),
• Is due to kidney or nephron
dysfunction
• Caused by an insensitivity of
the Kidneys or nephrons to ADH.
204. Manifestations Of DI
•Polyuria with dilute urine.
•Due to osmotic diuresis
•Excessive thirst(Polydypsia)
•Dehydration
•Electrolyte imbalance
205. Diagnosis
• Urine Osmolarity
• Urine Specific gravity
• Electrolyte concentrations in
serum and urine
• Fluid Deprivation test
206. Treatment
• Central DI respond
to Desmopressin which is
given as intranasal or oral
tablets
211. Biochemical Alterations
• Hypoglycemia (reduced level of blood glucose)
• Hyponatremia (low sodium level in the blood)
• Hyperkalemia (elevated potassium level in the
blood)
• Hypercalcemia (elevated calcium level in the blood)
212. Manifestations
• Low blood pressure
• Syncope (loss of consciousness and
inability to stand)
• Confusion, Psychosis, slurred speech
• Severe Lethargy
• Convulsions
214. • Blood Cortisol levels
• ACTH Stimulation Test
• Uses synthetic pituitary ACTH
hormone Tetracosactide used
for diagnosis
215. Management
• Standard therapy involves intravenous
injections of Glucocorticoids
• of Hydrocortisone tablets,
Prednisone tablets
• Large volumes of intravenous saline
solution with Dextrose/Glucose.
• Oral doses of Fludrocortisone Acetate
219. Biochemical Alterations
• Hyperglycemia (Increased level of blood glucose)
• Hypernatremia (High Sodium level in the blood)
• Hypokalemia (Low potassium level in the blood)
• Hypocalcemia (Low Calcium level in the blood)
220. Manifestations
• High blood pressure
• Weight gain ,Central obesity. Buffalo
Hump and Moon Face
• Insomnia
• Excessive Sweating
• Depression
• Anxiety
222. Management
• In adrenal Adenomas surgical removal.
• Ketoconazole, Metyrapone inhibit
Cortisol biosynthesis.
• Mifepristone is a powerful
Glucocorticoid type II receptor
antagonist
224. • The Hypothalamus and
Pituitary gland
• Integrate communication
between nervous and
endocrine systems
• Stress severely affect this
coordination and affect Water
and Electrolyte balance
229. •Distribution & functions of
Water in human body.
•What are Electrolytes? Give
its distribution & functions
related to human body.
230. •What is water electrolyte
balance? Explain the factors
involved in water electrolyte
balance.
•What are disorders of Water
and Electrolyte imbalances?
231. • Dehydration- types, causes &
management.
• Differentiate between Primary and
Secondary Dehydration
• Over hydration/Water Toxicity/Water
Intoxication.
• Edema
• Diabetes Insipidus.
• Addison's & Cushing Syndrome.