C1EnglezaWater 2013 Print PDF

Raluca PAPACOCEA MD PhD
Body water. March 2013

INTRODUCTION IN PHYSIOLOGY

PHYSIOLOGY=
Physis

= nature, living

been
+
Logos = science

Thw

science

of natures

laws, of body

functions

Introduced

by

J. Fernel, in
1542, as title

to

his

medical
textbook

Medicine

HISTORY

William Harvey -1628-
FIRST PHYSIOLOGY PAPER

Claude Bernarde

-1835-
the

internal

environment

concept

Pflugger

-1900

electrophysiology

Otto Frank, E. Starling, 1925
blood

circulation

Cajal, Marinescu-1934, neuro

physiology

Secenov, Pavlov-1904
BODY WATER
WATER MOLECULE
PROPERTIES
1.

High

polarity

solubility = chemical

reactivity
2.

High

specific heat

avoid

hyperthermia
3.

High

vaporisation

heat

-

thermoregulation
4.

High

thermal

conductivity

fast

tranfer

of the

heat; rich

water

tissues

are not

good

insulators
5.

High

surface

tension

-

(-) role, prevent

alveolar
expansion
HIGH POLARITY

Water acts like a magnet and has 2 poles: positive and
negative (dipol). The positive end attracts the negative
ions or the negative end of other polar molecules. The
negative end is able to attract positive ions or the
positive end of other polar molecules.Water it is able to
dissolve many substances = universal solvent.
Molecules that dissolve in water, such as carbohydrates,
are named hydrophilic. In contrast, hydrophobic
molecule (compounds containing carbon and hydrogen)
cannot form hydrogen bonds with water. For example,
fats, oils, alkans, paraffin, are hydrophobic molecules.
High specifical heat

Q = c x m x T

Specific heat is the amount of heat per
gram, required to increase the
temperature by one degree Celsius. The
relationship between heat and
temperature change is expressed in the
formula shown below where c

is the
specific heat. where Q = heat added, c =
specific heat and T= temperature
variationThe specific heat of water is 1
calorie/gram C = 4.186 joule/gram

C
High heat of vaporization
(evaporation)

is higher than any other common substance. Water
molecule absorbes

a lot of heat, playing a key role in
the body temperature regulation, especially in the
prevention of the hyperthermia. is the energy required to
transform a 1 gram of water into gas. Fluid water that
becomes water vapor absorbes

heat in the process
called evaporation. By heat absorbtion, evaporation
cooles the surface exposed to this process. The amount
of heat transfer depends on the evaporation rate, on the
air humidity and temperature. This property is also
important for the body termoregulation. The sweat
evaporation at the surface of body produces skin
cooling.
High thermal conductivity

is the quantity of heat transmitted through a unit
thickness in a direction normal to a surface of
unit area, due to a unit temperature gradient
(1C) under steady state conditions. Thermal
conductivity (heat transfer coefficient) of water is
0,58 at 25C and provides the fast tranfer of the
heat; Tissues rich in water are not good
insulators. Fatty tissue -

containing a very low
percentage of water -

is an efficient body
insulator
High surface tension

is the property of a liquid surface that causes it to act
like a stretched elastic membrane. Surface tension is
caused by the attraction between the water's molecules
by intermolecular (cohesive) forces. It creates a driving
force which diminishes the surface area and generates a
spherical drops of liquid, (as the liquid tends to minimize
its surface area according to Laplace's law)In a spherical
organ T = (P x R)/2,where T = tension and P= pressure.
Surface tension is measured in dynes/cm, the force in
dynes required to break a film of 1 cm length.
WATER BALANCE

Definition = the equilibrium between
water gain and water loss
WATER BALANCE IN HUMAN
BODY
GAIN (ml) LOSS (ml)
Drink

1500
Food

500
Endogenous

water

250
(metabolism)
Urine 1500
Sweat

500
Insensible

water

loss

150*
Feces

100
2250 2250
* Diffusion

through

skin

and

evaporation

from

the

respiratory

tract
Water

distribution
1.

Depends

on

age
-

embrio97%
-

foetus

85%
-

child

80%
-

adult 60%
-

elder

55%
2.

Depends

on

gender
- male 60%
-

female

50%
3.

Depends

on

tissue
a.

Low

water

Enamel

0,2%

dentine

-

10%

bone

22%

Fat

tissue

35%
b. Rich

water

tissues

Muscle-

75%

thyroid, kidney

-80%

brain

85%
TOTAL BODY WATER

Healthy

adult, 70 kg

40 l water
60% from

body

weight
IVF

= 5%
IF

= 15%
ICF

= 40%
ECF
20%
THE 60

:

40

:

20

RULE
60

TBW
40

ICF
20

ECF
INTRACELLULAR COMPARTMENT

The

most

important quantity

(40%)

Exchanges

with

ECF only

through

IF

IC water

can

be

:

free
bound

(matrix, gel)

Sources:

IF
endogenous

water

Composition:

K, phosphates, proteinates
EXTRACELLULAR COMPARTMENT
Includes

IVF+

IF+

transcellular

fluid

(1%)
Transcellular

fluid

:
-

ICSF, endo/perilymph
-

aqueous

humor and

vitreous

body
-

digestive secretions
-

pleural, pericardic, peritoneal, synovial

fluid
In pathological

cases

(intestinal occlusion,
pleuresy

etc.) a new

compartment

appears:
The

TRANSCELLULAR COMPARTMENT
ELECTROLYTES DISTRIBUTION IN
WATER COMPARTMENTS
ION

(mEq/l)/
ECF ICF
Na
+
140 14
K
+
4 140
Ca
2+
5 0
Mg
2+
2 40
Cl

-
105 5
HCO
3

- 24 10
Proteins 15 60
Sodium (Na+)

is the main extracellular ion. It is involved in cellular
excitability because it is the generator of the action
potential. It is also responsible for the electrical impulse
transmission. It participates in fluid and electrolyte
balance by creating most of the osmotic pressure of
extracellular fluid. Daily average of Na+ intake exceeds
the bodys normal daily neccessities so kidneys eliminate
the suplimentary sodium. The Na+ level in the blood is
controlled by hormones like aldosterone and atrial
natriuretic peptide (ANP). Aldosterone regulates sodium
reabsorption by stimulating a pump Na+ / K+
Potassium (K+)

is the main positive ion from intracellular
fluid. It generates the rest membrane
potential, regulates thecellular excitability,
modulates muscle contraction, and blood
pH. The blood level of K+ is controlled
mainly by aldosterone (see above).
Calcium (Ca+2)

is an extracellular ion, representing an
important component of bones and teeth.
It is involved in blood clotting,
neurotransmitters

release, maintenance of
muscle tone, and excitability of nervous
and muscle tissue. The plasma level of
calcium is regulated by parathyroid
hormone and calcitonin. D vitamins control
Ca+2 absorbtion.
EXCHANGES BETWEEN
COMPARTMENTS

DIFFUSION

/

FILTRATION /

OSMOSIS
I.

Diffusion

=

the

main

exchange

mechanism

in microcirculation
1.

Simple D.

passive

particles

transfer
from

high

to

low

concentration

due

to

a
C
Ficks

Law
Diffus

C

x

A x Solub.
flow

d x M
=
Diffusion

Different substances diffuse across capillary walls by
different routes:Water, ions, and small molecules such
as glucose diffuse between adjacent endothelial cells
(pores), or through fenestrated capillaries.Some

ions
(Na+, K+, Ca++, Cl-) diffuse through channels in cell
membranes. Large, water-soluble compounds must pass
through fenestrated capillaries.Lipids

and lipid soluble
materials (including O2 and CO2) diffuse through
endothelial cell membranes

by dissolving in lipid bilayer
of membrane. Plasma proteins cross the endothelial
lining only in sinusoids, if pores are big enough.
2. Facilitated

Diffusion

Needs

a specifical

carrier

Is

also

passive

Has

a limited

capacity

Doesnt

need

energy
Diffusion

-

for fat

substances

-

through

lipidic bilayer
-

for hydrosoluble

substances

through

proteic channels, ionic channels
II.

FILTRATION

Net filtration

pressure

NFP.

= Profiltrant forces

Antifiltrant

forces

NFP = (pc + i)

(

c+ pi )
pc =30 mm Hg

c = 28 mm Hg
pHi

= -7 mm Hg
i = 5 mm Hg
pc =10 mm Hg

c = 28 mm Hg

pHi

= -7 mm Hg
i = 5 mm Hg
NET FILTRATION PRESURE (nfp)
ARTERIAL END : + 14 mm Hg

VENOUS END: -

6 mm Hg
p.ef.
p.ef.
ISOSFIGMIC POINT
FILTRATION
REABSORBTION
ISOSFIGMIC POINT
APPLICATIONS OF CAPPILARY

IF
EXCHANGES (IVF) -

(IF)
Edemas

= water

in excess

in the interstitial space
Mechanisms:
pHc

venous

stasis

flebitis, heart

failure
c

hypoproteinemia

lack

of proteins,
nephrotic

syndrome, hepatic failure

pHi

lymph

blockage

neoplasma, filariosis

capillary

permeability

alergies, inflammations
III.

OSMOSIS
MEDIUM 2

C
2
MEDIUM 1
C 1
C2 .C

1
PARTICLES
WATER
Water

transfer from

low

concentration

medium

into

high

concentration

medium

=
osmosis
The

pressure

applied

to

block

the

water

transfer =
osmotic pressure

().

does

not

depend

on

conc., but osmotic active
particles

number
osmotic active particles: ions, glucose, urea,
proteins
Osmol

= the

exerted

by

1 mol-gram of
unionizable

substance
mOsmol
OSMOLALITY = OSMOLI / kg.water
OSMOLARITY = OSMOLI / liter

of solution
A Molar Solution

is

an aqueous

solution

consisting

of one

mole of a substance

plus
enough

water

to

make

one

Liter

of solution.
A Molal Solution

is

an aqueous

solution

consisting

of one

mole of a substance

plus 1
kg of water

(usually

very

close

to

1 L water). The

total volume may

thus

be

more than

1 L
Osmolarity

in Complex Solutions
As described

under

Units

of Measure, the

osmolarity

of a simple solution

is

equal

to
the

molarity

times

the

number

of particles

per molecule.
Glucose

has

1 particle
NaCl

has

two
MgCl2 has

three.

can

be

expressed

in:

-mosmoli/l

-

mm Hg: 1 mosmol

= 19,3 mm Hg
normal

= 300 mosm/l = 5450 mm Hg
The

fraction

given

by

proteins

=

co =
Coloid osmotic (oncotic) pressure

= 28 mmHg
isotonic:

= 300 mosm/l
Depending

on, hypertonic: >300 mosm/l
, body

fluids

hypotonic

:

<300mosm/l
can

be:

= c x R xT

= osmotic pressure

in mm Hg
c = concentration

gradient
R = ideal gas constant
T= absolute temperature

in degrees

kelvin
vant Hoff

Ecuation
The

cell

volume changes

depends

~osmolarity
i x Vi = f x Vf
Vi = 100 c (erythrocite)

i =285 mosm/l
Vf

=88 c

f =325 mosm/l
Donnan

membrane equilibrium

(electrochemical)

anions

=

cations
Vesicular transport

is reserved for the specific transport of
large molecules, usually proteins. Not all
capillaries display this mechanism.
Exocytosis

moves substance from the cell
interior to the extracellular space.
Endocytosis

enables large particles and
macromolecules to enter the cell.
WATER BALANCE REGULATION
1.

WATER INTAKE REGULATION
2.

WATER LOSS REGULATION
REGULATION OF THE WATER
INTAKE

Thirst is the driving force for water intake and
represents the physiological impulse to drink
water.

A decrease in plasma volume of 10% and or an
increase in plasma osmolality of 1 to 2% results
in stimulation of the hypothalamic thirst centre.

This causes a subjective sensation of thirst,
which motivates the person to drink water.
Thirst is stimulated by four
elements
1.

Hypovolemia:

Low volume stimulates the low
pressure baroreceptors in the great veins and
right atrium
2.

Hypertonicity:

Cellular dehydration acts via an
osmoreceptor mechanism in the hypothalamus
3.

Hypotension: a decreasing in blood prerssure
stimulates the high pressure baroreceptors in
carotid sinus and aorta
4.

Angiotensin II: is synthesized in response to
renal hypoxia. (hypotension, hemorrhage,
anemia etc.)
RENIN ANGIOTENSIN ALDOSTERONE
SYSTEM
WATER BALANCE REGULATION
Is regulated by both, nervous and humoral
mechanisms.
A reflex mechanism has an anatomical substrate
represented by the reflex arch.
Each reflex arch consists of 5 elements:
Receptor
Afferent fibers
Nervous

center
Efferent fibers
Effector.
RECEPTORS
1.

Osmoreceptors are located in hypothalamus
and respond to changes in extracellular tonicity,
especially in Na+
2.

Volume receptors

(low pressure receptors)
are located in the right atria and great veins
3.

Baroreceptors

(high pressure receptors) are
located in the carotid sinus and respond to
changes in mean arterial blood pressure.
Nervous center

The central controller for water balance is
the hypothalamus. The osmoreceptors are
located in the area known as the AV3V
(anteroventral 3rd ventricle).

Lesions in the AV3V region in rats cause
acute adipsia (they do not drink water).
2. WATER LOSS REGULATION
1.

Sweating

-10 ml/h at

rest
2. Insensible

loss

(perspiration)
2.

Feces
3.

Diuresis
HUMORAL REGULATION

ADH

ALDOSTERONE

ANF
ADH

ADH = peptidic hormon synthetised in the
hypothalamus (supraoptic and
paraventricular nuclei) and transported to
the posterior pituitary.

In high doses ADH induces
vasoconstriction so it is also known as
vasopressin.
ADH exerts its physiological actions by
binding specific receptors.
V1 receptors are located in the smooth muscle
layer of the blood vessels

they induce
vasoconstriction
V2 are located in the membrane of the
nephrocytes of the distal tubule and collecting
tubule from kidney where ADH stimulates water
reabsorbtion causing:
-

urine volume decrease
-

urine concentration increase
-

blood volume increase
-

blood concentration decrease.
ADH is

stimulated

by:
-

Hypovolemia (decrease of blood volume) V =
5-10%
-

Hypertonicity (increase of osmotic pressure)

= 1%,
-

pain, stress, emotions
-

morphin, nicotin, barbiturics
ADH is

inhibited

by:
-

hypervolemia
-

Hypotonicity
-

alcohol
ADH REGULATION
Aldosterone
= mineralocorticoid

hormone produced by
adrenal gland.
It preserves

Na

in the body by increasing

the
Na

reabsorbtion and K/H

excretion in
kidney.
Cl follows Na and water

follows NaCl (due to
osmosis)
Aldosterone increases blood volume and
blood pressure
Aldosterone regulation
Aldosterone is stimulated by:
-

Hypovolemia
-

Hypotonicity
-

the decreasing of the Na/K

ratio
- ACTH
-

angiotensin

II, prostaglandin Pg E1, E2
Aldosterone is inhibited by:
-

Hypervolemia
-

Hypertonicity
-

Pg F1
-

Pg

F2
Atrial

Natriuretic

Factor /(Peptide )
ANF /(ANP)
Is a cardiac hormone secreted by the atrial

wall in
response to high venous return
Roles:
1.

it

lowers blood volume and blood pressure,
2.

produces vasodilation
3.

inhibits aldosterone

and ADH release
4.

increases glomerular

filtration rate
5.

increases

diuresis, natriuresis
6.

antirenin activity.
DISORDERS OF WATER
BALANCE
1. Isotonic fluid :

-

excess

EC hyperhidration
- lack

EC dehydration
2. Hypertonic

:

-

excess

EC hyperhidration
fluid

IC dehydration
(NaCl)

-

lack

IC hyperhidration
EC dehydration
2. Hypotonic

:

-

excess

EC hyperhidration
fluid IC hyperhidration
(pure water)

-

lack

IC dehydration
EC dehydration
STUDY QUESTIONS
1.

Transcellular fluid includes:
A.

Pericardial fluid
B.

Plasma
C.

Lymph
D.

Synovial fluid
E.

Interstitial fluid
Answers

A, D

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Raluca PAPACOCEA MD PhD

Body water. March 2013

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