Physiology Course: Dr. Velu M. Rachel

PHYSIOLOGY COURSE
MMP 1215
DR. VELU M. RACHEL

Recap
Con’t …
• ICF: 2/3 of TBW
• ECF: 1/3 of TBW

- Plasma: 20%
- IF: 80%
Body fluid volumes in a healthy 70-kg
adult male
Compartment Volume Subdivisions
Intracellular fluid, ICF (2/3 28 L -
of TBW)
Extracellular fluid, ECF; 14 L 10.5 L
1/3 of TBW (Interstitial fluid)
3.5 L
(Plasma)
Total body water (TBW); 42 L -
60% of body weight
Con’t ...
• In terms of composition, these fluids (ICF, Plasma, IF)
contain electrolytes (ions dissociate) and non-
electrolytes.
 Electrolytes – charged particles

 Cations – positively charged ions
• Na+, K+ , Ca++, H+
 Anions – negatively charged ions
• Cl-, HCO3- , PO43-
 Non-electrolytes - Uncharged
• Proteins, urea, glucose, O2, CO2
Measuring body fluid volumes
• Principe: Indicator-dilution principle
• Method:
1. Administer a known amount (A) of a substance that
will get distributed in a particular body fluid
compartment;
2. Determine the final steady state concentration (C) of

this indicator in blood;
3. Volume of distribution (Vd) of the indicator =

Amount of indicator injected (A)/ Concentration in
blood after mixing (C)
• Example
100 mg of sucrose is injected into a 70 kg man. The

plasma sucrose level after mixing is 0.01 mg/ml. If 5 mg
has been metabolized during this period, then, what is
the ECF volume?
• Solution
 Amount of sucrose injected = 100 mg

 Amount metabolized = 5 mg
 Amount remaining in ECF (A) = 95 mg
 Concentration in plasma after mixing (C) = 0.01 mg/ml
 Thus, volume of distribution (Vd) of sucrose = A / C = 95
mg / 0.01 mg/ml
= 9500 ml = 9.5 L (= ECF volume)
• How would you measure IF volume?
 Cannot be measured; it is calculated (estimated)..

 IF volume = ECF volume – plasma volume
• How would you measure ICF volume?
 Cannot be measured; it is calculated (estimated)..

 ICF volume = Total body water – ECF volume
• Relationship between blood volume and plasma

volume.
• Blood = plasma + cells in blood
• Volume of cells: packed cell volume (PCV)

• PCV is also called hematocrit (Hct)
• Blood volume = plasma volume × 100 / (100 – Hct)
• Example
In a healthy 70 kg adult male, plasma volume

was found to be 3000 ml. Hematocrit was 40%.
Calculate his blood volume?
• Lean body mass (LBM)
 LBM is the fat free mass.

 Total body mass = fat mass + fat free mass.
 Note: the water content of LBM is constant.
 Water content of LBM is constant - 70 ml /100mg
tissue.
• Example
In a healthy adult male weighing 70 kg, total
body water (TBW) was measured to be 42 L.
What is his lean body mass (LBM)? What is his
fat mass?
• Solution
• Given TBW = 42 L
• Assume all this water is in LBM & that fat is water
free.
• We know that water content of LBM is 70 ml/100 g
• Thus, if TBW is 42 L, LBM = 60 kg
• Since he weights 70 kg, his fat mass is 70-60 = 10 kg
Fluid and Electrolytes Regulation (RECAP)
• How does movement from space to space occur?
Simple Diffusion
• Movement of solutes from an area of higher concentration to

an area of lower concentration in a solution and or across a
permeable membrane.
• Characteristics:
 is the only form of transport that is not carrier-mediated.
 occurs down an electrochemical gradient ("downhill").
 does not require metabolic energy and therefore is passive.
Con’t….
Facilitated Diffusion
• It is a transport whereby the molecules move down a

concentration gradient through specific protein channels in the
membrane
• Characteristics of facilitated diffusion

 occurs down an electrochemical gradient ("downhill"), similar to
simple diffusion.
 does not require metabolic energy and therefore is passive.
 is more rapid than simple diffusion.
 is carrier-mediated and therefore exhibits saturation, and
competition.
Con’t….
• Saturation: the transport rate increases as the
concentration of the solute increases, until the
carriers are saturated.
• Competition: structurally related solutes compete for

transport sites on carrier molecules. For example,
galactose is a competitive inhibitor of glucose
transport in the small intestine.
Con’t….
• Example of facilitated diffusion
 Glucose transport in muscle and adipose cells is

"downhill," is carrier-mediated, and is inhibited by
sugars such as galactose; therefore, it is categorized
as facilitated diffusion.
Con’t….
Active transport (1airy)
• Characteristics of primary active transport
 occurs against an electrochemical gradient ("uphill").

 requires direct input of metabolic energy in the form
of adenosine triphosphate (ATP) and therefore is
active.
 is carrier-mediated and therefore exhibits saturation,
and competition.
Con’t….
• Examples of primary active transport
 Na+,K+-ATPase (or Na+-K+ pump) in cell membranes

transports
 Na+ from intracellular to extracellular fluid and K +
from extracellular to intracellular fluid; it maintains
low intracellular [Na +] and high intracellular.
 Both Na+ and K+ are transported against their
electrochemical gradients.
Con’t….
 Energy is provided from the terminal phosphate

bond of ATP.
 The usual stoichiometry is 3 Na +/2 K+.
 Specific inhibitors of Na+, K+-ATPase are the cardiac
glycoside
 drugs ouabain and digitalis.
Con’t….
H+,K+-ATPase (or proton pump) in gastric

parietal cells transports H+ into the lumen of
the stomach against its electrochemical
gradient.
 It is inhibited by omeprazole.
Con’t….
Secondary active transport
• Characteristics of secondary active transport
 The transport of two or more solutes is coupled.
 One of the solutes (usually Nat) is transported
"downhill" and provides energy for the "uphill"
transport of the other solute(s).
 Metabolic energy is not provided directly, but
indirectly from the Na+
gradient that is maintained across cell membranes.
Con’t….
• Thus, inhibition of Na+,K+ -ATPase will decrease
transport of Na + out of the cell, decrease the
transmembrane Na + gradient, and eventually inhibit
secondary active transport.
 If the solutes move in the same direction across the
cell membrane, it is called cotransport, or symport.
Examples are Na+-glucose cotransport in the small

intestine and Na+-K+-2Cl- cotransport in the renal thick
ascending limb.
 If the solutes move in opposite directions across the cell
membranes, it is called countertransport, exchange, or
antiport.
Osmosis
• Osmosis is the flow of water across a semipermeable
membrane from a solution with low solute
concentration to a solution with high solute
concentration.
The osmotic pressure difference across the membrane
causes water to flow from solution 2 (which has no
solute and the lower osmotic pressure) to solution 1
(which has the solute and the higher osmotic pressure).
Con’t….
 If two solutions separated by a semipermeable

membrane have different effective osmotic
pressures, the solution with the higher effective
osmotic pressure is hypertonic and the solution with
the lower effective osmotic pressure is hypotonic.
 Water flows from the hypotonic to the hypertonic

solution.
Con’t….
Osmolarity
• is the concentration of osmotically active particles in a
solution.
• can be calculated using the following equation:
• Osmolarity = g X C
where:
• Osmolarity = concentration of particles (osm/L)
• g = number of particles in solution (osm/mol)
 e.g. , gNaC1 = 2; g Glucose = 1
• C = concentration (mol/L).
Con’t…
• Two solutions that have the same calculated osmolarity
are isosmotic.
• If two solutions have different calculated osmolarities,
the solution with the higher osmolarity is hyperosmotic
and the solution with the lower osmolarity is
hyposmotic.
• Example
What is the osmolarity of a 1 M NaCl solution?
Osmolarity = g X C
= 2 osm/mol X 1 M
= 2 osra/L
Fluid movement between compartment
• Fluid exerts a force (pressure) against the vessels wall; this
causes movement of fluid between compartments.
• Two forces (called Starling Forces) determine this

movement.
• We have:
– The hydrostatic pressure of blood: is the pressure exerted by
blood against the walls of the blood vessels by the pumping
action of the heart.
– The colloid osmotic pressure: is a constant the pressure primarily

produced by circulating albumin in the blood vessels.
• Hydrostatic pressure (also known as capillary blood

pressure) is higher than the opposing colloid osmotic
pressure in blood at the arteriolar end of the capillary.
• This pressure (CHP) forces plasma and nutrients out of

the capillaries and into surrounding tissues.
• The colloid osmotic pressure (BCOP) maintains fluid in

the blood vessels.
• Thus, fluid and the cellular wastes in tissues enter the

capillaries at the venule end, where the hydrostatic
pressure is less than the osmotic pressure in the
vessel.
• These variation of pressure in the blood vessels

allows some phenomena: Filtration and Reabsorption
• Filtration is the process by which CHP squeezes fluid

from the plasma in the blood to the IF surrounding the
tissue cells.
• Net filtration occurs near the arterial end of the
capillary since capillary hydrostatic pressure (35 mmHg)
is greater than blood colloidal osmotic pressure (25
mmHg).
• Reabsorption is the process by which fluid re-enters

capillary when BCOP is greater than CHP.
• Net reabsorption occurs near the venous end of the

capillary since BCOP (25 mmHg) is greater than CHP
(18 mmHg).
• The surplus fluid in the interstitial space that is not

returned directly back to the capillaries is drained from
tissues by the lymphatic system, and then re-enters the
vascular system at the subclavian veins
• Application
• HP is especially important in governing the movement

of water in the nephrons of the kidneys to ensure
proper filtering of the blood to form urine.
• As HP in the kidneys increases, the amount of water

leaving the capillaries also increases, and more urine
filtrate is formed.
• Application cont.
• If HP in the kidneys drops too low, as can happen in

dehydration, the functions of the kidneys will be
impaired, and less nitrogenous wastes will be
removed from the bloodstream.
• Extreme dehydration can result in kidney failure.

• Fluid also moves between compartments along an

osmotic gradient (Osmosis).
• For example, if you are sweating, you will lose water
through your skin.
• Sweating depletes your tissues of water and increases
the solute concentration in those tissues. As this
happens, water diffuses from your blood into sweat
glands and surrounding skin tissues that have become
dehydrated because of the osmotic gradient.
Fluid movement between compartments
• Additionally, as water leaves the blood, it is replaced by

the water in other tissues throughout your body that
are not dehydrated.
• If this continues, dehydration spreads throughout the
body.
• When a dehydrated person drinks water and rehydrates,
the water is redistributed by the same gradient, but in
the opposite direction, replenishing water in all of the
tissues.
END

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PHYSIOLOGY COURSE

DR. VELU M. RACHEL

• ICF: 2/3 of TBW

• ECF: 1/3 of TBW

 Electrolytes – charged particles

2. Determine the final steady state concentration (C) of

3. Volume of distribution (Vd) of the indicator =

100 mg of sucrose is injected into a 70 kg man. The

 Amount of sucrose injected = 100 mg

 Cannot be measured; it is calculated (estimated)..

• How would you measure ICF volume?

 Cannot be measured; it is calculated (estimated)..

• Relationship between blood volume and plasma

• Volume of cells: packed cell volume (PCV)

In a healthy 70 kg adult male, plasma volume

• Lean body mass (LBM)

 LBM is the fat free mass.

• Movement of solutes from an area of higher concentration to

• It is a transport whereby the molecules move down a

• Characteristics of facilitated diffusion

• Competition: structurally related solutes compete for

• Example of facilitated diffusion

 Glucose transport in muscle and adipose cells is

• Characteristics of primary active transport

 occurs against an electrochemical gradient ("uphill").

• Examples of primary active transport

 Na+,K+-ATPase (or Na+-K+ pump) in cell membranes

 Energy is provided from the terminal phosphate

H+,K+-ATPase (or proton pump) in gastric

Examples are Na+-glucose cotransport in the small

 If two solutions separated by a semipermeable

 Water flows from the hypotonic to the hypertonic

• Two forces (called Starling Forces) determine this

– The colloid osmotic pressure: is a constant the pressure primarily

• Hydrostatic pressure (also known as capillary blood

• This pressure (CHP) forces plasma and nutrients out of

• The colloid osmotic pressure (BCOP) maintains fluid in

• Thus, fluid and the cellular wastes in tissues enter the

• These variation of pressure in the blood vessels

• Filtration is the process by which CHP squeezes fluid

• Reabsorption is the process by which fluid re-enters

• Net reabsorption occurs near the venous end of the

• The surplus fluid in the interstitial space that is not

• HP is especially important in governing the movement

• As HP in the kidneys increases, the amount of water

• If HP in the kidneys drops too low, as can happen in

• Extreme dehydration can result in kidney failure.

• Fluid also moves between compartments along an

• Additionally, as water leaves the blood, it is replaced by

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