[Music]
students are always asking me doc raj
i'm having a hard time keeping straight
and organized
the feedback mechanisms for water and
sodium pathophysiology
well this is probably the most important
section here
to go through as far as laying down the
foundation
of figuring out the two compartments of
ecf and icf
what kind of hormones will be involved
and a little bit of a clinical tag that
i'll be
putting in for you along with the
physiology
so that you clearly know how to move on
to
in the next lecture series of isotonic
hypotonic and hypertonic fluid disorders
let us now begin the basic definitions
well it comes down to the kidneys
doesn't it really
in terms of being able to properly
control
and regulate your fluids up to
neutrality
of body fluid compartments become
important so back in basic physio
physiology when you're dealing with
action potentials and all
and you're dealing with electro
neutrality whenever you have a positive
ion
such as sodium of course being the most
infamous of them all
then along with it must be a chloride so
that you can have proper up to
neutrality
as an example composition
between icf and ecf is basically what
this line is saying
for example when you talk about total
body water you should know that majority
of your
total body water is where
good icf two-thirds isn't it
simple simple things that you knew and
you know
that you keep repeating so that it
becomes part of your
unconscious reflex ecf
would you tell me as to what is the most
important component clinically
for us to measure in your ecf
and you're telling me the vascular
compartment isn't it
the plasma compartment the effective
circulating volume compartment
all of this is the same name they're all
synonyms
for your plasma compartment being a
measly
one-fourth now clinically
most clinicians will use it as being
one-third not saying that's wrong
but at this point i'd highly recommend
that you think of the plasma compartment
being
one-fourth and the interstitial being
three-fourths
body fluid compartments we'll take a
look at this when
we're dealing with the particular box
known as a daryl janet box which is
it's been around for a long time and
there's a reason for that because
it probably would be one of the most
effective measures for you to clinically
be able to
see conceptually in your head the
shifting of fluids
between your ecf and icf and there's a
particular chronological order
that you should already know but we will
then reinforce through clinical examples
regulation of water balance and
osmolarity will become the topic
initially here before we get into
isotonic fluid disorders
at some point we have to hit certain iv
fluid definitions
for example huh that patient that was
sweating excessively coming in
having low blood pressure what are you
going to do with that patient
without even blinking give that patient
iv
fluids of what type good normal saline
0.9 percent so this we must talk about
and give you definitions of what saline
is what is it
the electro neutrality component of
sodium
cation anion chloride
after neutrality you see how everything
is coming together
and then finally regulation of volume
remember
the osmolarity is an extremely sensitive
indicator
in our body isn't not osmolarity is
extremely monitored closely
and as soon as there's any little change
in osmolarity
then it's the adh that comes in that's
osmolarity and at some point we'll have
to switch over to volume
where it may then take priority
especially if you're losing
volume and excess
[Music]
you