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Harrison's Principles of Internal Medicine, 18e
| Part 2. Cardinal Manifestations and Presentation of Diseases > Section 7. Alterations in Renal and Urinary Tract Function > |
Chapter 45. Fluid and Electrolyte Disturbances
Sections: Sodium and Water, Sodium Disorders, Potassium Disorders, Further Readings.
Topics Discussed: disorder of fluid or electrolyte; electrolyte; fluids, electrolytes, and acid-base balance.
Excerpt:"Water is the most abundant constituent in the body, accounting for  50% of body weight in women and 60% in men. Total body water is distributed in two major compartments: 55–75% is intracellular [intracellular fluid (ICF)], and 25–45% is extracellular [extracellular fluid (ECF)]. ECF is subdivided into intravascular (plasma water) and extravascular (interstitial) spaces in a ratio of 1:3. Fluid movement between the intravascular and interstitial spaces occurs across the capillary wall and is determined by Starling forces, i.e., capillary hydraulic pressure and colloid osmotic pressure. The transcapillary hydraulic pressure gradient exceeds the corresponding oncotic pressure gradient, thus favoring the movement of plasma ultrafiltrate into the extravascular space. The return of fluid into the intravascular compartment occurs via lymphatic flow.Vasopressin secretion, water ingestion, and renal water transport collaborate to maintain human body fluid osmolality between 280 and 295 mosmol/kg. Vasopressin (AVP) is synthesized in magnocellular neurons within the hypothalamus; the distal axons of those neurons project to the posterior pituitary or neurohypophysis, from which AVP is released into the circulation. A network..."
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