Calcium

Normal calcium level

9 11 mg/dl
9.4 mg/dl or 2.4 mmol /L

Calcium important
Contraction of skeletal muscles
Contraction of smooth muscles
Cardiac muscle contraction
Transmission of nervous impulses
Clotting of blood
Secretory activity of the glands

Calcium
Excitable tissues are very sensitive to changed
calcium level

Hypercalcemia depression and sluggishness of

nervous tissue
Hypocalcemia increased excitability of nervous
tissue

99 % calcium in the bones

Reservoir and store (buffer calcium level in ECF)
0.1 % in the extra cellular fluid
1 % in the intracellular fluid

Phosphate
85 % stored in bones
14-15 % in the ICF
Less than 1 % in ECF

Three
forms
of
calcium
Bound to plasma proteins
41 %
Nondiffusible
Non ionizable

Bound to citrates, oxalates, phosphates etc

9 %
Diffusible
Nonionizable

50 % ionic calcium
Ionic
Diffusible
Functionally the most important calcium

Phosphate
HPO
1.05mmol/L
4

--

H2PO4-

0.26 mmol/L

pH H2PO4 pH HPO4
Phosphate level expressed as total quantity of

phosphorus in mg/dl
Normal levels
Children

4-5 mg/dl
Adults 3-4 mg/dl

Hypocalcemia
and
tetany
Hypocalcemia excitability of nervous tissue
neuronal cell membrane permeability to Na +
Easy initiation of depolarization and action

potential
50 % reduction in Calcium level spontaneous
nervous impulses propagation to skeletal
muscles spontaneous tetanic contraction of the
skeletal muscles Tetany

Tetany
Initially spontaneous tetanic contraction of
the muscles of hand and forearm i.e.
carpopedal spasm develops
Tetany develops at calcium level of about 6
mg/dl
Lethal at 4 mg/dl level
Latent tetany at level between 6 and 8
Minor stimulus causes nervous discharge

Hypercalcemia
Level 12 mg/dl
Depression of nervous system
Sluggish reflexes
Decreased QT interval of heart
Lack of appetite
Constipation

Level 17 mg/dl
Precipitation of calcium in all the tissues

Calcium absorption and

excretion
Daily intake 1000 mg
Secretion in GIT secretions 250 mg
Absorption 350 mg
Excretion in the feces 900 mg
Net absorption 100 mg
Excretion in urine 100 mg
Ca ++ like all other bivalent cations are

very poly absorbed

Its absorption requires activated vitamin D

Renal excretion of
Calcium
Daily excretion
100 mg
99 % of filtered calcium absorbed
PCT. LH, DCT and CD
Daily filtration 9980 mg
Daily absorption
Hypocalcemia
Hypercalcemia

9880 mg
No excretion
proportionate excretion

Renal excretion of
Phosphate
Threshold substance
No excretion if level is below 1 mmol/L
Higher level proportionate excretion