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Acid base lecture (shortened)
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Acid base lecture (shortened)

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  • 1. Chapter 24 Acid-Base Balance Anatomy & Physiology: The Unity of Form and Function , 5th Edition. By, Kenneth S. Saladin.
  • 2. Acid-Base Balance
    • Normal blood pH = 7.35-7.45
      • Arterial blood pH = 7.4
      • Venous blood pH = 7.35
    • Alkalosis : arterial blood pH rises above 7.45
    • Acidosis: arterial pH drops below 7.35 (physiological acidosis)
  • 3. Hydrogen Ion Regulation
    • Concentration of hydrogen ions is regulated sequentially by:
      • Chemical buffer systems – act within seconds
        • e.g. Bicarbonate Buffer System (H 2 CO 3 /HCO 3 - )
        • e.g. Proteins (hemoglobin)
      • The respiratory system – acts within 1-3 minutes
      • The renal (urinary) system – require hours to days to affect pH changes
  • 4. Acid-Base Regulation by Respiratory System:
    • As more CO 2 accumulates, so do H + ions, resulting in Acidosis.
    • To Compensate for Acidosis (  pH,  H + ): respiratory rate and depth are increased to eliminate more CO 2 and lower H + ions and raise blood pH.
    • To Compensate for Alkalosis (  pH,  H + ): respiratory rate and depth are decreased to accumulate more CO 2 and raise H + ions and lower blood pH.
      • CO 2 + H 2 O  H 2 CO 3  H + + HCO 3 ¯
  • 5. Acid-Base Regulation by the Renal System:
    • Chemical buffers can tie up excess acids or bases, but they cannot eliminate them from the body
    • The lungs can eliminate carbonic acid by eliminating carbon dioxide
    • Only the kidneys can rid the body of hydrogen ions as well as metabolic acids (phosphoric, uric, and lactic acids and ketones).
    • The ultimate acid-base regulatory organs are the kidneys
  • 6. Acid-Base Regulation by the Renal System:
    • To Compensate for Acidosis (  pH,  H + ): the kidneys reabsorb more HCO 3 - ions and secrete more H + ions to lower H + and increase pH.
    • To Compensate for Alkalosis (  pH,  H + ): the kidneys reabsorb more H + ions and secrete more HCO 3 - ions to increase H + and lower pH.
    Renal Compensation for Acidosis
  • 7. Respiratory Acidosis:
    • Blood pH is below 7.35
    • Due to decreased CO 2 elimination (hypoventilation)
    • Occurs when a person breathes shallowly , or gas exchange is hampered by diseases such as pneumonia, cystic fibrosis, or emphysema
    • Can be due to depressed respiration due to narcotic or barbiturate overdose
  • 8. Respiratory Alkalosis:
    • Blood pH is above 7.45
    • Due to increased CO 2 elimination (hyperventilation)
    • Occurs when a person breathes quickly and/or shallowly, usually due to pain, anxiety, or asthma .
  • 9. Metabolic Acidosis:
    • Blood pH is below 7.35
    • Due to increased bicarbonate loss or increased acid accumulation.
      • Typical causes of acid accumulation are ingestion of excess alcohol , excess asprin intake, excessive exercise , untreated diabetes mellitis , and starvation diets.
      • Typical causes of bicarbonate loss are excessive diarrhea and vomiting from the lower GI .
  • 10. Metabolic Alkalosis:
    • Blood pH is above 7.45
    • Due to increased reabsorption of bicarbonate ion or increased hydrogen ion loss .
        • Typical causes of bicarbonate ion reabsorption include excessive antacid ingestion and constipation .
        • Typical causes of hydrogen ion loss include excessive vomiting from upper GI (stomach); aldosterone hypersecretion .
  • 11. What is the effect of Acidosis / Alkalosis?
    • Acidosis : CNS depressed (muscle and nerve cells are hyperpolarized)  confusion, coma, death.
    • Alkalosis : CNS overstimulation (muscle and nerve cells are easily depolarized due to xs K + )  muscle tetany, nervousness, convulsions, respiratory paralysis, death.

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