This lecture discusses acid-base balance and covers several key points:
1) The human body maintains tight control over blood pH between 7.35-7.45 through buffer systems and respiratory/renal compensation.
2) The main buffer systems are bicarbonate, phosphate, and proteins which help absorb excess hydrogen ions.
3) Respiratory and renal systems also help through changing ventilation or excretion to remove/retain bicarbonate or hydrogen ions.
4) Imbalances can cause metabolic or respiratory acidosis/alkalosis depending on the primary driver of pH changes.
ACID & BASE
Acid is a molecule or an ion that can function as a proton donor. Base is the molecule or an ion that can function as a proton acceptor.
pH
pH is negative log of H+ ion concentration.
Normal pH of arterial blood is 7.4 and that of venous blood and
4. Renal Block-Acid Base Balance-for Medical students.pptxRajendra Dev Bhatt
Acid–Base balance (also known as pH HOMEOSTASIS ) : one of the essential functions of the body, it is concerned with the precise regulation of free (unbound) hydrogen ion concentration in body fluids.
ACID & BASE
Acid is a molecule or an ion that can function as a proton donor. Base is the molecule or an ion that can function as a proton acceptor.
pH
pH is negative log of H+ ion concentration.
Normal pH of arterial blood is 7.4 and that of venous blood and
4. Renal Block-Acid Base Balance-for Medical students.pptxRajendra Dev Bhatt
Acid–Base balance (also known as pH HOMEOSTASIS ) : one of the essential functions of the body, it is concerned with the precise regulation of free (unbound) hydrogen ion concentration in body fluids.
This presentation is clarifying how blood changes its medium from normal or neutral to either acidic or to alkaline medium depending on variable metabolic or respiratory circumstances.
عرض الكل
An acid is any hydrogen-containing substance that is capable of donating a proton (hydrogen ion) to another substance. A base is a molecule or ion able to accept a hydrogen ion from an acid. Acidic
A review of ACID AND BASE: What's Acid and Base? what are the normal range and how the body can regulate? finally what will happen if there is error in maintaining acid base balance system
Buffer-It is a solution of weak acid/base & it’s corresponding salt which resists a change in pH when a small amount of acid or base is added to it.
By buffering mechanism, a strong acid (or base) is replaced by a weaker one.
pH, quantitative measure of the acidity or basicity of aqueous or other liquid solutions
Blood buffer- 1. A chemical buffer is a system of one or two molecules that acts to resist changes in pH by binding H+ when the pH drops, or releasing H* when the pH rises.
2. The bicarbonate buffer system is the main buffer of the extracellular fluid, and consists of carbonic acid and its salt, sodium bicarbonate.
H2CO3+NaHCO3
a. When a strong acid is added to the solution, carbonic acid is mostly unchanged, but bicarbonate ions of the salt bind excess H+, forming more carbonic acid.
b. When a strong base is added to solution, the sodium bicarbonate remains relatively unaffected, but carbonic acid dissociates further, donating more H+ to bind the excess hydroxide.
c. Bicarbonate concentration of the extracellular fluid is closely regulated by the kidneys, and plasma bicarbonate concentrations are controlled by the respiratory system.
3. The phosphate buffer system operates in the urine and intracellular fluid similar to the bicarbonate buffer system: sodium dihydrogen phosphate (NaH,PO) is its weak acid, and monohydrogen phosphate (Na,HPO,) is its weak base.
4. The protein buffer system consists of organic acids containing carboxyl groups that dissociate to release H+ when the pH begins to rise, or bind excess H+ when the pH declines.
Respiratory regulation of PH-The lungs have the ability to exhale CO, which is the substrate for H2CO3 and HCO3.
Thus, by regulating the rate of pulmonary ventilation through chemoreceptors, PCO, is regulated by lungs.
So, a high PCO, leads to decrease in pH and low PCO, increase in pH.
High PCO, stimulates ventilation which results in removal of CO₂ by expiration.
Renal Mechanisms of Acid-Base Balance- 1. Only the kidneys can rid the body of acids generated by cellular metabolism, while also regulating blood levels of alkaline substances and renewing chemical buffer components.
a. Bicarbonate ions can be conserved from filtrate when depleted, and their reabsorption is dependent on H+ secretion
Conservation of Bicarbonate lons
b. Type A intercalated cells of the renal tubules can synthesize new bicarbonate ions while excreting more hydrogen ions.
Synthesis of New Bicarbonate/Excretion of BufferedH*
c. Ammonums are weak acids that are excreted and urine, replenishing the alkaline reserve of the blood.
NH4+, Excretion
d. When the body is in alkalosis, type B intercalated cells excrete bicarbonate, and reclaim hydrogen ions.
Acid base disorder-1. When arterial blood pH rises above 7.45, the body is in alkalosis; when arterial pH falls below 7.35, the body is in acidosis.
2. Most hydrogen ions originate as metabolic by-products, although they can also enter the body via ingested foods.
Metabolic acidosis:
The body's balance between acidity and alkalinity is referred to as acid-base balance. The blood's acid-base balance is precisely controlled because even a minor deviation from the normal range can severely affect many organs. The body uses different mechanisms to control the blood's acid-base balance.
essential details on maintenance of extracellular fluid pH, Especially Blood for normal physiological function of the body and condition associated wit acid base imbalance
This presentation is clarifying how blood changes its medium from normal or neutral to either acidic or to alkaline medium depending on variable metabolic or respiratory circumstances.
عرض الكل
An acid is any hydrogen-containing substance that is capable of donating a proton (hydrogen ion) to another substance. A base is a molecule or ion able to accept a hydrogen ion from an acid. Acidic
A review of ACID AND BASE: What's Acid and Base? what are the normal range and how the body can regulate? finally what will happen if there is error in maintaining acid base balance system
Buffer-It is a solution of weak acid/base & it’s corresponding salt which resists a change in pH when a small amount of acid or base is added to it.
By buffering mechanism, a strong acid (or base) is replaced by a weaker one.
pH, quantitative measure of the acidity or basicity of aqueous or other liquid solutions
Blood buffer- 1. A chemical buffer is a system of one or two molecules that acts to resist changes in pH by binding H+ when the pH drops, or releasing H* when the pH rises.
2. The bicarbonate buffer system is the main buffer of the extracellular fluid, and consists of carbonic acid and its salt, sodium bicarbonate.
H2CO3+NaHCO3
a. When a strong acid is added to the solution, carbonic acid is mostly unchanged, but bicarbonate ions of the salt bind excess H+, forming more carbonic acid.
b. When a strong base is added to solution, the sodium bicarbonate remains relatively unaffected, but carbonic acid dissociates further, donating more H+ to bind the excess hydroxide.
c. Bicarbonate concentration of the extracellular fluid is closely regulated by the kidneys, and plasma bicarbonate concentrations are controlled by the respiratory system.
3. The phosphate buffer system operates in the urine and intracellular fluid similar to the bicarbonate buffer system: sodium dihydrogen phosphate (NaH,PO) is its weak acid, and monohydrogen phosphate (Na,HPO,) is its weak base.
4. The protein buffer system consists of organic acids containing carboxyl groups that dissociate to release H+ when the pH begins to rise, or bind excess H+ when the pH declines.
Respiratory regulation of PH-The lungs have the ability to exhale CO, which is the substrate for H2CO3 and HCO3.
Thus, by regulating the rate of pulmonary ventilation through chemoreceptors, PCO, is regulated by lungs.
So, a high PCO, leads to decrease in pH and low PCO, increase in pH.
High PCO, stimulates ventilation which results in removal of CO₂ by expiration.
Renal Mechanisms of Acid-Base Balance- 1. Only the kidneys can rid the body of acids generated by cellular metabolism, while also regulating blood levels of alkaline substances and renewing chemical buffer components.
a. Bicarbonate ions can be conserved from filtrate when depleted, and their reabsorption is dependent on H+ secretion
Conservation of Bicarbonate lons
b. Type A intercalated cells of the renal tubules can synthesize new bicarbonate ions while excreting more hydrogen ions.
Synthesis of New Bicarbonate/Excretion of BufferedH*
c. Ammonums are weak acids that are excreted and urine, replenishing the alkaline reserve of the blood.
NH4+, Excretion
d. When the body is in alkalosis, type B intercalated cells excrete bicarbonate, and reclaim hydrogen ions.
Acid base disorder-1. When arterial blood pH rises above 7.45, the body is in alkalosis; when arterial pH falls below 7.35, the body is in acidosis.
2. Most hydrogen ions originate as metabolic by-products, although they can also enter the body via ingested foods.
Metabolic acidosis:
The body's balance between acidity and alkalinity is referred to as acid-base balance. The blood's acid-base balance is precisely controlled because even a minor deviation from the normal range can severely affect many organs. The body uses different mechanisms to control the blood's acid-base balance.
essential details on maintenance of extracellular fluid pH, Especially Blood for normal physiological function of the body and condition associated wit acid base imbalance
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Course outlines
• Buffer system
• Metabolic acidosis and alkalosis
• Respiratory acidosis and alkalosis
• Blood gases
Monday, 20 February 2023 2
3. Acid and base
Monday, 20 February 2023 3
Acids are H+ donors.
• Bases are H+ acceptors or give up OH- in solution.
• Acids and bases can be:
• Strong – dissociate completely in solution
• Ex: strong acids such as HCl
strong Bases as NaOH
• Weak – dissociate only partially in solution
• Lactic acid, carbonic acid
4. PH of the human body
• The body's balance between acidity and alkalinity is
referred to as acid-base balance or acid-base homeostasis.
• Homeostasis: the body's ability to physiologically regulate
its inner environment to ensure its stability in response to
fluctuations in the outside environment.
• Body PH ranged from 7.35-7.45, any change in blood PH is
critical because it affects protein and enzyme stability and
function.
Monday, 20 February 2023 4
6. Acid production in the body
• Human body produces acids more than bases.
• Acids are taken in with foods.
• Also, acids are produced by the metabolism of lipids and
proteins.
• Cellular metabolism produces CO2.
CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3
-
Monday, 20 February 2023 6
7. Body control against small change in PH
Monday, 20 February 2023 7
The body regulates its PH through two systems:
A) Chemical buffer systems:
1. Bicarbonate buffer system.
2. Phosphate buffer system.
3. Protein buffer system.
B) Physiological buffer systems:
1. Respiratory mechanism.
2. Renal (Kidney excretion) mechanism.
• Body response to acid-base imbalance is called compensation.
• It may be complete if brought back within normal limits, while
If the range is still outside normal it will be partial.
8. Bicarbonate buffer
• It is the main extracellular buffer and plays an important
role in maintaining the pH homeostasis of the blood.
• Carbonic acid (H2CO3, weak acid) dissociates reversibly and
releases bicarbonate ions (HCO3
–, , weak base) and protons
(H+) as follows:
1. Response to an increase in pH (H+ proton donor)
H2CO3 -> HCO3– + H+
2. Response to a decrease in pH (H+ proton acceptor)
H2CO3 <- HCO3– + H+
3. Under normal conditions, the ratio between the HCO3–
and H2CO3 in the blood is 20:1 (HCO3– : H2CO3)
Monday, 20 February 2023 8
10. Phosphate Buffer
• It is the major intracellular buffer.
• It consists of dihydrogen phosphate ions (H2PO4
-) as
hydrogen-ion donors (acid) and hydrogen phosphate ions
(HPO4
2-) as hydrogen-ion acceptors (base).
• These two ions are in equilibrium with each other as
indicated by the chemical equation below:
Monday, 20 February 2023 10
11. Protein buffer
• It includes hemoglobin, work in blood, and intracellular fluid
(ISF) (i.e. plasma proteins).
• Carboxyl group gives up H+
• Amino Group accepts H+
• Side chains that can buffer H+ are present on 27 amino acids.
Monday, 20 February 2023 11
13. Respiratory buffer mechanism
Monday, 20 February 2023 13
• Respiratory system does not respond as fast as the chemical
buffer systems.
• Powerful, but only works with volatile acids.
• Doesn’t affect fixed acids like lactic acid.
• CO2 produced by the tissue cells enters the red blood cells and
is converted to HCO3
– ions as follows:
CO2 + H2O↔ H2CO3 ↔ H+ + HCO3
-
• Body pH can be adjusted by changing the rate and depth of
breathing.
15. Renal buffer mechanism
• It can eliminate large amounts of acid and also excrete base.
• Can conserve and produce bicarb ions.
• Most effective regulator of pH
• If kidneys fail, pH balance fails.
Monday, 20 February 2023 15
17. Rate of PH correction
Monday, 20 February 2023 17
18. Metabolic acidosis
• It occurs due to a decrease blood bicarbonate level, either due to
increased H production or depletion of bicarbonate.
• Usually, associated with hyperkalemia due to sodium
reabsorption with excess H excretion.
• Causes of increase in H ions production:
1- Diabetic ketoacidosis.
2- Lactic acidosis.
3- Poisoning
• Causes of bicarbonate depletion:
1- Loss of bicarbonate through GIT as diarrhea.
2- Renal tubular acidosis.
• Compensatory mechanism: the respiratory mechanism through
hyperventilation
Monday, 20 February 2023 18
20. Metabolic alkalosis
• It occurs due to an increased bicarbonate level.
• It is less serious than metabolic acidosis because bicarbonate
production is slower than H production.
• Usually, associated with hypokalemia due to increased sodium
reabsorption with potassium excretion in the renal tubule.
• Causes:
1. GIT loss of H through vomiting or use of antacids.
2. Renal loss of H as in diuretic therapy.
3. Mineralocorticoid excess.
4. Cashing`s syndrome.
Compensatory mechanism: the respiratory mechanism through
hypoventilation
Monday, 20 February 2023 20
22. Respiratory acidosis
• It occurs due to the accumulation of PCO2 in the blood.
• Causes:
1. Chronic lung diseases.
2. Bronchial obstruction.
3. CNS depression.
• Compensatory mechanism: increase bicarbonate
reabsorption in the kidney.
Monday, 20 February 2023 22
24. Respiratory alkalosis
• It occurs due to a decrease in PCO2 in the blood.
• Causes:
1. Hypoxia.
2. CNS disorders.
3. Pregnancy.
• Compensatory mechanism: increase bicarbonate excretion
through the kidney.
Monday, 20 February 2023 24
27. Estimation of blood PH and gases
• Measurement of blood gases
requires the collection of
arterial blood in a specific
syringe containing heparin.
• Put in ice immediately and no
need for fasting.
• Blood gases analyzer used for
estimation of partial pressure
of oxygen (PO2), partial
pressure of carbon dioxide
(PCO2), and PH.
• Then both the anion gap and
bicarbonate were calculated by
the machine.
Monday, 20 February 2023 27