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65 Cards in this Set
- Front
- Back
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what is one of the most closely guarded parameters in the body
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pH
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pH is maintained around what #
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7.40
may vary by +/- 0.04 units |
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What can happen if the pH gets more acidic or alkaline than the normal range
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nerve cells wont fire
muscles cells wont contract brain cells malfunction |
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what is one of the major waste products in the body that must be eliminated each day to maintain normal pH
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CO2
CO2 + water= carbonic acid= H + bicarb |
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How much CO2 does the normal person produce daily
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20 moles/day
equivalent to 1 L HCl/day that the body must neutralize and eliminate |
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How much excess acid is in the normal daily diet that the body must neutralize and excrete
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50 mEq/day
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What is the major buffering system in the body for CO2
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hemoglobin buffering system in the blood
95% |
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What is the first line of defense against changes in pH in the blood and ECF
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buffers
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What are the primary buffers in the plasma and ECF
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Bicarbonate
phosphate Protein buffer systems |
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How do we get rid of most of the acids in the body
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blowing it off into respiratory gases
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What happens when the CO2 enters the blood and reacts with water
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catalyzed by CA (enzyme) to form carbonic acid
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Once CO2 is carbonic acid in the blood what does it react with and what does it form
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reacts with potassium hgb to form acidic hgb and K bicarb.
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What does K bicarb dissociated to and what happens next
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bicarb ions - which diffuses out of the cell as the conc. inside cell increases and is carried in the plasma as sodium bicarb
K ions |
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what happens to the Cl in the Cl shift
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chloride that was NaCl comes back into the cell as KCl
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what is the process of keeping the bicarb very low in the cell and exchanging it for chloride
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the chloride shift of the red cell
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what happens to the red cell once it gets to the lungs
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the chloride comes out and reacts with Na bicarb to get NaCl and bicarb ion. The bicarb goes into the cell to form K bicarb.
the whole process is reveresed and CO2 is released into the atmosphere |
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What takes care of the small amt of CO2 left in the plasma and the other excess acid taken in by diet
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3 buffering pairs
bicarb phosphate protein |
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which of the 3 buffering pairs is present in the highest quantity
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bicarb 27 mEq/L
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a buffering pair is made of what
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salt of a weak acid
and a weak acid |
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What is the normal ratio of base to acid of the buffering pairs
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20:1 in a pH of 7.40
same in all buffering pairs |
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What is the bicarb controlled by
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the kidneys
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what is the CO2 controlled by
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lungs
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What formula determines the pH of body fluids at any given time
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henderson hasselbach
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Why do we normally use the bicarb system to calculated acid base balance
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1.sodium bicarb and carbonic acid can be quickly adjusted by the body
2.bicarb is present in higher quantities 3.values can be quickly determined by lab |
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What is a quantitative expression of the chloride shift
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the hgb buffer slope
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Why does bicarb increase as PCO2 increases on the hgb buffer slope
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because more CO2 is entering the red cell and more bicarb comes out of the cell
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What happens to the slope of the hgb buffer slope if the hgb is decreased
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the slope of the line decreases
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what ph range compatible with life
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7.00- 7.80
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what state occurs with primary retention of CO2
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respiratory acidosis
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some causes of respiratory acidosis
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pneumonia
emphysema fibrotic disease drug overdose |
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what happens to the ratio of base:acid in resp acidosis
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decreases because there is more acid
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how do the kidneys compensate in resp acidosis
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start to retain or make new bicarb to increase the ratio towards normal
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what happens in the recovery phase of resp acidosis
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CO2 is gradually blown off and bicarb levels decrease to normal via kidneys
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where do pts with chronic lung disease stay
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in compensated state of resp acidosis
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what has pH decreased
pCO2 increased and bicarb increased |
uncomp resp acidosis
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what has pH normal, Increased CO2, and double increased bicarb
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comp resp acidosis
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what state is rate of CO2 eliminated exceeds CO2 production
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respiratory alkalosis
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causes of resp alkalosis
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hyperventilation
hypoxic reflex drive salicylate intoxication anxiety |
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what happens to the ratio in resp alkalosis
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the ratio increases
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how does the body compensate in resp alkalosis
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kidney excretes bicarb
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what happens in the recovery phase of resp alkalosis
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CO2 is retained by the lungs and bicarb levels increase to norm via the kidneys
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what state is increased pH, decreased CO2 and Bicarb
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uncomp resp alkalosis
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what state is normal pH decreased CO2 and double decreased bicarb
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comp resp alkalosis
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what can anxiety induced hyperventilation caused
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carpopedal spasms because the Ca binds to plasma proteins in an alkaline pH because they become neg charge making AP easier
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what state is retention or production of strong organic acids in greater amounts than what the body can get rid of
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metabolic acidosis
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what are some causes of metabolic acidosis
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diabetic ketoacidosis
ingestion of acid (antifreeze) ammonium chloride tablets methanol pancreatic fistula |
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what happens in met. acidosis
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as strong acids accumulate the bicarb is consumed buffering them and bicarb levels drop. resp system keeps CO2 constant
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what is the ratio in met acidosis
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decreased ratio
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how does the resp system compensate in met acidosis
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blowing off more CO2 to match the decrease bicarb by decreasing rate or depth of resp
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What happens in the recovery phase of met. acidosis
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excess production or ingestion of acids is reduced and kidneys retain bicarb to slowly return levels to normal
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what state is ph decreased, pCO2 normal, bicarb decreased
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uncomp met acidosis
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what state is normal ph, decreased CO2 and double decreased bicarb
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comp met acidosis
and resp alkalosis |
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what state is level of sodium bicarb has exceeded what can be excreted by the body
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met alkalosis
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causes of met alkalosis
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excessive ingestion of sodium bicarb
loss of acid inappropriate retention of bicarb by the kidney antacid overuse |
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what is the ratio in met alkalosis
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increased
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how does the resp system compensate in met alkalosis
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by decreasing ventilation
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what happens in the recovery phase of met alkalosis
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bicarb is excreted by the kidney and PCO2 is decreased to normal via resp system
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what state is increased ph, normal CO2, and incresed bicarb
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uncomp met alkalosis
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what state is normal ph increased pCO2 and double increased bicarb
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comp met alkalosis and resp acidosis
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What is delta base
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how much excess or deficit a person is in bicarb (base)
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where should the pt normally be on excess or deficit base
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on the slope or +/- 2.5
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positive delta base usually occurs in
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resp acidosis
met alkalosis |
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negative delta base usually occurs in
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met acidosis
resp alkalosis |
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delta base is used to determin compensation in what states
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resp acidosis or alkalosis
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what buffers the acid in the lumen of the kidney
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phosphate or ammonia buffer
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