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acid base and pH regulation Flashcards

1
Q

what is the normal level of plasma pH

A

7.4

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2
Q

what does acid base balance affect

A
  • enzyme function
  • cellular function
  • CNS and CVS function
  • oxygen transport
  • electrolyte balance
  • acid waste elimination
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3
Q

how is enzyme function affected by acid base

A
  • catalyst for biochemical
  • pH changes denatures and dysfunction hindering metabolism
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4
Q

how is cellular function affected by acid base

A
  • needed for cell integrity and function
  • have pH dependent transport mechanisms
  • ph change hinder cell function and cause death
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5
Q

how is CNS and CVS function affected by acid base

A
  • influences contractility of heart and response of blood vessels
  • acidosis and alkalosis cause neuronal dysfunction
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6
Q

how is oxygen transport affected by acid base

A
  • affect haemoglobin affinity
  • alters O2 carrying capacity
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7
Q

how is electrolyte balance affected by acid base

A
  • affects regulation of electrolytes
  • concentration needed for nerve conduction, muscle function and fluid balance
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8
Q

how is acid waste elimination affected by acid base

A
  • metabolism produces acid waste
  • elimination through lungs and kidneys prevents accumulation
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9
Q

what is pH

A

measure of how basic or acidic a solution is

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10
Q

what is acid

A

substance that donates protons

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11
Q

what is a base

A

substance that accepts protons

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12
Q

what is a buffer

A

solution which reduces the affect of adding or removing H+

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13
Q

what is HCO3-

A

bicarbonate acts as a base accepts excess H+ to regulate pH

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14
Q

what does the henderson-hasselbalch equation consider

A
  • changing concentration of CO2 or HCO3 alters the pH
  • increase arterial PCO2 drops arterial pH
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15
Q

what is the henderson -hasselbalch equation

A

pH = 6.1+ log [HCO3}/o.o3 x PCO2

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16
Q

how do changes in CO2, H+ and HCO3 affect each other

A

^ CO2 + H2O <-> H2CO3 <-> HCO3 + ^ H+

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17
Q

affect of decreased PaCO2

A

increases pH

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18
Q

affects of increase PaCo2

A

decreased pH

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19
Q

affects of increase HCO3

A

increased pH

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20
Q

affects of decreased HCO3

A

decrease pH

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21
Q

what is acidosis

A

increase of hydrogen ions and a reduction of bicarbonate

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22
Q

what is alkalosis

A

decrease in hydrogen ion and increase of bicarbonate

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23
Q

what is respiratory acidosis

A
  • CO2 retention from hypoventilation
  • increasing H+
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24
Q

what are causes of respiratory acidosis

A

resp conditions with CO2 retention

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25
Q

what is metabolic acidosis

A

all types of acidosis from excess CO2 in body fluids

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26
Q

what causes metabolic acidosis

A
  • increase acid production
  • loss of bicarbonate
  • decrease acid excretion
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27
Q

what is respiratory alkalosis

A

excessive CO2 lost from the body from hyperventilation

28
Q

what causes respiratory alkalosis

A
  • hypoxia
  • hyperventilation
29
Q

what is metabolic alkalosis

A

reduction in plasma caused by relative deficiency in no carbonic acids

30
Q

what causes metabolic alkalosis

A
  • hydrogen loss
  • excess HCO3 ingestion
31
Q

what are the differentiation values for acidosis

A
  • metabolic = HCO3 <24
  • respiratory = PaCO2 >6
32
Q

what are the differential values for alkalosis

A
  • metabolic = HCO3 >24
  • respiratory = PaCO2 <4.7
33
Q

how can COPD cause mixed metabolic and respiratory acidosis

A
  • hypoxic hypoxia increase lactic acid = decreases HCO3
  • decreased ventilation increase PaCO2 = increases PaCO2
34
Q

what causes H+ gain

A
  • acid production
  • HCO3 loss in stool
  • ingestion of acid
35
Q

what causes H+ loss

A
  • acidic gastric acid fluid in vomiting
  • loss of H+ in urine
36
Q

how is H+ maintained in normal limits

A
  • H+ with blood buffer or intracellular buffer
  • reduction of H2CO3 by CO2 elimination
  • renal elimination of H+
  • H+ moves into cells in exchange for K+
37
Q

how is normal plasma ph maintained

A
  • chemical buffer of the blood cells
  • renal regulation of H+ and HCO3
  • respiratory regulation
38
Q

how does the chemical buffer system work

A
  • reduces affect of adding or removing H+
  • ions are removed from the solution but not eliminated
  • incorporated into a buffer pair
39
Q

how does the bicarbonate buffer system work

A
  • increase or decrease H+
  • cant buffer pH changes cause by its own system
40
Q

how does the haemoglobin buffer work

A

RBCs buffer H+ from metabolically produced CO2

41
Q

how does protein buffer system work

A
  • albumin
  • has both acidic and basic groups that buffer
42
Q

how does the phosphate buffer system work

A
  • intracellular and urinary buffer
  • excess phosphate filtered through the kidneys
43
Q

what is the respiratory regulation of ph

A
  • alters pulmonary ventilation and so alters excretion of H+, generating CO2
44
Q

what is the respiratory regulation when there is an increase in arterial H+

A
  • increase pulmonary ventilation
  • increase CO2 blown off
45
Q

what is the respiratory regulation when there is a decrease in arterial H+

A
  • decreased pulmonary ventilation
  • increased CO2 accumulation
46
Q

what stimulate the peripheral chemoreceptors

A
  • decreased PaO2
  • increased H+
  • increased PaCO2
47
Q

what stimulates the central chemoreceptors

A
  • increase H+
  • increased PaCO2
48
Q

how does renal regulation of pH occur

A
  • removes H+ and adds HCO3 to body fluids
  • ammonia secretion
49
Q

what is the renal regulation when there is an increase in PaCO2

A
  • increased renal reabsorption or generation of HCO3
  • increase in Plasma
  • increase in pH
50
Q

what is the renal regulation when there is a decrease in PaCO2

A
  • increased renal excretion of HCO3
  • decreased plasma
  • decreased pH
51
Q

how is hydrogen secretion increased

A
  • increase secretion into renal tubes so more in urine
  • increase HCO3 reabsorption into the blood
  • decreases pH
52
Q

how is hydrogen secretion decreased

A
  • decrease H+ secretion into renal tubules
  • decrease HCO3 reabsorption into blood
  • increase pH
53
Q

what is the renal compensation in compensatory chronic respiratory acidosis

A
  • decreased urea production and increased glutamate, which becomes ammonia and HCO3
54
Q

what is the renal compensation in compensatory chronic respiratory alkalosis

A
  • increase in activity of type b intercalated cells
  • help to secrete HCO3 into tubule lumens to increase concentration
55
Q

what is the renal response in respiratory acidosis

A
  • increases H+ excretion
  • increases HCO3 reabsorption and regeneration
56
Q

what is the respiratory and renal response in metabolic acidosis

A
  • resps = decrease pH and increase CO2, increase vents
  • renal = increase H+ excretion
57
Q

what is the renal response in respiratory alkalosis

A

increase HCO3 excretion

58
Q

what is the renal and respiratory responses in metabolic alkalosis

A
  • resps = decrease ventilation and increase CO2
  • renal = increase HCO3 excretion
59
Q

what does ROME stand for in ph balance

A

Respiratory
Opposite
Metabolic
Equal

60
Q

what is type I respiratory failure

A
  • failure to oxygenate
  • hypoxemia without hypercapnia
  • low PO2
  • normal PCO2
61
Q

what is type II respiratory failure

A
  • failure of alveolar ventilation
  • hypoxaemia with hypercapnia
  • PO2 low
  • PCO2 high
62
Q

how does severe asthma cause respiratory acidosis

A

hypoxemia -> reduce tissue oxygenation -> anaerobic metabolism -> lactic acidosis

63
Q

how does severe asthma lead to respiratory alkalosis

A

hyperventilation -> hypocapnia -> respiratory alkalosis

64
Q

what order do you use to interpret bloods for oxygenation and respiratory failure

A
  1. oxygenation (low = resps, high = metabolic)
  2. alkalosis or acidosis
    (both for which respiratory failure)
  3. work out which pathway

20005 (29 decks)

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