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BMS 242 CVS & Respiration > Acid Base Balance II > Flashcards

Acid Base Balance II Flashcards

1
Q

Describe hypercapnia

A

high carbon dioxide

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2
Q

What stimulates central chemoreceptors

A

hypercapnia, pH

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3
Q

What is the main function of the central chemoreceptors

A

drive breathing

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4
Q

Who identified that central chemoreceptors are stimulated by pH

A

Isidore Leusen

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5
Q

Where are central chemoreceptors located

A

brain parenchyma

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6
Q

What bathes the central chemoreceptors

A

brain extracellular fluid

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7
Q

Which chemoreceptors are excretely expressed

A

central

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8
Q

What cell type are central chemoreceptors

A

neuronal

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9
Q

What is the blood brain barrier NOT permeable to

A

bicarbonate or hydrogen ions

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10
Q

What is the MAIN stimulation for central chemoreceptors

A

increased CO2, therefore pH fall

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11
Q

How does the BBB compensate for pH changes

A

can upregulate its permeability to bicarbonate

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12
Q

Why is brain extracellular fluid capacity to buffer pH low

A

fewer proteins

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13
Q

What is a drawback of brain extracellular fluid having low buffering capacity

A

small changes in CO2 will cause large pH changes

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14
Q

What concentrations are affected in metabolic disorders

A

hydrogen and/or bicarbonate

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15
Q

What is the impact of metabolic disorders compared to respiratory disorders on brain extracellular fluid pH

A

metabolic disorders change BECF pH by a very small amount compared to respiratory

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16
Q

Where are central chemoreceptors located

A

ventrolateral medulla and brainstem nuclei

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17
Q

What are the two central chemoreceptor populations

A

acid activated, acid inhibited

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18
Q

What neurotransmitter is associated with acid activated central chemoreceptors

A

serotonin

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19
Q

What neurotransmitter is associated with acid inhibited central chemoreceptors

A

GABA

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20
Q

What can some sudden infant death babies lack

A

serotonergic neurones

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21
Q

What defect might sudden infant death babies have

A

defect in central chemoreceptors

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22
Q

What receptors are stimulated during respiratory acidosis

A

central and peripheral chemoreceptors

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23
Q

Which receptors play the biggest role when oxygen levels are normal

A

central chemoreceptors

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24
Q

Which receptors have the fastest response during respiratory acidosis

A

peripheral chemoreceptors

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25
Q

Definition of normoxic

A

normal oxygen levels

26
Q

When does metabolic acidosis occur

A

extreme hyperventilation

27
Q

Describe carbon dioxide in metabolic acidosis

A

fall in partial pressure of CO2

28
Q

What drives the acute response in metabolic acidosis

A

peripheral chemoreceptors

29
Q

What is the effect of hyperventilation on pH

A

pH increases

30
Q

How does metabolic acidosis affect breathing rate

A

breathing rate increases

31
Q

What is the ONLY long term regulation of pH

A

renal mechanisms

32
Q

What are the 3 mechanism of the renal system for pH regulation

A

bicarbonate handling, urine acidification, ammonia synthesis

33
Q

What does bicarbonate handling mean

A

bicarbonate is reabsorbed

34
Q

Where is the majority of bicarbonate reabsorbed

A

90% in proximal tubule

35
Q

What enzyme catalyses the break down of carbonic acid

A

carbonic anhydrase

36
Q

What does base conservation mean

A

bicarbonate conservation

37
Q

What is the main contributer to base conservation

A

ammonia synthesis

38
Q

What can generate bicarbonate

A

renal epithelial cells

39
Q

What can undergo urine acidification

A

uric acid, creatinine

40
Q

Where does urine acidification occur

A

nearly all the way down the nephron

41
Q

TRUE or FALSE - ammonia is impermeable across the cell membrane

A

false - its permeable

42
Q

What does ammonia come from in renal cells

A

break down of glutamine

43
Q

What does ammonium allow the secretion of

A

hydrogen ions

44
Q

What does ammonia production prevent

A

acidification of the urine

45
Q

What increases during alkalosis

A

bicarbonate excretion, pH increases

46
Q

What decreases during alkalosis

A

plasma pH, H+ excretion

47
Q

What increases during acidosis

A

H+ excretion, plasma pH

48
Q

What stays the same during acidosis

A

bicarbonate excretion

49
Q

Describe carbon dioxide levels during respiratory alkalosis

A

CO2 decreases

50
Q

When is respiratory acidosis seen

A

lungs have a problem excreting CO2

51
Q

What diseases would have a respiratory acidosis

A

emphysema, chronic bronchitis

52
Q

When would metabolic acidosis occur

A

ingestion of acid, loss of alkaline fluid, diarrhoea, cholera

53
Q

What is stimulated during metabolic acidosis

A

central chemoreceptors to increase ventilation

54
Q

In what disorder does the renal system not contribute to

A

metabolic alkalosis

55
Q

Where does compensation come from for metabolic alkalosis

A

respiratory system

56
Q

What is a mixed disorder

A

more than one disorder e.g. respiratory and metabolic acidosis

57
Q

Examples of mixed disorders

A

Alcoholics, asthma, COPD, salicylate poisoning

58
Q

Which is the most life threatening mixed disorder

A

asthma

59
Q

What mix disorders do COPD patients have

A

respiratory acidosis and metabolic alkalosis

60
Q

What mix disorders do patients with salicylate poisoning have

A

respiratory alkalosis and metabolic acidosis

BMS 242 CVS & Respiration (10 decks)

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