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Applied Physiology > Acid base physiology > Flashcards

Acid base physiology Flashcards

1
Q

What is normal blood plasma pH

A

7.35-7.45

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2
Q

how is blood plasma maintained

A

lungs: through CO2 excretion
kidneys: varying rate of H+ excretion and HCO3- production

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3
Q

What is a normal PCO2 level and HCO3 concentration

A

40mmHG (PCO2)
24mmol/L
-to maintain pH

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4
Q

what pH range is compatible with life but if it is maintained chronically can cause kidney failure

A

6.8-7.8

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5
Q

Respiratory acidosis/alkalosis is measured by what
Metabolic acidosis/alkalosis is measured by what

A

CO2
HCO3-

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6
Q

Normal defense against a pH disturbance occurs in what order

A

1st line of defense is buffers
2nd line of defense is ventilation
3rd is the renal system

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7
Q

Buffers as a normal defense against pH disturbance

A

immediate limitation on pH change
-henderson-hasselbalch equation is used to mathematically calculate the ability of a buffer to change pH
-chemical reactions

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8
Q

ventilation changes as a normal defense against pH disturbance

A

-CO2 excretion can adjust within seconds to minutes
-henry’s law: concentration of a gas in solution is directly proportional to partial pressure of the gas
-CO2 + H2O –> H2CO3 –> H+ +HCO3-
-as CO2 increases so does the concentration of H2CO3 and H+

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9
Q

Renal system as a normal defense against pH disturbance

A

-finally line of defense
-regulates plasma HCO3- (buffer in plasma)
-excretes fixed metabolic acids (NH4+ and H2PO4-)

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10
Q

what makes someone go into metabolic acidosis or metabolic alkalosis

A

-vomiting = metabolic alkalosis
-diarrhea = more bicarb

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11
Q

Respiratory role in acid base balance

A

-balance CO2 excretion with metabolic CO2 production
-arterial PCO2 is monitored by central chemoreceptors
-increase in pulmonary ventilation (hyperventilation)
~decrease CO2 and H+
~increase pH (more basic)
-decrease in pulmonary ventilation (hypoventilation)
~increases CO2 and H+
~decrease pH (more acidic)
-alkalosis causes a less severe acidosis

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12
Q

what is the kidney’s role in acid base balance

A

-regulation of plasma HCO3-
~most is reabsorbed in proximal tubule
~in tubule bicarbonate binds with H+ to form carbonic acid and then carbonic anhydrase in the membrane converts the carbonic acid to CO2
-excretion of fixed metabolic acids
~ammonium ions - accounts for approx. 75% of H+ excretion
~phosphoric acid - 25%

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13
Q

urine concentration: -renal system has much to do with body maintaining fluid osmolarity within narrow limits by

A

-adequate glomerular filtration (kidney failure = GFR decreases)
-Na+ reabsorption without H2O reabsorption in the ascending limb of the loop of hence
-H2O permeability in the collecting ducts is variable and controlled by ADH

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14
Q

Clearance

A

-volume of plasma (going through at a time) rendered fee of a given substance in 1 minute

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15
Q

What is used to estimate GFR

A

-inulin
-creatinine
can also be used to estimate the renal blood flow

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16
Q

Inulin

A

a low-molecule weight polysaccharide but must be infused intravenously
-small enough to be filtered through glomerulus
-not reabsorbed nor secreted through glomerulus
-see how long it goes through

17
Q

creatinine

A

product of muscle metabolism (kidney function)
-constant function of muscle mass
- slightly overestimate GFR because some is secreted in PCT
-good diet index of GFR
-low GFR results in increased plasma creatinine
-defines stages of renal failure

18
Q

Na+

A

-65% reabsorbed in PCT
-active transport (Cl- is passive but coupled to movement of Na+)
-distal tubule and collecting duct has variable reabsorption of the 10% that it receives (water reabsorption is coupled to NaCl via osmosis)

19
Q

Mg++

A

balance between intestinal uptake and urinary excretion
-regulation occurs in thick ascending limb and DCT
-essential cofactor in enzymatic reactions

20
Q

Urea

A

normal 8mg/dL-25mG/dL
-end product of nitrogen metabolism
-bun not subjected to homeostatic regulation
-ADH stimulates urea reabsorption in the collecting duct

21
Q

Ca++

A

normal 4.0-5.2 mg/dL
-balance between GI system, renal system, and extracellular fluid and bone matrix
-PTH and vitamine D control
-handling is similar to Na+

22
Q

PO4

A

-normal 2.5 - 4,5 mG/dL
-intestinal uptake, renal excretion and exchange in bone
-almost exclusively reabsorbed in PCT

23
Q

K+

A

-normal 3.5-5.5mEq/L
-majority reabsorbed in PCT
-essential to maintain resting membrane potential
-aldosterone control K balance intra and extracellularly
-reciprocal relationship between secretion of H+ and K+ in collecting duct

24
Q

Respiratory acidosis

A

-decreased excretion of CO2
-increased arterial PCO2 and H+
-PCO2>45mmHg
-renal compensation
~increase H+ excretion and HCO3 production
~secondary metabolic alkalosis

25
Q

respiratory alkalosis

A

-decrease arterial PCO2 and H+
-PCO2 < 35mmHG
-renal compensation
~decrease H+ excretion and HCO3 production
~secondary metabolic acidosis

26
Q

metabolic acidosis

A

-deceased kidney elimination of H+ and increased production of acidic substances
-plasma HCO3 < 22meq/L
-respiratory compensation
~hyperventilation
~secondary respiratory alkalosis

27
Q

metabolic alkalosis

A

-plasmas HCO3- >28meq/L
-respiratory compensation
~hypoventilation
~secondary respiratory acidosis

28
Q

What happens to pH during exercise

A

pH drops
-production of CO2 and carbonic acid in working skeletal muscle
-production of lactic acid
-ATP breakdown in woking skeletal muscles

29
Q

-effects of increased acidity in skeletal muscle

A

-inhibits enzymes that imitate ATP production in glycolysis and aerobic respiration
-inhibites contractile process because H+ competes with calcium ions for binding on troponin (needed for contraction)

30
Q

effects of exercise on pH depend on

A

-exercise intensity
-amount of muscle mass involved
-duration of exercise

31
Q

Lactate threshold

A

around the shift of low intensity to moderate intensity exercise
-HCO3 drops and pH drops

32
Q

intracellular buffer systems

A

-4 in the cytosine of muscle fiber
-sarcolemma hydrogen ion transporters
-influence of muscle fiber types

33
Q

what are the 4 cytosine muscle fiber buffers system

A

-bicarbonate: converts strong acid to weak
-phosphates: converts strong acid to weak
-cellular proteins: accepts H+
-histidine-dipeptides (carnosine): accepts H+

34
Q

Sacrolemma hydrogen ion transporters

A

-protect muscle tissue
-NA-H exchange 1:1
-monocarboxlate transporters (MCTs) - 1:1 of lactate;H+ ARE MOVED ACROSS

35
Q

influence of muscle fiber types on intracellular buffer systems

A

-type 2 muscle fibers higher buffering capacity
-HITT improves buffering capacity

36
Q

extracellular (blood) buffer systems

A

-proteins
hemoglobin
bicarbonate

37
Q

proteins as an extracellular buffer syste

A

-similar to function in intracellular compartment
-usefullness during exercise is limited

38
Q

hemoglobin

A

important buffer (6x more than proteins)
-especially during gest
-deoxygenated>oxygenated

39
Q

bicarbonate as an extracellular buffer

A

-pobablly most important
-henderson-hasselbach equation is used to describe the ability of bicarbonate and carbonic acid to act as a buffer system

Applied Physiology (15 decks)

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