Phys 4 Flashcards

1
Q

changes in pH are tightly regulated by what?

A
  • buffer systems
  • respiratory function
  • renal processing of filtrate
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2
Q

What are the 3 chemical buffer systems?

A
  1. phosphate buffer system
  2. protein buffer system
  3. carbonic acid - bicarb buffer system
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3
Q

bicarb buffer system

A
  • important in ECF
  • bicarb converts a strong acid to a weak one
  • carbonate converts a strong base to a weak base
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4
Q

phosphate buffer system

A
  • monohydrogen phosphate ion converts a strong acid to a weak one
  • dihydrogen phosphate ion converts a strong base to a weak one
  • (think phosporylation)
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5
Q

protein buffer system

A
  • carboxyl group of aa can release H

- amine group of aa can accept H

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6
Q

What happens when our physiologic buffer systems aren’t working adequately?

A

organ systems have to step in

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7
Q

normal process going on in the respiratory system

A
  • CO2 produced by cells, transported in blood, eliminated by lungs
  • exhalation = production
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8
Q

What happens in the respiratory system when CO2 exceeds elimination (i.e hypercapnia)

A
  • central medullary detection of elevated H stimulates increase rate and depth of ventilation to unload CO2
  • slower than chemical buffering but is more powerful
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9
Q

since the lungs only deal with carbonic acid via CO2 elimination, what deals with everything else?

A
  • kidneys
  • they deal w/ all other metabolic acids:
  • phosphoric acids
  • uric acid
  • ketone bodies
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10
Q

metabolic acidosis

A

accumulation of the metabolic acids

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11
Q

what is a function that only the kidneys have?

A

regulation of alkaline substances and renewal of buffer systems

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12
Q

the most important renal mechanism for regulating acid-base balance of the blood involves what?

A
  • excreting H
  • conserving or generating HCO3-

(intercalating cells of collecting tubules can do opposite if needed)

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13
Q

secretion of H is a function of what?

A

tubular cells (PCT, DCT, collecting ducts)

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14
Q

what is responsible for renal secretion of H ions at the PCT?

A
  • Na-H exchanger

- Na/bicarb symporter

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15
Q

Na-H exchanger

  • where
  • what it does
A
  • at apical surface

- secretes H in exchange for Na

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16
Q

N/bicarb symporter

A
  • bicarb and Na are cotransported from the cell

- Na enters the interstitial space then peritubular capillary

17
Q

what is the end result of exchanges at the PCT?

A

for each H secreted, 1 Na and 1 bicarb ion enters the blood

18
Q

renal secretion of H ions at the DCT and collecting duct is done by what?

A

-active secretion of protons by proton pump

19
Q

how does the proton pump work?

A
  • ATPase proton translocation

- no dependence on Na

20
Q

what effect does acidosis have on proton pump?

A

it increases its activity

21
Q

where does the phosphate buffer system primary work at?

A

DCT and collecting tubules

22
Q

what is the ammonia buffer system?

A
  • H binds ammonia to form ammonia ion
  • source is from aa metabolism from tubular cells
  • the ammonia ion is secreted into the lumen
  • combines w/ Cl and is excreted
23
Q

pH of normal urine

A
  • 4.5-8

- depends on the interrelated processes of acid secretion, ammonium ion production and bicarb excretion

24
Q

possible causes of acidosis

A
  • retention of CO2 via respiratory cause
  • excess acids
  • strenuous exercise
  • starvation
  • ketosis
  • acid ingestion
  • diseased kidneys
  • bicarb loss via diarrhea
25
Q

what is the most important regulator and indicator of respiratory function?

A

pCO2:

  • > 45: acidosis
  • <35: alkalosis
26
Q

metabolic causes of acid-base imbalance

A

all imbalances not related to CO2, bicarb is the indicator

27
Q

bicarb

  • nl
  • alkalosis
  • acidosis
A
  • nl: 22-28 mEg/l
  • metabolic alkalosis: >28
  • metabolic acidosis: >22
28
Q

how do the lungs compensate for acid-base imbalance

A

alter CO2 levels for metabolic causes

29
Q

how to the kidneys compensate for acid-base imbalance?

A

alter hydrogen and bicarb ion levels for respiratory causes

30
Q

pH panic levels and their results

A
  • pH <7: CNS depression, coma, death

- pH >7.8: CNS stimulation, tetany, seizure, respiratory arrest

31
Q

charts

A

the end of her ppt is many charts repeating respiratory and metabolic compensation