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Title: Acid Base Balance
Description: Notes on acid base balance from an Anatomy and Physiology module
Description: Notes on acid base balance from an Anatomy and Physiology module
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Acid-base Balance
pH = pK + log [HCO3] / [CO2]
To increase pH, HCO3 (bicarbonate) goes up and CO2 has to increase too
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Alkalosis – an abnormal process or condition that would raise an arterial pH in
response to the primary casual factor
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Mixed (acid-base) disorders – are those in which two or more primary disorders are
present simultaneously
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36 (i
...
[H+] > 44nM)
Alkalaemia – Arterial pH > 7
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e
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Respiratory disorders are caused by abnormal processes that tend to alter pH
because of a primary change in PCO2 levels
...
Normally, bicarbonate is 24 mM/L and PCO2 40 mmHg
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6
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This is achieved by compensatory bicarbonate retention in the
kidney
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This is achieved by a compensatory increase in
ventilation
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If the primary process is respiratory, the compensation is renal
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The biggest source of acid in the body is CO2
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o At onset, the acidosis is designated as an acute respiratory acidosis
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A rise in arterial PCO2 is potent stimulus to ventilation so a respiratory
acidosis will rapidly correct unless some abnormal factor is maintaining the
hypoventilation
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The factor causing the disorder is also the factor maintaining it
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An extremely high arterial PCO2 has direct anaesthetic effects and this will lead to a
worsening of the situation either by central depression of ventilation or as a result of
less of airway patency or protection
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o About 99% of this buffering occurs intracellularly, including the
haemoglobin contained within the erythrocytes (RBCs)
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o This response is slower and takes 3 or 4 days to reach its maximum
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o This causes the arterial plasma bicarbonate to fall to a level lower than
expected
...
e
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- Compensation for a metabolic acidosis is hyperventilation to decrease the
arterial PCO2
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Definition of a Buffer
A buffer is a solution containing substances that have the ability to minimize changes
in pH when an acid or base is added to it (Worthley, 1977)
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g
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The principle is that the salt privides a
reservoir of A- to replenish [A-] when A- is removed by reaction with H+
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Buffering hides from view the real change in H+ that occurs
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This is
responsible for about 80% of extracellular buffering
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These are the only blood buffer systems capable of buffering respiratory acid-base
disturbances as the bicarbonate system is ineffective in buffering changes in H+
produced by itself
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Haemoglobin is an important blood buffer particularly for buffering CO2
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Bone is an important source of buffer in chronic metabolic acidosis (i
...
renal tubular
acidosis and uraemic acidosis)
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Loss of bone crystal in uraemic acidosis is multifactorial and acidosis is only a minor
factor
...
The Davenport diagram is extremely important
Title: Acid Base Balance
Description: Notes on acid base balance from an Anatomy and Physiology module
Description: Notes on acid base balance from an Anatomy and Physiology module