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Acid, Base, Electrolytes

Acid, Base, Electrolytes. Regulation for BALANCE. Fluid Compartments. Fluid Compartments: 20 – 40 – 60 Rule. Fluid Movement. Input = output Hormones Na+ / K+ Renin Aldosterone ANP Reproductive Hormones GCC Ca++ / Mg++ Calcitonin PTH H2O ADH. Anions follows passively Cl- HCO3- .

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Acid, Base, Electrolytes

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  1. Acid, Base, Electrolytes Regulation for BALANCE

  2. Fluid Compartments

  3. Fluid Compartments:20 – 40 – 60 Rule

  4. Fluid Movement

  5. Input = output Hormones Na+ / K+ Renin Aldosterone ANP Reproductive Hormones GCC Ca++ / Mg++ Calcitonin PTH H2O ADH Anions follows passively Cl- HCO3- Water and Electrolyte Balance

  6. Electrolyte Fluid Composition

  7. Cations and Anions balance for Electroneutrality

  8. Acid Base Terms • Define • pH • Acid • Strong • Weak • Volatile : CO2 from CH20 and Fat Metabolism • Nonvolatile: H2SO4, H2PO4 from protein metabolism • Base • Strong • Weak • Salt • Buffer

  9. Acid Sources

  10. pH • Define • pH = log (1/[H+]) • pH = -log [H3O+] • Water Dissociation • H2O + H2O  H3O+ + OH- • Scale • Blood values • Venous • Arterial • Abnormal Values • Acidemia • Alkalemia

  11. pH formula and scale

  12. Acid Base Chart

  13. pH of Solutions

  14. Acid Base Regulation for Balance • Systems • Chemical Buffer Systems • Respiratory System • Renal • Time • Seconds to Minutes • Minutes to Hours • Hours to Days / Weeks • Strength • Problems (reference 7.4 as normal average): • + / - 0.1 changes result in respiratory rate changes • + / - 0.2 to 0.3 changes result in CV and Nervous changes • + / - 0.4 to 0.5 changes result in death

  15. Chemical Buffer Systems • Define • 3 types • Name of System • Buffer formula or name of chemical • Location • Effectiveness [pKa buffer = pH location] • Why important

  16. pH changes with/without buffers

  17. Buffer Effectiveness HA  [H+] + [A-] pKa = -logKa

  18. Titration of Buffer System

  19. pK of Bicarbonate System

  20. Formulas • K = [H+] [HCO3-] / [H2CO3] • pH = log (1 / [H+]) • Henderson-Hasselbach Equation: CO2 is directly related to H2CO3, as CO2 + H20  H2CO3; can substitute this equivalent [amount x solubility coefficient] in the above equation (0.03 X pCO2)

  21. Bicarbonate Chemical Buffer • H2CO3, HCO3- • Plasma buffer • pK = 6.1 • Important: • Can measure components • pCO2 = 40 mmHg • HCO3- = 24 mM • Can adjust concentration / ratio of components • HCO3- @ kidneys • CO2 @ lungs • Recalculate pH of buffer system in ECF using Henderson-Hasselbach • pH = 6.1 + log(24 / 0.03x40) • pH = 6.1 + log (20/1) • pH = 7.4

  22. Bicarbonate pK

  23. Bicarbonate Buffer System

  24. Phosphate Chemical Buffer • H2PO4-, HPO4= • ICF, Urine • pK = 6.8 • Important • Intracellular buffer • ICF pH = ~ 6.5 – 6.8 • Renal Tubular Fluids • Urine pH ranges 6.0 – 7.0

  25. Protein Chemical Buffer • Proteins • With Histadine: AA contain imidazole ring, pKa = 7.0 • R-COOH  R-COO- + H+ • R-NH2  R-NH3+ • ICF (hemoglobin), ECF • pK = 7.4 • Important • Most numerous chemicals • Most powerful chemical buffer

  26. Proteins in acid base

  27. Acid-Base Properties of Alanine

  28. Hemoglobin

  29. Protein Chains

  30. Hemoglobin Buffer for H+

  31. CO2 transport and RBC buffer

  32. Respiratory for A/B Balance • Occurs in minutes • CO2 only • Rate changes

  33. Respiratory Controls for Acid /Base balance • Volatile Acid: CO2 • pH changes in CSF • Respiratory Rate • Pons • Medulla Oblongata • Chemoreceptors • pCO2 • pO2

  34. CO2 and pH • Increase CO2 • Increase H+ • Decrease pH • Decrease CO2 • Decrease H+ • Increase pH

  35. Renal Control for Long Term Acid / Base Balance

  36. Renal processes in A/B balance

  37. Renal Physiology • Filtration • Remove metabolic acids: Ketones, Uric acid • Filter Base [HCO3-] @ Renal Filtration Membrane • Reabsorption • Base @ PCT • Reverse CO2 equation to create HCO3- • Secretion • H+ @ PCT, late DCT and Cortical CD • CO2 equation to create H+ for secretion

  38. Renal Mechanisms for A/B

  39. Renal Ion Exchanges • Na+ / K+ antiporter • Na+ / H+ antiporter • Na+ / HCO3- cotrans • H+ / K+ ATPase • H+ ATPase • Cl- / HCO3- exchanger

  40. Renal Reabsorption of HCO3-

  41. Renal Movement of Ions andCO2, HCO3-, and H+  Acidic Urine

  42. Renal Tubular Buffer:Phosphate Buffer System

  43. Use of HPO4 buffer system

  44. Ammonium Buffer System in Renal Tubules Deamination of Glutamine creates HCO3- for more base creates NH3 for buffering H+

  45. Increase of HCO3- Buffer

  46. Renal Buffer Mechanisms

  47. Normal Acid Base Values

  48. Respiratory and Renal Balance

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