Acid Base Imbalance

Question 1

pH

Answer 1

–power or potential of hydrogen
–scale that identifies the acidity or basicity of a solution
–hydrogen ion concentration

Question 2

increase in hydrogen ions equals…

Answer 2

more acidic pH (lower)

Question 3

decrease in hydrogen ions equals…

Answer 3

more basic pH (higher)

Question 4

what can acids do with hydrogen ions?

Answer 4

donate them

Question 5

what can bases do with hydrogen ions?

Answer 5

–accept them
–give up hydroxide ion (OH-)

Question 6

what do strong acids do in solutions?

Answer 6

dissociate

Question 7

what do weak acids do in solutions?

Answer 7

dissociate partially

Question 8

what does hydrogen do in the body?

Answer 8

–helps maintain cell membranes
–helps with enzyme activity
–component of H2O and keeps the body hydrated
–helps in energy production

Question 9

what is hydrogen a component of?

Answer 9

–sugars
–proteins
–starch
–fats

Question 10

what is a neutral pH?

Answer 10

7.0 (equal H+ and OH-)

Question 11

pH normal range in the body

Answer 11

7.35-7.45

Question 12

where is the most acidic place in the body?

Answer 12

stomach

Question 13

how is the stomach equipped to handle a lower pH?

Answer 13

–produces mucus and bicarb to protect stomach lining from HCl
–duodenum has defense mechanisms to neutralize the acid
–LES prevents the movement of gastric acid into the esophagus

Question 14

pH in skeletal muscle

Answer 14

6.9-7.2

Question 15

pH in bone

Answer 15

7.4

Question 16

pH in liver

Answer 16

7.2

Question 17

pH in pleural fluid

Answer 17

7.6

Question 18

what electrolytes are affected by the acid-base balance?

Answer 18

Na+, K+, Cl-

Question 19

what else can be affected by the acid base balance?

Answer 19

–hormones
–oxygen transport and delivery

Question 20

how is oxygen transport and delivery affected by acid base balance?

Answer 20

–more acid = Hgb will give up O2 more readily at the tissues
–more alkalotic = Hgb will hold on to O2
**prefer the body to be more acidic than alkalotic for oxygenation purposes

Question 21

pH levels incompatible with life

Answer 21

pH < 6.8 OR pH > 7.8

Question 22

two types of acids in the body

Answer 22

–volatile acid
–non-volatile acid

Question 23

volatile acids

Answer 23

–can be converted to gas
–excreted/eliminated by the lungs
carbonic acid (H2CO3)

Question 24

non-volatile acids

Answer 24

–lactic acid
–phosphoric acid
–sulfuric acid
–acetoacetic acid
–beta-hydroxybutyric
**eliminated by the kidney

Question 25

phosphoric acid

Answer 25

works with calcium in bone

Question 26

sulfuric acid

Answer 26

protein metabolism

Question 27

acetoacetic acid

Answer 27

liver

Question 28

beta-hydroxybutyric

Answer 28

diagnosis of DKA

Question 29

what non-volatile acid is not excreted by the kidneys?

Answer 29

lactic acid

Question 30

lactic acid

Answer 30

--metabolized by the body -- primarily liver and kidneys --can be utilized for energy production

Question 31

how do acids get into the body?

Answer 31

--ingest in food/drink --metabolism of lipids and proteins --cellular metabolism waste product

Question 32

buffers

Answer 32

chemicals in the body that combine with acid or base to change the pH

Question 33

buffer specifics

Answer 33

--accept or release a H+ --almost instantaneous --short-lived

Question 34

3 main buffer systems

Answer 34

--bicarb (carbonic acid buffer) --phosphate --protein (hemoglobin)

Question 35

bicarb location

Answer 35

ECF

Question 36

bicarb

Answer 36

--CO2 byproduct of cellular metabolism --combines with H2O in serum to form carbonic acid --carbonic anhydrase breaks down carbonic acid

Question 37

carbonic anhydrase location

Answer 37

many tissues of the body especially in lungs and kidneys

Question 38

how is carbonic acid formed in lungs?

Answer 38

CO2 + H2O

Question 39

how is carbonic acid formed in the kidneys?

Answer 39

H+ + HCO3-

Question 40

phosphate buffer

Answer 40

--main intracellular buffer --H+ + HPO4 = H2PO4- --hydrogen + hydrogen phosphate = dihydrogen phosphate ion

Question 41

protein buffers

Answer 41

--nearly all proteins can function as buffers --hemoglobin picks up CO2 at the cellular level

Question 42

how do proteins work as buffers?

Answer 42

carboxyl group (COOH) is a weak acid that gives up H+ --amino acid --acetic acid amino group (NH2-) accept H+ --amino acids have both a carboxyl and amino group --ammonia NH3

Question 43

what particles are involved in cellular compensation?

Answer 43

H+ --> positively charged ions K+ --> positively charged ion, mostly found inside cell

Question 44

what happens when there is an increase in H+ concentration?

Answer 44

--pH decreases = more acidic --H+ move into the cell --more positively charged ions in the cell --K+ moves out of cell --electrical neutrality is restored inside cell

Question 45

effect on K+ when pH becomes more acidic

Answer 45

increased K+ in the blood --> hyperkalemia

Question 46

cellular compensation

Answer 46

--temporary correction of pH --process will reverse as pH returns to normal --if kidneys are working, they will excrete the excess K+ = hypokalemia

Question 47

respiratory mechanisms in acid base balance

Answer 47

--body produce CO2 --CO2 and H2O creates carbonic acid --exhalation excretes carbonic acid --doesn't affect fixed acids (non volatile) like lactic acid --converts volatile acids to gas --body pH can be adjusted by changing rate and depth of breathing

Question 48

RR in acidotic patients

Answer 48

increased RR to blow off CO2

Question 49

RR in alkalotic patients

Answer 49

decreased RR to retain CO2

Question 50

kidney excretion role in acid base balance

Answer 50

--can eliminate large amounts of acid except carbonic acid --can also excrete base --can conserve and produce bicarb ions --most effective regulator of pH --if kidneys fail, pH balance fails --depends on normal functioning of renal system

Question 51

rates of correction for mechanisms

Answer 51

--buffers almost instantaneously --respiratory = several minutes to hours --renal = several hours to days

Question 52

compensation

Answer 52

body response to acid-base imbalance

Question 53

respiratory compensation

Answer 53

if underlying problem is metabolic, hyperventilation or hypoventilation can help

Question 54

metabolic compensation

Answer 54

if problem is respiratory, renal mechanisms can help

Question 55

process for correcting acidosis

Answer 55

acidosis --> stimulates brain and arterial receptors --> increase RR --> decrease blood CO2 --> decrease carbonic acid --> increased pH

Question 56

process for correcting alkalosis

Answer 56

alkalosis --> stimulates brain and arterial receptors --> decrease RR --> increase blood CO2 --> increase carbonic acid --> decrease pH

Question 57

what is the primary controller of the body's carbonic acid supply?

Answer 57

lungs

Question 58

what does CO2 mix with to form carbonic acid in the lungs?

Answer 58

H2O

Question 59

hyperventilation

Answer 59

blows off CO2 and increases pH

Question 60

hypoventilation

Answer 60

retains CO2 and decreases pH

Question 61

renal response time for correcting pH

Answer 61

hours to days

Question 62

what are the primary controllers of bicarb in the body?

Answer 62

kidneys

Question 63

how do kidneys control pH?

Answer 63

by adjusting amount of bicarb that is... (1) reabsorbed into the bloodstream (2) excreted in the urine

Question 64

how will kidneys respond if blood is too acidic?

Answer 64

reabsorb bicarb

Question 65

how will kidneys respond if blood is too alkalotic?

Answer 65

excrete bicarb

Question 66

normal range for CO2

Answer 66

35-45

Question 67

normal range for HCO3

Answer 67

22-26