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Terms in this set (106)
Retain or blow off CO2 as required by changing the rate or depth of respiration, ___________ compensation.
Respiratory
An increased ratio of bicarbonate to carbonic acid.
Alkalosis
Within erythrocytes, this has a net negative charge and can attract hydrogen ions and buffer them.This is the second most important buffer system in the body.
Hemaglobin
This buffer system is found in both erythrocytes and plasma
Phosphate
Compensation involving renal mechanisms
Metabolic
Lactic acid, ketones, pyruvic acid, sulfuric acid, phosphoric acid, acetic acid, and uric acid are all ________ metabolic by-products.
Acidic
The physiological response to an acid-base imbalance which attempts to normalize the pH.
Compensation
A mixture of a weak acid and its salt.
Buffer
Acidosis results from an ________ in pCO2.
Increase
These metabolic by-products: ammonia and bicarbonate are ___________ in nature.
Alkaline
State in which blood pH is below normal.
Acidosis
Can attract hydrogen ions and buffer them
Protein
The most important buffer in blood
Bicarbonate
Hemoglobin bound with carbon dioxide.
Carbamino hemoglobin
When regulating blood pH, a buffer is defined as a mixture of a weak acid and its _______ .
salt
The movement of chloride from the plasma to the RBCs to maintain electrical neutrality caused by the loss of bicarbonate is termed _______
chloride shift
Metaboic acidosis occurs as a results of decreased serum _______________.
Bicarbonate
When assessing acid-base balance, ________ is required when evaluating TCO2.
a. plasma
b. serum
c. whole blood
d. citrate blood
b
List the three main buffer systems in the blood
1. Bicarbonate (most important) 2. Hemoglobin and Protein 3. Phosphate
Herbivores typically excrete a _______ urine
alkaline
Acidosis is a condition in which blood pH is _______ normal.
below
Alkalois is a condition in which blood pH is _______ normal
above
The respiratory system regulates the level of _____ in the blood to maintain a
consistant pH.
a. CA
b. HCO3
c. H2CO3
d. CO2
c
In a metabolic disturbance, the main compensation will be _______.
respiratory
With respiratory acidosis, metabolic compensation will reabsorb increased amounts of HCO3 and increase the excretion of H+. This will result in a more _______ urine pH.
acidic
Normal blood pH is maintained by the combined effects of all of the following, EXCEPT:
a. Blood Buffers System
b. Cardiac System
c. Respiratory System
d. Renal System
b
The pH of body fluids can be adjusted in _______ minutes by a change in the rate and depth of breathing.
1-3
With metabolic alkalosis, the kidney will try to compensate by ________ HCO3 reabsorbtion and ____________ H+ secretion
-decreasing -decreasing
TC02 is a way of measuring _______ HC03.
plasma
TC02 is a way of measuring _______ _____.
-plasma HCO3
Blood gas analysis measusures the partial pressures of what gases? (3)
1. O2 2. CO2 3. H+
In a respiratory disturbance, the main compensation will be by _______ means through the ______
-metabolic -kidney
Carbon dioxide is carried in the blood in all of the following forms,
EXCEPT:
a. it is physically dissoved in plasma
b. some binds with hemoglobin to form carbamino hemoglobin
c. some diffuses into the tissues
d. some binds with water to form carbonic acid
c
Marks: 1 To measure blood gasses a ________________ sample is needed.
Heparinized whole blood
T or F TC02 measures pH directly
F
The ____________ system contols the level of H2CO3 in the blood
respiratory
The respiratory center is located in an area of the brain called the ________________.
Medulla oblongata
With respiratory acidosis, respiratory compensation will be activated to stimulate hyperventilation to decrease the level of:
CO2
Respiratory acidosis occurs in conditons of ___________ ____________ elimination
decreased CO2
A change in blood pH may be compensated by which two mechanismsÉ
1. Respiratory 2.Metabolic (kidney)
With metabolic alkalosis, the kidney will try to compensate by decreasing _____ reabsorbtion and decreasing ___ secretion
-HCO3 -H+
Define buffer
a mixture of a weak acid and its salt
Metabolic alkalosis occurs as a results of increased serum _________________.
bicarbonate
Respiratory alkalosis occurs as a result of decreased ___________.
carbonic acid
Cl is excreted or reabsorbed by the kidney along with ______.
Na
Blood pH is determined by the ratio of ______ :______ which is
-HCO3:H2CO3 -20:1
List four ways CO2 is carried in the blood
1. Physically dissolved in plasma (7%) 2. Binds with hemoglobin to form carbamino hemoglobin (20%) 3. Binds with water to form carbonic acid (70%) (4. Bicarbonate ions?)
Name two ways O2 is transported in the blood
1. Dissolved
2. Bound to hemoglobin
Write the
equation which describes how CO2 is carried in the blood and then released as CO2
again.
CO2 + H2O « H2CO3 « H=+ HCO3-
What is the normal ratio for the bicarbonate system?
HCO3- -: H2CO3 in a ratio of 20:1
List the three blood buffer systems
1. Bicarbonate
2. Phosphate
3. Protein and
hemoglobin
How does the respiratory system respond if there is an increase in the plasma level of
H2CO3?
The depth and rate of respiration is increased to expel CO2
How does the respiratory system respond if there is a decrease in plasma H2CO3?
The depth and rate of respiration is decreased to conserve CO2
Name and describe the three systems that protect the body against changes in blood pH.
1. Blood buffers - provides immediate buffering of acids and bases from metabolic processes.
2. Respiratory - regulates the exhalation of CO2
3. Renal - regulates the reabsorbtion of H2CO3- and the secretion of H+
(Assume the following normal values in answering the following question:
pH = 7.4
pCO2 = 40 mmHg
Total CO2 = 25.7 mmol/L
HCO3 = 24.5 mmol/L
H2CO3 = 1.2 mmol/L) A patient has a blood pH of 7.27 and a pCO2 of 62 mmHg. The HCO3- is 24.5 mmol/L.
a) Is this a state of acidosis or alkalosis?
b) Is the origin of the condition respiratory or metabolic and why?
c) What are two conditions that can cause this?
d) How will the body compensate?
a) A pH of <7.4 is acidosis
b) pCO2 is increased, HCO3- is normal so
respiratory
c) 1. Respiratory depression e.g. barbituate drugs
2. Decreased lung function e.g. pneumonia
d) 1. Renal
- increased HCO3-resorbtion
- increased H+ secretion
2. Respiratory
- hyperventilation
(Assume the following normal values in answering the following question: pH = 7.4
pCO2 = 40 mmHg
Total CO2 = 25.7 mmol/L
HCO3 = 24.5 mmol/L
H2CO3 = 1.2 mmol/L) A patient has a blood pH of 7.27, a pCO2 of 40 mmHg,
[H2CO3] of 1.2 mmol/L and
[HCO3-] of 22 mmol/L.
a) Is this a state of acidosis or alkalosis?
b) Is the origin of the condition respiratory or metabolic and why?
c) What are two general causes of this condition and give a specific example of each?
d) How will the body try to compensate?
a) pH is <7.4 so acidosis b) HCO3is decreased, pCO2 is normal, so metabolic
c) 1. Excess loss of HCO3, e.g. diarrhea
2. Accumulation of acids e.g.
ketosis
d) 1. Renal
- increased HCO3- esorbtion
- increased H+ secretion
2. Respiratory
- hyperventilation
a) Describe what acid-base condition would result from excess vomiting in a dog? b) Describe how the body will try to compensate?
a) Metabolic alkalosis
Loss of HCl from the stomach b) Renal
- decreased HCO2- reabsorbtion
- decreased H+ secretion
Respiratory
-
hypoventilation
In a condition of respiratory acidosis, the kidney will try to compensate to bring the
ratio back to normal by increasing reabsorption of HCO3-] and increasing excretion of
H+. Use this knowledge and the law governing electrical neutrality by explaining the
affect on blood levels of:
a) Chloride
b) Potassium
c) Sodium
a) Decreased
Due to decreased renal Cl-reabsorbtion
b)
K secretion decreases so concentration
Increases
(The renal H+ secretion increases, K+) c) Increased
Renal reabsorbtion of Na+ occurs in exchange for H+ secretion
Matching
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
a) pH decreased
b) carbon dioxide level increased
c) bicarbonate decreased
d) caused by decreased respiration rate
e) caused by accumulation of
bicarbonate
f) caused by fever or stress
g) caused by ketosis
h) compensation by increased H+ excretion in kidneys
a) AC b) A c) C d) A e) D f) B g) C h) AC
Is the PCO2 increased or decreased in Respiratory Acidosis
Increased
Is the PCO2 increased or decreased in Metabolic Acidosis
Normal
Is the PCO2 increased or decreased in Respiratory Alkalosis
Decreased
Is the PCO2 increased, normal or decreased in Metabolic Alkalosis
Normal
In acidosis respiratory rate will ______ to compensate and in alkalosis respiratory rate will _______ to compensate
-Increase -Decrease
What is a chloride shift? What causes it?
-The movement of chloride from the plasma to the RBC to maintain electrical neutrality -The loss of bicarbonate (acidosis?)
The respiratory center is located in an area of the brain called the _______ ________. This center controls the ____ and ____ of respiration and monitors ____ and ______.
-Medulla oblongata -rate -depth -pH -pCO2
The ______ _______ regulates the amount if carbonic acid (_____) in the blood
-respiratory system -H2CO2
In the bloodstream a small amount of O2 is physically dissolved and the majority of it binds with hemoglobin to form _______. This reaction depends on blood ____, ____ and _____.
-Oxyhemoglobin -pH -pCO2 -pO2
What is the function of a buffer?
To resist changes in pH
HCO3
Bicarbonate
H2CO3
Carbonic acid
What is the second most important buffer system after bicarbonate?
Hemoglobin
Where is the protein buffer system found? How does it work?
-Mainly in plasma -Proteins have anet negative charge and can, therefore attract hydrogen ions and buffer them
In the bicarbonate system the salt is _____ and the acid is _______ in a ratio of ____ :____. What determines the blood pH?
-Bicarbonate (HCO3-) -Carbonic acid (H2CO3) -20:1 -The ratio rather than the individual concentrations is what determines blood pH
The effectiveness of the bicarbonate system is based on the fact that the ____ ______ can increase or decrease the reabsorption of _____ and the ______ can increase or decrease the excretion of _____ through a change in ______ rate. This returns the ratio back to 20:1
-Renal tubules -bicarbonate -Lungs -CO2 -Respiratory
Decrease in the bicarbonate ratio results in _______ and an increase in the ratio results in _________
-Acidosis (a decrease would mean less bicarbonate and more of the acid) -Alkalosis (more of the alkaline bicarbonate)
The phosphate buffer system includes HPO4 and H2PO4 normally at a ratio of ____. Where is it found?
-4:1 -In both the erythrocytes and plasma
It is the ratio of _____: ______ that reflect pH. In the respiratory control of the acid-base balance a decrease in pCO2 decreases the ________ in the blood which means _______ occurs and the resp rate ______. An increase in pCO2 causes an decrease in ____ and _________ occurs and the resp rate ____
-20:1 -Bicarbonate (HCO3): Carbonic acid (H2CO3) -carbonic acid -alkalosis -decreases -pH -acidosis -increases
How does the repiratory system compensate for respiratory acidosis (a(n) _______ in pCO2)? How about respiratory alkalosis (a(n) _____ in pCO2)?
-increases rate and depth of respiration to exhale CO2 and bring pH up to normal -increase -decreases the rate and depth of respiration to retain the CO2 in the body -decrease
In the renal control of pH the kidney regulates what two factors
1. The reabsorption of HCO3 (bicarbonate) 2. The excretion of H+
When blood pH is too low (_________) how does the kidney respond?
-Acidosis 1. H+ is excreted (to bring up the pH) 2. HCO3 (Bicarbonate) and Na+ are actively reabsorbed
When blood pH is too high (______) how does the kidney respond
-Alkalosis 1. H+ is retained 2. HCO3 (bicarbonate) is excreted passively (not reabsored)
Carnivores on a high meat diet have a high metabolic ______ production, they therefore excrete ______ urine. Herbivores have a low metabolic _____ production and so excrete an _____ urine in order to do what?
-acid -acidic -acid -alkaline -conserve H+
The repiratory system control the amount of _____ in the blood through changing the depth and rate of respiration to excrete or retain _____ and the renal system controls the amount of ______ reabsorbed back into the body and the amount of _____ excreted in the urine
-Bicarbonate -CO2 -Bicarbonate -H+
Acidosis is generally caused by a gain in carbonic acid (H2CO2) from the ______ system or a loss of bicarbonate (HCO3) from the _____ system
-respiratory -metabolic (renal)
Alkalosis is generally caused by a ____ of bicarbonate (HCO3) by the ______ system or a ____ of carbonic acid (H2CO3) by the ______ system
-gain -metabolic (renal) -loss -respiratory
What are the two means by which acid-base balance and blood pH can be assessed
1. Total CO2 (aka TCO2) 2. Blood gases
T or F TCO2 (total CO2) is the same as pCO2
F
TCO2 is a way of measuring _____ _______. What kind of sample must be collected?
-Plasma HCO3 (bicarbonate)
When performing a TCO2 _____, _____ and ______ will all falsely ______ values
-time -hemolysis -lipemia -decrease
Does TCO2 measure pH directly? How does it work?
-No -Changes in pH are implied. If TCO2 increases then HCO2 (bicarbonate) is increased which means pH has increased (alkalosis)
A high TCO2 implies ______ and a low TCO2 implies _____
-alkalosis -acidosis (It measures bicarbonate)
What does blood gass analysis measure (3)
1. partial pressure of O2 2. Partial pressure of CO2 3. Concentration of H+ (pH)
What sample is required to run blood gas analysis? Any special instructions? Only arterial samples are suitable for measuring what? Venous samples can be used for what?
-Heparinized whole blood -Collected immediately or within three hours of analysis if kept at 4 C and not exposed to air -Only arterial samples for pO2 -Venous samples can be used for pCO2 and pH
The root of respiratory acidosis is decreased ____ __________. List some things that can cause that to occur
-Decreased CO2 elimination 1. Respiratory depression 2. Lung dysfunction 3. Decreased circulation 4. Airway obstruction
In respiratory acidosis what is the TCO2? What is the PCO2?
-TCO2 is Normal -PCO2 is increased
In respiratory acidosis what happens in renal compensation? How about respiratory compenstion?
-Renal: Increase bicarbonate reabsorption and increased H+ excretion which makes urine acidic -Respiratory: Increased resp rate
List the two root causes of metabolic acidosis and some examples
1. Increased loss of HCO3 (bicarbonate): Diarrhea, Intestinal obsrtuction, Renal disease 2. Decreased bicarbonate due to buffering excess acids: ketosis, physical activity (lactic acid), renal failure (can't secrete H+)
In metabolic acidosis what is the TCO2? What is the PCO2?
-TCO2 decrease -PCO2 normal
In metabolic acidosis what happens in renal compensation? How about respiratory compenstion?
-Renal: Increase bicarbonate reabsorption and increased H+ secretion which makes urine acidic -Respiratory: Increase resp rate
The root cause of respiratory alkalosis is decreased _____ ____ due to an increased ______ ______. List some examples
-Decreased carbonic acid (increase in CO2 elimination) - Increased respiratory rate: pain, psychological stress, fever, seizures, high environmental temp, Low O2
In respiratory alkalosis what is the TCO2? What is the PCO2?
-TCO2 normal -PCO2 decreased
In repsiratory alkalosis what happens in renal compensation? How about respiratory compenstion?
-Renal: decrease HCO3 (bicarbonate) reabsorption and decreased H+ excretion which makes alkaline urine -Decreased resp rate and depth to conserve pCO2
What causes metabolic alkalosis? List some examples
Increased serum bicarbonate or decrease in H+ (Can be due to vomiting, loss of HCl, hypokalemia, Iatrogenic)
In respiratory alkalosis what is the TCO2? What is the PCO2?
-TCO2 normal -PCO2 decreased
In metabolic alkalosis what happens in renal compensation? How about respiratory compenstion?
-Renal: Decrease bicarbonate reabsorption and decrease H+ elimination which makes alkaline urine -Respiratory: decrease resp rate
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