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What is the normal range of pH in the body?
7.35-7.45
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What are the 3 organs that affect acid-base balance?
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How do kidneys affect pH?
- Excreting acid
- Reabsorbing HCO3
- Excreting NH4+
- Creating new HCO3-
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How do lungs affect pH?
Alteration in PCO2
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How does the liver affect pH?
- Metabolizes NH4+ into urea (lowers pH)
- Uses H+ in gluconeogensis (raises pH)
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Kidneys secrete NH4+ as a mechanism of eliminating what?
H+
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Each molecule of NH4+ excreted results in formation of what?
HCO3-
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NH4+ not excreted in urine is converted into what by the liver?
urea
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Acidosis stimulates what in the nephron?
H+ secretion
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Chemoreceptors detect PCO2 and pH to regulate what?
ventilatory rate
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Increased respiratory rate does what?
- Decraesed PCO2
- Increased pH
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What can cause metabolic acidosis?
- Diabetic ketoacidosis
- Diarrhea (loss of HCO3-)
- Kidney failure (inhibition of H+ excretion)
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What can cause metabolic alkalosis?
- Volume contraction (hemorrhage, loss of ECF)
- Excessive antacid ingestion
- Loss of acid (vomiting)
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What can cause respiratory acidosis? (Hypoventilation)
- Lung Disease
- Depressed respiratory center (sedative drugs, anaesthetics)
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What can cause respiratory alkalosis? (hyperventilation)
- Drugs (caffeine, aspirin, doxapram)
- Disorders of CNS (Stroke, meningitis)
- High altitude
- Anxiety, pain, fear
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What is normal value of HCO3?
24mEq/L
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What are the three steps in assessing acid-base balance disorders in the lab?
- Assess pH level
- Determine metabolic v. respiratory disorder
- Analyze compensatory response to pH change
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What are symptoms of metabolic acidosis?
- Lethargy, confusion, rapid and shallow breathing
- Shortness of breath
- Easily fatigable, sleepiness
- Dehydration
- Coma in severe cases (uncontrolled diabetes mellitus)
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What are some symptoms of respiratory acidosis?
- Shortness of breath
- headache, drowsiness
- Progression of stupor and coma
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What are some symptoms of alkalosis?
- Light-headedness, syncope
- Shortness of breath
- Muscle twitching, muscle spasm, hand tremor
- Numbness or tingling of face and extremities
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