63. CARBON DIOXIDE DIFFUSION CO 2 CO 2 Red Blood Cell Systemic Circulation HCO 3 - Cl - (Chloride Shift) CO 2 diffuses into plasma and into RBC Within RBC, the hydration of CO 2 is catalyzed by carbonic anhydrase Bicarbonate thus formed diffuses into plasma carbonic anhydrase Tissues Plasma CO 2 H 2 O H + HCO 3 - + +
64. CARBON DIOXIDE DIFFUSION CO 2 Red Blood Cell Systemic Circulation H 2 O H + HCO 3 - carbonic anhydrase Plasma CO 2 CO 2 CO 2 CO 2 CO 2 CO 2 CO 2 Click for Carbon Dioxide diffusion + + Tissues H + Cl - Hb H + is buffered by Hemoglobin
73. CARBON DIOXIDE DIFFUSION CO 2 CO 2 Red Blood Cell Systemic Circulation HCO 3 - Cl - (Chloride Shift) CO 2 diffuses into the plasma and into the RBC Within the RBC, the hydration of CO 2 is catalyzed by carbonic anhydrase Bicarbonate thus formed diffuses into plasma carbonic anhydrase Tissues Plasma CO 2 H 2 O H + HCO 3 - + +
74. BICARBONATE DIFFUSION Red Blood Cell Pulmonary Circulation CO 2 H 2 O H + HCO 3 - + + HCO 3 - Cl - Alveolus Plasma CO 2 Bicarbonate diffuses back into RBC in pulmonary capillaries and reacts with hydrogen ions to form carbonic acid The acid breaks down to CO 2 and water
75. BICARBONATE DIFFUSION Red Blood Cell Pulmonary Circulation CO 2 H 2 O H + + + HCO 3 - Cl - Alveolus Plasma CO 2 CO 2 H 2 O
103. RESPIRATORY ACIDOSIS - metabolic balance before onset of acidosis - pH = 7.4 H 2 CO 3 HCO 3 - 1 20 : H 2 CO 3 : Carbonic Acid HCO 3 - : Bicarbonate Ion (Na + ) HCO 3 - (K + ) HCO 3 - (Mg ++ ) HCO 3 - (Ca ++ ) HCO 3 -
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105.
106. RESPIRATORY ACIDOSIS - therapy required to restore metabolic balance - lactate solution used in therapy is converted to bicarbonate ions in the liver H 2 CO 3 HCO 3 - 2 40 : Lactate Lactate LIVER HCO 3 -
152. METABOLIC ACIDOSIS BODY’S COMPENSATION - hyperactive breathing to “ blow off ” CO 2 - kidneys conserve HCO 3 - and eliminate H + ions in acidic urine H 2 CO 3 HCO 3 - 0.75 10 : CO 2 CO 2 + H 2 O HCO 3 - + H + HCO 3 - + H + Acidic urine
153. METABOLIC ACIDOSIS - therapy required to restore metabolic balance - lactate solution used in therapy is converted to bicarbonate ions in the liver H 2 CO 3 HCO 3 - 0.5 10 : Lactate Lactate containing solution
171. METABOLIC ALKALOSIS BODY’S COMPENSATION - breathing suppressed to hold CO 2 - kidneys conserve H + ions and eliminate HCO 3 - in alkaline urine 1.25 30 CO 2 + H 2 O HCO 3 - + H + HCO 3 - H + + Alkaline urine : H 2 CO 3 HCO 3 -
172. METABOLIC ALKALOSIS - Therapy required to restore metabolic balance - HCO 3 - ions replaced by Cl - ions H 2 CO 3 HCO 3 - 1.25 25 : Cl - Chloride containing solution
173. ACIDOSIS deep vomiting from GI tract kidney disease (uremia) increase in plasma H + concentration depression of nervous system decreased removal of CO 2 from lungs failure of kidneys to excrete acids metabolic acid production of keto acids absorption of metabolic acids from GI tract prolonged diarrhea accumulation of CO 2 in blood accumulation of acid in blood excessive loss of NaHCO 3 from blood metabolic acidosis accumulation of CO 2 in blood accumulation of acid in blood excessive loss of NaHCO 3 from blood respiratory acidosis
174. ALKALOSIS overexcitability of nervous system respiratory alkalosis anxiety overdose of certain drugs high altitudes prolonged vomiting ingestion of excessive alkaline drugs excess aldosterone hyperventilation loss of CO 2 and H 2 CO 2 from blood loss of acid accumulation of base metabolic alkalosis decrease in plasma H + concentration hyperventilation loss of CO 2 and H 2 CO 2 from blood loss of acid accumulation of base
209. RESPIRATORY CONTROL OF pH pH rises toward normal rate and depth of breathing increase CO 2 eliminated in lungs H + stimulates respiratory center in medulla oblongata H 2 CO 3 H + + HCO 3 - H + acidosis; pH drops CO 2 + H 2 O H 2 CO 3 cell production of CO 2 increases
210. 1) Buffer Systems 2) Respiratory Responses 3) Renal Responses 4) Intracellular Shifts of Ions
213. ACIDIFICATION OF URINE BY EXCRETION OF AMMONIA Capillary Distal Tubule Cells Tubular urine to be excreted NH 2 H + NH 3 NH 2 H + NH 3 WHAT HAPPENS NEXT?
214. ACIDIFICATION OF URINE BY EXCRETION OF AMMONIA Capillary Distal Tubule Cells Tubular Urine NH 3 Na + Cl - + H 2 CO 3 HCO 3 - + NaCl NaHCO 3 Click Mouse to Start Animation NaHCO 3 NH 3 Cl - H + NH 4 Cl Click Mouse to See Animation Again Notice the H + - Na + exchange to maintain electrical neutrality Dissociation of carbonic acid
215. ACIDIFICATION OF URINE BY EXCRETION OF AMMONIA Capillary Distal Tubule Cells Tubular Urine NH 3 Na + Cl - + H 2 CO 3 HCO 3 - + NaCl NaHCO 3 Click Mouse to Start Animation NaHCO 3 NH 3 Cl - H + NH 4 Cl Click Mouse to See Animation Again Notice the H + - Na + exchange to maintain electrical neutrality
216. RESPIRATORY / EXCRETORY RESPONSE Hyperventilation removes H + ion concentrations Hypoventilation increases H + ion concentrations Kidneys eliminate or retain H + or bicarbonate ions CO 2 + H 2 O H 2 CO 3 H + + HCO 3 -
217. 1) Buffer Systems 2) Respiratory Responses 3) Renal Responses 4) Intracellular Shifts of Ions
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221. ELECTROLYTE SHIFTS Acidosis Compensatory Response Result - H + buffered intracellularly - Hyperkalemia Alkalosis Compensatory Response Result - Tendency to correct alkalosis - Hypokalemia cell H + K + H + K + cell