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Acid-Base Balance, Nervous Tissue, Spinal Cord and Spinal Nerves

Acid-Base Balance, Nervous Tissue, Spinal Cord and Spinal Nerves

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Published by Christine Balanza

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Published by: Christine Balanza on Jan 23, 2012
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12/24/2012

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Acid-Base ImbalancesThe normal pH range of systemic arterial blood is between 7.35 and 7.45.
Acidosis
(or
academia
) is acondition in which blood pH is below 7.35;
alkalosis
(or
alkalemia
) is a condition in which blood pH ishigher than 7.45.- The major physiological effect of acidosis is depression of the central nervous system throughdepression of synaptic transmission. If the systemic arterial blood pH falls below 7, depression of thenervous system is so severe that the individual becomes disoriented, then comatose, and may die.Patients with severe acidosis usually die while in coma.- A physiological effect of alkalosis, by contrasts, is over excitability in both the central nervous systemand peripheral nerves. Neurons conduct impulses repetitively, even when not stimulated by normalstimuli; the results are nervousness, muscle spasms, and even convulsions and death.A change in blood pH that leads to acidosis or alkalosis may be countered by compensation, thephysiological response to an acid-base imbalance that acts to normalize arterial blood pH.Compensation may be either complete, if pH indeed is brought within the normal range, or partial, if systemic arterial blood pH is still lower than 7.35 or higher than 7.45.
y
 
If a person has altered blood pH due to metabolic causes, hyperventilation or hypoventilationcan help bring blood pH back toward the normal range; termed:
r
espi
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ato
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compensation
 
y
 
If person has altered blood pH due to respiratory causes, then
r
enal
 
compensation
- changes insecretion of H+ and reabsorption of HCO3- by the kidney tubules- can help reverse the change.
o
 
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espi
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Acidosis
is an abnormally high Pco2 in systemic arterial blood-above 45mmHg. Inadequate exhalation of CO2 causes the blood pH to drop. Any condition thatdecreases the movement of CO2 from the blood to the alveoli of lungs to theatmosphere causes a buildup of CO2, H2CO3, and H+
 
E
xamples: emphysema, pulmonary edema, injury to the respiratory center othe medulla oblongata, airway obstruction, or disorders of the muscles involvedin breathing.
y
 
If the respiratory problem is not too severe, the kidneys can help raiseblood pH into the normal range by increasing excretion of H+ andreabsorption of HCO3-
 
Treatment: to increase the exhalation of CO2, as for instance by providingventilation therapy. Intravenous administration of HCO3- may be helpful
o
 
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Alkalosis
systemic arterial blood Pco2 falls below 35 mmHg. The cause of the drop in Pco2 and the resulting increase in pH is hyperventilation, which occurs inconditions that stimulate the inspiratory area in the brain stem.
 
E
xamples: oxygen deficiency due to high altitude, pulmonary disease,cerebrovascular accident (stroke), or severe anxiety.
y
 
R
enal compensation may bring blood pH into the normal range if thekidneys are able to decrease excretion of H+ and reabsorption of HCO3-
 
 
Treatments: aimed at increasing the level of CO2. Have the person inhale andexhale into a paper bag for a short period.
o
 
M
etabolic
 
Acidosis
systemic arterial blood HCO3- level drop below 22 m
E
q/liter. BloodpH to decrease.
 
E
xamples: (1) actual loss of HCO3-, such as may occur with severe diarrhea orrenal dysfunction (2) accumulation of an acid other than carbonic acid, as mayoccur in ketosis or (3) failure of kidneys to excrete H+ from metabolism of dietary proteins.
y
 
If problem is not too severe, hyperventilation can bring blood pH intothe normal range.
 
Treatment: consists of administering intravenous solutions of sodiumbicarbonate and correcting the cause of the acidosis
o
 
M
etabolic
 
Alkalosis
systemic arterial blood HCO3- concentration is above 26 m
E
g/liter.A nonrespiratory loss of acid or excessive intake of alkaline drugs causes the blood pH toincrease above 7.45.
 
E
xamples
:
 
E
xcessive vomiting of gastric contents, which results in a substantialloss of hydrochloric acid, is probably the most frequent cause of metabolicalkalosis. Other causes include gastric suctioning, use of certain diuretics,endocrine disorders, excessive intake of alkaline drugs(antacids), and severedehydration.
y
 
R
espiratory compensation through hypoventilation may bring blood pHinto the normal range.
 
Treatment: consists of giving fluid solutions to correct Cl-, K+ and otherelectrolyte deficiencies plus correcting the cause of alkalosis
Acidosis
of the blood is pH less than 7.35 and
Alkalosis
is pH above 7.45. Normal blood pH is 7.35-7.45What is the system (buffer system) that maintains normal blood pH? Carbonic acid/ bicarbonic buffersystem
Carbonic Acid/Bicarbonic buffer system
: H+ (+) HCO3-

HCO3

HO (+) CO
y
 
In this buffer system, what we have is. There are molecules floating around the blood. H+ is ourstrong acid. Any change in the amount of H+ is going to significantly change blood pH. Whetherwe add or remove H+ is going to significantly change blood pH.
y
 
HCO3- is bicarbonate. Bicarbonate is a weak base.
o
 
E
xample: if we have too much acid (H+ in our blood) what this buffer system does is, ittakes excess H+ and it makes the bicarbonate bind to any extra H+. Its trying to take thestrong acid and make it less powerful. It does that by combing with the weak base.There is a basic chemistry principle balance.
y
 
HCO3 is carbonic acid. Carbonic acid is a weak acid.
 
o
 
Too many H+ is going to push the reaction to the other side. Bicarbonate is going to bindto H+ and form HCO3 molecule. When it does this it is weakening the strong acid.Making HCO3 a weak acid.
y
 
Now we have a buildup of HCO3 of carbonic acid. The body wants to get rid of the excess acidso:What molecules could we make up HCO3 (basic familiar molecule)? H0 (+) CO(slightly acidic)How do you get rid of extra CO?
E
xhale which helps take care of acidosis-
 
Another way is through your urinary system: The kidney helps regulate and filters things outof the blood. Takes the blood and actually filters out any execs molecule via water or certainelectrolytes and that includes H+. Your kidney plays a great role in regulating how muchbase or acid floating around your blood.Four different Conditions:1.
 
M
etabolic
 
acidosis
pH causes diarrhea, renal dysfunction, accumulation of acid
o
 
The blood pH is going to go down which is more acidic. We are going to end up withtoo much acid and by getting rid of the acid, we exhale it out. The compensation iswhat we refer to as respiratory hyperventilation.
o
 
R
espiratory hyperventilation meaning when you are breathing it refers to thediffusion of oxygen and carbon dioxide from the lungs. Into and out from the blood.2.
 
M
etabolic
 
alkalosis
 
pH 
 
causes vomiting, diuretics, intake of alkaline drugs
o
 
When you vomit youre going to get rid of too much H+ which raises your pH.
E
ssentiallyyoure losing your acids.
o
 
Hows your body going to bring high pH level back to normal? Its going to take HCO3and break it down. Infuse more strong acid into the blood. Whats going to happen tothe carbon dioxide? Youre going to retain it. And your breathing with behypoventilation. Youre going to be breathing but will not be exhaling as much carbondioxide as you normally do.What kind of metabolic/gastrointestinal things that go on that ultimately cause your blood to have anacidic pH? Diarrhea and vomitingWhat happens when you vomit? It affects the pH of your blood and when you vomit the acid comes outfrom your stomach causing metabolic alkalosis. Physically removing H+ from your body.What happens when you have diarrhea? Diarrhea is the cause of metabolic acidosis. When you havediarrhea your body doesnt have time to reabsorb certain bicarbonate ions. Bicarbonate ions are not astrong base but it will affect your pH.-
 
E
xample: If you have one episode of diarrhea it is not going to change the pH dramaticallybut it will slightly change it. If you catch a bug and been sitting on the toilet for weeks thanmetabolic acidosis will become an issue.3.
 
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Acidosis
pH emphysema. Kidneys kick in and tries to get rid of H+ excess.

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