- Dr.

Al-Matary

|| || Acid base Regulation

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: : :
:
acid base regulation

40
10 2013

Acid base balance
,,
acid base balance
,,
acid
acid
hydrogen ions
Acid H ion donor
Ionized H ion
acid
Acid
ionized H ion

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|| || Acid base Regulation

HCL H2 CO3
HCL Hydrogen ion
carbonic acid H ions
!!!!

HCL strong acid
H2 CO3 weak acid
strong acid
H ions
H ions
ionization H ions
PH
Carbonic acid
: carbonic acid weak acid
weak acid
H ions

,,
HCL ,, H2 CO3

HCL
H ions
HCL
,, ,, acid
,, weak acid strong acid

Buffer
Buffer H ions
Buffer H ions

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- Dr. Al-Matary

|| || Acid base Regulation

weak acid
PH
Buffer H ions
,, weak acid PH

Buffer
By definition
Salt of weak acid

,,,
) Na HCO3 (
acidic alkaline
,, Nutrient
,,
H ion
,, weak acid weak acid
PH
buffer
Buffer << salt of weak acid
Salt nutrient

,,
H ion
,, H ions weak acid
,, weak acid PH
buffer << by definition
,,
acid
acid
H ion
strong acid H ions
weak acid H ions

Buffer
Buffer nutrient

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- Dr. Al-Matary

|| || Acid base Regulation

Salt of weak acid

,,
,, H ion weak acid
PH
,,
,,
acid
metabolism
,, ,,

aerobic anaerobic
Aerobic

) ( oxygen

,,

,, ATP

,,
) ,,, ( CO2 ) Carbonic acid ( H2 CO3
,, carbonic acid
carbonic acid acidic alkaline
Acidic

,,
,,

Carbonic acid ,, carbonic acid ,, carbonic acid

,, ,,

,,
,, ,,
anaerobic
acid

Lactic acid
acidic

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|| || Acid base Regulation

,, metabolism acid
,, Aerobic ,, anaerobic acid

metabolism acid
acid
,,
metabolism acid


mainly

,, buffer
salt of weak acid

buffer

buffer!!!

buffer
% 60 buffering effect intracellular
:
buffer
curve
shift to the left
,,
,, shift to the right
curve
curve
,,
,,
,, ,, buffer buffer
,,
% 40 buffering effect fluid
% 60 buffering effect

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|| || Acid base Regulation

) ( salt of weak acid
) Na HCO3 (

lactate
,, buffers
salt of weak acid
buffer

,, ,,
,, ,, lactate

,,
buffer ,, ,,
,,

,,
,,
,,

,, Lung ,,
H ion
) H2 CO3 ( carbonic acid

,,
H ion
carbonic acid

,,
Lung !!!
,,
carbonic acid
,,
) Kidney

(
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|| || Acid base Regulation

,, ,, ,,
carbonic anhydrase

proximal convoluted tubules

,, distal convoluted tubules

,,

,,

,, ,, ,, Lung

,,
metabolism mainly
% 60 buffering effect

% 40 buffering effect
buffering
:
Dilution

dilution
,,
% 60

dilution

,, ,,

!!!
,,

,,

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|| || Acid base Regulation

- Dr. Al-Matary

dilution

% 70

% 70

dilution
,,
dilution
,,
,,
,,
,, dilution ,,
,,
,, dilution
,, ,,

Lung and kidney

,, ,,
equation
,,

,,

,, ,, ,,
acid base balance
,,


,,

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|| || Acid base Regulation

PH ,,
PH ,,

: PH ,,
,, ,,
) pKa + log ( HCO3 / H2CO3

,,

PH ) pKa + log ( HCO3 / H2CO3

,, ,,

,, constant

,, ( 3.14 ) 22/7
,,

,,
,,


( ( dissociation constant
,,
,,

dissociation constant ,,

,, carbonic acid 6.1
,, HCL 2 ,,
,,

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|| || Acid base Regulation

,,
,,
pKa
carbonic acid << 6.1

,,
carbonic acid ,, Normal

20
pKa >> 6.1
carbonic acid Normal
1.3

PH 7.4
,,
1.3
PH 7.4 = 1.3 + 6.1
PH ,,

!!!
,,,
,, ,, ,,

buffering effect
) (


pKa 6.1
PH

6.1 ,,

10

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|| || Acid base Regulation

PH
20
20



level
level carbonic acid

,, carbonic acid
,,
,,
respiratory acidosis ,, respiratory alkalosis
Metabolic acidosis ,, metabolic alkalosis

,,
pKa ) ( 6.1
) ( 20
,,
acid base balance ,,
MCQ acid base balance
,,

,,
,,
,,


,, ,,
Level
carbonic acid level
ratio
20

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|| || Acid base Regulation

,, ,,

Tachypnea ,, tachypnea

,, wash CO2
wash carbonic acid
wash CO2
wash carbonic acid

Alkalosis

,,
,, ,, ,, ,,

alkalosis!!!
,,
,,
,, ,,
) ( Kidney
,, Lung carbonic acid
carbonic acid

carbonic acid lung

,, ,, ,,
Kidney
,, ,, ,, ,,
20
,,
,, ,, ,,
Lung

12

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|| || Acid base Regulation

,,
,,
kidney 20
PH
alkalosis
,, kidney
capacity

,,
respiratory alkalosis
PH ,,
alkalosis
,,,
PH alkalosis ,,
,,
renal compensation

kidney ,,


Level carbonic acid
ratio carbonic acid

Lung
kidney

20
,, ,, alkalosis
renal compensation
PH

carbonic acid ratio
20

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|| || Acid base Regulation

carbonic acid

carbonic acid

20
,, ,, ,,
carbonic acid
,, carbonic acid kidney
,,


,, alkalosis
alkalosis
renal compensation
respiratory alkalosis

,,
respiratory failure

Respiratory failure ,, pulmonary fibrosis

,,
,, .T.B .T.B Healing fibrosis
respiratory failure
respiratory failure
) carbon dioxide retention ( CO2 retention
CO2 retention

carbonic acid
carbonic acid ,, ,, ,,
Kidney
,, ,, ,,

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|| || Acid base Regulation

carbonic acid ,,
20
kidney ,,
,,
acidosis
,,
,,
renal compensation
,,
respiratory failure ,, PH ) acidosis
(
carbonic acid
kidney
,,
acidosis

,, ,,
PH

ratio
carbonic acid

20

,,
respiratory alkalosis
respiratory acidosis
renal compensation

,,
Metabolic acidosis
metabolic acidosis
H ions ,,

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- Dr. Al-Matary

metabolic acidosis
Diabetic
keto
diabetic keto acidosis
H ions

,,
) DKA ( Diabetic keto acidosis
H ions ,,
acid ,,
hydrogen ions
,,



H ions
,,



Carbonic acid

,, carbonic acid

,, H ions
carbonic acid

,,
carbonic acid
,,
Diabetic keto acidosis

Hydrogen ion

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|| || Acid base Regulation

carbonic acid
,,
Lung ,,
wash
Wash CO2
,,
carbonic acid
Lung wash
Diabetic keto acidosis
,, ,, wash CO2
,, Lung

Kidney
,,
carbonic acid
kidney excretion
,,
acidosis
system << failure
,, Lung kidney to compensate

,,
Diabetic keto acidosis
PH
>> Acidosis ) (
Diabetic keto acidosis
PH

,,

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|| || Acid base Regulation

- Dr. Al-Matary

,, H ions ,, ,,
compensation
,, ,, to compensate

,,
,, metabolic acidosis
respiratory acidosis
Respiratory acidosis
PH
Metabolic acidosis

PH

renal compensation
PH

,,
,,
,,
metabolic
,, PH
respiratory
metabolic alkalosis
metabolic alkalosis
) ( CHIPS

,,
HCL
HCL
metabolic alkalosis

,, HCL

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|| || Acid base Regulation

,,

carbonic acid
,,
Lung

,, HCL
HCL ,, ,, Pyloric
obstruction

GIT
,, HCL ,, stomach

,, HCL
,,
,,


Lung
Lung ,,

carbonic acid
carbonic acid 20
,, Lung
,, ,,
Metabolic alkalosis

,,
,,
Lung !!! !!!
Lung

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|| || Acid base Regulation

- Dr. Al-Matary

,, Lung carbonic acid

Lung
metabolic alkalosis
PH

,, PH
mainly ratio carbonic acid

20
lung kidney

20
,,
acidosis alkalosis
PH
respiratory metabolic

PH >> Metabolic
H >> respiratory
,,
,, lung renal compensation
lung compensation


,, ,,

PH alkalosis acidosis

acid base regulation

12
10 2013
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|| || Acid base Regulation

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