Acid Base Physiology HSF

Department of Physiology | School of 10/7/2020
Biomedical Sciences
Acid-Base
Physiology
Physiological Buffers
Yossi Rathner
Joseph.rathner@unimelb.edu.au
Department of Physiology
School of Biomedical Sciences
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Biomedical Sciences
Major physiological buffers

• Bicarbonate • Bicarbonate
• HCO3-
• CO2 + H2O ⇌ H2CO3 ⇌ HCO3- + H+
• Phosphate
- Organic • Phosphate
▪ Nucleotides
• HPO4- + H+ ⇌ H2PO4-
- Inorganic
▪ HPO42-
▪ H2PO4-
• Ammonium/Ammonia
• Ammonium/Ammonia
• NH4+/NH3 • NH4+ ⇌ NH3 + H+
• Proteins
• Albumin • Hemoglobin
• intracellular
• Hemoglobin • Hb +H+ ⇌ H-Hb+
Location of Buffer Systems in the body
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Biomedical Sciences
Blood/plasma ECF Intracellular fluid
H+ +HPO42- ⇌H2PO4-
H+ 2-
+HPO4 ⇌H2PO4 -
Protein + H+ ⇌Protein-H
RBC
* H CO ⇌ H++HCO -
CO2 + H2O ⇌ 2 3 3
*
CO2 + H2O ⇌ H2CO3 ⇌ H++HCO3-
Albumin - H
* Regulated by the enzyme – carbonic anhydrase
H+ absorbed by the principal buffer

systems
Buffer Amount per litre of Mmol H+ absorbed
blood per litre
Bicarbonate 25 mmole 18 *
Phosphate 1.25 mmole 0.3
Plasma Protein 40 g 1.7
Haemoglobin 150 g 8
Total 28
• Note the relative importance of the bicarbonate buffer system:

• CO2 as a gas – open system, regulated by ventilation.
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Biomedical Sciences
Isohydric principle
All the buffer systems in the body are linked.

• Altering one = impact on all others.
• ∴ by knowing what happens in the bicarbonate
system in the body – we know what is happening
to all systems.
• ∴ we typically only assess the HCO3- system.
Acid-Base
Physiology
Physiological Acid Production
Yossi Rathner
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Biomedical Sciences
Two basic forms of acids

1) Volatile acids
• Can be converted into a gas
• Eliminated via the lungs
• Most prominent = CO2/bicarbonate
2) Fixed acids
• “non-volatile” – cannot be made into a gas
• Eliminated via the kidneys
• Normal metabolism of proteins and phospholipids results in generation of sulfuric acid
• strenuous exercise can result in the generation of substantial lactic acid
• Ketoacidosis – large amounts of β-hydroxybutyric acid and acetoacetic acid
• Dietary and pharmacological acid
• E.g. asprin → salacyclic acid
Acid-Base
Physiology
Respiratory control of pH
Yossi Rathner
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Biomedical Sciences
Alterations in PaCO2 alter pH CSF

• Respiration is involved in the short term control of pH
in the body.
• CO2 dissolved in water is an acid
• Central chemoreceptors are sensitive to changes in pH
• Increased ventilation, decreased PaCO2, increased pH
Relationship between PaCO2 and CSF pH
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Biomedical Sciences
Central chemoreceptors are sensitive to

changes in pH
• Change in sensitivity
to PaCO2 in response
to change in CSF [H+]
- As ↓ pH,
respiratory rate ↑
Ventilation in the control of pH
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Biomedical Sciences
Acidosis
Alkalosis
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Biomedical Sciences
Acid-Base
Physiology
Kidneys in long term regulation of pH
Yossi Rathner
The kidneys are involved in long term

regulation of acid base balance
• Bicarbonate buffer system
• CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3- (Carbonic anhydrase)
• CO2 is membrane permeable, HCO3- is not!
• Shifting this reaction to the right, recovers bicarbonate from the filtrate
→ lowers blood pH
• CO2 removed via lungs
• Phosphate buffer system
• H+ is actively pumped into filtrate
• H+ + HPO42- → H2PO4-
• Inside cell HCl →H+ + Cl-
• Cl- is exchanged for HCO3-
• Ammonium (NH4+)
• Not membrane permeable.
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Biomedical Sciences
Summary of secretion
and reabsorption in
kidneys
Proximal convoluted
tubules
NH4+ secretion
Distal collecting
ducts
Tubular regulation of Acid-Base balance
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Biomedical Sciences
Acid secretion coupled with phosphate

buffer
Amino Acid metabolism – ammonia secretion

PCT
Biomedical Sciences
Acid-base
physiology
Acidosis and alkalosis
Yossi Rathner
Anion Gap
• Electroneutrality
• σ 𝑐𝑎𝑡𝑖𝑜𝑛𝑠 = σ 𝑎𝑛𝑖𝑜𝑛𝑠
• Measured ions
• HCO3-
• Na+
• (maybe – K+)
• Cl-
• Anion gap
• AG=[unmeasured anions]-[unmeasured cations]
Biomedical Sciences
Acidosis and
Alkalosis
Acid-base nomogram
Respiratory acidosis and alaklosis
Biomedical Sciences
Metabolic Acidosis and alkalosis

Acid Base Physiology HSF

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Acid Base Physiology HSF

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Department of Physiology | School of 10/7/2020

This material has been reproduced and communicated to you

The material in this communication of this material by you

Major physiological buffers

Location of Buffer Systems in the body

Blood/plasma ECF Intracellular fluid

H+ absorbed by the principal buffer

• Note the relative importance of the bicarbonate buffer system:

All the buffer systems in the body are linked.

Physiological Acid Production

Two basic forms of acids

Alterations in PaCO2 alter pH CSF

Relationship between PaCO2 and CSF pH

Central chemoreceptors are sensitive to

Ventilation in the control of pH

Kidneys in long term regulation of pH

The kidneys are involved in long term

Tubular regulation of Acid-Base balance

Acid secretion coupled with phosphate

Amino Acid metabolism – ammonia secretion

Acidosis and alkalosis

Respiratory acidosis and alaklosis

Metabolic Acidosis and alkalosis

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