Biokimia & Biomolekuler

Elektrolit & Gas dalam Darah

oleh: Febrial Hikmah, S.Si., M. Biomed.
Zahara Fadillah, S.Si., M.Si.
Rustiana Tasya A, S.Kep., Ns., M.Biomed.

Program Studi DIV Teknologi Laboratorium Medik (TLM)

Sekolah Tinggi Ilmu Kesehatan Binawan, Jakarta
2
Ringkasan Isi: (TNR 44)

 Sejarah (TNR 20-30)

 Definisi sel
 dll
 The Body’s Internal Water Is
Compartmentalized
A. INTRACELLULAR FLUID (ICF)
This compartment constitutes two-thirds of total body water and provides
the environment for the cell
1. to make, store, and utilize energy
2. to repair itself
3. to replicate
4. to perform special functions.
B. EXTRACELLULAR FLUID (ECF)
-The extracellular fluid is a delivery system. It brings to the cells
nutrients (eg, glucose, fatty acids, amino acids), oxygen, various ions and
trace minerals, and a variety of regulatory molecules (hormones) that
coordinate the functions of widely separated cells.
-Extracellular fluid removes CO2, waste products, and toxic or detoxified
materials from the immediate cellular environment.
 The Ionic Compositions of
Intracellular & Extracellular
Fluids Differ Greatly
 Why is there such a
difference?
 Cells developed
barriers-membranes
with associated
“pumps”—to
maintain the
internal
microenvironment

Harper, 26th Ed.

 Body-Fluid Compartment
Sherwood, 7th ed.
MINERALS ARE
REQUIRED
FOR BOTH
PHYSIOLOGIC &
BIOCHEMICAL
FUNCTIONS

Harper, 26th Ed.

Potensial Membran Sel
Seluruh Tubuh

Guyton & Hall, 11th ed.

 Hubungan Potensial Difusi
Terhadap Perbedaan Konsentrasi-
Potensial Nerst
 Nilai potensial difusi yg melintasi suatu membran, yang berbanding
terbalik dengan difusi net suatu partikel ion melalui membran 
disebut potensial Nerst untuk ion tsb.

EMV (milivolt) = + 61 x log konsentrasi sisi dalam

konsentrasi sisi luar

 Persamaan Nerst memprediksi potensial membran untuk 1 ion.

 Potensial nerst ditentukan oleh perbandingan konsentrasi ion
spesifik pada kedua sisi membran.
 Semakin besar perbandingan ini  semakin besar ion ini berdifusi
ke satu arah  semakin besar pula potensial Nerst yang dibutuhkan
untuk difusi Neto tambahan.
Na+ K+ ATPase PUMP

Harper, 26th Ed.

 Blood Gases
 Molecular Basis of Gas
Diffusion
 All the gases of concern in
respiratory physiology are
simple molecules that are
free to move among one
another, which is the
process called “diffusion.”
 This is also true of gases
dissolved in the fluids and
tissues of the body.
Guyton & Hall, 11th ed.
 Gas Pressures in a Mixture of
Gases-“Partial Pressures” of
Individual Gases
 This means that the pressure is directly proportional to
the concentration of the gas molecules.
 Henry’s law:

Guyton & Hall, 11th ed.

 Composition of Alveolar Air-Its
Relation to Atmospheric Air
 Reason:
1) The alveolar air is only partially replaced by atmospheric air with each
breath.
2) O2 is constantly being absorbed into the pulmonary blood from the
alveolar air.
3) CO2 is constantly diffusing from the pulmonary blood into the alveoli.
4) Dry atmospheric air that enters the respiratory passages is humidified
Guyton & Hall, 11th ed.
even before it reaches the alveoli.
 Rate at Which Alveolar Air Is
Renewed by Atmospheric Air

Guyton & Hall, 11th ed.

 Shows this slow rate of renewal of the alveolar air. In the first
alveolus of the figure, an excess amount of a gas is present in the
alveoli, but note that even at the end of 16 breaths, the excess gas
still has not been completely removed from the alveoli.
Oxygen and Carbon Dioxide
Partial Pressures
Guyton & Hall, 11th ed.
Diffusion of Gases Through
the Respiratory Membrane

Guyton & Hall, 11th ed.

PO2 and PCO2

Guyton & Hall, 11th ed.

 Oxygen-Hemoglobin
Dissociation Curve
 Normally, 97 % O2
transported from the
lungs to the tissues is
carried in chemical
combination with Hb in
the RBCs.
 3% is transported in the
dissolved state in the
water of the plasma and
blood cells.
 Under normal
conditions, O2 is
carried to the tissues
almost entirely by Hb.
Po2 95 mm Hg = Saturation O2 97%
Po2 40 mm Hg = Saturation O2 75%.
Guyton & Hall, 11th ed.
Forming Blood Gases
Analysis
FLUID & ACID-BASE
BALANCE
THEIR REGULATION IN THE BODY
SYSTEM
 Fluid Balance
Fluid balance is maintained by regulating ECF
volume and osmolarity.
1) ECF volume must be closely regulated to help
maintain blood pressure. Maintaining salt balance is of
primary importance in the long-term regulation of ECF
volume.
2) ECF osmolarity must be closely regulated to
prevent swelling or shrinking of cells. Maintaining
water balance is of primary importance in regulating
ECF osmolarity.
Control of salt balance is primarily
important in regulating ECF
volume.
Na and its attendant
anions account for
more than 90% of the
ECF’s osmotic activity.
As the kidneys
conserve salt, they
automatically conserve
H2O because H2O
follows Na osmotically.
Sherwood, 7th ed.
Control of
increased
vasopressin
secretion and
thirst during a
H2O deficit.
Sherwood, 7th ed.
 Acid–Base Balance
The term acid–base balance refers to the
precise regulation of free (that is,
unbound) hydrogen ion (H)
concentration in the body fluids.
To indicate the concentration of a
chemical, its symbol is enclosed in square
brackets. Thus, [H+] designates H+
concentration.
 Acid–Base Balance
 Acids
Are a special group of hydrogen-containing substances that
dissociate, or separate, when in solution to liberate free H+
and anions (negatively charged ions).
Many other substances (e.g, carbohydrates) also contain
hydrogen, but they are not classified as acids, because the H
is tightly bound within their molecular structure and is never
liberated as free H.
 Base
Is a substance that can combine with a free H and thus
remove it from solution.
A strong base can bind H more readily than a weak base can.
 Acids liberate free
hydrogen ions, whereas
bases accept them

Lehninger, 4th ed.

 ACIDIC AND BASIC
SOLUTIONS IN CHEMISTRY
The pH of pure H2O is 7.0, which is considered
chemically neutral.
An extremely small proportion of H2O molecules
dissociate into hydrogen ions and hydroxyl (OH) ions.

Hydrogen ions formed in water are immediately

hydrated to hydronium ions (H3O).
Lehninger, 4th ed.
 ACIDOSIS AND ALKALOSIS
IN THE BODY
 H2O is neutral, being neither acidic nor basic.
 pH < 7.0 : contain a higher [H] than pure H2O and are considered
acidic.
 pH > 7.0 : contain a lower [H] and are considered basic, or
alkaline.
 Arterial pH normally 7.45 and venous pH is 7.35, for an average
blood pH of 7.4.
 The pH of venous blood is slightly lower (more acidic) than that
of arterial blood because H is generated by the formation of
H2CO3 from CO2 picked up at the tissue capillaries.
 Acidosis exists whenever blood pH falls below 7.35
 Alkalosis occurs when blood pH is above 7.45
pH and H concentration of
body fluid

Guyton & Hall, 11th ed.

Fluctuations in [H] alter nerve,
enzyme, and K activity

Sherwood, 7th ed. Lehninger, 4th ed.

 Defenses Against Changes in
Hydrogen Ion Concentration:
Buffers, Lungs, and Kidneys
 3 primary systems that regulate the H+ concentration in the
body fluids to prevent acidosis or alkalosis:

1) The chemical acid-base buffer systems of the body

fluids, which immediately combine with acid or base to
prevent excessive changes in H+ concentration;
2) The respiratory center, which regulates the removal of
CO2 (and, therefore, H2CO3) from the extracellular fluid
3) The kidneys, which can excrete either acid or alkaline
urine, thereby readjusting the extracellular fluid H+
concentration toward normal during acidosis or alkalosis.
 1) Buffering of Hydrogen Ions
in the Body Fluids
A buffer is any
substance that can
reversibly bind H+.
The general form of
the buffering
reaction is:

Sherwood, 7th ed.

 Action of Chemical Buffers
Sherwood, 7th ed.
FIGURE 15-8
(a)Addition of HCl to an
unbuffered solution. All the
added hydrogen ions (H)
remain free and contribute
to the acidity of the solution.
(b)Addition of HCl to a
buffered solution.
Bicarbonate ions (HCO3),
the basic member of the
buffer pair, bind with some
of the added H and remove
them from solution so that
they do not contribute to its
acidity.
 2) Respiratory Regulation of
Acid-Base Balance
 Pulmonary Expiration of
CO2 Balances Metabolic
Formation of CO2
E.g: Increased
Hydrogen Ion
Concentration
Stimulates Alveolar
Ventilation
E.g: astma increased
CO2  H+ increased
 Acidosis

Sherwood, 7th ed.

The respiratory system serves
as the second line of defense
against changes in [H]

Sherwood, 7th ed.

 3) Renal Control of Acid-Base
Balance
Kidneys regulate extracellular fluid H+ concentration
through three fundamental mechanisms:
1) Secretion of H+
2) Reabsorption of filtered HCO3
3) Production of new HCO3
 Secretion of Hydrogen Ions and
Reabsorption of Bicarbonate Ions by
the Renal Tubules
 Keep in mind that for each bicarbonate reabsorbed, an H+ must be secreted.
 About 80 to 90 per cent of the bicarbonate reabsorption (and H+ secretion)
occurs in the proximal tubule, so that only a small amount of bicarbonate
flows into the distal tubules and collecting ducts

Guyton & Hall, 11th ed.

 Hydrogen secretion coupled with
bicarbonate reabsorption in a Type A
intercalated cell
Sherwood, 7th ed.
 Bicarbonate secretion coupled with
hydrogen ion reabsorption in a Type
B intercalated cell
Sherwood, 7th ed.
 The Kidneys Conserve or Excrete
HCO3 Depending on The Plasma [H]

Sherwood, 7th ed.

 Renal Handling of HCO3
During Acidosis and Alkalosis
Sherwood, 7th ed.
Acid-Base Disturbances
Guyton & Hall, 11th ed.
Summary of Renal Responses
to Acidosis and Alkalosis
Sherwood, 7th ed.
 Analysis of Simple Acid Base
Disturbances
Guyton & Hall, 11th ed.
44
Daftar Pustaka
 Rodwell VW, Bender DA, Botham KM, Kennelly PJ, Weil
PA. Harper’s illustrated biochemistry. 30th ed. New York:
Mc Graw-Hill Education, 2015.
 Nelson DL, Cox MM. Lehninger principles of
biochemistry. 4TH ed.
 Guyton, A,C & Hall. J.E. 2006. Textbook of Medical
Physiology. 11 ed. Philadelphia, Pennsylvania: Elsevier.
 Sherwood, L. 2010. Human Physiology: From Cells to
Systems. 7 ed. Canada: Nelson Education, Ltd.