MD8401–Medical Instrumentation

PHYSIOLOGY OF
ACID-BASE BALANCE

Presented by:
Dr. A. K. Gnanasekar
Associate Professor
Department of Medical Electronics
Saveetha Engineering College.
 Introduction
♠ Acid-base homeostasis is the
part of human homeostasis
concerning the proper balance
between acids and bases, in
other words, the pH.

♠ Chemical and physiologic processes

responsible for the maintenance of
the acidity of body fluids.

2
 Acid Base
Homeostasis
 Chemical processes:
 extracellular
 intracellular buffers

 The physiologic processes: the excretion of

volatile acids by the lungs and fixed acids by
the kidneys

3
 Acids can be defined as a proton (H+ )
donor

 Hydrogen containing substances

which dissociate in solution to release
H+

6
Lactic acid Phosphoric acid

Pyruvic acid

7
9
 -

Biphosphate

1
0
8
 OH- H+ H+
H+ + - - H
+
OH- HOHOH
+ - H+
H+ H+
+
H OH- H+
OH OH-
-
OH- H+
OH- H+ OH- OH- H+
1
H+OH-
3
H+
OH-
OH -

6.8 - 8.0
9
 ACIDOSIS NORMAL ALKALOSIS
DEAT DEAT
H H
6.8 7.3 7.4 7.5 8.0
Venou Arterial
15 s Blood
• pH = pK + log
HCO3
CO2

16
 ♠ A condition in which the blood has too
much acid (or too little base), frequently
resulting in a decrease in blood pH

♠ A condition in which the blood has too

much base (or too little acid), occasionally
resulting in an increase in blood pH
1
8
 H + OH -

19
H + OH -
14
15
2
2
K+
Na+
H+

2 K+
3
K+
Na+
H+

2
4
 H+
H2CO3
25
HCO3 -
20
21
22
23
 -

H2CO3 HCO -
3

24
 HCO3-
H+

25
CO2 + H2O H2CO3 H+ + HCO3-
Addition of lactic acid
Exercise
Loss of HCl
Vomiting

26
Na2HPO4 + H+ NaH2PO4 + Na+

+Na2HPO4
H+

NaH2PO4 + Na +

27
HPO4-2

28
29
O2 O2

Hb
O2 O2

30
O2 O2

Hb
O2 O2

31
 3 2 2
O2 3
H+

Hb
O2 O2
38
Pons
Respiratory centers

Medulla oblongata
39
 CO2
CO
CO22
C
CO2CO
40
O2 CC
 cell production of CO2 increases

CO2 + H2O H2CO3

H2CO3 H+ + HCO3-
H+ acidosis; pH drops

H+ stimulates respiratory center in medulla oblongata

rate and depth of breathing increase

CO2 eliminated in lungs

41
pH rises toward normal
36
 ELECTROLYTE SHIFTS

Compensatory Response Result

- H+ buffered intracellularly
H+
- Hyperkalemia
K+ -Diabetic ketoacidosis
cell

Result
Compensatory Response - Tendency to correct alkalosis
H+
- Hypo kalemia

K+ 37
44
45
• Caused by hyperkapnia due
to hypoventilation
– Characterized by a pH decrease
and an increase in CO2

pH
CO2 CO2
CO2 CO2
CO CO2
2 CO2
CO2 CO2
CO 2CO2
pH
CO2
4 CO2
6
41
42
Left lung
collapsed

43
 CO CO
2
2
CO
CO
2
2

2 : 20

◊ breathing is suppressed holding CO2 in body

◊ pH = 7.1
44
 H2CO3

HCO3-
HCO3-
+
H+

2 : 30
BODY’S COMPENSATION acidic urine
♠ kidneys conserve HCO3 - ions to restore
the normal 40:2 ratio (20:1)
♠ kidneys eliminate H+ ion in acidic urine
45
 Lactate
H2CO3 HCO3- LIVER
Lactate
HCO3-

2 : 40
♠ therapy required to restore metabolic balance
♠ lactate solution used in therapy is converted
to bic5a2 rbonate ions in the liver
H2CO3 HCO3-

0.5 : 20 == 7.4
53
 CO CO
CO CO CO CO
2 CO
CO 2CO CO 2 2
CO CO2 2
2 2 2
2 2
2
5
4
 HCO3-
+ HCO3
-
H-
HCO3 HCO H+ -
3
H + +
H H+
HCO3-
HCO+3HCO
- H+
-
HCO3- H H + 3
HCO3 -

H+
56
HCO3- H+
H+
 H2CO3 HCO3- Cl -

Chloride
containing
0.5 : 10 solution

 therapy required to restore

metabolic balance
5
CO3- ions replaced by Cl- ions
H2CO3 HCO3-

== 7.4
58 1 : 12
53
 METABOLIC ALKALOSIS

65 7.4
55
Thank you