Final-Chpt07-Carbon Dioxide Transport and Acid-Base Balance

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63% - Bicarbonate (HCO3)
21% - Carbamino Hb
5% - Dissolved CO2

What are three ways CO2 is transported in the blood?

5% - Bicarbonate (HCO3)
5% - Dissolved CO2
1% - Bound to protein (Carbamino compound)

What are three ways CO2 is transported in the plasma?

Bohr effect

What can shift the oxygen-Hb dissociation curve to the right?

increase in PCO2 or decrease in pH shifts curve to right

What is the Bohr effect?

unloads more O2 at the same PO2

What is the effect of shifting the oxygen-Hb dissociation curve to the right?

Haldane effect

The fact that deoxygenated blood in the lung enhances the loading of CO2 is called?

Haldane effect

The fact that oxygenated blood enhances the unloading of CO2 from the tissues is called?

Chemical buffers, which responds within seconds

What is the body's first line of defense in regulating body pH?

Respiratory system, which responds within 1 to 3 minutes

What is the body's second line of defense in regulating body pH?

Renal system, which requires a day or more to respond

What is the body's third line of defense in regulating body pH?

Acids

What is a proton donor?

Base

What is a proton acceptor?

pH = -log10 [h+]

What is the pH of a solution?

pH = 6.1 + log(HCO3/H2CO3)

(6.1 is the pk value of H2CO3-Carbonic Acid)
H2CO3 = Pco2 * .03

What is the Henderson-Hasselbalch Equation?

The ratio of HCO3- (bicarbonate) to H2CO3 (carbonic acid) is 20:1 (normal value)

What is the normal HCO3- to H2CO3 blood plasma ratio?

It will secreate H+ and retain HCO3-

How does the renal system compensate for metabolic acidosis?

It will retain HCO3- and retain H+

How does the renal system compensate for metabolic alkalosis?

Used to determine if a patient's metabolic acidosis is caused by either (1) the accumulation of fixed acids, or (2) by an excessive loss of HCO3-.
Anion gap = [Na+] - ([Cl-] + [HCO3-])
Normal aniion gap range is 9 to 14 mEq/L
If greater than 14 then metabolic acidosis
if less than 9 then metabolic alkalosis

What is the anion gap?

Metabolic acidosis caused by a decreased HCO3- loss as a result of something like renal disease or severe diarrhea.

What is hyperchloremic metabolic acidosis?

4-3-2-1
1-Check pH
greater than 7.4, Alkalosis, less than 7.4 Acidosis
2-Cause
Respiratory acidosis, CO2 greater 45
Respiratory alkalosis, CO2 less 35
Metabolic acidosis, HCO3- less 22
Metabolic alkalosis, HCO3- greater 28
3-Check for Compensation
Respiratory if CO2 less 35?????????
Metabolic if HCO3- ???????
4-Check pH
If within normal range then fully compensated

How to tell respiratory or metabolic acidosis/alkalosis

Arterial 7.35 - 7.45
Venous 7.30 - 7.40

What are the normal blood gas values for pH ?

Arterial 35 - 45 mm Hg
Venous 42 - 48 mm Hg

What are the normal blood gas values for Pco2 ?

Arterial 35 - 45 mEq/L
Venous 42 - 48 mEq/L

What are the normal blood gas values for HCO3- ?

Arterial 80-100 mm Hg
Venous 35-45 mm Hg

What are the normal blood gas values for Po2 ?

As HCO3- moves out of the RBC, the Cl- (which has been liberated from the NaCl molecule) moves into the RBC to maintain electric neutrality.

What is the Chloride shift, or the Hamburger phenomenon?

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