0, ,54 0, , , ,5. H+ Ca++ mmol.l -1
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1 Acidbase equilibrium
2 Physiologic ph Plasma and most extracellular fluids ph = 7.40 ± 0.02
3 Significance of constant ph ph influences properties of proteins enzyme activity structure of cell components permeability of membranes distribution of electrolytes ph < 7.0 or > 7.7 is lethal
4 H + and other cathions mmol.l 1 0, ,54 0, ,5 2 0, , ,5 1,5 80 0, , , , ,5 0, , H+ Ca++ K+ Na+ Martin Vejražka, 2007
5 ph gastric juice 0,8 1,5 urine 4,5 7,2 plasma 7,38 7,42 pancreatic juice ~ 8, lemon juice 2,3 CocaCola 2,6 vinegar 2,4 beer 4,0 4,9 marine water 8,5 soap enysek.blog.cz/0607/kuriozitymore Martin Vejražka, 2007
6 Proton sources Anaerobic glycolysis 1Glc 2lactate + 2H + Lipolysis TAG 3FA + glycerol + 3H + Formation of ketone bodies FA acetoacetate + hydroxybutyrate + nh +
7 Proton sources Oxidation of Scontaining AA Metabolism of org. phosphates Oxidation of other AA Ureasynthesis from NH + 4 CO 2 + 2NH 4+ urea + H 2 O + 2H +
8 MV6 Consumption of protones Oxidation of lactate lactate + 3O 2 + H + 3CO 2 + H 2 O Anaerobic glycolysis 1Glc 2lactate + 2H + May be separated in time or space 2lactate + 2H + + 6O 2 6CO 2 + 2H 2 O Oxidation of lactate Martin Vejražka, 2007
9 Snímek 8 MV6 Udělat ještě jeden obrázek? Martin Vejražka;
10 MV4 Consumption of protones Gluconeogenesis 2lactate + 2H + Glc Oxidation of neutral AA Oxidation of dicarboxylic AA Oxidation of anions of org. acids
11 Snímek 9 MV4 Udělat ještě jeden obrázek? Martin Vejražka;
12 Proton sources Food contains Compounds metabolised to organic acids compounds metabolised to sulphuric acid compounds metabolised to phosphoric acid
13 Maintaining ph Fast but incomplete BUFFERS Complete but slow CONTROL of METABOLISM respiration, transporting mechanisms Martin Vejražka, 2007
14 Maintaining acidity of inner environment CO 2 NH 3 formation of urea glutamin H + HCO 3 Martin Vejražka, 2007
15 Respiration CO 2 + H 2 O H 2 CO 3 ventilation pco 2 alkalinisation ventilation pco 2 acidification
16 Liver CO NH urea + 2H + H 2 O NH 4+ + Glu Gln + H 2 O
17 Amminoacids Liver H + NH 4+ + HCO 3 Glucose H 3 PO 4 + H 2 SO 4 Urea Glutamine HCO 3 H + HPO 4 2 SO 4 2 Kidney Glutamine NH 4 + HCO 3 2oxoglutarate H + H 2 PO 4 Urine Urea NH 4 + H 2 PO 4 SO 4 2
18 Kidney BLOOD URINE CO 2 CO 2 + H 2 O H 2 CO 3 C A HCO 3 Na + Na + H + Martin Vejražka, 2003
19 Kidney BLOOD URINE H + Na + Na + H + Martin Vejražka, 2003
20 Kidney BLOOD URINE CO 2 CO 2 + H 2 O H 2 CO 3 C A HCO 3 Na + Na + H + Martin Vejražka, 2003
21 Kidney BLOOD URINE HCO 3 H 2 CO 3 HCO 3 CO 2 + H 2 O C A CO 2 Na + H + Na + Martin Vejražka, 2003
22 Kidney BLOOD URINE HCO 3 HCO 3 Na + Na + Martin Vejražka, 2003
23 Kidney BLOOD URINE HCO 3 H 2 CO 3 HCO 3 CO 2 + H 2 O C A CO 2 Na + H + Na + Martin Vejražka, 2003
24 Buffers 7 % plasma proteins 3 % inorganic phosphates 2 % organic phosphates 35 % haemoglobin 53 % Hydrogen carbonates
25 Haemoglobin buffer Hb H + H + HbO 2 H + H + Oxyhaemoglobin is more acidic than desoxyhb partially compensates ph change in lungs after exhalation CO 2 easier to release O 2 in acidic environment (hypoxic tissue) Martin Vejražka, 2001
26 Bicarbonate buffer H 2 O + CO 2 H 2 CO 3 HCO 3 + H +
27 HendersonHasselbalch Hasselbalch equation ph = pk a + a [ HCO ] log 3 [ H ] 2 CO 3 In tables: pk a = 6,35 = 6,35 > 10! pk a = 6,1 [HCO 3 ] = 24 mmol.l 1 [ HCO 3 ] = 20 [H 2 CO 3 ] = 1,2 mmol.l 1 [ H CO ] 2 3
28 HendersonHasselbalch Hasselbalch equation ph = pk + a a ] 3 [ log HCO α pco 2 pk a = 6,1 [HCO 3 ] = 24 mmol.l 1 α = 0,224 mmol.l 1 / kpa pco 2 = 5,3 kpa
29 Bicarbonate buffer tissue H 2 O + CO 2 H 2 CO 3 HCO 3 + H + lungs kidney
30 ph change in vomiting loss of ca. 0.5 L of gastric juice, ph 0.8 w/o buffer ph 7,4 > 14 insulated system 7,4 7,9 opened system 7,4 7,415 Martin Vejražka, 2007
31 Bicarbonate buffer CO 2 H + H 2 CO 3 H 2 O HCO 3 N.B.: Boxes differ in scale!
32 Bicarbonate buffer CO 2 H + H 2 CO 3 H 2 O HCO 3
33 Bicarbonate buffer CO 2 H + H 2 CO 3 H 2 O HCO 3
34 Bicarbonate buffer lungs CO 2 H + H 2 CO 3 H 2 O HCO 3
35 Bicarbonate buffer lungs CO 2 H + H 2 CO 3 H 2 O HCO 3
36 Bicarbonate buffer CO 2 H + H 2 CO 3 H 2 O HCO 3 Respiratory part Metabolic part Martin Vejražka, 2007
37 Actual and standard bicarbonates CO 2 H + H 2 CO 3 H 2 O HCO 3
38 Actual and standard bicarbonates CO 2 H + H 2 CO 3 H 2 O HCO 3 Martin Vejražka, 2007
39 ABE and ions Na + Cl HCO 3 Electroneutrality must be kept HCO 3 charged, CO 2 w/o charge ABE connected with ion metabolism Disturbances in ion concentrations are most easily compensated by HCO 3 Ca Mg Ca 2+ Mg 2+ K + prot SO 2 4, HPO 2 4, lactate, ketoacids
40 Hypochloremic alkalosis Na + Cl Lack of Cl is replaced with increased HCO 3 Change of ration of bicarbonate and CO 2 leads to alkalosis E.g. vomitting HCO 3 Ca Mg Ca 2+ Mg 2+ K + prot SO 2 4, HPO 2 4, lactate, ketoacids
41 H + and other cations H+ Ca++ K+ Na+
42 HendersonHasselbalch Hasselbalch equation ph = pk a + a [ HCO ] log 3 [ H ] 2 CO 5 6 orders more 3 than [H + ] pk a = 6,1 [HCO 3 ] = 24 mmol.l 1 [ HCO 3 ] = 20 [H 2 CO 3 ] = 1,2 mmol.l 1 [ H CO ] 2 3
43 ph change in vomiting loss of ca. 0.5 L of gastric juice, ph 0.8 w/o buffer ph 7,4 > 14 insulated system 7,4 7,9 opened system 7,4 7,415 Martin Vejražka, 2007
44 Hypochloremic alkalosis HCl HCO 3 CO 2 Cl H + H 2 CO 3 Chlorides replaced with bicarbonates HCO 3 rises, pco 2 constant Martin Vejražka, 2007
45 Hypochloremic alkalosis Na + Cl Lack of Cl is replaced with increased HCO 3 Change of ration of bicarbonate and CO 2 leads to alcalosis E.g. vomitting HCO 3 Ca Mg Ca 2+ Mg 2+ K + prot SO 2 4, HPO 2 4, lactate, ketoacids
46 Acidbase equilibrium Don t think about change in H + or OH but about changes in concentration of major ions ph change is secondary to change of HCO 3 / pco / pco 2 ratio Martin Vejražka, 2007
47 Proton sources Anaerobic glycolysis 1Glc 2lactate + 2H + Lipolysis TAG 3FA + glycerol + 3H + Formation of ketone bodies strong acids FA acetoacetate + hydroxybutyrate + nh + Martin Vejražka, 2007
48 Ketoacidosis Na + Cl Excess of ketoacid anions leads to decrease of bicarbonate concentration E.g. decompensated diabetes mellitus type 1, starvation HCO 3 Ca Mg Ca 2+ Mg 2+ K + prot SO 2 4, HPO 2 4, lactate, ketoacids
49 Physiologic saline is acid Na + Cl Relative excess of chloride anions in physiologic saline Na + Cl plasma physiologic saline
50 ABE and potassium Exchange of K + a H + on cell membrane acidemia hyperkaliemia alkalemia hypokaliemia hyperkaliemia acidemia hypokaliemia alkalemia
51 ABE and calcium Exchange of H + and Ca 2+ on plasma proteins acidemia hypercalcemia alkalemia hypocalcemia
mmol.l -1 H+ Ca++ K+ Na+
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