Chapter 20: Acid Base Balance (Study Guide in Question Form)Introduction: (Page 445)

1. Maintaining acid base balance means keeping the concentration of __________________ ions in the body fluids relatively consistent.

pH of Body Fluids: (Page 446)2. Water and all water solutions contain _____________ ions and ________________ ions. pH is an acronym for

power of H+.3. The term _______ followed by a number indicates a solutions hydrogen ion concentration compared with hydroxide

concentration.

Using the pH Scale:

4. At pH ______ a solution contains an equal concentration of hydrogen and hydroxide ions. 5. PH 7.0 also indicates that a fluid is _______ in reaction.6. The pH of pure water is __________.7. A pH higher than 7.0 indicates an __________ solution (that is one with a lower concentration of hydrogen then

hydroxide ions).8. The more alkaline a solution, the _________ its pH value.9. Alkaline solutions are also called ________ solutions.10. A pH lower than _____ indicates an ______ solution (that is one with a higher hydrogen concentration than

hydroxide ion concentration).11. The higher the __________ ion concentration, the lower the pH and the more acidic the solution.12. The terms ______________ and ______________ always refer to the systemic circulation, not the pulmonary

circulation, unless stated otherwise.13. Arterial and venous blood are both slightly ____________.14. Venous blood is less _____________ than arterial blood because venous blood’s pH of about 7.37 is slightly lower

than arterial blood’s pH of about 7.4.

The pH Unit:

15. The difference between pH 7 and PH 6 is a ____________ increase in H+.16. Moving from pH 7 to PH 5 is a ____________ increase in H+ concentration.17. Blood plasma is a key ___________ compartment in the body.

QUICK CHECKS: (Page 446)

1. What does pH measure? ____________________________________________________________________________________________________________________________________________________________________________________________________

2. What does a pH of “neutral” indicate?

____________________________________________________________________________________________________________________________________________________________________________________________________

3. What does it mean when a solution’s pH increases?

____________________________________________________________________________________________________________________________________________________________________________________________________

Using Figure 20-1, list the pH value of the following and list whether it is an acid or a base:

1. Hydrochloric Acid: ____________ Acid or Base

2. Gastric Juice: ____________ Acid or Base

3. Lemon Juice: ____________ Acid or Base

4. Vinegar: ____________ Acid or Base

5. Wine & Orange Juice: ____________ Acid or Base

6. Beer & Tomatoes: ____________ Acid or Base

7. Coffee: ____________ Acid or Base

8. Skin Film: ____________ Acid or Base

9. Milk & Urine: ____________ Acid or Base

10. Distilled Water: ____________ Acid or Base

11. Blood: ____________ Acid or Base

12. Semen & Saliva: ____________ Acid or Base

13. Egg White: ____________ Acid or Base

14. Baking Soda & Pancreatic Juice: ____________ Acid or Base

15. Borax: ____________ Acid or Base

16. Great Salt Lake: ____________ Acid or Base

17. Milk of Magnesia: ____________ Acid or Base

18. Household Ammonia: ____________ Acid or Base

19. Oven Cleaner: ____________ Acid or Base

20. Lye & Caustic Soda: ____________ Acid or Base

21: Sodium Hydroxide: ____________ Acid or Base

Mechanisms That Control pH of Body Fluids: (Page 447)

18. The body has two types of mechanisms for regulating the pH of its fluids:1. _____________________________________2. _____________________________________

19. These two processes constitute the complex pH ______________ mechanism.20. A normal blood pH is _____ to _____.21. As ______________ _______________ enters the blood, some of it combines with water (H2O) and is converted

to carbonic acid by _________________ __________________ (CA), an enzyme found in RBCs.22. The lungs remove the equivalent of more than _____L of carbonic acid each day from the venous blood by

elimination of CO2. This most unbelievable quantity of acid is so well buffered that a liter of venous blood contains only about 1/1,000,000,000 grams more H+ than does _____L of arterial blood.

Integration of pH Control:

23. The circulating blood and RBCs provide a chemical pH ____________ ______________, which is based on buffers and act immediately to help prevent harmful swings in pH when added acids or bases enter ___________ ___________. If this immediate-acting chemical control mechanism is unable to stabilize the pH, the lungs and kidneys can both provide a ____________ pH control mechanism to halt and reverse harmful pH shifts. The lungs respond in _____ to _____ minutes when the brainstem adjusts the respiratory rate and thus the adjustment of _____ is accomplished.

24. If the respiratory mechanism is unable to stop the pH shift, powerful but slower-acting renal mechanisms will be initiated in a _____ hour period.

Chemical pH Control Mechanisms:

25. Chemical ________ are substances that prevent a sharp change in the pH of a fluid when an acid or base is added to it.

26. Strong acids and bases, if added to blood, would ____________ almost completely and release large quantities of H+ or OH- ions.

27. More ________ than ________ are usually added in body fluids. This is because of _____________, it produces acids that enter blood as it flows through tissue capillaries. Almost immediately, one of the salts present in blood, a ________, reacts with these relatively strong acids to change them into weaker acids.

28. Buffers consist of two kinds of substances and are often called ___________ ___________. One of the main buffer pairs is ___________________ and __________________ acting as the __________________________________________ system.

29. Bicarbonate is the sole ingredient of ordinary ______________ ______________.30. Changes in blood result from buffering of fixed acids in tissue capillaries: (Page 449-450)

1. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________4. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

31. _______ is the most abundant acid in body fluids because it is formed by the buffering of fixed acids.32. Large amounts of CO2, an end product of ______________, continually pour tissue capillary blood from cells. 33. Much of the H2CO3 formed in blood diffuses into ________________ where it is buffered by the potassium salt of

hemoglobin.34. The body has other buffer pair systems that also contribute to the stability of blood pH.35. ___________ ______________ ________________ and _______________ ________________

_______________. 36. The protein system includes both ____________ _____________ and ___________________.

QUICK CHECKS: (Page 450)

1. What 3 mechanisms does the body have for regulating pH of body fluids?

____________________________________________________________________________________________________________________________________________________________________________________________________

2. What are buffers?

____________________________________________________________________________________________________________________________________________________________________________________________________

Physiological pH Control Mechanism:

37. Physiological pH control mechanisms influence pH by ______________ substances from the body for retaining substances in the body.

38. The two types of physiological pH control mechanisms are the ___________________ ____________________ and the ____________________ ____________________.

Respiratory Mechanism:

39. The _____________________ mechanism relies on ventilation (_________________) to control pH in the body. With every expiration, _____ and _____ leave the body in the expired air.

40. The CO2 has __________ out of the pulmonary blood as it moves through the lung capillaries. Less _________, therefore remains in the blood leaving the lung __________________, so less of it is available for combining with water to form ________. Hence, after expiration the blood contains less H2CO3, has ____________ hydrogen ions, and has a higher pH (______) than the deoxygenated blood entering the pulmonary circulation (pH 7.37).

Health and Well-Being:

- Some athletes have adopted a technique called _________________ _________________, ingesting large amounts of sodium bicarbonate to counteract the effects of lactic acid buildup.

41. When blood pH increases to or above normal, then the state of breathing ____________________.42. Any factor that causes an appreciable decrease in respirations may in time produce __________________.

Conversely, any factor that causes an excessive increase in respirations may in time produce _________________.

Urinary Mechanism: (Page 451)

43. The ________________ mechanism of pH control depends on the normal functions of the _______________.44. One reason that the __________________ are the body’s most effective regulators of blood pH is because they

can eliminate much larger amounts of acid than can the lungs and, if it becomes necessary, they also can excrete excess _________________.

45. The ________________ fence against wide variations in blood pH.46. More _______________ than ________________ are usually excreted by the kidneys.47. Most of the time the kidneys _____________ urine, frequently as low as _________.48. The tubules of the kidneys ride the blood of excess acid and at the same time conserve the base present in it by

secreting ___________ ions into the urine while retaining ______________ in the blood.49. Much of the excess H+ is combined with the amine group _______ of an amino acid (glutamic acid) to form

_____________ and ammonium ions before it is secreted into the _______________.

QUICK CHECKS: (Page 451)

1. How can breathing affect the pH of the blood?

____________________________________________________________________________________________________________________________________________________________________________________________________

2. By what mechanism can the kidney change the pH of the blood?

____________________________________________________________________________________________________________________________________________________________________________________________________

3. What is the body’s fast and best defense system against wide variations in blood pH?

____________________________________________________________________________________________________________________________________________________________________________________________________

CLINICAL APPLICATION:

- The accumulation of ______________ _________________ results in a condition called ______________ ______________, that causes the blood to become dangerously acidic. The body attempts to correct or “__________________” for the acidosis by rapid breathing to blow off CO2 and decrease blood carbonic acid levels.

pH Imbalances:Acidosis & Alkalosis:

50. The chemistry of life can operate only within the range od pH ___________ to ___________. The range of optimal human function is much lower than that pH ___________ to _______________.

51. ________________ and ________________ are the two kinds of pH or acid-base imbalances that can threaten our health or survival.

52. ____________ is used to describe the condition that produces an arterial blood pH of less than ________.53. ____________ is used to describe the condition that produces an arterial blood pH of greater than ______.54. In acidosis, the blood pH falls as H+ concentration increases or as bases such as ________________ ions are lost.55. In alkalosis, the blood pH is higher than normal because of a loss of acids or an accumulation of bases.56. Blood levels of NaHCO3 can be regulated by the _____________ system (kidneys) and H2CO3 levels by the

________________ system (lungs).

Clinical Application:

- Vomiting is also called ________________. This is the force of emptying or expulsion of gastric and occasionally intestinal contents through the mouth.

- One of the most frequent and serious complications of the repetitive vomiting that continues over time is __________________ __________________.

- Therapy to actually restore the buffer pair ratio to normal includes intravenous administrations of chloride-containing solutions such as __________________ ___________________.

Metabolic and Respiratory Disturbances:

57. Two types of disturbances, metabolic and respiratory can alter the proper ratio of bicarbonate to carbonic acid.58. Fill in the following for metabolic and respiratory disturbances:

1. Metabolic Disturbances:a.) Metabolic Acidosis: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________b.) Metabolic Alkalosis: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. Respiratory Disturbances:a.) Respiratory Acidosis: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________b.) Respiratory Alkalosis: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CLINICAL APPLICATION: (Page 454)

- _________________ __________________ ________________ (ABGs) are used in a test to show the key characteristics of blood related to respiratory functions: List them below:1. _______________________________________2. _______________________________________3. _______________________________________4. _______________________________________5. _______________________________________

Compensation for pH Imbalances:

59. When acidosis or alkalosis occurs in the body, our various pH-balancing mechanisms try to restore balance as soon as possible. The term for this is ____________________.

QUICK CHECKS: (Page 455)

1. What is acidosis? ____________________________________________________________________________________________________________________________________________________________________________________________________

2. What is alkalosis? ____________________________________________________________________________________________________________________________________________________________________________________________________

3. What factors may cause a metabolic disturbance in pH? ____________________________________________________________________________________________________________________________________________________________________________________________________

4. What situations may cause a respiratory disturbance in pH? ____________________________________________________________________________________________________________________________________________________________________________________________________

5. What does the term “compensate” mean when referring to pH imbalance? ____________________________________________________________________________________________________________________________________________________________________________________________________

Arterial Blood Gas Analysis for Acid-Base Status:

ABC Component:

Normal Values:

Acidosis:Respiratory:

Acidosis:Metabolic:

Alkalosis:Respiratory:

Alkalosis:Metabolic:

pH

PCO2

(HCO3-)