Acid-Bases
_______ and ___ ________ occurs according to Boyle's Law
respiration and gas exchange
________ ___ states that for a fixed amount of gas kept at a fixed temperature, pressure and volume are inversely proportional
Boyles' Law
Oxygen and carbon dioxide ______ between the air in the alveoli and blood, this movement is governed by Henry's Law
dissolve
________ ___ states that gases can be forced to dissolve into a liquid, such as blood, if there is enough pressure applied and a controlled volume
Henry's Law
_______ ____ states that the sum of partial pressures equal the total pressure of that mixture
Dalton's Law
The ______ of oxygen and carbon dioxide are driven across the respiratory membrane by their partial pressure gradients, this reaction occurs according to Dalton's Law
diffusion
Boyle's _________
Breathing
Dalt(+)ons _________
Diffusing
Henry's ________
dissolving
________ ______ is fluid surrounding your lungs
Pulmonary Edema
Factors that can influence O2 movement through the alveoli are ___________________
destruction of the alveoli, pulmonary edema, airway blockage, and inadequate blood supply
O2 is transported to tissue by _________
Hemoglobin
Hemoglobin can carry up to _ O2 molecules
4
______ is a byproduct of glycolisis that occurs in the RBCs and effects hemoglobin to release more O2 into tissues
2,3-DPG
__% of functional hemoglobin will bind to O2
95
_____________ is reversibly bound to O2
oxyhemoglobin
__________________ can be bound to O2 but isnt yet
Deoxyhemoglobin
_____________ are hemoglobins incapable of binding to O2
Dyshemoglobins
___________________ is hemoglobin bound to carbon monoxide
Carboxyhemoglobin
Hemoglobin bound to CO has a bond ___ times stronger than an oxygen bond
200
_________________ is hemoglobin unable to bind to O2 because iron is in an oxidized (ferric) state instead of a reduced (ferrous) state
Methemoglobin
The ______ ____________ ______reflects the affinity that hemoglobin has for O2 and the rate of dissociation between the O2 and the hemoglobin
oxygen dissociation curve
The oxygen dissociation curve can be affected by ________________
pH, pCO2 and CO levels, body temperature, and 2,3 DPG
With hyperventilation, CO2 decreases causing you to become more ______, lose H+, and "crave" O2 (pH increase)
basic
With hypoventilation, CO2 increases causing you to become more _____, gain H+, and need O2 (pH decrease)
acidic
With normal breathing, pH should be _________
7.34-7.44
A shift to the right on a Oxygen dissociation curve indicates _________ O2 affinity (Acidosis)
decreased
A shift to the left on a Oxygen dissociation curve indicates _________ O2 affinity (Alkalosis)
increased
Acids ______ hydrogen ions
release
Bases ______ hydrogen ions
accept
__ is a measure of the hydrogen ion concentration in the body
pH
________ and pH have an inverse relationship
Hydrogen
________ are systems that minimize pH changes by absorbing hydrogen ions
Buffers
Buffers are a combination of a ____ _____ and a _____
weak acid and a salt
Normal H+ concentration in the ECF is _____ mmol/L
36-44
The body controls and excretes ___ to maintain pH homeostasis
H+
A pH below average (< 7.34) is ________
acidosis
A pH above average (> 7.44) is ________
Alkalosis
Arterial pH is controlled by the production and retention of ______ and ______
acids and bases
The bodys first line of defense against H+ concentration changes is the _______ _________
buffer systems
Hemoglobin is the major buffer system inside ____
RBCs
The bicarbonate-carbonic acid buffer system is the major buffer system is the most important _______ buffer system
plasma
The phosphate buffer system is the most important buffer system in the _______
urine
______ ______ (such as albumin) are also important plasma buffers
Plasma Proteins
CO2 is the end product of most ______ __________ processes
aerobic metabolic
Respiration is regulated by the brains _______
medulla
____________ present in the aortic arch and carotid sinus respond to levels of H+, O2, and CO2 in the blood and CSF
Chemoreceptors
_______________ chemoreceptors work with plasma pH
Peripheral
______________ chemoreceptors work with the CSF pH/ pCO2
Central
The kidneys maintain blood pH by reabsorbtion/ production of ____ and the excretion of __ as dihydrogen phosphate or ammonium
HCO3; H+
In Acidosis, _____ is increased and _____ is conserved
acid; base
In Alkalosis, _____ is increased and _____ is conserved
base; acid
Acidosis causes _________ (K)
hyperkalemia
Alkalosis causes _________ (K)
hypokalemia
The body produces ______ mmol/L of H+ (acid) each day
50-100
The ____________________ __________ aids in understanding pH regulation of body fluids
Henderson-Hasselbalch equation
The Henderson-Hasselbalch EQUATION is ____________
pH= pKa' + log HCO3/pCO2
the normal HCO3:pCO2 ratio is _____
20:1
__________ compensated implies pH is approaching normal
Partially
______ compensated implies pH is normal
Fully
Metabolic Acidosis is caused by ______________
HCO3 consumption, HCO3 loss, and kidney problems
The body compensates for metabolic acidosis through ___________ and ____ retention
hyperventilation and HCO3 retention
Metabolic Alkalosis is caused by ____________
excessive HCO3 addition or excessive H+ loss
The body compensates for Metabolic Alkalosis through ____________
hypoventilation
Causes of Respiratory Acidosis are ________________
depression of the respiratory center and obstruction of the airflow
The kidneys compensate for Respiratory Acidosis by retaining ____ and increasing ____ excretion
HCO3; H+
Causes of Respiratory Alkalosis are ________________
hyperventilation and hypoxemia
The kidneys compensate for Respiratory Alkalosis by reclaiming ____ and excreting ____
H+; HCO3
The 4 parameters commonly used to asses patient oxygen status include __________________________
oxygen saturation, measure fractional (percent) oxyhemoglobin, Partial Pressure of Oxygen, and Pulse Oximetry
__________ ____________ is the sum of oxyhemoglobin and deoxyhemoglobin
Oxygen Saturation
The normal Oxygen Saturation range is _____%
94-98
_____________ __________ _______ ___________ is the ratio of oxyhemoglobin compared to total hemoglobin present
Measured Fractional (percent) Oxyhemoglobin
Measured Fractional (percent) Oxyhemoglobin levels are _____%
90-95
______ _______ _ _________ is the amount of O2 dissolved in the blood
Partial pressure of Oxygen
_______ ___________ is a noninvasive measurment for oxygen saturation trends
Pulse Oximetry
The actual percent oxyhemoglobin can be determined spectrophotometrically using a __________
CO-Oximeter
The pO2 measurement is __________ using a Clarke electrode
amperometric
The pCO2 and pH measurements are __________ using a Severinghaus electrode
potentiometric
_______ ________ is the specimen of choice for blood gas analysis
Whole Blood
For arterial blood collection, a ____________________ is used
1-3 mL self filling, plastic, disposable syringe
Dry ______ is the prefered anticoagulant for blood gas analysis
heparin
Blood gas samples should be __________
anaerobic
Adequate __________ of blood gas samples are important
mixing
Transport times of blood gas samples should be minimal and if possible analyzed within __ minutes
30