Major intracellular buffer
H+ + HPO42- ↔ H2PO4-
OH- + H2PO4- ↔ H2O + H2PO42-
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Includes hemoglobin, work in blood and ISF
Carboxyl group gives up H+
Amino Group accepts H+
Side chains that can buffer H+ are present on 27 amino acids.
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2. Respiratory mechanisms
Exhalation of carbon dioxide
Powerful, but only works with volatile acids
Doesn’t affect fixed acids like lactic acid
CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3-
Body pH can be adjusted by changing rate and depth of breathing
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3. Kidney excretion
Can eliminate large amounts of acid
Can also excrete base
Can conserve and produce bicarb ions
Most effective regulator of pH
If kidneys fail, pH balance fails
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Buffers function almost instantaneously
Respiratory mechanisms take several minutes to hours
Renal mechanisms may take several hours to days
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pH< 7.35 acidosis
pH > 7.45 alkalosis
The body response to acid-base imbalance is called compensation
May be complete if brought back within normal limits
Partial compensation if range is still outside norms.
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If underlying problem is metabolic, hyperventilation or hypoventilation can help : respiratory compensation.
If problem is respiratory, renal mechanisms can bring about metabolic compensation.
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Principal effect of acidosis is depression of the CNS through ↓ in synaptic transmission.
Generalized weakness
Deranged CNS function the greatest threat
Severe acidosis causes
Disorientation
coma
death
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Alkalosis causes over excitability of the central and peripheral nervous systems.