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Chem 2
Blood gases, pH & buffer systems
| question | Answer |
|---|---|
| Respiratory acidosis | lower pH and an increased PCO2 and is due to respiratory depression |
| Respiratory alkalosis, | raised pH and a decreased PCO2, |
| due to over ventilation caused by hyperventilating, pain, emotional distress, or certain lung diseases that interfere with oxygen exchange. | repiratory alkalosis |
| Metabolic acidosis | a lower pH and decreased HCO3- |
| blood is too acidic on a metabolic/kidney level | metabolic acidosis |
| Metabolic alkalosis | elevated pH and increased HCO3- |
| seen in hypokalemia, chronic vomiting (losing acid from the stomach), and sodium bicarbonate overdose. | metabolic alkalosis |
| pH decreased; HCO3- decreased | Metabolic acidosis |
| pH increased; HCO3- increased | metabolic alkalosis |
| pH decreased; pCO2 increased | Respiratory acidosis |
| pH increased; pCO2 decreased | Respiratory alkalosis |
| pCO2 | pressure due to carbon dioxide in the blood |
| pO2 | measure of the pressure of the oxygen dissolved in the blood |
| O2 saturation | represents the proportion of oxygenated hemoglobin compared to the total functional hemoglobin |
| reference range for pH | 7.35-7.45 |
| reference range for pCO2 | 40 mm hg |
| reference range for HCO3- | 24 mmol/L |
| reference range for total CO2 content | 23-27 mmol/L |
| reference range for pO2 | 80-110 mmol/L |
| reference range for SO2 | >95% saturation |
| reference range for O2Hb | >95% |
| carbonic acid | H2CO3 |
| bicarbonate | HCO3- anion |
| Oxygen content | sum of the oxygen bound to hemoglobin as O2Hb and the amount dissolved in the blood |
| Oxygen saturation SO2 | represents the ratio of oxygen that is bound to the carrier protein(hemoglobin) compared with the total amount that the hemoglobin could bind |
| Base Excess | theroretical amount of titratable acid or base required to return the plasma pH to 7.40 at a pCO2 of 40mm Hg at 37C |
| Metabolic | refers to all acids and metabolites other than carbonic acid and is measured as HCO3- |
| To maintain a stable pH | plasma proteins and plasma buffers combine with the freed H+ |
| Fractional hemoglobin FO2Hb | ratio of the concentration of oxyhemoglobin to the concentration of total hemoglobin (ctHb) |
| Hemoglobin-oxygen(binding)capacity | maximum amount of oxygen that can be carried by hemoglobin in a given quantity of blood |
| PO2 definition | partial pressure of oxygen |
| PCO2 definiton | partial pressure of carbon dioxide |
| pH | represents the negative or inverse log of the hydrogen ion concentration |
| Hypercarbia | abnormally increased arterial carbon dioxide tension |
| Acidemia | a pH of blood less than reference range |
| Alkalemia | a blood pH greater than the reference range |
| Respiratory | pertains to the lungs and is associated with an increase or decrease in carbonic acid & is measured as pCO2 |
| Positive value base excess | non respiratory alkalosis |
| Negative value base excess | non respiratory acidosis |
| Non respiratory (other name) | Metabloic |
| Acid | substance that can yield a hydrogen ion(h+) or hydrogen ion when dissolved in water |
| Base | Substance that can ield hydroxyl ions (OH-) |
| Buffer | combination of a weak acid or weak base and its salt |
| System that resists change in pH | Buffer |
| Regulation of H+ | bodys first line of defense against extreme changes in H+ concentration is the buffer system present in all body fluids |
| Carbon dioxide | the end product of most aerobic metabolic processes |
| Chloride shift | maintain electroneutrality, diffuses into the cell |
| electroneutrality | same number of positively and negatively charged ions on each side of the red cell membrane |
| Acidosis | pH below 7.35 |
| Alkalosis | pH above 7.45 |
| Bicarbonate buffering system | open system |
| lungs | participate rapidly in the regulation of blood pH through hypoventilation or hyperventilation |
| Control the bicarbonate concentration | Kidneys ( nonrespiratory or metabolic component |
| When arterial blood from a normal patient is exposed to room air | pCO2 increases & PO2 decreases |
| Normal ratio of carbonic acid to bicarbonate in arterial blood | 1:20 |
| at a pH of 7.10 the H concentration is equal to... | 80 nmol/L |
| The anticoagulant of choice for arterial blood gas measurments | Lithium heparin in the dry state |
| Carbonic acid concentration in blood plasma equals | 0.0307 mmol-1 mn hg-1 times the pCO2 value in mmhg |
| Q. bicarbonate leaves the rbcs and enters plasma through an exchange mechanism with (BLANK) to maintain electroneutrality | A. Chloride |
| Q. pH 7.48 ;pCO2 54 mm; HCO3- 38mmol/L | A. Compensated nonrespiratory alkalosis |
| Q. Oxygen content in blood reflects | A. pO2 value |
| Q. pH 7.37 ; pCO2 75mm hg ; HCO3- 37 mmol/L | A. Compensated respiratory acidosis |
| Q. Hemoglobin oxygen binding capacity for a blood sample that is 100% saturated with O2 and has a total hemoglobin calue of 12g/dL is approximatly | A. 17 mL O2/dL |
| Q. Hypoventilation can compensate for | A. Non respiratory acidosis |
| Respiratory Alkalosis signs & symptoms | Dizziness, syncope, tingling, numbness, early tetany |
| Respiratory acidosis signs and symptoms | Early: anxiety, restlessness, dyspnea, headache Late: confusion, somnolence, coma |
| Metabolic alkalosis signs and symptoms | weakness, mental dullness |
| Metabolic acidosis signs and symptoms | Secondary hyperventilation, nausea, lethargy, coma |
| Respiratory alkalosis causes | Alveolar hyperventilation |
| Respiratory acidosis causes | Alveolar hypoventilation |
| Metabolic alkalosis causes | Bicarbonate ingestion, vomiting, diuretics, steroids, adrenal disease |
| Metabolic acidosis causes | Diabetic, lactic, or uremic acidosis, prolonged diarrhea |
| ^ pH ; low pCO2 ; decreased HCO3 | metabolic compensation |
| ^ pH ; low pCO2 ; normal HCO3 | no compensation |
| ^ pH; ^ HCO3 ; elevated pCo2 | respiratory compensation |
| ^ pH; ^ HCO3; normal pCO2 | no compensation |
| metabolic compensation | low pH; ^ pCO2 ;increased HCO3 |
| No compensation | low pH; ^ pCO2; normal HCO3 |
| Respiratory compensation | low pH; low HCO3; decreased pCO2 |
| Acidosis metabolic -no compensation | low pH; low HCO3; normal pCO2 |
| Metabolic acidosis potassium ( increased or decreased) | Increased(metabolic) |
| Metabolic alkalosis potassium (increased or decreased) | Decreased(metabolic) |
| Respiratory acidosis potassium ( increased or decreased) | Increased ( respiratory) |
| Respiratory alkalosis potassium (increased or decreased) | Decreased ( respiratory) |
| disorders where pCO2 are normal | Metabolic alkalosis and acidosis |
| Shift in curve to the left | results in easier binding of oxygen to haemoglobin, but decreased ability to dissociate from haemoglobin and move to the tissues. Can cause hypoxia |
| common causes of left shifts of the curve | alkalosis, hypocapnia, hyperthermia |
| Shifts in curve to the right | Causes oxygen to associate poorly with haemoglobin but dissociate more readily at a tissue level. this can easily lead to tissue hypoxia from poor arterial oxygenation |
| Common causes of right shifts of the curv25`e | Acidosis, hypercapnia, hyperthermia |
Created by:
Sdevries0982