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Acid-Base balance - Coggle Diagram

- - - - more H+ means more acidic and lower pH
      - less H+ means more basic and higher pH
    - - above 7 is basic
        
        when body fluids above 7.4 (normal blood pH), person has alkalosis
        
        alkalosis is caused by
        
        too much bicarbonate (HCO3-)
        
        too little acid (H+)
        
        types of alkalosis
        
        respiratory alkalosis
        
        caused by increased ventilation
        
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        decreased PCO2
        
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        metabolic alkalosis
        
        caused by buildup of bicarbonate or loss of H+ from the body
        
        most commonly caused by loss of HCl from stomach through vomiting
        
        can also be caused by ingestion of alkaline drugs such as sodium bicarbonate for ulcers
      - below 7 is acidic
        
        when body fluids below 7.4 (normal blood pH), person has acidosis
        
        acidosis is caused by
        
        too much acid (H+) in body
        
        too little bicarbonate
        
        types of acidosis
        
        respiratory acidosis
        
        caused by decreased ventilation
        
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        increased partial pressure of CO2 (PCO2)
        
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        metabolic acidosis
        
        caused by decreased in extracellular bicarbonate ions
        
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  - - - comes from carbonic acid in the respiratory system
        
        known as volatile because carbonic acid is reconverted to CO2 and H2O, removed from lungs, causing no net increase of free H+
    - - comes from the stomach
        
        known as nonvolatile because the acids cannot be removed by lungs and are a constant source of free H+
- - - - X + H+ ⇌ XH
    - - phosphates
      - intracellular proteins
      - hemoglobin
        
        can reversibly bind to H+ to to stabilize the acidity
        
        can bind to CO2 to reduce potential acidity in case it combines with H2O to form carbonic acid
    - - bicarbonate
  - - - ensure that CO2 levels are constant, meaning a constant pH of the blood
      - CO2 regulation is detected by the central and peripheral chemoreceptors
        
        BOTH these receptors will detect change and cause increased ventilation
        
        ventilation causes more CO2 to be removed and return blood CO2 levels to normal
  - - - how this function is performed
        
        excreting the H+ coming from non-volatile acids
        
        the H+ are secreted into the filtrate in the proximal tubule by the Na+/H+ exchanger
        
        the H+ are also secreted in the late distal tubule and collecting duct by a H+/ATP pump
        
        active transport
        
        secretes only 5% of H+ ions
        
        these H+ come from CO2 combining into water in the tubule cells, forming bicarbonate and H+
        
        this CO2 came from the cell itself or the interstitial fluid
        
        the pump is found on the luminal side of tubule cells, secreting 1 H+ for 1 ATP used
        
        makes urine extremely acidic
        
        when 1 H+ is secreted, a new bicarbonate is absorbed into circulation
        
        try to reabsorb all bicarbonate ions filtered at the glomerulus
        
        the reabsorption of bicarbonate ions at the glomerulus is done at the proximal tubule
        
        the bicarbonate must first be converted to CO2 before getting reabsorbed by tubule cells
        
        The CO2 then combines with H2O and using carbonic anhydrase, bicarbonate and H+ is made
        
        bicarbonate ions leave the tubule cells by simple diffusion and are reabsorbed into circulation
        
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        H+ is secreted into the lumen by the Na+/H+ exchanger
        
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        bicarbonate first becomes carbonic acid which dissociates into H2O and CO2
        
        creation of new bicarbonate ions that get absorbed into the circulation
      - when more H+ is excreted than bicarbonate, there is net loss of acid, causing increase in pH
        
        the body balances this by excretion of H+ and reabsorption of bicarbonate to balance the buffer
      - when bicarbonate excretion is greater than H+ secreted, there is net base loss, causing decrease in pH