Chapt27 Lecture10e

Chapter 27
Water, Electrolytes, and

Acid-Base Balance
27-1
27.1 Body Fluids
Intracellular fluid compartment

All fluids inside cells of body
About 40% of total body weight
Extracellular fluid compartment

All fluids outside cells
About 20% of total body weight
Subcompartments
Interstitial fluid and plasma; lymph, CSF, synovial fluid
Primary intracellular ions, interstitial fluid ions, and plasma ions
Intracellular cation = K+
Interstitial fluid cation = Na+
Plasma cation = Na+
Intracellular anion = Phosphate
Interstitial fluid = ClPlasma anion = Cl-
27-2
Body Fluid Compartments
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
TABLE 27.2 Approximate Concentration of major Solutes in Body Fluids*

Solute
Plasma
Interstitial Fluid
Intracellular Fluid
Cations
Sodium (Na+)
Potassium (K+)
Calcium (Ca2+)
Magnesium (Mg )
153.2
145.1
12.0
4.3
4.1
150.0
3.8
3.4
4.0
1.4
1.3
34.0
162.7
153.9
200.0
111.5
118.0
4.0
25.7
27.0
12.0
Phosphate (HPO4 plus HPO4 )
2.2
2.3
40.0
Protein
17.0
0.0
54.0
2+
TOTAL
Anions
Chloride (Cl)
Bicarbonate (HCO3 )
Other
TOTAL
Expressed as milliequivalents per liter (meq/l).
Data are from skeletal muscle.

*
6.3
6.6
90.0
162.7
153.9
200.0
27-3
27.2 Regulation of Body Fluid

Concentration and Volume
Content regulated so
total volume of water in
body remains constant
Kidneys are primary
regulators of water
excretion
Regulation processes
Osmosis
Osmolality
Baroreceptors
Learned behavior
Sources of water
Ingestion
Cellular metabolism
Routes of water loss

Urine
Evaporation
Perspiration
Respiratory passages
Feces
27-4
Extracellular Fluid Osmolality

Osmolality
Measure of water vs. solute concentration; the higher the
solute concentration, the higher the osmolality
Adding or removing water from a solution changes
osmolality
Increased osmolality: triggers thirst and ADH secretion
Decreased osmolality: inhibits thirst and ADH secretion
27-5
4 Increased
thirst
1
Baroreceptors
in heart
Osmoreceptors in
hypothalamus
(increased osmolality)
Juxtaglomerular
apparatuses in kidney
The baroreceptors in the carotid sinuses and aortic arch detect reduced blood
pressure, which signals the hypothalamic thirst center.
Simultaneously, the juxtaglomerular apparatuses detect low blood pressure, which

activates the renin-angiotensin system to produce angiotensin II. Angiotensin II
stimulates the hypothalamic thirst center.
Osmoreceptors in the hypothalamus shrink when blood osmolality goes up,

triggering action potentials that stimulate thirst.
The combination of these inputs activates thirst and promotes water consumption.
27-6
Hormonal Regulation of Blood Osmolality

4
Reactions
Actions
Control Center
Osmoreceptors in the hypothalamus
control center detect the increase in
blood osmolality and signal the posterior
pituitary to secrete ADH, which
causes thirst. ADH also increases the
permeability of the distal convoluted
tubule and collecting ducts to water.
2
Blood osmolality increases:
Homeostasis Disturbed
Blood osmolality decreases:

Homeostasis Restored
Start here
Blood osmolality
(normal range)
1
Blood osmolality
(normal range)
Effectors Activated:
Water reabsorption at the distal
convoluted tubule and collecting
duct increases; water consumption
increases .
Blood osmolality decreases:

Actions
Control Center
Osmoreceptors in the hypothalamus
detect the decrease in blood
osmolality and signal the posterior
pituitary to reduce ADH secretion,
which decreases thirst.
Blood osmolality increases:

Reactions
Water reabsorption at the distal
convoluted tubule and collecting
duct decreases; water
consumption decreases.
27-7
Regulation of ECF Volume

ECF can increase or decrease even if osmolality of
extracellular fluid is maintained
Carotid sinus and aortic arch baroreceptors monitor blood
pressure, juxtaglomerular apparatuses monitor pressure
changes, receptors in walls of atria and large vessels
respond to small changes in BP
These receptors activate these mechanisms
Neural: increase in BP recognized by baroreceptors. Decreased
sympathetic stimulation of afferent arteriole leads to increased
pressure in glomerulus leading to increased filtration and increased
urine output.
Renin-angiotensin-aldosterone
Atrial natriuretic hormone (ANH)
Antidiuretic hormone (ADH)
27-8
Regulation of Blood Volume

4
Actions
Blood vessels:
Sympathetic division baroreceptors detect increased blood
volume, which causes vasodilation of renal arteries.
Heart:
Atrial cardiac muscle cells secrete ANH when blood
volume increases.
Kidney:
Juxtaglomerular apparatuses inhibit renin release when
blood volume increases, which decreases
aldoster one secretion.
Pituitary:
Baroreceptors inhibit posterior pituitary ADH secretion
when blood volume increases.
2
High blood volume induces elevated blood
pressure: Homeostasis Disturbed
Increased renal blood flow increases the rate of filtrate
formation, and more water is excreted in the urine.
Decreased aldosterone and increased ANH decrease
Na+ reabsorption into the distal convoluted tubule and
collecting duct. More Na+ in urine, which decreases
blood volume
Decreased ADH decreases water reabsorption by the
distal convoluted tubules and collecting ducts. Less
water returns to the blood, and more water is
excreted in the urine.
Reduced blood volume due to loss of water

and Na+ in the urine lowers blood pressure:
Start here
Low blood volume induces lowered blood

pressure: Homeostasis Disturbed
Blood volume
(normal range)
1
Blood volume
(normal range)
Reactions
Increased blood volume due to decreased Na+

and water loss in the urine raises blood pressure:
Actions
Blood vessels:
Sympathetic division baroreceptors detect decreased
blood volume, which causes vasoconstriction of renal
arteries.
Heart:
Atrial cardiac muscle cells do not secrete ANH when
blood volume decreases.
Kidney:
Juxtaglomerular apparatuses stimulate renin release
when blood volume decreases, which increases
aldosterone secretion.
Reactions
Decreased renal blood flow decreases filtrate formation,
and less water is excreted in urine.
Increased aldosterone and decreased ANH increase
Na+ reabsorption in the distal convoluted tubule and the
collecting duct. Less Na+ and water are excreted in the
urine.
Increased ADH increases the permeability of the
distal convoluted tubule and the collecting duct to
water. Less water is excreted in urine.
Pituitary:
Baroreceptors stimulate posterior pituitary ADH secretion
when blood volume decreases. Increased ADH also
increases the sensation of thirst.
27-9
Regulation of ECF Volume

Increased BP
in right atrium
Increased
renin secretion
(from kidney)
Decreased
BP
Angiotensinogen
Angiotensin I
Kidney
ANH
Kidney
Angiotensin II
Increased
aldosterone secretion
Increased Na+
and water
reabsorption
results in
increased BP.
Increased ANH
Increased Na+
excretion and
increased water
loss result in
decreased BP.
27-10
Regulation of ECF Osmolality
Electrolytes
Molecules or ions with an
electrical charge
Ingestion adds electrolytes to
body
Kidneys, liver, skin, lungs
remove from body
Concentration changes only

when growing, gaining or
losing weight
Na+ Ions
Dominant ECF cations
Responsible for 90-95% of
osmotic pressure
Regulation of Na+ ions

Kidneys major route of
excretion
Small quantities lost in sweat
{sweat = (in decreasing
amounts) water, Na+, urea, ClK+, NH3}. Insensible
perspiration is water
evaporating from skin.
Sensible perspiration is
secreted by the sweat glands.
Contains solutes
Terms
Hypernatremia: elevated
plasma Na+
Hyponatremia: decreased
Na+
27-11
27.3 Regulation of ICF

1 Large organic molecules, such as proteins,

which cannot cross the plasma membrane,
are synthesized inside cells and influence
the concentration of solutes inside the cells.
2 The transport of ions, such as Na+, K+, and

Ca2+, across the plasma membrane influences
the concentration of ions inside and outside
the cell.
Extracellular fluid
1 Large organic
molecules
Intracellular
fluid
2 Ion transport
(e.g., Na+, K+, Ca2+)
(e.g., K+)
3 An electrical charge difference across the

plasma membrane influences the distribution
of ions inside and outside the cell.
3 Electrical charge
difference
4 The distribution of water inside and outside the
cell is determined by osmosis.
Water moves by osmosis.
27-12
27.4 Regulation of Specific Electrolytes

Chloride ions
Predominant anions in ECF
Magnesium ions
Capacity of kidney to
reabsorb is limited
Excess lost in urine
Decreased extracellular
magnesium results in
greater degree of
reabsorption
Potassium ions
Maintained in narrow range
Affect resting membrane
potentials
Aldosterone increases
amount secreted
Terms
Hyperkalemia: abnormally
high levels of potassium in
extracellular fluid
Hypokalemia: abnormally
low levels of potassium in
extracellular fluid.
27-13
Table 27.5
Homeostasis: Mechanisms Regulating Blood Sodium
Mechanism
Stimulus
Response to Stimulus
Effect of Response
Result
Increased blood
osmolality (e.g.,
increased Na+
concentration)
Increased ADH secretion

from the posterior pituitary;
mediated through cells in
the hypothalamus
Increased water reabsorption

in the kidney; production
of a small volume of
concentrated urine
Decreased blood osmolality

as reabsorbed water dilutes
the blood
Decreased blood
osmolality (e.g.,
decreased Na+
concentration)
Decreased ADH secretion

from the posterior pituitary;
mediated through cells in
the hypothalamus
Decreased water reabsorption

in the kidney; production of a
large volume of dilute urine
Increased blood osmolality

as water is excreted from
the blood into the urine
Response to Changes in Blood Osmolality

Antidiuretic hormone
(ADH); the most
important regulator
of blood osmolality
Response to Changes in Blood Pressure

Renin-angiotensinaldosteroneDecreased blood
hormone
pressure in the kidneys
mechanism
afferent arterioles
Atrial natriuretic
hormone (ANH)
ADHactivated by
significant decreases
in blood pressure;
normally regulates blood
osmolality (see above)
Increased renin release

Increased Na+ reabsorption
from the juxtaglomerular
in the kidney (because of
apparatuses; renin
increased aldosterone);
initiates the conversion
increased water reabsorption
of angiotensinogen to
as water follows the Na+;
angiotensin; angiotensin I
decreased urine volume
is converted to
angiotensin II, which increases
aldosterone secretion from
the adrenal cortex
Increased blood pressure

as blood volume increases
because of increased water
reabsorption; blood
osmolality is maintained
because both Na+ and
water are reabsorbed*
Increased blood
pressure in the kidneys
afferent arterioles
Decreased renin release

from the juxtaglomerular
apparatuses, resulting in
reduced formation of
angiotensin I; reduced
angiotensin I leads to
reduced angiotensin II,
which causes a decrease
in aldosterone secretion
from the adrenal cortex
Decreased Na+ reabsorption

in the kidney (because of
decreased aldosterone);
decreased water reabsorption
as less Na+ is reabsorbed;
increased urine volume
Decreased blood pressure

as blood volume decreases
because water is excreted in
the urine; blood osmolality
is maintained because both
Na+ and water are excreted
in the urine*
Decreased blood
pressure in the
atria of the heart
Decreased ANH released

from the atria
Increased Na+ reabsorption

in the kidney; increased
water reabsorption as water
follows the Na+; decreased
urinary volume

as blood volume increases
because of increased water
reabsorption; blood
osmolality is maintained
because both Na+ and
water are reabsorbed*
Increased blood
pressure in the
atria of the heart
Increased ANH released

from the atria
Decreased Na+ reabsorption

in the kidney; decreased
water reabsorption as
water is excreted with Na+
in the urine; increased
urinary volume
Decreased blood osmolality

as blood volume decreases
because water is excreted in
the urine; blood osmolality
is maintained because both
Na+ and water are excreted
in the urine*
Decreased arterial
blood pressure
Increased ADH secretion

from the posterior
pituitary; mediated
through baroreceptors
Increased water reabsorption

in the kidney; production
of a small volume of
concentrated urine

resulting from increased
blood volume; decreased
blood osmolality
Increased arterial
blood pressure
Decreased ADH secretion

from the posterior
pituitary; mediated
through baroreceptors
Decreased water reabsorption

in the kidney; production of a
large volume of dilute urine
Decreased blood pressure

resulting from decreased
blood volume; increased
blood osmolality
Abbreviation: A DH = antidiuretic hormone.

*Assumes normal levels of A DH.
27-14
TABLE 27.6
Consequences of Abnormal
Plasma Levels of Sodium Ions
HYPONATREMIA
Causes
Inadequatedietary intake of sodium

Extrarenal losses
Dilution
Hyperglycemia
Symptoms
Lethargy, confusion, apprehension, seizures, and coma

When accompanied by reduced blood volume:
reduced blood pressure, tachycardia, and decreased
urine output
When accompanied by increased blood volume:
weight gain, edema, and distension of veins
HYPERNATREMIA
Causes
High dietary sodium (rarely causes symptoms)

Administration of hypertonic saline solutions
Oversecretion of aldosterone
Water loss
Symptoms
Thirst, fever, dry mucous membranes, and restlessness

Most serious symptoms are convulsions and
pulmonary edema
When occurring with increased water volume:
weight gain, edema, elevated blood pressure,
and bounding pulse
27-15
Potassium Ion Regulation in ECF

4
Actions
Control Center
Increased blood levels of K+ act
on the adrenal cortex to increase
aldosterone secretion.
Reactions
Elevated aldosterone increases the
rate of K+ secretion from the distal
convoluted tubules and collecting
ducts of the kidney into the urine.
5
Blood K+ levels decrease:
Blood K+ levels increase:

Start here
Blood k+
(normal range)
Blood k+
(normal range)
Blood K+ levels increase:

Blood K+ levels decrease:

Actions
Control Center
Decreased blood levels of K+ act
on the adrenal cortex to decrease
aldosterone secretion
Reactions
Decreased aldosterone reduces the
rate of K+ secretion from the distal
convoluted tubules and collecting
ducts of the kidneys into the urine.
27-16
TABLE 27.7
Concentrations of Potassium Ions
HYPOKALEMIA
Causes
Alkalosis
Insulin administration
Reduced K intake
Increased renalloss
Symptoms
Decreased neuromuscular excitability

Decreased smooth muscle tone
Delayed ventricular depolarization
Bradycardia
Atrioventricular block
HYPERKALEMIA
Causes
Loss of intracellular K+ due to cell trauma or

reduced permeability of plasma membrane
Reduced renal excretion
Symptoms
Mild
Increased neuromuscular irritability

Intestinal cramping and diarrhea
Rapid cardiac repolarization
Severe
Muscle weakness
Loss of muscle tone and paralysis
Reduced rate of cardiac action potential conduction
27-17
Regulation of Calcium Ions

Regulated within
narrow range
Elevated extracellular
levels prevent
membrane
depolarization
Decreased levels lead
to spontaneous action
potential generation
Terms
Hypocalcemia
Hypercalcemia
PTH increases Ca2+

extracellular levels and
decreases extracellular
phosphate levels
Vitamin D stimulates
Ca2+ uptake in
intestines
Calcitonin decreases
extracellular Ca2+
levels
27-18
TABLE 27.8
Concentrations of Calcium Ions
HYPOCALCEMIA
Causes
Nutritional deficiencies
Vitamin D deficiency
Decreased parathyroid hormone secretion
Malabsorption of fats (reduces vitamin D absorption)
Bone tumors that increase Ca2+ deposition
Symptoms
Confusion
Muscles pasmsa
Hyperreflexi
Intestinal cramping
Convulsions
Tetany
Inadequate respiratory movements
Prolonged cardiac ventricular depolarization
HYPERCALCEMIA
Causes
Excessive parathyroid hormone secretion

Excess vitamin D
Symptoms
Fatigue
Weakness
Lethargy
Anorexia
Nausea
Constipation
Reduced cardiac ventricular depolarization
Kidney stones
27-19
Regulation of Magnesium Ions

4
Reactions
Actions
Control Center
Increased blood Mg2+ levels in
the filtrate exceed the kidney's
capacity to reabsorb Mg2+ from
the filtrate.
The Mg2+ not reabsorbed from the
filtrate enter the urine.
2
Blood Mg2+ levels increase:
6
Blood Mg2+
(normal range)
Blood Mg2+
(normal range)
Blood Mg2+ levels decrease:

Start here
Blood Mg2+ levels decrease:

Blood Mg2+ levels increase:

Reactions
Actions
Control Center
2+
Decreased blood Mg levels

cause the kidneys to reabsorb
most of the Mg2+ from the filtrate.
Less Mg2+ enters the urine, and the
blood Mg2+ level is maintained.
27-20
TABLE 27.9
Concentrations of Magnesium Ions
HYPOMAGNESEMIA (rare)
Causes
Malnutrition
Alcoholism
Reduced magnesium intestinal absorption
Renal tubular dysfunction
Some diuretics
Symptoms
Irritability
Muscle weakness
Tetany
Convulsions
HYPERMAGNESEMIA (rare)
Causes
Renal failure
Magnesium-containingant acids
Symptoms
Nausea
Vomiting
Muscle weakness
Hypotension
Bradycardia
Reduced respiration
27-21
Regulation of Blood Phosphate ion

4
Reactions
Actions
Control Center
Increased blood PO43 levels
cause the PO43 levels in the
filtrate to exceed the kidneys
capacity to reabsorb PO43 from
the filtrate.
The PO43 not reabsorbed from the filtrate
enter the urine.
5
Blood PO43 levels increase:
Start here
Blood PO43
(normal range)
Blood PO43
(normal range)
Blood PO43 levels decrease:

Blood PO43 levels decrease:

Blood PO43 levels increase:

Reactions
Actions
Control Center
Decreased blood PO43 levels
cause the kidneys to reabsorb
most of the PO43 from the
filtrate.
Less PO43 enter the urine and the blood
PO43 level is maintained.
27-22
Regulation of Phosphate Ions

Under normal conditions, reabsorption of phosphate occurs
at maximum rate in the nephron
An increase in plasma phosphate increases amount of
phosphate in nephron beyond that which can be
reabsorbed; excess is lost in urine
Hypophosphatemia: reduced absorption from intestine
due to vitamin D deficiency or alcohol abuse.
Hyperphosphatemia: renal failure, chemotherapy,
hyperparathyroidism (secondary to elevated plasma
calcium levels)
27-23
TABLE 27.10
Concentrations of Phosphate Ions
HYPOPHOSPHATEMIA
Causes
Reduced intestinal absorption due to vitamin D

deficiency or alcohol abuse
Hyperparathyroidism (elevatedrenal PO 4 excretion)
Symptoms
Reduced metabolicrate
Reduced oxygentransport
Reduced blood clotting
Reduced white blood cell functions
HYPERPHOSPHATEMIA
Causes
Renal failure
Tissue destruction from chemotherapy
Hyperparathyroidism (reduced renal PO4 excretion)
Symptoms
Formation of calcium phosphate deposits in tissues

of lungs, kidneys and joints
Symptoms of reduced Ca2+ related to formation
of deposits
27-24
Comparison of Strong and Weak Acids

Strong acid
HCI
H+
Hydrochloric acid
Hydrogen ion
CI
Chloride ion
(complete dissociation)
Na+
NaOH
Strong base
Weak acid
Sodium hydroxide
H2CO3
Carbonic acid
OH
Sodium ion
Hydroxide ion
(complete dissociation)
H+
Hydrogen ion
Equilibrium
HCO3
Bicarbonate ion
(partial dissociation)
27-25
27.5 Regulation of Acid-Base Balance

Acids
Release H+ into
solution
Bases
Remove H+ from
solution
Acids and bases

Grouped as strong or
weak
Buffers: Resist changes in

pH
When H+ added, buffer
removes it
When H+ removed, buffer
replaces it
Types of buffer systems

Carbonic acid/bicarbonate
Protein
Phosphate
27-26
Regulation of Acid-Base Balance

4
Reactions
Actions
Buffers:
Buffers release H+.
H2O + CO2
H2CO3
H+ + HCO3
Lungs:
The respiratory center in the brain
decreases the rate and depth of
breathing, which increases blood CO2 .
Kidney:
The distal convoluted tubules
decrease H+ secretion into the urine
and decrease HCO3 reabsorption into
the blood.
Buffers:
The number of H+ in the blood increases.
Lungs:
Increased blood CO2 reacts with
water to produce carbonic acid,
which dissociates to increase H+.
H2O + CO2
H2 CO3
H+ + HCO3
Kidney:
Fewer H+ are removed from the blood,
and fewer HCO3 are available to bind
to H+
Blood pH increases (H+ decreases):

6
Blood pH
(normal range)
Blood pH
(normal range)
Blood pH decreases (H+ increases):

Start here
Blood pH decreases (H+ decreases):

Blood pH decreases (H+ increases):

Reactions
Actions
Buffers:
Buffers bind H.
H2O + CO2
H2CO3
H+ + HCO3
Lungs:
The respiratory center in the brain
increases the rate and depth of
breathing, which decreases blood CO2 .
Kidney:
The distal convoluted tubules
increase H+ secretion into the urine
and increase HCO3 reabsorption into
the blood.
Buffers:
The number of H+ in the blood
decreases.
Lungs:
Decreased blood CO2 causes H+
react with HCO3 to form carbonic acid,
which decreases H+ in blood.
H2O + CO2
H2CO3
H+ + HCO3
Kidney:
Fewer H+ are removed from the blood,
and fewer HCO3 are available to bind
to H+
27-27
Regulation of Acid/Base Balance

Buffers: if pH rises, buffers bind H+; if pH falls,
buffers release H+
Protein buffer: Intracellular and plasma proteins absorb
H+. Provide of buffering in body. E.g., hemoglobin.
Bicarbonate buffering system: Important in plasma
Phosphate buffer system: important as an intracellular
buffer
Respiratory center: if pH rises, respiratory rate

decreases; if pH falls, respiratory rate increases
Kidneys: if pH rises, distal tubule decreases H +
secretion into the urine and decreases HCO3absorption into the blood (more H2CO3 will
dissociate into H+ and HCO3-); if pH falls, distal
tubule increases H+ secretion into the urine and
increases HCO3- absorption into the blood
27-28
TABLE 27.11
Characteristics of Buffer Systems
Carbonic acid/
bicarbonate
buffer system
Components of the carbonic acid/bicarbonate buffer system are not present in high enough concentrations in the extracellular
fluid to constitute a powerful buffer system. However, the concentrations of the components of the buffer system are regulated.
Therefore, it plays an exceptionally important role in controlling the pH of extracellular fluid.
Protein buffer system
Intracellular proteins and plasma proteins form a large pool of protein molecules that can act as buffer molecules. Because of
their high concentration, they provide approximately three-fourths of the bodys buffer capacity. Hemoglobin in red blood cells is
an important intracellular protein. Other intracellular molecules, such as histone proteins and nucleic acids, also act as buffers.
Phosphate buffer
system
Components of the phosphate buffer system are low in the extracellular fluids, compared with the other buffer systems, but it is
an important intracellular buffer system.
27-29
Respiratory Regulation of
Acid-Base Balance
Achieved through carbonic acid/bicarbonate
buffer system
As carbon dioxide levels increase, pH decreases
As carbon dioxide levels decrease, pH increases
Carbon dioxide levels and pH affect respiratory
centers
Hypoventilation increases blood carbon dioxide levels
Hyperventilation decreases blood carbon dioxide levels
27-30
Capillary
Circulation
H2O + CO2
Carbonic
an hydrase
1 Carbon dioxide reacts with H O to

2
form H2CO3. An enzyme, carbonic
anhydrase, found in red blood cells
and on the surface of blood vessel
epithelium, catalyzed the reaction.
Carbonic acid dissociates to form
H+ and HCO3. An equilibrium is
quickly established.
H+ + HCO3
Decreased
pH
Decreased pH in the extracellular

fluid stimulates the respiratory
center and causes an increased
rate and depth of breathing.
3 Increased rate and depth of

breathing causes CO2 to be
expelled from the lungs, thus
reducing the extracellular CO2
levels. As CO2 levels decrease,the
extracellular concentration of H+
decreases, and the extracellular
fluid pH increases.
H2CO3
Respiratory
center in
brainstem
Lungs
Increased
respiratory rate
and depth
Increased CO2
expelled from the lungs
27-31
Renal Regulation of
Acid-Base Balance
Secretion of H+ into filtrate and reabsorption of
HCO3- into ECF cause extracellular pH to
increase
HCO3- in filtrate reabsorbed
Rate of H+ secretion increases as body fluid pH
decreases or as aldosterone levels increase
Secretion of H+ inhibited when urine pH falls
below 4.5
27-32
Renal Regulation of
Acid-Base Balance
1 When the filtrate or blood pH

decreases, H+ combine with HCO3
to form carbonic acid that is converted
into CO2 and H2O. The CO2 diffuses
into tubule cells.
Peritubular
capillary
Interstitial
fluid
2 In the tubule cells, CO2 combines with
Basal
H2O to form H2CO3 that dissociates to
membrane
form H+ and HCO3.
Tubule cell
3 An antiport mechanism secretes H+ into cytoplasm
the filtrate in exchange for Na+ from the Apical
filtrate. As a result, filtrate pH decreases. membrane
4 Bicarbonate ions are symported with
Na+ into the interstitial fluid. They then
diffuse into capillaries.
5 In capillaries, HCO3 combine with H+.
This decreases the H+ concentration
and increases blood pH.
Lumen
1 CO2 + H2O
CO2 + H2O
H2CO3
H2CO3
H+
+ HCO3
Na+
H+ + HCO3
3
CO2
5
HCO3 + Na+
Na+
+
Antiport
Symport
27-33
Hydrogen Ion Buffering

1 Hydrogen ions secreted into the

filtrate are buffered.
2 Hydrogen ions can react with HCO3
that enters the filtrate to form H2CO3,
which is in equilibrium with H2O and
CO2.
3 Hydrogen ions can react with HPO 2
4
that enters the filtrate to form H2PO4.
form NH4 .
Na +
Tubule cell
cytoplasm
HCO3 + H+
Apical
membrane
4 Hydrogen ions can react with NH3 to

+
Na+ + HCO3
Interstitial
fluid
Basal
membrane
Lumen
1
From
filtrate
NaHCO3
Na2HPO4
NH3
Na + HCO3 + H+
2 Na+ + HPO42 + H+
+
NH3 + H+
H3CO3
2
H2CO3
H2O + CO2
H2O + CO2
Na + H2PO42
3
NH4+
4
+
Antiport
Symport
27-34
Acidosis and Alkalosis

Acidosis: pH body fluids below 7.35
Respiratory: Caused by inadequate ventilation- reduced
elimination of CO2, asthma, damage to respiratory center in brain,
emphysema.
Metabolic: Results from all conditions other than respiratory that
decrease pH- diarrhea, vomiting, ingesting overdose of aspirin,
untreated diabetes mellitus, anaerobic respiration
Alkalosis: pH body fluids above 7.45

Respiratory: Caused by hyperventilation, high altitude (reduced
partial pressure of O2
Metabolic: Results from all conditions other than respiratory that
increase pH- severe vomiting, too much aldosterone, ingestion of
substances like bicarbonate of soda.
Compensatory mechanisms
27-35
27-36

Chapt27 Lecture10e

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Chapt27 Lecture10e

Hochgeladen von

Copyright:

Verfügbare Formate

Chapter 27

Water, Electrolytes, and

27.1 Body Fluids

Intracellular fluid compartment

Extracellular fluid compartment

Primary intracellular ions, interstitial fluid ions, and plasma ions

Body Fluid Compartments

TABLE 27.2 Approximate Concentration of major Solutes in Body Fluids*

Phosphate (HPO4 plus HPO4 )

Data are from skeletal muscle.

27.2 Regulation of Body Fluid

Routes of water loss

Extracellular Fluid Osmolality

Simultaneously, the juxtaglomerular apparatuses detect low blood pressure, which

Osmoreceptors in the hypothalamus shrink when blood osmolality goes up,

Hormonal Regulation of Blood Osmolality

Blood osmolality decreases:

Blood osmolality decreases:

Blood osmolality increases:

Regulation of ECF Volume

Regulation of Blood Volume

Reduced blood volume due to loss of water

Low blood volume induces lowered blood

Increased blood volume due to decreased Na+

Regulation of ECF Volume

Regulation of ECF Osmolality

Concentration changes only

Regulation of Na+ ions

27.3 Regulation of ICF

1 Large organic molecules, such as proteins,

2 The transport of ions, such as Na+, K+, and

3 An electrical charge difference across the

Water moves by osmosis.

27.4 Regulation of Specific Electrolytes

Homeostasis: Mechanisms Regulating Blood Sodium

Increased ADH secretion

Increased water reabsorption

Decreased blood osmolality

Decreased ADH secretion

Decreased water reabsorption

Increased blood osmolality

Response to Changes in Blood Osmolality

Response to Changes in Blood Pressure

Increased renin release

Increased blood pressure

Decreased renin release

Decreased Na+ reabsorption

Decreased blood pressure

Decreased ANH released

Increased Na+ reabsorption

Increased blood pressure

Increased ANH released

Decreased Na+ reabsorption

Decreased blood osmolality

Increased ADH secretion

Increased water reabsorption

Increased blood pressure

Decreased ADH secretion

Decreased water reabsorption

Decreased blood pressure

Abbreviation: A DH = antidiuretic hormone.

Inadequatedietary intake of sodium