Health Science 11: Anatomy and Physiology

CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE

COVERAGE:
27.1 Body Fluids
27.2 Regulation of Extracellular Fluid Composition
27.3 Regulation of Intracellular Fluid Composition
27.4 Regulation of Specific Electrolytes in the
Extracellular Fluid
27.5 Regulation of Acid-Base Balance

27. 1 BODY FLUIDS

- The human body's weight is composed of at least
50% water, varying with factors such as age, gender,
and body composition. Infants, for instance, have 75% - Despite ion differences, normal conditions maintain
of their weight as water. approximately equal osmotic pressure in each
compartment, facilitating continuous and extensive
bodily functions. When the composition of a fluid
compartment undergoes significant changes, water will
shift towards the compartment with a higher solute
concentration.

- Osmosis, the diffusion of water towards areas with

higher solute concentrations, plays a crucial role in
maintaining the homeostatic fluid balance between
- Water distribution is affected by adipose tissue, with
compartments. For instance, in an inflammatory
men generally having a higher percentage of body
response, increased capillary permeability allows
weight due to water than women.
proteins to move from plasma to interstitial fluid,
causing osmotic movement of water and resulting in
THE BODY'S TOTAL WATER CONTENT IS
swelling or edema. Conversely, dehydration triggers
CATEGORIZED INTO TWO MAJOR
osmotic water movement into the plasma when blood
COMPARTMENTS:
osmolarity surpasses that of interstitial fluid.
 intracellular fluid (inside cells)
 extracellular fluid (outside cells)

- Intracellular fluid constitutes about 70% of body

water, equivalent to roughly 40% of total body weight.
Extracellular fluid, comprising around 30% of body
water (20% of total body weight), the extracellular
fluid is distributed throughout the body and is divided
into multiple sub compartments, including:
 interstitial fluid between cells
 plasma of the blood
 lymph within lymphatic vessels
 cerebrospinal fluid of the brain and spinal cord
 synovial fluid within synovial joints 27.2 REGULATION OF EXTRACELLULAR
FLUID COMPOSITION
- Each fluid compartment contains water, electrolytes REGULATION OF WATER CONTENT
(ions), and other solutes. Notably, intracellular fluid CHANGES IN THE TOTAL WATER VOLUME
has higher potassium (K+) and protein concentrations, ALTER SEVERAL FACTORS IN THE BODY:
while extracellular fluid has higher sodium (Na+) and  the solute concentration of body fluids,
chloride (Cl-) concentrations.  blood pressure, and
 interstitial fluid pressure.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
- 90% of the water that enters the body each day comes 2. Arterial and juxtaglomerular baroreceptors
from beverages and food. The remaining 10% of water suppress thirst as blood volume increases and
is produced during cellular respiration. stretch the blood vessel wall.
- These volumes total around 1500–3000 mL (1.5–3.0 3. Mouth dryness-induced thirst diminishes after
L) of water entering the body each day. consuming liquid, with longer-term
suppression occurring when extracellular fluid
REGULATION OF THIRST solute concentration and blood pressure
- Thirst is the sensation that induces an urge to drink normalize.
liquids. 4. Stomach distension, caused by consumed
fluid, temporarily suppresses thirst through
FOUR MECHANISMS ACT TO INCREASE sensory action potentials in stretch receptors,
THIRST OR DECREASE THIRST: preventing excessive fluid intake. Typically, a
 hypothalamic osmoreceptors, healthy person drinks slightly more than the
 arterial and juxtaglomerular apparatus minimum required, with excess body water
baroreceptors, eliminated by the kidneys.
 dryness of the mouth, and
 distension of the stomach. REGULATION OF WATER LOSS
WATER LOSS FROM THE BODY OCCURS
THROUGH THREE ROUTES:
 from the kidneys as urine,
 from the skin and respiratory passages by
evaporation,
 from the digestive tract in feces
- Approximately 61% of water loss happens through
urine, 35% through evaporation (including
perspiration), and 4% in feces.
- The kidneys play a crucial role in regulating the
composition and volume of body fluids by controlling
MECHANISMS THAT INCREASE THIRST water excretion in urine.
- Thirst is triggered by mechanisms such as decreased
blood volume or increased blood osmolality. THREE FACTORS DETERMINE THE VOLUME
1. Hypothalamic osmoreceptors in the OF WATER LOST THROUGH THE
hypothalamus detect changes in extracellular RESPIRATORY PASSAGES:
fluid concentration, leading to the sensation of  temperature and humidity of air,
thirst.  body temperature,
2. Arterial and juxtaglomerular baroreceptors  the volume of air expired per breath.
respond to low blood pressure by stimulating - Insensible perspiration, water lost through the skin,
the thirst center. regulates heat loss, with increased water loss during
3. Mouth dryness, due to reduced saliva elevated body temperature.
production from decreased body water. - Sweat, or sensible perspiration, is produced by sweat
4. Stomach distension is more influential in glands and contains solutes like sodium chloride
decreasing thirst (NaCl), potassium (K+), ammonia, and urea.
- Neural mechanisms primarily regulate sweat
MECHANISMS THAT DECREASE THIRST production based on body temperature, with increased
- When the body's water content is sufficient, sweating during exercise, high environmental
mechanisms act to decrease the sensation of thirst. temperatures, or fever.
1. Hypothalamic osmoreceptors stop action - - Adequate fluid replacement is crucial during
potential conduction and the thirst sensation extensive
subsides when extracellular solute sweating to counter the hypoosmotic nature of sweat
concentration returns to normal. and prevent dehydration.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
- Severe dehydration from extensive sweating can lead
to increased extracellular fluid solute concentration,
reduced plasma volume, and increased hematocrit,
potentially causing heart failure.
- Fecal water loss is generally low, as most fluid
secreted into the digestive tract is reabsorbed under
normal conditions, except in cases of severe
vomiting and diarrhea.
- The body can produce either concentrated or dilute
urine, depending on extracellular fluid osmolality and
volume, to maintain total body water content within a
narrow range.
REGULATION OF EXTRACELLULAR
FLUID OSMOLALITY
- Osmolality, the concentration of a solution, is
REGULATION OF EXTRACELLULAR
influenced by altering its water content. Body fluid
osmolality is maintained between 285 and 300
FLUID VOLUME
mOsm/kg. - Extracellular fluid volume can change independently
 An increase in extracellular fluid osmolality
of osmolality, with blood volume directly proportional
can result from factors such as prolonged to blood pressure.
sweating or excessive alcohol consumption,
MONITORING BLOOD PRESSURE:
leading to elevated water loss. This triggers
- Baroreceptors in carotid sinus, aortic arch,
thirst and antidiuretic hormone (ADH)
juxtaglomerular apparatus, atria, and large veins
secretion.
regulate extracellular fluid volume.
 ADH acts on the kidneys' distal convoluted
 Neural Mechanisms:
tubules and collecting ducts, increasing water
 Increased blood pressure causes vasodilation
reabsorption from the filtrate. Consumed water
of afferent arterioles, raising glomerular
is absorbed, reducing extracellular fluid
filtration rate (GFR) and urine volume.
osmolality.
 Thirst and ADH mechanisms respond rapidly  Decreased blood pressure leads to
to small changes in extracellular fluid vasoconstriction, reducing GFR, filtrate
osmolality (minutes to a few hours). During volume, and urine volume.
dehydration, larger increases in osmolality  Renin-Angiotensin-Aldosterone Hormone
intensify thirst and ADH secretion. Mechanism:
 A decrease in extracellular fluid osmolality  Juxtaglomerular cells release renin on
occurs with excess water intake. Drinking a detecting low blood pressure.
large volume of dilute fluid inhibits thirst and  Renin converts angiotensinogen to angiotensin
ADH secretion. Less water is consumed and I, then to angiotensin II.
reabsorbed in the kidneys, leading to the  Angiotensin II raises blood pressure through
excretion of a large volume of dilute urine. vasoconstriction, thirst stimulation, and
 Excreting excess water restores extracellular aldosterone secretion.
fluid osmolality to its normal range. Thirst and  Aldosterone promotes Na+ reabsorption,
ADH mechanisms play a crucial role in increasing blood osmolality and water
maintaining osmolality homeostasis. reabsorption in the kidneys, reducing urine
volume, elevating extracellular fluid volume,
and returning blood pressure to normal.
 Atrial Natriuretic Hormone (ANH)
Mechanism:
 Increased blood volume stretches atrial walls,
triggering ANH secretion.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
 ANH reduces Na+ reabsorption, increasing  Dehydration increases extracellular solute
Na+ loss in urine, raising urine volume, and concentration, causing water to move out of
decreasing extracellular fluid volume and cells.
blood volume.  Severe dehydration leads to cell shrinkage and
 ANH response weakens with decreased abnormal function.
pressure in the atria.  Increased water intake after dehydration
 Antidiuretic Hormone (ADH) Mechanism: decreases extracellular solute concentration,
 ADH regulates extracellular fluid volume in allowing water to move back into cells.
response to significant blood pressure changes.  Impact on Cell Function:
 Low blood pressure stimulates ADH secretion,  Cellular functions can be affected by changes
promoting water reabsorption in distal in fluid composition.
convoluted tubules and collecting ducts.  Understanding these differences is crucial for
 This results in a small volume of concentrated maintaining cell function and ensuring proper
urine, increasing extracellular fluid volume responses to changes in solute concentrations
and blood pressure. and hydration levels.
 Mechanisms working together maintain
extracellular fluid concentration and volume.
Dysregulation can lead to increased
extracellular fluid volume, as seen in
conditions like excessive aldosterone
secretion.
 Despite conditions like edema or heart failure,
mechanisms such as ADH secretion and renin
secretion work to
maintain the osmolality of extracellular fluid
between 285 and 300 mOsm/kg.
27.3 REGULATION OF INTRACELLULAR
FLUID COMPOSITION
 Selective Permeability: 27.4 REGULATION OF SPECIFIC
 Plasma membrane is selectively permeable. ELECTROLYTES IN THE EXTRACELLULAR
 Large and polar molecules can't easily diffuse, FLUID
while small and nonpolar molecules can easily BODY'S FLUID COMPARTMENTS:
cross.  Water
 Reasons for Different Composition:  Electrolytes
 Intracellular fluid differs due to large proteins  Solutes
synthesized inside cells that cannot exit. ELECTROLYTES DISSOCIATE INTO IONS IN
 Transport proteins in the plasma membrane, WATER:
like the Na+–K+ ATP pump, contribute to  inorganic salts
differences by expending ATP to create ion  acids
concentration gradients.  bases
 Ion Distribution and Charge Difference:  certain proteins.
 Na+–K+ ATP pump moves K+ into the cell - Remaining solutes: nonelectrolytes, don't dissociate
and pumps Na+ out, creating an uneven in water, organic molecules with covalent bonds
distribution of ions and a charge difference (lipids, urea, glucose).
across the plasma membrane. - Electrolytes, especially Na+, influence fluid
 Osmosis and Water Movement: osmolality, can be cations or anions.
 Water movement across the membrane is - Major extracellular ions: Na+, Cl−, K+, Ca2+, Mg2+,
determined by changes in solute and phosphate ions (Po4 3−).
concentrations in intracellular and extracellular - Electrolytes in ingested food and water, removed by
fluids. organs (kidneys, liver, skin, lungs).
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
- Electrolyte concentrations regulated in extracellular - Hyponatremia (low plasma Na+) symptoms include
fluid, maintained unless growing, gaining, or losing mental confusion, seizures, and coma.
weight. - Hyponatremia can result from excessive water intake
- Regulation involves coordinated participation of after exercise.
multiple organ systems. - Hypernatremia (high plasma Na+) symptoms include
REGULATION OF SODIUM IONS pulmonary edema and muscle convulsions.
- Sodium ions dominate as extracellular cations, - Hypernatremia can result from excess aldosterone
creating osmotic pressure. secretion.
- Osmotic pressure drives water toward areas of higher
solute concentration.
- Na+ and associated negative ions contribute to 90–
95% of extracellular fluid osmotic pressure.
- Excessive NaCl consumption is common in the U.S.
- Body regulates Na+ through excess excretion or
conservation based on intake.
- Kidneys play a major role in Na+ excretion,
involving glomerulus, Bowman capsule, and renal
tubule.
- Na+ concentration in urine is determined by
reabsorption in the renal tubule.
- Aldosterone controls Na+ reabsorption in the distal
convoluted tubule and collecting duct.
- Sweating releases small amounts of Na+, regulated
by body temperature and sweat production.
- Primary mechanisms are sensitive to extracellular
fluid osmolality and blood pressure.
- Changes in Na+ quantity impact extracellular
osmotic pressure and fluid volume.
- Increased Na+ promotes ADH secretion, water
reabsorption, and thirst.
- Decreased Na+ leads to reduced ADH, dilute urine
production, and decreased thirst.
- Regulation maintains Na+ concentration within a
narrow range.
- Elevated blood pressure increases Na+ and water
excretion.
- Low blood pressure activates mechanisms like renin-
angiotensin-aldosterone, increasing Na+ concentration
and water volume.
- Increased blood pressure stretches heart walls,
particularly in the right atrium.
- Stretch in the right atrium triggers the secretion of
ANH hormone.
- ANH acts on kidneys, increasing urine production by
inhibiting Na+ reabsorption.
- ANH also inhibits ADH effects on distal convoluted
tubules, collecting ducts, and ADH secretion.
- Deviations from normal Na+ concentration cause
significant symptoms.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
• ALDOSTERONE
- increases the rate of K+ secretion in the kidney,
which lowers levels of K+ in the blood.
- Hypokalemia can also be caused by insulin
administration. Insulin activates the Na+–K+ pump in
cells, which causes a decrease in extracellular K+.
- Low K+ levels in the blood can cause fatigue, muscle
cramps, or temporary paralysis.
• HYPERKALEMIA (hī′per-kă-lē′mē-ă)
- is due to an abnormally high level of K+ in the
extracellular fluid.
-Due to reduced renal excretion, can lead to intestinal
cramping, diarrhea, and temporary paralysis

REGULATION O CHLORIDE IONS

• CHLORIDE IONS
- the predominant anions in the extracellular fluid. The
concentration of chloride ions in extracellular fluid is
regulated alongside cations like sodium, potassium,
and calcium. Since sodium is the primary cation,
controlling its levels is crucial for regulating
extracellular chloride.
REGULATION OF POTASSIUM IONS
• POTASSIUM ION REGULATION OF CALCIUM IONS
- concentration across the plasma membrane is very - As with other ions, the extracellular concentration of
tightly regulated because K+ is the critical factor for calcium ions is regulated within a narrow range. Major
determining the resting membrane potential for symptoms develop when the extracellular
electrically excitable cells concentration of Ca²+ moves out of its normal range.
- Potassium ions are readily filtered out of the blood in • HYPOCALCEMIA
the renal corpuscle. - is due to a below-normal level of Ca²+ in the
- Also actively secreted in the distal convoluted tubules extracellular fluid.
and collecting ducts - increases the plasma membrane's permeability to
NOTE: Na+.
If extracellular K+ concentrations increase, the cell • HYPERCALCEMIA
depolarizes, whereas if it decreases, the cell - is due to an above-normal level of Ca²+ in the
hyperpolarizes. extracellular fluid.
• HYPOKALEMIA (hī′pō-ka-lē′mē-ă) - decreases the plasma membrane's permeability to
- due to an abnormally low level of K+ in the Na+, preventing normal depolarization of nerve and
extracellular fluid. muscle cells.
- Hypokalemia can be caused by excess K+ secretion - High extracellular Ca²+ levels cause the deposition of
in the kidney due to abnormally elevated aldosterone calcium carbonate salts in soft tissues, resulting in
levels. irritation and inflammation of those
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
tissues. 2. Renal Tubules - PTH increases Ca2+
THREE MAJOR SITES FOR REGULATION OF reabsorption from the kidney tubules.
CA²+ LEVELS IN THE EXTRACELLULAR However, PTH stimulates phosphate excretion
FLUID: in the kidneys, which results in low blood
1. Kidneys levels of phosphate.
2. Digestive tract 3. Vitamin D3 - PTH increases the rate of active
3. Bones: almost 99% of total body calcium is vitamin D3 formation, which indirectly
contained in bone. increases Ca2+ levels through the actions of
vitamin D3.
- Lack of PTH secretion causes a rapid reduction in
blood Ca2+ levels. This could result in death primarily
due to tetany of the respiratory muscles.
- Vitamin D can be obtained from the diet or from
vitamin D3 synthesis. Normally, vitamin D3 synthesis
is adequate; however, because ultraviolet light is
required for this process, prolonged lack of sun
exposure reduces vitamin D3 blood levels.
- Without vitamin D3, the transport of Ca2+ across the
wall of the digestive tract is negligible.
• CALCITONIN
- secreted by the parafollicular cells of the thyroid
gland. Calcitonin lowers extracellular Ca2+ levels. The
major effect of calcitonin is in bone, where it inhibits
osteoclasts. Thus, calcitonin prevents bone
degradation, which keeps blood Ca2+ levels from
rising.
REGULATION OF MAGNESIUM IONS
- Most magnesium in the body stored in bones or
Calcium ion regulation partly involves the regulation intracellular fluid.
of Ca²+ deposition into and reabsorption from bone. - Less than 1% of total magnesium ions in extracellular
However, long-term regulation of Ca²+ levels depend fluid.
on maintaining a balance between Ca²+ absorption - About half of extracellular magnesium ions bound to
across the intestinal wall and Ca²+ excretion by the plasma proteins, rest are free (Mg2+).
kidneys. - Magnesium ions are cofactors for intracellular
enzymes, like Na+–K+ pump.
THREE MAJOR HORMONES THAT - Low and high plasma magnesium levels affect Na+–
REGULATE BLOOD LEVELS OF CA²+: K+ active transport.
1. Parathyroid hormone - Hypomagnesemia (low blood magnesium) from
2. Vitamin D3 alcoholism leads to muscle weakness and convulsions.
3. Calcitonin - Hypermagnesemia (high blood magnesium) in kidney
failure causes nausea, low blood pressure, low
Parathyroid hormone is secreted by the parathyroid respiratory rate.
glands when blood Ca²+ levels are too low. - Free Mg2+ passes through kidney filtration
membranes into filtrate.
PTH INCREASES BLOOD CA²+ THROUGH - 85–90% of filtered Mg2+ reabsorbed, only 10–15%
THREE PRINCIPAL MEANS: enters urine.
1. Osteoclasts - PTH stimulates osteoclasts to - Most Mg2+ reabsorbed by the loop of Henle, rest by
reabsorb bone, which increases blood levels proximal convoluted tubule, distal convoluted tubule,
Ca2+ and phosphate. and collecting duct.
- Kidney's capacity to reabsorb Mg2+ is limited.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
- Excess free Mg2+ in extracellular fluid increases hormone increases extracellular phosphate levels by
Mg2+ loss in urine. promoting bone reabsorption. Bone reabsorption
- Decreased free Mg2+ in extracellular fluid leads to releases Ca2+ and phosphate ions into the
increased Mg2+ reabsorption. extracellular fluid. Thus, kidney do not need to
- Mechanism controlling Mg2+ reabsorption not clear conserve phosphate ions, and more are excreted in the
but decreased extracellular Mg2+ concentration urine. If phosphate levels in the extracellular fluid
increases renal tubule reabsorption rate. increase above normal levels, Ca2+ and phosphate ions
precipitate as calcium phosphate salts in soft tissues.
• HYPOPHOSPHATEMIA
 a below-normal blood level of phosphate.
• HYPERPHOSPHATEMIA
 an above-normal blood level of phosphate.

REGULATION OF PHOSPHATE IONS

About 85% of the phosphate in the body is in the form 27.5 REGULATION OF ACID-BASE
of calcium phosphate salts in bone and teeth. Most of
BALANCE
the remaining phosphate is inside cells. Many of the
THREE MAJOR MECHANISMS FOR
phosphate ions are covalently bound to other organic
REGULATION OF H+ CONCENTRATION
molecules. For example, phosphate ions are bound to
lipids (to form phospholipids), proteins, and  Buffer System
carbohydrates. They are important components of  Respiratory System
DNA, RNA, and ATP.  Kidneys
• PHOSPHATE
 play important roles in regulating enzyme - Buffers and other mechanisms of acid-base
activity. balance regulation work together to regulate acid-
• PHOSPHATE IONS base balance.
 are dissolved in the intracellular fluid and acts • BUFFER SYSTEM
as buffers. - prevent extreme changes in the pH of a solution.
 most common phosphate ion is HPO42−.
Buffers within body fluids stabilize the pH by
- The kidney’s capacity to reabsorb phosphate ions is
binding to excess H+ or by releasing H+.
limited. If the level of phosphate ions increases in the
extracellular fluid, more phosphate is excreted in the
IMPORTANT BUFFER SYSTEMS FUNCTION
urine. If the level of phosphate ions decreases in the
TOGETHER TO PREVENT MAJOR CHANGES
extracellular fluid, less phosphate is excreted in the
IN THE PH OF BODY FLUIDS:
urine.
- A diet low in phosphate can increase the rate of  Carbonic Acid/Bicarbonate Buffer System
phosphate reabsorption. Additionally, parathyroid  Protein Buffer System
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
 Phosphate Buffer System - As CO2 levels increase, pH decreases.
 Carbonic Acid/Bicarbonate Buffer System - As CO2 levels decrease, pH increases.
- Carbonic acid (H2CO3) is a weak acid. It is - The increased rate and depth of breathing cause CO2
formed when CO2 reacts with water. to be eliminated from the body through the lungs at a
- The carbonic acid/bicarbonate buffer system depends greater rate, which decreases the concentration of CO2
on the equilibrium that is quickly established between in the body fluids.
H2CO3 and H+/HCO3 −. When H+ is added to this - The decreased rate and depth of breathing cause less
solution, a large proportion of the H+ binds to HCO3 − CO2 to be eliminated from the body through the lungs.
to form H2CO3, and only a small percentage remains
as free H+. Thus, the carbonic acid/bicarbonate buffer
system resists a large decrease in pH when acidic
substances are added to a solution containing H2CO3.
- The carbonic acid/bicarbonate buffer system plays an
important role in regulating the extracellular pH. It
quickly responds to several metabolic conditions:
 the addition of substances such as CO2 or
lactate produced by increased metabolism
during exercise.
 increased fatty acid and ketone body
production during periods of elevated lipid
metabolism.
 the addition of basic substances, such as large
• CARBONIC ANHYDRASE
amounts of NaHCO3 consumed as an antacid.
- a catalyzed enzyme reaction between CO2 and H2O.
• PROTEIN BUFFER SYSTEM
- This enzyme does not influence equilibrium but
- the high concentration of intracellular proteins and
accelerates the rate at which the reaction proceeds in
plasma proteins forms a large pool of buffer
either direction, so that equilibrium is achieved
molecules.
quickly.
- Hemoglobin in red blood cells is one of the most
REGULATION OF ACID-BASE BALANCE BY
important intracellular proteins.
THE KIDNEYS
- Other intracellular molecules associated with nucleic
- Renal tubules secrete H+ into the tubular fluid
acids, such as histone proteins, also act as buffers.
- The capacity of proteins to function as buffers is due
to the functional groups of amino acids, such as
carboxyl (–COOH) or amino (–NH2) groups, which
can act as weak acids and bases. Consequently, as the
H+ concentration increases, more H+ binds to the
functional groups; when the H+ concentration
decreases, H+ is released from the functional groups.
• PHOSPHATE BUFFER SYSTEM
- Phosphate-containing molecules in solution, such as
DNA, RNA, ATP, and phosphate ions, act as buffers.
most binds to bicarbonate, ammonia, and phosphate
- When the pH decreases, ions, such as HPO4 −, bind
buffers bound and free H+ are excreted in the urine
H+ to form H2PO4 −; however, when the pH becomes
actually expelling H+ from the body.
more basic, H2PO4 releases H+ into solution. In this
- Other buffer systems only reduce its concentration by
way, these two ions fluctuate between gaining and
binding it to other
losing H+ ions, which helps balance the pH.
REGULATION OF ACID-BASE BALANCE BY
THE RESPIRATORY SYSTEM
- The respiratory system regulates acid-base balance
through the carbonic acid/bicarbonate buffer system.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
chemicals. - A major effect of alkalosis is hyperexcitability of the
nervous system. Peripheral nerves are affected first,
resulting in spontaneous nervous stimulation of
muscles. Spasms, tetanic contractions, and possibly
extreme nervousness or convulsions result. Severe
alkalosis can cause death as a result of tetany of the
respiratory muscles.
- Buffers help resist changes in the pH of body fluids,
the respiratory system and the kidneys regulate the pH
Excretions to maintain pH of the body fluids.
- The secretion of H+ into the filtrate and the - Malfunctions in either the respiratory system or the
reabsorption of HCO3 − into extracellular fluid cause kidneys can result in acidosis or alkalosis.
extracellular pH to increase.
 Carbonic acid dissociates to form H+ and ACIDOSIS AND ALKALOSIS ARE
HCO3 − in tubule cells. CATEGORIZED ACCORDING TO THE CAUSE
OF THE CONDITION.
 An antiport mechanism moves H+ into the
tubule lumen and Na+ into the tubule cell.
 Respiratory acidosis and alkalosis result from
 Sodium ions and HCO3 − diffuse into the abnormalities in the respiratory system.
extracellular fluid.  Metabolic acidosis and alkalosis result from
 Bicarbonate ions in the filtrate are reabsorbed. abnormal metabolism.
 Bicarbonate ions combine with H+ to form
carbonic acid, which dissociates to form CO2 - Inadequate ventilation causes respiratory acidosis
and water. because CO2 is retained in the body rather than being
 Carbon dioxide diffuses into tubule cells and eliminated.
forms carbonic acid, which dissociates to form - If the pH falls below 7.35, the symptoms of
HCO3 − and H+. respiratory acidosis appear.
 Bicarbonate ions diffuse into the extracellular - During respiratory acidosis, buffers help resist the
fluid, and H+ is secreted into the filtrate decrease in pH. In addition, the kidneys increase the
- The rate of H+ secretion increases as body fluid pH rate of H+ secretion into the filtrate and also reabsorb
decreases or as aldosterone levels increase. HCO3−. However, the capacity of buffers to resist
 Ammonia and phosphate buffers in the urine changes in pH can be exceeded, and a period of 1–2
resist a drop in pH. days is required for the kidneys to become maximally
 As the buffers absorb H+, more H+ is pumped functional.
into the urine. - Respiratory alkalosis results from hyperventilation,
ACIDOSIS AND ALKALOSIS which eliminates greater-than-normal CO2 from the
- Body fluids typically have a pH of 7.35 to 7.45. body, resulting in a decreased CO2 concentration in
Lower than 7.35 pH causes acidosis (as-i-dō′sis); the body fluids (table 27.12). As CO2 levels decrease,
alkalosis (al′kă-lō′sis) happens at pH values higher H+ reacts with HCO3− to form H2CO3. The H2CO3
than 7.45. forms H2O and CO2. The resulting decrease in the
- Metabolism produces acidic products that lower the concentration of H+ causes the pH of the body fluids
pH of the body fluids. to increase. If the pH increases above 7.45, the
- Failure to eliminate the acidic products of symptoms of respiratory alkalosis appear.
metabolism results in acidosis. - During respiratory alkalosis, the kidneys decrease the
- Excess elimination of the acidic products of rate of H+ secretion into the filtrate and the rate of
metabolism results in alkalosis. HCO3− reabsorption. If pH increases, the kidneys
- The major effect of acidosis is depression of the need 1–2 days to compensate.
central nervous system. When blood pH falls below - Metabolic acidosis results from all conditions that
7.35, the central nervous system malfunctions. The decrease the pH of the body fluids below 7.35, except
individual becomes disoriented, and possibly comatose for certain respiratory system conditions.
as the condition worsens.
Health Science 11: Anatomy and Physiology
CHAPTER 27: WATER, ELECTROLYTE, AND ACID-BASE BALANCE
- If metabolic acidosis persists for many hours and if
the kidneys are functional, the kidneys can also help
compensate for metabolic acidosis by secreting H+ at a
greater rate and increasing the rate of HCO3−
reabsorption. The symptoms of metabolic acidosis
appear if the respiratory and renal systems are not able
to maintain the pH of the body fluids within its normal
range.
- Metabolic alkalosis results from all conditions that
increase the pH of the body fluids above 7.45, with the
exception of those resulting from altered function of
the respiratory system. If metabolic alkalosis persists
for several hours and if the kidneys are functional, the
kidneys reduce the rate of H+ secretion to help reverse
alkalosis.