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By the end of this section, you will be able to:
  • Identify the three blood variables considered when making a diagnosis of acidosis or alkalosis
  • Identify the source of compensation for blood pH problems of a respiratory origin
  • Identify the source of compensation for blood pH problems of a metabolic/renal origin

Normal arterial blood pH is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood pH below 7.35 is considered to be in acidosis (actually, “physiological acidosis,” because blood is not truly acidic until its pH drops below 7), and a continuous blood pH below 7.0 can be fatal. Acidosis has several symptoms, including headache and confusion, and the individual can become lethargic and easily fatigued ( [link] ). A person who has a blood pH above 7.45 is considered to be in alkalosis, and a pH above 7.8 is fatal. Some symptoms of alkalosis include cognitive impairment (which can progress to unconsciousness), tingling or numbness in the extremities, muscle twitching and spasm, and nausea and vomiting. Both acidosis and alkalosis can be caused by either metabolic or respiratory disorders.

As discussed earlier in this chapter, the concentration of carbonic acid in the blood is dependent on the level of CO 2 in the body and the amount of CO 2 gas exhaled through the lungs. Thus, the respiratory contribution to acid-base balance is usually discussed in terms of CO 2 (rather than of carbonic acid). Remember that a molecule of carbonic acid is lost for every molecule of CO 2 exhaled, and a molecule of carbonic acid is formed for every molecule of CO 2 retained.

Symptoms of acidosis and alkalosis

This figure points out the symptoms of acidosis and alkalosis on a silhouette of a human torso. The effects of acidosis on the central nervous system include headache, sleepiness, confusion, loss of consciousness and coma. The effects of acidosis are given on the left side of the diagram. The effects of acidosis on the respiratory system include shortness of breath and coughing. The effects of acidosis on the heart include arrhythmia and increased heart rate. The effects of acidosis on the muscular system include seizures and weakness. The effects of acidosis on the digestive system include nausea, vomiting and diarrhea. The right side of the diagram describes the symptoms of alkalosis. The effects of alkalosis on the central nervous system include confusion, light-headedness, stupor, and coma. The effects of alkalosis on the peripheral nervous system include hand tremor and numbness or tingling in the face, hands, and feet. The effects of alkalosis on the muscular system include twitching and prolonged spasms.  The effects of alkalosis on the digestive system include nausea and vomiting.
Symptoms of acidosis affect several organ systems. Both acidosis and alkalosis can be diagnosed using a blood test.

Metabolic acidosis: primary bicarbonate deficiency

Metabolic acidosis occurs when the blood is too acidic (pH below 7.35) due to too little bicarbonate, a condition called primary bicarbonate deficiency. At the normal pH of 7.40, the ratio of bicarbonate to carbonic acid buffer is 20:1. If a person’s blood pH drops below 7.35, then he or she is in metabolic acidosis. The most common cause of metabolic acidosis is the presence of organic acids or excessive ketones in the blood. [link] lists some other causes of metabolic acidosis.

*Acid metabolites from ingested chemical.
Common Causes of Metabolic Acidosis and Blood Metabolites
Cause Metabolite
Diarrhea Bicarbonate
Uremia Phosphoric, sulfuric, and lactic acids
Diabetic ketoacidosis Increased ketones
Strenuous exercise Lactic acid
Methanol Formic acid*
Paraldehyde β-Hydroxybutyric acid*
Isopropanol Propionic acid*
Ethylene glycol Glycolic acid, and some oxalic and formic acids*
Salicylate/aspirin Sulfasalicylic acid (SSA)*

The first three of the eight causes of metabolic acidosis listed are medical (or unusual physiological) conditions. Strenuous exercise can cause temporary metabolic acidosis due to the production of lactic acid. The last five causes result from the ingestion of specific substances. The active form of aspirin is its metabolite, sulfasalicylic acid. An overdose of aspirin causes acidosis due to the acidity of this metabolite. Metabolic acidosis can also result from uremia, which is the retention of urea and uric acid. Metabolic acidosis can also arise from diabetic ketoacidosis, wherein an excess of ketones is present in the blood. Other causes of metabolic acidosis are a decrease in the excretion of hydrogen ions, which inhibits the conservation of bicarbonate ions, and excessive loss of bicarbonate ions through the gastrointestinal tract due to diarrhea.

Questions & Answers

what is oedema
Nantumbwe Reply
i want abook about physiology including the vitamins
Belal
fluid retention in the body. (also spelt as edema) e.g. fluid retention in the lungs is called Pulmonary Edema). It can also happen as a result of Injury manifested as swelling.
Arif
can you give me an example of a tissue composed of few related types of cells
Theresa Reply
What is LMx1600
Mae Reply
the skeletal system includes all of the bones
All Reply
what is the bone not contain red bone marrow in medulla
Duha Reply
To know the part of human body
Sarah Reply
Anatomy refers to as structure of human body
Sarah
so is the macroscopic and microscopic the types of anatomy
Gloria Reply
is microscopic and macroscopic a type of anatomy
Gloria
yes
Maxine
yes
Yabsra
yes
Sarah
Please can someone explain three glands in endocrine system?
josh
.
Robin
can someone explain disease and the category
gege
type 2 is controled by diet
Chloe Reply
Diet and life style
Paias
Diet how? maybe eating food containing less sugar?
BTS
we must eat protein food to check our diet
Sarah
type 2 diabetes cannot be controlled by insulin so therefore your diet should be well balanced especially you shouldn't eat foods with high sugar level or stopping sugar at all so that the sugar content needed by your body will be provided by the balanced diet taken
Enada
what is hypotension
regina Reply
hypotension is when the blood pressure is less than 60/50
Mursal
hypo means low so it implies low blood pressure
Isaac
ok
Mursal
what is mild DKA
Mursal
mild diabetic ketoacidosis is when there is high level of sugar in the blood and the ketone bodies build up in the body ,is a type 1 which can lead to type 2
Isaac
what is the normal range for blood pressure?
BTS
120 over 80
Danielle
low blood pressure; opposite of high blood pressure which is hypertension
Regina
what if your a type 2 diabetic and you have no way to get meds due to no insurance what is some good over the counter medications to take?
Ashley
type 2 diabets is controlled by diet not meds.type 1 is contolled by insulin.
Chloe
type 1 diabets cant be controlled type 2 can be controlled.type 1 is worse than type 2 diabets.
Chloe
type 2 is purely a lifestyle disease, eat healthy, fresh, natural unprocessed real foods.
Danielle
sometime , we already eat diabetic diet than the results of blood sugar level not turn good , what is the reason ?
Muhammad
What is a "diabetic diet" though? Be specific. Juvenile diabetes and/or Type 1 diabetes is something that one can be born with, this needs medical diagnosis and intervention.
Danielle
what i mean by diabetic diet is we take fiber-rich food like vegetables,nut and also fish.
Muhammad
ok, no cause a doctor told me I needed metformin and my suger won't go under 300
Ashley
what is the difference between plasma and serum
Gloria Reply
Plasma contains fibrinogen while serum doesn't
Kateregga
plasma ----- fibrinogen = serum
Sneha
serum is blood plasma without fibrinogen or other clotting factors While blood plasma contains dissolved protein like fibrinogen,globulin, and albumin), glucose, clotting factors,mineral ions like Na2+,Cl-1,hormones and carbon dioxide
Prince
In what time stomach empty it's content in to doudemun? what is chyme?
Sneha Reply
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Chemical digestion---Mixtures of the food with the gastric acid Mechanical digestion--- churning of the food in the stomach making it become more involved into chyme
Mercy
absorption takes place in the small intestine because of the presence of the villi
Enada
name the muscles supplied redina nerve
Appu Reply
mechanism of hormone releasing by gland
said Reply
why is muscle tissue not considered to be a type of connective tissue?
Ezel Reply
A Skeletal muscles consist of numerous muscles cells called Muscle Fibers . Three layers of connective tissues surrounded these fibers to make the muscles tissues
Manisha
that's wny connective tissues is not considered as muscles fibers
Manisha
there are 4 types of tissues : epithelial, connective tissue, nervous tissue and muscle tissue, each one has its own properties. The main function of connective tissue is nutrition, it supplies nutrientes to epithelial tissues that are responsible for protection.
Ariete
Muscle tissue has properties that allow movement, the function here is movement and not nutrition like connective tissue.
Ariete
In what time stomach empty it's content in to doudemun?
Sneha
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Does absorption take place in stomach? what are the absorption in the stomach by which cell?
Sneha
mechanism of hormone controlling releasing by gland
said
please can someone explain renin angiotensin aldosteron system for me
okolie
name the joint present between epichysif and diachysif
JAYKISHAN Reply
what is arteries
JAYKISHAN
oxygenated blood carrying vessels
Karanpreet
I think oxygenated blood carrying pulmonary vein
Omaryare
ya this stetment is right 4 pulmonary vein carrying the oxygenated blood
Sneha
Rheumatoid arthritis affects
Jessica Reply

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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