. Chapter 12 Outline
 
  1. Introduction
     
  2. Objectives
     
  3. Body Fluid Buffer Systems
     
    1. Chemical Definition of Acids and Bases
       
      1. Strong Acids
      2. Weak Acids
      3. Dissociation Constant
         
    2. Mechanism of Chemical Buffering
       
      1. Addition of Acid
      2. Addition of Base
      3. Henderson-Hasselbach Equation
         
    3. Physiological Definition of Acids
       
      1. Volatile Acid
      2. Nonvolatile Acids
         
    4. Isohydric Principle of Buffering
    5. Intracellular Buffers
    6. Extracellular Buffers
    7. Physiological Value and Critical Role of The Bicarbonate-Carbonic Acid Buffer
    8. Limitation of Buffers
       
  4. Role of The Respiratory System
     
  5. Role of the Kidney
     
    1. Proximal Tubular Reabsorption of Bicarbonate
    2. Bicarbonate Reabsorption in the Thick Limb of Henle’s Loop
    3. Role of Carbonic Anhydrase
    4. Factors Which Influence Bicarbonate Reabsorption
       
      1. Filtered Load of Bicarbonate
      2. ECF Volume Expansion
      3. Effect of Pco2
         
  6. Regeneration of Bicarbonate, The Role of Titratable Acid
     
    1. Definition of Titratable Acid
    2. Phosphate, The Major Nonbicarbonate Urinary Buffer
       
      1. Interaction With Acid
      2. Interaction With Base
         
    3. Proximal Tubular Formation of Titratable Acid
    4. Distal Nephron Formation of Titratable Acid
       
  7. Regeneration of Bicarbonate, The Role of Ammonium
     
    1. Proximal Tubular Secretion of Ammonium
    2. Ammonium Handling in The Thick Limb of Henle’s Loop
    3. Distal Nephron Secretion of Ammonium
    4. Regulation of Ammonium Secretion
       
      1. Urinary pH
      2. Adaptation of Ammonium Secretion
         
    5. The Importance of Urinary Buffers
       
  8. Quantification of Renal H+ Secretion
     
    1. HCO3- Reabsorption
    2. HCO3- Regenerated
       
  9. Disturbances of Acid Base Balance
     
    1. Respiratory Disturbances
       
      1. Respiratory Acidosis
         
        1. Definition
        2. Buffering
        3. Renal Compensation
           
      2. Respiratory Alkalosis
         
        1. Definition
        2. Buffering
        3. Renal Compensation
           
    2. Metabolic Disturbances
       
      1. metabolic acidosis
         
        1. Definition
        2. Anion Gap
        3. Buffering
        4. Respiratory Compensation
        5. Renal Compensation
        6. Renal Dysfunction as a Cause of metabolic acidosis
           
      2. Metabolic Alkalosis
         
        1. Definition
        2. Buffering
        3. Respiratory Compensation
        4. Respiratory Compensation
        5. Factors Influencing Metabolic Alkalosis
           
          1. ECF Volume Depletion
          2. Chloride Depletion
          3. Hypokalemia
             
    3. Mixed Acid-Base Disturbances
       
  10. References
     
  11. Questions & Answers

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