Module 9:

Fluid, Electrolyte,
& pH Balance
BIOL 2458
ANATOMY & PHYSIOLOGY II

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 Learning Objectives
By the end of this lesson, students should be able to: 9. Differentiate between acidosis & alkalosis.
10. List the 3 major buffering systems in the body, identifying the order in which
1. Identify the components (cations, anions, and relative protein abundance) of they are activated and the potency of each.
intracellular & extracellular fluids. 11. Describe how weak acids & weak bases can function as a buffer in the body.
2. Describe the impact of osmolarity & osmolality on the movement of water in 12. Describe how the three major chemical buffering systems in the body
the body. function.
3. Describe the pattern of movement of water, ions, nutrients, wastes, and 13. Describe how the respiratory system buffers against change in blood pH.
gases between body compartments.
14. Explain the importance of bicarbonate in the buffering function of the renal
4. Describe the effects of increased & decreased osmolality on thirst & ADH system.
(the hormone) release.
15. Differentiate between respiratory acidosis & metabolic acidosis, including
5. Identify the major stimuli leading to thirst as well as the body’s basic the causes of each.
responses to thirst.
16. Differentiate between respiratory alkalosis & metabolic alkalosis, including
6. Describe the stimuli & effects of the renin-angiotensin-aldosterone system, the causes of each.
as well as its role in sodium level regulation.
7. Identify the stimuli that lead to the release of atrial natriuretic peptide (ANP)
& describe ANP's effect on sodium level in the body.
8. Identify the normal pH range for the human body.

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Pond Analogy

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Fluid Compartments
TOTAL FLUIDS

ICF – fluid within cells

(60%)

ECF – fluid surrounding

cells (40%)

Interstitial fluid –
fluid outside blood vessels
(15%)

Intravascular fluid (plasma) –

fluid inside blood vesicles
(6%)

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 Fluids of the Human Body
Each body fluid has a different “recipe”
The human body is 55-60%
water Plasma
Na+, Cl-, & proteins

~60% of this fluid is

Interstitial fluid
intracellular fluid
(cytosol) Na+ & Cl-

Intracellular fluid
~40% of this fluid is (cytosol)
extracellular fluids like K+, HPO42-, & proteins-
plasma & interstitial fluid

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 Water Movement
The body’s fluids (compartments) are constantly exchanging water &
solutes
◦ Solutes include electrolytes (cations & anions) & non-electrolytes (glucose,
lipids, urea, etc.)
◦ The direction of these movements are determined by osmolality
◦ The exchange between the two major divisions of the ECF occurs at the
capillaries

Osmolality is the number of solute molecules per kilogram of solvent

◦ Water is the solvent in all body compartments
◦ Because all compartments are connected, osmolality changes in one
compartment will lead to the movement of water into or out of all others
◦ Water moves through osmosis (passively)
◦ If extracellular osmolality is HIGH (hypertonic), water leaves the cell
◦ If extracellular osmolality is LOW (hypotonic), water enters the cell

When pure water is consumed, the osmolality of both ECF & ICF fall
When water is lost & electrolytes are retained, osmosis moves water from ICF to ECF

Osmolarity is the concentration of a solution expressed as osmoles of solute particles per liter of solution 6
 Solute Movement
While water & small ions can move both
into AND out of the body’s ICF & ECF
compartments, large solutes cannot.

Small nutrients & O2 move from the

environment INTO interstitial fluid, and
then INTO cells

CO2 & nitrogenous wastes (ammonia to urea)

move OUT OF cells, and then OUT OF
interstitial fluid to exit the body

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 Water Balance
Water balance is regulated via behaviors & hormones

When water levels are LOW (HIGH osmolality) (hypertonic)

◦ Thirst (the desire to ingest water) is triggered by the hypothalamic thirst center
◦ Antidiuretic hormone (ADH) is released, increasing water reabsorption
◦ Angiotensin II & aldosterone are released, increasing Na+ (and water)
reabsorption

When water levels are HIGH (LOW osmolality) (hypotonic)

◦ Thirst is suppressed
◦ ADH is not released
◦ Atrial natriuretic peptide (ANP) may be released, increasing Na+ (and water)
loss

Angiotensin II – is the major thirst inducing hormone, then Aldosterone & ADH

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 Antidiuretic Hormone The Renin-Angiotensin-
Aldosterone System
The RAA System is a hormonal cascade
ADH is a hormone released by ◦ Renin activates angiotensin II
the posterior pituitary gland ◦ Angiotensin II activates the adrenal gland
(neurohypophysis) ◦ The adrenal gland release aldosterone

Antidiuretic A(ADH) release is Renin release is triggered by:

triggered by: ◦ Low plasma Na+
◦ Increased osmolality ◦ Low blood pressure (caused by low blood
volume)
◦ Increased Na+ ◦ Sympathetic nervous system activation
◦ Decreased plasma volume
Angiotensin II is the most potent thirst
(leading to decreased blood stimulator
pressure)
Aldosterone release is triggered by:
◦ Angiotensin II
ADH triggers the synthesis of High serum potassium levels
aquaporin proteins in kidney ◦
◦ ACTH & sympathetic activation
collecting ducts
◦ Aquaporins reabsorb water from Aldosterone increases Na+ reabsorption
urine, returning it to the & potassium secretion in the distal
bloodstream convoluted tubules & collecting ducts
◦ Water follows salt, so water reabsorption
increases as well
ADH - indirectly stimulates thirst … ◦ Aldosterone is the second most effective
its primary function is to regulate hormone causing thirst
urine concentration, not to directly
stimulate thirst.

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Atrial Natriuretic Peptide (ANP)

ANP is released when blood osmolality is LOW

◦ Low blood osmolality indicates high levels of water
◦ High levels of water leads to increased blood volume &
increased blood pressure, stretching the atria

ANP inhibits the water-conserving hormones

◦ By inhibiting renin & angiotensin, it decreases blood
pressure
◦ By inhibiting ADH & aldosterone, it decreases Na+ (and
water) reabsorption

Ultimately, by blocking the body’s water-conserving

pathways, ANP decreases blood volume & blood pressure

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 ANP

Water
Balance –
A Review

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"corrosive" "caustic"

Acids release H+ ions when dissolved in water. Bases absorbs H+ ions when dissolved in water.

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Acid-Base Balance
pH affects all functional proteins and biochemical
reactions, so it is closely regulated by the body.

Alkalosis (alkalemia) = arterial pH >7.45

Acidosis (acidemia) = arterial pH <7.35

Due to the body's production of organic

acids, there is more tolerance on the
acidic side:
o The normal ratio of 1-part H2CO3
to 20 parts HCO3- indicates that the
body is in acid-base balance

o Respiratory buffering is mostly dependent on

changes in carbonic acid concentrations.
o Renal buffering is mostly dependent on changes
in bicarbonate concentrations.

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 pH Many of the normal cellular processes generate acidic by
products (amnio acid, phosphoric acid, lactic acid, fatty acids, ketones)
◦ Aerobic Respiration (turning glucose into ATP) generates CO 2, which
forms H2CO3 (carbonic acid) in the blood
pH is a measure of the number of H+ ions in a
solution ◦ Anaerobic respiration (processing glucose without oxygen) generates
lactic acid
◦ More H+ ions = acidic solution
◦ Protein metabolism generates amino acids & phosphoric acids
◦ Fewer H+ ions = basic (alkaline) solution ◦ Lipid metabolism generates fatty acids & ketones

Carbonic acid-Bicarbonate buffer system:

The normal pH range for blood plasma is 7.35 – carbonic anhydrase

7.45
◦ Acidosis (too acidic) occurs when pH is lower than 7.35 bicarbonate
carbonic acid
◦ Alkalosis (too basic) occurs when pH is higher than 7.45

The body uses

multiple buffering
systems to
maintain a
relatively stable
plasma pH
o pH affects all functional proteins & biochemical reactions, so it is
closely regulated by the body.

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 The Body’s Buffering Systems
Carbonic acid-Bicarbonate
buffer system
The respiratory
buffer system kicks
in relatively quickly The renal (metabolic)
(within minutes of a buffer system is the most
pH change) Chemical effective buffering system
buffer
◦ By altering systems ◦ It takes longer to kick in,
breathing rate & but it creates permanent
depth, the level of effects
CO2 released from
the body is changed This system regulates the
◦ Shifts in CO2 alter Chemical buffer systems are the body’s first line of bicarbonate (HCO3-) level in
the level of carbonic defense to fluid pH changes the bloodstream
acid (H2CO3) in the Chemical buffering systems include:
◦ It maintains a bicarbonate
bloodstream ◦ carbonic acid (H2CO3)-bicarbonate(HCO3-) system reserve to offset the acidity
◦ phosphate (HPO42-) & (H2PO4-) system of cellular metabolism
◦ Protein system
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 Chemical Buffering Systems

o Carbonic acid (H2CO3)-Bicarbonate (HCO3) buffer

system is the main ECF buffer
HCO3 metabolic (renal) control
H2CO3 respiratory control

o The phosphate buffer system is the main ICF

buffer.
H2PO4- (dihydrogen phosphate) buffers all cells
HPO4-- (monohydrogen phosphate) buffers urine
Phosphate can also buffer urine

o The protein buffer system is used as an ICF and

ECF (blood plasma) buffer

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 Chemical Buffers:
Carbonic acid (H2CO3)-Bicarbonate (HCO3) buffer system

The carbonic acid bicarbonate buffer system helps maintain the pH of Added a base?
extracellular fluid carbonic acid donates
o It uses bicarbonate (HCO 3-) and carbonic acid (H2CO3) H+ to become
bicarbonate

Carbonic acid (H2CO3) is used to neutralize strong bases carbonic

anhydrase
o H CO donates an H+ ion to the base, generating bicarbonate (HCO -)
2 3 3

◦ Bicarbonate is a weak base, so its impact on pH is comparatively weaker

o Source: the CO from respiring tissues, which is transformed into H CO
2 2 3

Bicarbonate (HCO3-) is used to neutralize strong acids in the bloodstream

o Bicarbonate binds to H+ ions (from strong acids) & forms carbonic acid (H2CO3)
◦ Carbonic acid is a weak acid, so its impact on pH is comparatively weaker
o Source: constant reabsorption by the kidneys, which generates an alkaline reserve (of Added an acid?
HCO3-) Bicarbonate absorbs H+
to become carbonic acid

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 Chemical Buffers:
The Phosphate & Protein Buffering Systems

The phosphate buffering system helps maintain The protein buffering system is the most important
the pH of intracellular fluid (and urine) system in both intracellular & extracellular fluids
◦ It uses monohydrogen phosphate (HPO42-) and dihydrogen
phosphate (H 2PO4-) Proteins are amphoteric
◦ Definition: they can function as weak acids OR weak bases
MonoHydrogen phosphate (HPO42-) neutralizes
strong acids
◦ It binds to H+ ions, forming dihydrogen phosphate (H2PO4-)

amphoteric

How does protein buffering work?

Dihydrogen phosphate (H2PO4-) neutralizes strong ◦ The carboxylic acid groups (-COOH) release H+ when pH is
bases too high
◦ It donates an H+ ion, forming hydrogen phosphate (HPO 42-) ◦ The amine groups (-NH2) bind to H+ when pH is too low
The most important blood buffer is hemoglobin
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 Intracellular Buffering: Phosphate

H+ release
lowers
H+ absorption raises extracellular pH
extracellular pH

Intracellular fluid Extracellular fluid

Intracellular fluid Extracellular fluid

The most important protein in intracellular

fluid buffering is hemoglobin. REMEMBER:
Protein buffers are used in extracellular fluids too!

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 Chemical Buffer Systems
Chemical Buffers:
A Review
Chemical buffers use compounds that are already
present in the body’s fluids to absorb or release H +
ions in response to pH changes

Chemical buffers are constantly adjusting to pH

changes

Because chemical buffers CANNOT eliminate extra

H+ ions from the body, they are less effective than
respiratory and metabolic buffer systems

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 The Respiratory Buffer System
The respiratory buffering system alters pH by changing the rate of
CO2 release during respiration

Situation #1: Respiration Blood

decreases blood Carbonic acid is broken
Rapid breathing down to compensate becomes
CO2 carbonic more basic
anhydrase

Situation #2: Decreased Carbonic acid is Blood

respiration made with the extra becomes
Slow breathing more acidic
increases blood CO2
CO2

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Respiratory Buffering
Problem Problem
The blood has too many The blood has too
H+ ions. few H+ ions.

Solution Solution
Respiratory rate increases. Respiratory rate decreases.

Effect Effect
As carbon dioxide is lost, As carbon dioxide builds
carbonic acid must be up, carbonic acid is
metabolized to replace it. generated to store it.

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The Renal (Metabolic) Buffer System
The kidneys buffer blood pH by changing bicarbonate levels
◦ They increase or decrease the bicarbonate levels as needed
◦ They maintain a large alkaline reserve

Kidneys increase blood bicarbonate to increase blood pH

◦ The enzyme carbonic anhydrase uses CO2 & H20 to build H2CO3
◦ Kidney cells then break this into bicarbonate, which enters the bloodstream
◦ Carbonic anhydrase uses CO2 from urine or from blood to make H2CO3

Kidneys decrease blood bicarbonate to decrease blood pH

◦ Every bicarbonate molecule that is excreted alters pH in the same way as
absorbing one H+ ion

While the kidneys are less effective at rapid responses to pH changes, this
alkaline reserve is powerful in stabilizing blood pH overall

Excess H + ions are largely eliminated from the body by the kidneys! Phosphate can
buffer urine

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 The kidneys release
The lungs H+ to raise pH
release CO2
to raise pH

The Body’s Buffers: The kidneys make

new bicarbonate

A Review to raise pH

Proteins
absorb H + to The kidneys reabsorb
raise pH most bicarbonate to
The chemical, respiratory, & renal raise pH
buffers all work to increase the pH
of body fluids.

This basic shift offsets the acidic

nature of cellular metabolism.

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 pH Imbalances
The normal pH range of blood is 7.35 – 7.45
◦ The body uses the chemical, respiratory, and renal buffering
systems to remain within this normal rang09If the pH drops below
7.35, this is known as acidosis
◦ If the pH rises above 7.45, this is known as alkalosis

pH imbalances can be caused by problems with the

respiratory buffering system or the renal buffering system
◦ If the respiratory system is malfunctioning, the level of CO2 in the
blood will be incorrect
◦ If the metabolic system is malfunctioning, the level of bicarbonate
in the blood will be incorrect

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 pH Imbalances:
Acidosis & Alkalosis
If one of the body’s major buffering systems fails, the other
will try to fix it
◦ This is known as compensation

If the renal buffering system is not buffering blood, the

respiratory system will compensate
◦ Ventilation increases if metabolic acidosis is occurring
◦ Ventilation decreases if metabolic alkalosis is occurring

If the respiratory buffering system is not buffering correctly,

the kidneys will compensate
◦ Bicarbonate levels increase if respiratory acidosis is occurring
◦ Bicarbonate levels decrease is respiratory alkalosis is occurring

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 Cause Effect
Blood CO2 rises (due to hypoventilation / Renal compensation
Respiratory acidosis lung disease). The kidneys reabsorb bicarbonate & release H+.
(pH < 7.35) Blood pH drops as H2CO3 is formed pH rises with increased basic substances.

Blood bicarbonate levels drop (due to Respiratory compensation

Metabolic acidosis diarrhea / the accumulation of acidic Ventilation increases, releasing more CO2.
(pH < 7.35) metabolites).
H2CO3 is broken down, raising pH.
Blood pH drops as acids accumulate.
Renal compensation
Respiratory alkalosis Blood CO2 drops (due to hyperventilation).
The kidneys excrete bicarbonate & retain H+ Ions
(pH > 7.45) H2CO3 is broken down, causing pH to rise. Loss of bicarbonate decreases blood pH.
Blood bicarbonate levels increase (due Respiratory compensation
Metabolic alkalosis to H+ loss through vomiting / excessive Ventilation decreases to retain CO2.
(pH > 7.45) antacid use).
H2CO3 is created, decreasing pH.
Blood pH rises.

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 Diagnosing a pH Imbalance
How can I tell if it’s a respiratory or metabolic acidosis/alkalosis?
If an acid-base imbalance
is due to the malfunction
of one physiological buffer
system, the other system
tries to compensate:
o The respiratory system
tries to correct
metabolic acid-base
imbalances.
o Kidneys try to correct
respiratory acid-base
imbalances.

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