Chapter 19 (Lesson 16)

As a person hyperventilates, __________. The person would have an excessively high arterial PCO2. the person becomes alkalotic The person becomes acidotic. The person would have a dangerously high amount of arterial PO2.

the person becomes alkalotic

Part complete Why was the breath held after the second hyperventilation? to absorb H+ to retain carbon dioxide to retain oxygen to absorb water

to retain carbon dioxide

Hyperventilation can result in _______. too little carbon dioxide in the blood too much oxygen in the blood too much carbon dioxide in the blood respiratory acidosis

too little carbon dioxide in the blood

Part complete At which partial pressure of carbon dioxide did respiratory acidosis occur? 60 mm Hg 40 mm Hg 30 mm Hg, 40 mm Hg and 60 mm Hg 30 mm Hg

60 mm Hg

Which metabolic rate resulted in metabolic acidosis? 50 kcal/hr 40 kcal/hr 60 kcal/hr 80 kcal/hr

80 kcal/hr

In a respiratory acidosis the kidney would do which of the following? The kidney would increase excretion of both bicarbonate and hydrogen ions. The kidney would reabsorb bicarbonate and secrete hydrogen ions. The kidney will reabsorb both bicarbonate and hydrogen ions. When it reabsorbs the hydrogen ion, it also generates more bicarbonate ions.

The kidney would reabsorb bicarbonate and secrete hydrogen ions.

Which of the following is NOT one of the functions of angiotensin II? Angiotensin II stimulates vasoconstriction. Angiotensin II stimulates the secretion of atrial natriuretic peptide (ANP) by cells in the atria of the heart. Angiotensin II stimulates the secretion of aldosterone. Angiotensin II stimulates ADH secretion.

Angiotensin II stimulates the secretion of atrial natriuretic peptide (ANP) by cells in the atria of the heart.

Which of the following is NOT a cause of metabolic disturbances of acid-base balance? a high-fiber diet a high-protein diet a high-fat diet excessive vomiting

a high-fiber diet

A major hormone controlling sodium and potassium balance is __________. It is secreted by the adrenal cortex. oxytocin aldosterone antidiuretic hormone (ADH) cortisol

aldosterone

Which of the following hormones does NOT regulate plasma calcium levels? parathyroid hormone (PTH) aldosterone calcitonin 1,25-Dihydroxycholecalciferol (1,25-(OH)2D3)

aldosterone

The most common and physiologically significant buffer is __________. an anion a protein an intracellular buffer carbon dioxide

an anion

Respiratory acidosis is a result of _______. an increase in the H+ in the blood a decrease in H+ in the blood an increase in blood pH a decrease in H+ in the blood and an increase in blood pH

an increase in the H+ in the blood

Hyperventilation is defined as _______. an increase in the depth of breathing an increase in the rate of breathing and a decrease in the depth of breathing an increase in the rate of breathing a decrease in the depth of breathing an increase in the rate and depth of breathing

an increase in the rate and depth of breathing

Which of the following hormones is currently thought to decrease plasma calcium levels in pregnant women and children? calcitriol calcitonin parathyroid hormone (PTH) thyroid hormones

calcitonin

Part complete Which hormone works directly in the intestine to increase plasma calcium levels? calcitonin parathyroid hormone (PTH) calcitriol

calcitriol

The kidneys compensate for respiratory alkalosis by _______. conserving H+ and bicarbonate ion conserving H+ and excreting bicarbonate ion conserving bicarbonate ion and excreting H+ excreting H+ and bicarbonate ion

conserving H+ and excreting bicarbonate ion

Compensation of metabolic alkalosis includes which of the following? excreting bicarbonate ion in the renal system excreting bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system conserving bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system conserving bicarbonate ion in the renal system retaining carbon dioxide through the respiratory system

excreting bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system

Part complete Which of the following is NOT one of the body's chemical buffering systems? phosphate bicarbonate protein hydrochloride

hydrochloride

Metabolic acidosis results in _______. rebreathing hypoventilation and rebreathing hyperventilation hypoventilation

hyperventilation

Which of the following does NOT result in metabolic alkalosis? decrease in food intake constipation hyperventilation lowered body temperature

hyperventilation

Part complete Which of the following would NOT be a way that parathyroid hormone (PTH) could alter plasma calcium levels? (Which one of the following is FALSE?) increase osteoclasts increase osteoblasts on bone increase reabsorption of calcium in the kidney

increase osteoblasts on bone

Lack of rehydration during exercise can lead to excessive fluid loss through sweat. As water is lost and body fluid osmolarity increases, which of the following events will most likely take place? decreased water reabsorption increased ADH release increased urine output decreased ADH release

increased ADH release

Which of the following would raise mean arterial pressure (MAP)? increased aldosterone secretion decreased renin secretion increased ANP secretion decreased ADH secretion

increased aldosterone secretion

In response to hemorrhage, which would you NOT want to occur? increased angiotensin II increased glomerular filtration rate increased sympathetic nerve activity enhanced medullary osmotic gradient

increased glomerular filtration rate

What is the renal response to hypovolemia? increased water secretion decreased water secretion decreased water reabsorption increased water absorption

increased water absorption

During intense exercise, the body produces large amounts of lactic acid, which decreases the pH of the body. Which of the following is the body's first line of defense against this deviation from homeostatic pH? intracellular buffers such as proteins and phosphates renal excretion of H+ extracellular buffers such as bicarbonate anions increased ventilation

intracellular buffers such as proteins and phosphates

Aldosterone __________. is secreted in response to increased levels of plasma angiotensin II removes Na+/K+ pumps from the basolateral membranes of the principal cells of the collecting duct is secreted from the posterior pituitary gland in response to hyperosmolar interstitial fluid binds to receptors on epithelial cells of the proximal convoluted tubule where it regulates Na+ reabsorption

is secreted in response to increased levels of plasma angiotensin II

What is the osmolarity of the filtrate at the end of the proximal tubule? hypotonic - 100 mOsm hypertonic - 1200 mOsm isotonic - 300 mOsm hypertonic - 600 mOsm

isotonic - 300 mOsm

Respiratory alkalosis is characterized by a blood pH _______. greater than 7.45 less than 7.45 less than 7.00 less than 7.35

less than 7.45

Excessive diarrhea results in which of the following? loss of acid, metabolic acidosis loss of acid, metabolic alkalosis loss of bicarbonate, metabolic alkalosis loss of bicarbonate, metabolic acidosis

loss of bicarbonate, metabolic acidosis

Water has a net movement from a __________ osmotic pressure environment to a __________ osmotic pressure environment. high (hyperosmotic); low (hypoosmotic) low (hypoosmotic); high (hyperosmotic) very high; very low isosmotic; isoosmotic

low (hypoosmotic); high (hyperosmotic)

Antidiuretic hormone (ADH), which regulates urine concentration and dilution, is __________. highest six hours after Max exercises highest before Max exercises lowest before Max exercises lowest immediately after Max exercises

lowest before Max exercises

Which of Mr. Henderson's organs are normally responsible for compensating for changes in blood pH? View Available Hint(s) lungs and liver kidneys and spleen liver and spleen lungs and kidneys

lungs and kidneys

A decreased pH coupled with a decreased plasma concentration of bicarbonate ion indicates that __________ is occurring and the __________ will compensate for this change. metabolic acidosis; respiratory system metabolic acidosis; urinary system respiratory acidosis; respiratory system respiratory acidosis; urinary system

metabolic acidosis; respiratory system

Ingesting too much antacid would cause which of the following acid-base disturbances? respiratory alkalosis respiratory acidosis metabolic alkalosis metabolic acidosis

metabolic alkalosis

Vomiting will cause which type of acid-base disturbance? metabolic acidosis metabolic alkalosis respiratory alkalosis respiratory acidosis

metabolic alkalosis

Which of the following occurred when the metabolic rate was set to 20 kcal/hr? metabolic acidosis and hypoventilation hypoventilation metabolic alkalosis metabolic acidosis metabolic alkalosis and hypoventilation

metabolic alkalosis and hypoventilation

The sweat that is secreted onto the surface of the skin during exercise consists of both water and salt. The sweat is hypo-osmotic to body fluids, meaning that __________. more salt is lost than water sweat osmolarity is greater than 300 mOsm more water is lost than salt sweat osmolarity is 300 mOsm

more water is lost than salt

A medical condition known as the 'syndrome of inappropriate ADH (SIADH)' results from increased ADH secretion. It has opposite clinical effects to that of diabetes insipidus. Therefore, untreated SIADH can cause __________, and thus can be one cause for __________. no change in hydration; water intoxication overhydration; water intoxication hypotension; water intoxication under-hydration; dehydration

overhydration; water intoxication

Seventy percent of the water filtered from plasma at the renal corpuscle is reabsorbed (in an unregulated fashion) in the __________. collecting ducts ascending limb of the loop of Henle distal tubule proximal tubule

proximal tubule

Which of the following have the same effect on plasma pH? excretion of bicarbonate and excretion of H+ reabsorption of bicarbonate and reabsorption of H+ all of the above reabsorption of bicarbonate and excretion of H+

reabsorption of bicarbonate and excretion of H+

Which of the following is NOT an effect of aldosterone on kidney late distal tubules and collecting ducts? reabsorption of sodium increased mean arterial pressure (MAP) reabsorption of potassium potassium secretion

reabsorption of potassium

Of the three buffering mechanisms in the body, which is the strongest? chemical buffer system renal system respiratory system

renal system

Which of the following has the greatest capacity for pH change in the body? digestive system endocrine system renal system respiratory system

renal system

In __________, arterial PCO2 decreases, increasing the ratio of bicarbonate to carbon dioxide. Which of the following terms is best defined by the preceding statement? respiratory acidosis metabolic alkalosis metabolic acidosis respiratory alkalosis

respiratory alkalosis

Which other system in the body works closely with the kidneys to regulate arterial blood pH? digestive system cardiovascular system nervous system respiratory system

respiratory system

Renin cleaves off several amino acids of __________, converting it to __________. angiotensinogen; angiotensin I angiotensinogen; angiotensin II angiotensin I; angiotensin II angiotensin-converting enzyme (ACE); angiotensin

angiotensinogen; angiotensin I

PTH promotes the formation of which hormone? calcitriol calcitonin thyroid hormones vitamin D

calcitriol

Which of the following occurred during rebreathing? hyperventilation, carbon dioxide increased and pH increased hyperventilation pH increased carbon dioxide increased

carbon dioxide increased

In uncompensated respiratory acidosis, the _______. pH of the blood is high carbon dioxide levels of the blood are elevated carbon dioxide level of the blood is normal carbon dioxide levels of the blood are low

carbon dioxide levels of the blood are elevated

The formation of carbonic acid from water and carbon dioxide is catalyzed by _______. bicarbonic anhydrase carbonic anhydrase renin carbonic hydrolase

carbonic anhydrase

Antidiuretic hormone (ADH) regulates the formation of concentrated or dilute urine. In which time period is Max's body secreting its highest amount of ADH? Explain your answer.

ADH is going to be highest when the body is most dehydrated. In Max's case, this is right after his 2-hour run. During his run, Max loses water via sweat and exhalation, and doesn't effectively replace it. The osmolality of his blood increases, signaling the posterior pituitary to release ADH. ADH targets the principle cells in the collecting ducts of the kidney tubules, causing them to increase reabsorption of water from the filtrate. This negative feedback mechanism attempts to conserve water in order to decrease blood osmolality and restore body fluid homeostasis.

Max's regular exercise regimen has reduced his high blood pressure, allowing him to achieve normal blood pressure on a single antihypertensive medication. The medication he takes is called an angiotensin converting enzyme inhibitor, or ACE inhibitor, which blocks the activation of angiotensin II. Describe at least two mechanisms by which angiotensin II targets the kidneys to increase extracellular fluid volume and, therefore, increase blood pressure.

Angiotensin II directly signals the renal tubules to reabsorb sodium. Where sodium goes, water follows by osmosis, causing blood volume and pressure to increase. Angiotensin II signals the release of ADH from the posterior pituitary. ADH acts on the principle cells of the collecting ducts to cause reabsorption of water from the filtrate into the blood. Blood volume and pressure are increased. Angiotensin II is a potent vasoconstrictor, which leads to a decline in peritubular capillary hydrostatic pressure and more fluid reabsorption. Blood volume and pressure are increased. Angiotensin II prompts the release of aldosterone from the adrenal medulla. Aldosterone stimulates renal tubules to reabsorb sodium (with water following) and this leads to an increase in blood volume and pressure. Angiotensin II stimulates the glomerular mesangial cells to contract and reduce glomerular filtration rates. Less filtrate is produced, less fluid is lost in urine, and blood volume and pressure are increased. Angiotensin II triggers thirst by acting at the hypothalamus. This increases blood volume and blood pressure.

Max needs to drink more water before exercise to avoid dehydration. False True

False

Max is curious about the protein content of his urine. Which of these statements provides an accurate basis for Tracey's response, explaining normal conditions? View Available Hint(s) All proteins are negatively charged and too large to pass through the glomerular membrane. So, proteins are not normally present in urine. Few proteins are small enough to pass through the glomerular membrane, but the few that do are reabsorbed. So, proteins are not usually present in urine. Most proteins pass through the glomerular membrane and are reabsorbed. So, proteins are not present in urine. Most proteins pass through the glomerular membrane and are present in varying amounts in urine.

Few proteins are small enough to pass through the glomerular membrane, but the few that do are reabsorbed. So, proteins are not usually present in urine.

Tracey had been slightly concerned about the trace glucose that was found in Max's urine six hours after his exercise until she discovered that he had eaten an entire large pizza an hour before the urinalysis. Explain why glucose might show up in Max's urine after a particularly heavy meal.

Glucose passes easily through the glomerular filtration membrane, and normally 100% of it is reabsorbed in the proximal convoluted tubule (PCT). The reabsorption of glucose is accomplished by secondary active transport and requires a transport protein in the membrane to facilitate the movement of glucose across the membrane. Typically, there are more than enough of these transport proteins, but they do have an upper limit beyond which no more glucose can be transported. This is called the transport maximum (Tm) for glucose. Generally, the Tm for glucose is not reached until blood levels of glucose exceed 180 mg/dL, which is known as the renal threshold. The most common cause of hyperglycemia (high blood glucose) is diabetes mellitus. So, if the renal threshold is exceeded for glucose in the PCT, it will "spill" into the filtrate and be eliminated in urine. Without further testing, it's unknown whether Max has a lower-than-normal renal threshold for glucose, or has exceeded the normal renal threshold of 180 mg/dL with his heavy meal.

Lactic acid accumulation can be a consequence of intense exercise. Tracey notes that Max's kidneys are working to defend his body against acidosis. How can she tell? Describe this mechanism.

Max's pH is more acidic right after his run. This is evidence of a higher hydrogen concentration in urine. When pH drops, the tubule cells secrete hydrogen into the filtrate, allowing it to be lost in urine. They also reabsorb bicarbonate (a base) to help buffer the body fluids. The result is a restoration of normal pH.

Based on Max's urinalysis data, should he drink more water prior to exercise to ensure that he doesn't dehydrate during intense activity? Explain your answer.

Max's urine is already extremely dilute before exercise, indicating he is probably well hydrated. If he were to drink more, then he would simply end up with a full bladder during his run (the kidneys would eliminate the excess water). Better advice would be to drink more strategically during his run. For instance, when he is doing his training runs, Max could take a drink every 15 minutes (more if he is sweating heavily) and practice different drinking regimens when he trains until he finds one that keeps him hydrated but does not require him to stop to urinate during his run.

Tracey explains to Max that his transiently elevated blood glucose leads to "spilling" of glucose into his urine. Why does this happen? The tubule cells actively secrete excess glucose into the filtrate. Tubule cells inhibit glucose production when blood levels are elevated. Reabsorption of glucose is limited by transport proteins. The tubule cells are unable to reabsorb any glucose that enters the filtrate.

Reabsorption of glucose is limited by transport proteins.

Tracey knows that proteinuria (protein in the urine) after intense exercise is physiological (normal). However, protein is typically not present in urine. Why is that?

The glomerulus is a passive filter that acts as a barrier to larger molecules, such as most plasma proteins. Also, because most proteins carry a net negative charge, they are repelled by the membrane, thereby hindering their passage. However, some smaller proteins can and do pass through the filtration membrane. Most of them are reabsorbed in the proximal convoluted tubule by endocytosis and then broken down into amino acids to be returned to the blood in the peritubular capillaries. The mechanism of exercise-induced proteinuria is unclear, but it is typically a transient occurrence. Any kidney disease can render the glomerulus dysfunctional, leading to a more sustained proteinuria. In fact, Max's hypertension, if left unchecked, could damage the filtration membrane of the glomerulus. The proteinuria will increase the specific gravity of his urine (along with his relative dehydration).

Tracey knows that the large pizza Max consumed just prior to collecting his third urine sample caused a transient increase in his blood glucose levels. What can be accurately said about the relationship between glucose in the blood and the amount of glucose filtered through the glomerular membrane? Glucose requires a transport protein to get through the glomerular membrane, so glucose in the filtrate cannot increase even when blood glucose concentration is high. The glomerular membrane prevents glucose from entering the filtrate unless blood glucose concentration is abnormally high. The higher the blood glucose concentration, the more glucose is filtered through the glomerular membrane. Only small glucose molecules can filter through the glomerular membrane, but high blood glucose concentration increases the amount of glucose in the filtrate.

The higher the blood glucose concentration, the more glucose is filtered through the glomerular membrane.

What does the color of Max's urine tell Tracey about how concentrated or dilute it is? How does Max's urine color/concentration compare to the urine specific gravity at the same time?

The pale urine is dilute, the yellow urine is more concentrated, and the dark yellow urine is very concentrated. Specific gravity is the ratio of the density of a substance compared to the density of an equal volume of distilled water. Urine, with its various solutes, has a greater specific gravity than water (1.001-1.035), which varies depending on the concentration of solute. The more concentrated the urine, the darker its color and the higher its specific gravity.

Based on the urine color and specific gravity, what might Tracey conclude about the hydration status of Max's body at the three different times?

When Max's urine is pale with a low specific gravity, his body is likely to be well hydrated; the kidneys are reabsorbing less water, allowing it to be eliminated in urine. When his urine is dark yellow with a higher specific gravity, his kidneys are concentrating urine and reabsorbing more water in an attempt to maintain body fluid homeostasis (defend plasma osmolality). Dehydration will trigger this response. The yellow urine signals euhydration; the corresponding high-normal specific gravity is likely due to the small amount of glucose in the urine.

In the body, as the volume of pure water increases, the __________ of electrolytes will __________, if the electrolyte amount is not also increased. The opposite will occur if pure water is lost from the body. concentration; increase number; increase concentration; decrease number; decrease

concentration; decrease

When it comes to electrolyte balance in the human body, electrolyte sensors measure electrolyte __________ rather than the absolute amount of electrolytes. Thus, the human body measures both water and electrolyte amounts in a somewhat indirect manner. volumes actions concentrations changes

concentrations

Too much carbon dioxide in the blood can be the result of _______. hyperventilation emphysema anxiety fever

emphysema

Ingestion of too much alcohol results in which of the following? gain of bicarbonate, metabolic alkalosis gain of bicarbonate, metabolic acidosis gain of acid, metabolic acidosis gain of acid, metabolic alkalosis

gain of acid, metabolic acidosis

Carbon dioxide levels in the blood and blood pH are _______. directly proportional to each other independent of each other inversely proportional to each other directly proportional to the amount of oxygen

inversely proportional to each other

During strenuous exercise, Max's body produces lactic acid and his blood pH begins to decline. His kidneys go to work to preserve acid-base balance by doing all of the following EXCEPT __________. reabsorbing hydrogen generating new bicarbonate secreting hydrogen reabsorbing bicarbonate

reabsorbing hydrogen

Severe anxiety would cause which type of acid-base disturbance? What would be the compensation? respiratory alkalosis; kidneys would retain HCO3 respiratory acidosis; kidneys would excrete HCO3 respiratory alkalosis; kidneys would excrete HCO3 metabolic alkalosis; hypoventilation by the lungs

respiratory alkalosis; kidneys would excrete HCO3

What is the normal range for the partial pressure of carbon dioxide in the blood? 35 - 45 mm Hg 55 - 65 mm Hg 7.35 - 7.45 mm Hg 15 - 25 mmHg

35 - 45 mm Hg

Explain how Mr. Henderson's rib fractures are related to the suspected hemothorax.

A hemothorax is a condition in which blood collects in the pleural cavity around the lungs. Rib fractures can be severe enough that the fracture can become displaced and produce a penetrating injury. In Mr. Henderson's case, the broken ribs may have produced the bleeding noted on the chest X ray.

The bicarbonate buffer system is one of the chemical buffer systems of the body. How would the bicarbonate buffer system work if sodium hydroxide were added to a solution? The hydrogen ion would attach to bicarbonate (HCO3) to form carbonic acid (H2CO3). A hydrogen on carbonic acid would dissociate and join the hydroxyl group on the base to form water and sodium bicarbonate. The hydrogen ion would attach to carbonic acid.

A hydrogen on carbonic acid would dissociate and join the hydroxyl group on the base to form water and sodium bicarbonate.

What are the normal ranges for the measurements listed in the blood and urine tests? Arterial Blood Gas (ABG) pH 7.35 - 7.45 CO2 35 - 45 bicarbonate 22 - 26 mEq/L Urinalysis pH 4.5 - 8.0

ABG pH 7.35-7.45 pCO2 35-45 mmHg bicarbonate 22-26 mEq/L Urinalysis Ph 4.5 to 8

In severe dehydration or blood loss, what would be the levels of ADH and what would be the urine flow rate? ADH - low; high urine flow rate (16 ml/min) ADH - high; high urine flow rate (16 ml/min) ADH - low; low urine flow rate (0.25 ml/min) ADH - high; low urine flow rate (0.25 ml/min)

ADH - high; low urine flow rate (0.25 ml/min)

In overhydration, what would be the levels of ADH (high, normal, or low) and what would be the osmolarity of the urine? ADH - high; 100 mOsm (urine) ADH - low; 600 mOsm (urine) ADH - low; 100 mOsm (urine) ADH - high; 600 mOsm (urine)

ADH - low; 100 mOsm (urine)

Which of the following statements about ADH (antidiuretic hormone) is correct? ADH inserts water channels into the luminal membrane of the proximal tubules. ADH would increase urine volume. ADH is released by the posterior pituitary gland. ADH is synthesized by the adrenal gland and works in the kidney.

ADH is released by the posterior pituitary gland.

Which of the following correctly pairs the hormone with its mechanism of action in the kidney? PTH; stimulates Ca++ secretion ADH; stimulates K+ reabsorption ANP; stimulates diuresis aldosterone; stimulates Na+ secretion

ANP; stimulates diuresis

Alcohol has diuretic properties. Based on this, which of the following would you hypothesize to be true? Alcohol enhances water secretion. Alcohol makes "tight" tight junctions leaky. Alcohol decreases urine osmolarity. Alcohol stimulates ADH secretion from the posterior pituitary gland.

Alcohol decreases urine osmolarity.

Which of the following statements about aldosterone is NOT correct? Aldosterone is stimulated by decreased plasma sodium levels and increased plasma potassium levels. Aldosterone increases the number of passive sodium channels in the luminal membrane of the distal tubule and collecting duct, thus aiding sodium reabsorption. Aldosterone is produced in the adrenal cortex. Aldosterone increases sodium reabsorption by increasing the number of Na+-K+ ATPase pumps in the luminal membrane of the proximal tubule.

Aldosterone increases sodium reabsorption by increasing the number of Na+-K+ ATPase pumps in the luminal membrane of the proximal tubule.

How do the kidneys compensate for acid-base imbalances? by excreting H+ by reabsorbing bicarbonate ion by reabsorbing H+ by excreting bicarbonate ion all of the above

All of the above

The nephron is responsible for maintaining _______. acid-base balance in the body fluid balance in the body electrolyte balance in the body all of the above

All of the above

Which of the following is true regarding aquaporins and water permeability of the collecting duct? Aquaporin-2 proteins are present in the apical membrane of the principal cells of the collecting duct at all times. Aquaporin-3 proteins are present in the basolateral membrane of principal cells of the collecting duct at all times. Aquaporin-2 and aquaporin-3 proteins are inserted into the apical membrane of principal cells of the collecting duct when ADH binds to receptors on these cells. Some water is able to diffuse across the principal cells of the collecting duct without the use of aquaporins.

Aquaporin-3 proteins are present in the basolateral membrane of principal cells of the collecting duct at all times.

Why is the amount of blood bicarbonate important to Mr. Henderson's case? Bicarbonate is a buffer and can help stabilize blood pH. Bicarbonate can bind directly with carbon dioxide and help raise blood pH. Bicarbonate is an acid and can help raise blood pH. Bicarbonate is a base and can help lower blood pH.

Bicarbonate is a buffer and can help stabilize blood pH.

Define the following terms contained in this case: Bilateral Hypoventilation Hemothorax Arrhythmias

Bilateral: Bi = two; lateral = side (two sides / both sides) Hypoventilation: hypo = below; ventilation = breathing (low breathing rate) Hemothorax: hemo = blood; thorax = chest (blood in the chest cavity) Arrhythmias: a = without; rhythmos = rhythm (irregular heartbeat)

Why does rebreathing simulate hypoventilation? Carbon dioxide accumulates in the blood with either. Respiratory alkalosis results from either and oxygen accumulates in the blood with either Respiratory alkalosis results from either. Oxygen accumulates in the blood with either.

Carbon dioxide accumulates in the blood with either.

Part complete The respiratory system is one of the three systems that regulate acid-base balance in the body. How does it work to decrease an acidosis? Carbonic acid is converted to bicarbonate and hydrogen ions. Carbonic acid is broken down into water and CO2; the CO2 is then exhaled. Carbonic acid converts a strong acid to a weak acid, thus decreasing acidity. Carbonic acid is converted to bicarbonate, which then buffers the acid.

Carbonic acid is broken down into water and CO2; the CO2 is then exhaled.

The transport of materials across the wall of the gastrointestinal tract normally amounts to a net __________ of solutes and water by the body. gain loss

Gain

When the partial pressure of carbon dioxide was decreased, what changes occurred in the urine? H+ and bicarbonate ion both decreased in the urine. H+ in the urine increased and bicarbonate ion decreased in the urine. H+ and bicarbonate ion both increased in the urine. H+ in the urine decreased and bicarbonate ion increased in the urine.

H+ in the urine decreased and bicarbonate ion increased in the urine.

Describe how the high bicarbonate in Mr. Henderson's blood is related to the low pH in his urine.

In response to the drop in pH, the kidneys increase the reabsorption of bicarbonate, which becomes elevated in the blood. The bicarbonate acts as a buffer to help restore and stabilize blood pH. At the same time, the kidneys secrete more hydrogen ions into the urine. This leads to low urine pH. The elimination of hydrogen ions from the blood also contributes to the restoration of blood pH.

Which of the following interventions might help address Mr. Henderson's problems? View Available Hint(s) Introduce sodium bicarbonate through an IV. Administer a drug that will help reduce Mr. Henderson's respiratory rate. Have Mr. Henderson breathe air enriched in CO2. Introduce carbonic acid through an IV.

Introduce sodium bicarbonate through an IV.

Part complete What happens to the renal filtrate as it moves from the outer regions of the renal medulla toward the innermost regions of the medulla? The filtrate becomes hyperosmotic because solutes are secreted. The filtrate becomes hyperosmotic because water is reabsorbed. The filtrate becomes hypo-osmotic because water is secreted. The filtrate becomes hypo-osmotic because solutes are reabsorbed.

The filtrate becomes hypo-osmotic because water is secreted.

Which of the following describes a state of positive balance? Trevor has been diagnosed with osteoporosis. Apparently his body is breaking down his own bones in order to increase his plasma levels of calcium, which continually decline. Kenneth is participating in a 10K fun-run on a hot and humid day. At the end of the race he feels very ill and is diagnosed with severe dehydration. Stephanie consumes a large bag of potato chips. As she eats the chips, her body (mostly her renal system) works to rid her body of the excess salt. Jenny participates in a contest in which she drinks 2 liters of water over 3 hours and is not permitted to go to the bathroom during that time.

Jenny participates in a contest in which she drinks 2 liters of water over 3 hours and is not permitted to go to the bathroom during that time.

Given the correlation between urine color and urine concentration, which of the following statements is true about Max's urine? Max's urine is least concentrated six hours post-exercise. Max's urine is most dilute immediately post-exercise. Max's urine is most concentrated before exercise. Max's urine is most dilute before exercise.

Max's urine is most dilute before exercise.

Which of the following would be an accurate comparison of Mr. Henderson's blood and urine pH? View Available Hint(s) Mr. Henderson's urine is 3 times more alkaline than his blood. Mr. Henderson's urine is 3 times more acidic than his blood. Mr. Henderson's urine is 1000 times more acidic than his blood. Mr. Henderson's urine is 100 times more alkaline than his blood.

Mr. Henderson's urine is 1000 times more acidic than his blood.

Which solute is primarily responsible for producing the osmotic gradient that drives water reabsorption? Cl- Na+ K+ Ca++

Na+

Osmosis is the diffusion of water. Diffusion involves movements down concentration gradients. Osmosis is a type of__________ transport. cotransport (symport) passive countertransport (antiport) active

Passive

What type of intervention might the doctors and nurses initiate in order to address the hemothorax? Explain how this intervention will lead to changes in PCO2 and blood pH

The blood that is collecting in the pleural cavity around the lungs can be drained (usually done by inserting a chest tube). This will help eliminate one of the issues preventing proper ventilation. If Mr. Henderson can return to a normal or even elevated respiratory rate, he will be able to remove CO2 from the blood. Less CO2 in the blood would mean a reduction in the formation of carbonic acid. This should help to restore blood pH to normal.

Describe how the high PCO2 and low pH in Mr. Henderson's blood are related in this case.

The high pCO2 directly causes an increase in bicarbonate in the blood which needs to be neutralized by increasing levels of H+ in the blood. This lowers the blood pH value.

A patient complains of tingling and numbness in her hands and feet, frequent muscle cramps in her calves, and lightheadedness. Her blood pressure is remarkably low. Which of the following might you predict based on this patient's symptoms? This patient has hyperkalemia. This patient has an overactive parathyroid gland. This patient is hypercalcemic. This patient has an overactive thyroid gland.

This patient has an overactive thyroid gland.

Mr. Henderson's PCO2 is elevated. Under normal conditions, what would be the PRIMARY mechanism that his body would use to reduce the amount of PCO2 in the blood? Why is this mechanism not working in this case?

Under normal conditions, the rise in pCO2 would stimulate the respiratory center which would cause short hyperventilation that would bring down the pCO2 to normal levels. In this case since the patient is already suffering from hypoventilation, the mechanism to reduce the high pCO2 would not work.

Mr. Henderson's blood pH is low. This is primarily due to__________. View Available Hint(s) an increased number of hydrogen ions in his blood a decreased number of hydrogen ions in his blood a decreased number of potassium ions in his blood an increased number of sodium ions in his blood

an increased number of hydrogen ions in his blood

The hormone __________, secreted by the posterior pituitary, is the major hormone controlling water balance. Another hormone that affects water balance is __________, secreted by the atria. oxytocin; atrial natriuretic peptide (ANP) atrial natriuretic peptide (ANP); Antidiuretic (ADH) antidiuretic (ADH); atrial natriuretic peptide (ANP) aldosterone; angiotensinogen

antidiuretic (ADH); atrial natriuretic peptide (ANP)

Respiratory acidosis can be a result of _______. hyperventilation and a panic attack asthma hyperventilation asthma and hyperventilation a panic attack

asthma

The body mainly uses __________ as the means to measure and control water volume; thus, the human body measures its water volume indirectly and not directly. Osmoreceptors in the hypothalamus measure __________. View Available Hint(s) temperature; temperature blood pressure; blood pressure blood osmotic pressure; blood osmotic pressure blood oxygen levels; blood oxygen levels

blood osmotic pressure; blood osmotic pressure

Two major problems occur in water intoxication; one problem is that the overhydration leads to a non-homeostatic decrease in the concentration of __________; this leads to a significant decrease in blood osmotic pressure. The second problem is that the excessive increase in water volume, due to too much water intake, increases its extracellular (intravascular and interstitial) concentration out of normal homeostatic range. This high extracellular concentration of water causes water to move down its concentration gradient into cells; cells begin to __________ to a non-physiologic size. blood solutes; shrink antibodies; shrink blood solutes; swell hormones; swell

blood solutes; swell

Which of the following events does NOT result in water conservation? decreased activity in venous and cardiac baroreceptors ADH secretion secretion of atrial natriuretic peptide (ANP) decrease in mean arterial pressure (MAP)

secretion of atrial natriuretic peptide (ANP)

If a person, over a short period of time, drinks an excessive amount of water, there will be a fairly rapid increase in intravascular volume; water absorbed from the gastrointestinal tract will move into the bloodstream. The excessive amount of water will rapidly move from the blood into the interstitial fluid, as a result of a tremendous osmotic pressure changes. The rapid water movement into the interstitial fluid will cause the interstitial fluid osmotic pressure to no longer be in homeostatic balance with intracellular fluids; the interstitial fluid becomes hypoosmotic compared to the intracellular fluid. Therefore, water will move into the body cells. When the movement of water affects brain cells, it causes brain neurons to __________. This eventually can lead to an __________ intracranial pressure. If severe enough, this could ultimately lead to death. This is what happened to 28-year-old Jennifer Strange in 2007. shrink; decrease swell; increased swell; decrease shrink; increase

swell; increased

Respiratory acidosis can be compensated for by _______. hypoventilation rebreathing the kidneys hyperventilation hypoventilation and rebreathing

the kidneys

Respiratory alkalosis is a result of _______. too little oxygen in the blood too little carbon dioxide in the blood too much carbon dioxide in the blood too much oxygen in the blood

too little carbon dioxide in the blood

Part complete The movement of fluid and solutes from the peritubular capillary to the renal tubule is referred to as _______. tubular reabsorption glomerular filtration tubular absorption tubular secretion

tubular secretion

Ketoacidosis is usually a result of _______. an increase in food intake uncontrolled diabetes mellitus vomiting

uncontrolled diabetes mellitus