During a routine medical checkup, Shelby, a 26-year-old physiotherapy student, is surprised to hear that her blood pressure is 180/110. She also has a rumbling systolic and diastolic abdominal bruit (murmur) that is loudest at the mid-epigastric area. Her physician suspects renal artery stenosis (narrowing). She orders an abdominal ultrasound and renal artery arteriography, which confirm that Shelby has a small right kidney and the distal part of her right renal artery is narrowed by more than 70%. Her physician prescribes diuretics and calcium channel blockers as temporary measures, and refers Shelby to a cardiovascular surgeon. Explain the connection between Shelby's renal artery stenosis and her hypertension. Why is her right kidney smaller than her left? What would you expect Shelby's blood levels of K⁺, Na⁺, aldosterone, angiotensin II, and renin to be?
26. Fluid and Electrolyte Balance, Acid Base Balance
Acid-Base Balance
Problem 12
Textbook Question
What is the main buffer system of the ECF?
a. Protein buffer system
b. Carbonic acid–bicarbonate ion buffer system
c. Phosphate buffer system
d. None of the above
Verified step by step guidance1
Step 1: Understand the concept of buffering systems in the body. Buffers are chemical systems that help maintain pH balance by neutralizing excess acids or bases. The extracellular fluid (ECF) requires a specific buffer system to stabilize its pH.
Step 2: Review the main buffer systems in the body. The protein buffer system primarily works in intracellular fluid (ICF) and blood plasma. The phosphate buffer system is more active in the ICF and kidneys. The carbonic acid–bicarbonate buffer system is the primary buffer system in the ECF.
Step 3: Learn how the carbonic acid–bicarbonate buffer system works. It involves the equilibrium between carbonic acid (H₂CO₃) and bicarbonate ions (HCO₃⁻). The reaction can be represented as: . This system helps resist changes in pH by shifting the equilibrium as needed.
Step 4: Compare the buffer systems listed in the question. The protein buffer system and phosphate buffer system are not the primary systems for ECF. The carbonic acid–bicarbonate buffer system is specifically designed to regulate pH in the ECF.
Step 5: Conclude that the correct answer is the carbonic acid–bicarbonate buffer system, as it is the main buffer system of the ECF, maintaining pH balance effectively.
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Key Concepts
Here are the essential concepts you must grasp in order to answer the question correctly.
Buffer Systems
Buffer systems are solutions that resist changes in pH when small amounts of acid or base are added. They play a crucial role in maintaining the acid-base balance in biological systems, particularly in extracellular fluid (ECF), where they help stabilize pH levels essential for physiological functions.
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Buffers
Carbonic Acid–Bicarbonate Buffer System
The carbonic acid–bicarbonate buffer system is the primary buffer system in the ECF. It involves the equilibrium between carbonic acid (H2CO3) and bicarbonate ions (HCO3-), which can neutralize excess acids or bases, thus maintaining a stable pH in the blood and other extracellular fluids.
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Extracellular Fluid (ECF)
Extracellular fluid refers to all body fluids outside of cells, including interstitial fluid and plasma. It is vital for transporting nutrients, waste, and signaling molecules, and its pH must be tightly regulated to ensure proper cellular function and overall homeostasis.
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