Typing as You Talk... not paying attention to you....

So we have this little structure here made up of these parts. One part is called the maculadensa. If you look you can see the cells are large, if they are budding the glumerulus they become very large. Then they come to the distal convoluted tubule. The book is wrong. The point is, that is why they are called the maculadensa. Ok? Kidneys are going to try to compensate, ok, by doing things by the bicarb, then if we get metabolic problems lungs are going to try to compensate from the O2 side. So the places you would get a metabolic, as opposed to a respiratory acidosis... we have too many so they get shoved off to a place where they make keto acids. Our pH is going down, not from a CO2 source, our kidneys are one of the few places where we can make bicarbonate. Kidneys are going to try to compensate by increasing their bicarbonate excretion, but again they might not do that adequately enough, which is why we have all these sorts of problems. That's why you need to know pH or your patients are going to die! Don't blow off pH like it's no big deal, because it's not! If you go on and take pathophys you will see that people can have one or two or three of these at the same time... you HAVE to know how to deal with the pH so they don't die! pH is really critical. I have had students who don't know if your Hydrogen ions are increasing if they are acidodical. I'm sorry, but I'm tired of people not knowing pH! 

Oh how I miss the days that my teachers spoke english.... (oh ya, and didn't make me feel like I'm probably going to kill someone)