10,18 Flashcards by Taylor Fee

Caloric intake is controlled by….
Hunger and satiety centers in …..
Calorie use is controlled by …

Calories are stored in …..
……adipose tissue
……adipose tissue

Caloric intake is controlled by appetite
Hunger and satiety centers in hypothalamus
Calorie use is controlled by metabolic rate
-Thyroid hormones
-Activity levels

Calories are stored in adipose tissue
White adipose tissue
Brown adipose tissue

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Hypothalamus satiety center

satisfied -adjusting both the sensation of hunger, and adjusting energy expenditures

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obesity

BMI > 25 increases risk DM x 4

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Anorexia athletica –
Anorexia nervosa –
Bulimia –
Binge eating –

Anorexia athletica – injuries, osteoporosis
Anorexia nervosa – fatal arrhythmias
Bulimia – aspirant pneumonia
Binge eating – obesity related diabetes, cardiac disease

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cardiac output

= stroke volume x HR

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BP =

cardiac output and vascular resistence

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Cardiac out put

stroke vol. x HR

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Mechanisms of Blood Pressure regulation

Neural
intrinsic
Extrinsic
humoral
Renin
vasopressin

*Neural(brain) mechanisms
-intrinsic reflex receptors – baroreceptors(stretch) in the lining the vessels, arterial or chemo
-Extrinsic , Carotid Artery - hypothalamus,
*humoral mechanisms
-Renin, (found in kidney primary retain fluid) – angio(vessel)tensin(tention) angiotensin, to I in blood, in lungs I to II = vasoconstriction: also stimulates aldosterone secretion (inc retention of Na and H2O)
-vasopressin - vasoconstriction
*long term regulation
kidneys and autoregulation (local and generalized)

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Mechanisms of BP elevation

Multifactorial- lots of factors
Constitutional- what your made of
Family history- simmalr to parents
Age related changes- baby have lower BP  older
Race- AA- high Pb
Insulin resistance – more pron to BP
lifestyle
High salt intake – bad
Low potassium intake
Obesity
Excess alcohol consumption

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Hypertension (HTN)
Most common ...Disorder most common in ...
Normal BP
Prehypertensive
hypertensives grater than

Most common adult disorder - 25% of male
males, black, poor salt intake, elderly- vaso old veins
post menopausal women
Essential- basic
Normal 120/80
prehypertensive 120-139/ 80-89
hypertensive greater than>139/ >90

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Systolic hypertension

140, <90
results in inc pulse pressure
develop left ventricular hypertrophy
Top number TO much PRESSURE

Hypertrophy – heart inlarge less space for blood

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Secondary hypertension

Secondary not caused by heart
- high BP and cause kidney fail, and vis versa
-Renal HTN- if kidney disease, then dec output - then inc retention of Na and H20
2 stages- 1st release to much 2nd doesn’t release any, increased BP

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Disorders of adrenocorticosteroid hormones

if inc prod of aldosterone then inc retention of salt and water, increase BP

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pheochromocytoma- increases cuzzzz

Oral conr

tumor secretes epinephrine - inc BP

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oral …. Can cause HIGH BP

Oral contraceptive drugs

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Malignant hypertension

WHO?

Malignant(damaging, Fatal) hypertension

Fatal form
young black males- makes blood thick more clots
pregnant women with HTN
diastole > 120

Pre-eclampsia

Pre-eclampsia, blood pressure is high enough to cause protein problems
Shorter wider thicker more at risk has high BP must watch

Proteinuria-

protein in urine and inc BP after 20th week,
inc liver enzymes and low platelets
HELLP- HTN, Elevated liver enzymes, Low platelets.

Chronic HTN

Gestational HTN

chronic HTN - HTN before pregnancy- before during after birth
Gestationa- (prego)l HTN - resolves after pregnancy- she didn’t have BP problems Before or After

HTN in elderly

60-70% have HTN
Arterial hardening
dec renal blood flow

Orthostatic Hypotension (postural

Drop in BP when stand
should autoregulate
500-700 ml blood drops by gravity - dec volume perceived - HR increase - increase volume and BP returns to normal (RTN)

if abnormal, then faint or pre-syncope
Aging, dec blood volume, bed rest, drug induced hypotension or disorders of the autonomic nerv system

Elderly may have
Decrease vol

How would each affect blood pressure?
Vasodilation-

Decreased stretching of baroreceptors-

Hypoxemia-

Vasodilation- drop bp

Decreased stretching of baroreceptors- increase HR then BP

Hypoxemia- Low O in blood increase HR then BP

Disorders of Arterial Circulation
three types

Hyperlipidemia-
Atheroslerosis-
aneurysms and dissections-
the vasculitides-
arterial disease of the extremities-

Three types of arteries- large, medium, small
causes –ischemia( insaifecint(not good quality) Hurts ually cause Paint , infarction(tissue death)

Disorders
Hyperlipidemia- Fats
Atheroslerosis- Arterial wallas thickening due 2 WBC
aneurysms and dissections- ruptures
the vasculitides-destroy blood vessels by inflammation.
arterial disease of the extremities

HDL from…

LDL From….

HDL- exerse

LDL- from diet

Atherosclerosis develops because Oxidized..... and....form

Atherosclerosis develops because scavenger cells encounter the fatty deposits in the artery lining and try to destroy the fats by oxidizing them Oxidized fats injure the endothelium Clots form and release growth factors

Stable plaques have...

Have thic fibrous caps Partially blocked vessels Do not tend to form clots or emboli-embolism is the lodging of an embolus, which may be a blood clot, a fat globule or a gas bubble, in the bloodstream. This can cause a blockage in a blood vessel.[1] Such a blockage (vascular occlusion) may affect a part of the body distanced from the actual site of the embolism. This is in contrast to a thrombus, which causes a blockage at the site of origin.[2]

Unstable plaques- Happen comes from

- happens quickly Comes from animals fat Have thin fibrous caps(plac - can cause attention of platelets then clot Plaque can rupture and cause a clot to form May completely block the artery The clot may break free and become an embolus

Aneurysms and dissection Weakness in... aortic aneurysm dissection

Aneurysm(weekness in vessels) - localized abnormal dilation of vessel -aortic aneurysm – asymptomatic- cuz it’s the biggest vessel -Aortic aneurysm dissection - acute rupture (all blood go to your adomen) abrupt pain, ripping or tearing

The vasculitides,Group of vascular disorders that cause ...

inflammatory injury small vessel - skin - hypersensitivity medium vessel - polyarteritis nodosa *large vessel - giant cell - temporal arteritis

Arterial disease of the extremities Acute arterial occlusion atherosclerotic occlusive disease Medium- thromboangitis obliterans (Buerger’s Raynaud’s disease and phenomenon

Acute arterial occlusion(blood clot) Thrombus- atherosclerotic occlusive disease ( aculsion by narrowing)- lower extremities – intermittent (random) claudication Pain with walking , PVD ,superficial arteries , Sx Pain ,Smokers- thicker blood hard to Medium- thromboangitis obliterans (Buerger’s occlusion by inflammation) 25-40 - **dec pulses, ** Raynaud’s disease and phenomenon - vasospasm of arteries in fingers (toes) Go into cold weather then vaso constriction

Disorders of venous circulation - Varicose veins - Chronic venous insufficiency - venous thrombosis

-Varicose veins - dilated tortuous veins primary-inc pressure cause weak valves secondary - impaired flow in deep veins -Chronic venous insufficiency – congested viend symptoms of impaired blood flow congestion, edema, stasis, ulcers - venous thrombosis- CLOT - superficial or deep * * - triad-stasis (don’t move), hypercoagulation (OVER CLOT), injury (smoking)