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Pathophysiology > 16 Alterations in Blood Pressure > Flashcards

16 Alterations in Blood Pressure Flashcards

1
Q

Components of BP measurement

A 
1 Systolic BP
2 Diastolic BP
3 SV is primary factor of systolic p
4 SVR is major determinant of diastolic p
5 Pure Pressure = sys-dias 
6 Mean Arterial Pressure
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2
Q

Systolic Blood Pressure [SBP]

A

peak pressure during cardiac systole

-the squeezing of heart to pump

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3
Q

Diastolic Blood Pressure [DBP]

A

lowest pressure during cardiac diastole

  • dilating/relaxing part of heart/refilling
  • takes longer than systolic
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4
Q

SV

A

primary factor influencing systolic pressure

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5
Q

SVR

A

major determinant of diastolic pressure

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6
Q

Pulse pressure

A

systolic - diastolic

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7
Q

Mean Arterial Pressure [MAP]

A

calculated average pressure w/in circulatory system throughout the cardiac cycle
MAP=
{[2x dias.press]+sys.press}/3

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8
Q

Direct measurements of BP

A
  • requires intraarterial catheter + specialized euipt to transduce arterial fluid pulsations into electrl sgnals.
  • catherer commonly placed in RADIAL ARTERY
  • most accurate method to measure BP
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9
Q

where is catheter usually placed to measure BP?

A

radial artery

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10
Q

Indirect measurement of BP

A
  • commonly via brachial artery w stethoscope + sphygmomanometer or automated oscillometric systm
  • requires careful technique for accuracy
  • auscultation of korotkoff sounds
  • white coat effect
  • elderly auscultatory gap
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11
Q

Auscultation of Korotkoff Sounds

A

-indirect form of measurement of BP
SBP: onset of Korotkoff sounds
DBP: disappearance of Korotkoff sounds

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12
Q

Auscultatory Gap

A
  • occurs in elderly

- period of absent Korotkoff sounds during manual measurement of BP

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13
Q

Cardiac Output [CO]

A

Q=strok vol x heart rate

vol of blood being pumped by heart

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14
Q

Preload

A

end-diastolic volume

-amount of blood returned to heart

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15
Q

Afterload

A
  • systemic vascular resistance

- determined by radius of arteries + degree of vessel compliance

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16
Q

Sympathetic Nervous System [SNS] on BP

A
  • short-term regulator of systemic blood pressure

- based on epinephrine + norepinephrine

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17
Q

parasympathetic nervous system on BP

A

slows heart

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18
Q

Renin-Angiotensin-Aldosterone System [RAAS]

A 
-important long-term regulator of BP
1 low arterial pressure causes Juxtaglomerular cells to secrete Renin
2 Renin activates ANG  to ANG I
3 ACE activated ANG I into II [PRELOAD]
4 ANG II stim release of ALDOSTERONE
5 reabsorption of Na + H2O> PRELOAD
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19
Q

Angiotensin II

A
  • activated from Angiotensin I by ACE
  • potent vasoconstrictor [AFTERLOAD]
  • stimulates the release of Aldosterone in RAAS
20
Q

Aldosterone

A

hormone that causes reabsorption of Na

  • causes water to follow
  • PRELOAD
  • release of aldosterone is stimulated by Angiotensin II
21
Q

Na + H2O retention causes…

A

increase in BLOOD VOLUME>

increase in BLOOD PRESSURE

22
Q

what it the main outcome of RAAS?

A

pathway leads to INCREASE IN BLOOD PRESSURE

23
Q

RAAS/long-term syst BP

REGULATION

A

-regulated by neural, hormonal, + renal

24
Q

increase in xtracellular FLUID VOLUME [PRELOAD]

A

1 increase in CO + SVR
2 elevated BP
-causes kidneys to EXCRETE excess Na + fluid

25
Q

increase in SERUM SODIUM LVL

A

1 increase osmolality
2 increase ADH secretion
-causes kidneys to REABSORB water + increase PRELOAD

26
Q

Vasopressin [ADH]

A
  • hormone made by hypothalamus
  • stored in PIT gland
  • causes kidney to conserve/reabsorb H2O
27
Q

Atrial Natriuretic Peptides [ANP]

A

1 increases GLOMERULAR FILTRATION RATE >
2 increase in H2O + Na EXCRETION
3 results in decrease of PRELOAD

28
Q

Normal Blood Pressure

A

SBP <120

DBP <80

29
Q

PRE hypertension

A

SBP 120-139

DBP 80-89

30
Q

Stage 1 Hypertension

A

SBP 140-159

DBP 90-99

31
Q

Stage 2 Hypertension

A

SBP >160

DBP >100

32
Q

Primary Hypertension

A

aka HIGH BLOOD PRESSURE aka silent killer bc organs are damaged before diagnosis is made [END-ORGAN DAMAGE]
-no clear cause

33
Q

End-Organ Damage

A

1 renal failure, stroke, heart disease
2 damaged arterial sytm >atherosclerosis >cardiovasc disease
3 incr myocardial work > heart failure
4 glomerular damage > kidney failure
5 affects microcirculation of eyes
6 incr pressure in cerebral vasculature > hemorrhage

34
Q

Primary Hypertension

subtypes

A

1 Isolated Systolic Hypertension
2 Isolated Diastolic Hypertension
3 Combined

35
Q

Isolated Systolic Hypertension

A

SBP>140 [stage 1 hypertension+]

DBP<90 [normal - prehypertension]

36
Q

Isolated Diastolic Hypertension

A

SBP<140 [normal - prehypertension]

DBP>90 [stage 1 hypertension+]

37
Q

Combined Sys + Dias Hypertension

A

both exceed prehypertension levels

SBP>140
DBP>90

38
Q

what determines the degree of hypertension?

A

the highest reading

39
Q

Primary Hypertension

risk factors

A
  • family history
  • age
  • ethnicity
  • genetics
40
Q

Primary Hypertension

modifiable risk factors

A
  • diet
  • sedentary lifestyle
  • obesity/weight gain
  • metabolic syndrome
  • elevated blood glucose/diabetes
  • elevated total cholesterol
  • alcohol + smoking
41
Q

Primary Hypertension

treatment

A

lifestyle modifications are first + most important prevention + treatment strategy
-drug therapy affects heart rate, SVR, + stroke volume

42
Q

lifestyle modifications are first + most important prevention + treatment strategy for primary hypertension

A
  • weight loss
  • exercise
  • DASH diet
  • alcohol moderation
  • decreased sodium intake
43
Q

Secondary Hypertension

A

-attributed to specific identifiable pathology or condition

44
Q

most common form of hypertension in infants + children

A

Secondary Hypertension

45
Q

most common cause of childhood secondary hypertension

A

RENAL DISEASE + coarctation of the aorta [AORTIC NARROWING]

-other cause is obstructive sleep apnea

46
Q

normal BP

A

120/80

Pathophysiology (32 decks)

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