23 Blood Flow Regulation Flashcards
What are the two vasoactive factors released from platelets and their functions?
- Serotonin: Vasoconstriction, more platelet activation, and promoting NO release (vasodilation)
- Thromboxane: Vasoconstriction, more platelet activation
What are the 3 endothelium-secreted vasoactive factors and their functions?
- NO: vasodilation and platelet inhibition (Serotonin, ACh, or high flow (shear forces) stimulates its release. It is synthesized from L-arginine.)
- Prostacyclin: vasodilation and platelet inhibition
- Endothelin: powerful vasoconstrictor
How do the kidneys increase blood pressure? (pathway)
- Renin-> Angiotensin 2 -> Constricts vessels
- (And fluid balance we will learn later)
What are the 3 determinants of cardiac work? How can cardiac work be estimated?
- Contractility
- Wall stress
- Heart rate
- Can be estimated: systolic arterial pressure X Heart Rate
- (also recall that the isovolumetric phase of contraction is the most work-intensive)
What 7 methods are used to regulate blood flow to the heart?
- Metabolic regulation (vasodilator metabolites)
- Aortic pressure
- Neural and humoral (like hormonal) factors (strong indirect influence! Thru changes in cardiac workload (heart rate, wall stress, contractility) and metabolic demand)
- Paracrine factors (NO and prostacyclin)
- Coronary steal
- Extravascular compression (heart compresses its own vessels in left ventricle systole)
- The principle that guides all these is the need for O2 in the heart
Which things influence cerebral blood flow MOST? What 7 factors affect cerebral blood flow?
- Primariy local metabolic, strong autoregulation, and CO2.
- CO2 & H+ (biologically equivalent), O2, K+, adenosine, NO, and in cerebral ischemia the rest of the body will vasoconstrict to send extra blood to head
What is active versus reactive hyperemia? (a local vascular control)
- Active=more blood due to increased tissue activity. (Tissue actually produces more vasodilator metabolites)
- Reactive=more blood after ischemia (Less vasodilator metabolites are washed away by blood flow, concentration of them increases)
Describe the mechanism of each of the 2 methods of autoregulation? (a local vascular control)
- Metabolic: Up pressure, up blood flow, up amt. of vasodilator metabolites being washed away.
- Myogenic: Up volume, up stretch vascular smooth muscle (VSM), up Ca++ in VSM, smooth muscle contracts. (this is intrinsic property of smooth muscle)
What tissues is neurohumoral vascular control strong in? (such that it can override local control in these regions)
- Skin
- Resting skeletal muscles (primarily neural and myogenic at rest)
- kidney (has good local control too though)
- viscera
What tissues is neurohumoral vascular control weak in? (and thus local control dominates)
- heart
- brain
- exercising skeletal muscle (primarily “local” vasodilator metabolites, a.k.a. hyperemia during exercise)
What are the 3 methods of “local” vascular control? What factors are used by each of these?
- Autoregulation (myogenic, metabolic)
- Hyperemia (vasodilator metabolites: K+, adenosine, prostaglandins, nitric oxide, hydrogen peroxide)
- Paracrine factors (tonic NO, prostacyclin, serotonin, endothelin)
What are the 2 methods of “neurohumoral” vascular control?
- Autonomic: Most important norepinephrine on alpha adrenergic receptors. Tonic & activate-able. Regionally selective.
- Circulating vasoactive factors: Epi, NorEpi, angiotensin, vasopressin (ADH)
With atherosclerosis, what happens to the vasoconstriction response?
Greater response for same amt. chemical (NorEpi, serotonin, thromboxane)
Cutaneous circulation is controlled by what 2 methods?
- Mostly neural
- Bit of local
Why is control of splanchnic circulation important to the body?
Helps determine TPVR (total peripheral vascular resistance) (sympathetic tone also determines TPVR)