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Block 3 Found Sci > 3-Blood Pressure Regulation > Flashcards

3-Blood Pressure Regulation Flashcards

1
Q

BP calculation

A

mean arterial pressure = cardiac output x total peripheral resistance

MAP = CO x TPR

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2
Q

resistance buffer

A

since biggest change in R @ arterioles it buffers pulse pressure so not transmitted to capillary vessels

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3
Q

waveform features

A
  1. systolic P = when heart contracting/ejecting
  2. diastolic P = when heart relaxing
  3. pulse P = diff b/t systolic and diastolic
  4. diacrotic notch/inclsura = dip, aortic valve closure
  5. diastolic run off curve = indicates arteriolar R
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4
Q

diastolic runoff curve

A

vascular resistance downstream of aorta

dec R = inc slope v/v

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5
Q

pulse pressure =

A

systolic P - diastolic P
rearrange so MAP = diastolic P + 1/3 PP

affected by stroke volume and vascular resistance

net amplitude of waveform pressure

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6
Q

how vascular compliance affects PP

A

stiffer vessel = lower compliance = higher pulse pressure, happens with age

stroke volume inc = higher PP

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7
Q

amplification from central to peripheral

A

as blood travels to periphery pulse pressure amplifies from wave reflection

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8
Q

dampening pulse pressure

compliant

A

if large arteries compliant then more dampening of PP so less PP @ small arteries/arterioles = healthy, functional cerebral vasculature

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9
Q

dampening in stiff arteries

A

in large arteries less dampening so takes longer and greater PP when it reaches small arteries = damaged, dysfunctional cerebral vasculature

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10
Q

wave propagation depends on

A
  1. velocity related to distensibility/compliance
  2. stroke vol
  3. aortic compliance
  4. distance to reflection points
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11
Q

what does wave reflection represent

A

index of how compliant vessels are overall

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12
Q

auscultatory method assessing BP

A

relies on listening to blood flow over brachial A
-korotkoff sounds = turbulent flow from inc velocity after dec cross section with cuff

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13
Q

short term regulation

A

mostly neural reflex arcs
baroreceptor reflex

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14
Q

long term regulation

A

hormones and control of circulating vol (changes in renal fxn)

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15
Q

arterial barorecptors activate

A

brainstem vasomotor center so affects
1. TPR
2. cardiac performance (SV, HR)
3. symp drive to kidney (SV)
4. venous compliance (SV)

inc BP = dec HR and TPR v/v

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16
Q

cardiopulmonary baroreceptors activate

A

brainstem vasomotor center so TPR, symps to kidney, venous compliance, cardiac perform

and hypothalamus so ADH affects SV

17
Q

intrarenal baroreceptors activates

A
  1. renin angiotensin system
  2. GFR
  3. salt and water reabsorption

all impact SV

18
Q

arterial baroreflex pathway

A
  1. sensory receptors @aortic arch and carotid sinus
  2. afferent signal synapse @ NTS
  3. signal sent to CVLM
  4. signal sent to RVLM
  5. spinal cord IML with cell bodies of presymp neurons
  6. presymp synpase in sympathetic chain
  7. efferents synapse on heart/vasculature
19
Q

vagal efferent pathway

A
  1. reduce HR = baroreceptor act
  2. signal from NTS project to neurons in mucleus abiguus (NA)
  3. NA act vagal projections to heart esp SA and AV nodes to alter K permeability
20
Q

low BP = ? discharge

A

decreases impulse discharge rate

v/v, high BP inc discharge

21
Q

valsalva maneuver

A
  1. BP rises
  2. straining vs closed airway inc intrathoracic P + compresses great veins
  3. venous return impeded
  4. cardiac output fails
  5. HR inc from baroreceptor act

BP will inc and HR dec when airway opened

nerves must be intact and functional ANS

22
Q

carotid massage

A

technique to activate baroreflex
-deforming carotid mimics effect of pressure = afference nerve activity inc + efferent activity causes bradycardia (from parasymps)

23
Q

resetting set point

A

in disease processes like hypertension baroreflex will reset to defend higher point

24
Q

chemoreflex

A
  1. stimulus (arterial pH, O2, inc CO2)
  2. detection by carotid body and aortic body
  3. integrate in NTS (>NA>DMNV>RVLM> CVLM)
  4. vagus and IML in spinal cord
  5. effector - vasoconstriction
25
Q

renin-angiotensin II system pathway

A
  1. liver produces angiotensinogen
  2. renin cleaves into angiotensin I
  3. converted to II by ACE
  4. vasoconstriction, salt/water retention, dec baroreflex
  5. inc blood pressure
26
Q

beta adrenergic blockade does what

A

inhibits renin so can’t make angiotensin I

27
Q

ACE inhibitor does what

A

inhibits ACE so can’t cleave into angiotensin II

28
Q

ANGII type 1 receptor blockade

ARB

A

blocks angiotensin II from acting on system so
no inc sodium reabsorption
no inc vasoconstriction
no inc aldosterone secretion

29
Q

long term effects of ANGII

A
  1. altered peripheral resistance so rapid pressor resp
  2. altered renal function so slow pressor resp
  3. altered cardiovascular structure so hypertrophy and remodelling
30
Q

endothelin 1

A

ETA receptor
VSMC cell type
will vasoconstrict

31
Q

ANF/ANP
atrial natriuretic factor

A

GC-A/NPR1 receptor
many cell types
inc cGMP to vasodilate, inhibit renin and aldosterone, dec Na reabsorption in nephron

32
Q

ADH/AVP
anti diuretic hormone, vasopressin

A
  1. V1 receptor, VSMC cell type, vasoconstrict
  2. V2, collecting duct epi, water reabsorption
33
Q

epinephrine

A
  1. B2 adrenergic, skeletal muscle VSMC, vasodilate
  2. B1 adrenergic, cardiac cells, inc chronotropy, inotropy
  3. alpha1 adrenergic, VSMC, vasoconstrict
34
Q

kidney role in long term BP

A

control of volume/urine loss from kidneys to maintain given pressure

P inc then urine output inc

35
Q

sodium balance

A

inc P = glomerular capillary hydrostatic P inc = filtration
-more Na excreted followed by water so vol dec = BP drop

pressure natriuresis

36
Q

salt sensitive hypertension

A

renal dysfunction = hypertension can’t match Na/vol output to maintain P

changes kidney mass, tubular reabsorption, reduced capillary filtration coefficient

if inc pre-glomerular resistance shifts normal curve to right, keep salt excretion/pressure relationship intact

37
Q

regulators time response

A
  1. baroreceptors
  2. chemoreceptors
  3. renal volume control

Block 3 Found Sci (60 decks)

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