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Blake_Physiology_Test 2 > Blake_Physio_11_Control of Blood Flow > Flashcards

Blake_Physio_11_Control of Blood Flow Flashcards

1
Q

Acute control of Blood Flow: (3)

A
  • Rapid changes in local vasodilation/vasoconstriction
  • Occurs in seconds to minutes
  • Basic theories:
    • Vasodilator theory
    • Oxygen (nutrient) lack theory
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2
Q

Long-term control of local blood flow: (2)

A
  • Increase in size/numbers of vessels
  • Occurs over a period of days, weeks, or months
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3
Q

Acute control of blood flow:

Vasodilator Theory

A
  • Increased Metabolism
  • Decreases O2 availability
  • Forms Vasodilators
    • Adenosine
    • CO2
    • Adenosine phosphate compounds
    • Histamine
    • K+
    • H+
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4
Q

Acute control of blood flow:

Oxigen/Nutrient lack theory

A
  • Decreased O2
  • Blood Vessel Relaxation
  • Vasodilation
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5
Q

Define Vasomotion:

A

Cyclical opening and closing of precapillary sphincters

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6
Q

Hyperemia

A
  • Reactive:
    • Tissue blood flow blocked
    • When unblocked -> blood flow increases 4-7x norm
  • Active
    • When any tissue becomes active, rate of blood flow increases
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7
Q

Autoregulation of Blood Flow:

A

In any Tissue:

  • Rapid increase in arterial pressure leads to increased blood flow
  • Within minutes, blood flow returns to normal, even with elevated pressure
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8
Q

Views to explain autoregulation of blood flow:

A

Metabolic Theory

Myogenic Theory

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9
Q

Metabolic Theory of blood flow Autoregulation:

A
  • Increase in blood flow
  • too much oxygen or nutrients
  • Washes out vasodilators
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10
Q

Myogenic theory of blood flow autoregulation:

A
  • Stretching of vessels
  • reactive vasculature constriction
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11
Q

Special acute Blood flow control mechanisms (3)

A

Kidneys

Brain

Skin

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12
Q

How do kidneys control acute blood flow?

A
  • Tubologlomerular feedback:
    • Involves the maclula densa/juxtaglomerular apparatus
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13
Q

How dow the brain control acute blood flow?

A
  • [CO2] increases and/or [H+] inceases
  • cerebral vessel dilation
  • washing out of excess [CO2]/[H+]
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14
Q

How does the skin regulate acute blood flow?

A
  • Blood flow is linked to body Temp
  • Sympathetic nerves via CNS
  • 3ml/min/100g tissue -> 7-8L/min for entire body
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15
Q

How do Endothelial Cells control tissue blood flow?

A
  • Healthy Endothelial Cells export NO
  • NO dephosphorylates cGTP to cGMP
  • cGMP activates protein Kinases
  • Vasodilation
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16
Q

Humoral Circulation Control

A

Vasoconstriction

Vasodilation

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17
Q

Vasoconstrictive hormones

A
  • Norepinephrine
  • Epinephrine
  • Angiotensin II (increases total peripheral resistance)
  • Vasopressin (aka: ADH)
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18
Q

Vasodilating Hormones

A

Bradykinins

Histamine

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19
Q

How does the sympathetic system control vasodilation?

A
  • Vasoconstrictor area of upper medulla transmits a continuous signal to blood vessels resulting in continually, partially contraction of blood vessels = vasomotor tone
  • Vasodilator area (bilateral in the anterolateral portions of lower medulla) inhibits the activity of the vasoconstrictor area
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20
Q

Sensory area of vasomotor center of brain

A
  • Bilateral in tractus solitarius in posterolateral portion of medulla
  • Receives signals via:
    • Vagus Nerve (CN X)
    • Glossopharyngeal Nerve (CN IX)
  • Controlled by higher nervous centers:
    • Reticular Substance (RAS)
    • Hypothalamus
    • Cerebral Cortex
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21
Q

How does the Adreanal Medulla affect vasomotion?

A

secretes epinephrine and norepinephrine

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22
Q

Neural Rapid Control of Arterial Pressure: (4)

A
  • Simultaneous Changes
    • Constriction of most systemic arteries
    • Constriction of veins
    • Increased heart rate
  • Rapid response (w/in seconds)
  • Increased blood pressure during exercise (accompanied by vasodilation)
  • Alarm reaction (fight or flight)
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23
Q

Where are baroreceptors located?

A

Carotid sinuses and aortic sinus

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24
Q

How are Baroreceptors stimulated? (5)

A
  • Stimulated by low arterial pressures
    • carotid sinuses are stimulated by pressure >60mmHg
    • Aortic sinus is stimulated by pressure >30mmHg
  • CN X, CN IX (via small Herring’s nerves)
  • RAS
  • Hypothalamus
  • Cerebral Cortex
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25
Q

Signals from baroreceptors do the following 4 things:

A
  1. Inhibit vasoconstrictor center
  2. excite vasodilator center
  3. signals cause either increase or decrease in arterial pressure
  4. primary function is to reduce the minute-by-minute variation in arterial pressure
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26
Q

Where are Chemoreceptors located?

A

carotid bodies in bifurcation of the common carotids and in aortic bodies

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27
Q

what do chemoreceptors sense?

A

lack of oxygen, excess carbon dioxide, excess hydrogen ions

28
Q

How do signals from chemoreceptors pass to the brain?

A

Herring’s nerves to vagus (CN X)

29
Q

what is the most important role for chemoreceptors?

A

respiratory control

30
Q

What are Atrial Reflexes?

A

Low pressure receptors are located in the atria and pulmonary arteries and play an important role in minimizing arterial pressure changes in response to changes in blood volume.

31
Q

Increase in Atrial stretch results in:

A
  • Reflex dilation of kidney afferent arterioles
    • increases kidney fluid loss
    • decreases blood volume
  • Increase in heart rate (via CN X to medulla)
  • Signals to hypothalamus -> increases [ADH]
  • Atrial natriuretic peptide (ANP) -> kidneys
    • increased GFR (glomerular filtration rate)
    • decreased reabsorption of Na+
32
Q

Arterial pressure and kidneys:

  • Arterial pressure =
  • Arterial pressure rises when____
  • How do normal functioning kidneys regulate arterial pressure?
A
  • arterial pressure = cardiac output * total peripheral resistance
  • Arterial presure rises when total peripheral resistance is increased
  • Normal functioning kidneys return arterial pressure back to normal w/in a day or two
    • pressure diuresis
    • pressure natriuresis
33
Q

pressure diuresis

A

urinary excretion of water in order to reduce arterial pressure

34
Q

pressure natriuresis

A

urinary excretion of sodium in order to reduce arterial pressure

35
Q

What are the 5 characteristics of primary hypertension?

A
  1. Increased Cardiac output
  2. increased sympathetic nerve activity
  3. increased angiotensin II and aldosterone levels
  4. Impairment of renal-pressure natriuresis mechanisms
  5. Inadequate secretion of salt and water
36
Q

What are the 2 major factors of primary hypertension?

A
  1. Weight gain
  2. Sedentary life style
37
Q

What are the major causes of secondary hypertension? (6)

A
  1. Tumor affecting renin-secreting juxtaglomerular cells
  2. Renal artery constriction
  3. Coarctation (narrowing) of the aorta
  4. preclampsia
  5. neurogenic hypertension
  6. genetic causes
38
Q

What are the Renal Causes of Hypertension?

A
  1. Chronic renal diseas
  2. Renal artery stenosis
  3. Renin-producing tumors
  4. Acute Glomerulonephritis
  5. Polycystic disease
  6. Renal Vasculitus
39
Q

What are the Endocrine causes of Hyertension? (7)

A
  1. Cushing syndrome (adrenocortical hyperfunction)
  2. Exogenous hormones (glucocorticoids, estrogen)
  3. Pheochromocytoma
  4. Acromegaly
  5. Hypothyroidism (myxedema)
  6. Hyperthyroidism (thyrotoxicosis)
  7. Pregnancy induced
40
Q

What are the Cardiovascular causes of hypertension? (5)

A
  1. Coarctation of teh aorta
  2. polyateritis nodosa
  3. increased intravascular volume
  4. Rigidity of the aorta
  5. Increased cardiac output (usually an outcome of other cause)
41
Q

What are the neurological causes of hypertension? (4)

A
  1. Psychogenic
  2. Increased Intracranial pressure
  3. Sleep Apnea
  4. Acute Stress
42
Q

What are the contributing factors in Hypertension? (8)

A
  1. Genetic
    1. multifactorial
    2. single-gene disorders that alter Na+ reabsorp.
    3. Variants in the renin-angiotensis system
  2. Lifestyle
    1. stress
    2. obesity
    3. smoking
    4. inactivity
    5. heavy dietary sodium
43
Q

Factors resulting in decreased peripheral resistance leading to decreased blood pressure: (5)

A
  1. Increased production of NO
  2. increased release of prostacyclin
  3. increased release of kinins
  4. increase in atrionatriuretic peptide (ANP)
  5. Decreased neural factors (ß-adrenergic)
44
Q

Factors resulting in decreased cardiac output leading to decreased blood pressure:

A
  1. Decreased blood volume
  2. Decreased heart rate
  3. Decrease contractility
45
Q

Factors resulting in INCREASED cardiac output leading to increased blood pressure: (3)

A
  1. Increased heart rate
  2. increased contraction
  3. increased blood volume (aldosterone)
46
Q

Factors resulting in increased peripheral resistance leading to increased blood pressure: (4)

A
  1. Increased angiotensin II
  2. Increased catecholamines
  3. increased thromboxane
  4. Increased Neural factors (a-adrenergic)
47
Q

3 Humoral Vasoconstrictors:

A

Angiotensin II

Catecholamines

Endothelin

48
Q

3 Humoral vasodilators:

A

Kinins

Prostaglandins

Nitric Oxide

49
Q

Atherosclerosis (2)

A
  • a type of arteriosclerosis (hardening of the arteries)
  • Presence of lesions within the intima of the vessel wall that protrude into the vessel lumen
50
Q

Non-modifiable risk factors for Atherosclerosis:

A

Age

Gender

Genetics

51
Q

Modifiable risk factors for atherosclerosis:

A

hyperlipidemia

hypertension

smoking

diabetes

52
Q

Other risk factors for atheroclerosis (6)

A
  1. Inflamation
  2. Hyperhomocystenemia
  3. Metabolic sydrome
  4. Lipoprotein (a)
  5. Factors affecting hemostasis)
  6. life-style
53
Q

Pathogenesis of Atherosclerosis:

Endothelial injury or dysfunction: (3)

A
  • Intimal thickening
  • Formation of atheroma in presence of hyperlipidemia
  • Factors:
    • hypertension
    • hyperlipidemia
    • cigarette smoke
    • homocysteine
    • infectious agents
    • hemodynamic disturbances
54
Q

Pathogenesis of Artherosclerosis:

Accumulation of Lipo proteins (esp LDL): (5)

A
  1. Result of chronic hyperlipidemia
  2. Lipoproteins accumulate in intima and are oxidised by free radicals generated by macrophages or endothelium
  3. Oxidised LDL is injested by macrophages which become foam cells
  4. Oxidised LDL stimulates release of GFs: cytokines and chemokines
  5. Oxidized LDL is toxic to endothelial cells and smooth muscle
55
Q

Pathogenesis of atherosclerosis

Monocyte adhesion to endothelium: (4)

A
  1. Endothelial cells express VCAM-1 adhesion molecules to bind monocytes and T-cells
  2. Monocytes transform into macrophages and engulf lipoprotiens
  3. T-cells stimulate a chronic inflammatory response
  4. Activated leukocytes and endothelial cells release GFs to promote smooth muscle proliferation
56
Q

Pathogenesis of atherosclerosis

Smooth muscle proliferation:

A

Intimal smooth muscle cell proliferation and extracellular matrix deposition converts a fatty streak into a mature atheroma

57
Q

Atheroma Morphology

A

cap of smooth muscle cells, macrophages -> foam cells, and other extracellular components overlying a necrotic center composed of cell debris, cholesterol, foam cells, and calcium

58
Q

Developmental stages of atherosclerosis: (5)

A
  1. Fatty streaks - even in children >10
  2. Atherosclerotic plaques - impinge on the lumen of the artery and grossly appear white or yellow
  3. Enlarged plaques - due to cell death and degeneration and synthesis/degradation of EC matrix
  4. calcified plaques
  5. Ruptured, ulcerated, or erroded plaques
59
Q

Most common sites for atherosclerosis (5)

A
  • Lower abdominal aorta
  • coronary arteries
  • popliteal arteries
  • internal carotid
  • circle of Willis
60
Q

Short term control of arterial pressure:

A

Sympathetic nervous system effects on

  • total peripheral vasculare resistance and capacitance
  • Cardiac pumping
61
Q

Long term control of arterial pressure:

A
  • Multiple nervous and hormonal controls
  • Local controls in the kidney that regulate salt and water excretion
62
Q

7 Steps by which increasing EC fluid volume increases arterial pressure

A
  1. Increased EC fluid volume
  2. Increased blood volume
  3. Increased mean circulatory filling pressure
  4. Increased venous return of blood to the heart
  5. Increased cardiac output
    • autoregulation
    • increased total peripheral resistance
  6. increased arterial pressure
  7. increased urine output
    • decreased EC fluid vollume (negative feedback)
63
Q

Define Chronic Hypertension:

  • Normal:
  • Hypertensive:
  • Severe Hypertsnsive:
A
  • One’s mean arterial pressure is greater than the upper range of accepted normal pressure
  • Normal: 90 mmHg (110/70)
  • Hyper: 110mmHg (135/90)
  • Severe: 150-170mmHg (180+/120)
64
Q

Renin-agiotensin vasoconstrictor mechanism: (6)

A
  1. Decreased arterial pressure
  2. Renin (kidney)
  3. Renin substrate (angiotensinogen)
  4. Angiotensin I (ACE: agiotensin converting enzyme; lung)
  5. Agiontensin II (inactivated by angiotensinase)
    • Atrial natriuretic peptide = Vasoconstriction
    • Aldosterone (Adrenal gland) = renal retention of salt and water
  6. Increased arterial pressure (negative feedback)
65
Q

Return of arterial pressure to almost normal by renin-angiotensin system following increased salt intake (7)

A
  1. Increased salt intake
  2. Increased EC fluid volume
  3. Increased arterial pressure
  4. Decreased Renin and Angiotensin
  5. Decreased renal retension of Na+ and H2O
  6. Return of EC volume almost to normal
  7. Return of arterial pressure to almost normal

Blake_Physiology_Test 2 (6 decks)

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