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Cardiovascular System BDS1 > Blood Pressure > Flashcards

Blood Pressure Flashcards

1
Q

what is mean arterial blood pressure the driving force for?

A

blood flow through organs (except lungs)

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2
Q

what is arterial blood pressure maintained at?

A

120/80mmHg

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3
Q

when do variations in blood flow to different organs occur?

A

when demand arises to ensure adequate perfusion

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4
Q

what is systolic blood pressure

A

pressure in arteries (aorta) during myocardial contraction (systole)

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5
Q

what is diastolic blood pressure?

A

pressure in arteries (aorta) during myocardial relaxation (diastole) = when ventricles are refilling

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6
Q

what is mean arterial pressure equal to?

A

diastolic blood pressure + 1/3 pulse pressure

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7
Q

what is pulse pressure?

A

SBP-DBP

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8
Q

how do you calculate the mean arterial pressure

A

cardiac output x total peripheral resistance

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9
Q

what is cardiac output?

A

stroke volume x heart rate

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10
Q

what is total peripheral resistance?

A

systemic vascular resistance - total resistance to flow of blood in systemic vasculature (circulation)

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11
Q

when is blood pressure greatest?

A

when walking

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12
Q

when is blood pressure lowest?

A

when sleeping

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13
Q

when does blood pressure increase?

A

in response to exercise, stress or sensory stimuli

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14
Q

what controls the rapid regulation of blood pressure

A

nerves and hormones

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15
Q

what controls blood pressure long-term

A

blood volume

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16
Q

what does the pressure gradient exist from?

A

from arterial to venous system

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17
Q

when is blood pressure highest?

A

when blood enters the aorta on contraction of the left ventricle

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18
Q

what are baroreceptors?

A

mechanoreceptors that defect the degree of stretch of blood vessel walls

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19
Q

what is the function of the baroreceptors?

A

to monitor blood pressure

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20
Q

what does mechanical stretch in the arteries occur to?

A

pulsatile blood flow

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21
Q

what is mechanical stretch related to?

A

blood pressure

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22
Q

when does mechanical stretch increase?

A

during systole

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23
Q

what happens to the mechanical stretch during diastole?

A

it gradually decreases

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24
Q

where are the baroreceptors most abundant?

A

in the aortic arch and carotid sinus

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25
Q

what are the baroreceptors sensitive to?

A

the changes in stretch (pressure) and the rate of pressure change

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26
Q

how many carotid arteries are there?

A

2 - right and left

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27
Q

what do the carotid arteries supply?

A

head and neck

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28
Q

what is the carotid sinus?

A

where each carotid artery divides into two smaller arteries where the artery wall is thinner and contains a large number of branching nerve endings

29
Q

what are carotid sinus baroreceptors innvervated by?

A

the sinus nerve of Hering

30
Q

what are the aortic arch baroreceptors innervated by?

A

the aortic nerve (combines with the vagus nerve)

31
Q

what is the difference between aortic arch baroreceptors and carotid sinus baroreceptors?

A

aortic arch baroreceptors have a higher threshold pressure and so are less sensitive than carotid sinus baroreceptors to changes in stretch

32
Q

what is the nerve of Hering a branch of?

A

the glossopharyngeal nerve

33
Q

what is the sequence of events when baroreceptors detect a DECREASE in arterial blood pressure?

A

reduced AP firing from baroreceptors - stimulation travels along afferent neurons - medullary CVS centre in medulla oblongata - increased stimulation of sympathetic nerves to heart/arterioles/veins - decreased stimulation of parasympathetic neurons (vagus nerve) to heart

34
Q

what is the sequence of events when the baroreceptors detect an INCREASE in arterial blood pressure?

A

increased action potential firing from baroreceptors - stimulation along afferent neurons - medullary CVS centre (in medulla oblongata) - decreased stimulation of sympathetic neurons to heart/arterioles/veins - increased stimulation of parasympathetic neurons to heart/arterioles/veins

35
Q

what is the valsalva manoeuvre?

A

an attempt to expire against a closed glottis, exhaling when mouth and nose are closes or e.g. lifting of heavy weights

36
Q

what is the physiological response of the valsalva maneouvre?

A

increased intrathoracic pressure, raising blood pressure; normal LV contraction + increased baroreceptor firing, heart rate falls transiently - impeding venous return of blood to heart, fall in CO and MAP, as MAP decreases, HR rises and stabilises blood pressure

37
Q

what happens in the valsalva manoeuvre when the glottis is re-opened to allow expiration?

A

intrathoracic pressure falls, BP falls initially, venous return is rapidly restores, EDV and CO increase, raising BP, increased BP is sensed by baroreceptors results in freflex bradychardia (slowing of HR)

38
Q

what happens to baroreceptor activity when arterial blood pressure is elevated for prolonged periods?

A

the threshold rises to a higher value

39
Q

how long are baroreceptors good enough for regulating blood pressure?

A

short term only

40
Q

how is cardiac output maintained during exercise whilst the baroreceptor sensitivity is resetting

A

heart rate does not fall in response to increase in BP accompanying exercise

41
Q

what is the major influence for long term regulation of blood pressure?

A

blood volume

42
Q

what does blood volume influence?

A

venous pressure, venous return, end-diastolic volume, stroke volume and cardiac output

43
Q

what does increased blood volume do to arterial pressure?

A

increases arterial pressure

44
Q

what does an increased arterial pressure do to blood plasma volume?

A

reduces it via increasing renal excretion of salt and water

45
Q

what type of feedback is long-term BP regulation?

A

long-term

46
Q

what are arterioles?

A

small diameter blood vessels

47
Q

how do arterioles control local control of blood pressure

A

small changes in arteriolar radius control blood pressure in response to circulating substances

48
Q

what happens when there is a decreased arteriolar radius?

A

the sympathetic nerves release

noradrenaline and alpha-1 adrenoreceptors which causes constriction

49
Q

what happens when there is an increased arteriolar radius?

A

sympathetic cholinergic nerves release acetylcholine and muscarinic receptors, plasma released adrenaline and beta-2 adrenoreceptors, there is increase K+ and adenosine and a decrease in PO2 which causes dilation

50
Q

what does local control of blood pressure do?

A

modulates blood pressure and blood flow and has the ability to override central blood pressure control systems

51
Q

what is local blood pressure modified by?

A

local changes in systemic vascular resistance (TPR)

52
Q

what does capillary fluid shift occur due to?

A

venous dilators

53
Q

what is capillary fluid shift caused by?

A

reduced proximal capillary hydrostatic pressure

54
Q

what is capillary fluid shift?

A

the movement of fluid across the capillary membrane between the blood and the interstitial fluid compartment

55
Q

clincially, what is hypertension?

A

BP of 140mmHg Systolic and 90mmHg diastolic or higher

56
Q

what is the risk of hypertension raised by?

A

age, cigarette smoking, high salt intake, lack of exercise, being overweight, regularly drinking large amounts of alcohol, stress, genetic predisposition, family history

57
Q

what are the health conditions that can raise hypertension risk?

A

kidney conditions (CKD, renal hypertension, long-term infections, glomerulonephritis), diabetes, obstructive sleep apnoea, hormone problems

58
Q

what therapeutics increase hypertension risk?

A

contraceptive pill, non-steroidal anti-inflammatory drugs (NSAIDS), recreational drugs

59
Q

what can the damage due to hypertension lead to?

A

aneurysms in cerebral arteries, left ventricular hypertrophy, thickening of arteries, atherosclerosis deterioration leading to renal disease, heart failure, malignant hypertension, angina, stroke

60
Q

what are the drugs which treat hypertension?

A

Clondine and alpha methyldopa

61
Q

what is clondine?

A

alpha-2 adrenoreceptor agonist, stimulates alpha-2 adrenoreceptors in brainstem, reduces sympathetic outflow from CNS

62
Q

what does clondine decrease?

A

peripheral resistance, renal vascular resistance, heart rate, blood pressure

63
Q

what is alpha methyldopa?

A

alpha-2 adrenoreceptor agonist

64
Q

what happens to alpha methyldopa and what does it do?

A

converted into metabolite - methylnoradrenaline in CNS which stimulates central inhibitory alpha adrenocreceptors and reduces sympathetic tone, TPR and BP

65
Q

what are the dental considerations with hypertension?

A

anti-hypertensive drugs interact with anaesthetics and analgesics (may lead to local anaesthetic toxicity), an increase in BP due to stress can lead to stroke, CV disease patients have associated higher risk of complications due to release of endogenous catecholamines due to pain/stress

66
Q

what is the BP for hypotension?

A

90/60 mmHg

67
Q

what is postural hypotension?

A

abnormal drop in BP when individual stands up after sitting/lying down

68
Q

what are the symptoms of hypotension?

A

dizziness, light-headedness, fainting, possible fall but may also be asymptomatic

69
Q

who is hypotension common in?

A

older patients and those with underlying health conditions that affect sympathetic or parasympathetic nervous system e.g. parkinsons or diabetes

Cardiovascular System BDS1 (4 decks)

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