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Bio 472 > Blood Pressure Regulation > Flashcards

Blood Pressure Regulation Flashcards

1
Q

Cardiac Output Formula

A

CO=HRxSV

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2
Q

Regular Cardiac Output

A

5000mL

72bpmx70mL

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3
Q

Stroke Volume Formula

A

SV=EDV-ESV

70mL=120mL-50mL

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4
Q

Frank Sterling Law

A

heart has intrinsic ability to change SV in response to input (venous return)

the heart pumps what it recieves

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5
Q

Preload

A

filling of the ventricle

increases SV

direct result of venous return

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6
Q

Contractility

A

heart contracts more or less forcefully

increases SV

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7
Q

Afterload

A

pressure the heart must overcome to eject blood

decreases SV

blood pressure

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8
Q

Ejection Fraction

A

SV/EDV

normally 60%-70%

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9
Q

Positive Inotropes

A

increase contractility, increase Ca++ flow, increases cAMP

examples are Epinephrine, Caffiene, and digitalis

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10
Q

Chronotropes

A

increase cardiac rate

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11
Q

Sympathetic Chronotropes

A

positive inotropes, increases cardiac rate,

Epinephrine, Norepinephrine

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12
Q

Parasympathetic Chromotropes

A

negative inotropes, decreases cardiac rate

Vagus Nerve via ACh

Atropine blocks ACh, stimulating cardiac rate

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13
Q

Max Heart Rate Formula

A
  1. Old Formula: 220-age in years
  2. New Formula: 208-(0.7xage in years)
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14
Q

CO in Tachycardia

A

in a heart rate over 170bpm CO is decreased die to insufficient filling time

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15
Q

Digitalis

A

enhances Ca++ entry, increases contractility

antidepressant

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16
Q

Nitroglycerin

A

cardiac vasodilator, increases preload

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17
Q

Ca++ channel blockers

A

smooth muscle antagonist, dilates smooth muscle, lower BP

decreases afterload, negative inotrope

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18
Q

Fick Principle

A

used to estimate Cardiac Output in living subjects, application of law of conservation of mass

can be estimated knowing O2 consumption, with arterial pulmonary and venous valves for O2

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19
Q

Fick Principle

C.O. (Q) formula

A

(O2 consumption(mL/min))/(O2 arterial - O2 venous)

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20
Q

Fick Principle Thermodilution

A

cold saline is used instead of dye and thermal identification is used

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21
Q

Fick Principle Thermodilution

C.O. formula

A

(mg of dye injectedx60 sec)/(avg dye conc.(mg/L)xduration of curve in seconds)

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22
Q

atherosclerosis

A

hardening of arteies due to gradual plaque buildup

treated by beta blockers, calcium channel blockers, and anti-clotting medications

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23
Q

Angina Pectoris

A

squeezing, heaviness, tightness, or pain in the chest

caused by reduced blood flow to the heart muscle (ischemia)

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24
Q

Coronary Bypass

A

surgical procedure to treat coronary artery disease

reroutes blood flow from clogged coronary arteries to arteries and veins harvested from elsewhere, utilizes a bypass machine

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25
Q

Angioplasty

A

minimally invasive procedure meant to widen narrowed or obstructed arteries and veins

uses guide wire, catheter, and a balloon

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26
Q

The Sounds of Korotkoff

A

the sounds heard during the measurement of blood pressure

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27
Q

Pulse Pressure Formula

A

Systolic-Diastolic=Pulse Pressure

120mmHg-80mmHg=40mmHg

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28
Q

Mean Arterial Pressure

A

Effectivness of the heart as a pump, resistance to blood flow, distribution of blood between arterial and venous blood vessels

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29
Q

Mean Arterial Pressure Formulas

A

MAP=(1/3)Pulse Pressure + Diastolic Pressure
MAP=(1/3)(2Diastolic Pressure + Systolic Pressure)
MAP=COxTPR(total peripheral resistance)

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30
Q

Formulas for Flow

A

DeltaP/R
MAP/Resistance

Resistance to flow = 1/(radius)^4 or MAPx(radius^4)

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31
Q

Arterioles

A

Resistance vessels in system

pressure flow regulators

small in diameter

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32
Q

Venuoles and Veins

A

capacitance vessels

volume storage

54% of blood volume is in venous system

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33
Q

Capillaries

A

exchange vessels (O2, CO2, hormones)

largest area

5 liters or blood but 8-10 liters of capillary space

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34
Q

shunting example

A

increased blood flow to the digestive system after eating, reducing blood to other systems

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35
Q

Which organ requires the most blood?

A

the kidney requires the most blood per gram

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36
Q

Continuous Capillary

A

body capillaries with confluent lining

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37
Q

Fenestrated Capillaries

A

capillary endothelium has windows or pores called fenestra

in kidneys and intestines

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38
Q

Sinusoidal Capillaries

A

wide clefts between endothellial cells

in liver, bone marrow, and lymphatic system

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39
Q

Law of Laplace Formula

A

Pressure = Wall Tension / radius

T/r

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40
Q

Batista Procedure (Brazil)

A

removes part of the ventricular wall of an enlarged heart, reducing the radius, then less tension is required to mantain blood pressure

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41
Q

Bernoulli Principle

A

sum of kinetic energy and flow energy in a closed system is constant, when fluid moves from a wide to narrow tube, potential energy falls as velocity increases and kinetic energy increases

lower pressure in smaller diameter tube with faster velocity

42
Q

Blood Pressure Regulators

A
  1. Autonomic Nervous System
  2. Baroreceptors
  3. Renal Mechanisms
  4. Role of Venous Return
  5. Role of Hormones
  6. Autoregulation
  7. Chemoreceptors
  8. Effect of Temperature
43
Q

ANS

Sympathetic BP Regulation

A

increase heart rate, force of contraction, Alpha Receptors Vasoconstrict w/ NE

Beta 1 receptors increase heart rate and force of contraction

44
Q

ANS

Parasympathetic BP Regulation

A

decrease heart rate via vagus nerve, ACh, no effect on contraction force

45
Q

ANS

Acetylcholine and BP regulation

A

ACh is a vasodilator, but usually not a force in blood flow regulation

46
Q

ANS

Medullary Ischemia

A

ischemia to the medulla oblongata triggers body wide vasocontriction, increased HR and contractility

47
Q

Most Important Flow Regulator

A

vasocontriction

will restrict flow to nonessential organs

48
Q

Baroreceptors

A

most important short term regulator, rapid acting

located in the carotid sinus and aortic body

49
Q

Effect of increased BP on Baroreceptors

A
  1. BP increase
  2. Baroreceptors increase firing
  3. Excites vagal nerve (decreased HR)
  4. Inhibits Medullary vasocontriction centers

Decrease is the opposite

50
Q

Baroreceptors long term

A

not good at long term BP regulation as they reset after several days with a prevailng BP

51
Q

Orthostatic Hypotension

A

pressure compensation from lying to standing

51
Q

Renal Mechanisms

A

Very important long term regulator

52
Q

Renal Angiotension Aldosterone System (RAAS)

A

hormone system that regulates blood pressure

when renal blood flow is reduced Angiotension is released, which vasocontricts

53
Q

J-G Apparatus

A

contains renin producing cells

54
Q

RAAS Steps

A
  1. Macula Densa of DCT senses decrease in Renal BP
  2. Increase in Renin release by J-G apparatus is signaled
  3. Renin acts on Angiotensinogen making Angiotensin 1,
  4. Angiotensin 1 is altered by Angiotensin Converting Enzyme(ACE)
  5. Angiotensin 2(vasocontrictor) is made
  6. Angiotensin 2 triggers Aldosterone release
  7. Aldosterone increases sodium and water reabsorbtion by distal tubule, increasing blood volume and blood pressure
  8. Angiotensin 3 acts as a vasoconstrictor
55
Q

Factors of Venous Return

A
  1. Venous Valves
  2. Skeletal Muscle Pump
  3. Thorasic Pump Inhalation
56
Q

Venous Valves

57
Q

Skeletal Muscle Pump

A

When skeletal muscles contract and squeeze veins, pushing more blood toward the heart.

58
Q

Thoracic Pump Inhalation

A

venous return is increased during to inhalation due to increased pressure on abdoninal veins and decreased pressure on throracic veins

59
Q

Endothelium Derived Relaxing Factor (EDRF)

A

Endothelium derived relaxing factor, relaxes vascular smooth muscle

Nitroglycerin, Viagra

60
Q

Bradykinin

A

vasodilator, increases vascular permeability,

61
Q

Histamine

A

vasodilator, constricts EDHF to produce vasodilating agents

62
Q

Epinephrine

A

dilator in heart , liver, skeletal muscle, B2 receptor activation

63
Q

Atrial Natriuretic Peptide/Factor (ANP/ANF)

A
  1. Released by an increase in BP
  2. Causes Vasodilation
  3. Opposite action of Aldosterone

Vasodilates by increasing kidney sodium secretion by DCT, water excretion, less volume, less BP

64
Q

prostocyclin

A

inhibits platelet aggregation, vasodilator

65
Q

Thromboxane

A

platelet aggregator, vasocontrictor

66
Q

aspirin

A

cyclooxygenase inhibitor, inhibits platelet aggregation

67
Q

Autoregulation

A

Myogenic Theory and Metabolic Theory

68
Q

Myogenic Theory

A

smooth muscles reaction to stretch is contraction as BP increases, vessel wall contracts, flow “autoregulates”

69
Q

Metabolic Theory

A

tissues produce vasodilators,
decrease in flow -> vasodilators accumulate
increase in flow -> vasodilators wash away

70
Q

Active Hyperemia

A

metabolic demand of tissue causes vasodilation

skeletal muscle, digestive tract

71
Q

Reactive Hyperemia

A

transient increase in organ blood flow following a brief period of ischemia

72
Q

Chemoreceptors

A

more important at lower pressures,

73
Q

Chemoreceptor vasodilation

A

increase PCO2, H+
decrease in pH
decrease PO2

74
Q

Effect of temperature

A

increase: vasodilation
decrease: vasoconstrict

75
Q

Four Starling Forces

A

determine fluid movement in capillaries

Pc, Pi, pic, pii

76
Q

Pc

A

hydrostatic pressure in capillary(filtration force)

primary outward force

tends to force fluid out of the capillary

77
Q

Pi

A

hydrostatic pressure of interstitial fluid(0 or filtration force)

weak force

zero to negative in value

78
Q

pic

A

oncotic pressure of capillary plasma proteins(reabsorbtion force)

tends to force fluid into the capillary

79
Q

pii

A

oncotic pressure of interstitial fluid proteins(filtration force)

tends to force fluid out of the capillary

80
Q

Net filtration rate formula

A

L[(Pc-Pi)-(pic-pii)]

81
Q

arterial side of capillaries

A

have a net outward force (filtration)

82
Q

venous side of capillaries

A

have a net inward force (reabsorbtion)

83
Q

summation of both arterial and venous capillaries

A

yields a net outward force (filtration)

2mL/min

84
Q

Lymphatic system funciton in fluid accumulation

A

lymphatic system shunts fluid and proteins back into circulation from the area around the capillaries

85
Q

Edema Causes

A

high capillary permeability(blood pressure), low blood protein(starvation), lymphatic blockage(mastectomy, cancer), increased capillary permeability

86
Q

High Blood Pressure

A

140/90 mmHg

87
Q

Primary or Essential Hypertension

A

Hypertension from an undetermined cause

88
Q

treatment of hypertension

A
  1. Diuretics
  2. Beta Blockers
  3. Calcium Channel Blockers
  4. Ace inhibitors
  5. ARB(s)
89
Q

Diuretics

A

decrease fluid absorbtion by kidney

fluid loss = blood volume loss = blood pressure drop

90
Q

Beta Blockers (B1 receptors)

A

decrease heart rate, contractility due to B1 receptrors blocking

blood pressure drop due to decreased heart pump functions

91
Q

Calcium Channel Blockers

A

block calcium entry into muscle, esp smooth muscle of vasculature

blocks vasoconstriction

92
Q

ACE inhibitors

A

blocks Angiotensin Converting Enzyme “ACE”, less Angiotenin 2 and Aldosterone production,

less vasoconstriction and less Na+ and volume recovery by Kidney

93
Q

ARB(s)

A

Angiotensin Receptor Blockers, blocks Angiotensin receptor at the target tissue level

blocks vasoconstriciton and adrenal release of Aldosterone

94
Q

Alpha 1 receptors

A

stimulates contraction of smooth muscles, increases IP3

95
Q

Alpha 2 receptors

A

same as A1 receptors, also inhibits smooth muscle contraction of the GI system, decrease cAMP

96
Q

Alpha receptors

A

greater affinity for NE

97
Q

Adrenergic Receptors

A

Alpha and Beta Receptors

98
Q

Beta 1 receptors

A

stimulates heart rate, contractility, increase cAMP

99
Q

Beta 2 receptors

A

inhibits smooth muscle, increase cAMP, esp in lung, heart, skeletal muscle blood vessels

100
Q

Beta 3 receptors

A

fat exclusively, lipolysis, increase cAMP

Bio 472 (23 decks)

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