Blood Pressure Regulation Flashcards

1
Q

Regulation of BP occurs through which 2 mechanisms?

A
  1. Hormonal
  2. Neural
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2
Q

Hormonal and neural mechanisms that effect BP respond to changes in?

A

Cardiac Output (CO)
Systemic Vascular Resistance (SVR)
Blood Volume

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3
Q

The cardiovascular control centre is located in which part of the brain?

A

The medulla oblongata.

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4
Q

The medulla oblongata receives input from?

A

Sensory receptors & higher brain centres.

Sensory inputs include:
-Baroreceptors: detect changes in BP
-Chemoreceptors: Detect chemical changes in the blood (pH, O2 and CO2)
-Proprioceptors: detect changes of limb and muscle position

Higher brain centers include:
-Cerebral cortex
-Limbic system: monitors emotions and anticipation of activity
- Hypothalamus: monitors body temperature

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5
Q

The medulla oblongata sends what kind of signals where?

A

Sends autonomic motor output to pacemaker cells, myocardium and blood vessels.

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6
Q

Describe the sympathetic innervation of the heart as part of motor output from the medulla oblongata.

A

Sympathetic innervation (via cardiac accelerator nerves): of pacemaker and myocardial cells increases HR and contractility.

Sympathetic neurons exit the spinal cord in the upper thoracic region.

Innervate:
- the SA and AV nodes
- atrial and ventricular myocardium

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7
Q

What are baroreceptors and where are they located? How are they stimulated?

A

Pressure-sensitive sensory receptors (mechanoreceptors) located in the wall of the aortic arch and the carotid sinuses.

Stimulated when mechanoreceptors are stretched with increased BP

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8
Q

Carotid sinus baroreceptors monitor blood flow to… and nerve impulses are carried to the medulla oblongata via the…?

A

to the brain

by the Glossopharyngeal nerve (CN IX)

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9
Q

Aortic arch baroreceptors monitor blood flow to… and nerve impulses are carried by the…?

A

to the systemic circulation

by the Vagus nerve (CN X)

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10
Q

What is the baroreceptor reflex?

A

Change in BP is detected by the mechanoreceptors in the aortic arch and the carotid sinuses.

Nerve impulses travel to the medulla oblongata by the vagus and glossopharyngeal nerves.

The medulla oblongata has a sympathetic (low BP) or parasympathetic (high BP) response.

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11
Q

Describe the sympathetic cardiac effects on HR.

A

NE released form sympathetic neurons binds to B1-adrenergic receptors in pacemaker cells

Causing an increase in Na+ and Ca2+

Pacemaker cells reach threshold more quickly = increased HR

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12
Q

Describe sympathetic cardiac effects on contractility.

A

NE binds to B1-adrenergic receptors on cardiac muscle cells

Opens Ca2+ channels

Ca2+ influx increases contractility

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13
Q

Describe the parasympathetic innervation of the heart as part of the motor response of the medulla oblongata.

A

Parasympathetic innervation (via vagus nerve): of pacemaker and myocardial cells decreases HR.

Innervates:
- SA and AV nodes
- Atrial myocardium

Ach released from parasympathetic neurons binds ot cholinergic receptors on pacemaker cells

Results in the efflux of K+ causing hyperpolarization

Pacemaker cells reach threshold more slowly = decreased HR

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14
Q

Describe the vasomotor effects.

A

Vasomotor centre in the medulla oblongata receives input from baroreceptors.

Sympathetic vasomotor nerves exit the spinal cord through all thoracic and the first two lumbar spinal nerves

Vascular smooth muscle cells contain adrenergic receptors

Alpha-1 receptors (most blood vessels):
- bind NE
- stimulates smooth muscle contraction and vasoconstriction

Beta-2 receptors (coronary and skeletal muscle vessels):
- greater affinity for epinephrine
- stimulates smooth muscle relaxation and vasodilation

Stimulation of the vasomotor centre causes venoconstriction and the mobilization of venous reserve

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15
Q

Adrenal catecholamines (epinephrine and norepinephrine) and antidiuretic hormone are stimulated to release in response to?

A

The baroreceptor reflex. These aid in regulation of BP.

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16
Q

What happens to the baroreceptor reflex with age?

A

Baroreceptors become less sensitive with age (less effective and lead to a slower response).

Change in position from sit to stand, receptors don’t respond as quickly (BP does not rise) and hypotensive signs occur (dizziness or blurred vision) = orthostatic hypotension.

17
Q

What are the 4 hormonal mechanisms for BP regulation?

A
  1. renin-angiotensin-aldosterone system (RAAS)
  2. antidiuretic hormone (ADH)
  3. Adrenal catecholamines
  4. Natriuretic peptides
18
Q

The RAAS is activated by?

A
  1. reduced renal perfusion (e.g. decreased BV or BP)
  2. sympathetic activation of juxtaglomerular cells
19
Q

What happens when the RAAS is activated?

A

Juxtaglomerular cells release renin into the blood

Renin converts angiotensinogen (from the liver) to angiotensin I

Angiotensin I enters lung capillaries containing angiotensin-converting enzyme (ACE) and is converted to angiotensin II (AII)

20
Q

What does angiotensin II (AII) do?

A
  1. potent vasoconstrictor
  2. stimulates aldosterone release (adrenal gland)
  3. stimulates ADH release (posterior pituitary gland)
21
Q

What does aldosterone do?

A

Mainly targets tubule cells of the kidney.

Stimulates synthesis of Na+ channels and Na+/K+ pumps = Na+ reabsorbed, water follow by osmosis, and K+ excreted.

22
Q

Where is antidiuretic hormone released from and how is it simulated?

A

Released from the posterior pituitary in response to:

  1. Activation of osmoreceptors (increased blood osmolality)
  2. Increased angiotensin II (activation of the RAAS)
  3. sympathetic activation of the hypothalamus
23
Q

What does antidiuretic hormone (ADH) do?

A

Stimulates the insertion of aquaporins (water channels) into the plasma membrane of kidney tubule cells = stimulates water reabsorption = increases blood volume.

Is a vasoconstrictor (also called a vasopressin).

24
Q

What is the RAAS effect on the hypothalamus?

A

Increases thirst

25
Q

What are the types of natriuretic peptides? What stimulates their release?

A

Atrial natriuretic peptide (ANP) = released by atrial muscle

B-type natriuretic peptide (BNP) = released by ventricular muscle cells

Release stimulated by excessive stretching (dilation) of the atrium or ventricle.

26
Q

What are the renal effects of natriuretic peptides?

A

Dilates afferent arterioles of kidneys = diuresis

Suppresses renal reabsorption of Na+ = natriuresis

Decreases renin (and thus angiotensin II and aldosterone)

27
Q

What are the arterial and venous effects of natriuretic peptides?

A

Arterial dilation = decreases vascular resistance

Venous dilation = decreased venous return

28
Q

What is the effect of the vasoactive substances: nitric oxide, prostacyclin and endothelin when released from endothelial cells?

A

Nitric oxide = vasodilation, inhibited platelet aggregation.

Prostacyclin = vasodilation and platelet inhibition

endothelin = potent vasoconstrictor