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Physiology > Cardiovascular Physiology 4 Arterial Pressure Cardiovascular Disease > Flashcards

Cardiovascular Physiology 4 Arterial Pressure Cardiovascular Disease Flashcards

1
Q

what happens to hydrostatic pressure in the capillary if flow in > flow out

A

increases

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2
Q

what is the function of the arterial system and its regulation

A

keep MAP constant
-regulation: systemic

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3
Q

what is the flow out of the arterial system controlled by

A

TPR

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4
Q

what is the flow into the capillary system controlled by

A

resistance of tissue arteriole

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5
Q

what is the function of the capillary system

A

deliver O2 and nutrients, pick up CO2 and other metabolic waste

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6
Q

what controls the capillary system

A

local (active hyperemia)- match tissue blood flow to tissues metabolic activity

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7
Q

what is the flow to tissues in the capillary system controlled by (formula)

A

F tissue= MAP/R of tissue arteriole

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8
Q

what is the flow out of the capillaries dependent on

A

venous pressure

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9
Q

what is the function of the venous system

A

-peripheral venous pressure
- venous return

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10
Q

what is the regulation of the venous system

A

systemic

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11
Q

what does the baroreceptor reflex respoond to

A

changes in blood volume and/or MAP

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12
Q

what does a decrease in blood volume do to Venous pressure ,VR, atrial pressure, EDV, SV,CO and BP

A

decreases everything

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13
Q

describe the baroreceptor reflex

A

-stimulus: change in MAP
-reflex receptor: baroreceptors
-afferent pathway: visceral sensory neurons
-integrating center: medullary CV control centers in medulla oblongata (brainstem)
-efferent pathway: autonomic motor neurons
-effectors: cardiac muscle (AR and contractile cells), arteriolar smooth muscle, venous smooth muscle
-effector response: change rate and force of contraction (CO), change arteriolar resistance (TPR), change venous tone (VR -> EDV -> CO)
-feedback regulation: negative

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14
Q

what is happening with the sympathetic and parasympathetic nervous systems during the baroreceptor reflex

A

-decrease in sympathetic outflow to heart, arterioles, veins
- increase in parasympathetic outflow to heart

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15
Q

where are baroreceptors located

A

mainly aortic arch and carotid arteries but also large systemic veins, the pulmonary vessels, and the walls of the heart

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16
Q

what are the functions of the baroreceptor reflex

A
  • immediate changes to restore MAP to homeostatic level
  • allows time for other mechanisms to occur to eliminate disturbance
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17
Q

what happens to the baroreceptor reflex with prolonged increased MAP over time

A

adapt overtime and decrease rate of firing
-reflex functions around a higher than normal setpoint

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18
Q

how does high arterial pressure regulate blood volume? how does low blood volume negatively inhibit arterial pressure

A

decreases it
-acts on kidneys to increase excretion of water and sodium

negative feedback by acting on cardiac muscle to decrease CO, SV< EDV, VR, and VP

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19
Q

how does high blood volume regulate arterial pressure? how does arterial pressure negatively inhibit high blood volume

A

increases it
-acts on cardiac muscle to increase VP, VR, EDV, SV, and CO

negative feedback by increasing kidney excretion of water and sodium

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20
Q

what are some other stimuli that increase MAP

A

-decreased arterial [O2]
-increased arterial [CO2]
-decreased brain blood flow
-pain originating in skin
- stress
-anger
-eating
- sexual activity

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21
Q

what are stimuli that decrease MAP

A

-pain originating in viscera or joints
- sleep
-happy mood

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22
Q

what are the 4 causes of hypotension

A

-hemorrhage
-shock
- orthostatic
- other causes

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23
Q

what are the RAPID compensatory mechanisms for hemorrhage and explain each

A
  • baroreceptor reflex: returns MAP toward normal, increases CO and TPR
  • autotransfusion: movement of ISF, arteriolar constriction causing decreases Pc, net absorption of fluid into capillary
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24
Q

what is the LONG TERM compensatory mechanism of hemorrhage and describe each

A

-endocrine system: ANGII, aldosterone, ADH, erythrothropoietin
-behavior: thirst and consumption of water

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25
Q

what is shock

A

a condition in which there is inadequate blood flow to meet tissue needs

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26
Q

what are the 3 types of shock

A

-hypovolemic shock
- vascular shock
- cardiogenic shock

27
Q

what is hypovolemic shock and what are the causes

A

-most common, results from a large loss of blood
-causes: hemorrhage, severe vomitting, severe diarrhea, and extensive burns

28
Q

what is vascular shock and what are the causes

A

-blood volume is normal but circulation is poor due to abnormal expansion of the vascular bed caused by extreme vasodilation. huge drop in TPR leads to a drop in MAP
-causes:
anaphylaxis- loss of vasomotor tone due to allergic reactions
neurogenic shock- loss of autonomic control
septic shock- loss of vasomotor tone due to infections in the blood stream

29
Q

what is cardiogenic shock and what are the causes

A
  • this is pump failure, the heart can not sustain adequate circulation
    -causes: myocardial damage following a severe MI or multple MIs
30
Q

what is orthostatic hypotension and what is it causes by

A

-drop in MAP upon standing
-cause: effects of gravity cause a decrease in VR -> decrease in EDV -> decrease SV -> decrease CO -> decrease in MAP

31
Q

what are the effects of training of cardiac performance

A

heart accomplishes same amount of work with less beats

32
Q

what is hypertension defined as

A

chronically elevated MAP

33
Q

why is hypertension a silent killer

A

most people dont know they have it until it has caused significant damage

34
Q

what are the two forms of hypertension and what is the incidence and cause of both

A

-primary (essential) hypertension- 90%- idiopathic
- secondary hypertension- 10%- secondary to disease state. can be treated by treating disease

35
Q

what are factors that are involved in the development of hypertension

A

-diet: high sodium, cholesterol
obesity
-age (signs appear around 40 y/o)
-gender (males> females until menopause)
-DM
- genetics (runs in families, black more prevalent than whites)
- stress
-smoking

36
Q

what are the diseases associated with secondary hypertension

A

-tumor of the adrenal medulla (excess EPI)
- cushings disease (glucocorticoid excess)
-atherosclerosis of the renal arteries (RAS)
- renal hypertension (kidney disease)(RAS)
-arteriosclerosis
- hyperthyroidism (TH excess)

37
Q

what are the treatments for hypertension

A

-diuretics
-beta-adrenergic receptor blockers (beta blockers)
- calcium channel blockers
- renin angiotensin aldosterone system inhibitors/blockers
-sympathetic nervous system modulators

38
Q

what are the two pharmacologically relevant alpha receptors for hypertension and what to they do and where are they located

A

-alpha 1- peripheral receptor - stimulate VSM to contract
- alpha 2- central receptor- inhibit NE and EPI secretion

39
Q

what are the two types of vascular remodeling in hypertension

A

inward eutrophic remodeling and hypertrophic remodeling

40
Q

what happens in inward eutrophic remodeling

A

-small vessels that constrict in response to increased MAP
- VSM growth around narrowed lumen
- no change in total cross sectional area of vessel

41
Q

what happens in hypertrophic remodeling

A

-large vessels that do not constrict in response to increased MAP
-size of VSM cells increase
-increase in EC matrix proteins to support wall
-increase in total cross sectional area of vessel
- makes large vessels stiffer (less compliant)

42
Q

what are the 2 types of flow in vessels

A

laminar flow and turbulent flow

43
Q

what can turbulent flow cause

A
  • damage to endothelial cells and plaque development in wall of BV
  • bruits and murmurs
    -increases friction and the energy required to drive flow
  • increases the possibility of thrombotic events
44
Q

when does laminar flow occur

A

when vessels are straight, endothelium is healthy, and smaller vessles

45
Q

where is the velocity of flow greater in laminar flow in the BV

A

in the center of the vessel compared to the outside

46
Q

describe the type of laminar flow

A

parabolic profile of flow

47
Q

what is shear in laminar flow and what can it cause

A

when adjacent layers of blood move at different velocities- can break up RBC aggregates

48
Q

what is reynolds number (Re)

A

the calculation of the tendency for turbulent flow

49
Q

what does it mean if Re is greater than 2000

A

flow is mostly likely turbulent

50
Q

what does it mean if Re is greater than 3000

A

always turubulent

51
Q

what causes turbulent flow

A

increased velocity of blood flow, increased diameter of vessel, increased density of blood, decreased viscosity of blood (hematocrit)

52
Q

what is heart failure (CHF) defiend as

A

heart fails to pump adequate CO

53
Q

what are the two types of CHF

A

-diastolic dysfunction
-systolic dysfunction

54
Q

what happens in diastolic dysfunction

A

-ventricles have reduced compliance
-creates problems with ventricular filling
-reduced EDV

55
Q

what is the most common cause of diastolic dysfunction in CHF

A

hypertension- ventricular hypertrophy

56
Q

what happens in systolic dysfunction

A

-ventricle has reduced contractility
-decreased SV at any given EDV

57
Q

what is the most common cause of systolic dysfunction

A

myocardial damage as a result of myocardial infarct

58
Q

what are the treatments for CHF

A

-diuretics
- beta blockers
- cardiac inotropic drugs
- renin-angiotensin-aldosterone system inhibitors/blockers

59
Q

why does systemic Pc increase during right heart failure and not during left heart failure

A

accumulation of volume in systemic criculation

60
Q

what type of heart failure is pulmonary edema seen in

A

LHF

61
Q

what does the baroreceptor reflex do

A

alters Co and TPR to restore MAP to homeostatic levels

62
Q

what system mediates the baroreceptor reflex

A

the nervous system

63
Q

how fast is the baroreceptor reflex

A

short term response (minutes to hours)

64
Q

can the baroreceptor reflex override local control

A

yes

Physiology (41 decks)

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