Control of Blood Pressure Flashcards

1
Q

which vessels are muscular and elastic?

A

arteries

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2
Q

describe arterioles

A

thinner than main arteries but muscular

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3
Q

which vessels are thinned walled, burst under high pressure because they can not change diameter?

A

capillary

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4
Q

what do veins and venules act as?

A

conduits and reservoirs

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5
Q

where is approx 70% of blood volume within circulation?

A

in venous circulation - they act as drainage and have large diameter vessels and can enter active circulation whenever

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6
Q

what are conduits?

A

channel for conveying water/ fluid

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7
Q

define heart rate

A

number of times the heart beats in a minute

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8
Q

what is a normal heart rate?

A

60-100 bpm

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9
Q

define stroke volume

A

volume of blood ejected from the heart in one beat

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10
Q

what is the stroke volume at rest usually?

A

70ml per beat

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11
Q

what is cardiac output?

A

the volume of blood ejected from the heart per minute

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12
Q

what is usual cardiac output?

A

5l of blood pumped in a minute

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13
Q

what is classed as bradycardic?

A

less than 60bpm

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14
Q

what bpm starts to show signs of bradycardia?

A

50 or less

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15
Q

what is tachycardia?

A

heart rate greater than 100 bpm

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16
Q

what is the calculation to get Cardiac output?

A

SV x Hr

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17
Q

define mean arterial blood pressure

A

average pressure exerted by the blood on the walls of major arteries

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18
Q

what is an average MABP at rest?

A

107mmHg

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19
Q

why is peripheral resistance hard to measure?

A

invasive procedure - aortic catherization

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20
Q

what three factors affect arterial blood pressure?

A
  1. circulatory volume (stroke vol)
  2. force of ventricular contraction
  3. elasticity of arteries
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21
Q

can stroke volume be altered?

A

yes - endurance exercises

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22
Q

what happens to arterial elasticity with age?

A

arterial stretch declines with age. Gradual thickening and changes in wall content - less elastin, advanced glycation, more inflammation, build up of ROS

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23
Q

what is the pressure of MABP as it reaches RA?

A

0 - end of journey

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24
Q

what three factors affect resistance?

A
  1. viscosity of blood
  2. length of vessels
  3. radius of vessels
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25
Q

for every pound you put on, how much more vessels are made?

A

5 miles

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26
Q

which vessels have the largest role to play within vascular resistance?

A

arterioles, capillaries and venules

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27
Q

when does the blood have the fastest velocity?

A

through aorta and arteries but it fluctuates with each beat

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28
Q

which nerve slows the heart rate down?

A

vagus nerve

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29
Q

how does the vagus nerve slow heart rate?

A

cardioinhibitory works via parasympathetic systems. The activity of the vagus nerve results in Ach being released

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30
Q

which cranial nerve is the vagus nerve?

A

X

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31
Q

what increases the heart rate? (system)

A

cardio-accelarator via sympathetic NS where noradrenaline is released

32
Q

where does the glossopharyngeal nerve do?

A

provides sensory information from baroreceptor to medulla.

33
Q

which cranial nerve is the glossopharyngeal?

A

cranial nerve IX

34
Q

where are the baroreceptors within the heart

A

arch of aorta and carotid sinus of the brachiocephalic artery

35
Q

what are sensory neurones known as and where do they go?

A

afferent - go back to the brain

36
Q

what are motor neurones and where do they go?

A

efferent and go to organs/ muscles

37
Q

during rest what are the sympathetic and parasympathetic NS doing to the heart?

A

providing slight stimulation contributing to autonomic tone

38
Q

what is the role of baroreceptors?

A

detect change in pressue

39
Q

How do baroreceptors detect change in blood pressure?

A

by atrial stretch - the more they are stretched the higher the blood pressure and the more they fire signals

40
Q

what do atrial myocytes releae?

A

atrial natriuretic peptides

41
Q

what do ANP do?

A

vasodilate
promotes Na+ secretion (water follows)
inhibits secretion of ADH (vasopressin)
only mechanism to lower BP

42
Q

what is the NICE definition of hypertension?

A

having high blood pressure measurement that is consistently above 140/90 mmHg

43
Q

how many people worldwide are affected by hypertension?

A

16 million people

44
Q

what primary hypertension is also known as?

A

essential hypertension

45
Q

is primary hypertension common?

A

yes -97% of hypertension cases

46
Q

what does primary hypertension mean?

A

no clear cause - many factors involved

47
Q

what can cause primary hypertension?

A
  1. haemodynamic factors
  2. physiological factors
  3. lifestyle
48
Q

what are haemodynamic and physiological factors contributing to hypertension

A
  • total circulating fluid volume
  • vascular resistance
  • plasma renin activity
  • malfunctioning ion channels/ pumps in peripheral vasculature can lead to chronic increased stroke volume
49
Q

what can contribute to lifestyle factors contributing to hypertension?

A

diet, stress, sodium intake, alcohol use, medications, drug use, oral contraceptives, corticosteriods

50
Q

define secondary hypertension

A

another underlying disease eg CKD, atherosclerosis

51
Q

can hypertension fluctuate?

A

yes - during normal daily activities eg sleeping (lower)

52
Q

define polycythaemia and what is another name for it?

A

increased red blood cells - erthyocytosis

53
Q

where are baroreceptors within the kidney?

A

juxtaglomerular cells

54
Q

where is adrenaline released from?

A

adrenal medulla in response to lowered BP

55
Q

what are the functions of adrenaline?

A
  1. speeds up Hr
  2. increases force of ventricular contraction
  3. dilate skeletal muscle and constricts splanchnic vascular beds
  4. diverts blood to other places that needs eg shifts to muscles in fight or flight response is triggered
56
Q

what is splanchnic ciruclation?

A

goes to organs within abdo cavity

57
Q

what is antidiuretic hormone is also known as?

A

vasopressin

58
Q

where is ADH released from?

A

released from posterior part of pituitary in response to decreased blood pressure and increased plasma osmolarity

59
Q

how does alcohol effect ADH?

A

slows down the release of ADH

60
Q

how does ADH work?

A
  1. promotes reabsorption of water in the kidney
  2. constricts blood vessels
61
Q

where is renin released from?

A

juxtaglomerular cells in the wall of the afferent arterioles of kidney glomeruli

62
Q

when is renin released in response to?

A

to lower kidney perfusion caused by lowered BP

63
Q

what does ACE do?

A

convert angiotensin I to angiotensin II

64
Q

what does angiotensin lead to the secretion of?

A

aldosterone

65
Q

what does aldosterone do?

A

reabsorb NaCl2 and H20

66
Q

what is the medical terms of extreme thirst?

A

dipsogenic/ polydipsia

67
Q

what is hyperplasmia?

A

enlargement of organ/ tissues by cell proliferation

68
Q

what is polyuria?

A

constant need to wee

69
Q

Does ANP affect renin?

A

can slow the release of renin

70
Q

where is ACE produced?

A

in the lungs

71
Q

where is ACE released from?

A

kidneys

72
Q

what is conn’s disease?

A

primary aldosteronism

73
Q

how does conn’s present as?

A

symptoms - polydipsia, polyuria, persistent hypokalaemia

74
Q

what is the pathology of conns disease?

A

high levels of plasma aldosterone

75
Q

what causes primary aldosteronism?

A

tumours/ hyperplasia of the cortex

76
Q

how is conns managed?

A

laproscopic removal of adrenal gland
spironoactone

77
Q

what can cause hypotension?

A

dehydration
heart failure
heart attack
shock
orthostatic hypotension