Control of blood pressure

Question 1

what three factors in the maintenance of arterial blood pressure

Answer 1

1. blood volume
2. peripheral (systemic) vascular resistance (PVR or SVR, vaso constriction/dialation)
3. cardiac output (hr.sv)

Question 2

how does the neural control center control bp

Answer 2

CV conrtol in the medulla-> SNS impulses release norepi/epi-> then either:

1. excited alpha receptors in vessels-> vasoconstriction
2. excites beta receptors in heart-> increase hr-> increased force of cardiac contraction

Question 3

what are the two baroreceptors

Answer 3

1. arterial pressoreceptors

2. arterial receptors (volume receptors)

Question 4

how do arterial pressoreceptors work

Answer 4

1. sense changes in the “pressure” in the major arteries ia stretch
2. send impulses to SV conrol center to either increase or decrease SNS inhabition

Question 5

where are arterial pressoreceptors located

Answer 5

in aorta and carotid arteries

Question 6

how do arterial receptors work

Answer 6

sense changes in volume in large VEINS

Question 7

where are arterial receptors locatd

Answer 7

in vena cava and right atrium

Question 8

what is the chain for atrial receptors

Answer 8

decreased bp-> decrease blood flow through major arteries and venous return sensed by receptors-> sv control center-> DECREASES inhibition-> increased SNS response-> increased HR and force of contraction, vasoconstriction-> increased Bp

Question 9

how is angiotensin II made

Answer 9

decreased blood volume/flow to kidney-> stimulates kidney to release renin-> liver makes angiotensinogen-> renin and angiotensinogen combine to make angiotensin I-> ace in the lungs converts angiotensin I into angiotensin II

Question 10

what does angiotensin II do with kidneys

Answer 10

stimulates the adrenal cortex to increase the release of aldosterone which causes the kidneys to increase sodium reabsorption which increases blood volume and restores bp and volume

Question 11

what does angiotensin II do with the vessels

Answer 11

is a direct vasoconstrictor and acts on the receptors in the BV’s which increase BP

Question 12

what does angiotensin II do with the brain

Answer 12

acts on posterior pituitart and stimulates thirst, increased ADH to increase H2O resorption in the kidneys which raise blood volume and restores BP

Question 13

What are the two types of hypertension

Answer 13

primary

secondary

Question 14

what is primary hypertension

Answer 14

90%- no known cause- treatable

Question 15

what is secondary hypertension

Answer 15

10%- due to a known cause- fixed depending on cause

Question 16

what is the hypothesis of primary HTN

Answer 16

1. increase in BV
2. overstimulation of SNS
3. H2O + Na retention by kidneys (chronic)

Question 17

why does renovascular disease cause secondary HTN

Answer 17

renal stenosis or clot which stimulates the R/A system because kidneys don’t believe that the whole body is getting blood when it is actually just the kidney cuz of the clot

Question 18

what are the 3 patho of HTN

Answer 18

1. vascular cellular proliferation and damages arterial walls
2. thickening of basement mems and arteries
3. permanent narrowing and poor perfusion out of caps

Question 19

what are the clinical mani of mild to moderate HTN

Answer 19

may be asymptomatic or vague

Question 20

what are the symptoms with ADVANCED HTN

Answer 20

r/t increased pressure in arterial system and fragile caps:

1. headache, epistaxis (nosebleed)
2. dizziness, unsteadiness, blurred vision
3. retinopathy- retina damage
4. CAD
5. renal insufficiency

Question 21

what organs are most acutely affected by HTN

Answer 21

heart, brain, eyes, kidneys

Question 22

what are the matinence of HTN

Answer 22

drug therapy
exercise
diet
low Na+

Question 23

what is orthostatic hypotension

Answer 23

decrease in bp upon standing due to poor reflex vasoconstriction with dizziness, blurred vision, fainting

Question 24

what is shock

Answer 24

overall or generalized reduction of adequate blood flow and o2 delivery to the tissues

Question 25

what is hypovolemic shock

Answer 25

results from loss of circulating blood volume

Question 26

what are the causes of hypovolemic shock

Answer 26

hemorrhage
dehydration
burns/tissue trauma

Question 27

what are the clinical mani of hypovolemic shock

Answer 27

r/t decreased perfusion and compensatory mechanisms

1. Hypotension
2. tachy
3. oliguria (decreased urine output)
4. cool/pale skin (blood shunted)
5. restlessness, altered LOC

Question 28

what are the 3 stages of shock

Answer 28

non progressive
progressive
irreversible

Question 29

what is nonprogressive shock stage

Answer 29

Initial or early phase- referable

compensatory mechanisms are activated which maintain adequate perfusion to the tissues

Question 30

what is progressive shock stage

Answer 30

reversible

compensatory mechanisms are still activated but are unable to restore BP and perfusion

Question 31

what is the irreversible stage

Answer 31

inadequate compensation
ischemic cell death
multi organ dysfunction

Question 32

what is the patho of physical inactivity

Answer 32

skeletal muscles down regulate their capacity to burn fuel
decreased cap density
increased insulin resistance
decreased glucose transport across cell mems

Question 33

what is the patho with physical activity

Answer 33

decreased: LDL, VLDL, BP, insulin resistance, CRP, platelet aggregation, myocardial o2 demand
increased: HDL, CV function, coronary blood flow