Control of Vascular Resistance Flashcards

1
Q

What leads to release of NO? Mechanism?

A

ACh. Ca2+ influx activates eNos, argine -> citrilline producing NO. NO diffused out of endothelium into muscle cell where it activates guanylyl cyclase. GTP -> GMP and PKC leading to relaxation

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2
Q

Other endothelium derived vasodilators?

A

EDHF - hyperpolarises the membrane, preventing contraction

Prostacyclin - generated from AA by COX, reduces intracellular Ca2+ via cAMP pathway and MLCK activity

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3
Q

Endothelium derived vasoconstrictor?

A

Endothelin - binds ET-R on SMC to increase intracellular Ca2+ and SMC contraction

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4
Q

What is the effect of atherosclerosis?

A

Reduces production of NO. Vasculature will still react in the same way as non-pathologica tissue if exposed to an NO donor.

Uncoupling of NO synthesis due to lack of availability of BH4 or arginine produces superoxide which can further damage the endothelium.

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5
Q

Why control blood flow?

A

Reduce cardiac work

Adequately meet metabolic needs

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6
Q

How is blood flow controlled? (general)

A
Hormones
Local mediators
Metabolites
Nerves
Angiogenesis
Physical factors
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7
Q

Where do metabolic vasodilators act?

A

Terminal resistance arterioles

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8
Q

3 mechanisms of autoregulation?

A

Myogenic mechanism
Vasodilator washout
Tissue fluid pressure

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9
Q

Myogenic mechanism?

A

Proposed by Bayliss, 1902. Increased perfusion pressure increases wall tension, VSMC contracts when stretched and relaxes when passively shortened. Action purely myogenic, no mediators required. Involves activation of L-type Ca2+ channels and PKC to enhance contractility. Braking mechanism includes Ca2+ activated K+ channels and shear induced NO release.

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10
Q

Tissue pressure mechanism of autoregulation?

A

Increased perfusion pressure increases flow out of capillaries, increasing tissue vol and therefore pressure. This reduces the transmural pressure distending the vessel, increasing vessel resistance and therefore reducing flow.

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11
Q

Vasodilator washout mechanism of autoregulation?

A

Increased blood flow washes out local vasodilators

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12
Q

What is active/metabolic hyperaemia?

A

Increased tissue metabolic activity causes local vasodilation due to release of local metabolites. Eg adenosine, K+, H+, hypoxia, Pi, hyperosmolarity, CO2

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13
Q

Reactive/ischaemic hyperaemia?

A

Due to myogenic response and local accumulation of vasodilators.

Risk of re-perfusion injury.

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14
Q
Effect hypoxia?
Effect hypercapnia?
Effect increased interstitial K+?
Effect of changes interstital ADP/ATP/adenosine?
Effect of decreased interstitial ATP?
A
Released adenosine, decreased intracellular ATP
Decreased pH
Depolarisation, opens VGCC
Activates purinergic-R 
Opens K-ATP channels
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15
Q

Effect of histamine?

A

Vasodilator. Released from mast cells and leukocytes in response to injury. Extravasation of plasma proteins. Leads to oedema and inflammation. Increases NO release fro endothelium via Histamine-R.

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16
Q

Effects of bradykinin?

A

Vasodilator formed by enzyme kallikrein during inflammation, contributes to hyperaemia by increasing No release from endothelium. Sensitises nerves.

17
Q

Effect 5-HT?

A

Derivative of tryptophan, released from platelets to cause vasoconstriction of arteries and veins.

18
Q

Effects thromboxane?

A

Formed from AA and released from platelets to cause vasoconstriction. Aspirin inhibits synthesis.

19
Q

Effect alpha-R? Effect beta-R? ACh-R?

A

Vasoconstrict. Vasodilate. Vasodilate.