Coordinated CVS responses: Gravity & Exercise Flashcards

1
Q

How are the everyday demands of life met through the CVS?

A

Many components of the CVS coordinate together to produce the everyday demands of life
adaptation by integration - small responses create a larger effect

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2
Q

What is orthostasis?

A

Standing up

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3
Q

How does CVS respond to orthostasis?

A

On standing up, CVS changes accordingly to the effect of gravity

  • BP falls at first
  • postural hypotension, lack of blood flow to brain = faint
  • Quickly recovers
  • due to homeostatic mechanism e.g. baroreflex
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4
Q

How does baroreflexes increase BP?

A

Increases BP by integrating 3 smaller changes by increasing:

  • Heart rate
  • Heart contractility
  • Total peripheral resistance
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5
Q

What is the effect of gravity on BP when lying down?

A

Lying down, pressure is the same at the head and the feet

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6
Q

How does BP change due to the effect of gravity during orthostasis?

A

When standing up blood pools at the feet increasing pressure

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7
Q

Outline Bernoulli’s Law

A

Blood flow = pressure energy + potential energy + kinetic energy

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8
Q

Using Bernoulli’s Law, describe the pressure change due to gravity during orthostasis

A

Increased potential energy but slightly lower pressure at the heart level compared to the feet
Increased kinetic energy of ejected blood

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9
Q

What is meant by total energies?

A

Total energies means the blood flow from the heart to the feet

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10
Q

How is pressure calculated?

A

pressure = phg

p- fluid density
h - height
g - gravitational acceleration constant

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11
Q

What does magnitude of pressure depend upon?

A

Pressure is dependent on the height of the fluid column, the density of the fluid and gravity

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12
Q

What is the high pressure at the feet caused by?

A

The high pressure in the venous system at the feet is due to hydrostatic pressure

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13
Q

Why are veins described as the capacitance levels of the body?

A

Store most of the blood volume

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14
Q

Why do arteries have higher pressure than veins?

A

Arteries are muscular and under sympathetic tone

- have higher pressure which distends at the bottom –> blood pools at feet

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15
Q

What is hypotension caused by?

A

Hypotension (decreased CVP) caused by orthostasis

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16
Q

Describe how Hypotension occurs due to orthostasis

A
orthostasis causes a fall in CVP 
-> decreased EDV
-> LV stretched less
-> Contracts less
-> less CO
-> Decreased BP 
-> poorer perfusion of brain 
=> dizziness and fainting
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17
Q

Describe the reflex response to orthostasis

A
  1. Less stimulation (unloading) of baroreceptors due to
    less LV stretching
  2. Lower afferent fibre activity to NTS
  3. Switches off inhibitory nerves from CVLM to RVLM
  4. Results in RVLM being more active, sending efferent
    signals to the heart
  5. Increased sympathetic drive to SA node and increased
    HR.
    Myocardium increased contractility, vasoconstriction
    (arterioles, veins) increases TPR.
    Less vagal parasympathetic activity to SA node
  • overall BP increased
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18
Q

What can cause postural hypotension to be worsened?

A
  • Generalised sympathetic or 𝛼 adrenergic blockade
  • drugs that reduce vascular tone
    e.g.
    side effect with VGCC blockers used to treat
    hypotension, angina etc.
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19
Q

What is a varicose vein?

A

enlarged / torturous vein

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20
Q

What are the consequences of varicose veins?

A
  • impairs venous return
  • valves become compromised
  • blood pooling in legs worsen
  • lack of skeletal muscle activity due to paralysis or forced
    inactvity (e,g. long term bed rest, soldiers on guard)
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21
Q

What can cause a reduction in circulating blood volume?

A

Haemorrhage

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22
Q

How is core temperature increased?

A

Peripheral vasodilation, less blood volume available

e.g. standing up after a bath

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23
Q

What is a major difference in the effect of blood volume distribution between gravity and microgravity?

A

In microgravity, it doesn’t matter if you’re standing up or lying down
- less need of ANS, RAAS, ADH, ANP systems to control
BP
- redistribution of blood into chest region

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24
Q

What are the initial effects of microgravity?

A

Blood doesn’t pool at feet
Returns to heart easily - increased preload, increased AV volume sensed by cardiac mechanoreceptors (Starling’s law)

Decreased sympathetic nerve activity (RAAS, ADH, & increased GFR, ANP and diuresis) = 20% reduction in blood volume

= heart muscle becomes weaker

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25
What are the long term effects on CVS of microgravity?
Less blood volume Reduced stress on heart heart reduces in muscle mass general drop in BP
26
What is the effect on CVS on return to gravity after microgravity exposure?
Severe postural hypotension due to a much smaller heart, baroreceptor reflex can't compensate
27
What is Dynamic exercise?
Constantly shortening and relaxing of different muscle groups
28
What is static exercise?
One specific muscle group being worked without constant movement
29
How are responses to different types of exercise initiated?
Integrated by central command in the brain
30
What is the response of the CVS to exercise?
Once exercise commences, feedback from muscles via mechanoreceptors and metaboreceptors will occur: - Increase lung O₂ uptake, transport around body & supply to exercising muscle - Control BP: despite huge changes in CO & TPR (protect heart from excessive afterload)
31
Why is it important to selectively target where O₂ is delivered in the body during exercise?
Need to selectively target areas where O₂ is delivered so coordinated dilation/constriction of vascular beds
32
During exercise, is the CVS under sympathetic or parasympathetic control?
Due to brain central command - early phase: sympathetic Muscle mechanoreceptors - vagal sympathetic Muscle metaboreceptors - sympathetic
33
How do such small adaptations control the response to exercise?
Integration of small adaptations creates overall large response to exercise
34
How does strenuous exercise effect O₂ uptake?
O₂ uptake by pulmonary circulation increases by 10 - 15x during strenuous exercise
35
What small changes integrate to cause the big change in the CVS during exercise?
- Increased HR - Increased SV - Increased (AV)O₂
36
Describe the changes in pulmonary circulation during exercise
Increased blood flow and greater O₂ gradient - increased lung uptake (AV)O₂ difference reaches a plateau at high exercise levels
37
What does O₂ uptake tell us about exercise done?
O₂ consumption tells us the amount of exercise undertaken
38
What effect does exercise have on CO?
During exercise SV reaches a maximum value Plateau phase on Starling's Curve and max contractility Diastolic time reduces so less Starling's Law & filling of the heart - there's a limit to CO
39
Describe the effect of exercise induced tachycardia on the CVS responses
Brain central command - ready for exercise Muscle mechanoreceptors - fast feedback on exercise being carried out HR increases from 65 to 195
40
What causes exercise induced tachycardia?
- Decreased vagal tone (SA and AV nodes) - Increased sympathetic activity (SA and AV nodes) - CO increases = 22 L/min - HR and SV increase
41
Why does stroke volume increase during exercise?
Increased Sympathetic activity - causes increased EDV Increased Venous return / CVP through venoconstriction Increased sympathetic and calf muscle pump => activates Starling's Law; preload increases
42
What causes faster ejection during strenuous exercise?
Increased contractility by sympathetic activation of β1 receptors (inotropic increase in Ca2+)
43
Why does the End systolic volume decrease?
There's increased ejection fraction due to an increase in SV Increased contractility by sympathetic activation of β1 receptors and Starling's Law
44
Why does vasodilation occur in arterioles during exercise?
Vasodilation of arterioles in active myocardium and skin during moderate exercise due to increased HR and CO
45
Why is there a fall in local resistance during leg exercise?
Fall in local resistance due to metabolic hyperaemia vasodilation Local sympathetic response and β2 mediated vasodilation via circulating adrenaline β2 adrenoceptor expression is high in skeletal muscle and coronary arteries
46
How does an increase in CO affect BP?
Large increase in CO = relatively small increase in BP due to dilated skeletal muscle arterioles, decreasing TPR => causes a large decrease in TPR
47
What is the purpose of compensatory vasoconstriction?
Compensatory vasoconstriction of non-essential circulations prevents hypotension due to exercise induced decreased TPR -> prevents BP from falling
48
Where does compensatory vasoconstriction take place?
- kidneys - GI tract - inactive muscle
49
What is the significance of central control (medulla)?
RVLM controls specific preganglionic sympathetic nerves in the spinal cord which send out postganglionic nerves to specific tissues
50
Which type of exercise raises BP most?
Static exercise increases BP more than dynamic
51
What is static exercise?
Constant contraction of a small number of muscles, high load | e.g. weight lifting
52
How does static exercise effect the rest of the body?
Muscles contracting statically but rest of body needs higher BP to allow blood flow to static vessels
53
What is Dynamic exercise?
Shortening / lengthening of many muscles - low load | e.g. running
54
How does dynamic exercise affect blood flow?
Need to reduce TPR and allow blood flow to active muscles
55
What are muscle metaboreceptors?
Small diameter fibres in skeletal muscles
56
How are metaboreceptors stimulated?
They are chemosensitive | stimulated by k+, H+, lactate - all which increase in exercising muscle
57
What type of reflex response is produced during exercise?
Pressor response - especially significant in isometric exercise (incraesed muscle load) produces tachycardia via increased sympathetic activity due to increased BP
58
How does increasing BP aid static exercising muscle?
Raised BP maintains blood flow to contracted muscle which contain dilated vessels (local) due to metabolism - selective metabolic hyperaemia
59
How is the requirement of an increased lung O₂ uptake managed by the CVS?
HR and SV is increased
60
How does the CVS increase O₂ transport in the body?
Increased extraction of O₂ from blood- Bohr effect
61
How is there a direct increase in O₂ supply to exercising muscle?
There's decreased vascular resistance in exercising muscle; metabolic vasodilation
62
How is BP stabilised by the CVS?
Vasoconstriction in non-exercising / unrequired tissue