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MBBS CPRS > CPRS 29 30: Blood Flow and Blood Pressure > Flashcards

CPRS 29 30: Blood Flow and Blood Pressure Flashcards

1
Q

What is the formula for calculation of Mean Arterial Pressure

By stroke volume, heart rate, total peripheral resistance

A

Stroke volume x Heart Rate x Total Peripheral Resistance

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2
Q

Laplace equation: How to calculate tension?

A

Transmural pressure x (Vessel radius/vessel wall thickness)

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3
Q

Which section in the blood vessels have the highest resistance?

A

Arterioles

NOT capillaries

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4
Q

Name 3 assumptions in resistance calculation

  • Vessel is ______ and _____ and has constant _____
  • Blood flow is ________ and _______
  • Blood has constant _________
A

Name 3 assumptions in resistance calculation

  • Vessel is straight, cylindrical and have constant radius
  • Blood flow is laminar and steady
  • Blood has constant viscosity
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5
Q

Why does veins have higher compliance (lower elasticity) than arteries?

Because arteries have thicker ___________ making it more difficult to change shape

After aging of arteries, the arterial wall gets even thicker. The artery will be _______ elastic (less or more)

A

Why does veins have higher compliance (lower elasticity) than arteries?

Because arteries have thicker collagen fibres/ elastic fibres making it more difficult to change shape

After aging of arteries, the arterial wall gets even thicker. The artery will be more elastic (less or more)

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6
Q

Normal Arteries
- Systole: After blood ejection from the left ventricle, small portion of blood leaves the aorta immediately. Some remains in the aorta and stretch the aorta, which increases the aortic pressure.

-Diastole: After elastic recoil, there is minor backflow of blood that closes the _______ and most blood are pushed towards downstream

Rigid Arteries
- Systole: Volume of blood equal to the entire ________ will leave the aorta which increases the aortic pressure by a lot

  • Diastole: Blood flow will _____________
A

Normal Arteries
- Systole: After blood ejection from the left ventricle, small portion of blood leaves the aorta immediately. Some remains in the aorta and stretch the aorta, which increases the aortic pressure.

-Diastole: After elastic recoil, there is minor backflow of blood that closes the aortic valve and most blood are pushed towards downstream

Rigid Arteries
- Systole: Volume of blood equal to the entire stroke volume will leave the aorta which increases the aortic pressure by a lot

  • Diastole: Blood flow will cease
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7
Q

Name the systolic and diastolic pressure range for the following

Normal:
Prehypertension:
Hypertension Stage 1:
Hypertension Stage 2:

A

Name the systolic and diastolic pressure range for the following

Normal: <120; <80
Prehypertension: 120-139; 80-89
Hypertension Stage 1: 140-159; 90-99
Hypertension Stage 2: >160; >100

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8
Q

Name the vascular shunt when all the precapillary sphincters are closed/ fully contracted

A

Metarteriole

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9
Q

For the smooth muscles, what are the dense body made of?

A

Vimentin and Desmin

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10
Q

What are the details of process during the smooth muscle contraction process?

  1. Increase Ca2+ due to increase _________ and increased influx of Ca2+
  2. More Ca2+ binds to __________
  3. __________ binds and activates more ________
  4. More MLCK _______________
  5. Increase myosin heads binding to actin facilitating contraction
A

What are the details of process during the smooth muscle contraction process?

  1. Increase Ca2+ due to increase CICR and increased influx of Ca2+
  2. More Ca2+ binds to Calmodulin (CaM)
  3. Ca2+-CaM binds and activates more MLCK
  4. More MLCK phosphorylates more myosin
  5. Increase myosin heads binding to actin facilitating contraction
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11
Q

What are the details for the smooth muscle relaxation process?

  1. Decrease in Ca2+ due to __________ and _____________
  2. Decrease Ca binding to ________
  3. Decreased formation of __________ complex
  4. Decrease MLCK which___________

or

Phosphorylates _________ so it becomes less sensitive to be activated by _______________

A

What are the details for the smooth muscle relaxation process?

  1. Decrease in Ca2+ due to Ca2+ pumped in SR by SERCA and Ca2+ pumped out by Ca2+ ATPase
  2. Decrease Ca binding to Calmodulin (CaM)
  3. Decreased formation of Ca2+-CaM complex
  4. Decrease MLCK which phosphorylates less myosin

or

Phosphorylates MLCK so it becomes less sensitive to be activated by Ca2+-CaM

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12
Q

By T = Transmural pressure x (Radius/thickness of vessel)

When blood pressure increases, what will happen

When vessel radius reduces, what will happen

A

By T = Transmural pressure x (Radius/thickness of vessel)

When blood pressure increases, what will happen
The transmural pressure increases, tension increases

When vessel radius reduces, what will happen
Tension reduces

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13
Q 
Consider Nitric Oxide
- Endothelium derived vasoconstrictor/ vasodilator?
- Agonists?
- Mechanism of action:
Activates \_\_\_\_\_\_\_\_
More \_\_\_\_\_\_ becomes \_\_\_\_\_\_
Increase activity of \_\_\_\_\_\_\_\_\_\_
Increase phosphorylation of \_\_\_\_\_\_\_\_\_
Increase \_\_\_\_\_\_ Ca2+ sequestration by SR
Smooth muscle relaxation
A 
Consider Nitric Oxide
- Endothelium derived vasodilator
- Agonists: Acetylcholine, Histamine
- Mechanism of action:
Activates guanylyl cyclase
More cGTP becomes cGMP
Increase activity of Protein Kinase G
Increase phosphorylation of MLCK
Increase SERCA Ca2+ sequestration by SR
Smooth muscle relaxation
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14
Q 
Consider Prostaglandin I2
- Endothelium derived vasoconstrictor/ vasodilator?
- Mechanism of action:
Activates \_\_\_\_\_\_\_\_
More \_\_\_\_\_\_ becomes \_\_\_\_\_\_
Increase activity of \_\_\_\_\_\_\_\_\_\_
Increase phosphorylation of \_\_\_\_\_\_\_\_\_
Increase \_\_\_\_\_\_ Ca2+ sequestration by SR
Smooth muscle relaxation
A 
Consider Prostaglandin I2
- Endothelium derived vasodilator?
- Mechanism of action:
Activates adenylyl cyclase
More cATP becomes cAMP
Increase activity of Protein Kinase A
Increase phosphorylation of MLCK
Increase SERCA Ca2+ sequestration by SR
Smooth muscle relaxation
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15
Q 
Consider Endothelin-1
- Endothelium derived vasoconstrictor/ vasodilator?
- Mechanism of action:
Activates \_\_\_\_\_\_\_\_
Increase \_\_\_\_\_\_ level in cytoplasm
Increase \_\_\_\_\_\_ bind on \_\_\_\_\_\_ receptors in SR
Increase Calcium release by SR
Increase \_\_\_\_\_\_ activity
Increase smooth muscle contraction
A 
Consider Endothelin-1
- Endothelium derived vasoconstrictor?
- Mechanism of action:
Activates Phospholipase C (PLC)
Increase IP3 level in cytoplasm
Increase IP3 bind on IP3 receptors in SR
Increase Calcium release by SR
Increase MLCK activity
Increase smooth muscle contraction
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16
Q 
Classify the following as Vasodilator or Vasoconstrictor
Angiotensin II
Acetylcholine
Epinephrine
Norepinephrine
A 
Classify the following as Vasodilator or Vasoconstrictor
Angiotensin II- Vasoconstrictor
Acetylcholine- Vasodilator
Epinephrine- Vasodilator
Norepinephrine- Vasoconstrictor
17
Q

Compare unitary smooth muscle VS multiunit smooth muscle

  • influence by neurons
  • apply to which blood vessels?
  • Gap junctions?
A

Compare unitary smooth muscle VS multiunit smooth muscle

  • bunch of smooth muscle cells influenced by single neuron VS smooth muscle cells influenced individually by different neurons
  • In most blood vessels VS In aorta or large elastic arteries
  • Smooth muscle cells connected by gap junctions VS not connected by gap junctions
18
Q

In splanchnic circulation (activated when a person thinks about food), the CNS will initiate a response to increase the splanchnic blood flow

In this circulation, what substance is required for vasoconstriction, what substance is required for vasodilation?

A

Constriction: NE
Dilatation: Adenosine

19
Q

Coronary blood flow is higher during

systole or diastole?

20
Q

During exercise, the circulation would be as follows:

  • _____ binds to alpha receptors on VSMC to cause vasoconstriction of ______ muscles
  • _______ is responsible for vasodilatation of arterioles in ______ muscles
  • Will reduce ______ circulation so the blood flow is diverted more to skeletal muscles
A

During exercise, the circulation would be as follows:

  • NE binds to alpha receptors on VSMC to cause vasoconstriction of inactive muscles
  • Adenosine is responsible for vasodilatation of arterioles in active muscles
  • Will reduce splanchnic circulation so the blood flow is diverted more to skeletal muscles
21
Q

When there is increased arterial pressure, what is the response after detected by baroreceptors?

A

When there is increased arterial pressure, what is the response after detected by baroreceptors?

Decrease cardiac output
Decrease peripheral resistance

Finally: Decrease in mean arterial pressure
(P=COxTPR)

22
Q

When there is decreased arterial pressure, it will stimulate chemoreceptors. What are the responses

A

Increase cardiac output
increase peripheral resistance

Finally: Increase in mean arterial pressure
(P=COxTPR)

23
Q

When the initial heart rate is low, what type of reflex will be triggered?

When the initial heart rate is high, what type of reflex will be triggered?

A

When the initial heart rate is low, what type of reflex will be triggered? Bainbridge reflex, causing acceleration of heart rate

When the initial heart rate is high, what type of reflex will be triggered? Baroreceptor reflex, cause decrease in heart rate

24
Q

When Tension is too high, the first step to reduce tension is called Inward Eutrophic Remodelling.

By Tension = Transmural pressure x (radius/thickness), deduce what will happen

But what will happen if it’s prolonged?

A

When Tension is too high, the first step to reduce tension is called Inward Eutrophic Remodelling.

By Tension = Transmural pressure x (radius/thickness), deduce what will happen next

Decrease radius (Vasoconstriction)
Prolonged: Lead to increased resistance due to prolonged vasoconstriction
25
Q

When Tension is too high, the first step to reduce tension is called Inward Eutrophic Remodelling.

The radius of vessel will reduce, in order to reduce the tension. What if it is still not enough to reduce the tension,

It will undergo hypertrophic remodelling. What is the principle behind it?

A

When Tension is too high, the first step to reduce tension is called Inward Eutrophic Remodelling.

The radius of vessel will reduce, in order to reduce the tension. What if it is still not enough to reduce the tension,

It will undergo hypertrophic remodelling. What is the principle behind it?

To increase the deposition of extracellular matrix proteins, like collagen or fibronectin, so that the vessel wall will thicken, which reduces the tension

By Tension = Transmural pressure x (radius/thickness), deduce what will happen

MBBS CPRS (44 decks)

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