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CVS > CVS Physiology 3: Regulation Of Blood Pressure. > Flashcards

CVS Physiology 3: Regulation Of Blood Pressure. Flashcards

1
Q

Definition: is the lateral pressure exerted by the blood on the walls of blood vessels?

A

Blood pressure.

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2
Q

Definition: systolic BP - diastolic DP.

A

Pulse pressure.

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3
Q

Definition: average arterial pressure during a cardiac cycle 85 to 115 mmHg (for tissue perfusion)?

A

Mean arterial pressure (MAP).

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4
Q

How do we calculate MAP?

A

MAP = DP + 1/3 (SP-DP)
Or
MAP= DP + 1/3 (PP)
Or
MAP = cardiac output (CO) * total peripheral resistance (TPR).

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5
Q

How do we calculate cardiac output?

A

CO = HR * stroke volume (SV).

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6
Q

SBP is given mainly by _____, DPB is given mainly by ______.

A

SBP > CO.
DBP > TPR.

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7
Q

List the 4 factors that affect TPR?

A

1- blood vessel diameter.
2- vessel elasticity.
3- blood viscosity.
4- total blood volume.

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8
Q

What affect stroke volume?

A

1- contractility (+).
2- preload (+).
3- afterload (-).

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9
Q

List the 2 clinical conditions of blood pressure?

A

1- hypertension.
2- shock.

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10
Q

What is the most prevalent form of hypoperfusion?

A

Hypovolemic shock.

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11
Q

which clinical condition of blood pressure is a chronic condition?

A

Hypertension.

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12
Q

Definition: high arterial blood pressure with a consistent systolic readings of 130 mmHg or higher or diastolic readings higher than 80 mmHg.

A

Hypertension.

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13
Q

How does hypovolemic shock occur?

A

Occurs when the vascular system loses blood or fluid either externally or internally, leading to a fall in perfusion pressure.

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14
Q

Chronic hypertension leads to what in the heart?

A

1- left ventricular hypertrophy.
2- angina or myocardial infarction.
3- heart failure.

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15
Q

Chronic hypertension leads to what in the brain?

A

Stroke or transient ischemic attack.

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16
Q

Chronic hypertension leads to what in the kidneys?

A

Chronic kidney disease.

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17
Q

Chronic hypertension leads to what in the arteries?

A

Peripheral arterial disease.

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18
Q

Chronic hypertension leads to what in the eyes?

A

Retinopathy.

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19
Q

List the 3 BP regulatory mechanisms?

A

1- neural control.
2- humoral control.
3- renal-body fluid control system.

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20
Q

List neural control regulatory mechanisms of BP?

A

1- baroreceptor reflex.
2- chemoreceptor reflex.
3- brain (CNS) ischemic response.

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21
Q

List humoral control regulatory mechanisms of BP?

A

1- catecholamines (adrenaline and noradrenaline).
2- vasopressin (ADH).
3- renin-angiotensin-aldosterone system (RAAS).

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22
Q

Which BP regulatory mechanisms are short term?

A

1- neural control.
2- humoral control (catecholamines and vasopressin only).

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23
Q

Which BP regulatory mechanisms are long term?

A

Kidney control:
1- humoral control: RAAS.
2- renal-body fluid control system.

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24
Q

When do baroreceptors work?

A

100-60 mmHg.

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25
When do chemoreceptors work?
60-40 mmHg.
26
When does CNS ischemic response work?
40-20mmHg.
27
how does baroreceptor reflex works?
1-stimulates the parasympathetic centers (dorsal motor nucleus of X nerve, vagus) in the medulla. 2- inhibits the vasomotor (VMC) in the medulla (through inhibitory interneurones).
28
How does baroreceptor reflex inhibits the VMC in the medulla?
1- decreased excitatory discharge from the VMC to the sympathetic nervous system in the spinal cord. 2- this in turn causes decreased sympathetic activation.
29
How does hypertension affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: increase. Parasympathetic activity: increase. Sympathetic activity: decrease. Hemostatic response: to decrease.
30
How does shock affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: decrease. Parasympathetic activity: decrease. Sympathetic activity: increase. Hemostatic response: to increase.
31
How does carotid occlusion affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: decrease. Parasympathetic activity: decrease. Sympathetic activity: increase. Hemostatic response: to increase.
32
How does carotid sinus massage affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: increase. Parasympathetic activity: increase. Sympathetic activity: decrease. Hemostatic response: to decrease.
33
How does cutting afferent to NTS affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: decrease. Parasympathetic activity: decrease. Sympathetic activity: increase. Hemostatic response: to increase.
34
How does posture change: lying down to standing affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: decrease. Parasympathetic activity: decrease. Sympathetic activity: increase. Hemostatic response: to increase.
35
How does volume overload affects afferents to nucleus tractus solitarius, parasympathetic activity, sympathetic activity, and what is it’s effect on heart rate and BP (hemostatic response)?
Afferents to nucleus tractus solitarius: increase. Parasympathetic activity: increase. Sympathetic activity: decrease. Hemostatic response: to decrease.
36
What do baroreceptors maintain during changes in position?
MAP.
37
What happens to BP when changing the position from supine to erect?
There is a sudden decrease in MAP which activates the sympathetic impulses leading to vasoconstriction to minimize MAP drop.
38
If BP was not corrected by baroreceptors this will lead to what?
Orthostatic hypotension.
39
List the 2 locations of chemoreceptors?
1- peripheral. 2- central.
40
*What do peripheral chemoreceptors sense?
Low O2.
41
Where are peripheral chemoreceptors located?
Carotid and aortic bodies.
42
Peripheral chemoreceptors synapse with ___ and ___, respectively.
IX (glossopharyngeal nerve) and X (vagus nerve).
43
Where are central chemoreceptors located?
Medulla.
44
*What do central chemoreceptors sense?
Sense low pH primarily.
45
What do chemoreceptors respond to?
Respond to a low PaO2, high PaCO2, and fall in pH.
46
Chemoreceptors exert which effect on VMC?
Exert a positive effect on VMC - vasoconstriction.
47
Chemoreceptors exert which effect on cardio-inhibitory area?
Exert a positive effect on cardio-inhibitory area - bradycardia.
48
Which BP control system operates as an emergency arterial pressure control system?
CNS ischemic response.
49
How does CNS ischemic response work?
When BP < 40mmHg > cerebral ischemia of VMC > strong excitation of VMC > strong vasoconstriction of blood vessels.
50
Which BP control system is one of the most powerful activators of the sympathetic vasoconstrictor system?
CNS ischemic response.
51
How do catecholamines regulate BP?
low MAP > high sympathetic activity > adrenal medulla > high adrenaline secretion = high heart rate (SA node) and high stroke volume (ventricular myocardium).
52
NA/NE released from the sympathetic nerves bind primarily to which receptors?
Alpha 1 adrenoreceptors.
53
Adrenaline released from the adrenal medulla circulates in the blood and can bind to which receptors?
To both alpha 1 and beta 2 adrenoreceptor.
54
At low (adrenaline) preferential binding to which receptors?
Beta 2 adrenoreceptor.
55
At low (adrenaline) results in what?
Vasodilation.
56
At high (adrenaline) bind to which receptors?
Both alpha 1 and beta 2 adrenoreceptor.
57
Adrenaline in cardiac and skeletal muscle vessels bind to which receptors?
Beta 2 > alpha 1 receptors.
58
Adrenaline promotes what in cardiac and skeletal muscle vessels?
Vasodilation.
59
Adrenaline in most other tissues bind to which receptors?
Alpha 1 receptors > beta 2 receptors.
60
Adrenaline promotes what in most other tissues?
Vasoconstrictions.
61
What does alpha 1 receptors do when activated?
Vasoconstriction.
62
What does beta 2 receptors do when activated?
Vasodilation.
63
How does vasopressin (ADH) regulate BP?
Dehydration or salt ingestion > high blood osmolarity > stimulates osmoreceptors in the hypothalamus > triggers ADH release from the pituitary = Causes vasoconstriction > high TPR > high BP. Promotes water retention by kidney > high BP.
64
What does vasopressin (ADH) bind to to cause generalized vasoconstriction?
V1 receptors.
65
What does vasopressin (ADH) bind to to cause renal reabsorption of water?
V2 receptors.
66
Long term control of blood pressure requires control of what?
Control of blood volume.
67
Blood volume is controlled by which organs?
By the kidney.
68
How do kidneys control blood volume?
1- kidneys can eliminate excess water by excreting a dilute urine. 2- kidneys can conserve water by excreting a concentrated urine.
69
What happens when blood volume and BP is decreased?
1- decreased glomerular capillary hydrostatic pressure. 2- decreased glomerular filtration rate (GFR). 3- oliguria (decreased urine formation).
70
Kidneys conserve ____ fluid volume
Extra-cellular fluid (ECF) volume.
71
How does the RAAS work?
Low blood pressure= Kidneys release renin, liver releases angiotensiongen. Renin + angiotensinogen = angiotensin 1 Angiotension 1 + angiotensin converting enzyme (ACE) = angiotensin 2.
72
How does angiotensin 2 affect vascular smooth muscle?
Vasoconstriction.
73
How does angiotensin 2 affect sympathetic nerve endings?
Facilitates release of noradrenaline.
74
How does angiotensin 2 affect the brain: hypothalamus?
Release of vasopressin. Stimulation of thirst > high water intake.
75
How does angiotensin 2 affect adrenal cortex?
Secretion of aldosterone > high renal reabsorption of sodium and water.

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