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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
Q

When do chemoreceptors work?

A

60-40 mmHg.

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26
Q

When does CNS ischemic response work?

A

40-20mmHg.

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27
Q

how does baroreceptor reflex works?

A

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).

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28
Q

How does baroreceptor reflex inhibits the VMC in the medulla?

A

1- decreased excitatory discharge from the VMC to the sympathetic nervous system in the spinal cord.
2- this in turn causes decreased sympathetic activation.

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29
Q

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)?

A

Afferents to nucleus tractus solitarius: increase.
Parasympathetic activity: increase.
Sympathetic activity: decrease.

Hemostatic response: to decrease.

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30
Q

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)?

A

Afferents to nucleus tractus solitarius: decrease.
Parasympathetic activity: decrease.
Sympathetic activity: increase.

Hemostatic response: to increase.

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31
Q

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)?

A

Afferents to nucleus tractus solitarius: decrease.
Parasympathetic activity: decrease.
Sympathetic activity: increase.

Hemostatic response: to increase.

32
Q

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)?

A

Afferents to nucleus tractus solitarius: increase.
Parasympathetic activity: increase.
Sympathetic activity: decrease.

Hemostatic response: to decrease.

33
Q

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)?

A

Afferents to nucleus tractus solitarius: decrease.
Parasympathetic activity: decrease.
Sympathetic activity: increase.

Hemostatic response: to increase.

34
Q

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)?

A

Afferents to nucleus tractus solitarius: decrease.
Parasympathetic activity: decrease.
Sympathetic activity: increase.

Hemostatic response: to increase.

35
Q

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)?

A

Afferents to nucleus tractus solitarius: increase.
Parasympathetic activity: increase.
Sympathetic activity: decrease.

Hemostatic response: to decrease.

36
Q

What do baroreceptors maintain during changes in position?

A

MAP.

37
Q

What happens to BP when changing the position from supine to erect?

A

There is a sudden decrease in MAP which activates the sympathetic impulses leading to vasoconstriction to minimize MAP drop.

38
Q

If BP was not corrected by baroreceptors this will lead to what?

A

Orthostatic hypotension.

39
Q

List the 2 locations of chemoreceptors?

A

1- peripheral.
2- central.

40
Q

*What do peripheral chemoreceptors sense?

A

Low O2.

41
Q

Where are peripheral chemoreceptors located?

A

Carotid and aortic bodies.

42
Q

Peripheral chemoreceptors synapse with ___ and ___, respectively.

A

IX (glossopharyngeal nerve) and X (vagus nerve).

43
Q

Where are central chemoreceptors located?

A

Medulla.

44
Q

*What do central chemoreceptors sense?

A

Sense low pH primarily.

45
Q

What do chemoreceptors respond to?

A

Respond to a low PaO2, high PaCO2, and fall in pH.

46
Q

Chemoreceptors exert which effect on VMC?

A

Exert a positive effect on VMC - vasoconstriction.

47
Q

Chemoreceptors exert which effect on cardio-inhibitory area?

A

Exert a positive effect on cardio-inhibitory area - bradycardia.

48
Q

Which BP control system operates as an emergency arterial pressure control system?

A

CNS ischemic response.

49
Q

How does CNS ischemic response work?

A

When BP < 40mmHg > cerebral ischemia of VMC > strong excitation of VMC > strong vasoconstriction of blood vessels.

50
Q

Which BP control system is one of the most powerful activators of the sympathetic vasoconstrictor system?

A

CNS ischemic response.

51
Q

How do catecholamines regulate BP?

A

low MAP > high sympathetic activity > adrenal medulla > high adrenaline secretion = high heart rate (SA node) and high stroke volume (ventricular myocardium).

52
Q

NA/NE released from the sympathetic nerves bind primarily to which receptors?

A

Alpha 1 adrenoreceptors.

53
Q

Adrenaline released from the adrenal medulla circulates in the blood and can bind to which receptors?

A

To both alpha 1 and beta 2 adrenoreceptor.

54
Q

At low (adrenaline) preferential binding to which receptors?

A

Beta 2 adrenoreceptor.

55
Q

At low (adrenaline) results in what?

A

Vasodilation.

56
Q

At high (adrenaline) bind to which receptors?

A

Both alpha 1 and beta 2 adrenoreceptor.

57
Q

Adrenaline in cardiac and skeletal muscle vessels bind to which receptors?

A

Beta 2 > alpha 1 receptors.

58
Q

Adrenaline promotes what in cardiac and skeletal muscle vessels?

A

Vasodilation.

59
Q

Adrenaline in most other tissues bind to which receptors?

A

Alpha 1 receptors > beta 2 receptors.

60
Q

Adrenaline promotes what in most other tissues?

A

Vasoconstrictions.

61
Q

What does alpha 1 receptors do when activated?

A

Vasoconstriction.

62
Q

What does beta 2 receptors do when activated?

A

Vasodilation.

63
Q

How does vasopressin (ADH) regulate BP?

A

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
Q

What does vasopressin (ADH) bind to to cause generalized vasoconstriction?

A

V1 receptors.

65
Q

What does vasopressin (ADH) bind to to cause renal reabsorption of water?

A

V2 receptors.

66
Q

Long term control of blood pressure requires control of what?

A

Control of blood volume.

67
Q

Blood volume is controlled by which organs?

A

By the kidney.

68
Q

How do kidneys control blood volume?

A

1- kidneys can eliminate excess water by excreting a dilute urine.
2- kidneys can conserve water by excreting a concentrated urine.

69
Q

What happens when blood volume and BP is decreased?

A

1- decreased glomerular capillary hydrostatic pressure.
2- decreased glomerular filtration rate (GFR).
3- oliguria (decreased urine formation).

70
Q

Kidneys conserve ____ fluid volume

A

Extra-cellular fluid (ECF) volume.

71
Q

How does the RAAS work?

A

Low blood pressure=
Kidneys release renin, liver releases angiotensiongen.
Renin + angiotensinogen = angiotensin 1
Angiotension 1 + angiotensin converting enzyme (ACE) = angiotensin 2.

72
Q

How does angiotensin 2 affect vascular smooth muscle?

A

Vasoconstriction.

73
Q

How does angiotensin 2 affect sympathetic nerve endings?

A

Facilitates release of noradrenaline.

74
Q

How does angiotensin 2 affect the brain: hypothalamus?

A

Release of vasopressin.
Stimulation of thirst > high water intake.

75
Q

How does angiotensin 2 affect adrenal cortex?

A

Secretion of aldosterone > high renal reabsorption of sodium and water.

CVS (11 decks)

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