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MSS - CV Exam 2 > Determinants of MAP > Flashcards

Determinants of MAP Flashcards

1
Q

regulation of MAP?

A

arteriolar resistance

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2
Q

prehypertension?

A

120-139

80-99

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3
Q

stage 1 HTN?

A

140-159

90-99

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4
Q

stage 2 HTN?

A

greater 160

greater 100

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5
Q

BP regulation?

A

short term - neural

long term - endocrine/paracrine

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6
Q

sympathetic effects?

A

increased vasoconstriction - increased TPR

increased HR and SV (increased CO)

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7
Q

pressor effect?

A

NE - generalized vasoconstriction

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8
Q

alpha1

A

vasoconstriction

NE, E

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9
Q

beta2

A

vasodilation

E preferentially

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10
Q

exercising skeletal muscle

A

autoregulation dominates (vasodilation)

as opposed to resting muscle - vasoconstrictor neural control dominates

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11
Q

parasympathetic effect on MAP?

A

indirect vasodilation
decrease HR
some decrease in contractility (SV)

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12
Q

high P baroreceptors

A

carotid sinus and aortic arch
-increased P, increased stretch
-increased firing rate
graded response**

most responsive to change in pressure vs. simply a sustained pressure

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13
Q

increased high P baroreceptor firing rate?

A

increased MAP

and vice versa for decrease in firing rate

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14
Q

pulse pressure?

A

baroreceptors greater response to greater PP
-firing rate decrease with decreased PP

increased MAP with decreased PP

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15
Q

end-result of high P baroreceptor?

A

vasodilation and bradycardia

  • increased MAP
  • increased stretch
  • decreased sympathetic output
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16
Q

high P baroreceptor and vasodilation?

A 
increased stretch
increased firing rate
inhibits vasomotor area
decreased sympathetic
decreased vasoconstriction
increased vasodilation***
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17
Q

high P baroreceptor and HR?

A 
increased stretch
increased firing rate
excitation of cardioinhibitory area
increased parasympathetic
decreased heart rate***
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18
Q

increased baroreceptor firing?

A

decreased sympathetic output and increased parasympathetic output

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19
Q

low-P baroreceptors?

A

in cardiac chambers and large pulmonary vessels
-involved in blood volume regulation

increased firing rate with increased stretch

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20
Q

A fibers?

A

low P baroreceptors

-monitor HR

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21
Q

B fibers?

A

low P baroreceptors
-monitor atrial volume

impacted by CVP

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22
Q

activation of low P receptors?

A 
increased VR
increased stretch
increased firing rate
increased heart rate
decreased renal vasoconstriction
increased renal blood flow
decreased effective circulating volume
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23
Q

bainbridge reflex?

A

increased VR and RAP > increased HR

conterbalance to high P baroreceptor

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24
Q

low P baroreceptors?

A

renal vasodilation!

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25
at high volume
bainbridge reflex > increased heart rate
26
at low volume
baroreceptor reflex > increased heart rate
27
volume loading?
bainbridge dominant
28
volume depletion?
high P baroreceptor dominant
29
peripheral chemoreceptors?
carotid body and aortic body PO2 (at low levels), PCO2 and pH changes - regulates respiration - some influence on cardiovascular system
30
central chemoreceptors?
medulla oblongata PCO2 and pH changes
31
increased PCO2, decreased pH?
increased vasoconstriction | increased TPR
32
decreased PCO2, increased pH?
decreased vasoconstriction | decreased TPR
33
chemoreceptors and HR?
integrated physiologic response - increases the rate of ventilation - inhibits cardioinhibitory centers - increase in HR, TPR, and MAP tachycardia and vasoconstriction***
34
balance between chemoreceptor and baroreceptors?
if activated together: - decreased MAP, increased CO2 - increased chemoreceptors, decreased baroreceptors - vasoconstriction if activated separataely: increased MAP, increased CO2 -increased chemoreceptors, increased baroreceptors -baroreceptor mediated inhibition dominates
35
vasoconstrictors
``` Epi (a1) serotonin ANG II AVP endothelin ```
36
vasodilators
``` Epi (B2) histamine ANP bradykinins PGE2, PGI2 NO ```
37
ANG II
converted from ANG I by ACE - mainly in lungs** - stimulated by increased renin - released during blood loss or exercise vasoconstrictor
38
what stimulates renin release?
dropped renal BP
39
ADH/AVP
aka vasopressin posterior pituitary gland -vasocontrictor released during hemorrhagic shock
40
histamine
released with tissue damage | -vasodilator
41
ANP
atrial myocytes release with increased stretch | -vasodilator
42
kidney
key organ for long-term blood volume regulation | Na+ and H2O secretion
43
decreased kidney blood pressure?
leads to decreased GFR and decreased urine volume
44
humoral regulation of BP?
RAAS ADH/AVP ANH/ANP
45
RAAS
increases Na+ reabsorption (water follows) | -increased ECF volume and MAP
46
renal juxtaglomerular apparatus?
macula densa cells detect Na+ in distal tubules | -secrete renin with low levels
47
angiotensinogen?
inactive form -renin converts angiotensinogen to ANG I ANG I > ANG II when comes in contact with ACE results in thirst, vasoconstriction, vasopressin
48
ANG II
``` vasoconstriction adrenal gland aldosterone stimulates vasopressin stimulates thirst stimulates Na+ reabsorption stimulates SNS activity ```
49
aldosterone
stimulated by ANG II promotes renal Na+ reabsorption
50
ADH/AVP
vasoconstrictor -stimulated by hypothalamus increases water reabsorption in kidneys - distal tubules and collecting duct aquaporins - increases MAP***
51
vasopressin
antidiuretic hormone | -decreased urine output
52
ANP
vasodilator - get rid of Na+ (natriuresis) - released by atrial cells - increased stretch - ANP release opposes RAAS decreased ECF volume and MAP
53
intermediate response?
RAAS
54
respiratory system and MAP?
decreased thoracic P > more VR water evaporation ventilation - affects chemoreceptor response
55
liver and MAP?
hematocrit and protein content | starling forces
56
GI and urinary and MAP?
long term BP regulation | -electrolyte and H2O
57
endocrine and MAP
blood volume and vascular tone
58
temperature and MAP?
skin blood flow | sweating is fluid loss
59
orthostasis
gravity affects - hypotension - increased VR - muscle pump response is baroreceptor reflex
60
vasovagal syncope
emotional stress -dramatic parasympathetic response bradycardia, hypotension, apnea decreased MAP - failed baroreceptor response
61
fight or flight
increased sympathetic response - increased skeletal muscle blood flow (beta2) - vaso and venoconstriction (alpha1) renal and splanchnic increased CO increase blood volume net increase MAP
62
exercise
early and delayed response central and local control -overall decrease in TPR**
63
early exercise response?
hypothalamus -increased HR and contractility early vasoconstriction to inactive tissues
64
delayed exercise response?
mechanical: pump of muscles, increased VR (increased SV) chemical: local metabolites increasing flow to working muscles -causes decreased TPR
65
exercising muscle?
increased capillary hydrostatic pressure increased O2 delivery increased O2 consumption
66
6 changes with exercise?
exercise pressor reflex -sustain sympathetic outflow arterial baroreflexes -reset so sympathetic output continues with increased MAP vasodilation (local) epinephrine (beta1 and beta2) increased venous return (muscle pump) temperature regulation
67
noticeable changes with exercise?
increased MAP - SBP > DBP due to increased CO - increased PP decreased TPR*** -vasodilation in working muscles
68
training
greater O2 extraction increased capillary, oxidative enzymes, mitochondria, and myoglobin lower resting HR greater SV lower TPR
69
endurance training
increased LV volume (no change in wall thickness) | -increased filling
70
resistance training
increased LV wall thickness | -hypertrophy
71
hemorrhagic shock?
high P baroreceptor reflex dominates with volume depletion ``` increased vasopressin (increased vasoconstriction) decreased ANP (decreased vasodilation) ``` increased PCO2 - increased chemoreceptor firing -integrated response increase HR and vasoconstriction
72
survive hemorrhage?
die of kidney failure -renal ischemia

MSS - CV Exam 2 (7 decks)

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