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Exam 1 - HTN (No Pharmacology) Flashcards

1
Q

What are the components of the circulatory system?

A

Blood
Heart
Blood vessels

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2
Q

What are the functions of the circulatory system?

A

Transportation
Protection
Prevent excessive blood clots

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3
Q

What is BP?

A

The force of circulating blood on the walls of the arteries

Pressure exerted by circulating blood upon the walls of the blood vessels

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4
Q

What is the formula for BP?

A

CO x SVR

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5
Q

What is CO?

A

amount of blood pumped out of the heart in 1 min

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6
Q

what is the formula for CO?

A

HR x SV

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7
Q

what is stroke volume?

A

qty of blood pumped out of the left ventricle w/ each heartbeat

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8
Q

What is blood viscosity directly related to? What factors increase blood viscosity?

A

Directly related to BP

Increased by:
- Dehydration
- RBCs
- High blood glucose

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9
Q

What is normal BP?

A

120/80

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10
Q

what is systolic BP?

A

peak BP reached during cardiac contraction

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11
Q

what is diastolic BP?

A

pressure blood exerts within the arteries between heartbeats (during cardiac relaxation)

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12
Q

what is cardiac preload/left ventricular end diastolic pressure (LVEDP)?

A

stretching of the left ventricle at end diastolic volume

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13
Q

what is cardiac afterload/SVR?

A

the amount of resistance the heart must overcome to open the aortic valve and push the blood volume out into the systemic circulation

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14
Q

what factors can increase CO?

A

Increased cardiac preload
Venous constriction

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15
Q

how does increased preload increase CO?

A

increased fluid volume from excess Na+ intake or renal Na+ retention

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16
Q

how does venous constriction increase CO?

A

excess RAAS stimulation and sympathetic nervous system overactivity

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17
Q

what factors can increase SVR?

A

Functional vascular constriction
Structural vascular hypertrophy

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18
Q

How can functional vascular constriction cause increased SVR?

A
  • Excess RAAS stimulation
  • SNS overactivity
  • Genetic alterations of cell membranes
  • Endothelial derived factors (NO, ET-1, PGI2)
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19
Q

how can structural vascular hypertrophy increase SVR?

A
  • Excess RAAS stimulation
  • SNS overactivity
  • Genetic alterations of cell membranes
  • Endothelial derived factors (NO, ET-1, PGI2)
  • Hyperinsulinemia from metabolic syndrome
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20
Q

Why is it important to maintain BP?

A

to ensure a steady blood flow (perfusion) to tissues to ensure adequate supply of oxygen and nutrients

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21
Q

how is BP regulated?

A

neurally through CV centers in the medulla oblongata

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22
Q

what do CV centers detect changes in?

A

BP
pH
Dissolved gas concentrations (O2 or CO2)

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23
Q

what are the 2 types of transducers that sense changes in the body affecting BP?

A

Baroreceptors
Chemoreceptors

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24
Q

Baroreceptors are ___ sensors

A

pressure (think barometer)

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25
chemoreceptors are __ sensors
chemical
26
What are the CV centers in the medulla?
Cardiac acceleratory center Cardiac inhibitory center Vasomotor center
27
The cardiac acceleratory center is made up of ___ fibers
sympathetic
28
what does the cardiac acceleratory center cause?
increases CO via HR and SV
29
The cardiac inhibitory center is made up of ___ fibers
parasympathetic (vagus)
30
what does the cardiac inhibitory center cause?
decreases CO via HR and SV
31
the vasomotor center (aka pressor area) is made up of ___ fibers that control ___
sympathetic fibers that control SVR
32
What does the vasomotor center cause?
inhibition = vasodilation = decreased SVR Stimulation = vasoconstriction = increased SVR
33
What fibers are cholinergic?
ALL preganglionic fibers All postganglionic parasympathetic fibers
34
What fibers are adrenergic?
almost all postganglionic sympathetic fibers
35
how does the SNS affect the heart?
Increase HR Increase force of contraction
36
how does the SNS affect blood vessels
constriction
37
how does the SNS affect the lungs?
bronchodilation
38
how does the SNS affect the GI?
Decreases motility Sphincter contraction Decreased secretions
39
how does the PNS affect the heart?
Decreases HR Decreases force of contraction
40
how does the PNS affect the blood vessels?
no effect
41
how does the PNS affect the lungs?
bronchoconstriction
42
how does the PNS affect the GI?
Increases motility Sphincter relaxation Increased secretions
43
Where are alpha 1 receptors located?
smooth muscle
44
what happens to smooth muscle when alpha 1 receptors are stimulated?
contraction
45
where are alpha 2 receptors found?
Presynaptic nerve endings Smooth muscle
46
what happens when alpha 2 receptors are stimulated?
Decreased NE release
47
where are ß1 receptors located?
Heart Kidneys
48
what happens when ß1 receptors are stimulated
Increased contraction Increased renin secretion (think about how this relates to the RAAS pathway)
49
where are ß2 receptors located?
Vascular smooth muscle Bronchial smooth muscle GI tract
50
what happens when ß2 receptors are stimulated?
Vasodilation Bronchodilation Decreases GI motility
51
How do alpha 1 receptors cause smooth muscle contraction?
Binding of the IP3 signal pathway that causes the release of Ca2+
52
What happens when an alpha agonist binds at the sympathizers nerve terminals? What does this cause?
Inhibits NE release Causes vascular smooth muscle relaxation (the predominant effect for alpha 2 stimulation)
53
What happens when an alpha agonist binds to alpha 2 receptors?
decreases intracellular cAMP
54
What is required for both cardiac and smooth muscle contraction? What is the difference?
Calcium Mechanism is different
55
what is the primary adrenergic receptor in the heart?
ß1
56
what is the primary adrenergic receptor in blood vessels and lungs?
ß2 (ß2 = 2 locations and 2 lungs)
57
What is the primary effect of ß2 stimulation?
Vasodilation Decreases SVR (decreases BP) Bronchodilation
58
What is the type of GPCR for alpha 1 receptors?
Gq
59
What is the type of GPCR for alpha 2 receptors?
Gi
60
what is the type of GPCR for ß 1,2,3?
Gs
61
what is the basic pathway for alpha 1?
Increase PLC, IP3, and Ca2+
62
what is the basic pathway for beta 1,2,3?
increase AC and cAMP
63
Where are M1 receptors located? What are their functions?
Location: secretory glands Functions: - Salivation - Stomach acid - Lacrimation
64
Where are M2 receptors located? What are their functions?
Location: heart Function: decrease HR (bradycardia)
65
Where are M3 receptors located?
Smooth muscle Pupil & ciliary muscle
66
What is the function of M3 receptors in smooth muscle?
Contraction (diarrhea, bronchospasm, urination)
67
What is the fucntion of M3 receptors in the pupil and ciliary muscle?
Contraction (miosis, increased aqueous humor flow)
68
Where are Nm receptors located? Function?
Skeletal muscle and plate Contraction of skeletal muscle
69
where are Nn receptors located? Function?
Autonomic ganglia and adrenal medulla Secretion of epi, controls ANS
70
How does ACh cause bradycardia?
1. ACh binds M2 receptor in heart 2. Activates Gi (G protein) 3. K+ channels open 4. Intracellular K+ channels decrease 5. Hyperpolarization of cardiac cells = less frequent firing = decreases HR
71
How does ACh indirectly decrease BP?
1. ACh binds to M3 receptors on the endothelial cells lining the smooth muscles of blood vessels 2. M3 receptors activated 3. PLC pathway activated 4. Increase in [Ca2+] 5. NO synthase activated 6. Increase of NO 7. NO binds to NO receptor 8. GTP converted to cGMP 9. Protein kinase G activated 10. Vascular smooth muscle relaxes = decreases SVR = decreases BP
72
what happens to vascular cholinergic receptors in the absence of administered cholinergic agents? Why?
They have no known function This is because ACh is never released into the blood in significant qtys
73
What happens when baroreceptors sense a change in BP?
1. They will either send more or fewer impulses to the CV centers in the spinal cord 2. Reflex response of increased sympathetic and decreased parasympathetic output to the heart and vasculature 3. Vasoconstriction or vasodilation and an adjustment of CO —> return to normal BP
74
What stimulates chemoreceptors?
Chemical changes in the blood, including: - Hypoxia (decreased O2) - Hypercapnia (increased CO2) - pH changes
75
What hormonal agents cause vasoconstriction?
Noradrenaline/NE Adrenaline/epi (except skeletal) Vasopressin/ADH Renin Angiotensin II Aldosterone
76
What hormonal agents cause vasodilation (aka opposing RAAS)?
ANP BNP CNP

Cardio (12 decks)

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