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Cardio > Exam 1 - HTN (No Pharmacology) > Flashcards

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
Q

chemoreceptors are __ sensors

A

chemical

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26
Q

What are the CV centers in the medulla?

A

Cardiac acceleratory center
Cardiac inhibitory center
Vasomotor center

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27
Q

The cardiac acceleratory center is made up of ___ fibers

A

sympathetic

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28
Q

what does the cardiac acceleratory center cause?

A

increases CO via HR and SV

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29
Q

The cardiac inhibitory center is made up of ___ fibers

A

parasympathetic (vagus)

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30
Q

what does the cardiac inhibitory center cause?

A

decreases CO via HR and SV

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31
Q

the vasomotor center (aka pressor area) is made up of ___ fibers that control ___

A

sympathetic fibers that control SVR

32
Q

What does the vasomotor center cause?

A

inhibition = vasodilation = decreased SVR

Stimulation = vasoconstriction = increased SVR

33
Q

What fibers are cholinergic?

A

ALL preganglionic fibers

All postganglionic parasympathetic fibers

34
Q

What fibers are adrenergic?

A

almost all postganglionic sympathetic fibers

35
Q

how does the SNS affect the heart?

A

Increase HR
Increase force of contraction

36
Q

how does the SNS affect blood vessels

A

constriction

37
Q

how does the SNS affect the lungs?

A

bronchodilation

38
Q

how does the SNS affect the GI?

A

Decreases motility
Sphincter contraction
Decreased secretions

39
Q

how does the PNS affect the heart?

A

Decreases HR
Decreases force of contraction

40
Q

how does the PNS affect the blood vessels?

41
Q

how does the PNS affect the lungs?

A

bronchoconstriction

42
Q

how does the PNS affect the GI?

A

Increases motility
Sphincter relaxation
Increased secretions

43
Q

Where are alpha 1 receptors located?

A

smooth muscle

44
Q

what happens to smooth muscle when alpha 1 receptors are stimulated?

A

contraction

45
Q

where are alpha 2 receptors found?

A

Presynaptic nerve endings
Smooth muscle

46
Q

what happens when alpha 2 receptors are stimulated?

A

Decreased NE release

47
Q

where are ß1 receptors located?

A

Heart
Kidneys

48
Q

what happens when ß1 receptors are stimulated

A

Increased contraction

Increased renin secretion (think about how this relates to the RAAS pathway)

49
Q

where are ß2 receptors located?

A

Vascular smooth muscle
Bronchial smooth muscle
GI tract

50
Q

what happens when ß2 receptors are stimulated?

A

Vasodilation
Bronchodilation
Decreases GI motility

51
Q

How do alpha 1 receptors cause smooth muscle contraction?

A

Binding of the IP3 signal pathway that causes the release of Ca2+

52
Q

What happens when an alpha agonist binds at the sympathizers nerve terminals?

What does this cause?

A

Inhibits NE release

Causes vascular smooth muscle relaxation (the predominant effect for alpha 2 stimulation)

53
Q

What happens when an alpha agonist binds to alpha 2 receptors?

A

decreases intracellular cAMP

54
Q

What is required for both cardiac and smooth muscle contraction? What is the difference?

A

Calcium

Mechanism is different

55
Q

what is the primary adrenergic receptor in the heart?

56
Q

what is the primary adrenergic receptor in blood vessels and lungs?

A

ß2

(ß2 = 2 locations and 2 lungs)

57
Q

What is the primary effect of ß2 stimulation?

A

Vasodilation
Decreases SVR (decreases BP)
Bronchodilation

58
Q

What is the type of GPCR for alpha 1 receptors?

59
Q

What is the type of GPCR for alpha 2 receptors?

60
Q

what is the type of GPCR for ß 1,2,3?

61
Q

what is the basic pathway for alpha 1?

A

Increase PLC, IP3, and Ca2+

62
Q

what is the basic pathway for beta 1,2,3?

A

increase AC and cAMP

63
Q

Where are M1 receptors located? What are their functions?

A

Location: secretory glands

Functions:
- Salivation
- Stomach acid
- Lacrimation

64
Q

Where are M2 receptors located? What are their functions?

A

Location: heart

Function: decrease HR (bradycardia)

65
Q

Where are M3 receptors located?

A

Smooth muscle
Pupil & ciliary muscle

66
Q

What is the function of M3 receptors in smooth muscle?

A

Contraction (diarrhea, bronchospasm, urination)

67
Q

What is the fucntion of M3 receptors in the pupil and ciliary muscle?

A

Contraction (miosis, increased aqueous humor flow)

68
Q

Where are Nm receptors located? Function?

A

Skeletal muscle and plate

Contraction of skeletal muscle

69
Q

where are Nn receptors located? Function?

A

Autonomic ganglia and adrenal medulla

Secretion of epi, controls ANS

70
Q

How does ACh cause bradycardia?

A
  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
Q

How does ACh indirectly decrease BP?

A
  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
Q

what happens to vascular cholinergic receptors in the absence of administered cholinergic agents? Why?

A

They have no known function

This is because ACh is never released into the blood in significant qtys

73
Q

What happens when baroreceptors sense a change in BP?

A
  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
Q

What stimulates chemoreceptors?

A

Chemical changes in the blood, including:

  • Hypoxia (decreased O2)
  • Hypercapnia (increased CO2)
  • pH changes
75
Q

What hormonal agents cause vasoconstriction?

A

Noradrenaline/NE
Adrenaline/epi (except skeletal)
Vasopressin/ADH
Renin
Angiotensin II
Aldosterone

76
Q

What hormonal agents cause vasodilation (aka opposing RAAS)?

Cardio (10 decks)

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