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Physiology I > Exam 2 Part I - regulation of BP and CO > Flashcards

Exam 2 Part I - regulation of BP and CO Flashcards

1
Q

Blood pressure is the function of ___, ___ and ___

A

Blood, vascular tree, heart

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2
Q

The left ventricle creates and initial pressure that results in an

A

Aortic pressure

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3
Q

Pulse pressure is (equation)

A

Systolic pressure (SBP) - diastolic pressure (DBP)

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4
Q

Pulse pressure is ~

A

~40mm Hg

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5
Q

Augmentation is seen in what kind of arteries?

A

Large arteries

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6
Q

Augmentation is likely due to ________ in the arterial tree

A

Pulse reflection

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7
Q

Pulse reflexion causes summation of pulse wave-forms and may correlate with a condition like

A

Aneurysm

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8
Q

Systemic venous BP is also called

A

Central venous pressure

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9
Q

Central venous pressure (CV) averages about

A

0 mmHg

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10
Q

systemic vasculature has an average pressure about

A

100 mmHg

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11
Q

Venous pump is a term that describes the combination of ____ and ____

A

Valves and skeletal muscles

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12
Q

The primary role of valves is to prevent

A

Retrograde flow in low-pressure blood vessels

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13
Q

What are the 2 pumps in the systemic circulatory systeM/

A
  1. Left ventricle

2. Collective venous pump

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14
Q

What do left ventricles do?

A

Establish arterial pressure and flow to body tissues

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15
Q

What does the collective venous pump do?

A

Establish a venous pressure and flow back to the heart

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16
Q

What are hydrostatic forces?

A

Gravity — force due to pressure at rest

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17
Q

In an average person of average height in a standing position at rest, the venous pressure rises to _____ in the feet

A

90 mmHg

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18
Q

In an average person of average height WHILE WALKING, the venous pressure drops to _____ in the feet

A

25 mmHg

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19
Q

What is the impact of hydrostatic forces in the head?

A

Negative venous pressure

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20
Q

BP =

A

Cardiac output X peripheral resistance

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21
Q

CO =

A

Stroke volume X heart rate

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22
Q

Peripheral resistance is due to many factors including:

A

— blood volume
— viscosity
— size of vascular container (primarily r^4)

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23
Q

When you put all the factors together (including cardiac output formula and peripheral resistance) you end up with, BP =

A

~ SC and HR and collective ‘r^4’

OR

BP = CO/ ‘r^4’

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24
Q

Mean arterial blood pressure (MAP) is what?

A

Average blood pressure from left ventricle that is responsible for flow (Q) in the arterial tree

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25
Q

Mean arterial blood pressure (MAP) =

A

DBP + 1/3 (SBP - DBP)

In other words: MAP is diastolic pressure plus 1/3 * (systolic pressure - diastolic pressure)

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26
Q

Blood pressure control systems can be fast or slow acting; high or low “____”

A

Gain (power to correct)

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27
Q

There are two main systems of blood pressure control:

A

Nervous and renal mechanisms

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28
Q

Short term adjustments in BP are best done with ______

A

Rapid-acting ANS

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29
Q

Rapid-acting ANS (blood pressure control system) affects

A

Heart and vessels

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30
Q

Long term regulation is done by controlling

A

Volume of blood in vascular compartment

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31
Q

What are the pressure-sensors in the arterial tree close to the out put of the left ventricle?

A

Aortic and carotid baroreceptors

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32
Q

Where are signals from the aortic arch and carotid bifurcation baroreceptors delivered to in the brain?

A

Cardiovascular center in the brain medulla

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33
Q

When carotid sinus nerve impulses, what does that do to cardiac output?

A

Slows heart rate

Decreases contractility

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34
Q

When vagus nerve impulses, what does that do to cardiac output?

A

Slows heart rate

Decreases contractility

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35
Q

When carotid sinus OR vagus nerve impulses, what does that do to peripheral resistance?

A

Decreases vasoconstriction

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36
Q

When sympathetic cardiac nerve impulses, what does that do to cardiac output?

A

Accelerates heart rate

Increases contractility

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37
Q

When sympathetic cardiac nerve impulses, what does that do to peripheral resistance?

A

Increases vasoconstriction

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38
Q

How fast and what kind of gain does arterial baroreceptor reflex get in controlling BP?

A

Fast and high gain

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39
Q

Arterial baroreceptor reflex reaches a peak within what length of time?

A

15 seconds

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40
Q

Arterial baroreceptor reflex has a responsiveness that is lose in what timeframe?

A

2-4 days

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41
Q

The function of arterial baroreceptor reflex is what?

A

Sudden changes in BP

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42
Q

What system is used for postural changes?

A

Arterial baroreceptor reflex

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43
Q

Aortic and carotid chemoreceptors are within small “organs” called

A

Aortic and carotid bodies

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44
Q

Aortic and carotid baroreceptors are used in _________ while aortic and carotid chemoreceptors are used in ________

A

Arterial baroreceptor reflex; arterial chemoreceptor reflex

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45
Q

How fast/slow and how effective is the arterial chemoreceptor reflex?

A

Fast and high gain

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46
Q

What is the peak timeframe of arterial chemoreceptor reflex?

A

60 seconds

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47
Q

Arterial chemoreceptor reflex is very strong when

A

MAP drops below 80 mmHg

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48
Q

Atrial stretch reflex uses stretch-receptors in the walls of the

A

Right atrium

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49
Q

Atrial stretch receptors are not pressure receptors, they are actually

A

Volume receptors

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50
Q

How fast/slow and what gain is atrial stretch reflex?

A

Fast and unknown gain

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51
Q

Bainbridge reflex dominates when _______; baroreceptors dominate when _______

A

Blood volume rises; blood volume diminishes

52
Q

Intravenous infusion leads to…

A

Increased R atrial pressure —> atrial receptor stimulation —> Bainbridge reflex and INCREASED heart rate

BUT ALSO

Increased cardiac output —> increased arterial pressure —> baroreceptor reflex and DECREASED heart rate

53
Q

What serves to minimize venous damming of blood?

A

Bainbridge reflex

54
Q

Atrial stretch can cause a hormonal effect from

A

Atrial natriuretic factor (ANF)

55
Q

Atrial natriuretic factor (ANF) is released with increased

A

Atrial pressure/stretch

56
Q

Atrial natriuretic factor (ANF) functions to

A

Decrease blood volume and decrease BP

57
Q

A nervous control “system” that involves neurons of cardiovascular control center:

A

CNS Ischemic Response

58
Q

How fast/slow and what kind of gain does the CNS Ischemic Response get?

A

Fast and high gain — aka last ditch effort

59
Q

CNS Ischemic Response uses neurons of the

A

Medullary “pressor” area due to cerebral ischemia

60
Q

The CNS Ischemic Response is a reflex triggered from

A

Very slow moving blood that fails to remove CO2 from cardiovascular center

61
Q

What does the pressor region do?

A

Evokes vasoconstriction, cardiac acceleration, and myocardial contractility

62
Q

In the pressor region, vasoconstrictor sub-areas are

A

Topically active and responsible for vasomotor tone

63
Q

The depressor region functions to

A

Inhibit Pressor area

Decrease sympathetic outflow and increase parasympathetic activity

64
Q

Withdrawal of sympathetic tone is the primary mechanism for nervous-induced

A

peripheral vasodilation and low BP

65
Q

Humoral control system that uses hormones from adrenal medulla that act as sympathetic neurotransmitters

A

Epinephrine system

66
Q

Epinephrine system uses what neurotransmitters?

A

Epinephrine (80%) and norepinephrine (20%)

67
Q

Epinephrine and norepinephrine land on what kind of receptors?

A

Alpha and beta adrenergic receptors

68
Q

When epinephrine and norepinephrine land on alpha and beta adrenergic receptors, it causes

A

Peripheral vasoconstriction and increased cardio output

69
Q

How fast is the Epinephrine system? And what is the gain?

A

Fast-acting and unknown gain

70
Q

Epinephrine system is under what kind of control?

A

Smooth muscle control

71
Q

What is a property of the arterial system (and vascular smooth muscle) that causes an increase or decrease in constant pressure on arterial vessel that results in a change in contractile state?

A

Stress-relaxation behavior

72
Q

Stress-relaxation behavior has what kind of speed and gain?

A

Slow acting, low gain

73
Q

What system is a property of the capillaries of the body?

A

Capillary fluid shift (edema)

74
Q

How fast and what kind of gain does capillary fluid shift get?

A

Slow acting and low gain

75
Q

What system can account for peripheral edema in pathological states?

A

Capillary fluid shift

76
Q

A humoral control system that uses hormones from kidney and blood

A

Renin-angiotensin system

77
Q

What hormones does the renin-angiotensin system use?

A

Renin and angiotensin II

78
Q

Renin-angiotensin system works closely with what system?

A

Aldosterone system

79
Q

Renin-angiotensin system is how fast and what kind of gain?

A

Slow-acting and low gain

80
Q

The renin-angiotensin system’s participation is modified by

A
  • increase or decrease in BP at different arterioles
  • increase or decrease in sympathetic stimulation to kidneys
  • increase or decrease in sodium levels in nephron
81
Q

What are the effects of angiotensin?

A
  • Cause cardiac myocytes to hypertrophy
  • cause thirst
  • stimulate nephron to retain Na+ and H2O
  • cause efferent arteriolar vasoconstriction and increase glomerular filtration
  • stimulate release of ADH from posterior pituitary

** all to increase BP **

82
Q

A humoral control system that uses a hormone from the adrenal cortex

A

Aldosterone system

83
Q

Aldosterone works closely with what other BP regulatory system

A

Renin-angiotensin system

84
Q

The aldosterone system is how fast and what kind of gain?

A

Slow-acting and low gain

85
Q

Aldosterone system’s participation is modified by:

A
  • increase or decrease in angiotensin II levels

- K+ levels to adrenal cortex

86
Q

A humoral control system that uses osmotically sensitive neurons in hypothalamus to produce a hormone that is released from posterior pituitary gland

A

Vasopressin system

87
Q

What is the alternate name for vasopressin?

A

Anti-diuretic hormone (ADH)

88
Q

What does vasopressing / ADH do?

A

Acts as both a cardiovascular pressor agent and renal fluid retention agent

89
Q

V1 receptors on vascular smooth muscle can cause

A

vasoconstriction

90
Q

What speed and gain is vasopressin system?

A

Slow-acting and unknown gain

91
Q

A fluid (and humoral) control system that uses the kidney

A

Renal-blood fluid (volume pressure) system

92
Q

The renal-blood fluid system involves what?

A

Nephron and renin-angiotensin system

93
Q

The renal-blood fluid (volume pressure) system is how fast and what kind of gain?

A

Slow-acting and very high gain

94
Q

Which BP control system is the ultimate mechanism?

A

Renal-blood fluid (volume pressure) system

Because it works by adjusting the amount of fluid in the vascular compartment, rather than just manipulating existing fluids of the body.

95
Q

Pressure diuresis

A

Increased arterial BP leads to increased water disposal

96
Q

Pressure natriuresis

A

Increased arterial BP leads to increased salt/sodium disposal

97
Q

Diuresis

A

Formation of urine

98
Q

What system relies on diuresis?

A

Renal-blood fluid (volume pressure) system

99
Q

A moment-to-moment adjustment process that attempts to stabilize and match input and output (of both salt and water)

A

Renal output curve

100
Q

ADH causes kidneys to

A

Retain water

101
Q

How does salt intake increase extra cellular fluid volume?

A
  • Stimulates hypothalamic thirst center
  • Stimulates hypothalamic production of anti-diuretic hormone (ADH)
  • ADH causes kidneys to retain water
102
Q

2 primary determinants of long-term arterial pressure

A
  1. Level of water and salt intake (net fluid vol)

2. Behavior of kidneys as represented in the acute renal output curve

103
Q

Renal output curve can be changed by

A
  • addition of hormonal controls

- abnormalities of nephrons

104
Q

Angiotensin acts directly on kidneys to

A

Retain salt and water

105
Q

Angiotensin acts on adrenal glands to

A

Increase aldosterone secretion which increases salt and water retention in the kidneys

106
Q

The pressure in the system is created primarily from

A

The heart

107
Q

Cardiac output =

A

Venous return

108
Q

What determines CO?

A

By the end-diastolic volume which is dictated by venous return

109
Q

What determines venous return?

A

The size of peripheral vascular tubes

110
Q

What determines the r^4 (all vessels of the body) / size of vascular container?

A

Release of local factors from metabolizing tissues

In other words, metabolizing tissues determines venous return which determines C.O.

111
Q

If there is increased tissue metabolism, what are the next steps?

A
  • Increased in local metabolites
  • Increased vasodilation
  • Increased flow into venous system
  • Increased venous return
  • Increased cardiac output
  • Increased flow to original metabolizing tissues
112
Q

If there were 2 outputs in the cardiovascular system and cardiac output is 1 them, what is the other?

A

Tissue output (from the body) coupled with venous pump

*this is another way to think about it

113
Q

If you think of the systemic circulation as having 2 pumps with the left ventricle for Cardiac Output being 1, what is the other?

A

Collective skeletal muscles of the body (for venous return)

114
Q

Remember the equation:

Q = ∆P * r^4 where Q is flow, ∆P is pressure and r^4 is the size of all the vessels/vascular container…

∆P must be maintained, how is it maintained?

A

By the many BP regulatory systems that regulate the redistribution (and a few manage the volume) of blood

115
Q

Given the limited supply of blood and changing needs of the body, what becomes an important balancing act?

A

Distribution of blood

116
Q

What system can modify both cardiac output and the peripheral resistance and manage the distribution of blood?

A

Sympathetic nervous system

117
Q

If the body has an increased work-load, what will happen to CO and BP?

A

Increase

118
Q

How does changing blood chemistry alter breathing?

A

Increased H+ leads to increased ventilation

119
Q

Breathing serves as additional venous pumping

A

Respiratory pump

120
Q

“Warming down”

A

Continue to move though not fully exercising that is needed to prevent sudden post-exercise pooling of blood through venous pumping

121
Q

Exercise and related metabolism of skeletal muscles is often measured by amount of oxygen consumed by the body

A

VO2, volume of O2 consumed per minute

122
Q

VO2 levels at rest? But can rise to?

A

250 ml/min at rest

3,000 ml/min or more

123
Q

A maximum aerobic limit of VO2 is called

A

maxVO2

124
Q

A-V O2 difference is

A

Measure of tissue metabolism (or O2 extraction)

A-V O2 = Atriovenous oxygen difference

125
Q

In exercise, as total body Q increases, what happens?

A

Redistribution

  • increased Q to skin for sweating
  • stable Q to brain
  • increased Q to heart
  • decreased Q to gut
  • decreased Q to kidneys

Q = flow

126
Q

During exercise, CO can raise from ~5 l/m to

A

> 25 l/m

See graph on Pg 35 if Beck doesn’t insert it here

Physiology I (15 decks)

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