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Cardiovascular Pathophysiology > Hemodynamic Defense Response > Flashcards

Hemodynamic Defense Response Flashcards

1
Q

what is the main goal of the hemodynamic defense?

A

maintain cardiovascular integrity

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2
Q

what are the key systems involved in blood pressure control?

A

baroreceptor reflexes
sympathetic nervous system
renin angiotensin aldosterone system
antidiuretic hormone

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3
Q

what is the equation for cardiac output?

A

CO= stroke volume x heart rate

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4
Q

what is the equation for mean arterial pressure?

A

MAP= diastolic blood pressure + 1/3 of pulse pressure

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5
Q

what happens with mean arterial pressure during exercise?

A

it stays the same

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6
Q

what vessels determine peripheral vascular resistance?

A

arterioles

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7
Q

what is the major determinant of resistance?

A

radius of the vessel

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8
Q

what performs short term blood pressure control?

A

vasomotor center
baroreflexes and autonomic control

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9
Q

where is the vasomotor center located?

A

reticular substance of the medulla and lower pons

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10
Q

what is the sensory area of the vasomotor center?

A

nucleus solitarius

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11
Q

how does the vasodilator area of the vasomotor center perform?

A

inhibit vasoconstrictor activity with its fibers

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12
Q

where are high pressure baroreceptors located?

A

carotid sinus and aortic arch

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13
Q

what is the first line of defense to acute changes in blood pressure?

A

high pressure baroreceptors in carotid sinus and aortic arch

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14
Q

where are low pressure baroreceptors located?

A

large intrathoracic vessels and the heart

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15
Q

what is the stimulus for the low pressure baroreceptors?

A

increased stretch

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16
Q

what is the bainbridge reflex?

A

increased sympathetic outflow detected by low pressure baroreceptors (increased stretch) leads to an increase in heart rate

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17
Q

what are the specific responses to acute hypotension?

A

vasomotor center receives input from baroreceptor via cranial nerves IX and X: vasomotor center
nucleus solitarius conveys signal to vasoconstrictor and vasodilator centers
increased sympathetic activity: vasoconstriction, increased heart rate and contractility

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18
Q

what is the general response to acute hypotension?

A

increased cardiac output
restoration of normal blood pressure

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19
Q

what serves as the intermediate control of blood pressure?

A

epinephrine and norepinephrine

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20
Q

what are alpha1 receptors chiefly mediated by?

A

norepinephrine

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21
Q

what are beta1 receptors chiefly mediated by?

A

epinephrine

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22
Q

what is the net result of beta1 receptors being stimulated?

A

increased cardiac output

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23
Q

what type of blood pressure control does the renin angiotensin aldosterone system provide?

A

intermediate to long term

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24
Q

what are the causes of renin release?

A

renal sympathetic stimulation
decreased renal perfusion
decreased sodium delivery to the macula densa

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25
Q

what organ releases and produces renin?

A

kidney

26
Q

where is angiotensinogen made?

A

liver

27
Q

how do renin and angiotensinogen interact?

A

renin acts on angiotensinogen to make angiotensin-I (AT-I)

28
Q

how is angiotensin-I converted into angiotensin-II (AT-II)?

A

angiotensin converting enzyme (ACE)

29
Q

what are some stimuli of aldosterone?

A

angiotensin II
decreased sodium load at the macula densa
increased potassium
ACTH

30
Q

why is antidiuretic hormone primarily released?

A

plasma hyperosmolarity (dehydration)

31
Q

when is antidiuretic hormone inappropriately elevated?

A

in CHF

32
Q

what is the response to antidiuretic hormone?

A

direct vasoconstriction
increased permeability to water in the distal tubule

33
Q

what are the two natriuretic peptides?

A

atrial and brain natriuretic peptides

34
Q

what stimulates the release of the natriuretic peptides?

A

stretch of the atria or ventricles
myocardial dysfunction

35
Q

how are the natriuretic peptides activated?

A

proteolytic cleavage

36
Q

what maintains cardiovascular integrity in the short term?

A

autonomic nervous system

37
Q

what maintains cardiovascular integrity in the long term?

A

salt and water retention

38
Q

what maintains cardiovascular integrity in the intermediate term?

A

humoral factors

39
Q

what is the first line defense against rapid changes in blood pressure?

A

baroreceptor reflexes

40
Q

how does the sympathetic nervous system control blood pressure?

A

rapid selective vasoconstriction and increased cardiac output

41
Q

what timeline does the renin angiotensin aldosteron system work over?

A

intermediate and long term

42
Q

how is peripheral vascular resistance decreased in exercise?

A

arteriolar vasodilation in skeletal muscle

43
Q

what is poiseuille’s law?

A

R=8nL/(pi x r^4)

44
Q

what controls peripheral vascular resistance acutely?

A

autonomic control: baroreceptors
metabolic, paracrine factors

45
Q

what controls peripheral vascular resistance in intermediate and long-term?

A

sympathetic nervous system
angiotensin
vasopressin
endothelin

46
Q

what does the vasomotor center transmit?

A

parasympathetic impulses through vagus to heart
sympathetic impulses through spinal cord and sympathetic nerves to vasculature and heart

47
Q

what does the vasoconstrictor area of the vasomotor center do?

A

distributes fibers to cord: excited vasoconstrictor neurons of sympathetic nervous system

48
Q

what do high pressure baroreceptors detect?

A

magnitude, rate of change of pressure-induced stretch of arterial wall

49
Q

what is the response to increased stretch in the low pressure baroreceptors?

A

bainbridge reflex
decreased renin and AVP release: increase Na and H2O excretion

50
Q

what is the pathway for secretion of epinephrine and norepinephrine?

A

adrenal medullary secretion of both
epi: alpha and beta
norepi: alpha

51
Q

what is the stimulus to release epinephrine and norepinephrine?

A

generalized sympathetic nervous system stimulation

52
Q

what does alpha1 stimulation by norepinephrine lead to?

A

increased peripheral vascular resistance and venous return to heart
arteriolar vasoconstriction
venous vasocnstriction

53
Q

what does beta1 stimulation by epinephrine lead to?

A

increased chronotropy, inotropy, and lusitropy (relaxation): increased cardiac output

54
Q

what is the response to angiotensin II?

A

vasoconstriction, thirst
kidney: conserve Na and H2O, efferent arteriolar vasoconstriction
aldosterone and ADH release

55
Q

how does aldosterone work?

A

transcription of Na/K pumps in distal convoluted tubule
increased number of Na channels
increased potassium secretion into tubules

56
Q

what is the response to aldosterone?

A

sodium and water retention, potassium excretion
myocardial remodeling and fibrosis

57
Q

why is antidiuretic hormone released?

A

primary: plasma hyperosmolarity
also: decreased atrial stretch, angiotensin II, decreased arterial stretch

58
Q

what is the response to antidiuretic hormone?

A

direct vasoconstriction
increased permeability to water in distal tubule

59
Q

what do the intra-cardiac RAAS systems drive?

A

remodeling
progressive hypertrophy
fibrosis

60
Q

what do the atrial and brain natriuretic peptides do?

A

diuretic effect
endogenous antagonists to RAAS
inhibit sympathetic nervous system and vasopressin

61
Q

what do the natriuretic peptides do to blood pressure?

A

decrease it

Cardiovascular Pathophysiology (35 decks)

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