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Patho Exam 3 > HTN > Flashcards

HTN Flashcards

1
Q

Optimal blood circulation requires ______ (of blood) that fills the blood vessels, and _______ to move the blood into all parts of the body

A

Optimal blood circulation requires volume (of blood) that fills the blood vessels, and pressure to move the blood into all parts of the body

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2
Q

what is the inner wall of the arteries called and some risk factors associated with it?

A

the endothelium

o Endothelium injury is a factor in developing atherosclerosis or arteriosclerosis

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3
Q

Atherosclerosis

A

is the deposition of fatty plaques in the endothelium

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4
Q

Arteriosclerosis

A

is the hardening of the artery walls

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5
Q

possible causes of arteriosclerosis (2)

A
  1. increased blood sugar (DM)

2. smoking

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6
Q

what is cardiac output (CO)? w/ normal CO

A

the amount of blood that flows from the heart’s left ventricle per minute

  • about 5 L of blood per minute
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7
Q

Blood pressure (arterial blood pressure) measures what?

A

measures the force against the walls of the arteries as the heart pumps blood

  • higher in the arteries than in the veins
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8
Q

describe Total Peripheral Vascular Resistance (PVR)

A

amount of obstruction to blood flow caused by vessel diameter, vessel length, and blood viscosity

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9
Q

list the 2 equations for obtaining CO

A
  1. BP / PVR (hard to compute)

2. SV x HR

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10
Q

what do baroreceptors do? where are they located?

A
  • regulate BP - it is a neural mechanism

- located along the walls of arteries particularly carotid artery and carotid arch

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11
Q

describe systolic BP

A

max pressure that the heart exerts while beating - during contraction

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12
Q

describe diastolic BP

A

pressure in the arteries in between beats - during relaxation

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13
Q

describe the pathway of cardiovascular regulation in the brain (2)

A
  1. pons and medulla

2. transmit sympathetic and parasympathetic signals to the heart and blood vessels

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14
Q

describe stroke volume

A

the volume of blood ejected per ventricular contraction

  • same thing as EF
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15
Q

describe ejection fraction w/ example

A

how much blood the left ventricle pumps per contraction (%)

  • at any given time there is 100ml of blood in the left ventricle
  • ex: if patient has 70% EF then only 70% of blood is being ejected from the LV = 70ml
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16
Q

describe orthostatic hypotension

A

significant drop of BP when changing position = decrease in cerebral perfusion = dizziness

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17
Q

if HR is 68 and EF is 65%, what is the CO in L/min?

A

68 x 65 ml = 4,420 ml = 4.42 L/min

18
Q

what is RAAS?

A

Renin - Aldosterone - Aldosterone Syndrome

19
Q

what is the function of RAAS?

A

Raises BP in response to decreased blood circulation

- the kidney is very sensitive to the drop in blood pressure

20
Q

describe the pathway of RAAS to increase BP

A
  1. kidney detects drop in BP
  2. nephrons release Renin = stimulates the liver to secrete angiotensinogen
  3. angiotensinogen reaches the lungs = is transformed into Angiotensin I
  4. then ACE transforms Angiotensin I to Angiotensin II
  5. Angiotensin II stimulates adrenal gland to release Aldosterone
  6. Aldosterone works at nephrons to increase sodium and water reabsorption into the bloodstream (increases potassium excretion in the urine)
21
Q

what is important to note about Angiotensin II?

A

Angiotensin II is a strong arterial vasoconstrictor

22
Q

what is the anti-diuretic hormone (ADH) also called?

A

vasopressin

23
Q

what is the function of ADH?

A

secreted by posterior pituitary gland to increase water reabsorption

24
Q

what chemicals affect the arteries?

A
  1. lipids
  2. glucose
  3. free radicals
  4. nicotine
  5. homocysteine
25
Q

describe natriuresis

A

sodium being excreted in the urine

26
Q

describe how lipids affect the arteries

A

Fats that circulate in the bloodstream; mainly composed of cholesterol

  1. Cholesterol: comes from diet and also synthesized by the liver
  2. Triglycerides: lipid molecules acquired through diet and stored as fat tissue - usually elevated in a high-carb diet
  3. LDL; HDL
    - LDL: bad cholesterol, fatty plaques deposited along the walls of the arteries = inflammatory reaction which macrophages try to engulf but they get stuck
    - HDL: brings LDL back to the liver = lower blood LDL level
27
Q

describe how glucose affect the arteries

A
  1. Chronic elevation of blood glucose can injure the endothelial walls of the arteries
  2. uncontrolled diabetes
    = high risk for atherosclerosis and myocardial infarction
28
Q

describe how free radicals affect the arteries

A

Have high affinity to cell membranes

= can damage the endothelial lining of the arteries

29
Q

describe how nicotine affect the arteries

A

can cause vasoconstriction

30
Q

describe how homocysteine affect the arteries

A
  1. Amino acid involved in metabolism Vitamin B complex but a deficiency in Vitamin B
  2. decreased breakdown of homocysteine
    = high level of homocysteine can damage the endothelial walls of the arteries; also linked to increased thrombosis formation
  • homocysteine is high in meats
31
Q

describe HTN

A

The elevation of blood pressure to values that are correlated with cardiovascular damage

32
Q

AHA/AAC description of HTN

A

HTN exists when 2 or more diastolic blood pressure measurement on at least 2 or more clinical visits is 80 mmHg or higher; or when systolic blood pressure measurement is consistently 130 mmHg or higher

33
Q

what is the cause of primary HTN

A

exact cause is unknown

34
Q

what is the cause of secondary HTN

A

effect or complication of other systemic disorders; or side effects of some drugs/toxins

35
Q

what are some risk factors for HTN (9)

A
  1. Family history
  2. advancing age
  3. race
  4. obesity
  5. tobacco use
  6. high salt and saturated fat intake
  7. excessive alcohol intake
  8. sedentary lifestyle
  9. chronic stress
36
Q

describe the pathologic changes of HTN (5)

A
  1. changes in arterial bed/ endothelial lining = increased peripheral resistance
  2. increased tone in the SNS = increased peripheral resistance
  3. increased blood volume
  4. arterial wall thickening = increased peripheral vascular resistance
  5. abnormal release of renin, produces Angiotensin II = increased blood volume and increased constriction of arterioles

= could lead to prolonged HTN

37
Q

describe the pathway of prolonged HTN

A
  1. increases resistance to ventricular ejection and workload of heart increases
  2. left ventricle hypertrophies
    = further increases workload of the heart
38
Q

complications of prolonged HTN (7)

A
  1. Stroke
  2. MI
  3. heart failure
  4. arrhythmias
  5. retinopathy
  6. encephalopathy
  7. renal failure
39
Q

treatment of HTN

A
  1. diet
  2. moderate exercise
  3. medications
    • α - adrenergic blocker like Doxazosin; terazosin (lowers BP)
    • β - adrenergic blocker like Atenolol, metoprolol, propranolol, carvedilol (lowers BP & HR)
    • Diuretics (lowers BP)
    • ARB/Ace-inhibitors/Ace-receptor blockers (lowers BP)
40
Q

s/s of HTN

A

it is asymptomatic except an elevated BP
- in severe untreated cases
= headaches or neck pain
= organ specific s/s

Patho Exam 3 (9 decks)

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