hypotension Flashcards

1
Q

what happens to baroreceptors when there is hypotension

A

the blood vessel walls are not stretching, meaning the sodium channels on the nerve endings are not opened leading to no action potentials
therefore there is inhibition of the baroreceptors

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2
Q

what are the three centres in the medulla oblongata

A

cardiac acceletory
vasomotor
cardiac inhibitory

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3
Q

which centres of the medulla oblongata are sympathetic

A

cardiac acceletory and vasomotor

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4
Q

which regions of the medulla oblongata are parasympathetic

A

the cardiac inhibitory centre becuase it has the dorsal nucleus of the vagus nerve

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5
Q

which two factors will affect blood pressure

A

total peripheral resistance and cardiac output

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6
Q

what is total peripheral resistance

A

the constriction of the blood vessels that impacts the speed or force that blood is being pumped

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7
Q

which centres are activated when there is low blood pressure

A

the vasomotor A1 centre and the cardiac acceletory centre

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8
Q

what are the main pathways the activation of the cardiac accelatory centre

A
  • sinoatrial node stimulation
  • atrioventricular node stimulation
  • increase contractility through the myocardium
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9
Q

how does the cardiac acceletory system increase heart rate through the nodes of the heart

A
  • preganglionic fibres in the lateral grey horn of the thoracolumbar region of the spinal cord come out
  • release noradrenaline and bind to beta one adrenergic receptors on the nodes
  • g stimulatory proteins activated
  • GDP to GTP
  • GTP works with adenyl cyclase to convert ATP to cAMP
  • cAMP activates the protein kinase A
  • phosphorylates calcium channels
  • influx of calcium
  • more action potentials
  • increased heart rate
  • increased cardiac output
  • increased blood pressure
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10
Q

how does the cardiac acceletory centre act on the myocardium to increase blood pressure

A
  • same mechanism as the nodes
  • noradrenaline binding to stimulate influx of calcium ions into the contractile units of the heart
  • more cross bridge formation
  • more powerful contractions
  • increased stroke volume
  • increased cardiac output
  • increased blood pressure
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11
Q

how does the vasomotor centre increase blood pressure

A

post ganglionic nerve fibres from thoracolumbar region that goes to blood vessels tunica media
- release noradrenaline to bind to alpha one adrenergic receptors
- more calcium enters the cell
- vasoconstriction
- decreased radius
- increased total peripheral resistance
- increased blood pressure

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12
Q

how does the adrenal medulla act to increase blood pressure

A

sympathetic fibres activate production of adrenaline and noadrenaline from the chromaffin cells of the medulla.
adrenaline causes vasoconstriction of blood vessels and contractility in the myocardium

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13
Q

what proportion of hormones from the adrenal medulla is adrenaline

A

80%

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14
Q

what proportion of hormones produced by the adrenal medulla are noradrenaline

A

20%

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15
Q

how do kidneys increase blood pressure

A
  • detect low blood delivery
  • release renin from its JG cells
  • adrenaline also acts on beta one adrenergic receptors in the kidney to increase renin production
  • renin in the bloodstream
  • comes across angiotensinogen and activates it
  • angiotensin follows circulation to the lungs
  • ACE converts it to angiotensin 2
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16
Q

what produces angiotensinogen

A

liver

17
Q

how does angiotensin 2 increase blood pressure

A
  • adrenal cortex zona glomerulosa: stimulates aldosterone release
  • stimulates action potentials in hypothalamus: release ADH into bloodstream
  • increases thirst levels: greater fluid absorption in the small intestine, greater blood volume
  • increase sodium water and chloride absorption in the proximal convoluted tubule to increase blood volume
  • act on tunica media for vasoconstriction
18
Q

what does ADH do

A

goes to kidney to act on receptors to activate g stimulatory proteins - same pathway for protein kinase A to phosphorylate the aquaporins to increase water absorption into the blood to increase plasma volume and therefore blood volume.

19
Q

what does aldosterone do

A

increases sodium levels

20
Q

what happens to urination during hypotension and why

A

oliguria, decreased urine flow, occurs due to an increase in absorption of fluids into the body to try and maintain the blood volume and pressure.