Jeopardy Flashcards
What are the main determinants of MAP?
CO and TPR
What are the 3 main mechanisms of regulating blood pressure?
Baroreceptor reflex
Renin-angiotensin
Aldosterone
Define hypertension
A sustained elevation of systemic arterial BP >120/80
What causes hypertension?
Hypertension is caused by increases in CO, peripheral resistance, or both
True/False - Most cases of hypertension are secondary to other diseases?
FALSE - only 5-8% are secondary with the majority primary (idiopathic)
What’s the 1st morphological change that occurs in the myocardium with hypertension?
Hypertrophy of the left ventricle
Why do you get light-headed when standing after sitting down for extended periods?
Venous pooling (in legs and lower body) leading to a decreased BP when standing - orthostatic hypotension
What are the 2 most common reasons for heart failure?
- Damage to the heart muscle
2. Prolonged pumping against a chronically increased afterload
What happens to the Frank-Starling law in the left ventricle in heart failure?
The curve is shifted downward and to the right
How does the sympathetic nervous system help compensate to restore SV in heart failure?
Sympathetic activity to the heart is increased which increases HR and inotropy
Is sympathetic compensation a long-term fix for decreased SV?
No - the heart becomes less responsive to norepi and the norepi in the nerve terminals becomes depleted (atrophy?)
What does the term decompensated heart failure mean?
When the contractility of the heart deteriorates to the point where it is no longer able to pump out a normal SV despite the compensatory measures
What 2 events directly affect mucous membrane color in a person with decreased cardiac function?
Blood flow slows in the capillaries which causes:
1 - a long contact time between the tissues and hemoglobin carrying RCBs
2 - development of metabolic acidosis
What can a palpated pulse tell us about cardiac function?
It can tell us rate, rhythm, strength of ventricular systole (and more if measured bilaterally)
In an adult when we would usually hear S3 or S4?
If the person has a stiffened left ventricle (heart failure is a usual cause)
What type of heart failure leads to pulmonary edema?
Left heart failure
What can we determine from a chest x-ray?
Mostly size and structure of the heart - and you can also see the lungs
How do we get blood to the working muscles during exercise if we have high levels of norepi?
Metabolic trumps sympathetic - although the overall effect on the vasculature is vasoconstriction, blood flow to the working organs is primarily controlled by local metabolic factors
During exercise what mechanisms are helping to increase venous return to the heart?
- Venous constriction
- Skeletal muscle pump
- Respiratory pump
When we need to control BP what mechanism is the fastest?
Baroreceptors - they sense the change and make adjustments in seconds
T/F - Insulin resistance contributes to increased peripheral resistance?
True - along with inflammation and endothelial dysfunction
For what 2 diseases would you put somebody on a sodium restricted diet?
Hypertension and heart failure
Why does BP tend to increase with age?
As we age compliance of the blood vessels decreases (they get stiffer)
Following training what happens to a persons resting CO?
It remains about the same as before training - this is because that although training decreases resting HR it increases SV
