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Human physiology > Lecture 13: Control of blood flow 2 > Flashcards

Lecture 13: Control of blood flow 2 Flashcards

1
Q

Atherosclerosis

A

Major characteristic is the presence of lesions within the intima of the vessel wall that protrude into the vessel lumen

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2
Q

Non-modifiable (constitutional) risk factors of atherosclerosis

A

Age (Risk increases between 40-60)
Gender- Uncommon in premenopausal women, increases after menopause and eventually exceeds men
Genetics

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3
Q

Modifiable risk factors of atherosclerosis

A

Hyperlipidemia (high cholesterol)
Hypertension
Smoking
Diabetes

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4
Q

Other risk factors of atherosclerosis

A

Inflammation- CRP is a major marker for inflammation
-correlated w/high LDL levels
Hyperhomocystinemia
Metabolic syndrome-associated w/insulin resistance
Lipoprotein a
Factors affecting hemostasis
Life style

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5
Q

Endothelial injury/dysfunction

A

Results in intimal thickening

May lead to formation of atheroma in presence of hyperlipidemia

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6
Q

Accumulation of lipoproteins (esp. LDL)

A

Result of chronic hyperlipidemia
Lipoproteins accumulate and are oxidized by oxygen free radicals
Oxidized LDL is toxic to endothelial cells and smooth muscle cells

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7
Q

Monocyte adhesion to endothelium

A

Endothelial cells express adhesion molecules that bind monocytes and T-cells to endothelium
Monocytes transform into macrophages and engulf lipoproteins
T-cells stimulate chronic inflammatory response
Activated leukocytes and endothelial cells release growth factors that promote smooth muscle proliferation

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8
Q

Smooth muscle cell proliferation

A

Intimal smooth muscle cell proliferation and extracellular matrix deposition converts a fatty streak into a mature atheroma

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9
Q

Characteristics of hypertension

A

Increased cardiac output
Increased sympathetic nerve activity
Increase in angiotensin II and aldosterone levels
Impairment of renal-pressure natriuresis mechanism
Inadequate secretion of salt and water

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10
Q

Factors leading to secondary hypertension

A 
Tumor affecting renin-secreting juxtaglomerular cells
Renal artery constriction
Coarctation of the aorta
Preeclampsia
Neurogenic hypertension
Genetic causes
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11
Q

Factors resulting in increased cardiac output leading to increased blood pressure

A

Increased heart rate
Increased contraction
Increased blood volume (due to aldosterone)

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12
Q

Factors resulting in increased peripheral resistance leading to increased blood pressure

A

Increased angiotensin II
Increased catecholamines
Increased thromboxane
Increased neural factors (alpha-adrenergic)

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13
Q

Developmental stages of atherosclerosis

A

Earliest lesions are fatty streaks
Atherosclerotic plaques impinge on the lumen of the artery
Plaques progressively enlarge due to cell death
Plaques often undergo calcification
Plaques may rupture, ulcerate or erode

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14
Q

Most common arterial sites of artherosclerosis

A 
Lower abdominal aorta
Coronary arteries
Popliteal arteries
Internal carotids
Circle of willis
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15
Q

Short term control of arterial pressure

A

Via sympathetic nervous system effects on total peripheral vascular resistance/capacitance and cardiac pumping ability

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16
Q

Long term control of arterial pressure

A

Via multiple nervous and hormonal controls

Local controls is kidneys that regulate salt and water excretion

17
Q

Increased arterial pressure causes

A

Increased urine output- pressure diuresis

Increased sodium output- pressure natriuresis

18
Q

Return of arterial pressure always back to the equilibrium point=

A

Near infinite feedback gain principle

19
Q

Primary determinants of the long term arterial pressure level

A

Degree of pressure shift of the renal output curve for water/salt
Level of water/salt intake

20
Q

Increased salt intake causes

A

Only small changes in the arterial pressure

21
Q

Acute increases in blood pressure cause

A

2-3x increase in urinary sodium output

22
Q

Chronic hypertension definition

A

Ones mean arterial pressure is greater than the upper range of the accepted normal pressure

23
Q

Normal pressure

A

90mm hg 110/70

24
Q

Hypertensive pressure

A

110mm Hg 135/90

25
Q

Severe hypertensive pressure

A

150-170mm Hg 250/130

26
Q

Lethal effects of chronic hypertension

A 
Early heart failure
Coronary heart disease
Heart attack
Cerebral infarct
Destruction of area of kidney--kidney failure--uremia--death
27
Q

Decreased arterial pressure causes kidneys to

A

Release renin

28
Q

Angiotensin II causes

A

Renal retention of salt and water

Vasoconstriction

29
Q

Angiotensin II effect on adrenal gland

A

Adrenal gland releases aldosterone, which causes kidney to increase sodium/water reabsorption

30
Q

Increased blood pressure can cause volume overload in heart, which causes

A

Atrial natriureteric peptide release, which causes vasodilation

Human physiology (16 decks)

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