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Year 1: 08. CPR Exam 1 > Lecture 21: Regulation of Arterial Pressure > Flashcards

Lecture 21: Regulation of Arterial Pressure Flashcards

1
Q

What are the equations for calculating Mean Arterial Pressure?

A
  • Mean Arterial Pressure = Cardiac Output x Total Peripheral Resistance
  • Mean Arterial Pressure = Heart Rate x Stroke Volume x Total Peripheral Resistance
  • Mean Arterial Pressure = 2/3 (Diastolic BP) + 1/3 (Systolic BP)
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2
Q

What regulates mean arterial pressure?

A
  • Baroreceptor Reflex
  • RAAS System
  • ADH
  • ANP
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3
Q

Where are baroreceptors located?

A
  • Carotid sinus
  • Aortic sinus
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4
Q

What nerves are involved in the carotid sinus?

Where do they send their information?

A
  • CN IX
  • Sinus nerve of Hering
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5
Q

What nerves are involved in the aortic sinus?

A
  • CN X
  • Aortic Nerve
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6
Q

Where do nerves from the aortic and carotid sinus send their information?

A

Nucleus Tractus Solitatrius

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7
Q

What neurotransmitter do afferent signals from baroreceptors use when sending information to the nucleus tractus soliatrius?

A

Glutamate

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8
Q

What do chemoreceptors respond to?

A
  • PO2
  • PCO2
  • pH
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9
Q

What do mechanoreceptors respond to?

A
  • Changes in arterial pressure
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10
Q

What causes increased firing in a baroreceptor?

A

Increased pressure/stretch

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11
Q

What causes decreased firing in a baroreceptor?

A

Decreases in pressure/stretch

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12
Q

Where do baroreceptors send their signals to?

A

Medulla: Vasomotor center

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13
Q

What area of the brainstem is involved in parasympathetic activity in cardiovascular function?

A
  • Dorsal motor nucleus of the vagus
  • Nucleus ambiguus
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14
Q

What area of the brainstem is involved in sympathetic activity in cardiovascular function?

A

Rostral ventrolateral medulla

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15
Q

What is stroke volume is dependent on?

A
  • Sympathetic stimulation of the heart
  • Preload (EDV)
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16
Q

Heart rate is dependent on?

A
  • Sympathetic stimulation
  • Parasympathetic stimulation
17
Q

Total peripheral resistance (TPR) is dependent on?

A

Sympathetic stimulation of arterioles

18
Q

What is the difference between aortic and carotid baroreceptors?

A
  • Aortic baroreceptors has higher threshold for activation
    • ​Continues to respond above saturation
    • Less sensitive to rate
19
Q

Sympathetic nervous system causes _ baroreceptor firing rate

A

Decreased

20
Q

What are the effects of the sympathetic nervous system on HR, contractility, vein and arteriolar radius, fluid retention?

A
  • Constriction of arterioles and veins (alpha receptors)
  • Increases HR and contractility (beta 1)
  • Renin secretion and increased fluid retention
21
Q

Parasympathetic nervous system causes _ baroreceptor firing rate

A

Increased

22
Q

What are the effects of the parasympathetic NS on arterial pressure?

A
  • We want to decrease MAP
  • Decrease HR
    • Vagus nerve signal to SA node
    • Muscarinic receptors
  • Also indirect vasodilation on blood vessels via NO
23
Q

How does hypertension saffect baroreceptors?

A

Changes “normal” set point to something higher, which becomes the new “normal”

24
Q

What enzyme is secreted by the kidney in response to drops in BP? What type of cell secretes this?

A

Juxtaglomerular cells produces renin.

25
Q

What stimulates the release of renin?

A
  • Sympathetic Nervous System
  • *Specifically beta 1 adrenergic receptor activation*
26
Q

What does renin do as an enzyme?

A

Converts angiotensinogen to angiotensin I

27
Q

Angiotensin I is converted to Angiotensin II via which enzyme?

Where is this occurring?

A

Converted by ACE in lungs

28
Q

What does angiotensin II do in its active form?

A
  • Causes secretion of aldosterone from the adrenal cortex
  • Stimulates secretion of ADH/Vasopressin
  • Causes global constriction of arterioles by binding to AT1 receptors
29
Q

What does aldosterone do?

A
  • Increases Na+ and H2O retention
  • Increases blood volume, preload, SV, CO, and MAP
30
Q

What does ADH/Vasopressin do?

It is not only secreted in response to angiotensin II, but what other factors?

A
  • Acts on V1 and V2 receptors of smooth muscle, and collecting ducts, respectively and increases TPR and water retention
  • Atrial receptors during low preload, increased osmolarity of blood
31
Q

What are the three natriuretic peptides that affect arterial pressure?

When are they secreted?

What are their effects?

A
  • ANP, BNP, CNP
  • Excessive preload of atria and ventricles
  • Effects
    • Arteriolar dilation: decrease TPR
    • Increases fluid loss: decreases preload
    • Inhibits renin: decreases TPR and preload
32
Q

What happens when you have a hemorrhage?

A
  • Decrease in blood volume and MAP
  • Decreased firing of mechanoreceptors
  • Increase sympathetic activation to bring MAP back up
  • Sympathetics will:
    • Increase HR, CO and contractility via alpha ine adrenergic receptors
    • Constrict arterioles to increase TPR
    • Constrict the veins to decrease unstressed volume and increase venous return
    • Increased RAAS activation
33
Q

What happens when you have too much blood?

A
  • Increase in blood volume and increase in MAP
  • Activate parasympathetics to bring MAP back down
    • Increased ANP secretion
    • Decreased ADH secretion
    • Renal vasodilation
    • Increased HR? (d/t increased preload?)*
34
Q

What happens during exercise?

A
  • Most important thing is getting blood to heart and skeletal muscle-increased sympathetic activation and decreased parasymp activation
  • Central command
    • Increase HR/contractility via Beta 1 adrenergic receptors
    • Increase venous return
    • Alpha one receptor activation leads to SELECTIVE vasoconstriction in skin, kidney, splanchnic regions, and inactive muscle
    • Vasodilation in active muscles due to metabolites such as K+, adenosine and lactate
  • Effects:
    • ​Increase in pulse pressure
    • SBP increases
    • DBP should not change much
    • Overall TPR will decrease (d/t dilation of skeletal muscle arterioles
35
Q

What happens during orthostatic hypotension?

What happens in response?

A
  • Decreased MAP; no change in HR and TPR, CO goes down from decreased venous return, central venous pressure decreases d/t pooling of blood in lower extremities
  • Increase sympathetic activation
    • Increase HR, contractility and CO via beta 1 adrenergic receptors
    • Want to increase TPR via constriction of arterioles
    • Want to decrease unstressed volume and increase venous return so we constrict the veins

Year 1: 08. CPR Exam 1 (29 decks)

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