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Physiology I Block 4 > Long Term > Flashcards

Long Term Flashcards

1
Q

what controls long term pressure

A

how much extracellular fluid you have in body

balance b/w fluid intake and output

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2
Q

if blood volume increases, vascular capacitance:

A

is not altered

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3
Q

if blood volume increases, arterial pressure will

A

increase

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4
Q

rising arterial pressure causes kidneys to

A

excrete excess volume, returning pressure to normal

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5
Q

level of extracellular fluid volume in body determines

A

long term arterial pressure

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6
Q

when arterial pressure falls below 50, what happens to urinary output

A

there is nourinary output

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7
Q

if arterial pressure is increased to 200 what happens to urinary output

A

it increases 8x

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8
Q

diuresis means

A

increase in urinary output

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9
Q

increased arterial pressure means what for urinary output

A

increase

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10
Q

increase in pressure causes what to happen to sodium

A

increase in sodium output

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11
Q

if water leaves

A

sodium leaves

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12
Q

pressure diuresis

A

Increased urinary output in response to increasing pressure

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13
Q

pressure natriuresis.

A

The increase in pressure causes an approximate equal increase in sodium output

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14
Q

if you infuse saline into dog what happens to CO

A

increases

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15
Q

if you infuse saline into dog what happens to urinary output

A

increases

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16
Q

if you infuse saline into dog what happens to arterial pressure

A

increases

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17
Q

what determines each person’s arterial pressure?

A

water and salt output has to equal water and salt intake - long term they have to be equal

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18
Q

equilibrium point

A

where intake and output curves intersect and is an individuals long term arterial pressure.

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19
Q

if BP increases what will system do

A

increase urine until pressure goes back down to equilibrium

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20
Q

anything that increases arterial pressure will cause

A

urinary output to go up until it goes down to equilibrium point

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21
Q

if there is decrease in arterial pressure what will happen to urinary output

A

decrease

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22
Q

if equilibrium point determine BP why is everybody’s BP a little bit different

A

there are two ways to determien long term arterial pressure:

shift salt and water intake or shift ability of kidneys to excrete fluid at a particular pressure

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23
Q

the two ways to determine long term arterial pressure

A

The degree of pressure shift of the renal output curve for water and salt
Some abnormality has caused the renal output curve to shift 50 mmHg to the right

Salt and water intake line
Increase intake of salt and/or water

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24
Q

in most people renal function curve is steep and chanages in salt take

A

only have have a modest effect on arterial pressure

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25
Q

review graph on pg 9

A

9

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26
Q

a human can change salt and water intake trremendously and not alter

A

BP

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27
Q

most people are salt _____

A

insensitive

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28
Q

if you are salt sensitive, it means that

A

the chronic renal output curve is much less steep, so increase in salt or water changes pressure and you have to change renal output to change it

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29
Q

what can cause salt sensitive

A

loss of functional nephrons due to kidney injury

excessive formation of antinatriuretic hormones

reduction in kidney mass or injury to kidney

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30
Q

what can cause loss of functional nephron

A

kidney injury

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31
Q

nephron is

A

functional unit of kidney

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32
Q

can kidney regenerate new nephrons

A

no

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33
Q

what happens to nephron number as you age

A

decrease

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34
Q

once a nephron is gone

A

its gone :(

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35
Q

each nephron contains

A

a tuft of glomerular capillaries called the glomerulus

a long tubule in which the filtered fluid is converted into urine.

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36
Q

if kidneys are destroyed, only way to remove extracellular fluid is

A

dialysis

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37
Q

what happens to BP to someone in renal failure

A

increase - you can’t get rid of the fluid

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38
Q

antinatriuretic hormones do what

A

hormones that reabsorb sodium and water in kidney to increase blood volume

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39
Q

examples of anti­natriuretic hormones

A

angiotensin II

aldosterone

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40
Q

if person has too much renin released they are

A

incresing sodium reabsorption, pressure will get higher

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41
Q

antiotensin II at level of adrenal gland, does what

A

increases release of aldosterone

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42
Q

hyperaldosterone can lead to

A

hypertension

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43
Q

aldosterone increases

A

sodium reabsorption, extracellular fluid volume, arterial pressure

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44
Q

hypertension itself will cause

A

renal damage

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45
Q

hypertension that causes renal damage is causing

A

more hypertension

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46
Q

diabetes causes renal

A

damage

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47
Q

diabetes is a risk factor for

A

hypertension

48
Q

greater than normal increase in arterial pressure is reuired to raise renal output sufficiently to maintain:

A

a balance b/w intake and output of salt and water

49
Q

why does increasing fluids increase arterial pressure

A

see chart pg 13

50
Q

mean circulatory filling pressure

A

average pressure necessary to cause filling of the circulation with blood

51
Q

the higher the blood volume, what happens to mean circulatory filling pressure

A

the higher

52
Q

the higher mean circulatory filling pressure, the more

A

venous return

53
Q

increase extracellular fluid volume, then what happens

A

increase blood volume, increase mean circulatory filling pressure, increase venous return

54
Q

mean systemic circulatory pressure

A

pressure in systemic circulation w/out the heart

55
Q

arterial pressure =

A

CO x TPR

56
Q

hemorrhaging pt what would happen to mean circulatory filling pressure

A

decrease

57
Q

hemorrhaging person with decreased mean circulatory filling presure, how do we get blood back toheart?

A

baroreceptors fire less and veins will constrict (decrease compliance) so even though there’s less blood we can compensate to bring more blood to heart

58
Q

increase in arterial pressure has to do with what tow different things

A

CO x TPR

59
Q

what is thought to happen is that increased in cardiac output increases arterial pressure, and also the tissues do what

A

autoregulation

60
Q

describe tissue autoregulation

A

they will constrict themselves if they get too much blood, to increase arterial pressure

61
Q

changes in long term artierial pressure

A

anything that increases renal vascular resistance

62
Q

if increase in renal vascular resistance, more pressure is needed to

A

excrete same amount of salt and water

63
Q

what things would increase peripheral resistance in kidney

A

atherlosclerotic plaques

64
Q

anything that decreases number of functional nephrons will do what

A

make it harder to cause same amount of urine flow, so pressure has to be higher

65
Q

changes in total peripheral resistance do not change

A

long term arterial pressure

66
Q

review pg 15

A

15

67
Q

review pg 16

A

16

68
Q

ace blocks levles of

A

angiotensin II

69
Q

angiotensin II is a

A

vasoconstrictor

70
Q

pacemaker in the heart is the thing that is firing

A

fastest

71
Q

a mean arterial pressure greater than what is considered hypertensive

A

110

72
Q

diastolic blood pressure greater than what is hypertension

A

90

73
Q

what can the lethal effects of hypertension be

A

excess workload on the heart - will cause heart failure over time
stroke
injury of kidneys

74
Q

athletic hypertrophy vs. hypertension causing hypertorphy

A

they are different kinds of hypertrophy, they don’t understand why

75
Q

if a lot of left kidney is removed and entire right kidney is removed what happens to pressure right after

A

increases

76
Q

if you put the rats who have had most of kidney removed put them on .9% NaCl what happens to their mean arterial rpessure

A

it goes way up

77
Q

why does the salt make the rats with removed kidneys arterial pressure go way up

A

they need the extra pressure to get rid of the salt in the water that they are drinking b/c you removed a bunch of their kidney
they also drink more b/c the salt water doesn’t quench their thirst

78
Q

review pg 19

A

19

79
Q

read pg 20

A

20

80
Q

read pg 21

A

21

81
Q

read pg 22

A

22

82
Q

kidneys themselves can sense when pressure

A

falls

83
Q

when pressure decreaes in kidney what is released

A

renin

84
Q

renin substrate converts angiotensinogen into

A

angiotensin I

85
Q

angiotensin I is turned into Angiotensin II by what enzyme

A

converting enzyme

86
Q

what enzyme do ACE inhibitors block

A

converting enzyme, so block effects of angiotensin II

87
Q

ACE inhibitors do what

A

enhance effects of bradykinin

block angiotensin II

88
Q

what does angiotensin II do

A

vasoconstriction

renal retention of salt and water

89
Q

how long does it take for vasoconstriction to happen with angiotensin II

A

minutes - very quickly

90
Q

how long does it take for angiotensin II to increase salt and water retention

A

days

91
Q

there are beta 1 receptors in kidney, that when there is sympathetic stimulation what will happen

A

increase renin release

92
Q

if BP falls, decrease in pressure is sensed in kidney and kidney releases

A

renin

93
Q

when BP falls sympathetic activity goes up and what happens in kidney

A

NE activate beta receptors which further activate renin release

94
Q

effects of angiotensin II in kidney causes kidney to

A

retain salt and water

95
Q

what is direct effect of angiotensin II in kidney

A

Increases tubular reabsorption of sodium and water

Decreases renal blood flow

96
Q

what is indirect effect of angiotensin II in kidney

A

Potent stimulator of aldosterone release from adrenal glands

Increases sodium reabsorption in renal tubules

97
Q

explain the renin dependent “one kidney” goldblatt hypertension experiment

A

pg 26

98
Q

pts with stenosis of renal artery of single remaining kidney what would happen

A

renin dependent hypertension

99
Q

what is the clinical significance of the two kidney hypertension

A

Stenosis of a single renal artery caused by atherosclerosis, in a person who has two kidneys

100
Q

review pg 27

A

27

101
Q

describe hypertension in preeclampsia

A

toxemia of pregnancy - ischemic placenta. it’s in pregnant women. usually goes awway after baby is born

102
Q

neurogenic hypertension

A

Strong stimulation of the sympathetic nervous system

103
Q

Hypertension in the Upper Part of the Body Caused by

A

coarction of the aorta

104
Q

risk factors for hypertension

A

sedentary lifestyle, weight gain, too much salt

105
Q

most hypertension the cause is

A

unknown

106
Q

the best medicine for hypertension

A

exercise

107
Q

what is primary hypertension

A

hypertension with unknown cause

108
Q

what is another name for primary hypertension

A

essential hypertension

109
Q

describe graphical analysis of arterial pressure in essential hypertension

A

it will shift left to the level your BP has increased

110
Q

the larger the shift left in graphical analysis of hypertension the

A

higher the BP is

111
Q

thiazide diuretics for hypertension what do they do

A

work at kidney to try to remove extracellular fluid

112
Q

beta blockser for hypertension what do they do

A

block/diminish sympathetic stimulation on beta receptors

113
Q

ACE inhibitors for hypertension what do they do

A

decrease production of angiotensin II

114
Q

ACE inhibitors, what does ACE stand for

A

Angiotensin-converting enzyme

115
Q

ARBs what do they do for hypertension

A

block the receptor that angiotensin works at

116
Q

what does ARB stand for

A

angiotensin II receptor blockers

117
Q

calcium channel blockers for hypertension how do they work

A

smoth muscles contract with calcium - this limits the contraction of the heart (and I think arteries?) so vessels would dilate

Physiology I Block 4 (13 decks)

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