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Cardiovascular Physiology > Long term control of blood pressure > Flashcards

Long term control of blood pressure Flashcards

1
Q

State 5 functions of the kidney

A 
Waste excretion
Ion balance maintenance
pH regulation
Osmolarity regulation
Plasma volume regulation
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2
Q

What is the purpose of plasma volume regulation?

A

MAP control

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3
Q

State the function of Counter Current System of the kidney

A

The counter current system creates high osmolarity outside the collecting duct.

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4
Q

What determines the size of the osmotic gradient generated by the Counter Current System?

A

Na+ transport

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5
Q

What determines whether or not water follows the osmotic gradient generated by the Counter Current System or not?

A

Control over permeability of collecting duct to sodium determines whether water follows osmotic gradient or not.
This allows control over how much water is lost in urine and how much is reabsorbed into blood

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6
Q

What are the effects of a very permeable collecting duct?

A

Reabsorb lots of water
Small volume of hyperosmotic urine produced
Conserve plasma volume

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7
Q

What are the effects of an impermeable collecting duct?

A

Excrete lots of water in a
Large volume of hypo-osmotic urine
Reduce plasma volume

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8
Q

State the three mechanisms of long term BP control

A

Renin-Angiotensin-Aldosterone System
ADH (vasopressin)
ANP

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9
Q

What cells release renin in the Renin-Angiotensin-Aldosterone System?

A

Juxtaglomerular granule cells

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10
Q

What triggers juxtaglomerular granule cells to release renin?

A

Signals of reduced MAP to juxtaglomerular granule cells

  • Macula densa detects reduced NaCl delivery
  • Afferent arterioles have reduced distension
  • Sympathetic system innervation
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11
Q

What is the function of renin?

A

Converts angiotensinogen to angiotensin I

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12
Q

What converts Angiotensin I to Angiotensin II

A

ACE (angiotensin converting enzyme)

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13
Q

What two hormones does Angiotensin II stimulate the release of?

A

Aldosterone

ADH

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14
Q

Where is aldosterone released from?

What is its function?

A

Released from adrenal cortex

Function: increases Na+ reabsorption at Loop of Henle -> reduced diuresis and increased plasma volume

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15
Q

Where is ADH released from?

What are its two functions?

A

Released from pituitary gland
Functions:
- increases water reabsorption at collecting duct reading to reduced diuresis and increased plasma volume
- Vasoconstrictor so increases TPR

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16
Q

Summarise the renin-angiotensin-aldosterone system

A

Reduced MAP signalled to juxtaglomerular granule cells by reduced NaCl in macula densa, reduced distension of afferent arteriolar cells and sympathetic system innervation
Juxtaglomerular granule cells release renin which converts angiotensinogen -> angiotensin I
ACE converts Angiotensin I to angiotensin II
Angiotensin II stimulates aldosterone release from the adrenal cortex which increases sodium reabsorption at the Loop of Henle -> reduced diuresis and increased plasma volume
Angiotensin to stimulates ADH release from pituitary gland which increases water permeability of the collecting duct -> reduced diuresis and increased plasma volume. It is also a vasoconstrictor thus increasing TPR

17
Q

Where is ADH synthesised?

A

Hypothalamus

18
Q

Where is ADH released?

A

Posterior pituitary gland

19
Q

What triggers ADH release?

A
  • Reduced blood volume detected by cardiopulmonary baroreceptors and relayed to medullary cardiovascular centres
  • increased Osmolarity of ISF as sensed by osmoreceptors of hypothalamus
  • circulating angiotensin II
20
Q

What are the two actions of ADH?

A

Increased permeability of collecting duct to H2O leading to reduced diuresis and increased plasma volume
Vasoconstrictor -> increased TPR and thus increased MAP

21
Q

What is another name for ADH?

A

Vasopressin

22
Q

How are the renin-angiotensin-aldosterone system and ADH negative feedback mechanisms?

A

Multiple mechanisms detect reduced MAP and bring about multiple mechanisms to bring about increased MAP.

23
Q

Where is Atrial Natriuretic Peptide (ANP) produced and released?

A

Myocardial cells of the atria

24
Q

What triggers the release of ANP?

A

Distension of the atria and ventricles leading to increased MAP

25
Q

What are the actions of ANP?

A
  • increases Na+ excretion

- inhibits renin release, thus reducing MAP

26
Q

Where does BNP act on?

A

Medullary cardiovascular centres to reduced MAP

27
Q

How is the release of ANP a negative feedback system?

A

Increased MAP stimulates ANP release which evokes multiple mechanisms to reduced MAP

28
Q

What percentage of hypertension cases have a known cause (are secondary)?

A

5-10%

29
Q

List the rational bases of drug treatment for primary hypertension

A 
Ca2+ channel antagonists 
Beta blockers
Thiazide diuretics
ACE inhibitors 
ARBs

Cardiovascular Physiology (10 decks)

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