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Systems: Cardiovascualar AB > Long Term Control of Blood Pressure > Flashcards

Long Term Control of Blood Pressure Flashcards

1
Q

What is long term control probably nor mediated by?

A

Arterial baroreflex

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2
Q

What does long term control revolve around?

A

Control of plasma volume by the kidney

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3
Q

What are the 3 hormone systems involved in the long term control?

A
  • Renin-angiotension-aldosterone system
  • Antidiuretic factor (ADH/ vasopressin)
  • Atrial natriuretic peptide
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4
Q

What are the functions of the kidney?

A
  • Excretion of waste products
  • Maintenance of ion balance
  • Regulation of pH
  • Regulation of osmolarity
  • Regulation of plasma volume
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5
Q

What is controlling plasma volume used to regulate?

A

MAP

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6
Q

What is the main site of reabsorption in the kidney?

A

Loop of Henle

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7
Q

What is created by the renal counter current system?

A

A very high osmolarity outside the collecting duct

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8
Q

What does control over Na transport determine?

A

The size of the osmotic gradient

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9
Q

What does control over the permeability of the collecting duct to water determine?

A

If th water follows the osmotic gradient or not

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10
Q

What is reabsorbed from the filtrate?

A

Na

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11
Q

What does the reabsorption of Na cause?

A

A progressive increase in the Na concentration outside of the collecting duct

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12
Q

What will making the collecting duct very permeable to water result in?

A
  • Lots of water reabsorption
  • Little urine
  • Conservation of plasma volume
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13
Q

What will making the collecting duct very impermeable to water result in?

A
  • Little reabsorption
  • Lots of urine
  • Reduction in plasma volume
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14
Q

Where is renin produced?

A

Juxtaglomerular of the kidney

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15
Q

What triggers renin production?

A
  • Activation of sympathetic nerves to the juxtaglomerular apparatus
  • Decreased distension of afferent arterioles
  • Decreased delivery of Na/Cl through the tubule
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16
Q

What are the triggers of renin production all signs of?

A

Low MAP

17
Q

What does renin do?

A
  • Converts inactive angiotensinogen to angiotensin I

- Angiotensin I is then converted by angiotensin converting enzyme to angiotensin II

18
Q

What does angiotensin II do?

A
  • Stimulates release of aldosterone from the adrenal cortex
  • Increases release of ADH from the pituitary
  • Is a vasoconstrictor
19
Q

What does stimulation of the release of aldosterone from the adrenal cortex do?

A
  • Increases Na reabsorption in the loop of Henle

- Therefore reduced diuresis and increases plasma volume

20
Q

What does an increase in the release of ADH from the pituitary do?

A
  • Increases water permeability of the collecting duct
  • Therefore reduces diuresis and increases plasma volume
  • And increases sense of thirst
21
Q

What does vasoconstriction cause?

A

Increase in TPR

22
Q

Why can the renin-angiotensin-aldosterone system be considered a negative feedback system?

A
  • Multiple mechanism detect any decrease in MAP
  • Stimulates release of renin
  • This evokes multiple mechanisms which increase MAP
23
Q

Where is ADH produced?

A
  • Synthesised in the hypothalamus

- Released from the posterior pituitary gland

24
Q

What triggers ADH release?

A
  • A decrease in blood volume (as sensed by cardiopulmonary baroreceptors and relayed via medullary CV centres)
  • An increase in osmolarity of interstitial fluid (as sensed by osmoreceptors in the hypothalamus)
  • Circulating angiotensin II (triggered by the renin-angiotensin -aldosterone system)
25
Q

What are the trigger of the release of ADH all signs of?

A

Low plasma volume and/or low MAP

26
Q

What does ADH do?

A
  • Increases the permeability of the collecting duct to H2O, therefore reduces diuresis and increases plasma volume- increases MAP
  • Causes vasoconstriction, therefore increasing Map
27
Q

Why can the release of ADH be considered a negative feedback system?

A
  • Multiple mechanism detect any decrease in MAP
  • Stimulates release of ADH
  • This evokes multiple mechanisms which increase MAP
28
Q

Where are ANP and BNP produced?

A

Produced in and released from myocardial cells in the atria and ventricles respectively

29
Q

What triggers ANP and BNP release?

A

Increased distension of the atrium

30
Q

What do ANP and BNP do?

A
  • increases excretion of Na
  • Inhibits the release of renin
  • Acts on medullary CV centres to reduce MAP
31
Q

Why can the release of ANP/BNP be considered a negative feedback system?

A
  • A mechanism that detects any increase in MAP
  • Stimulates release of ANP and BNP
  • This evokes multiple mechanisms which reduce MAP
32
Q

What is increased distension of the atrium a sign of?

A

Increased MAP

33
Q

What does the release of ANP/BNP tend to do?

A

Decrease MAP

34
Q

What are the 2 classes of causes of hypertension?

A
  • Primary, of unknown cause

- Secondary, known cause

35
Q

What types of drugs are used in the long term treatment of hypertension?

A
  • Ca channel antagonists
  • B-adrenoreceptor antagonists
  • Thiazide diuretics
  • Angiotensin converting enzyme inhibitors

Systems: Cardiovascualar AB (42 decks)

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