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Cardiovascular system SA > Long term control of blood pressure > Flashcards

Long term control of blood pressure Flashcards

1
Q

What does long term control of blood pressure revolve around

A

plasma volume by the kidney

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2
Q

What are the functions of the kidneys

A 
Excretion of waste products 
Maintenance of ion balance
Regulation of pH 
Regulation of osmolarity 
Regulation of plasma volume
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3
Q

How does the kidneys regulate plasma volume

A

creates high osmolarity outside the collecting ducts

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4
Q

What determines the size of the osmolarity gradient

A

Control over Na transport

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5
Q

What determines if the water will follow the osmolarity gradient

A

Control over the permeability of the collecting duct

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6
Q

What would happen if you made the collecting ducts very impermeable

A

Less water reabsorbtion
Lots of dilute urine
Reduction in plasma volume

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7
Q

What would happen if you made the collecting ducts permeable

A

lots of water reabsorption,
little concentrated urine,
conserve plasma volume

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8
Q

What is the three regulating hormones that regulate the process of kidney reabsorption

A 
Renin-angiotensin-aldosterone system
Antidiuretic factor (ADH, vasopressin)
Atrial natriuretic peptide
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9
Q

Where is Renin-angiotensin-aldosterone system produced

A

From the juxtaglomerular (= granule cells) of the kidney

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10
Q

What triggers renin production

A

A reduction in mean arterial pressure

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11
Q

How is mean arterial pressure reduced to trigger renin production

A

Activation of sympathetic nerves to the juxtaglomerular apparatus
Decreased distension of afferent arterioles (the “renal baroreflex”)
Decreased delivery of Na+/Cl- through the tubule to the

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12
Q

Where is the Na/Cl delivered through in the tubule

A

to macula densa

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13
Q

What is the action of rensin

A

Converts inactive angiotensinogen to angiotensin I

Which is in turn converted by angiotensin converting enzyme to angiotensin II

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14
Q

What is the function of angiotensin II

A

Stimulates release of aldosterone from the adrenal cortex Increases release of ADH from the pituitary
Acts as a vasoconstrictor - increase TPR

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15
Q

What is the affect of aldosterone on the kidney

A

Increases Na+ reabsorption in the loop of Henle

Therefore reduces diuresis and increases plasma volume

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16
Q

What is the affect of ADH on the kidney

A

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

17
Q

How is the Renin-angiotensin-aldosterone system a negative feedback system

A

As the Multiple mechanism detect any decrease in MAP
which stimulates release of renin
This evokes multiple mechanisms which increase MAP

18
Q

Where is ADH synthesised

A

The hypothalamus

19
Q

Where is ADH released

A

The posterior pituitary

20
Q

What triggers the release of ADH

A

A decrease in blood volume
An increase in osmolarity of interstitial fluid
Circulating angiotensin II

21
Q

What detects the decrease in blood volume that triggers the release of ADH

A

Sensed by cardioplumonary baroreceptors and relayed via medullary cardiovascular centres

22
Q

What senses the increase is osmolarity interstitial fluid that stimulates the release of ADH

A

Sensed by osmoreceptors in the hypothalamus

23
Q

What is the function of ADH

A

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

24
Q

What is the steps of ADH as a negative feedback system

A

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

25
Q

Where is the atrial natriuretic peptide produced and released

A

myocardial cells in the atria

26
Q

What triggers atrial natriuretic peptide release

A

Increased distension of the atrium

- a sign of increased MAP

27
Q

What is the overall function of atrial natriuretic peptide

A

Decrease plasma volume and mean arterial pressure

28
Q

What is the different actions of the atrial natriuretic peptide

A

Increases excretion of Na+ (natriuresis)
Inhibits the release of renin
Acts on medullary CV centres to reduce MAP

29
Q

What is the steps of atrial natriuretic peptide being a negative feedback system

A

A mechanism that detects any increase in MAP
Stimulates release of ANP
This evokes multiple mechanisms which reduce MAP

30
Q

What is the two classification (and their probabilities) of hypertension

A

Primary - unknown cause ( ±90%)

Secondary - known underlying cause (5-10%)

31
Q

The reason for hypertension is usually unknown, how is the condition treated then

A

By giving a rational basis for drugs treatments

32
Q

What is the different drug treatments for hypertension

A

Ca2+ channel antagonists
-adrenoceptor antagonists
Thiazide diuretics
Angiotensin converting enzyme inhibitors

33
Q

What is the affect of thiazide diuretics

A

make you exreet more water, prvent build up of calcium

34
Q

What is the affect of Ca2+ channel antagonists

A

Reduce the release of calcium therefore reduce the force of contraction of the myocardium and decreasing blood pressure

35
Q

What is the affect of the adrenoceptor antagonists

A

block the affects of the sympathetic NS, therefore decrease Heart rate and blood pressure

36
Q

What is the affect of Thiazide diuretics

A

Preventing the build of sodium therefore reducing plasma volume there blood pressure

37
Q

What is the affect of Angiotensin converting enzyme inhibitors

A

Decreases the production of angiotensin II which causes blood vessels enlarge or dilate therefore blood pressure is reduced

38
Q

What is long term control of mean arterial pressure dependant on

A

hormones acting on the kidney to control plasma volume

Cardiovascular system SA (43 decks)

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