Long Term Control of Blood Pressure Flashcards

1
Q

What does long term control of blood pressure revolve around?

A

The control of plasma volume by the kidneys

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2
Q

What three systems does long term control of BP involve?

A

Renin-angiotensin-aldosterone system
Antidiuretic factor
Atrial natriuretic peptide

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3
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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4
Q

What is controlling plasma volume used to regulate?

A

MAP

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5
Q

Does the renal counter-current system create a high or a low osmolarity outside of the collecting duct?

A

Very high

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6
Q

What determines how large the osmotic gradient is?

A

Control over Na+ transport

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7
Q

What determines if water will follow the osmotic gradient or not?

A

Control over the permeability of the collecting duct

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8
Q

What does control over Na+ transport and permeability of the collecting duct allow?

A

Control of how much water is lost in the urine and how much is retained

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9
Q

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

A

Lots of water reabsorption
Small volume of hyper-osmotic urine excreted
Conservation of plasma volume

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10
Q

What will result from making the collecting duct less permeable to water?

A

Little water reabsorption
Large volume of hypo-osmotic urine excreted
Reduction in plasma volume

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11
Q

Where is renin produced?

A

From the juxtaglomerular cells of the kidney

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12
Q

What is renin production triggered by?

A

Activation of sympathetic nerves to the juxtaglomerular apparatus
Decreased distension of afferent arterioles
Decreased delivery of Na+/Cl - through the tubule

All of MAP

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13
Q

What does renin convert?

A

Angiotensinogen to angiotensin I

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14
Q

What does angiotensin converting enzyme convert?

A

Angiotensin I to angiotensin II

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15
Q

What does angiotensin II stimulate?

A

Release of aldosterone from the adrenal cortex

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16
Q

How does angiotensin II stimulate the release of aldosterone?

A

By;
Increasing Na+ reabsorption in the loop of Henle
Reducing diuresis
Increasing plasma volume

17
Q

How does angiotensin II increase the release of ADH from the pituitary?

A

Increasing water permeability of the collecting duct
Reducing diuresis
Increasing plasma volume
Increasing sense of thirst

18
Q

How does angiotensin II work as a vasoconstrictor?

A

Increases TPR which is part of the negative feedback system which detects any decrease in MAP and will stimulate the release of renin to increase MAP

19
Q

Where is antidiuretic hormone synthesised and released?

A

Synthesised by the hypothalamus

Released from the posterior pituitary

20
Q

What is the release of antidiuretic hormone triggered by?

A

Decrease in blood volume
Increase in osmolarity of interstitial fluid
Circulating angiotensin II triggered by the renin-angiotensin-aldosterone system

All of the above are signs of a low plasma volume +/- MAP

21
Q

What detects a decrease in blood volume?

A

Cardiopulmonary baroreceptors

22
Q

What detects an increase in osmolarity of the interstitial fluid?

A

Osmoreceptors in the hypothalamus

23
Q

What does ADH cause?

A
Increase in permeability of the collecting duct to water 
Reduced diuresis 
Increased plasma volume 
Vasoconstriction 
Increased MAP
24
Q

Where is atrial natriuretic peptide produced and released from?

A

Myocardial cells in the atria

25
What triggers the release of atrial natriuretic peptide?
Increased distension of the atrium (sign of increased MAP)
26
What does atrial natriuretic peptide cause?
Increased excretion of Na+ (natriuresis) Inhibits release of renin Acts on medullary CV centres to reduce MAP
27
What percentage of hypertension is due to a known cause (secondary hypertension)?
5-10%
28
What is the majority of hypertension with no known cause classed as?
Primary or essential