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Cardiovascular > Long Term Control of BP COPY > Flashcards

Long Term Control of BP COPY Flashcards

1
Q

What is long term blood pressure control probably not controlled by?

A

Arterial baroreflex

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2
Q

What three hormone systems does the long term control of BP rely on?

A
  • Renin-angiotensin-aldosterone system - Antidiuretic factor (ADH and Vasopressin) - Atrial natriuretic peptide
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3
Q

What structure is responsible for the long term control of BP?

A

Kidney

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4
Q

What are the main functions of the kidney?

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

Which of the kidney functions is used to regulate MAP?

A
  • Regulation of plasma volume
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6
Q

Describe what is going on here

A
  • Blood enters Bowman’s capsule
  • Glomerular filtration takes place into the proximal tubule
  • Blood enters peritubular capillaries where some fluid is reabsorbed and some is secreted
  • Blood travels down nephron to loop of henle where some fluid is reabsorbed
  • Blood travels back up the other side where more fluid is reabsorbed
  • Blood reaches distal tubule where some fluid is reabsorbed and some is lost
  • Blood leaves the nephon out of the renal vein
  • Waste collected from the blood collects in the collecting duct where it goes to be excreted
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7
Q

How does the renal counter current system ensure that waste moves into the collecting duct to regulate plasma volume?

A

Creates a very high osmolarity outside the collecting duct

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8
Q

What controls the osmolarity gradient across the collecting duct?

A
  • Control over Na+ transport determines the size of it
  • Control over permeability of collecting duct to water determines if water follows the gradient or not
  • This allows the volume of water in the urine to be controlled
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9
Q

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

A
  • Lots of water reabsorption
  • Little urine
  • Conserved plasma volume
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10
Q

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

A
  • Little water reabsorption
  • Lots of urine (diuresis)
  • Reduction in plasma volume
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11
Q

Where is renin produced?

A
  • Juxtaglomerular cells (granule cells)
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12
Q

What will trigger renin production?

A
  • Activation of sympathetic nerve to juxtaglomerular apparatus
  • Decreased distention of afferent arterioles (renal baroflex)
  • Decreased delivery of NaCl through the tube
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13
Q

What will cause a reduced NaCl?

A
  • Reduced arterial pressure in glomerulus
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14
Q

What are all three renin triggers caused by?

A

Decreased mean arterial pressure

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15
Q

What does renin do?

A

Converts inactive angiotensin to angiotensin I

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16
Q

What happens to angiotensin I after conversion through renin?

A

Converted through angiotensin II by angiotensin converting enzyme (ACE)

17
Q

What does angiotensin II do?

A
  • Stimulates release of aldosterone from adrenal cortex
  • Increases release of ADH from pituitary
  • Acts as a vasoconstrictor therefore increase TPR
18
Q

What does the release of aldosterone from the adrenal cortex cause?

A
  • Increased Na+ reabsorption from loop of Henle
  • This reduces diuresis and increase plasma volume
19
Q

What does the release of ADH from the pituitary cause?

A
  • Increases water permeability of collecting duct
  • Reduces diuresis and increases plasma volume
  • Increases sense of thirst
20
Q

What type of feedback is the renin-angiotensin-aldosterone system?

A

Negative feedback

21
Q

Where is ADH synthesised and released?

A

Synthesised in Hypothalamus and released in pituitary

22
Q

Apart from angiotensin II what causes the release of ADH?

A
  • Decrease in blood volume (sensed by baroreceptors)
  • Increase in osmolarity of interstitial fluid
23
Q

What receptors sense a change in interstitial fluid osmolarity?

A

Osmoreceptors

24
Q

What other effect does ADH have on the circulation?

A
  • Vasoconstriction (it’s alternate name is vasopressin)
  • This increases MAP
25
Q

Where is atrial natriuretic peptide produced?

A

Myocardial cells in the atria

26
Q

What triggers the release of atria natriuretic peptide?

A

Increase atrial distention

27
Q

What does atrial natriuretic peptide do?

A
  • Increases Na+ excretion (natriuresis)
  • Inhibits release of renin
  • Acts on medullary CV centre to reduce MAP
28
Q

What type of feedback are ALL responses to low MAP?

A

ALL negative feedback

29
Q

How do drugs used to treat hypertension usually work through?

A
  • Ca2+ channels antagonists
  • B-adrenoreceptor antagonists
  • Thiazide diuretics
  • Angiotensing converting enzyme inhibitors
30
Q
A

Cardiovascular (37 decks)

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