Module 1: cardiovascular system Flashcards

1
Q

what are the 3 functions of the Cardiovascular system?

A
  1. transport
  2. homeostasis
  3. protection
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2
Q

what are the 3 functions of the transport system in the CVS?

A
  1. oxygen and nutrients to cells
  2. wastes incluing CO2
  3. hormones (endocrine)
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3
Q

how does the CVS achieve homeostasis?

A
  1. body termperature by redistributing blood
  2. pH levels in blood and interstitial fluid (fluid between cells)
  3. blood volume/pressue
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4
Q

how does the CVS protect?

A

white blood cells create an immune response

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5
Q

what are the 3 major structures of the CVS?

A
  1. Blood
  2. Heart
  3. Blood Vessels
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6
Q

what are the 5 blood vessels of the CVS?

A
  1. arteries (blood away from the heart)
  2. capillaries ( exchange between blood and tissue)
  3. Veins (blood towards the heart)
  4. Arterioles
  5. Ventrioles
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7
Q

what do the capillaries exchange between blood and tissue?

A
  1. nutrients
  2. waste products
  3. gases
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8
Q

what does the heart serve as?

A

a pump to establish a pressure gradient

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9
Q

what does the atrium do in the heart?

A

receives blood into the heart

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10
Q

what does the ventricle do in the heart?

A

pumps blood out of the heart

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11
Q

what does the septum do in the heart?

A

divides the heart into left and right

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12
Q

what are the 4 “great vessels”

A
  1. Aorta
  2. pulmonary artery (deoxy)
  3. pulmonary vein (oxy)
  4. vena cava
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13
Q

what is the function of the pericardium?

A
  1. maintain heart position
  2. prevent heart from over filling
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14
Q

what is the anatomy of the pericaridum?

A
  1. outer fiberous pericardium
  2. inner serous pericardium
    2a. serous has 2 layers, parietal (outer) and visceral (inner)
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15
Q

what does the superior vena cava do?

A

returns deoxygenated blood from the upper half of the body to the right atrium

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16
Q

what does the inferior vena cava do?

A

returns deoxygenated blood from the lower half of the body to the right atrium

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17
Q

what does the pulmonary artery/trunk do?

A

transports deoxygenated blood to the lungs

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18
Q

what does the aorta do?

A

distributes oxygenated blood into systemic circulation

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19
Q

describe the function of coronary arteries

A

cover the entire heart to provide arterial (oxygenated) blood for coronary circulation as the heart is an organ and needs energy and oxygen to survive

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20
Q

which side of the heart has a thicker wall?

A

left

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21
Q

why is the left side of the heart thicker?

A

it needs a higher pressure to pump blood around the systemic circuit (all of body, minus the lungs)

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22
Q

why is the right side of the heart thinner?

A

it is only pumping blood to the pulmonary circuit (lungs)

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23
Q

which side of the heart has a tricuspid valve?

A

right - low pressure

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24
Q

what is another name for a tricuspic valve?

A

right atrioventricular valve

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25
Q

which side of the heart has a biscuspid valve?

A

left - high pressure

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26
Q

what is another name for the bicuspid valve?

A
  1. mitral valve
  2. Left atrioventricular valve
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27
Q

what are papillary muscles?

A

muscles in the ventricles of the heart, attached to the chordae tendineae to prevent the heart from prolapsing (inversion) during contraction

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28
Q

what is the job of the chordae tendineae?

A

to prevent prolapse of the the valves by being attached to the cusps

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29
Q

where is the aortic semilunar valve?

A

between the aorta and the left ventricle

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30
Q

where is the pulmonary semilumar valve?

A

between the pulmonary artery and the the right ventricle

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31
Q

what is the purpose of the semilunar valve?

A

to prevent backflow from arteries to ventricles

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32
Q

do the semilunar valves have a chordae tendineae?

A

No

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33
Q

are semilunar valves bi or tricuspid?

A

tricuspid

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34
Q

which circulation is the left heart functioning with?

A

Systemic Circulation

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35
Q

which circulation is the right side of the heart functioning with?

A

pulmonary circulation

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36
Q

is the vena cava a vein or artery?

A

vein, it carries deoxygenated blood to the heart

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37
Q

is the aorta a vein or artery?

A

artery, it carries oxygenated blood to the systemic circuit

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38
Q

does the brain change blood supply percentage?

A

No, it stays at 13%

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39
Q

where is most of our blood at any point in time?

A

84% is in the systemic circuit

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40
Q

where is the least amount of blood at any point in time?

A

16% in the pulmonary circuit

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41
Q

what are the 7 components of the CVS and their function?

A
  1. heart, atria: recevies blood returning to heart from veins
  2. heart, ventricles: contracts to generate pressure for blood flow
  3. arteries: moves blood to organs and tissues, without loss of pressure
  4. arterioles: smaller than arteries, controls resistance to blood flow, so distribuition of blood to body
  5. capillaries: substance exchange between blood and cells
  6. venules: collect blood from capillaries
  7. veins: returns blood to heart
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42
Q

what does the pulmonary vein do?

A

transports oxygenated blood from the lungs to the heart

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43
Q

recite the 10 step circuit of blood flow in the body

A
  1. D Superior and inferior vena cava pump blood into the right atrium
  2. D right atrium pushes blood into the right ventricle via the tricuspid valve
  3. D The right ventricle pushes blood into the pulmonary trunk via the pulmonary semilunar valve
  4. D blood travels to the lungs via the pulmonary arteries
  5. D/O Gas exchange occurs in the lungs, CO2 out, O2 in
  6. O blood flows into 4 pulmonary veins to left atrium
  7. O left atrium pumps blood into left ventricle via the bicuspid valve
  8. O blood is pumped into the aorta through the aortic semilunar valve into the systemic circuit
  9. O/D Gas exchange occurs between the body via capillaries in the systemic circuit and travels back to the heart
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44
Q

what is a diastole re the heart?

A

a Diastole is the heart at rest, filling with blood

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45
Q

what is a systole re the heart?

A

a systole is the heart contracting, so pumping blood out

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46
Q

what pressure gradient does blood flow in?

A

High pressure to low pressure

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47
Q

what are the 4 sounds of the heart beat?

A
  1. closure of the AV valves (mitral and tricuspid)
  2. closure of semilunar valves (aortic and pulmonary)
  3. rapid filling, recoil of blood on ventricular wall
  4. atrial contraction (shouldn’t hear in healthy person)
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48
Q

what is End Diastolic volume? (EDV)

A

volume of blood in the ventricle before contraction

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49
Q

what is End Systolic Volume (ESV)?

A

volume of blood left in the ventricle after contraction

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50
Q

what is stroke volume?

A

amount of blood pumped out of the heart for 1 heart beat (single contraction)

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51
Q

how is stroke volume measured?

A

EDV-ESV

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52
Q

what is cardiac output?

A

volume of blood pumped out of the heart by each ventricle per minute

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53
Q

how do you calculate Cardiac output?

A

Heart rate x stroke volume

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54
Q

what is preload?

A

the volume of blood received by the heart (stretch)

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55
Q

what is afterload?

A

the pressure or resistance the heart has to overcome to eject blood

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56
Q

what is the primary determinant of preload?

A

left ventricular EDV

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57
Q

what is the primary determinant of afterload?

A

the resistance in the blood vessels

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58
Q

What does sympathetic stimulation do to stroke volume?

A

increases it due to an increase in contractile strength of the heart

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59
Q

what effect does the parasympathetic nervous system have on the stroke volume?

A

Minimal effect

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60
Q

does stimulation of the sympathetic nervous system increase or decrease the contractile strength of the heart?

A

increases

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61
Q

what are the 2 factors that contribute to stroke volume?

A
  1. sympathetic activity
  2. Frank Starlings Law
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62
Q

what blood vessels have valves?

A

veins and the venous system

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63
Q

what is the purpose of valves in blood vessels?

A

to enable unidirectional blood flow

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64
Q

how does skeletal muscle contribute in the CVS?

A

skeletal muscle contracts the vessels to increase pressure, enabling blood flow

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65
Q

what is the parasympathetic division known as in the CVS?

A

“brake” to the heart, it reduces the heart rate

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66
Q

which ANS division is a ‘brake’ to the heart?

A

the parasympathetic

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67
Q

what are the 2 types of cell in the heart?

A
  1. contractile cells (99%)
  2. non-contractile (pacemaker) cells (1%)
68
Q

how do pacemaker cells depolarise?

A

spontaneously, aka autorhythmic

69
Q

what is a demosome?

A

an adhesive junction that mechanically integrates adjacent cells

70
Q

what is a gap junction?

A
  1. a passage within the cell that allows direct communication between cells.
  2. mediates electrical coupling of cardiomyocytes (speed and direction of cardiac conduction)
  3. allows passage of ions and transmission of AP
71
Q

what is a cardiac cell also known as?

A

myocyte

72
Q

How are myocytes joined together?

A

intercalalted disks

73
Q

what is excitation contraction coupling?

A

when an electrical stimulus is converted to a mechanical response

74
Q

describe the flow of contraction coupling in the heart

A
  1. (electrical) AP triggers from pacemaker cell and travels to sarcoplasmic reticulum (SR)
  2. SR releases Ca2+
  3. Ca2+ binds to troponin, triggering the cross bridge cycle
  4. cardiomyocye contacts (mechanical)
75
Q

where are pacemaker cells mostly located?

A

Sinoatrial Node (SA node)

76
Q

how does spontaneous AP occur?

A

through cellular drifting, the resting MP is not stable and slowly drifts to threshold due to K+ channels closing and Na+/Ca2+ leaking out

77
Q

What are the 3 pacemakers of the heart?

A
  1. Sinoatrial Node (primary)
  2. atrioventricular Node (secondary)
  3. Pirkinji Fibers (tertiary)
78
Q

what are the inherent rhythms of each pacemaker nodes?

A
  1. Sinoatrial Node - 70-80 AP/m
  2. atrioventricular Node 40-60 AP/m
  3. Pirkinji Fibers 20-40 AP/m
79
Q

describe the spread of excitement through the heart

A
  1. Sinotrial Node
  2. atrioventricular node
  3. bundle of His
  4. apex of ventricle
  5. Pirkinje fibers
  6. rest of ventricle
80
Q

how do the nodes support each other?

A

when 1 node fails, the other kicks in to become primary, in a cascade effect

81
Q

why is there a delay in propogation in the AV node?

A

to allow the atrium to contract first

82
Q

what causes ventricles to contract?

A

Pirkinje fibers

83
Q

which electrical signals connect with the atria?

A
  1. Av node
  2. Bundle of His
84
Q

is propogation from Pirkinji fibers to apex fast or slow

A

Fast

85
Q

where does ventricle contraction start?

A

at the apex

86
Q

what is the purpose of a plateau in cardiac AP?

A
  1. to allow for optimal chamber emptying
  2. reduces likeihood of tetanus
87
Q

why is there a plateau in cardiac AP?

A

due to a balance of influx and eflux of ions

88
Q

how does the parasympathetic system reduce depolarision (reduce heart rate)

A
  1. opening K+ channels and less leak of NA+ an Ca2+ channels
  2. hyperpolarisation
  3. slow depolarisation
  4. release of chemicals such as acetylcholine
89
Q

how does the sympathetic system increase depolarision (increase heart rate)

A
  1. opening more Na+ and Ca2+ channels
  2. close more K+ channels
  3. no hyperpolarisation
  4. faster depolarisation due to not reaching resting
  5. use of chemicals such as noradrenaline
90
Q

which blood vessel has the largest capacity?

A

veins

91
Q

what is another term for veins?

A

capacitance vessels

92
Q

what blood vessels are within the microcirculation?

A
  1. arterioles
  2. capillaries
  3. venules
93
Q

what are the similarities of veins and arteries?

A
  1. tunica: intima, media, externa
  2. subenodthelial layer
  3. endothelium
  4. vaso vasorum
94
Q

what is the difference of a vein to an artery?

A
  1. has valves
  2. large lumen
  3. rigid
  4. thick tunics externa
  5. smooth muscle walls
  6. carry waste and deoxygenated blood
95
Q

what is the difference of an artery to a vein?

A
  1. small lumen
  2. has internal and external lamina to allow for flexibilty
  3. can withstand high pressures and adapts (flexible)
  4. thin tunica externa
  5. muscular walls
  6. carry oxygenated blood
96
Q

which Tunica do capillaries have?

A

intima

97
Q

what do arterioles do?

A

regulate blood flow into tissues

98
Q

what is the pressure measured in?

A

mm/Hg

99
Q

what is the pressure quantity of thr CVS?

A
  1. Heart-arteries 100mm/Hg
  2. arteries-capillaries 35mm/Hg
  3. capillaries-veins 18mm/Hg
  4. Veins-Heart <18mm/Hg
100
Q

why is there a drop in pressure in the CVS?

A

due ot being further away from the heart (pump)

101
Q

where does gas exchange occur?

A

in the capillaries?

102
Q

how many veins and arteries does the pulmonary circuit have?

A

2 arteries (deox)
4 veins (oxy)

103
Q

what number is systolic blood pressure?

A

120mm/Hg

104
Q

what number is diastolic blood pressure?

A

80 mm/Hg

105
Q

what can veins do to manage thermal regulation?

A

shunt blood between superficial and deep veins

106
Q

what is the blood composition %?

A

55% plasma (H2O and proteins)
1% Buffy Coat (Leukocytes and platelets)
44% RBC (erythrocytes)

107
Q

what is the formula for blood flow?

A

Flow= pressure gradient/resistance
F=xP/R

108
Q

describe blood flow (F)

A

volume of blood per unit of time through a vessel

109
Q

describe blood pressure

A

hydrostatic pressure in arterial system that pushes blood through capillary beds

110
Q

describe circulatory pressure

A

pressure difference between top of aorta and entrance to right atrium

111
Q

describe hydrostatic pressure

A

pressure exerted by a liquid in response to an applied force

112
Q

describe peripheral resistance (PR)

A

resistance of arterial system affected by vascular resistance/turbulence/viscotity

113
Q

describe resistance (R)

A

force opposing movement

114
Q

describe total peripheral resistance (TPR)

A

resistance of entire CVS

115
Q

describe turbulence

A

resistance due to irregular, swirling blood at high flow rates or exposure to irregular surfaces

116
Q

describe vascular resistance

A

resistance due to friction in a blood vessel, walls and blood

117
Q

describe venous pressure

A

hydrostatic pressure in venous system

118
Q

describe viscosity

A

resistance to flow from molecule interaction

119
Q

what is the formula for: flow directly proportional to pressure gradient?

A

F(DP) xP

120
Q

what is the formula for: flow inversely proportional to resistance

A

F (IP) 1/R

121
Q

what is the formula for: flow directly proportional to pressure and inverse to resistance?

A

F (DP) xP/R

122
Q

what is the formula for: flow directly proportional to BP, inverse to PR

A

F (DP) BP/PR

123
Q

what is the formula for: resistance inverse to fourth power of vessel radius

A

R (DP) 1/R^4

124
Q

how is pressure gradient measured?

A

difference between 2 ends of a vessel, not abolute pressures within a vessel

125
Q

what are the 3 factors of resistance?

A
  1. viscocity
  2. length
  3. radius
126
Q

of the 3 factors of resistance, which is the most important in terms of the CVS?

A

radius

127
Q

what is the opposite of turbulence?

A

Laminar

128
Q

describe Poiseuilles Law

A

the precise relationship between flow, pressure and resistance

129
Q

what is Poiseuilles law used for?

A

to determine the level of blockage in vessels

130
Q

when are blockages in vessels most often found?

A

during sympathetic activity (stress test)

131
Q

are arteries flexed or contracted during diastole?

A

contracted

132
Q

are arteries flexed or contracted during systole?

A

flexed

133
Q

do arterioles have high or low resistance?

A

high, due to small radius

134
Q

why is there a fall in pressure in arterioles?

A

distance from heart, helps with downstream blood flow

135
Q

how is blood supply determined to the organs?

A
  1. arteriolar resistance
  2. organ vascularisation
136
Q

how is resistance modulated in arterioles?

A
  1. vasodialiation
  2. vasocontriction
137
Q

what intrinsic controls affect arterioles?

A
  1. paracrines or autoregulation
  2. metabolic chemical transfer (CO2, O2, H+)
  3. myogenic (stretch)
138
Q

what extrinsic controls affect arterioles?

A
  1. nerve
  2. sympathetic stimulation
  3. hormones: angiotensin 2, ADH, adrenaline, moradrenaline
139
Q

how odes gas exchange occur in capillaries?

A

diffusion

140
Q

why do capillaries have a large surface area?

A

they’re tiny but a lot of them

141
Q

do capillaries have a high or slow vilocity?

A

slow, to allow more gas transfer

142
Q

what is the purpose of a precapillary sphincter?

A

to control blood flow to the capillaries, depending on metabolic activity

143
Q

what happens to precapillary sphincters during high metabolic activity?

A

they relax, allowing blood flow

144
Q

what happens to precapillary sphincters during low metabolic activity?

A

they contract, to restric blood flow

145
Q

describe vascular compliance

A

the ability of a blood vessel wall to expand and contract passively with changes in pressure

146
Q

what factors can effect vascular compliance?

A
  1. age
  2. disease
147
Q

what is the formula for vascular compliance?

A

Compliance=change in arterial blood volume/change in arterial blood pressure
C= xV/xP

148
Q

what 2 factors determine mean arterial pressure?

A
  1. Cardiac Output
  2. total peripheral resistance
149
Q

what is the formula for Mean Arterial Pressure?

A

Mean Arterial Pressure = cardiac outputx total peripheral pressure
MAP=COxTPR

150
Q

what is a pulse?

A

the throb of the arteries due to difference in pulse pressure

151
Q

what is pulse pressure?

A

the difference between systolic pressure and diastolic pressure

152
Q

what factors determine arterial blood pressure?

A
  1. elasticity of arteries close to the heart
  2. volume of blood forced into arteries at any one time
153
Q

does the heart spend more time in systole or diastole?

A

diastole

154
Q

how is MAP calculated?

A

MAP=DP+(SP-DP/3)

155
Q

how is blood pressure measured?

A

using a sphygmomanometer and listening for korotkoff sounds with a stethoscope

156
Q

what are the 5 Korotkoff sounds?

A
  1. no sounds due to cuff pressure exceeding 120mm/Hg
  2. Pressure when sound first occurs (SP~120mm/Hg)
  3. pressure when sound dissapears (DP~80mm/Hg)
  4. last sound heard at DP
  5. no sound due to laminar flow
157
Q

what are the 2 main neural mechanisms due to short term control?

A
  1. blood vessel diameter changed, to alter resistance
  2. blood ditribution to organs changed
158
Q

which 2 controls are short term pressure regulators?

A
  1. neural
  2. hormonal
159
Q

what control is the long term pressure regulator?

A

Renal

160
Q

describe the baroreceptor reflex arc

A
  1. arterial baroreceptors detect change in pressure
  2. afferent nerves send signals to medulla oblongata
  3. medullary cardiovascular centre sends efferent nerves to ANS
  4. heart/arterioles and veins adjust to the change in pressure
161
Q

what is the purpose of the baroreceptor reflex arc?

A

to provide rapid adjustment to MAP in the event of a sudden disturbance

162
Q

how long doe it take for the baroreceptor reflex arc to react?

A

seconds to minutes

163
Q

Where are the mechanorecptors for the baroreceptor reflex?

A
  1. Cartoid sinus (neck- to monitor blood flow to brain)
  2. Aortic arch (heart- to monitor systemic circulation)
164
Q

Where is the baroreceptor reflex send to?

A

Medulla cardiovascular centre

165
Q

Where is the medulla cardiovascular centre’s?

A

Medulla (neck) and subdivides into
1. Cardiac centre (controls heart)
2. Vasometer centre (controls blood vessels)

166
Q

What is the baroreceptor reflex arch?

A
  1. Drop in blood pressure is detected by the cartoid sinus or aortic arch
  2. Sends affrent signals to cardiac kr vasomotor centre
  3. CVS responds by constricting vessels and increase breathing ( Inc. CO2
167
Q

Explain chemical homeostasis for blood pressure arch (long term blood pressure reduction)

A
  1. Drop in blood pressure detected
  2. Endocrine system creates more ADH/angiotensin 2/aldosterone and releases to blood stream
  3. Blood pressure rises