Pathophys - Hypertension

Question 1

name the 2 categories of hypertension

Answer 1

primary/essential hypertension
secondary hypertension

Question 2

how can primary/essential hypertension be divided

Answer 2

into benign (slow onset over long period with no symptoms) and malignant (abrupt onset and more aggresive - renal failure and/or cerebral hemorrhage)

Question 3

define primary hypertension

Answer 3

hypertension whose cause is uknown

Question 4

define secondary hypertension

Answer 4

form of HTN with a SPECIFIC CAUSE – often outside of the CV system

can have a permanent cure

for ex - a tumor on the adrenal gland is causing HTN. if you remove the tumor, the pt wont have HTN anymore

Question 5

most of the population has primary (essential) or secondary hypertension?

Answer 5

primary hypertension, specifically benign

Question 6

the precise cause of primary hypertension is unknown – there is no generalized pathology that can be directly linked to hypertension

that being said, the mechanisms are involved with….

Answer 6

the method in which BP is controlled:

cardiac output * systemic vascular resistance to blood flow

Question 7

cardiac output is a function of what 2 things

Answer 7

stroke volume (end diastolic volume - end systolic volume)

rate of contraction of the heart

Question 8

what is “end diastolic volume”

Answer 8

the “filling time” — the volume JUST BEFORE THE HEART CONTRACTS

Question 9

The end diastolic volume is the volume in the heart just before the heart contracts

where does this volume of blood come from?

Answer 9

the venous returns

Question 10

4 things that affect venous return and thus affect the end diastolic volume

Answer 10

venous end restriction
pumps (skeletal muscle activity)
blood volume
changes in peripheral circulation

Question 11

simply, what is the end systolic volume

Answer 11

the amount of blood in the ventricles after contraction

Question 12

3 things that affect end systolic volume

Answer 12

preload (the end diastolic volume)

contractility

after load (peripheral resistance)

Question 13

2 things that affect the contractility of the heart and thus the end systolic volume

Answer 13

hormones and autonomic innervation

Question 14

how do the carotid sinus baroceptors control cardiac heart rate

Answer 14

when you stand up, your BP naturally falls

however, these baroceptors increase bp by restricting the vessels so we dont pass out - increases heart rate

Question 15

baroreceptors are located in the carotid sinuses (DETECT high) and they detect vascular pressure

a HIGH vascular pressure will cause the baroreceptors to do what?

Answer 15

to stimulate the vasomotor center in the brain. this stimulates the heart (via vagus nerve) to BEAT SLOWER

Question 16

Baroreceptors in the atria and pulmonary arteries detect LOW pressure

what happens when they detect low pressure?

Answer 16

they stimulate the hypothalamus, and ADH is released

this stimulates the reabsorption of water - thus increasing blood volume

the ATRIAL receptors will increase heart rate – called the bainbridge reflex

Question 17

where are chemoreceptors located

what do they detect?
what do they do to the heart rate when they detect this?

Answer 17

in the carotid and aortic bodies

accumulation of CO2 and H+

heart rate increases

Question 18

2 main factors that affect vascular resistance

Answer 18

-if they’re contracted or relaxed

-the volume of blood

Question 19

how does atherosclerosis affect hypertension

Answer 19

arteries narrow, and elasticity of blood vessels is reduced

widespread, permanent increase in blood pressure

Question 20

true or false

hypertension is not genetically linked

Answer 20

FALSE - it is

atherosclerosis seems to be genetic too, which is often linked to HTN