Physiology 4+5 Flashcards
What is blood pressure?
Outward hydrostatic pressure exerted by blood on blood vessel walls
What is systolic arterial blood pressure?
Pressure exerted by blood on walls of the aorta and systemic arteries when the heart contracts
What is normal value for systolic arterial blood pressure?
Should not reach or exceed 140 mm Hg under resting conditions
What is diastolic arterial blood pressure?
Pressure exerted by blood on walls of the aorta and systemic arteries when the heart relaxes
What is normal value for diastolic arterial blood pressure?
Should not reach or exceed 90 mm Hg under resting conditions
What is hypertension? (2)
- Clinic blood pressure of 140/90 mmHg or higher
* Day time average of 135/85 mmHg or higher
What is pulse pressure?
Difference between systolic and diastolic blood pressures
e.g. 120 - 80 = 40 mm Hg
What are normal values for pulse pressure?
Between 30 and 50 mmHg
What is a sphygmomanometer used for?
Indirect measurement of arterial blood pressure
What is the normal flow of blood in an artery?
Laminar
Is laminar flow audible through stethoscope?
No, no sound heard in normal patent artery
What will happen if external pressure (e.g. cuff) exceeds systolic blood pressure?
Will occlude artery and no sound is heart through stethoscope
When is arterial blood flow heard through a stethoscope?
- When external pressure kept between systolic and diastolic pressure, flow will become turbulent when blood pressure exceeds cuff pressure
- Turbulent flow is audible through stethoscope
What is first korotkoff sound?
Heard at peak systolic pressure (when blood pressure first exceeds cuff pressure)
What are korotkoff sounds 2 + 3?
Intermittent sounds due to turbulent spurts of flow
What is 4th korotkoff sound?
Heard at minimum/diastolic pressure (muffled, muted sound)
What is 5th Korotkoff “sound”?
No sound is heard because of smooth laminar flow
What point is diastolic pressure recorded? Why?
- 5th Korotkoff sound (point at which sound disappears)
* More reproducible
What drives blood around systemic circulation?
Pressure gradient between aorta and right atrium
What is the main driving force for blood flow?
Mean arterial pressure (MAP) because RA pressure is close to zero
What is the equation for pressure gradient between RA and aorta?
Pressure gradient = Mean Arterial Pressure (MAP) - Central Venous (right atrial) Pressure (CVP)
What is Mean Arterial blood Pressure?
Average arterial blood pressure during a single cardiac cycle
What is the equation for Mean Arterial blood Pressure using systolic diastolic pressures?
MAP = [(2 x diastolic pressure) + systolic pressure] / 3
OR
MAP = DBP + 1/3 pulse pressure
What is normal arterial blood pressure?
<140 systolic
<90 diastolic
What is the normal range of Mean Arterial blood Pressure?
70 - 105 mm Hg
How high does MAP have to be to perfuse coronary arteries, brain and kidneys?
At least 60 mm HG
Why must MAP be regulated within narrow ranges? (2)
To ensure
- Pressure is high enough to perfuse brain, heart and kidneys
- Pressure is not too high to damage blood vessels or put extra strain on heart
What is the equation for MAP without using systolic and diastolic blood pressures?
MAP = Cardiac output (CO) x Systemic Vascular Resistance (SVR)
Equation for cardiac output?
CO = HR x SV
What is systemic vascular resistance (total peripheral resistance)?
Sum of resistance of all vasculature in systemic circulation
In systemic vascular resistance, what are the major resistance vessels?
Arterioles
What is the effect of parasympathetic stimulation of the heart?
Decrease in heart rate, which results in decreased cardiac output, resulting in decreased MAP
What is the effect of sympathetic stimulation of the heart? (2)
- Increase in heart rate, resulting in increased cardiac output and MAP
- Increase in force of contraction which increases SV, leading to increased CO and MAP
What is the effect of sympathetic stimulation of arterioles?
Vasoconstriction, increasing SVR, resulting in increased MAP
What is the effect of sympathetic stimulation of veins?
Vasoconstriction, causing increased venous return (EDV), resulting in increased SV, CO and MAP
What is the baroreceptor reflex?
Short-term regulation of Mean Arterial blood Pressure