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GNUS627/Cardiac/Physiology for Anesthesia > Quiz 8 - Neurohumoral Control > Flashcards

Quiz 8 - Neurohumoral Control Flashcards

1
Q

1.Which sympathetic nerve receptor predominantly causes vasoconstriction?

A

Alpha 1

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2
Q

2.Which sympathetic nerve receptor predominantly causes increased contractility?

A

Beta 1

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3
Q

3.Which sympathetic nerve receptor predominantly causes bronchodilation?

A

Beta 2

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4
Q

4.Know the definition of the following terms: chronotropy, inotropy, dromotropy, and lusitropy.

A
  • Chronotropy - HR
  • Inotropy - contractility
  • Dromotropy - Conduction velocity
  • Lusitropy - Relaxation
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5
Q

5.What are some of the major differences between the sympathetic and parasympathetic nervous systems?

A
  • Symp –> increase HR, inotropy, dromotropy, arterial and venous resistance, and venous capacitance
  • Parasymp –> decrease HR, inotropy, dromotropy, arterial and venous resistance, and venous capacitance
  • *Symp nerves are Thoraco-lumbar
  • *Parasymp nerves are cranio-saccral
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6
Q

6.Does the sympathetic nervous system primarily stimulate or inhibit the heart?

A

Stimulates the heart

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7
Q

7.What is the “second messenger” that is involved with sympathetic stimulation of a cardiac muscle cell?

A

Cyclic AMP
How it works: contraction/relaxation by catecholamine the resulting increase cAMP activates a protein kinase which phosphorylates the Ca++ channel in the sarcolemma (allows greater Ca++ influx)

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8
Q

8.Which catecholamine does the adrenal gland predominantly release with sympathetic stimulation?

A

Epi (80%), Norepi (20%)

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9
Q

9.What is the Baroreceptor Reflex? Where are the receptors for this reflex located?

A

Located in the Carotid SINUS and aortic arch - senses and buffers changes in BLOOD PRESSURE

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10
Q

10.How does the Baroreceptor Reflex help with blood pressure regulation?

A
  • Helps reduce daily variation in blood pressure
  • Helps with postural changes in BP
  • Responds to rapidly changing pressure
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11
Q

11.During what surgery does Baroreceptor Reflex activation frequently cause hemodynamic changes?

A

Having a hard time finding this answer. My guess would be LAPRASCOPIC ABD PROCEDURES and CAROTID ENDARTARECTOMY. Both would cause pressure changes to the baroreceptors and likely change blood pressure.
Per Dr Larson - CEA is the answer

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12
Q

12.What is the Bainbridge Reflex? Where are the receptors for this reflex located?

A

Low pressure sensors that respond to STRETCH - located in pulmonary vein and vena cava

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13
Q

13.In addition to receptor activation what also contributes to the heart rate changes seen with the Bainbridge Reflex?

A
  • Infusion of volume causes an increase in heart rate.

* Baroreceptor reflex often change heart rate in opposite direction

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14
Q

14.The Baroreceptor Reflex responds to changes in arterial blood pressure or to changes in blood volume?

A

Atrial Blood Pressure

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15
Q

15.The Bainbridge Reflex responds to changes in arterial blood pressure or to changes in blood volume?

A

Blood Volume (stretch)

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16
Q

16.What are some of the effects of Atrial Stretch Receptor activation?

A
  • Decreased sympathetic kidney activity –> increased UOP
  • Decreased ADH (vasopressin) –> increased UOP & decreased water reabsorption
  • Increased Atrial Natriuretic Peptide –> increase natriuretic UOP and decreased BP
17
Q

17.What is the Bezold-Jarisch Reflex?

A

.Strong contraction of an underfilled ventricle elicits the reflex.
could lead to vasovagal syncope or cardiac arrest during spinal.

18
Q

18.What is the CNS ischemic response?

A
  • Result of decreased blood flow to vasomotor center in medulla
  • Results in increased BP
  • Very powerful activator of the sympathetic nervous system
19
Q

19.What is the Cushing Response?

A
  • Special type of CNS ischemic response
  • Result of increaased intra-cranial pressure
  • Increased ICP results in increased BP until blood flows once again in the vessels of the brain.
20
Q

20.What is Cushing’s Triad?

A
  • Increase ICP
  • Increase HTN
  • Bradycardia
21
Q

21.Under what circumstances can Peripheral Chemoreceptors cause hemodynamic changes? What hemodynamic changes occur?

A

Circumstances

  • Decrease PO2 (Hypoxemia)
  • Increase PCO2 (Hypercapnia)
  • Hydrogen Ion Concentration (acidosis)
Hemodynamic Changes
-Increase
     SVR
     CO
     MAP
22
Q

22.What is the Diving Reflex? What receptors are involved?

A
  1. Cold reflex (water) response on the face
  2. Activates THERMORECEPTORS
  3. Info relayed to brainstem via facial nerve afferents
  4. Vagus Nerve (decrease HR)
    Sympathetic Nerve (Peripheral Vasoconstriction)
  5. Reduced oxygen consumption by the body and myocardium
23
Q

23.An infusion of epinephrine will cause what changes in heart rate? Systolic blood pressure? Diastolic blood pressure?

A

-Increases
Heart rate
Systolic Blood Pressure

-Decreases
Diastolic Blood Pressure (Klabunde, pg. 136)

24
Q

24.An infusion of norepinephrine will cause what changes in heart rate? Systolic blood pressure? Diastolic blood pressure?

A
  • Heart rate transiently increases (B-adrenoceptor stimulation) and then decreases to baroreceptor reflex activation of vagal efferents to the heart.
  • Mean arterial pressure rises which increases Systemic vascular resistance. (Increase to both systolic and diastolic pressures.) (Klabunde, pg. 136)
25
Q

25.Vasopressin is released from which part of the brain? What are the effects of vasopressin on blood pressure? What are the effects of vasopressin on the kidney?

A
  • Posterior Pituitary releases arginine vasopressin
  • Increase Aterial Pressure
  • Vasopressin increases water reabsorption by the kidneys by increasing water permeability in the collecting duct (Concentrated Urine) (Klabunde, pg. 140)
26
Q

26.What is the stimulus for release of Atrial Natriuretic Peptide? What are the effects of ANP on blood pressure?

A 
- ANP release stimulated by
 Atrial Distension
 Sympathetic Stimulation
 Angiotensin II
 Endothelin (Klabunde, pg. 139)

Results in increased natriuretic diuresis and decreased BP

Occurs during condtions
Hypervolemia
Congestive Heart Failure

27
Q

27.What converts angiotensinogen to angiotensin I?

A

Renin (Klabunde, pg. 137)

28
Q

28.What converts angiotensin I to angiotensin II?

A

Angiotensin-converting enzyme (Klabunde, pg. 138)

29
Q

29.What are the INDIRECT effects of hypoxia on the circulatory system? What are the DIRECT effects?

A 
-Moderate Hypoxia
(Indirect Effects)
     Sympathetic Nervous System Activation
     Increased HR
     Increased CO
     Increased Contractility

-Severe Hypoxia
(Severe Effects)
Depressed Myocardial Contractility

30
Q

30.What are the INDIRECT effects of hypercarbia on the circulatory system? What are the DIRECT effects?

A 
-Indirect Effects
     Sympathetic Nervous System Activation
     Increased HR
     Increased CO
     Increased Contractility

-Direct Effects
Depressed Myocardial Contractility

GNUS627/Cardiac/Physiology for Anesthesia (12 decks)

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