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CVS Physiology > Regulation of arterial BP > Flashcards

Regulation of arterial BP Flashcards

1
Q

Why the aretrrial blood pressure should be regulated ?

A

It must be high so that it can drive the blood to the tissues
it must not be so high because this will
.increase the afterload
. risk of damage of blood vessels
. risk of small vessels ruptures

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2
Q

Short term regulation describe .

A

its is rapid and life saving by affecting vasuclar capacity by neral and hormonal effect
its problems is it finshis quickly and no full correction of abp

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3
Q

describe the long term regulation and its advantage over the STR

A

It is of slow onset within days affect the blood volume by renal and hormonal mechanism and its advantages and pros over the str is

  • full correction of the ABP
  • Contiunes much longer reach years
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4
Q

D/ intermdeiate term regulation

A

not very rapid
not last very long
by vascular mechanisms affecting the vascular capacity and the bllod volume
كأنها تمثل حلقة الوصل بين القصير والتنظيم الطويل !

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5
Q

vasomotor area

A

is the resopnsible for NE sympathattic flow pressore area

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6
Q

Nucleus ambigous

A

يطلع منها العصب التاسع والعاشر

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7
Q

cardio inhibitory area

A

arise from dorsal motor nuclei of vagus and nucleus ambigious

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8
Q

Nucleus tractus solitarus role ?

A

حلقة الوصل بين الاعصاب المخية والمراكز الدورية

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9
Q

decribe the course of signal from vasomotor centre

A

it begins in the medulla till the thoracolumbar sergments of spinal cord and symp fiber arise from there to reach the symppthatic ganglion ending as the preganglionic fibers then the post ganglionic arise to supply all over the heart

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10
Q

describe the course of the cardioinhibitory segment

A

it begins in the medulaa then reach the vagus till the ganglion very naer to the heart giving post ganglionic fiber which supply avn san and atrial muscles !

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11
Q

GR/stimulation of cic decrease ABP?

A

Because the Parasympathatic stimulation on san leads to decrease of heart rate so COP SO arterrial bp
avn de conductivity
atrial contractility

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12
Q

Vasmotor center effect on Bp ?

A

Sympathatic stimulation leads to increase all cardiac propeirties SAN AVN ATRIAS VENTRICLES
+chronotropin inc HR inc cop in BP
+INOTROPIC INC COP INC BP

arteriole is has a vasoconstircotr effect incresing TPR Increasing MAP
VENOconstiction in case of over activity not a tone!
leads to inc venous returen and cop and BP
SUPRERENAL GLANDS LEADS TO SYMPATAHIC STIMULATION

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13
Q

SHORT TERM REGULATION MECHAN

A

1-BARORECEPTORS ALL TIME MOST IMP! ALL TIME NOT ONLY IN BP
2-CHEMORECEPTORS low arterial blood pressure 80 or less
3-CNS ISCHEMIC REFLEXES 50 or less

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14
Q

Mention types of baroreceptors ?

A 
artetial BR
1- Carotid sinus receptor  glossopharyngeal 
2-aortic archh receptor  vagus 
9.10 buffer nerves they buffer the changes in ABP
cardiopulmonar receptors 
1-atria 
2-ventricles
3-pulmonary
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15
Q

Describe arterial baroreeceptorr ?

A

site at aortic arch and carotid sinus
stimulus : change in MAP 60- 200 SUSTAINED
Change in pusle pressure more effective
afferents buffer nerves :
sinus from glossopharyngeal
aortic from vagus
centers : Medullary
CIC:Stimulation thus decrasing bp
Vasmotor centere ; depression stimulation of depressor are dec BP

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16
Q

type of baroreceptor?

A

stretch

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17
Q

Baroreceptor imp notes

A

Monitior moment to moment change in abp
adapt the new pressure rapidly so senstive pulse pressure more than MAP
شغالين طول الوقت يزيد لما يزيد الضغط يقل لما يقل الضغط
FIRING RATE

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18
Q

Carotid sinus are called brain defenders ?

A

Because the are more senstive than the aortiic arch
they respond to changes at 60 mm Hg and both increase and decrease
but the aortic arch respond at 80 mm Hg mainly to the increases!

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19
Q

illustrate the role of baroreceptors

A

1- in case of normal bp it sends basal impulses to cic and vasomotor cntere depressor
causing
decrease in the TPR and HR and VR
2 in case of increased Bp it sends impulses to stimulate CIC and inhibit the VMC
CAUSING decrese TPR HR VR
3- in case of decreased BP less impulses causing inhibition of cic stimulations of pressore area to increase TPR HR VR
4- IN EXCESSIVE increasre increasing the firing rate causing stimulation of cic and inhibition of the VMC MARKED decrease in TPR HR VR
Then : the sympathatic cholinergic neurons in an attepmt to decrese this high bp

This can affect respiaratoy centere causing apnea

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20
Q

what is adrenalina apnrea

A

adrenaline may cause excessive increase in Bp causing barorecptors to send impulses casuing depression of respiratory centers !

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21
Q

Describe the effect of hemorrhage on STL

A

Hemohrrage leads to decreased SV then decreared COP AND BP
CAROTID RECEPTORS WILL respon d byn decresing the impulses causing
inhibtion of cic and stimulation VMC causing maintananve of vasoconstriction in an attempt to maitain BP
Carotid sinus receptors are the main effector

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22
Q

the effect of baroreceptors in postural changes ?

A

contiunous regulation of BP by baroreceptors during hypotension is done by the carotid sinus receptor ,
while standing the blood go down and the blood and its pressure decrease at upper part of the body causing less inhibition of the carotid receptores causing less impulses and less tim of cic and less inhibitikon of VMC causing venocostriction increasing venous return and cop the load of heat increasing the blood pressure !

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23
Q

why some people may go faintaing while shaving ?

A

That is because carotid sinus syndrome!
the carotid sinus is hyper senstive to any pressure
and this leads to inhibitoin of VMC ووووووووووووstimulation OF sympathatic vasodilator system lower BP – FAINTING BECAUSE OF BRAIN ISCHEMIA !

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24
Q

Describe the Cadiopulmonary high pressure type A baroreceptor

A 
it is stimulated as resonse to 
-atrial systole 
-ventricular systole 
-pulmonary hypertension 
and affects cic and vmc  like baroreceptors
-Reflex VD 
-bradycardia 
-decreased contractility
25
Q

What is Bainbridge reflex ?

A

it is a reflex out of low pressure atrial type B baroreceptor causing reflex tachycardia
may be due to direct stimulation of SAN

26
Q

LOW PRESSURE TYPE B ATRIAL AND PULMONARY BARORECEPTOR , what is their stimulus?

A

Increased blood volume venous returem

27
Q

GR/ low pressure barorecptors type b act an intermediate term regulation of abp

A

that is because their reflex VD in response to the increase in blood volume and venous return and thus causing increasing the capillary filtration pressure

28
Q

GR/low pressure receptors has a mixed type regulation ?

A

Long term regulation because of the VD of the afferent arterioles glomerular
intermediate term regulation because of VD of arterioles causing increased capillary filtartion rate

29
Q

The attempts of low pressure type B baroreceptors in lowering blood volume ?

A

Bainbridge reflex casusing tachycardia by direct stimuation of SAN
Intemediate regulation by VD of vessels increasing blood capillary filtration to tissue
long term regulation causing VD of afferent glomerulat aretrioles
decrasing ADH كده يزود ادرار البول
Increaseing ANP يخرج الصوديوم لوحده؟. لا أبدا !

30
Q

اشرح مختصرا عن المستقبلات الكيميائية الطرفية

Peripheral cheomreceptor

A

Carotid bodies and aortic bodies
the are stimulated by hypoxia hypercapnea and acidosis
when the MAP fall down below 80mm Hg it is stimulated in respone to hypoxia becasue of decrease of the physically dissolved o2 not chmically bounded
this leads to stimulation of of of ! Vasomotor center !
increasing VR HR TPR and adrenal gland sympathathic outflow causing incresing of the MAP

31
Q

Peripheral chemoreceptores afferent and centres ?

A

afferent - buffer nerves

centres medulary cardiovascular centers

32
Q

Illustrate Bezold-jarisch reflex .

A

it is reflex depending on the chemoreceptor found in the coronary vessels and stimulated by the pharamacological injection of some drugs like : veratidine and serotoinine and also
Mycardial ischemic heart the dead tissue secretes substances causing its stimulations
and thus causing —- severe hypotension and bradycardia

33
Q

MAP decrasing to 50 or below refers to ?

A

brain enters a severe state of ischemia

34
Q

CNS ischemic reflex describe ?

A

when map decrases to 50 or below this causes decrasring of blood flow tho the brain and especially the vmc
this cause hypoxia hypercapneia and acidosis and these factors are strong in stimulation VMC causing VC of blood vessels for 5-7 minutes incresaing ABP

35
Q

Cushing reflex mean ?

A

this is a reflex to the increase in the Intra cranial pressure causing pressure on the vessels and decrasing blood flow to brain and vasomotor center casuing hypoxia hypercapnia and acidosis this leads to stimulation of the VMC and vc of blood vessels and increase ABP and bradycardia due to baroreceptor stimulation or cic stim

36
Q

brain has no Vasoconstriction

A

no autononic supply to its vessel they are almost entirely controlled by local mechanisms

37
Q

Short term regulation hormonal effect ?

A

Neurohormonal reg

أدبر الليل
AdPR

Adrenalmedullary hormones epinephrine and norepinephrine
Posteior putiutary – ADH Vasopressin
Renin Angiotensin system within 20 minutes

38
Q

GR/ the COP decreases in norepinephrine release inspite of its cardiac acceleration activity ?

A

That is because the bradycardia resultus from stimulation of the baroreceptors because of the increase in the ABP because of its effect of vasoconstrivtion by the a receptors !
the brady cardia resulted has the upper hand over the cardiac acceleration by b1 receptors ! so COP DECRASES

39
Q

GR/ SP and DP increases in case of norepinhorine release ?

A

this is because it action on the a1 receptor causing vc effect

40
Q

Epinehrine role ?

A

AFFECT
a1 vasoconstrrction
b2 Vasodilation overcoming the effect of the a1 vd of skeletal msucles and liver vessels decrasing the tpr and dp and increasing the pp
b1 on the heart + chrono and ino and dromo tropic this cause increase SV HR COP AND arterial blood pressure exceeding the slow stimulation of baroreceptor that cannot lower blood pressure because b2 has the upper hand
in normal dose b mask a
in high dose a mask b

41
Q

the dose is detrminant of action of epinephrine ?

A

in normal dose b mask a

in high dose a mask b

42
Q

despite the action of epinephrine on a1 receptor it causes decrese in DP ???

A

a1 vasoconstrrction
b2 Vasodilation overcoming the effect of the a1 vd of skeletal msucles and liver vessels decrasing the tpr and dp and increasing the pp

43
Q

ADH HORMONE STIMULUS ?

A

1- changes in the osmolarity direct proprtional

2 decreased atrial volume causing decrased action of low pressure type b atrial receptor

44
Q

mention actions of the ADH OR VASOPRESSIN

A
  • Kidney Water retention at DCT and CT through V2 .

- bvs Vasoconstriction of blood pressure high dose V1 .

45
Q

Site of release and site of formation of ADH ?

A

1- PSOTEIROR PITUITARY

2- HYPOTHALAMUS

46
Q

Why renin is released in case of hyponatremia ?

A

that is because it turnis angiotensingogen from liver into ang 1 then converted into ang 2 that
1- induce release of ADH stimulating water perservastion
2- INCREASING Alodsterone responsible for salt and water retention pharma ?!

47
Q

Sympathahtic and b1 receptors can raise VC HOW ?

A

Becuase it works on b1 on juxta glmerular appartus which will release renin converting angen to ang1 then it will be converted to ang 2 the most potenet vasoconstrictior in the body

48
Q

Renin angiotensisn system decribe it and how many type of regulation it shares in ?

A

It depend on the angiotensiongen a2 glubulin released from the liver which will be activated by reinin release to ANG1
RENIN RELEASE DEPENDS ON :
1- LOW RENAL PERFUSION BECAUSE
A- RENAL ISCHEMIA B- DECREASE IN ARTERIAL BLOOD PRESSURE
2-HYPONATREMIA
SYMPATHATIC STIMUALTION WORKING ON THE B1 ON JGA

then ang1 will converted by the mean of ACE into ANG2
WHICH IS
- THE MOST POTENT VASOCONSTRICOR ON THE BODY
-INCREASING ALDOSTERONE TO SALT AND WATER RETENTION
-INCREASE ADH
-THIRST SENSASTION TO INCREASE BLOOD VOLUME THUS INCREASING BP

GREAT GREAT MY GREAT STAR !

49
Q

INTERMEDIATE TERM REGULATION MECHANISM ?

A
  • STRESS AND ANTI STRESS MECH

- CAPILLARY FLUID SHIFT

50
Q

SHOW THE MECHANISM OF STRESS METHOD REGULATION ?

A

INCREASING THE ABP increaseing the vasucluar capacity by opening of the artriole veins and capillarires decresaing the bp
anti stress
لما يقل الضغط يقل فتح الاوعية الدموية وتقل السعة الوعائية بتاعتها وعلي كده يزيد ضغط الدم علي الجدران مسخرة ؟ مش مفهومة ولا ايه ؟

51
Q

Show Capilllary fluid shift

s

A

simply it is when there is increase in abp increasing the filtration at the capillary and decreasing the reabsorption at the venous side and this will decresing the plasma volume and decresing the abp
وبكل بساطة لو قل الضعط الدموي هيقل الفلترة عند الشعيرات الدموية و هيزيد اعادة الامتصاص عند الجانب الوريدي وده بكل بساطة هيزود حجم البلازما مؤديا الي زيادة الضغط الدموي ؟!

52
Q

GR/the long term regulation may depends on the kideny ?

A

لانه بزيادة ضغط الدم هيزداد الامداد الدموي للكلية وهيزداد الفلترة الكلوية وهيزداد اخراج الصوديوم وفي ظهره الماء مؤديا لنقص حجم البلازما ونقص الرجوع الوريدي ونقص المخرج القلبي ونقص الضغط الدموي
والعكس صحيح فلو كان الضغط قليل لقل الامداد الدموي للكلية و قل الفقلترة الكلوية وقلت اخراج الماء والصوديوم و يزداد حجم البلازما والرجوع الدموي واملخرج القلي و في الاخر زيادة الضغط الدموي يا عمر !

53
Q

long term regulation may depends on hormones ? true or false why ?.

A

yes can depend on slow reacting hormones like ?
3A
1- the ADH
يقلل التبول ويزود حجم الدم يطلع عند انخقاط ضغط الدم
2-ANP بيطلع من الاذين يزود خروج الماء والصويدوم يعمل توسيع للاوعية يعمل مضاد للرنين وهو كمان بيقلل الضغط
3-CORTISOL ALODSTERONE ACTION ! يزود الضعط تركيز الماء والملح
4-ALODSTERNE تركيز الماء والملح يزود الضغط
5-RENIN ANGIOTENSIN SYSTEM !
في انخفاض ضغط الدم

54
Q

Classify the excitatory and inhibitory factor on the VMC

A

alram emotion Excitatory
grief emotion inhibitory
musclar excercis Excitatory
mild moderate pain Excitatory
severe pain inhibitory
lung over inflation inhibitory

55
Q

muscular excercise has to ways to excite VMC

A

1- CEREBRAL CORTEX VIA HYPOTHALAMUS

2- AFFERENTS VIA RETICULAR FORMATION

56
Q

Is there any direct stimulation for the VMC?

A

YES OF COURESE ESPECIALLY BY hypercapnia and hypoxia and acidosis

this lead to vc and inc in arterial blood pressure like in cushing reflex increasing ICP

57
Q

which is stronger the diret or indirect stim of VMC

A

Direct stimulation is much more stronger than the indirect Stimulation

58
Q

Baroreceptors work only in increasr BP ?

A

DEFINTELY FALSE !

ALL TIME

CVS Physiology (14 decks)

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