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CPR Exam 1 > Regulation of Arterial Pressure > Flashcards

Regulation of Arterial Pressure Flashcards

1
Q

What is the equation for mean arterial pressure?

A

MAP = Cardiac Output x Total Peripheral Resistance

(Cardiac Output = HR x Stroke Volume)

(Stroke Volume = EDP - ESP)

(MAP =2/3 diastolic BP + 1/3 systolic BP)

Normal MAP=93.3mmHg (approx 100)

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2
Q

What cranial nerve is associated with baroreceptors in the carotid sinus?

A

CN IX

Glossopharyngeal

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3
Q

What nerurotransmitter is associated with the nucleus tractus solitarius?

A

Glutamate

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4
Q

What is the rostral ventrolateral medulla in charge of?

A

Sending sympathetic signals to the heart as a part of the baroreceptor reflex.

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5
Q

What two regions of the brain stem are in charge of sending parasympathetic nerve fibers to the heart as a part of the baroreceptor reflex?

A

Dorsal motor nucleus of the vagus

Nucleus abmbiguus

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6
Q

What is the highest mean arterial pressure that the carotid bodies can report?

A

About 200 mmHg

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7
Q

What stimulates renin to be produced by the kidneys?

A

Low BP

Beta 1 adrenergic receptor activation

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8
Q

What four things does Angiotensin II do to increase blood pressure?

A

Contracts smooth muscle via the AT1 receptor

Causes secretion of aldosterone

Causes secretion of antiduretic hormone

Increases thirst

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9
Q

What stimulates the release of natriuretic hormone?

A

Excessive preload

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10
Q

What does natriuretic peptide do?

A

Dilates the arterioles

Increases fluid loss

Inhibits renin

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11
Q

What does the body do as a response to increased blood volume?

A

Increase secretion of atrial natriurietic peptide

Decreases aldosterone secretion

Renal vasodilation occurs

Increases heart rate

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12
Q

What nerves innervate the aortic sinus?

A

Vagus (X)

aortic nerve

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13
Q

When does the carotid sinus increase firing rate and when will it decrease firing rate?

A

increases firing rate in response to increased stretch (higher pressure)

decreases firing rate in response to low pressure (less stretch on walls)

most responsive to rate of change; reacts immediately and can “reset” the BP set point

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14
Q

Where in the brain do signals from the carotid sinus go?

A

First to the nucleus of tractus solitarius and then PNS sends signals to the dorsal motor nucleus of the vagus and nucleus ambiguus (inhibit vasoconstriction) and the SNS sends signals to the rostral ventraolateral medulla (vasomotor/constrict)

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15
Q

Compare and contrast the aortic and carotid sinuses

A

the aortic sinus:

has a higher threshold for activation

continues to respond above saturation

less sensitive to rate/less effected by decrease in rate

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16
Q

What is the sympathetic response to baroreceptor firing?

A

SNS responds to a decrease in baroreceptor firing rate

influences atria/ventricle, SA node, vessels directly

influences adrenal gland via splanchnics

causes:

constriction of vessels (alpha rec.)

increase HR and contract. (b1)

renin secretion by kidney

17
Q

What is the parasympathetic response to baroreceptor firing?

A

PNS responds to increase in baroreceptor firing rate

decreases HR via vagus to SA node and ach on muscarininc receptors

causes indirect vasodilation via NO release

18
Q

While the baroreceptor reflex takes seconds, what is a longer term hormonal response to vascular and fluid changes?

A

RAAS

controls BP by regulating blood volume and TPR

overlap with SNS

uses ADH and ANP

19
Q

What will be increased as a result of angiotensin II release (overall systemic changes)

A

Blood volume

EDV

Preload

SV

CO

BP

20
Q

What are the results of angiotensin II release (small scale changes)

A
  • increased aldosterone, Na reabsorption, ECF volume
  • Na/H exchange
  • thirst
  • vasoconstriction and TPR, BP (AT1 receptors)
21
Q

When is renin released?

What stimulated the release?

What does renin do?

A

released when there is a drop in BP

via B1 adrenergic receptor activation (and SNS stim.)

decreases NaCl at macula densa, converts angiotensinogen into angiotensin I which becomes II in the lungs and kidneys

22
Q

angiotensin II stimulates the release of ADH which dos what?

what else can stimulate the release of ADH?

What is the result of ADH

A

reduces urine production and increases fluid retenton

atrial receptors during low preload (decreased atrial firing rate)

hyperosmolarity

SNS activation

increases TPR and water retention, vasoconstirction on v1 and increased fluid reabs. on V2

23
Q

What are three types of natriuretic peptides?

why are they secreted?

what are their effects?

A

ANP, BNP, CNP (atrial, brain, c-type)

increased secretion by excessive preload of atrial and ventricles (increased blood volume)

dilate arterioles, decrease TPR

excrete fluid, decrease preload

inhibit renin

protects against overdilation/over stretchingof cardiac chambers

24
Q

What are the immediate effects of blood volume loss? (hemorrhage, dehydration or other source of loss would be same)

A

decreased

Venous return

preload

stroke volume

CO

MAP

vascular function curve shifts to left

25
Q

What is the compensatory response to hemorrhage?

A

carotid sinus nerve firing decreases

HR, contractility, CO increases

unstressed volume decreases

TPR increases

Epi, ADH, renin, ang. II, aldosterone increase

ANP decreases

26
Q

what compensatory responses occur when exercising?

A

increased SNS (B1 rec) and decreased PNS

increased HR/Contractility

increased venous return

selective arteriolar vasoconstriction with a1 rec. (slight increase in MAP)

vasodilation to active muscle and coronaries due to release of lactate, K, adenosine (active hypermia)

pulse pressure increases, SBP increases, DPB no change

TPR decreases overall

curve shifts up

27
Q

What is the compensatory repsonse to orthostatic position changes?

A

initially: MAP decreases

no change in HR and TP

SV and CO decrease (decreased venous return)

central venous pressure decreases

Compensatory: all above increase towards normal

uses baroreceptor reflex, maybe hormonal but less so

if no compensation: orthostatic hypotension

CPR Exam 1 (31 decks)

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