regulation of blood flow Flashcards

1
Q

why do organs need to regulate their blood flow (4)

A

to match blood supply to metabolic rate; to allow for efficient delivery of nutrients/removal of waste; increase/decrease heat loss; ensure blood flow to vital organs is maintained in the case of major haemorrhage

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2
Q

how is blood flow controlled (vascular level)

A

change in vascular tone

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3
Q

structure of non-striated vascular smooth muscle

A

single nucleus; membrane has Caveolae (similar to t tubules); dense bodies of a-actin (origin of actin + myosin filaments, similar to sarcomere); unorganised

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4
Q

what extrinsic factors affect vascular tone

A

circulating hormones; autonomic stimulation

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5
Q

what is the ion most important in sm contraction

A

Ca2+; intracellular levels govern contraction; L-type Ca2+ channels are found on vascular smooth muscle -> CCBs can affect contraction

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6
Q

what needs to occur to vsm myosin in order for it to form cross bridges with actin

A

phosphorylation of the light chain

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7
Q

light chain phosphorylation pathway

A

intracellular Ca2+ levels increase -> binds to calmodulin-> Ca2+-calmodulin activates myosin light chain kinase -> MLCK phosphorylates myosin - allows cross bridges to form

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8
Q

what happens to Ca2+ post contraction

A

binds with Calsequestrin in the sarcoplasmic reticulum and is stored there; or is transported out of the cell via Na+/Ca2+ exchanger etc.

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9
Q

an upregulation of what 2 molecules causes VSM to relax?

A

c-AMP (inhibits MLCK) and c-GMP (activates myosin phosphatase)

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10
Q

resistance equation (ohms law)

A

R = flow (V)/pressure (I)

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11
Q

what is autoregulation (blood flow)

A

intrinsic ability of an organ to maintain constant blood flow changes in perfusion pressure in the absence of external neural/hormonal stimuli i.e. constant flow is maintained despite changes in the perfusion pressure

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12
Q

what is the myogenic theory of autoreg

A

stretch receptors in the bv walls are activated -> influx of Ca2+ -> sm contraction -> decreased radius -> flow remains the same despite greater transient blood flow; bayliss myogenic response

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13
Q

what is the metabolic theory of autoreg

A

decrease in blood flow leads to an increase in waste product accumulation -> waste products activate receptors which cause vasodilation (Ca2+ influx etc.) -> blood flow increased back to desired rate

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14
Q

examples of vasodilatory metabolites (9)

A

↓ PO2; ↓pH; ↑ pCO2; ↑ temp; ↑K+; ↑ lactate; ↑osmolality; ↑histamine; ↑ products of ATP breakdown (adenosine, inorganic phosphate)

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15
Q

what is the effect of vasodilatory (waste) metabolites on the lungs

A

vasoconstriction

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16
Q

how does adenosine cause muscle relaxation

A

binds to AT2 receptors -> activates c-AMP -> inhibits MLCK binding -> vasodilation

17
Q

what does eNOS activation lead to

A

brachial artery vasodilation

18
Q

what is endothelin

A

a powerful vasoconstrictor; there are 3 isoforms coded for by different genes; produced as pro-hormone big endothelians, converted by endothelian converting enzyme

19
Q

what are prostoglandins synthesised by?

A

vascular endothelium from arachidonic acid

20
Q

what types of prostoglandins are vasoconstrictors and which are vasodilators

A

VC - F series, serotonin;
VD - E, I series, PGE2/4

21
Q

what can be given to raynauds patients to ease symptoms

A

prostacyclin (PGI2) - vasodiliator

22
Q

what hormones are vasodilators (3)

A

kinins (bradykinin, lysylbradykinin); adrenomedullin; atrial natiuretic peptide (ANP)

23
Q

kinin precursors

A

kininogens

24
Q

how do kinins work

A

act on B2 receptors on endothelial cells, causing a release of NO in endothelial cells

25
role of kinins in clotting
plasma kallikrenin acts on HMW kininogen to make bradykinin
26
action of adrenomedullin
a depressor polypeptide that inhibits alodsterone; releases NO and increases c-AMP in cells; exerts action through calcitonin receptor like recptor and RAMP2/3
27
action of ANP & BNP (3)
secreted from the heart (ANP from atria and BNP from ventricles); lowers BP by antagonising various vasocontrictors - released when the heart is stretched; inhibits renin secretion;
28
circulating vasoconstrictors (4)
angiotensin/renin; noradrenaline; urotensin II; vasopressin
29
pre ganglionic NT (ANS)
Ach
30
post ganglionic sympathetic NT
NA
31
post ganglionic parasympathetic NT
Ach
32
what does NA exist alongside in NT vesicles
ATP; neuropeptide Y
33
what is the neural mechanism of blood flow regulation
regulation of BF that depends on cardiovascular centres in the medulla oblongata
34
what does baroreceptor firing cause (neural mech of BF)
reflex via the medullary cardiovascular centre - decreased symp to heart, arterioles, veins; increase parasymp to heart
35
RAAS pathway
renin --> angiotensin -- (liver)--> angiotensin I -- (ACE) --> angiotensin II --> vasoconstriction (↓GFR, ↓urine output); adrenal gland stimulaton --> aldosterone --> ↑Na+ retention, ↑ water retention --> ↑ BP