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CPR Midterm > Regulation of Blood Pressure > Flashcards

Regulation of Blood Pressure Flashcards

1
Q

how does the body sense that there has been a loss/ addition of blood volume?

A

baroreceptors

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2
Q

what 3 systems regulate MAP?

A

barareceptor reflex (rapid); renin-angiotensin-aldosterone system (RAAS) (slower); some input from ADH (vasopression) and ANP (slower)

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3
Q

what are the detectors/sensors in the baroreceptor reflex?

A

the baroreceptors

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4
Q

how do baroreceptors function?

A

through TRP channels that sense changes in stretch of the artery walls

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5
Q

what is the role of the afferents in the baroreceptor reflex?

A

they alter their firing rate

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6
Q

where is the coordinator center for the baroreceptor reflex?

A

in the NTS-vasomotor center in the medulla

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7
Q

what makes up the efferent neural pathway of the baroreceptor reflex?

A

both parasympathetic (vagus) or sympathetics

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8
Q

what is the role of the effectors of the baroreceptor reflex?

A

change MAP by altering CO and TPR

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9
Q

where are the baroreceptors located?

A

carotid sinus and the aortic sinus

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10
Q

what nerves are responsible for the carotid sinus?

A

the glossopharyngeal nerve (CN IX) and the sinus nerve of Hering

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11
Q

what nerves are responsible for the aortic sinus?

A

the vagus nerve (CN X) and the aortic nerve

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12
Q

what do the afferent neurons in the nucleus tractus solitarius utilize as their neurotransmitter?

A

glutamate

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13
Q

what do chemoreceptors respond to?

A

PO2, PCO2, and pH

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14
Q

what will be the goal if there is a decrease in pressure, decrease in stretch, and decrease in firing rate of the afferent neurons located in the baroreceptor reflex?

A

to increase pressure

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15
Q

what will be the goal if there is an increase in pressure, increase in stretch, and an increase in firing rate of the afferent neurons located in the baroreceptor reflex?

A

to decrease pressure

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16
Q

increased pressure increases firing rate and frequency of stimulation; recruitment occurs up until what in carotid bodies?

A

200 mm Hg

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17
Q

decreased pressure decreases firing rate and frequency of stimulation; signal almost vanishes at what pressure?

A

40-60 mmHg

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18
Q

what is the main difference between the sensors in the aortic vs the carotid sinus?

A

the aortic has a higher threshold for activation- continues to respond above saturation; the aortic sinus is less sensitive to rate- it is less affected by decreases

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19
Q

where is the parasympathetic activity associated with CV function located?

A

the dorsal motor nucleus of the vagus and the nucleus ambiguus

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20
Q

where is the sympathetic activity associated with CV function located?

A

rostral ventrolateral medulla

21
Q

what are the influences of the sympathetic nervous system in the baroreceptor reflex?

A

the sympathetics influence the heart muscles (atria and ventricle), SA node, vessels, and the adrenal gland via the splanchnic

22
Q

what 3 effects does sympathetic activity have during the baroreceptor reflex?

A

it will constrict the arterioles and veins via alpha-receptors; it will increase HR and contractility via beta-1 receptors; and there will be fluid retention by the kidney

23
Q

how do the parasympathetics decrease heart rate during the baroreceptor reflex?

A

the vagus nerve signals to the SA node and through muscarinic receptors

24
Q

for long term adjustments to pressure what is invoked?

A

a hormonal response- the Renin-Angiotensin II- Aldosterone System; ADH/ vasopressin; ANP

25
Q

why is the parasympathetic nervous system not always active in a patient with chronic HTN?

A

because the baroreceptors reset

26
Q

what is angiotensinogen released by?

A

the liver

27
Q

what converts angiotensinogen into angiotensin I?

A

renin (an enzyme)

28
Q

what is renin released from?

A

the kidneys

29
Q

what converts angiotensin I into angiotensin II?

A

ACE (an enzyme)

30
Q

what is ACE released from?

A

kidneys and the lungs

31
Q

what effect does angiotensin II have on the kidneys?

A

it constricts the glomerular efferent arteriole and increases Na+/H+ exchanger activity

32
Q

what effect does angiotensin II have on the posterior pituitary?

A

it causes ADH secretion

33
Q

what effect does angiotensin II have on the vascular smooth muscle?

A

causes hypertension

34
Q

What effect does angiotensin II have on the hypothalamus?

A

it stimulates thirst

35
Q

what effect does angiotensin II have on the adrenal cortex?

A

causes aldosterone secretion

36
Q

Renin is released due to a response to what?

A

a drop in BP

37
Q

what is renin release stimulated by?

A

B-1 adrenergic receptor activation

38
Q

what specific part of the kidney secrets renin?

A

the juxtaglomerular cells in the walls of the renal afferent arterioles

39
Q

secretion of aldosterone by the adrenal cortex leads to what?

A

Na+ and H2O retention by the kidney; increases blood volume, stroke volume, and cardiac output

40
Q

secretion of ADH causes what?

A

a reduction in urine production (aka fluid retention)

41
Q

vasopressin is secreted in response to what?

A

angiotensin II, atrial receptors in presence of low preload, increased osmolarity of blood

42
Q

what is the effect of vasopressin release?

A

increased TPR and water retention

43
Q

what are the natriuretic peptides?

A

ANP, BNP, and CNP

44
Q

when are the natriuretic peptides secreted?

A

when there is excessive preload of the atria and the ventricles

45
Q

what does secretion of the natriuretic peptides cause?

A

arteriolar dilation, increased fluid loss, and inhibition of renin

46
Q

what does arteriolar dilation cause?

A

decrease in TPR

47
Q

what does increased fluid loss cause?

A

it decreases preload

48
Q

what does inhibition of renin cause?

A

a decrease in both TPR and preload

49
Q

what occurs during heart failure?

A

there is poor ventricular function-so there is reduced cardiac output and stroke volume; there will be SNS and RAAS activation; there will be secretion of natriuretic peptides

CPR Midterm (21 decks)

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