Regulation of BP

Question 1

How does the body sense there has been a loss or addition to the blood volume?

Answer 1

Baroreceptors

Question 2

Blood pressure = Mean Arterial Pressure =

Answer 2

CO X TPR = HR X SV X TPR

Question 3

Normally the MAP is around?

Answer 3

93 mmHg

Question 4

What are the 3 ways the blood pressure is regulated?

Answer 4

1. Baroreceptor reflex
2. Renin-Angiotensin-Aldosterone System (RAAS)
3. ADH and ANP

Question 5

Overall baroreceptor reflex pathway?

Answer 5

Detectors
Afferent neural pathway
Brainstem
Efferent neural pathway
Effectors - correct deviation from set point

Question 6

Baroreceptors use _____ to detect change in stretch of artery walls

Answer 6

TRP channels

Question 7

Where are the baroreceptors located?

Answer 7

1. Carotid Sinus

2. Aortic Sinus

Question 8

The carotid sinus sends afferents using what 2 nerves?

Answer 8

1. CN 9

2. Sinus N. of Hering

Question 9

The aortic sinus sends afferents using what 2 nerves?

Answer 9

1. CN 10

2. Aortic nerve

Question 10

Where in the brainstem do the carotid sinus and aortic sinus send their afferents?

Answer 10

Nucleus Tractus Solitarius

Question 11

What do the the afferents at the NTS release?

Answer 11

Glutamate

Question 12

Afferent neurons change their _____ to alter pressure

Answer 12

Firing rate

Question 13

Afferent neurons are most responsive to the?

Answer 13

RATE of change in pressure

Question 14

Decreased pressure causes what stretch and firing rate?

Answer 14

DECREASED

Question 15

Increased pressure causes what stretch and firing rate?

Answer 15

INCREASED

Question 16

With a decreased firing rate, what is the goal?

Answer 16

INCREASE PRESSURE

Question 17

With an increased firing rate, what is the goal?

Answer 17

DECREASE PRESSURE

Question 18

Which sinus has a higher threshold for activation, is less sensitive and less effected by decreases in pressure?

Answer 18

Aortic sinus

Question 19

Where does the NTS send signals to coordinate sympathetic efferents?

Answer 19

Rostral ventrolateral medulla

Question 20

Where does the NTS send signals to coordinate parasympathetic efferents?

Answer 20

Dorsal motor nucleus of vagus AND

Nucleus Ambiguus

Question 21

What activates sympathetic activity?

Answer 21

DECREASED pressure and firing rate

Question 22

What 2 things does activation of the sympathetic system do?

Answer 22

1. Vasoconstriction - INCREASES TPR

2. Increases HR and contractility - INCREASES CO

Question 23

What receptors do sympathetic efferents use for vasoconstriction?

Answer 23

Alpha

Question 24

What receptors do sympathetic efferents use to increase HR and contractility?

Answer 24

Beta 1

Question 25

What activates parasympathetic activity?

Answer 25

INCREASED pressure and firing rate

Question 26

What does activation of the parasympathetic system do?

Answer 26

Decreases HR - DECREASES CO

Question 27

What nerve and receptors does the parasympathetic system use to decrease HR?

Answer 27

Vagus nerve and muscarinic receptors

Question 28

When will orthostatic hypotension occur?

Answer 28

Lying supine and then rising to a standing position

Question 29

Describe orthostatic hypotension

Answer 29

``` Upon standing: - Blood pools in legs and veins - DECREASED MAP -- Decreased firing rate of baroreceptors activates SYMPATHETIC system = Increased CO and TPR = Increased MAP ```

Question 30

Where is Renin released from?

Answer 30

Kidney - juxtaglomerular cells on afferent arterioles

Question 31

What receptors on juxtaglomerular cells in the kidney is activated for renin release?

Answer 31

Beta 1 adrenergic

Question 32

What stimulate renin release?

Answer 32

Low BP Low NaCl at macula densa Increased sympathetic tone

Question 33

What creates Angtiotensin?

Answer 33

Liver

Question 34

Renin converts Angiotensin to?

Answer 34

Angiotensin 1

Question 35

What converts Angiotensin 1 to Angiotensin 2?

Answer 35

ACE

Question 36

What releases ACE?

Answer 36

Lungs and kidney

Question 37

What is the active form of Angiotensin?

Answer 37

Angiotensin 2

Question 38

What are 3 actions of Angiotensin 2?

Answer 38

1. Aldosterone release 2. ADH release 3. Vasoconstriction - INCREASES TPR

Question 39

What does Aldosterone release do?

Answer 39

Stimulates sodium and water retention which will increase the blood volume!! Increases stroke volume and CO to increase BP

Question 40

ADH

Answer 40

Antidiuretic Hormone (vasopressin)

Question 41

What can activate ADH release?

Answer 41

1. Angiotensin 2 2. LOW preload in atria 3. Sympathetics 4. Hyperosmolarity

Question 42

Where is ADH released from?

Answer 42

Posterior pituitary

Question 43

Actions of ADH?

Answer 43

Vasoconstriction - INCREASES TPR | Water retention - INCREASES SV

Question 44

What are the main Natriuretic Peptides?

Answer 44

ANP and BNP

Question 45

What causes secretion of ANP and BNP?

Answer 45

Excessive preload in atria and ventricles (cardiac distention)

Question 46

Actions of ANP and BNP?

Answer 46

Decrease renin release Vasodilation = DECREASE BP

Question 47

What is the purpose of ANP and BNP?

Answer 47

Protects against overstretching of cardiac chambers

Question 48

Most common cause of chronic hypertension?

Answer 48

Unknown

Question 49

Ideal salt intake

Answer 49

1500 mg -- For sure less than 2300 though

Question 50

Main symptoms of chronic hypertension?

Answer 50

Increased sodium concentration and water retention | Increased TPR, CO, sympathetic tone

Question 51

What 2 unbalanced systems are activated with heart failure?

Answer 51

RAAS and sympathetic system | ANP/BNP

Question 52

With exercise, what do local modulators do?

Answer 52

Vasodilation

Question 53

With exercise, what do central modulators do?

Answer 53

Increase sympathetic and Decrease sympathetic | = Increased HR and CO

Question 54

With exercise and the activation of local and central modulators, what is the overall effect?

Answer 54

Increased blood flow to the skeletal muscle

Question 55

What is the rapid method of altering blood pressure?

Answer 55

Baroreceptor reflex | -- RAAS and ADH are SLOW