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CPR > Regulation of BP > Flashcards

Regulation of BP Flashcards

1
Q

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

A

Baroreceptors

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2
Q

Blood pressure = Mean Arterial Pressure =

A

CO X TPR = HR X SV X TPR

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3
Q

Normally the MAP is around?

A

93 mmHg

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4
Q

What are the 3 ways the blood pressure is regulated?

A
  1. Baroreceptor reflex
  2. Renin-Angiotensin-Aldosterone System (RAAS)
  3. ADH and ANP
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5
Q

Overall baroreceptor reflex pathway?

A 
Detectors
Afferent neural pathway
Brainstem
Efferent neural pathway
Effectors - correct deviation from set point
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6
Q

Baroreceptors use _____ to detect change in stretch of artery walls

A

TRP channels

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7
Q

Where are the baroreceptors located?

A
  1. Carotid Sinus

2. Aortic Sinus

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8
Q

The carotid sinus sends afferents using what 2 nerves?

A
  1. CN 9

2. Sinus N. of Hering

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9
Q

The aortic sinus sends afferents using what 2 nerves?

A
  1. CN 10

2. Aortic nerve

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10
Q

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

A

Nucleus Tractus Solitarius

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11
Q

What do the the afferents at the NTS release?

A

Glutamate

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12
Q

Afferent neurons change their _____ to alter pressure

A

Firing rate

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13
Q

Afferent neurons are most responsive to the?

A

RATE of change in pressure

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14
Q

Decreased pressure causes what stretch and firing rate?

A

DECREASED

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15
Q

Increased pressure causes what stretch and firing rate?

A

INCREASED

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16
Q

With a decreased firing rate, what is the goal?

A

INCREASE PRESSURE

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17
Q

With an increased firing rate, what is the goal?

A

DECREASE PRESSURE

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18
Q

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

A

Aortic sinus

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19
Q

Where does the NTS send signals to coordinate sympathetic efferents?

A

Rostral ventrolateral medulla

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20
Q

Where does the NTS send signals to coordinate parasympathetic efferents?

A

Dorsal motor nucleus of vagus AND

Nucleus Ambiguus

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21
Q

What activates sympathetic activity?

A

DECREASED pressure and firing rate

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22
Q

What 2 things does activation of the sympathetic system do?

A
  1. Vasoconstriction - INCREASES TPR

2. Increases HR and contractility - INCREASES CO

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23
Q

What receptors do sympathetic efferents use for vasoconstriction?

24
Q

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

25
Q

What activates parasympathetic activity?

A

INCREASED pressure and firing rate

26
Q

What does activation of the parasympathetic system do?

A

Decreases HR - DECREASES CO

27
Q

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

A

Vagus nerve and muscarinic receptors

28
Q

When will orthostatic hypotension occur?

A

Lying supine and then rising to a standing position

29
Q

Describe orthostatic hypotension

A 
Upon standing:
- Blood pools in legs and veins
- DECREASED MAP
-- Decreased firing rate of baroreceptors activates SYMPATHETIC system
= Increased CO and TPR = Increased MAP
30
Q

Where is Renin released from?

A

Kidney - juxtaglomerular cells on afferent arterioles

31
Q

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

A

Beta 1 adrenergic

32
Q

What stimulate renin release?

A

Low BP
Low NaCl at macula densa
Increased sympathetic tone

33
Q

What creates Angtiotensin?

34
Q

Renin converts Angiotensin to?

A

Angiotensin 1

35
Q

What converts Angiotensin 1 to Angiotensin 2?

36
Q

What releases ACE?

A

Lungs and kidney

37
Q

What is the active form of Angiotensin?

A

Angiotensin 2

38
Q

What are 3 actions of Angiotensin 2?

A
  1. Aldosterone release
  2. ADH release
  3. Vasoconstriction - INCREASES TPR
39
Q

What does Aldosterone release do?

A

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

40
Q

ADH

A

Antidiuretic Hormone (vasopressin)

41
Q

What can activate ADH release?

A
  1. Angiotensin 2
  2. LOW preload in atria
  3. Sympathetics
  4. Hyperosmolarity
42
Q

Where is ADH released from?

A

Posterior pituitary

43
Q

Actions of ADH?

A

Vasoconstriction - INCREASES TPR

Water retention - INCREASES SV

44
Q

What are the main Natriuretic Peptides?

A

ANP and BNP

45
Q

What causes secretion of ANP and BNP?

A

Excessive preload in atria and ventricles (cardiac distention)

46
Q

Actions of ANP and BNP?

A

Decrease renin release
Vasodilation
= DECREASE BP

47
Q

What is the purpose of ANP and BNP?

A

Protects against overstretching of cardiac chambers

48
Q

Most common cause of chronic hypertension?

49
Q

Ideal salt intake

A

1500 mg – For sure less than 2300 though

50
Q

Main symptoms of chronic hypertension?

A

Increased sodium concentration and water retention

Increased TPR, CO, sympathetic tone

51
Q

What 2 unbalanced systems are activated with heart failure?

A

RAAS and sympathetic system

ANP/BNP

52
Q

With exercise, what do local modulators do?

A

Vasodilation

53
Q

With exercise, what do central modulators do?

A

Increase sympathetic and Decrease sympathetic

= Increased HR and CO

54
Q

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

A

Increased blood flow to the skeletal muscle

55
Q

What is the rapid method of altering blood pressure?

A

Baroreceptor reflex

– RAAS and ADH are SLOW

CPR (48 decks)

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