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CPR Exam 1 > Regulation of BP - Dr. Rogers > Flashcards

Regulation of BP - Dr. Rogers Flashcards

1
Q

CASE 1 38yo infusion of isotonic saline solution for a hangover, and too much was added
What sensed the addition of blood volume in the body

A

BARORECEPTORS (FAST)

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2
Q

Slow ways of regulating BP

A

RAAS (renin-angiotensin- aldosterone- system

ADH and ANP

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3
Q

Equation for MAP

A 
MAP = CO x TPR
MAP = HR x SV x TPR
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4
Q

Baroreceptor pathway

A
  1. BARORECEPTORS on the TPR channels sense stretch of Artery wall
  2. Increase firing of afferent n
  3. Signal to medulla
  4. Para and sympa go to cerebral cortex and hypothalamus (efferent n)
  5. Change MAP (by changing CO or TPR)*
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5
Q

Where are the BARORECEPTORS found and what nerve is there sending the signal

A
  1. Carotid sinus : (CN9) +sinus n of Hering
  2. Aortic Sinus : CN10 + Aortic nerve
    = BOTH go to Nucleus Tractus Solitarius and release GLUTAMATE
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6
Q

Chemoreceptors respond to what

A

Po2 and Pco2 and pH

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7
Q

Low firing of CN 10 and CN9 to NTS causes end goal of

A

Increase BP

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8
Q

BARORECEPTORS respond to magnitude of or rate of change in BP

A

RATE of change of BP (fast change in pressure activates them)

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9
Q

Which BARORECEPTORS has highest threshold

Also normal range for picking up BP

A

Aortic sinus

40-60mmHg to 200mmHg

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10
Q

Parasympathetic function on heart

A

HR ( to SA node muscarinic R) * only CO (not TPR)

NOT contractility

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11
Q

After signal to NTS where does signal go

A
  1. To Vagus nucleus or nucleus ambiguus———> send PARAsympathetic to SA and AV node (cardioinhibitory area)
  2. To Ventrolateral medulla ——> SYMPAtheic to heart (A, V, SA) + arteries + veins
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12
Q

Sympathetic function on low BP

3 ways

A
  1. A receptors: constriction of arteries and veins (TPR)
  2. B1 receptors: increase HR and contractility (CO)
  3. Kidney fluid retention : constriction afferent arteriole + release renin
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13
Q

Orthostatic HTN

A

Lying down and standing up causes:

- lightheaded, dizzy, normal movement helps move blood back to heart

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14
Q

Reason Orthostatic HTN happens

A
  1. Lying down causes blood to pool in legs(can cause edema)
  2. VR and CO decrease
  3. MAP decrease
  4. BARORECEPTORS activated
  5. Increase sympathetic outflow
  6. Something doesn’t happen : TPR increase, increase HR, contractility, CO, vein constriction, VR, decrease in unstressed volume
  7. BP doesn’t go back to normal right away *ANS dysfunction
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15
Q

BARORECEPTORS in HTN patients

A

They adjust to the new normal (reason its not active in HTN pts)

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16
Q

RAAS system steps

A

Over time regulation of right BP for the body

  1. Liver secretes Angiotensinogen
  2. RENIN (from juxtaglomerular cells) converts it to angiotensin 1
  3. ACE (from kidney and lungs) converts it to angiotensin 2
  4. Angiotensin 2 acts to increase BP
17
Q

Angiotensin 2 functions

A
  1. Kidney. Contract glomerular efferent arteriole
  2. PP : secrete ADH (increase H2O reabsorption)
  3. Vascular SM : HTN
  4. Hypothalamus: thirst
  5. Adrenal cortex : Aldosterone (increase NA+ reabsorption)
18
Q

2 things that cause Renin to be secreted

A
  1. Nerve to B1- receptor (sympathetic)

2. low NaCl at macula densa

19
Q

Where are juxtaglomerular cells found

A

On afferent arterioles

20
Q

How does angiotensin 2 cause vasoconstriction

A

Binds to AT1 receptors on vessels to increase TPR and BP

21
Q

BP equation

A

BP = CO x TPR

22
Q 
Increase Blood volume causes what 
preload
SV
CO
BP
A

All increase

23
Q

Where does ADH bind

function

A 
V5 receptors (SM)
V2 receptors (Collecting Ducts)
* increase H2O reabsorption + increase TPR (vasoconstriction)
24
Q

4 things making ADH secretion

A
  1. Angiotensin 2
  2. Low preload (atrial receptors
  3. Increased osmolarity in blood (viscosity)
  4. Sympathetic NS
25
Q

Natriuretic Peptides (there are 3)

A

ANP (atrial)
BNP (brain)
CNP (C-type)

26
Q

Natriuretic Peptides function

A
  1. Dilation of arterioles
  2. Decrease preload (increase fluid loss)-> lower ADH and aldosterone
  3. Inhibit renin (decrease TPR and preload
    * protect against overstretch of cardiac chambers
27
Q

What released Natriuretic Peptides

A

Excessive PRELOAD or A or V = releases ANP

28
Q

How long can BARORECEPTORS keep up with blood loss without permanent damage where ADH and RAAS can’t bring back BP to normal over time

A

2 hours

29
Q

American Heart association recommends how much salt intake

A

No more then 2,300mg a day
Ideal 1,500mg / day
Try to cut to 1,000mg / day

30
Q

Increased Na+ in blood can cause what to ANS

A

Increased Sympathetic NS and increased TPR

31
Q

What is heart failure

A

Reduced CO and SV

*ventricular dysfunction

32
Q

What happens in heart failure to BP regulation systems

A

RAAS and Sympathetic NS increases

ANP/BNP increased also

33
Q

What happens during exercise

A
  1. Increased sympathetic NS
  2. Decreases parasympathetic
  3. Increased HR + contractility + VR + vasoconstriction in some areas
  4. Vasodilation to SM = Overall decrease in TPR*
  5. SBP increase, DBP no change

CPR Exam 1 (20 decks)

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