Regulation of Peripheral and Coronary Circulation Flashcards

1
Q

What is compliance? Is the aorta compliant?

A

Compliance is how easily a structure can stretch to accomodate an increase in volume. Yeah the aorta is compliant.

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2
Q

The aorta expands during ventricular systole, storing _______ _______ in its elastic walls. During diastole the aorta’s elastic recoil continues pushing blood forward into the circulatory system.

A

pressure energy

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3
Q

The aorta’s compliance ________ the upswings and downswings of pressure and helps maintain continuous flow in the capillaries.

A

dampens

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4
Q

What vascular disease would greatly reduce the compliance of a great artery such as the aorta?

A

atherosclerosis

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5
Q

Is neural control the fastest acting of all the mechanisms that control BP?

A

Yeah

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6
Q

In which vessel layer do baroreceptors mainly run through?

A

adventitia

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7
Q

How do baroreceptors detect pressure changes?

A

Indirectly by sensing stretch of the cell membrane.

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8
Q

In which two vessels are baroreceptors mainly localized?

A

The aortic arch and in the carotid bifurcation

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9
Q

How does baroreceptor cell membrane stretch affect AP frequency?

A

Increased stretch = increased AP frequency

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10
Q

Are baroreceptors multipolar, unipolar, or bipolar?

A

bipolar

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11
Q

Carotid baroreceptors’ cell bodies are located in the ______ ______ outside the brainstem and they travel in the ___________ nerve to the carotid artery. The other end of the nerve projects to the ________.

A

cell bodies are located in the petrosal ganglion outside the brainstem and they travel in the glossopharyngeal nerve to the carotid artery. The other end of the nerve projects to the medulla.

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12
Q

Aortic baroreceptors’ cell bodies are located in the ______ ______ near the brainstem and they travel in the ______ nerve to the aorta. The other end of the nerve projects to the ________ where they synapse in the ______ ______ ______ which modulates cardiovascular activity via ANS connections with the heart and vessels.

A

cell bodies located in the nodose ganglion. Travel in the vagus nerve. Other end projects to the medulla where they synapse in the nucleus tractus solitaries.

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13
Q

Describe baroreceptor AP frequency with each heart beat.

A

AP frequency is high at the beginning of each ventricular systole and adaptation occurs quickly, lowering AP frequency.

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14
Q

Baroreceptor AP firing is most sensitive to changes in blood pressure between ____mmHg and ____mmHg. Therefore this is the BP range in which the system is most effective.

A

75 and 150

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15
Q

Name four physiologic changes that occur when baroreceptors tell the medulla that BP is too high.

A
  1. Decreased B1 receptor activation at the SA node and myocardial cells.
  2. Increased muscarinic Ach receptor activation in the SA node.
  3. Decreased alpha1 receptor activation of vessels.
  4. Increased venous capacitance –> decreased venous return –> decreased filling pressure of the heart –> decreased stroke volume and contractility (Starling law).
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16
Q

Low pressure baroreceptors exist in which three structures?

A

atria, ventricles, and pulmonary vessels.

17
Q

A constant low-level background of sympathetic outflow from the spinal cord generates ________ _____ in vascular smooth muscle and cardiac tissue that maintains normal BP.

A

sympathetic tone

18
Q

Arteriolar constriction/dilation is under _____ control (not ANS control).

A

local

19
Q

What two structures assist arterioles in distributing flow between different areas of the same capillary bed?

A

precapillary sphincters and metarterioles

20
Q

What are the two systems of autoregulation of the arterioles and precapillary sphincters?

A
  1. Myogenic mechanism

2. Dilator metabolite mechanism

21
Q

Describe the myogenic mechanism of autoregulation at the arteriolar level.

A

Increased venous smooth muscle stretch –> opening of stretch-sensitive channels –> Na+ and Ca2+ influx –> depolarization –> more Ca2+ influx (through L-type) –> vasoconstriction

22
Q

Describe the dilator metabolite mechanism of autoregulation at the arteriolar level.

A

Increased blood flow –> dilution of vasodilating metabolites –> inhibition of tonic dilating effect –> vasoconstriction

23
Q

How does a decrease in p02 cause smooth muscle relaxation in systemic arteries and arterioles? Does the same thing happen in pulmonary vessels?

A

Intracellular Ca2+ regulators are very sensitive to changes in O2 levels such that when O2 drops, so does intracellular [Ca2+] –> no muscle contraction (vasodilation).

Pulmonary vessels CONSTRICT in response to hypoxia.

24
Q

Adenosine, a byproduct of metabolism, is a potent _______ that acts through purinergic receptors.

A

vasodilator

25
Q

Which four major forces determine capillary blood flow? (In/out of capillary)

A
  1. Capillary BP (Pc)
  2. Blood oncotic pressure (pp)
  3. Interstitial hydrostatic pressure (Pi)
  4. Interstitial oncotic pressure (pi)
26
Q

At the arterial end of the capillary, _________ pressure contributes to a net outward force of ~9mmHg and at the venous end of the capillary, _______ pressure contributes to a net inward force of ~9mmHg.

A

hydrostatic at the arterial end, osmotic at the venous end.

27
Q

Imbalances in Starling forces can lead to ______ or a decrease in extracellular fluid (dehydration).

A

edema

28
Q

Is there a large pressure drop from the capillaries to the vena cavae?

A

No, only about 15mmHg

29
Q

Venous smooth muscle is arranged _______ and has compliant connective tissue to allow veins to function as variable _______ that can store large volumes of blood.

A

muscle is arranged helically, veins are variable capacitors.

30
Q

How does venous smooth muscle affect the heart’s stroke volume and contractility?

A

Contraction of venous smooth muscle leads to an increase of blood volume return to the heart, increasing filling pressure, and increasing stroke volume and contractility.

31
Q

Pain from coronary ischemia is called ______.

A

angina

32
Q

What are the three major determinants of myocardial work (and thus its O2 requirement)?

A
  1. Afterload (arterial pressure)
  2. Stroke volume
  3. Heart rate
33
Q

What is the only way to increase O2 delivery to the heart muscle?

A

Vasodilation of the coronary arterioles and small arteries increases coronary blood flow.

34
Q

How are are the effects of sympathetic stimulation of a-1 receptors on coronary arteries overridden when an increase in cardiac output is needed?

A

The effect of adenosine (as a byproduct of increased myocardial metabolism) acting on purinergic receptors on the coronary arteries (autoregulatory control) greatly overrides the a-1 stimulation to cause dilation of the arteries.

35
Q

Does perfusion of the heart muscle happen largely during systole, or diastole? How does the heart cope with increased heart rates?

A

It happens during diastole because contraction pinches off the coronary arteries. Aortic pressure during diastole is crucial to perfusing the coronary arteries and anything that lowers aortic pressure (such as aortic regurgitation or atherosclerosis) will compromise coronary blood flow.