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(3) Cardio-Pulmo-Renal Rehabilitation > S2 L1.2: SAH: Principal Mechanisms > Flashcards

S2 L1.2: SAH: Principal Mechanisms Flashcards

1
Q

Amount of volume inside blood vessels

A

Intravascular Volume

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2
Q

T/F: Intravascular volume is a primary determinant of arterial pressure over the long term.

A

True

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3
Q

Statement 1: If you decrease extracellular fluid volume, there is an associated increase in blood pressure
Statement 2: Alterations in total extracellular fluid volume are associated with proportional changes of blood volume

a. TF
b. FT
c. TT
d. FF

A

b. FT
If you increase extracellular fluid volume, there is an associated increase in blood pressure

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4
Q

Primary determinant of the extracellular fluid volume

A

Sodium

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5
Q

Statement 1: Where sodium goes water goes/ sodium attracts water
Statement 2: Body absorbs a lot of water resulting to hypertension

a. TF
b. FT
c. TT
d. FF

A

c. TT

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6
Q

When NaCl intake exceeds the capacity of the kidney to excrete sodium, __ __ initially expands and __ __ increases

A
  1. Vascular Volume
  2. Cardiac Output
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7
Q

Maintains cardiovascular homeostasis

A

Autonomic Nervous System

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8
Q

Autonomic Nervous System controlls all the involuntary things in the body (3)

A
  1. Blood Pressure
  2. Volume
  3. Chemoreceptor signals
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9
Q

Three endogenous catecholamines (Fight or flight hormones)

A

Norepinepherine
Epinephrine
Dopamine

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10
Q

Cardiovascular Regulation

Contraction of the blood vessels

A

Tonic

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11
Q

Cardiovascular Regulation

Overtime, sometimes excretes and sometimes they don’t

A

Phasic

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12
Q

Circadian Rhythm

Statement 1: When we sleep and rest, the blood pressure and heart rate goes down
Statement 2: When we are about to wake up, there is a surge of catecholamines resulting to increase in hr and bp

a. TF
b. FT
c. TT
d. FF

A

c. TT

Throughout the day, it subsides and goes
back to resting period

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13
Q

Reflexes that modulated blood pressure over the short term

A

Adrenergic reflexes

Fight or flight move (Increase BP & HR)

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14
Q

T/F: Adrenergic function, in concert with hormonal and volume-related factors, contributes to the long-term regulation of arterial pressure

A

True

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15
Q

Synthesized by adrenergic neurons

A

Noripinephrine and Dopamine

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16
Q

Taken back in a promise called Reuptake Mechanism

A

Synaptic Cleft

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17
Q

Method of Release:
Norepinephrine and Dopamine

A
  1. Initially stored in vesicles within the neuron
  2. It is then released into the synaptic cleft and to receptor sits on target tissues.
  3. It is then either metabolized or taken up into the neuron by an active reuptake process.
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18
Q

Synthesized in the adrenal medulla and released into the circulation upon adrenal stimulation

A

Epinephrine

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19
Q

This catecholamine does not get stored anywhere else

A

Epinephrine

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20
Q

Receptor that perceive the pressure.
Several reflexes modulate blood presure on a pressure on min-to-min basis

A

Baroreceptors

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21
Q

Where are the stretch sensitive sensory nerve endings located?

A

In the carotid Sinuses and the Aortic Arch

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22
Q

Rate of firing of these baroreceptors with arterial pressure

Increase or decrease?

A

Increase

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23
Q

Decrease of sympathetic outflow results in a ___ of arterial pressure and heart rate.

A

Decrease

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24
Q

Primary mechanism for rapid buffering of acute fluctuations of arterial pressure that may occur during __?

A

Postural changes, behavioral or physiological stress, and changes in blood volume

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25
Q

When the baroreceptors are stretched, what would it interpret?

A

An increase in pressure

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26
Q

Response of the Baroreceptors when they are stretched

A

Cascade of events that would bring down BP eventually and normalize it if BP increases (minute-to-minute basis)

27
Q

T/F: Patients with autonomic neuropathy
and impaired baroreflex function may have extremely labile blood pressures with difficult-to-control episodic blood pressure spikes.

A

True

28
Q

Statement 1: Baroreceptors deteriorate in elderly and can have autonomic neuropathy
Statement 2: Their bodies cannot adapt immediately which causes them to be asymptomatic with changes in position (esp in ADLs) because their nerves are problematic.

a. TF
b. FT
c. TT
d. FF

A

a. TF

Their bodies cannot adapt immediately which causes them to be symptomatic

29
Q

Hormone synthesized in the segment of the renal afferent renal arteriole that abuts the glomerulus and a group of sensory cells located at the distal end of the loop of Henle, the macula densa

A

Renin

30
Q

Primary Stimuli for Renin Secretion

This stimuli leads to hyponatremia

A

↓ NaCl transport in the thick ascending limb of the loop of Henle

Renin’s job is to increase sodium in the
body

31
Q

Primary Stimuli for Renin Secretion

↓ pressure or stretch within the ___ ___ ___ (baroreceptor mechanism)

A

Renal Afferent Aretriole

32
Q

Less fluid entering the kidney → detected by __ cells → renin secretion

A

JG Cells

33
Q

T/F: Renin’s job is to also decrease fluid

A

False (Increase)
↑ sodium → water follows (normal mechanism during dehydration)

34
Q

T/F: ↑ sodium → Less urine formation

A

True
D/t kidneys reabsorbing back the water that should come out as urine

35
Q

Primary Stimuli for Renin Secretion

Renin-secreting cells via β1 adrenoreceptors are stimulated by which system?

Clue: Nervousness and agitation stimulates renin

A

Sympathetic Nervous System

36
Q

Does stimulating renin add to the elevation in BP?

A

Yes
↑ sodium reabsorption → ↑ water absorption (more water circulating in the system) → expect elevated BP

37
Q

Renal Pathology Review

Where the blood enters the kidneys, circulates in the capillary tuft; gets cleansed in this system

A

Afferent Arteriole

38
Q

Renal Pathology Review

Wwhere further processing of the urine takes place until it finally forms urine

A

Tubular System

39
Q

Renal Pathology Review

Renin is inhibited by the ff except:
a. ↓ NaCl transport in the thick ascending limb of the loop of Henle
b. ↑ stretch within the renal afferent arteriole, and by β1 receptor blockade
c. May be modulated by a number of humoral factors, including angiotensin II

A

A.
Should be increase since it is inhibition

40
Q

T/F: Beta receptor blockers like metoprolol, nebivolol and carvedilol are antihypertensive agents causing renin inhibition → preventing increase in BP

A

True

41
Q

T/F: Renin stimulates the release of angiotensin II

A

True

42
Q

A potent vasoconstrictor in response to low renal arterial pressure or low concentration of filtered sodium in kidneys

A

Angiotensin II

43
Q

Angiotensin is responsible of the ff except:

a. ↑ intracellular calcium/blood vessel wall constriction
b. ↑ sympathetic nervous system activity
c. Inhibits vasopressin release
d. Stimulates aldosterone

A

C. Inhibits vasopressin release

Angiotensin II increases the blood pressure

44
Q

Statement 1: When done excessively, BP will rise excessively causing hypertension
Statement 2: Angiotensin I = found in the kidneys and goes to the lungs to become angiotensin II

a. TF
b. FT
c. TT
d. FF

A

TT

45
Q

A potent mineralocorticoid that increases sodium reabsorption and promoted water retention

A

Aldosterone

46
Q

Statement 1: Aldosterone may also enlarge the heart and lead to Cardiac hypertrophy
Statement 2: It can also enhance intracellular matrix and collagen deposition within the myocardium

a. TF
b. FT
c. TT
d. FF

A

a. TF
Extracellular

47
Q

Sort the events in order
a. The angiotensinogen peptide gives way to the release of angiotensin I (AI)

b. The angiotensin converting enzyme (ACE) that is found in the lungs will convert AI to angiotensin II (AII)

c. Under normal conditions, AII will stimulate adrenal cortex to secrete aldosterone & pituitary gland resulting to renal sodium & fluid retention in order to maintain homeostasis
d. Excessive AII will be sensed by renin to stop its production (NEGATIVE FEEDBACK MECHANISM)

e. AII promotes cardiac & vascular hypertrophy, systemic vasoconstriction, & inc blood volume ↓

f. Stimuli (i.e., sympathetic stimulation, hypotension, dec sodium delivery) causes the kidneys to secrete renin

A

F→A→B→E→C→D

48
Q

Statement 1: Vascular radius and compliance of resistance arteries are
also important determinants of venous pressure
Statement 2: In hypertensive patients, structural, mechanical, or functional changes may increase lumen diameter of small arteries and arterioles

a. TF
b. FT
c. TT
d. FF

A

d. FF
1. Arterial Pressure
2. Reduce Lumar Diameter

49
Q

T/F: Radius goes smaller, BP goes up

A

True
Smaller caliber blood vessels repeated constriction will release hypertension

50
Q

What are the main determinant of BP

A

Arterioles

51
Q

When an arteriole is flexoble or compliant, it can accomodate huge volume of blood without ___?

A

Increasing the BP

52
Q

T/F: As we grow old, component of blood vessels also changes and impact negatively on compliance of arteries → arteries become more rigid

A

True

53
Q

Refers to geometric alterations in the vessel wall without changing vessel volume and results in ↓ lumen size, ↑ peripheral resistance

A

Remodelling

54
Q

Type of remodelling that has increased cell number, increased cell size, and increased deposition of intercellular matrix

A

Hypertrophic Remodelling

55
Q

This type of remodelling has no change in the amount of material in the vessel wall; just becomes rigid

A

Eutrophic Remodelling

56
Q

Programmed Cell Death

A

Apoptosis

57
Q

T/F: Lumen diameter is also related to elasticity of the vessel

A

True
A high degree of elasticity can accommodate an increase of volume with relatively little change of pressure

58
Q

True or False: During Exercise

↑ venous return (sympathetic and muscle pumping)

A

True

59
Q

True or False: During Exercise

↑ parasympathetic, ↓ sympathetic stimulation

A

False
↓ parasympathetic, ↑ sympathetic stimulation

60
Q

True or False: During Exercise

↑SV,HR,CO

A

True

61
Q

True or False: During Exercise

Local metabolites dilate arterioles, ↑ regional blood flow

A

True

62
Q

True or False: During Exercise

Modest ↑SBP, no change in DBP

A

True

63
Q

True or False: During Exercise

Significantly ↑ systemic vascular resistance

A

False
Significantly ↓ systemic vascular resistance

64
Q

True or False: During Exercise

oxygen consumption 20x

A

True

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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