S2 L1.2: SAH: Principal Mechanisms Flashcards
Amount of volume inside blood vessels
Intravascular Volume
T/F: Intravascular volume is a primary determinant of arterial pressure over the long term.
True
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
b. FT
If you increase extracellular fluid volume, there is an associated increase in blood pressure
Primary determinant of the extracellular fluid volume
Sodium
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
c. TT
When NaCl intake exceeds the capacity of the kidney to excrete sodium, __ __ initially expands and __ __ increases
- Vascular Volume
- Cardiac Output
Maintains cardiovascular homeostasis
Autonomic Nervous System
Autonomic Nervous System controlls all the involuntary things in the body (3)
- Blood Pressure
- Volume
- Chemoreceptor signals
Three endogenous catecholamines (Fight or flight hormones)
Norepinepherine
Epinephrine
Dopamine
Cardiovascular Regulation
Contraction of the blood vessels
Tonic
Cardiovascular Regulation
Overtime, sometimes excretes and sometimes they don’t
Phasic
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
c. TT
Throughout the day, it subsides and goes
back to resting period
Reflexes that modulated blood pressure over the short term
Adrenergic reflexes
Fight or flight move (Increase BP & HR)
T/F: Adrenergic function, in concert with hormonal and volume-related factors, contributes to the long-term regulation of arterial pressure
True
Synthesized by adrenergic neurons
Noripinephrine and Dopamine
Taken back in a promise called Reuptake Mechanism
Synaptic Cleft
Method of Release:
Norepinephrine and Dopamine
- Initially stored in vesicles within the neuron
- It is then released into the synaptic cleft and to receptor sits on target tissues.
- It is then either metabolized or taken up into the neuron by an active reuptake process.
Synthesized in the adrenal medulla and released into the circulation upon adrenal stimulation
Epinephrine
This catecholamine does not get stored anywhere else
Epinephrine
Receptor that perceive the pressure.
Several reflexes modulate blood presure on a pressure on min-to-min basis
Baroreceptors
Where are the stretch sensitive sensory nerve endings located?
In the carotid Sinuses and the Aortic Arch
Rate of firing of these baroreceptors with arterial pressure
Increase or decrease?
Increase
Decrease of sympathetic outflow results in a ___ of arterial pressure and heart rate.
Decrease
Primary mechanism for rapid buffering of acute fluctuations of arterial pressure that may occur during __?
Postural changes, behavioral or physiological stress, and changes in blood volume
When the baroreceptors are stretched, what would it interpret?
An increase in pressure
Response of the Baroreceptors when they are stretched
Cascade of events that would bring down BP eventually and normalize it if BP increases (minute-to-minute basis)
T/F: Patients with autonomic neuropathy
and impaired baroreflex function may have extremely labile blood pressures with difficult-to-control episodic blood pressure spikes.
True
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. TF
Their bodies cannot adapt immediately which causes them to be symptomatic
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
Renin
Primary Stimuli for Renin Secretion
This stimuli leads to hyponatremia
↓ NaCl transport in the thick ascending limb of the loop of Henle
Renin’s job is to increase sodium in the
body
Primary Stimuli for Renin Secretion
↓ pressure or stretch within the ___ ___ ___ (baroreceptor mechanism)
Renal Afferent Aretriole
Less fluid entering the kidney → detected by __ cells → renin secretion
JG Cells
T/F: Renin’s job is to also decrease fluid
False (Increase)
↑ sodium → water follows (normal mechanism during dehydration)
T/F: ↑ sodium → Less urine formation
True
D/t kidneys reabsorbing back the water that should come out as urine
Primary Stimuli for Renin Secretion
Renin-secreting cells via β1 adrenoreceptors are stimulated by which system?
Clue: Nervousness and agitation stimulates renin
Sympathetic Nervous System
Does stimulating renin add to the elevation in BP?
Yes
↑ sodium reabsorption → ↑ water absorption (more water circulating in the system) → expect elevated BP
Renal Pathology Review
Where the blood enters the kidneys, circulates in the capillary tuft; gets cleansed in this system
Afferent Arteriole
Renal Pathology Review
Wwhere further processing of the urine takes place until it finally forms urine
Tubular System
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.
Should be increase since it is inhibition
T/F: Beta receptor blockers like metoprolol, nebivolol and carvedilol are antihypertensive agents causing renin inhibition → preventing increase in BP
True
T/F: Renin stimulates the release of angiotensin II
True
A potent vasoconstrictor in response to low renal arterial pressure or low concentration of filtered sodium in kidneys
Angiotensin II
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
C. Inhibits vasopressin release
Angiotensin II increases the blood pressure
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
TT
A potent mineralocorticoid that increases sodium reabsorption and promoted water retention
Aldosterone
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. TF
Extracellular
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
F→A→B→E→C→D
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
d. FF
1. Arterial Pressure
2. Reduce Lumar Diameter
T/F: Radius goes smaller, BP goes up
True
Smaller caliber blood vessels repeated constriction will release hypertension
What are the main determinant of BP
Arterioles
When an arteriole is flexoble or compliant, it can accomodate huge volume of blood without ___?
Increasing the BP
T/F: As we grow old, component of blood vessels also changes and impact negatively on compliance of arteries → arteries become more rigid
True
Refers to geometric alterations in the vessel wall without changing vessel volume and results in ↓ lumen size, ↑ peripheral resistance
Remodelling
Type of remodelling that has increased cell number, increased cell size, and increased deposition of intercellular matrix
Hypertrophic Remodelling
This type of remodelling has no change in the amount of material in the vessel wall; just becomes rigid
Eutrophic Remodelling
Programmed Cell Death
Apoptosis
T/F: Lumen diameter is also related to elasticity of the vessel
True
A high degree of elasticity can accommodate an increase of volume with relatively little change of pressure
True or False: During Exercise
↑ venous return (sympathetic and muscle pumping)
True
True or False: During Exercise
↑ parasympathetic, ↓ sympathetic stimulation
False
↓ parasympathetic, ↑ sympathetic stimulation
True or False: During Exercise
↑SV,HR,CO
True
True or False: During Exercise
Local metabolites dilate arterioles, ↑ regional blood flow
True
True or False: During Exercise
Modest ↑SBP, no change in DBP
True
True or False: During Exercise
Significantly ↑ systemic vascular resistance
False
Significantly ↓ systemic vascular resistance
True or False: During Exercise
oxygen consumption 20x
True
