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Phase 1 - S2 Cardiovasular System > Session 5 - Blood Pressure > Flashcards

Session 5 - Blood Pressure Flashcards

1
Q

what is mean atrial blood pressure equal to

A

cardiac output x total peripheral resistance

1/3 pulse pressure + diastolic pressure

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2
Q

what is cardiac output equal to

A

stroke volume x heart rate

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3
Q

what is pulse pressure equal to

A

systolic - diastolic

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4
Q

what is the short term regulation of blood pressure

A

the baroreceptor reflex were the amount of sympathetic and parasympathetic input to the heart is altered

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5
Q

where are the baroreceptors located

A

carotid sinus and aortic branch

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6
Q

how do baroreceptors detect an increase in blood pressure

A

they stretch due to increased arterial pressure

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7
Q

where do baroreceptors send signals to

A

the cardiovascular centre in the medulla oblongata

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8
Q

true or false: baroreceptors control short and long term changes in blood pressure

A

false - if there is sustained blood pressure than the threshold for baroreceptors increases

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9
Q

what responds for long term control of blood pressure

A

neurohumoral response

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10
Q

what are the neurohumoral responses directed at controlling

A

sodium balance and extracellular fluid volume

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11
Q

what are the 4 neurohumeral pathways to control blood pressure

A
  1. renin-angiotensin-aldosterone system
  2. sympathetic nervous system
  3. antidiuretic hormone (ADH)
  4. atrial natriuretic peptide (ANP)
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12
Q

where is renin released from

A

granular cells of the juxtaglomerular apparatus

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13
Q

what factors stimulate renin release

A
  1. reduced salt delivery to distal tubule
  2. reduced perfusion of kidneys
  3. sympathetic stimulation of JGA
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14
Q

how is a reduced perfusion of the kidneys detected

A

by baroreceptors in the afferent ateriole

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15
Q

what cells in the kidney detect the salt delivery

A

macula densa cells

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16
Q

what makes up the juxtaglomerular apparatus

A

macula densa + granule cells +surrounding cells

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17
Q

outline the renin-angiotensin-aldosterone system

A
  • renin causes the conversion of angiotensinogen to angiotensin I
  • ACE enzymes convert angiotensin I to angiotensin II
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18
Q

what does ACE stand for

A

angiotensin converting enzyme

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19
Q

what does angiotensin II do

A
  • causes vasoconstriction
  • releases aldosterone from the adrenal cortex
  • causes sodium reabsorption in the kidney (directly and indirectly through aldosterone)
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20
Q

what are the 2 main angiotensin II receptors and what type of receptors are they

A

AT1 (main) and AT2

GPCRs

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21
Q

how does angiotensin II alter the sympathetic nervous system

A

it causes an increase in noradrenaline release

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22
Q

what does angiotensin II do to the hypothalamus

A

increases thirst sensation so stimulates ADH release

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23
Q

what are the actions of aldosterone

A
  • acts on principal cells of the collecting duct to stimulat Na and water reabsorption
24
Q

what channels does aldosterone activate

A
  • apical Na channels (ENaC)
  • apical K channels
  • increases activity of Na/K/ATPase
25
Q

why do ACE inhibitors cause a build up of bradykinin

A

bradykinin is broken down into peptide fragments by ACE enzymes

26
Q

what effect does bradykinin have

A

vasodilator effects

27
Q

give an example of an ACE inhibitor

A

captopril

28
Q

what side effect does a build up of bradykinin cause

A

dry cough

29
Q

how does the sympathetic nervous system control blood pressure

A
  • high levels of sympathetic activation reduce renal blood flow decreasing Na excretion
  • activation of Na channels so theres more reabsorption
  • stimulates renin release from JG cells
30
Q

what is the role of antidiuretic hormone

A

increases water and Na reabsorption forming concentrated urine

31
Q

what stimulates ADH release

A
  • plasma osmolarity

- severe hypovolaemia

32
Q

what is hypovolaemia

A

decrease in the volume of blood in your body

33
Q

what are the actions of ANPs

A
  • vasodilation of afferent ateriole giving increased blood flow to kidneys
  • inhibits Na reabsorption
34
Q

where are ANPs released

A

atrial myocytes

35
Q

what causes the release of ANP

A

atria stretching due to high blood pressure

36
Q

what is natruresis

A

loss of sodium in the urine

37
Q

what are prostaglandins

A

vasodilators which act locally do enhance glomerular filtration and reduce Na reabsorption

38
Q

how does dopamine affect blood pressure

A

causes vasodilation, reduced NaCl absorption and increased renal blood flow

39
Q

what is hypertension

A

sustained increase in blood pressure seen over repeated readings

40
Q

what are the stages of hypertension

A

1 - over 140/80 mmHg
2 - over 160/100 mmHg
3. - over 180 systolic or 110 diastolic

41
Q

what is accelerated hypertension

A

where a significant rise in blood pressure rapidly can cause damage to the vessels

42
Q

what causes hypertension

A
  • 95% is unknown or multifactorial (primary hypertension)

- remainder is where the cause can be defined (secondary hypertension)

43
Q

what is renovascular disease

A

where there is an occlusion of the renal artery causing a fall in perfusion pressure in that kidney leading to increased renin production which increases blood pressure

44
Q

what does renal parenchymal disease cause

A

loss of vasodilator substances and retention of Na and water

45
Q

what happens to the appearance of the kidneys in renal parenchymal disease

A

they get smaller

46
Q

what is Conn’s syndrome

A

aldosterone secreting adenomas

47
Q

what happens in Cushing’s syndrome

A

there is an excess of glucocorticoid cortisol which acts on aldosterone receptors

48
Q

what is a phaeochromocytoma

A

a tumour of the adrenal gland which secretes catacholamines

49
Q

what are the symptoms of high blood pressure

A

none - but if severe it can give headaches

50
Q

what types of diseases occur due to hypertension

A

vascular diseases

51
Q

what organs should be assessed with someone with hypertension

A

brain, eyes, heart, kidneys and arteries

52
Q

how does hypertension damage arteries

A
  • causes atherosclerosis due to fat deposition and stiffness

- weakens vessels

53
Q

how does hypertension affect the heart

A

the increased pressure causes left ventricular hypertrophy leading to heart failure and theres an increased oxygen demand by the heart leading to myocardial ischemia and MI

54
Q

what are the non-pharmacological approaches to treating hypertension

A
  • diet
  • exercise
  • reduced Na intake
  • reduced alcohol
55
Q

what drugs help reduce blood pressure

A
  • ACE inhibitors
  • L type calcium channels blockers
  • beta blockers
  • alpha blockers
  • diruretics
56
Q

how do calcium blockers reduce hypertension

A

reduce calcium entry to smooth muscle cells so they relax

57
Q

what do alpha 1 blockers do

A

reduce sympathetic tone causing relaxation of smooth muscle

Phase 1 - S2 Cardiovasular System (16 decks)

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