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5. ADV PHYS > Short term BP > Flashcards

Short term BP Flashcards

1
Q

Darcy’s law of flow: and BP

A

Q = (P1 - P2)/R

  • Q: flow
  • P is pressure diff (mmHg)
  • R is hydraulic resistance

rearranged:
BP = CO x TPR

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2
Q

TPR provided by:

A

arterioles due to small radii in systemic circulation

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3
Q

arterioles function:

A
  • smooth mm in walls

- contraction decreases diameter (vasoconstriction) = increase TPR

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4
Q

which nn innervate arterioles:

A
  • sympathetic nn

- cause vasoconstriction

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5
Q

TPR equation:

A

resistance ∞ 1/ radius4

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6
Q

TPR: local control function

A
  • match blood flow to changing demands of tissues/ organs (metabolic control)
  • prevents excess/ insufficient flow to tissue due to BP changes
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7
Q

TPR: local control list (3)

A
  • extracellular accumulation of metabolites (CO2, K+, lactic acid, adenosine)
  • endothelial factors
  • myogenic control
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8
Q

TPR: central control function

A
  • maintains mean arterial BP
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9
Q

TPR: central control relies on (2)

A
  • ANS (symp cause vasoconstriction)

- hormones

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10
Q

TPR: central + local controls function

A
  • central dominates if BP changes rapidly

- local control overrides symp effects in exercising mm

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11
Q

TPR: list metabolic controls (9)

A
  • O2
  • CO2
  • pH
  • K+
  • osmolarity
  • prostaglandins
  • adenosine
  • NO (nitric oxide)
  • endothelins
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12
Q

TPR: list metabolic controls which constrict (1)

A
  • increase endothelins
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13
Q

TPR: list metabolic controls which dilate (7)

A
  • decrease O2
  • decrease pH
  • increase CO2
  • increase osmolarity
  • increase prostaglandins
  • increase adenosine
  • increase NO
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14
Q

TPR: list myogenic controls and effect

A
  • increase stretch = constrict
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15
Q

TPR: list extrinsic mechanisms

A
  • hormones

- nerves

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16
Q

TPR: list nerves and effect

A
  • sympathetic = constrict
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17
Q

TPR: list hormones (5)

A
  • Epi and NEpi
  • ADH (antidiuretic hormone)
  • ANP (atrial natriuretic peptide)
  • angiotensin II
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18
Q

TPR: list hormones which dilate (3)

A
  • ß receptors of Epi, NEpi

- ANP

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19
Q

TPR: list hormones which constrict (4)

A
  • å receptor of Epi, NEpi
  • ADH (vasopressin)
  • Angiotensin II
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20
Q

regulation of CO: formula

A

CO = HR x stroke vol

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21
Q

regulation of CO: has an effect on: para/symp/both?

A
  • para and symp effect

both

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22
Q

define CO:

A
  • vol of blood pumped (/ventricle) per min
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23
Q

regulation of CO: pacemaker cells SA node function and intrinsic rate

A
  • in SA node
  • produce spontaneous AP without any input of nn. or hormones
  • intrinsic rate 100 bpm
24
Q

regulation of CO: para input where (detail) and HR

A
  • increase Ach on muscarinic cholinergic receptors of SA node
  • decreases to 55-70 bpm
25
regulation of CO: Ach on receptors process + shifts graph L/R?
- GPCR opens K+ channels, closes Ca channels - hyperpolarisation - increases interval btw slow response AP - shifts graph R
26
regulation of CO: symp input and HR
- during stress/ exercise increases HR TO 130-190 bpm | - NAd onto ß-adrenergic receptors in SA node
27
regulation of CO: NAd on receptors process + shifts graph L/R?
- NAd acts through GPCR increases opening of (funny) Na + Ca channels - increases rapid AP upstroke - shifts graph L
28
regulation of CO: para or symp dominant?
- balanced - para dom when at rest - symp dom during increased activity, stress, exercise
29
regulation of stroke vol: by?
- intrinsic effects of heart itself | - extrinsic effects of nn. and hormones
30
regulation of stroke vol: Starling's Law ext/in?
- intrinsic effect
31
regulation of stroke vol: define Starling's Law
- strength of contraction depended on VR (blood flow back to heart)
32
regulation of stroke vol: Starling's Law curve explain
- end diastolic vol and R atrial pressure (aka. PRELOAD (x) over stroke vol/ CO) - CO on both sides of heart must be equal - CO = VR
33
regulation of stroke vol: Starling's Law- Guyton analysis
- combined VR curve (R atrium and venous circulation) and ventricular function curve (function of L ventricle + aa.) - point of intersection determines CO
34
regulation of stroke vol: Guyton's analysis- VR depends on
- pressure gradient btw peripheral v and R atria | - also compliance of veins
35
regulation of stroke vol: Guyton's analysis- list VR equation
(Pv - Pra) / Rv - Pv= peripheral v pressure - Pra= R atria pressure - Rv= resistance
36
regulation of stroke vol: VR equation- Rv significance
- lil effect as veins have large radii
37
regulation of stroke vol: VR equation- MSFP features
MSFP= mean systemic filling pressure - ~7 mmHg - pressure in circulation when flow stopped - how tightly blood fits into blood v and heart - end point of VR curve
38
regulation of stroke vol: VR equation- high Pra
- backwards force to flow - expected to increase Pv until P in both compartments is same - however, veins compliant accomodate extra blood, = slight increase in venous P
39
regulation of stroke vol: VR equation- if decrease Pra
- pressure grad btw atrium and peripheral v increases = increase driving force for flow into atrium
40
regulation of stroke vol: VR equation- if Pra below 0 mmHg
- negative pressure sucks in walls of v entering chest | - prevents further increase of VR
41
regulation of stroke vol: Guyton's analysis- increase MSFP on graph, how and result
- blood fits more tightly in circulation - via transfusion (increase blood vol.) or reduced compliance of veins (symp input contract smooth mm) - shift VR graph higher = increase CO
42
regulation of stroke vol: Guyton's analysis- decrease MSFP on graph
- decrease blood vol., increase compliance of v | - shift VR graph lower = decrease CO
43
regulation of stroke vol: Guyton's analysis- increase TPR
- slope decreases (less steep) - same MSFP - like hose: radii of arterioles shrink, increase TPR, pressure in aa rises, while P in veins fall - decrease in P grad of R atrium and peripheral v - driving force + VR decrease
44
regulation of stroke vol: extrinsic regulation from Ca
- strength of contraction increases (ventricle) if more Ca available to bind to troponin - increase influx of extracellular Ca or release of Ca stored in SR (sarcoplasmic reticulum)
45
regulation of stroke vol: extrinsic regulation Ad and NAd for contraction
- catecholamines from symp nn. and adrenal gland - bind to ß-adrenergic receptor on cardiac mm. initiate GPCR to increase strength and speed of contraction - vital allow time for filling in btw contractions
46
regulation of stroke vol: extrinsic regulation Ad and NAd function Ca physiology
- opening more Ca channels in plasma membrane and SR - phosphorylates myosin to increase rate of crossbridge cycling - activates SR Ca pump, more Ca enters SR and less free Ca
47
regulation of stroke vol: extrinsic regulation Ad and NAd on graph and list (2) opp effects
- increase slope of ventricular function curve - increase VR curve = increase CO 2 opposing effects - increase TPR depress VR - but reduce compliance (vasoconstriction) but increase VR
48
regulation of stroke vol: extrinsic regulation Ad and Nad- which opp effect dominate?
- decrease compliance | - VR increases
49
regulation of stroke vol: extrinsic regulation- whole body dynamic exercise effects on VR (3)
- VR increased by: - symp stimulation - Ad release - skeletal mm and thoracic pumps
50
baroreceptor reflex: features
- controls BP - v rapid response depends on autonomic nn - carotid sinus + aortic arch - triggers -ve feedback loop - by altering TPR,HR, SV + VR
51
baroreceptor reflex: central control features
- sensory info from carotid + aortic arch --> nucleus of solitary tract (NTS) of brainstem - via glossopharyngeal (carotid) + vagus nn (aortic)
52
baroreceptor reflex: rise in BP
- stimulates nuclei of NTS to activate centres in caudal ventrolateral medulla (CVLM) - output of CVLM inhibits symp control centre in rostral ventrolateral medulla (RVLM) - inhibition of RVLM reduces sym output to heart and blood v
53
baroreceptor reflex: fall in BP
- reduces baroreceptor firing | - reduce inhibition of RVLM = increased symp output to kidney
54
short term BP control: capillary fluid shift features
- following blood loss - P in capillaries decrease to below surrounding interstitial fluid - interstitial fluid moves down P grad. and increase plasma vol - autotransfusion help prevent circulatory collapse
55
short term BP control: CNS ischemic response
- BP falls to extent blood flow to CV control centre in brain stem so severely causes nutritional deficiency (cerebral ischemia) - max stimulation of symp nn. to attempt normal perfusion of heart and brain - blood flow to other organs almost completely stopped

5. ADV PHYS (10 decks)

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