Test 4 Study Guide Part 4 Flashcards
Average blood pressure in systemic circulation:
Average blood pressure in respiratory circulation:
120 / 80 mmHg
22 / 8 mmHg
Pulse pressure:
- Define:
- Relates to:
- Define: systolic - diastolic = pulse pressure E.G. 120 - 80 = 40 - Relates to: stroke volume strength ventricular contraction
Hypertension:
- Defined at:
- Primary (essential):
- Secondary:
- Defined at: > 130 mmHg systolic > 90 mmHg diastolic - Primary (essential): No known cause 90% of causes - Secondary: known cause
When does risk begin for high blood pressure?
- What is the medical goal?
> 115 mmHg systolic
75 mmHg diastolic
- What is the medical goal?
no more than 120 mmHg systolic, and 80 mmHg diastolic
Causes of secondary hypertension:
Diseases of kidney and arteriosclerosis of the renal arteries.
reduction of renal blood flow can cause hypertension do to renin release
What must be associated with essential hypertension?
Cardiac output could have increased (increased blood volume is associated with this)
Peripheral resistance could have increased
High salt diets can cause increased blood pressure because:
higher blood osmolality -> more ADH -> more retained water (plasma) -> higher blood pressure
Inappropriately high levels of aldosterone secretion are correlated with:
age (old people often have this)
higher blood osmolality and hypertension (retained salt -> higher blood osmolality -> more ADH -> more retained water (plasma) -> higher blood pressure)
Glomerular Filtration Rate:
- Relation to hypertension:
How much plasma is filtered out by the kidney
- Relation to hypertension:
The more inefficient the kidney’s the higher the salt conc. the higher blood pressure
Potassium’s effect on salt’s effect on blood pressure:
Increased levels of K+ can reduce NaCl’s ability to cause hypertension.
Issues associated with hypertension:
Organ failure
Enlargement of the heart
Stroke
Atherosclerosis
How is higher blood pressure treated?
1st:
- lifestyle: exercise, weight loss, stop smoking, reduce alcohol intake
2nd:
diuretics:
3rd:
B1 adrenergic antagonists (atenolol)
4th
angiotensin converting enzyme inhibitors (ACEIs) and Angiotensin-II Receptor Blockers (ARBs)
- Act to decrease salt levels, decreased osmolality, increased
Angiotensin Converting Enzyme inhitors (ACE inhibitors) and Angiotensin 2 receptor blocker (ARB) act to do what?
Decrease release of aldosterone (which increases salt retention)
- This will lower blood pressure
Reduce vasoconstriction caused by angiotensin II
Reduce ADH secretion slightly
What is the most common drugs to treat hypertension?
Angiotensin Converting Enzyme inhitors (ACE inhibitors) and Angiotensin 2 receptor blocker (ARB)
Shock:
Inadequate perfusion of the tissue
Hypovolemic Shock:
- Define:
- Causes:
- Define:
Inadequate perfusion of tissues do to inadequate blood supply - Causes:
burn, wound
Hypovolemic Shock:
- Body response:
Baroreceptors: increase vasoconstriction and heart rate
Activate renin angiotensin system: (increased salt, pulls fluid into the plasma, vasoconstriction
Hypovolemic Shock:
- Symptoms:
Low blood pressure Cold skin (blood diverted to brain and heart) Decreased urine production (ADH and Aldosterone, increased production)
Septic shock:
Endotoxin activates nitric oxide synthase within macrophages.
Causes vasodilation and sever hypotension (shock)
Anaphylactic shock:
Widespread release of histamine causes vasodilation and hypotension
Damage to brain or spinal cord, results in loss of sympathetic tone (which will cause vasodilation)
- Medula could be damaged
- Spinal cord injury
Neurogenic shock:
Cardiac failure, cardiac output has dropped low enough that perfusion cannot be maintained.
- myocardial infarction
- Severe valve damage or cardiac arrhythmia
Cardiogenic Shock:
Cardiac output of a ventricle is insufficient
Congestive Heart Failure:
Left Ventricular failure is usually caused by:
Myocardial infarction
aortic valve stenosis
incompetence of aortic or mitral valve
Heart failure can also be caused by changes in K+ and Ca2+ balance
True
Congestive is applied to heart failure because:
Usually left ventricle fails -> right ventricle pushes harder to counteract it -> increased pulmonary pressure causes fluid build up in lungs
If the right ventricle fails where will we see congestion?
The systemic circulation will have edema, not congestion
Chronically low cardiac output: is associated with:
- Causes:
elevated blood volume and dilation and hyptertophy of ventricles.
- Causes:
Less ventricular volume due to ventricular hypertrophy
Body has to overwork to compensate
Vasoconstriction compensates for low stroke volume (due to smaller end diastolic volume)
Treatment for chronically low cardiac output:
Drugs that…
- Strengthen contractility (digitalis)
- vasodilators (nitroglycerin)
- Beta adrenergic receptor blockers (atenolol), compensate for overactive sympathoadrenal system
- Diuretics (lower blood volume)
- ACE inhibitors ARBs
Endotoxin is a portion of lipolysaccharide, as it is shared by many pathogens, it is likely targeted by ____ immunity.
Innate
Ortho define:
straight upright
Lowering of blood pressure upon standing.
Orthostatic hypotension:
Hypotension after eating
Postprandial hypotension:
Normally baroreceptor reflexes stop orthostatic hypotension.
What causes it to happen anways?
Postprandial hypotension
Low blood pressure from dehydration
Medications (beta-adrenergic receptor blocks)
Postprandial hypotension (common among elderly)
Innate (nonspecific) Immunity:
Adaptive (specific ) immunity:
All mechanisms, intracellular, and extracellular, including barriers like the skin and mucous membranes, which act to hinder large groups of pathogens.
Taylor made responses for specific pathogens. Lymphocytes.
Pathogen-Associated Molecular Patterns (PAMPs):
- Define:
- Two common PAMPs:
- Define: Molecular domains or molecules which are commonly associated with pathogens which innate immune cells have hard programed receptors to recognize. - Two common PAMPs: Lipopolysaccharide Peptidoglycan
What are the receptors that recognize PAMPs called?
Pathogen Recognition Receptors (PRRs)
Toll-like receptors:
- class of:
- how many identified?
- purpose:
- class of: Pathogen Recognition Receptors - how many identified? 10 - purpose: recognize non-human (non-self) pathogen associated domains
NOD-like receptors:
- What are they?
- What do they do?
- What are they?
Intracellular receptors, which detect bacterial metabolic products (PAMPs and DAMPs). - What do they do?
Activate intracellular host defense mechanisms like autophagy
Chemokine:
Cell attractant molecules
Cytokine:
Cell growth and regulator molecules
Activation of a pathogen recognition receptor by a innate immune cell usually results in?
Cytokine and chemokine release
Mutated NOD-genes contributes to what disease?
Chrohn’s disease
Complement system:
- How many protein:
- How it the complement system activated?
- What does it do?
- How many protein:
9 proteins - How it the complement system activated?
Recognition of an antigen antibody complex - What does it do?
Promote phagocytosis, lysis, and other issues
Danger-Associated Molecular Patterns:
- Define:
- What do they do:
- Define:
Products of cell death (necrosis), which are produced when cells do not die form apoptosis. - What do they do:
similar to PAMPs, but activated by mass tissue damage. Promote inflammation (proinflammatory)
Three groups of phagocytic cells:
- Neutrophils:
- Mononuclear phagocytes:
- Organ specific phagocytes:
Neutrophils:
Phagocytic cells
Mononuclear phagocytes include:
Monocytes (in the blood)
Macrophages (in the tissue), derived from monocytes
Dendritic cells (in the tissue), derived from monocytes
Where do we have a high conc. of dendritic cells?
What are dendrites descended from (hint: same as macrophages)
In the skin.
Monocytes which leave the bloodstream
Organ specific phagocytes:
- Located in:
- Examples:
- Located in: Liver, brain, lungs, spleen, lymph nodes - Examples: Microglia Kuppfer cells
Kuppfer Cells:
Cells fixed in the hepatic sinusoids of the liver, which help eliminate pathogens from the blood
NOD in NOD-like receptor stands for:
nucleotide-binding oligomerization domain-like receptors
Alpha-1 andronergic receptors effect:
Vasoconstriction of smooth muscles in the veins of: - Skin - Gastrointestinal tract - Kidney - Brain Also glycolysis and gluconeogenesis
Alpha-2 andronergic receptors effect:
Negative feedback receptors on presynaptic cells
Beta-1 andronergic receptors effect:
Increase heart rate, causes renin release from juxtaglomerular cells
Beta-2 andronergic receptors effect:
Lungs dilate (relax smooth muscle of bronchioles) juxtaglomerular apparatus release renin Inhibit insulin release Glycolysis gluconeogenesis lipolysis
