Vitals/measure BP/venous return/regulation Flashcards
Clinical monitoring of circulatory efficiency
() signs: (), blood (), () rate, ()
Taking a pulse
() pulse (taken at the wrist): most routinely used
Other clinically important pulse points
Common ()
Femoral
Dorsal pedal
Vital
pulse
pressure
respiratory
temperature
Radial
Carotid
Measuring blood pressure:
Systemic arterial BP is measured indirectly by () methods using a ()
-Wrap cuff around arm superior to elbow
-Increase pressure in cuff until it exceeds systolic pressure in brachial artery
-Pressure is released slowly, and examiner listens for () sounds with a stethoscope
auscultatory,sphygmomanometer
Korotkoff
() pressure: normally less than 120 mm Hg
Pressure of blood against arteries when ventricles are ()
Systolic
contracting
() pressure: normally less than 80 mm Hg
Pressure of blood against arteries when ventricles are ()
Diastolic
relaxing
Factors aiding venous return
-() pump: contraction of skeletal muscles “milks” blood back toward heart (Soleus)
Valves prevent backflow
-() pump: lowering thoracic pressure and increasing abdominal pressure encourage blood flow back to heart
-Sympathetic (): smooth muscles constrict, pushing blood back toward heart
Muscular
Respiratory
venoconstriction
Maintaining blood pressure requires cooperation of (), blood vessels, and ()
All supervised by ()
heart
kidneys
brain
Three main factors regulating blood pressure:
Blood pressure varies directly with CO, PR, and blood volume
Cardiac output (CO)
Peripheral resistance (PR)
Blood volume
Factors can be affected by:
Short-term regulation: () controls
Short-term regulation: () controls
Long-term regulation: () controls
neural
hormonal
renal
() Controls :
() reflexes (cluster of nerve cells)
-Located in carotid sinuses, aortic arch, and walls of large arteries of neck and thorax
If BP is high:
-Increased blood pressure stimulates baroreceptors to increase input to vasomotor center of medulla oblongata
-() vasomotor and cardioacceleratory centers
-Stimulates cardioinhibitory center
-Results in () blood pressure
() & Decreased CO
Neural
Baroreceptor
Inhibits
decreased
Vasodilation
BP regulation via hormones
Short term: via changes in () resistance
Long term: via changes in /
peripheral
blood volume
Short Term
/ hormones
-Epinephrine and norepinephrine increase () and vasoconstriction
-Long Term
()-()-Aldosterone System
Angiotensin II is a potent vasoconstrictor
Aldosterone: causes ()+ reabsorption in kidneys
(): high levels can cause vasoconstriction
Atrial () peptide
Decreases BP by antagonizing aldosterone, causing decreased blood volume
Adrenal medulla
CO
Renin
Angiotensin
Na
ADH
natriuretic
Renal controls (long-term):
Kidneys regulate arterial blood pressure by:
() renal mechanism
Alters blood volume independently of hormones
Increased BP or blood volume causes elimination of more urine, thus reducing BP
Decreased BP or blood volume causes kidneys to () water, and BP rises
Direct
conserve
Indirect renal mechanism (renin-()-aldosterone)
-Decreased arterial BP causes release of () from kidneys
-() enters blood and catalyzes conversion of () from liver to () I
-()-converting enzyme, from lungs, converts () I to angiotensin ()
angiotensin
renin
Renin
angiotensinogen
angiotensin
Angiotensin
angiotensin
II
Renin-angiotensin-aldosterone-system:
Angiotensin () effects:
Stimulates () secretion
Causes () release
Stimulates ()
Acts as a potent (), directly increasing blood pressure
II
Aldosterone
ADH
sympathetics
vasoconstrictor
Goal of bp regulation:
Tissue ():
Requires adequate amount of blood pressure
Too high of BP, however, can damage blood vessels & heart
Perfusion
