101314 HTN

Question 1

if supine and standing NE concentrations are the same, what does this indicate?

Answer 1

arterial baroreceptors are dysfunctional

Question 2

arterial pressure = ?

Answer 2

cardiac output x total peripheral resistance

Question 3

what does short term regulation of BP consist of?

Answer 3

renin on peripheral resistance
increased HR
ADH and aldoesterone on increasing vascular volume, venous return, and CO to increase BP

Question 4

nervous regulation plays a role in what with regards to the circulation?

Answer 4

redistribution of blood flow to different areas
affects HR and contractility
essential for the very RAPID control of arterial pres

Question 5

where is the vasomotor center located?

Answer 5

reticular substance of medulla and lower third of pons

Question 6

sympathetic innervation excludes which blood vessels?

Answer 6

capillaires and precapillary sphincters and some meta arterioles

Question 7

parasympathetic nerv sys mainly controls what?

Answer 7

HR via vagus nerve

Question 8

sympathetics are responsible for what tone?

Answer 8

vasomotor

Question 9

baroreceptor signals from carotid sinus are transmitted to what nerve?

Answer 9

glossopharyngeal, to the nucleus tractus solitarii of medulla

Question 10

baroreceptor signals from aorta are transmitted by which nerve?

Answer 10

vagus nerve

Question 11

baroreceptor pressure control system

Answer 11

when arterial pressure goes up, baroreceptors sense and signals to CNS. get feedback to lower the pressure.

when common carotids are constricted so they can’t sense pres, the lowered pressure causes CNS to increase the arterial pressure

Question 12

feedback gain

Answer 12

G represents strength of feedback

G is equal to correction of error signal over the error or abnormality that remains

Question 13

as pressure increases in the carotid sinus, what happens to carotid sinus firing?

Answer 13

it increases

however, below 60 and over 180 mmHG, carotid sinus baroreceptors no longer respond

Question 14

what do baroreceptors respond to?

Answer 14

rapid arterial pressure CHANGES

Question 15

relationship btwn carotid distending pressure and muscle sympathetic nerve activity and cardiac R-R interval

Answer 15

as carotide distending pres increases, R-R interval increases, and muscle sympathetic nerve activity decreases

Question 16

main role of baroreceptors

Answer 16

to stabilize changes in BP

Question 17

if BP is higher for long period of time, what can happen with baroreceptor?

Answer 17

it can reset so that the new BP becomes baseline

Question 18

what are AT1 receptor mediated effects?

Answer 18

vasoconstriction
fibrotic
inflammatory
antinatriuretic

HTN

Question 19

what are AT2 receptor mediated effects

Answer 19

opposite of AT1

Question 20

ROS plays a role in HTN: true or false

Answer 20

true

Question 21

hypertension is more prevalent among what groups

Answer 21

elderly above 60 (largely systolic)

African Americans

Question 22

what is considered pre-HTN

Answer 22

systolic: 120-139
or
diastolic: 80-89

Question 23

stage 1 hypertension values

Answer 23

140-159 for systolic, or 90-99 for diastolic

Question 24

how is HTN diagnosed?

Answer 24

if the average of at least 2 readings per visit obtained at 3 separate visits each 2-4 wks apart is 140 mmHg or greater for systolic and 90mmHg or greater for diastolic

Question 25

age differences in terms of systolic vs diastolic HTN

Answer 25

if older, you see most cases of untreated HTN are isolated systolic HTN if younger, many cases of untreated HTN are isolated diastolic HTN

Question 26

essential HTN causes

Answer 26

polygenic and multifactorial (environment)

Question 27

what are most cases of HTN caused by

Answer 27

essential HTN (90% of cases) clinical clues include: onset at 20-50 yrs, family hx of HTN, normal serum K and urinalysis

Question 28

forms of HTN can be divided into two forms-what are they?

Answer 28

primary genetic forms secondary forms

Question 29

comorbidites of HTN

Answer 29

``` atherosclerosis CAD MI stroke congestive heart failure peripheral vascular disease ``` ``` chronic kidney disease obesity diabetes metabolic syndrome obstructive sleep apnea cognitive impairment ```

Question 30

long term regulation of BP is controlled by

Answer 30

kidney-mass balance of sodium and water

Question 31

what are general determinants of the pressure-natriuesis relationship

Answer 31

vascular resistance GFR tubular reabsorption

Question 32

what happens in a salt sensitive model of HTN?

Answer 32

you require higher pressures to achieve similar Na/H2O excretion rates as control in experiments, found that when angiotensin II levels are increased, the slope of the pressure-natriuresis relationship is reduced

Question 33

what happens when you remove the kidney to pressure-natriuresis relationshiP?

Answer 33

the slope gets shifted down and to right

Question 34

as age increases, what is the contribution of CO and TPR to essential HTN?

Answer 34

TPR contribution increases | CO contribution decreases

Question 35

what happens to the pressure-natriuresis relationship in hereditary forms of HTN?

Answer 35

the slope is reduced

Question 36

what is the possible mechanism of salt sensitive HTN?

Answer 36

too much Na reabsorption due to genetics

Question 37

what are the main downstream effects of HTN?

Answer 37

increased afterload arterial damage, leading to accelerated atherosclerosis or weakened vessel walls