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Cells to Organisms - Lectures > Lecture 28. Pathophysiology and Treatment of Hypertension > Flashcards

Lecture 28. Pathophysiology and Treatment of Hypertension Flashcards

1
Q

How does blood flow ?

A

From areas of higher pressure to areas of lower pressure

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2
Q

What is blood pressure ?

A

Force exerted in all directions

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3
Q

What plays a role in maintaining blood pressure ?

A

The recoil of arterial walls

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4
Q

What dissipates much of pressure ?

A

The resistance of blood flow in the narrow diameters of tiny capillaries and arterioles

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5
Q

What is systolic pressure ?

A

The pressure in the arteries during ventricular systole

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6
Q

What is the highest pressure in the arteries ?

A

Systolic pressure

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7
Q

What is pulse ?

A

Rhythmic bulging of artery walls with each heartbeat

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8
Q

What is diastolic pressure ?

A

The pressure in the arterioles during diastole, it is lower than systolic pressure

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9
Q

What is formula to measure flow ?

A

Flow = Pressure gradient/Resistance

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10
Q

What creates a pressure gradient for blood flow ?

A

Heart

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11
Q

What is the formula for resistance ?

A

Resistance = (Length x Viscosity)/ Radius ^4

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12
Q

What are the most important resistance vessel ?

A

Arterioles

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13
Q

How do homeostatic mechanisms regulate arterial blood pressure ?

A

By altering the diameter of arterioles (vasoactivity)

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14
Q

What is vasoconstriction ?

A

The contraction of smooth muscle in the arteriole walls increasing blood pressure

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15
Q

What is vasodilation ?

A

The relaxation of smooth muscles in the arterioles, causing blood pressure to fall

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16
Q

What is a major inducer of vasodilation ?

A

Nitric oxide

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17
Q

What is an inducer of vasoconstriction ?

A

The peptide endothelin

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18
Q

What is vasoconstriction and vasodilation often coupled to ?

A

Changes in cardiac output that affect blood pressure

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19
Q

What is vasoactivity influenced by ?

A
  1. Autonomic nerves
  2. Hormones
  3. Metabolism
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20
Q

Where is blood pressure measured from ?

A

The artery in the arm at the same height as the heart

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21
Q

What is the recommended blood pressure for a healthy young adult ?

A

At rest should be less than 120mm HG at systole and 70 mm Hg at diastole

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22
Q

What has a significant effect on blood pressure ?

A

Gravity

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23
Q

What is fainting cause by ?

A

Inadequate blood flow to the head

24
Q

Where is blood pressure low ?

A

In veins

25
Q

What is the return of blood enhanced by ?

A

Contraction of smooth muscle in vein walls and skeletal muscle contraction

26
Q

What is the formula of cardiac output ?

A

Cardiac output = Mean arterial pressure/ total peripheral resistance

27
Q

What is total peripheral resistance ?

A

The combined resistance of all blood vessels

28
Q

What is mean arterial pressure regulated by ?

A

HR, SV, TPR

29
Q

What is mean arterial pressure regulated by in the short term ?

A
  1. Baroreceptor reflex
30
Q

What is mean arterial pressure regulated by in the long term ?

A

Regulation of blood volume

31
Q

What happens to blood pressure in the parasympathetic division ?

A

Blood pressure decreases

32
Q

What happens to blood pressure in the sympathetic division ?

A

Blood pressure increases

33
Q

What are barorecptors ?

A

Specialised nerve endings that respond to stretch of vessel wall - indirect response to changes in blood pressure

34
Q

Where are baroreceptors found ?

A

Carotid sinus and aortic arch

35
Q

What are the two types of baroreceptors ?

A
  1. Type A

2. Type C

36
Q

What are type A baroreceptors ?

A
  1. Myelinated
  2. Low pressure (30-90mmHg)
  3. Important at rest
37
Q

What are type C baroreceptors ?

A
  1. Unmyelinated
  2. High pressure (70-140mmHg)
  3. Increasingly active at higher pressures
38
Q

Where does baroreceptor input go ?

A

Nucleus tractus solitarius in the medulla

39
Q

Where does the baroreceptor output from nucleus tractus solitarius go ?

A
  1. Parasympathetic nervous system
  2. Sympathetic nervous system
  3. Hypothalamus and amygdala
40
Q

What does the output from nucleus tractus solitarius to the the parasympathetic nervous system travel via ?

A

Nucleus ambiguous

41
Q

What does the output from the nucleus tractus solitarius to parasympathetic nervous system do ?

A

Cardiac control - limits heart rate

42
Q

What does output from the nucleus tractus solitarius to the sympathetic nervous system do ?

A

Cardiac and blood vessel control

43
Q

What does output from nucleus tractus solitarius to hypothalamus an amygdala ?

A

Allows theses areas to override the baroreceptor reflex during stress. This allows a stress associated increase in blood pressure to occur

44
Q

What does renin-angiotensin-aldosterone system do ?

A

Regulates sodium ion and as a result water

45
Q

What does a drop in blood pressure near the glomerulus cause ?

A

The juxtaglomerular apparatus of the kidney to release the enzyme renin

46
Q

What does renin trigger ?

A

The formation of the peptide angiotensis II

47
Q

What is the function of angiotensin II ?

A
  1. Raises blood pressure and decreases blood flow to the kidneys
  2. Stimulates release of the hormone aldosterone
48
Q

What is the function of the hormone aldosterone ?

A

Increases blood volume and pressure

49
Q

What are the factors affecting blood pressure ?

A
  1. Diet
  2. Smoking
  3. Obesity and type II diabetes
  4. Stress
  5. Low activity
  6. Age
  7. Sex
  8. Genes
50
Q

What is the strategy when treating hypertension ?

A

Reduce blood volume and reduce cardiac output

51
Q

What do thiazide diuretics do ?

A

Inhibit Na/K/Cl exchange in the distal renal tubule

52
Q

What is the function of B-blockers ?

A

Reduce heart rate and contractility

53
Q

What is the function of alpha-blockers ?

A

Reduce sympathetic tone, dilate arteriolar smooth muscle

54
Q

What is the function of the mixed alpha and beta blocker: L-type Ca channel blocker ?

A

Relaxation of vascular smooth muscle - reduced resistance

55
Q

What is the function of ACE inhibitors ?

A

Diuretic actions - inhibit aldosterone formation

Cells to Organisms - Lectures (36 decks)

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