Arterial Pressure Reg Flashcards

1
Q

Regulation of _______ ________ is accomplished by a complex system of positive and negative feedback systems.

A

arterial pressure

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2
Q

arterial pressure maintained by multiple ______ and ______ systems

A

nervous and hormonal

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3
Q

mean arterial pressure needed to allow for adequate _______ ______ to all tissues

A

nutrient delivery

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4
Q

At critical flows blood shunted to critical systems for life: ______ _______ _______

A

CNS, heart, kidneys

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5
Q

At basic level, Regulation of arterial pressure determined by ___________ __________ and _____ ________ ________

A

Cardiac Output CO-

Total Peripheral Resistance TPR

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6
Q

mechanoreceptors for transducing pressure and pressure changes to NS AP —> CNS (nervous portion)

A

baroreceptors

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7
Q

baroreceptor locations (2)

A

carotid sinus-

aortic arch

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8
Q

Baroreceptors sensitive to (2)

A

changes in pressure-

rate of change of pressure

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9
Q

baroreceptor impulses carried via CNs ___ and ___ to the _____ and ______

A

IX glosopharangeal and X Begus=

medulla and pons

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10
Q

Medulla/ pons regulation of BP via the ______ _____ ______ modulating _______/__________ NS outflow to _____ and _______ ________

A

autonomic nervous system -
sympathetic/parasympathetic-
heart and blood vessels

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11
Q

level of contractility ^ or v by

A

the level of sympathetic “tone” to arterioles and venules (vascular smooth muscle)

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12
Q

CNS CHEMORECEPTORS react to levels of ___, ____, and _____ in blood and CSF

A

O2, CO2, and pH

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13
Q

stimulation of CNS chemoreceptors results in symp or parasymp modification of ____ ______

A

blood pressure

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14
Q

disorders that may lead to autonomic hyperreflexia

A

higher spinal cord injury, MS

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15
Q

intracerebral bleed may lead to

A

acute hypertension

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16
Q

afferent neuron disease or peripheral neuropathies may be from

A

diabetes mellitus, alcoholic neurophathy, tabes dorsalis

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17
Q

angiotensenogen released systemically by

A

liver–in response to decreased BP or adverse Na concentrations

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18
Q

Renin released by _____ and cleaves angiotensenogen to form__________

A

kidneys-

angiotensin I

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19
Q

ACE

A

angiotensin converting enzyme–pulmonary circulation

20
Q

ACE further modifies ___________ to form ___________

A

angiotensen I, angiotensen II

21
Q

ACE also produced in vasculature of ______, _______, ______, and _______

A

adrenal gland, heart, brain, kidneys

22
Q

2 main systems for arterial pressure drug regulation

A
  1. autonomic NS
  2. Renin-angiotensin-aldosterone system
    Nervous/hormone
23
Q

faster system for arterial pressure regulation

A

Nervous over hormonal

24
Q

^ vagal tone =

A

slow heart contractility

25
Q

dx of nerve damage as from diabetes for orthostatic hypotension

A
  1. take BP/pulse just after standing
26
Q

dx of orthostatic for autonomic dysfunction

A

take serial BP 10 min after standing

27
Q

Nervous control of arterial pressure constituents 3.

A
  1. baroreceptors (carotid sinus & aortic arch)
  2. baroreceptor reflex sequence (CN IX & X) study ppt slide 6
  3. chemoreceptors (central & peripheral–O2, CO2, & pH)
28
Q

no O2 in environment –> minute ventilation will go

A

way up–usually driven by CaCO2

29
Q

Angiotensen II primarly leads to release of _______ from adrenal cortex (zona glomerulosa cells)

A

aldosterone

30
Q

aldosterone acts on ______ ______ ______ cells promoting INCREASED reabsorption of ____, ^ blood volume

A

distal renal tubule,

sodium Na+

31
Q

angiotensin II further actions 3

A
  1. acts as direct vasoconstrictor–> ^total peripheral resistance
  2. constriction of renal efferent arterioles (preserve GFR)
  3. stimulates Na+ - H+ exchange in renal proximal tubule ^ Na+/ HCO3 reabsorption
32
Q

in normal situations of depletion (hemorrhage, dehydration) of circulating blood volume, RAA system

A

attempts to preserve blood volume and flow

33
Q

ACE inhibitors will

A

control hypertension–not as much aldo released

34
Q

spironolactone

A

antimineralocorticoid (treats ^ BP)

35
Q

ADH secreted by

A

POSTERIOR pituitary–controlled by hypothalamus

36
Q

ADH secreted in response to

A

serum osmolarity (norm 295) & low circulating blood volume

37
Q

ADH promotes– V1 receptors

A

renal water reabsorption

38
Q

ADH promotes–V2 receptors

A

vasoconstriction in arterioles smooth muscles

39
Q

Brain natriuretic peptide aka

A

atrial natriuretic peptide (ANP)

40
Q

ANP released secreted by ATRIA in response to

A

increased VOLUME and PRESSURE in atria

41
Q

ANP inhibits

A

renal Na+ REABSORPTION & aldo release

42
Q

ANP useful lab measurement for

A

heart failure–

43
Q

ANP opposes

A

aldosterone – in reference to renal retention of Na+

44
Q

ANP mediates vasodilation of ________ renal arterioles, and constriction of ______ renal arteriles

A

AFFERENT,
EFFERENT
Increases GFR

45
Q

vasopressin also has ________-_______ properties

A

vaso-contrictive–INCREASES arterial pressure from 2 dirrections slide14

46
Q

SI ADH

A

syndrome of inappropriate of ADH – low serum Na+ CONCENTRATION due to high water (blood volume) retention