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Kidneys and Hormones > Endocrine and neuronal regulation of blood pressure > Flashcards

Endocrine and neuronal regulation of blood pressure Flashcards

1
Q

What are the two ways in which blood pressure is controlled?

A

Short term regulation

Long term regulation

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2
Q

What controls short term regulation of blood pressure ?

A

Autonomic nervous system

Baroreflex

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3
Q

What controls long term regulation of blood pressure?

A

Kidney

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4
Q

What is an example of something that triggers short term control of blood pressure ?

A

Postural hypotension - decrease in blood pressure due to gravity to head/neck

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5
Q

What is an example of something that triggers long term control of blood pressure?

A

Increase uptake of salt/ water fue to consumption of salty food

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6
Q

How does the baroreflex control blood pressure?

A

Baroreceptors detect changes in arterial pressure

Signal is sent to the medulla of the brainstem

Vagus nerve adjusts heart rate

Sympathetic nerves adjust cardiac contractility and peripheral resistance

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7
Q

How does the vagus nerve adjust heart rate?

A

Decrease in vagal activity leads to an increase in heart rate

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8
Q

How do the sympathetic nerves adjust cardiac contractility and peripheral resistance?

A

Causes vasoconstriction of peripheral blood vessels

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9
Q

How do the kidneys regulate long term control of blood pressure?

A

Hormones act on the kidney to regulate long term control of blood pressure

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10
Q

How do the hormones released that act on the kidney affect long term control of blood pressure?

A

Affect sodium and water reabsorption

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11
Q

What are the three hormones that act on the kidney that regulate long-term control of blood pressure?

A

Atrial natriuretic peptide

Renin-angiotensin system

ADH

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12
Q

What organ synthesises ANP?

A

The heart

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13
Q

What is the goal of ANP?

A

To decrease blood volume

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14
Q

How does ANP control blood pressure?

A

ANP binds to receptors on the DCT and collecting ducts

Interacts with NCC (sodium-chlorine cotransporter) and ENaC (epithelial sodium channel)

ANP also inhibits renin secretion - inhibits the renin-aldosterone system

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15
Q

What is the effect of ANP on the renin-angiotensin system?

A

Inhibits the renin-angiotensin system

Inhibits renin secretion

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16
Q

What part of the heart secretes ANP?

A

Cardiac atrial myocytes synthesise and store ANP

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17
Q

What do ventricles produce?

A

BNP

Brain natriuretic peptide

First isolated in the brain

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18
Q

Structure of ANP

A

28 aa peptide

17 aa ring in the middle of the molecule

19
Q

What is the main goal of the renin-angiotensin system?

A

Increase blood pressure

20
Q

What is the sensor of the renin-angiotensin system?

A

The juxtaglomerular apparatus

21
Q

What does the juxtaglomerular apparatus control?

A

Blood pressure

Concentration of solutes in the plasma

22
Q

What is the juxtaglomerular apparatus made of?

A

Glomerulus

Macula densa cells

Granular renin producing cells

Afferent and efferent arterioles

23
Q

Which cells produce renin?

A

Granular renin producing cells

24
Q

What are granular renin producing cells sensitive to?

A

Perfusion pressure - when P is low in afferent arteriole, it stimulates renin secretion

NaCl deliver to macula densa cells - when decreased, renin secretion is enhanced

25
Q

What happens when delivery of NaCl to macula densa cells is decreased?

A

Renin secretion is enhanced

26
Q

Describe the steps of renin-angiotensin system

A
  1. Angiotensinogen is released from the liver
  2. Renin is released from the kidneys, converts Angiotensinogen -> Angiotensin I
  3. Angiotensin I is inactive
  4. ACE releasedfrom the lungs and converts Angiotensin I -> II
27
Q

What are the effects of Angiotensin II?

A

Can affect smooth muscle receptors

Causes release of Aldosterone from the adrenal gland

When in high concentration, can activate the release of ADH

28
Q

What does Angiotensin II release when in high concentration?

A

ADH

29
Q

What is ADH?

A

A small peptide

30
Q

What is another name for ADH?

A

Vasopressin

31
Q

What are the two receptors for ADH?

A

V1

V2

32
Q

Where is the receptor V1 found?

A

In the vasculature

33
Q

What happens when ADH binds to V1?

A

G-protein coupled receptor

Increases IP3+ and Ca2+ levels

Causes vasoconstriction and release of von Willebrand factor/ factor VIII from endothelial cells

34
Q

What happens when ADH binds to V2?

A

G-protein coupled receptor

Increases cAMP levels

Causes insertion of aquaporin-2 channels into the luminal membrane of principal cells

35
Q

Which cells of the collecting duct does ADH affects?

A

Principal cells

36
Q

What types of receptors are V1 and V2?

A

G-protein coupled receptors

37
Q

What is normal plasma osmolarity?

A

280 - 330 mosm/L

38
Q

What releases ADH?

A

Posterior pituitary

39
Q

Which nucleus of the posterior pituitary releases ADH?

A

Suprachiasmatic nucleus

40
Q

What happens to the kidneys upon prolonged hypertension?

A

Kidney injury develops

Leads to hypertensive nephropathy

Damage to the capillaries leads to fibrosis

41
Q

What consequences does kindey injury have on blood volume regulation?

A

Kidney injury impairs blood volume regulation

42
Q

What causes benign arterial hypertension?

A

Excess sodium in the blood leads to activation of Angiotensin

43
Q

Pathogenesis of benign arterial hypertension

A

Activation of angiotensin causes accumulation of hyaline in the wall of arterioles

Narrowing lumina and thickening walls leads to ischaemia

Tubular atrophy, interstitial fibrosis , glomerular alterations and periglomerular fibrosis

In advanced stages = renal failure

44
Q

What structural changes does benign arterial hypertension cause?

A

Tubular atrophy

Interstitial fibrosis

Glomerular alterations

Periglomerular fibrosis

Kidneys and Hormones (39 decks)

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