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Blood Pressure Flashcards

(58 cards)

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1
Q

Mean blood pressure =

A

(systolic blood pressure +(2x diastolic blood pressure))/3

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2
Q

blood pressure basics

A
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3
Q

What type of flow in the aorta and large arteries?

A

pulsatile

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4
Q

What type of flow in the capillaries and veins?

A

laminar

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5
Q

If systemic arterial blood pressure is too low:

A
  • faint (vaso-vagal attack)
  • shock leading to tissue acidosis (pH<7.35)
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6
Q

If systemic arterial blood pressure is too high, leads to tissue damage

A

too high

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7
Q

Systemic arterial blood pressure is regulated to maintain

A

adequate tissue perfusion

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8
Q

Humans ideal blood pressure

A

120/80 mmHg

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9
Q

State the determinants of blood pressure:

A
  • cardiac output
  • vascular resistance
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10
Q

State the determinants of blood pressure: Cardiac Output:

A
  • amount of blood pumped by the heart: c. 5L/min
  • under hormonal and neurological control
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11
Q

State the determinants of blood pressure: Vascular Resistance:

A
  • predominantly determined by the level of constriction of arterioles
  • under hormonal and neurological control
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12
Q

Blood pressure Equation:

A

cardiac output x stroke volume

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13
Q

Ohm’s Law

A

V=IR

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14
Q

State 3 physical factors that affect blood pressure:

A
  • gravity
  • arterial compliance
  • blood viscosity
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15
Q

Physical factors that affect blood pressure: Gravity:

A
  • blood pressure is higher in feet, lower in head when standing upright….
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16
Q

Physical factors that affect blood pressure: arterial compliance:

A
  • arteries stretch and store elastic potential energy in systole
  • release energy to maintain flow in diastole
  • stiff arteries (eg old age) reduces
    compliance and increases systolic blood
    pressure
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17
Q

Physical factors that affect blood pressure: blood viscosity:

A
  • contributes to resistance to flow
  • high protein/hypercellular blood has high
    viscosity
  • higher pressure to maintain flow
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18
Q

Factors affecting CO and SVR

A
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19
Q

Cardiac output equation

A

CO = HR x SV
heart rate is per min
stroke volume is Liters

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20
Q

Usual cardiac output is

A

c.5L/min

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21
Q

Starling’s Law

A
  • the mechanical energy set free in the
    passage from the resting to the active state
    is a function of the length of the fiber
  • fiber length is determined by end diastolic
    volume (determined by venous return)
  • force contraction is translated into stroke
    volume
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22
Q

Cardiac pressure volume

A
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23
Q

Preload is

A

venous return

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24
Q

preload (venous return)

Study These Flashcards
A
  • circulating blood volume:
    - dehydration, major bleeding
    - kidney failure, over-transfusion
  • Venous tone:
    - autonomic nervous system
    - circulating vasoconstrictors
    - local vasoactive substances
25
Prostacyclin and nitric oxide are
vasodilator substances produced by the endothelium that controls local vascular tone
26
Endothelin
a vasoconstrictor substance produced by the endothelium that controls local vascular tone
27
Blood =
cells + plasma
28
Plasma =
water + salt + proteins
29
The kidney can affect blood volume.
- aldosterone (adrenal cortex) - salt retention - reabsorption in the distal convoluted tubule - ADH (posterior pituitary) - water retention - reabsorption in the distal convoluted tubule and collecting ducts - released in response to increased plasma osmolarity
30
The intrinsic heart rate is
set by the sinoatrial node in the right atrium
31
Sympathetic nervous system receptors to increase heart rate
Beta-1 adrenogenic
32
What receptor to slow the heart rate
- parasympathetic - vagus nerve - M2 muscarinic receptors
33
Circulating substances that can affect heart rate?
- adrenaline 9increases) binds to beta-1 receptors
34
control of systemic vascular resistance
35
Renin-Angiotensin-Aldosterone System
36
Local controls
tissue perfusion is autoregulated in response to local need (provide a minimum BP) - control occurs at arteriole level - dilation: low O2, high CO2, acidosis, nitric oxide, prostacyclin - constriction: endothelin
37
Circulating Catecholamines
- adrenaline and noradrenaline - responsible for generalised and sustained responses to acute changes - receptors: alpha: systemic arterioles = vasoconstriction (a1) beta: systemic arterioles - vasodilation (muscle b2) heart - increases rate and force of contraction (b1)
38
Noradrenaline is predominantly an
alpha agonist
39
Adrenaline is an
agonist of both alpha and beta receptors
40
Circulating catecholamines
41
Sensors involved in blood pressure:
- baroreceptors: aortic arch, carotid body at the carotid bifurcation - signal the brain via: - the vagus nerve - glossopharyneal nerve
42
Control Centers for blood pressure
- brainstem: - cardio-accelerator centre - cardio-inhibitory center - vasomotor center
43
Purpose of control centers for blood pressure
integrate sympathetic and parasympathetic responses
44
Blood pressure: effectors:
- sympathetic nerves: - noradrenaline (adrenergic) - vasoconstriction (muscle vasodilation) - increased heart rate and force - parasympathetic nerves: - acetylcholine - vasodilation - vagus nerve: decreases heart rate
45
vasomotor center
46
Causes of high blood pressure:
- chronic kidney disease - structural causes: - renal artery stenosis (narrowing) - aortic coarctation (narrowing of the aorta above the kidneys) - Endocrine causes: - high aldosterone lvels (conn's syndrome) - high catecholamine levels (phaeochromocytoma) - high cortisol levels 9cushings) - high growth hormone (acromegaly) - pregnancy/pre-eclampsia
47
hypertension is multifactorial:
- poly genetic - obesity - high salt intake - high alcohol intake - ethnicity
48
Effects of chronic hypertension
- heart muscle damage leading to heart failure - large vessel damage - microvascular damage
49
Effects of chronic hypertension: Large Vessels Damage:
Aortic aneurysm (and rupture) Cerebrovascular disease (stroke) Coronary artery disease (angina, myocardial infarction) Peripheral vascular disease (claudication, amputations)
50
Effects of chronic hypertension: Microvascular damage:
Kidney dysfunction (CKD) Brain dysfunction (multi-infarct dementia) Exacerbates vascular effects of diabetes (kidneys, eyes and peripheral nerves)
51
acute effects of severe hypertension:
- aortic dissection - acute heart failure (high afterload) - confusion (encephalopathy) - cerebral haemorrhage - retinal haemorrhage
52
Vaso-vagal episodes
- faints - neurally mediated syncope - generally reaction to a stressful episode - disproportionate parasympathetic activation: - arteriolar dilation - slow heart rate - above lead to fall in BP - reduced cerebral perfusion - transient loss of consciousness
53
Shock
persistently low blood pressure <90mmHg systolic state of organ hypoperfusion with resultant cellular dysfunction and death
54
Shock leads to
reduced perfusion of vital tissues one inadequate oygen delivery leads to anaerobic metabolism so cellular function declines and can be irreversible leading to death
55
Symptoms of shock
- altered mental status - tachycardia - hypotension - oliguria
56
Diagnosis of shock
- clinical - blood pressure <90mmHg systolic - measurements of markers of tissue hypoperfusion (blood lactate, base deficit)
57
treatment of shock
fluid resuscitation blood products correction of the underlyign disorder vasopressors
58
shock causes
- cardiogenic (large MI) low CO - sepsis due to low SVR - anaphylaxis due to low SVR - low blood volume - sympathetic activation: blood flow redistributed to head/heat/muscle - poor tissue perfusion: organ malfunction, acidosis

HLB (49 decks)

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