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BI0005 > Blood Pressure and Hypertension > Flashcards

Blood Pressure and Hypertension Flashcards

(68 cards)

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1
Q

What is blood flow

A

The movement of blood through the vessels from the arteries to the capillaries and then into the veins

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2
Q

How does velocity of blood flow vary

A

It varies inversely with the (total) cross sectional area of the vessel through which it is flowing. As the total cross-sectional area of the vessel increases, the velocity of flow increases

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3
Q

Where is blood flow slowest and why

A

It is slowest in the capillaries to allow time for exchange of nutrients and gases

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4
Q

What is vascular resistance

A

The resistance offered by blood vessels to the flow of blood. Resistance occurs where the blood vessels away from the heart oppose the flow of blood

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5
Q

Which 3 factors accumulate resulting in resistance

A

Vessel radius, blood viscosity and blood vessel length

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6
Q

What is blood pressure a measure of

A

The force that blood exerts against the vessel walls as it moves the blood through the vessels

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7
Q

What does vascular tone mean

A

Smooth muscle walls have a degree of resting tension

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8
Q

What is arterial blood pressure determined by

A

Total peripheral resistance and cardiac output

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9
Q

What does cardiac output equal

A

CO = SV x HR

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10
Q

What is a sphygomomanometer and how does it work

A

It is a device used to measure blood pressure. It is composed of an inflatable cuff to restrict blood flow and a mercury/ mechanical manometer to measure the pressure

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11
Q

Where is blood pressure measured

A

In the brachial artery

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12
Q

What is normal arterial blood pressure in a healthy adult

A

120/80

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13
Q

How is blood pressure written

A

Systolic pressure over diastolic pressure

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14
Q

What is systolic BP

A

Systole occurs during the contraction and emptying of the heart

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15
Q

What is diastolic BP

A

Diastole occurs during the relaxation and filling of the heart

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16
Q

What is the difference in systolic and diastolic BP called

A

Pulse pressure

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17
Q

What happens to normal arterial blood pressure

A

It falls at night due to patterns in the circadian rhythm

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18
Q

What happens to normal arterial blood pressure with age

A

Systolic BP increases due to a reduction in the elasticity of the arteries

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19
Q

What happens to normal arterial blood pressure during pain, fear, anger and sexual arousal

A

Short term increases in arterial BP

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20
Q

What happens to normal arterial blood pressure when you stand up

A

BP in all vessels below the heart is increased and BP in all above the heart is reduced

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21
Q

What is transient postural hypotension

A

When you change from lying position to standing about 700ml of blood is lost from the thorax resutling in a decreasing in systolic and diastolic pressures

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22
Q

What happens during vasoconstriction

A

Vascular resistance increases

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23
Q

What happens during vasodilation

A

Vascular resistance decreases

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24
Q

What is intrinsic control of blood pressure

A

Autoregulation which is stretch, temperature and locally released factors

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25
What is extrinsic control of BP
autonomic nervous system or hormones
26
Which receptors detect pressure during circulatin
Baroreceptors
27
Where are baroreceptors located
In the walls of the aorta (aortic arch) and carotid arteries (carotid sinus)
28
What happens when increased BP is detected
Increased BP detected by the baroreceptors info relayed cardiovascular control centre. Results in increased parasympathetic input and decreased sympathetic output which leads to decreased cardiac output. Decreased sympathetic input also leads to decreased peripheral resistance
29
Where is the cardiovascular control
Located within the medulla oblongata
30
What do sympathetic cardiac nerves do
Stimulates cardiac output by increasing heart rate and contractility (and so BP)
31
What do parasympathetic cardiac nerves do
Inhibits cardiac output by decreasing HR
32
What does the vasomotor centre regulate
Blood vessel diameter
33
What do vasomotor nerves innervate
Smooth muscles in the arterioles throughout the body to maintain vasomotor tone
34
What does hormonal control of blood pressure involve
The long term control of blood pressure involves the control of blood volume/ sodium balance by the kidneys
35
What 5 hormones are involved in the hormonal control of BP
1. Adrenaline 2. Angiotensin 3. Aldosterone 4. Antidiuretic hormone (ADH) 5. Atrial natriuretic peptide/ hormone
36
What does the renin-angiotensin-aldosterone system regulate
Blood volume
37
What does the renin-angiotensin-aldosterone system do in response to falling BP
Juxtaglomerular cells in kidneys secrete renin into blood. Renin converts angiotension to angiotensin I which is in turn converted to angiotensin II by enzymes from the lungs. Angiotensin II activates 2 mechanisms that raise BP
38
What are the two mechanisms activated by angiotensin II which raise BP
Vasoconstriction and stimulation of the adrenal cortex to secrete aldosterone
39
How does vasoconstriction raise BP
Constricted blood vessels reduce the amount of blood delivered to the kidneys, which decreases they kidneys' potential to excrete water (raising BP by increasing blood volume)
40
How does stimulation of the adrenal cortex to secrete aldosterone increase BP
Aldosterone reduces urine output by increasing the retention of water and Na+ by the kidneys (raising BP by increasing blood volume)
41
How do adrenaline and noradrenaline affect BP
They are secreted by the adrenal medulla and raise BP by increasing HR and causing vasocontriction (fight-or-flight response)
42
How does antidiuretic hormone affect BP
It is produced by the hypothalamus and released by the posterior pituitary gland. Raises BP by stimulating kidneys to retain water (raising BP by increasing blood volume)
43
How does atrial natriuretic peptide affect BP
Secreted by the atria of the heart, lowers BP by causing vasodilation and by stimulating the kidneys to secrete more water and Na+ (lowering BP by reducing blood volume)
44
Which hormones raise BP
Adrenaline, Aldosterone, Angiotensin, Antidiuretic hormone
45
Which hormone lowers BP
Atrial natriuretic peptide
46
Which part of the kidney does aldosterone affect
DCT
47
Which part of the kidney does ADH affect
Collecting duct
48
What is hypertension
High blood pressure
49
What does hypertension lead to
Stroke, CHD and chronic renal failure
50
What are risk factors of hypertension
Advancing age, sedentary lifestyle, obesity (BMI greater than 25), salt sensitivity, alcohol, smoking and family history
51
What is normal BP
52
What is pre-hypertention BP
120-139/ 80-89
53
What is hypertension stage 1 BP
140-159/ 90-99
54
What is hypertension stage 2 BP
\>160/ \>100
55
What is secondary hypertension
When high blood pressure occurs as a result of another condition
56
What percentage of people with high blood pressure have secondary hypertension
20%
57
What conditions result in secondary hypertension
Pregnancy, Endocrine disorders, Renal disease, atherosclerosis
58
How does pregnancy result in secondary hypertension
Pregnancy results in elevated hormone levels which may result in increased responsiveness to Angiotensin II
59
What is an example of an endocrine disease that leads to secondary hypertension and how does it cause high BP
Conn's and Cushing's syndrome results in hyperaldosteronism and cortisol increases resulting in a vasoconstrictive effect
60
What does high BP result in
Increased 'wear and tear' on the heart, vessels and organs
61
What cardiac changes does high BP result in
Heart must work harder with arterial blood pressure increases. Heart muscle hypertrophies to compensate. Diffusion of oxygen from capillaries to enlarged heart becomes less efficient. Left ventricular failure will eventually occur
62
Compare normal heart and heart of someone with high BP
See diagram
63
Describe the vascular effects high BP has
1. Narrowing of small arteries and arterioles 2. Myogenic response due to increase in stretch 3. Hypertrophy 4. Response to sympathetic stimulation increased 5. Arterioclerosis- reduction in elasticity/ hardening 6. Rarefaction: reduction of vessels in tissues 7. Rarefaction observed in retina and intestines of hypertensive patients
64
What are the complications of hypertension
Atherosclerosis, kidney damage, heart attack, stroke, enlarged heart- heart failure, blindness
65
What is the aim of treating hypertension
To lower cardiac output or to lower peripheral BP
66
What two drugs are used to treat hypertension
Diuretics and vasodilators
67
Give an example of a diuretic and explain how diuretics work
Thiazides. Diuretics reduce blood volume, they work by inhibiting sodium reabsorption at the beginning of the distal convoluted tubule. Water is lost as a result of more sodium reaching the collecting ducts
68
Give an example of a vasodilator and explain how they work
ACE inhibitors. Vasodilators decrease vasodilation and inhibit some renal function activities. ACE block the action of the enzymes from the lungs that convert angiotensin I to angiotensin II

BI0005 (21 decks)

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