Cardiology 5: Integration and Regulation

Question 1

the determinants of arterial blood pressure can be ___ or ___

Answer 1

physical or physiological

Question 2

list 2 physiological factors that influence arterial BP

Answer 2

cardiac output and periperal resistance

Question 3

list 2 physical factors that influence arterial BP

Answer 3

arterial blood volume and arterial compliance

Question 4

the body will alter all other factors to maintain ___

Answer 4

arterial blood pressure

Question 5

arteriole baroreceptors are ___ receptors located in the __ and ___

Answer 5

stretch, carotod sinuses and aortic arch

Question 6

stretch of the arterial baroreceptors ____ receptor firing and inhibits ____ outflow from the pressor region. This is called the ___ effect

Answer 6

increases; sympathetic; dpressor

Question 7

which of the arterial barorecptors is most sensitive?

Answer 7

carotid

Question 8

arterial baroreceptors are the key to ___term adjustment of bp

Answer 8

short

Question 9

cardiopulmonary baroreceptors are ___ receptors in the __, ___ and ___

Answer 9

atria, ventricles and pulmonary vessels

Question 10

cardiopulmonary baroreceptors inhibit ____ outflow from the pressor region, but also inhibit release of factors important to ____ (such as angiotensin, aldosterone, vasopressin)

Answer 10

sympathetic; water retention

Question 11

cardiopulmonary baroreceptors work to ___ BP

Answer 11

increase

Question 12

peripheral chemoreceptors are ___ bodies in the __ and ___

Answer 12

small; carotid sinuses and aortic arch

Question 13

peripheral chemoreceptors are stimulated by decreased __ and increased __

Answer 13

PO2 and pH; PCO2 and H+

Question 14

peripheral chemoreceptors primarily affect __, but also stimulate ___

Answer 14

respiration; pressor region

Question 15

peripheral chemoreceptors can also be found in the heart and cause ___ in response to low O2

Answer 15

pain (angina)

Question 16

central chemoreceptors are located in the __ and respond to changes in ___ and __ but not ___

Answer 16

brain; PCO2 and pH; PO2

Question 17

central chemoreceptors directly stimulate ____ regions of the medulla, causing ____ outflow and arteriole __

Answer 17

chemo-sensitive; sympathetic; constriction

Question 18

stimulation of the posterior hypothalamus __bP, while syimulation of the anterior hypothalamus ___BP

Answer 18

raises; lowers

Question 19

the hypothalamus contains ___sensation that controls blood flow to the skin

Answer 19

temperature

Question 20

stimulation of motor and premotor cortexes results in __-response, while emotional stimuli may result in a ___ response (such as fainting or blushing)

Answer 20

pressor; depressor

Question 21

painful stimulation of the skin causes a ___ response while distention causes ___ response

Answer 21

pressor; depressor

Question 22

in the barorecptor reflex, the sudden change in arterial blood pressure causes a(n) ____ change in heart rate

Answer 22

inverse

Question 23

the baroreceptor reflex is most pronounced ____ range of blood pressure

Answer 23

intermediate

Question 24

in the bainbridge reflex, stretch o f the right atrium by increased ___ causes a___ in heart rate

Answer 24

venous return ; increase

Question 25

at a slow heart rate, increased volume causes ___ in bp

Answer 25

increase

Question 26

at fast heart rate, increased volume casues __ in BP

Answer 26

decrease

Question 27

during hemorrhage, cardiac output and arterial pressure ___ and arterial pulse becomes __ and __

Answer 27

drops; fast and feeble

Question 28

during hemorrhage, skin veins ___, making skin __ and __

Answer 28

collapse; moist and blue

Question 29

during hemorrhage, respiration rate is ___ and the depth may be ___

Answer 29

rapid; shallow or deep

Question 30

if blood loss is sufficient to decrease mean pressure to 50mmHg, what tends to happen to pressure?

Answer 30

rise over next 30 minutes and continues until normotensive, or pressure falls dramatically until death (hemorrhagic shock)

Question 31

during hemorrhage, various adjustment occur by ___ feedback loops

Answer 31

negative

Question 32

during hemorrhage, the baroreceptor resposne is___-, causing a ___ in parasympathetic and a __ in sympathetic tone

Answer 32

decrease; increase

Question 33

during hemorrhage, arteriole constriction ___, minimizing the fall of arterial bp

Answer 33

increases

Question 34

arterial pressure drops below __mmHg cannot evoke barorecptor response as they are belowe threshold

Answer 34

60

Question 35

why can chemoreceptors take over for baroreceptors when arterial bp drops below threshold?

Answer 35

low blood flow leads to hypoxia which stimulates chemo

Question 36

in response to hemorrhage, chemoreceptors ___ peripheral vasoconstriction and ___ respiration, which increases___

Answer 36

increase; increase; venous return

Question 37

the cerebral ischemic response occurs when the arterial pressure falls below ___mmHG and ___ and ___ resposnes are recruited

Answer 37

40; sympathetic and adrenal

Question 38

during cerebral ischemic response the sympathetic discharge is increased several times, increasing __ and __

Answer 38

vasoconstriction and contractility

Question 39

with more severe ischemia, ____ centres become activated, resulting in bradycardia and reduced blood pressure

Answer 39

parasympathetic

Question 40

what are 2 endogenous vasoconstrictors released by the adrenal gland during hemorrhage?

Answer 40

Ne and E

Question 41

when bp drops to 40mmHg there is a __fold increase in NE and E

Answer 41

50

Question 42

during hemorrhage, vasopressin is secreted by the ___ due to baroreceptors or left atrial stretch receptors

Answer 42

posterior pituitary

Question 43

in hemorrhage, reduced renal perfusion causes secreation of ___, which results in production of potent vasoconstrictor __

Answer 43

renin; angiotensin 2

Question 44

during hemorrhage, tissue fluid reabsorption occurs due to __-forces

Answer 44

starling

Question 45

during hemorrhage, reduce arterial and venous pressure and increased arteriole constriction lowers ___pressure in the capillaries, which promotes net absorption of ___ into vessels

Answer 45

hydrostatic; interstitial fluid

Question 46

during hemorrhage, there is renal conservation of __ ad __

Answer 46

salt and water

Question 47

during hemorrhage, ___ and ___ activity promote fluid and electrolyte retention by the kidney s

Answer 47

vasopressin and sympathetci

Question 48

lower arterial pressure ___ glomerular filtration rate and elevated angiotensin 2 levels stimulates release of ___form the adrenal cortex. Both act to ___ fluid and electrolyte loss

Answer 48

decreases; aldosterone; decrease

Question 49

t/f bp normally increases with age

Answer 49

true

Question 50

hypertension is the persistent elevation of bp beyond __

Answer 50

normal range

Question 51

what are the 2 general forms of hypertension?

Answer 51

1. renal hypertension | 2. essential hypertension

Question 52

what is the cause of renal hypertension??

Answer 52

increased activity of renin-angiotensin system

Question 53

what is the cause of essential hypertension?

Answer 53

cause unknown, but risk fators include genetics, obesity, lifestyle and smoking

Question 54

what are the 2 common consequences of hypertension?

Answer 54

hypertrophy and atherosclerosis

Question 55

hypertrophy is the result of the heart pumping against chronically elecated __, which causes the ventricle to become stiff, requiring higher __ and becoming more dependent on atrial contraction

Answer 55

afterload ; preload

Question 56

atherosclerosis can cause: ___, ___, ___disease and ___disease

Answer 56

MI; stroke; peripheral vascular; renal

Question 57

what are the 2 principal treatments of hypertension?

Answer 57

1. lower cardiac output | 2. vasodilation

Question 58

what are 3 ways to lower cardiac output to treat hypertension?

Answer 58

reduce salt intake; B blockers; diuretics

Question 59

what are 2 ways to improve vasodilation to treat hypertension?

Answer 59

1. calcium channel blocker | 2. angiotensin converting enzyme inhibitor

Question 60

congestive heart failure occurs when the heart is unable to ___

Answer 60

pump enough cardiac output

Question 61

what are the 2 primary causes of congestive heart failure?

Answer 61

diastolic dysfunction and systolic dysfunction

Question 62

what are the 2 primary consequences of congestive heart failure?

Answer 62

1. reduced cardiac output/bp | 2. fluid retention

Question 63

what are 3 consequences of reduced cardiac output/pressure in CHF?

Answer 63

1. increased heart rate 2. vasoconstriction 3. fluid retention

Question 64

what are the 4 principal treatments for CHF?

Answer 64

1. diuretics 2. ionotropic drugs 3. vasodilators 4. B blockers

Question 65

what is the role of diuretics in treating CHF?

Answer 65

increase Na and water secretion (reduce fluid retention)

Question 66

what is the role of ionotropic drugs in treating CHF?

Answer 66

digoxin (increase ca for improved contractility )

Question 67

what is the role of vasodilators in treating CHF?

Answer 67

ACE inhibitors to reduce afterload

Question 68

what is the role of B blockers to treat CHF?

Answer 68

reduce sympathetic drive to the heart (suspected to reduce workload)