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Cardiology > Hyper/Hypotension Physiology > Flashcards

Hyper/Hypotension Physiology Flashcards

1
Q

What is another name for the right atrioventricular valve?

Why

A

Tricuspid valve

It has three flaps

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2
Q

What is the only vein that carries oxygenated blood ?

A

Pulmonary vein

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3
Q

What is the only artery that carries de-oxygenated blood ?

A

Pulmonary artery

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4
Q

What is the valve that most commonly experiences stenosis?

A

Mitral valve

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5
Q

When talking about systole and diastole what area of the heart does it refer to ?

A

Ventricle

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6
Q

When do the coronary arteries get filled up, during systole or diastole?

A

Diastole

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6
Q

What are the three layers of the heart ?

A

Endocardium - inner most
Myocardium - Middle
Epicardium - Outermost

Pericardium then surronds the heart.

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7
Q

What are the layers of the pericardium?

A

The outer layer is fibrous and it just holds the heart to the diaphragm.

The inner layer is the serious pericardium - which contains the pericardial fluid

Your pericardium is a protective, fluid-filled sac that surrounds your heart and protects and lubricates it.

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8
Q

What is a perfect blood pressure ?

A

120/80

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9
Q

What is prehypertension range ?

A
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10
Q

What is stage 1 hypertension range ?

A
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11
Q

What is stage 2 hypertension range ?

A
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12
Q

What can lead to the blood vessels ability to contract and relax

A
  • Reduced elastic eg with age
  • Atherosclerosis
  • Calcium

Need to change my lifestyle!

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13
Q

Why is smoking an issue for blood vessels ?

A

Basal release of nitric oxide ( NO ) from the vascular endothelium regulates the tone of muscular arteries and resistance vasculature.

Smoking reduced nitrous oxide supply - reduces the tunica media elastic.

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14
Q

What can happen if someone drinks alcohol and does not eat?

A

hypoproteinaemia

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15
Q

What happens if the aorta becomes narrow?

A

Left ventricular hypertrophy (LVH) means that the muscle of the heart’s main pump (left ventricle) has become thick and enlarged. This can happen over time if the left ventricle has to work too hard. This part of the heart needs to be strong to pump oxygen-rich blood to your entire body.

Think if you worked on your biceps for a month they are going to get bigger.

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16
Q

What is the term that measures the blood in the ventricle when it’s relaxing?

A

End diastolic volume (120ml)

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17
Q

What is the term that measured the blood in the ventricle when its relaxlaxing?

A

End systolic volume (50ml)

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18
Q

How to measure stroke volume

A

End disastolic volume - End systolic volime

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19
Q

What is cardiac output

A

About 5 L

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20
Q

If stroke volume is reduced, cardiac output is reduced which will result in reduced coronary supply to arteries to heart risk of an MI… what medication will you want to give?

A

Vasodilator

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21
Q

When would you likely see hypotension ?

A

Diarehhea
Vomiting

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22
Q

What are the clinical issues with low blood pressure

A

No perfusion to the bodies !!

Dizzy

23
Q

What does Baro mean ?

A

Pressure

24
Q

Why are the baroreceptors places at the aortic arch and the carotids?

A

Checks quality leaving the ventricles and going to the brain.

25
Q

Where are Baroreceptors found ?

A

Aortic arch and carotid

26
Q

Nerve fibres relay impulses in cranial nerves IX and X from the baroreceptors to where?

A

Medulla oblongata

The respiratory and cardiac system control

27
Q

What are the three volumes that stroke volume is based on?

A

preload
contractility
afterload

28
Q

what is the cardiac output

A

Stroke volume x Heart rate

29
Q

What is the HR if SA node is firing ?

A

60-100

29
Q

What is the HR is the SA node is not firing but the AV node is ?

A

40-60

30
Q

What happens if the sympathetic response on the heard and vessels ?

A

Heart:
Increase heart rate
Increase contractility (inotropy)
Increase conduction in the heart

Vessels:
Coronary vasodilation
Constriction of systemic vessels

Fight and Flight

31
Q

What is the parasympathetic respons on the heart rate and vessels ?

A

Parasympathetic Response is:
Heart:
Decrease heart rate
Vessels:
Dilation of systemic vessels

Rest and Digest

31
Q

Why does blood pressure drop when standing?

A

Most of the blood pressure is in the calf muscle.

When you stand you are pumping that blood and then there will be a circulation and perfusion to kidneys etc. and reduction of the blood vessels.

31
Q

What is the term known for when BP drops when standing

A

Orthostatic hypotension

32
Q

What is the range for orthostatic hypotension?

A

Decrease in BP:
≥ 20mm mmHg SBP,
≥ 10mm mmHg DBP

33
Q

What can you quickly do if patient has orthostatic hypotension?

A

Move legs

Lie on the left and let the blood refill for 5 minutes

Sit on the side of the bed for 5 minutes

34
Q

Causes of orthostatic hypotension?

A

Low blood volume

Drug use - anti-hypertensive and psychotropic

Ageing
Orthostatic tolerance decreases after 70.
Post-prandial BP can drop.
Change in ability to increase HR,
decrease in muscle

Disorders affecting Sympathetic control
Parkinson’s, Diabetic neuropathy

35
Q

What can cause Hypovalemic shock?

A

Loss of ≥20% of blood volume
Bleeding,
burns,
fluid loss (V+D),
perspiration,
internal haemorrhage

36
Q

How much blood do we have in our body at any time?

How much is lost for hypovalemic shock?

A

5l in our body

1l is 20%

37
Q

What presentations can be shown during hypovalemic shock ?

A

Pale, clammy skin, weak pulse, unconsciousness, in severe cases. Related to poor blood flow
Also thirst and decreased urination
Change in pH levels (anaerobic metabolism)
Agitation

38
Q

What is treatment for hypovalmeia

A

Replacement

D+V - fluid replacement
Blood - Transfusion

39
Q

Why should you immediately get a IV line in during hypovalemia ?

A

Viens shut down quickly

40
Q

Explain Septic shock

A

Bacterial infection produces endotoxins that increase inflammation and produce Nitric oxide.
NO → vasodilation
Vasodilation → wider lumen and decreased BP

41
Q

Explain Anaphylactic Shock

A

Vasodilation as a result of histamine production

Lips and tongue will be swollen - patient will be unable to breathe

42
Q

Treatment for anaphalaxis

A

EPIPEN

last line - tracheostomy

43
Q

What is nuerogenic shock

A

Damage to the sympathetic nervous system. Loss of vascular tone.

44
Q

What is Hypotension Compensatory mechanisms ?

A

Baroreceptors stimulate sympathetic nervous system:

Constricts vascular beds and stimulate the heart
This is rapid but unsustainable (sympathetic control)

Kidneys influence BP by regulating Blood Volume
Renin-Angiotensin-Aldosterone: increase blood volume and maintain vasoconstriction (angiotensin II production, vasopressin release)

Venous return increased by stimulating veins

Fluid also retained by a drop in capillary hydrostatic pressure

45
Q

What organ is not working if a patient has low BP ?

A

Kidneys

46
Q

How does the Kidney respond to low BP ?

A

remember sodium (aka aldosterone) increases water absorption !!

47
Q

What hormones are involved in increasing BP ?

A

Renin
Angiotensis
Aldosterone

and ADH

47
Q

What are the issues with hypertension ?

A

Hypertension: linked to MI, stroke, renal problems, visual disturbances - multifactorial

48
Q

Explain primary and secondary hypertension

A

Primary and secondary hypertension
Primary (essential): 90% of cases

Secondary hypertension:
Renal artery stenosis, renal disease, hyperaldosteronism,
Aortic coarctation, pregnancy, hyper and hypothyroidism, Cushing syndrome, Sleep apnoea

49
Q

Explain how HTN can be acute and chronic

A

Temporary (acute): stress

Chronic: Increase in vascular resistance and Cardiac Output (renal retention)

50
Q

What is the reference range for hypotension ?

A

A drop in systolic arterial pressure <90mmHg and <60mmHg diastolic pressure

Cardiology (18 decks)

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