Hypertension

Question 1

In what capacity is venous blood related to blood pressure?

Answer 1

It is a capacity pool that is holding blood volume

Question 2

What happens to vasculature as we age?

Answer 2

becomes stiffer

Question 3

With stiffer vessels, what happens to relative systolic and diastolic pressures?

Answer 3

systolic gets higher, diastolic stays the same or goes lower

Question 4

Names of sounds heard at different phases when measuring NIBP?

Answer 4

Karatkoff

Question 5

Basic process of NIBP measurement?

Answer 5

Cuff inflated to occlude artery. Cuff deflated and oscillations measured to determine systolic, diastolic pressure.

Question 6

Describe what MAP measures

Answer 6

Measure of entire blood ejected during entire systolic, diastolic period

Question 7

Describe pulse pressure

Answer 7

difference between systolic and diastolic pressures

Question 8

Why is persistent high BP bad for the heart? (very basic)

Answer 8

It is increased resistance that the heart has to beat against

Question 9

How is high blood pressure bad for the arterial system?

Answer 9

Increased resistance in arterial system distends arteries, causing SHEERING FORCES, damaging endothelium and muscular layer of vessels, leading to accelerated athlerosclorosis

Question 10

Stage 1 hypertension is AKA

Answer 10

Early HTN

Question 11

Pressures for early HTN

Answer 11

140/90 +

Question 12

What is hypertensive crisis?

Answer 12

BP’s >180 +- / >110

Question 13

What is hypertensive emergency?

Answer 13

Hypertension + end organ dysfunction (i.e. vessel rupture)

Question 14

Why might we not want to drop the BP too much with hypertensive emergency?

Answer 14

May lead to poor perfusion in ruptured area

Question 15

What categories of HTN are there?

Answer 15

essential, chemical, renal-vascular

Question 16

Examples of causes of chemical HTN?

Answer 16

Causes of electrolyte retension, leading to increase in IV volume, changes in vascular reactivity. Causes - Cushing’s diseas, Addison’s disease, problems with Na metabolism/excretion, CNS or ANS dysfunction

Question 17

Causes of renal-vascular HTN?

Answer 17

Anything that effects feedback regulation at kidneys. Anything that causes lack of perfusion, stenosis (narrowing of renal artery). Pheochromocytoma.

Question 18

Increase in BP and HR in normal pt due to surgical stimulation?

Answer 18

BP increase 20-30mmHg, HR increase 15-20 bpm

Question 19

Increase in BP and HR in hypertensive pt due to surgical stimulation?

Answer 19

BP increases up to 90mmHg, HR increases up to 40 bpm

Question 20

Explain BP autoregulation in basic terms

Answer 20

Organs vasodilate or vasoconstrict inflow vessels in order to provide adequate perfusion or prevent excessive flow

Question 21

What is range of BP to keep pt in?

Answer 21

+- 20% of normal

Question 22

Why keep BP +- 20% in hypertensive pt?

Answer 22

Autoregulation has developed over time to protect organs at high blood pressure. Dropping BP too much could decrease perfusion to organs by dangerous amount.

Question 23

Patients with HTN are how much more likely to die from CV complications than pts w/out?

Answer 23

40%

Question 24

How is the baroreceptor response in hypertensive patients to changes in BP?

Answer 24

it’s blunted

Question 25

hypercarbia hypoxia and agitation can impact sympathetic output and vascular tone

Answer 25

indeed

Question 26

bladder distension can lead to…?

Answer 26

hypertension

Question 27

diastolic of what may be criteria for cancelling a case

Answer 27

110