Lecture 5: CV Pathophysiology III

Question 1

ease with which a structure can be stretched; change in volume over change in pressure

Answer 1

compliance

Question 2

the difference between systolic and diastolic blood pressure; indicates compliance (if high –> compliance low)

Answer 2

pulse pressure

Question 3

MAP = ?

Answer 3

DP + 1/3(SP-DP)

Question 4

R = ?

Answer 4

8nL/pi*r^4

Question 5

What metabolites cause vasodilation?

Answer 5

increased CO2, H+, and K+

decreased O2

Question 6

vasodilator released by endothelium continuously; can be inhibited when endothelium is damaged

Answer 6

nitric oxide

Question 7

local inflammatory mediators

Answer 7

prostaglandins

Question 8

when NO and prostaglandin is inhibited, this is released from endothelium to cause smooth muscle vasodilation

Answer 8

EDHF (endothelium-derived hyperpolarizing factor

Question 9

produced by endothelium; causes vasoconstriction; stimulated via thrombin, angiotensin II, and epi

Answer 9

Endothelin-1

Question 10

What hormones cause vasoconrtsiction and where do they originate?

Answer 10

epinephrine/norepinephrine - adrenal medulla
vasopressin/ADH - posterior pituitary
angiotensin II - circulating precursor

Question 11

What are some demographics of hypertension?

Answer 11

• more common in african americans

- more common in men

Question 12

What is essential hypertension?

Answer 12

etiology unknown; 90-95% of cases

Question 13

What is secondary hypertension?

Answer 13

hypertension that has an underlying cause

Question 14

What are the ranges for prehypertension?

Answer 14

systolic: 120-139
diastolic: 80-89

Question 15

What are the ranges for stage I hypertension?

Answer 15

systolic: 140-159
diastolic: 90-99

Question 16

What are the ranges for stage II hypertension?

Answer 16

systolic: >160
diastolic: >100

Question 17

Why are women at lower risk of hypertension then men?

Answer 17

androgen (male sex hormone) makes the renin-angiotensin system less responsive to BP changes

Question 18

What affect does hypertension have on the heart?

Answer 18

• increased after load
• left ventricular hypertrophy
• increased stiffness of ventricular wall (inhibits filling)
• blood back-up
• interferes with cardiac contractility; SV decreases

Question 19

when renal blood vessels become infiltrated with hyaline material, occluding the lumen

Answer 19

hypertension-induced nephropathy

Question 20

How does hypertension affect the kidney?

Answer 20

decreased blood flow to kidneys initiates renal responses that increase blood volume

Question 21

How does hypertension affect the eyes?

Answer 21

small retinal vessels can burst, causing hemorrhage and blurred vision

Question 22

What can you do to treat hypertension?

Answer 22

• weight loss
• exercise
• decrease sodium and alcohol intake
• increase potassium/calcium and antioxidant intake
• stress management
• diuretics
• symptholytic agents
• beta blockers - slow HR
• calcium channel blockers
• ACE inhibitors
• direct vasodilators (usually take with beta blocker)

Question 23

atherosclerosis that occurs in vessels outside the brain and the heart

Answer 23

peripheral vascular disease (PVD)

Question 24

a single layer of endothelial cells plus layer of connective tissue

Answer 24

intima

Question 25

smooth muscle in connective tissue matrix

Answer 25

media

Question 26

connective tissue plus blood vessels that supply the artery

Answer 26

adventitia

Question 27

What are the phases of atherosclerotic lesion development?

Answer 27

1. fatty streak - area of yellowing discoloration resulting from sub epithelial foam cells containing lipids 2. fibrous plaque - accumulation of lipoprotein in the intimate causes injury and attracts inflammatory cells; foam cells are produced and release cytokines, PDGF, and recruit smooth muscle cells 3. fibrous plague grows until it occludes blood flow

Question 28

What are the factors of metabolic syndrome?

Answer 28

- abdominal obesity (waist circumference of >35-40 inches) - triglyceride levels >150 mg/dL - HDL 110 mg/dL

Question 29

What is abdominal obesity associated with?

Answer 29

insulin resistance, hyperinsulemia, glucose intolerance

Question 30

high cholesterol LDL and triglycerides, low HDL

Answer 30

dyslipidemia

Question 31

How do different fats affect plasma lipids?

Answer 31

polyunsaturated fats - promote HDL | saturated and trans fat - promote LDL

Question 32

drugs that lower LDL cholesterol levels and increase HDL levels

Answer 32

statin drugs

Question 33

What are the consequences of atherosclerosis?

Answer 33

- rupture of fibrous plaque - calcification of plaque - hemorrhage - thrombosis/embolism - aneurism