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Cardiovascular > Physiology 4 and 5- Control of BP > Flashcards

Physiology 4 and 5- Control of BP Flashcards

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1
Q

What is blood pressure?

A

The pressure exerted on the blood vessel walls by the blood

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2
Q

What is the systemic systolic blood pressure?

A

The pressure exerted on the walls of the aorta and systemic arteries when the heart contracts

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3
Q

What is the systemic diastolic blood pressure?

A

The pressure exerted on the walls of the aorta and systemic arteries when the heart relaxes

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4
Q

When will sound be heard when listening to the brachial artery?

A

When there is turbulent blood flow

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5
Q

When is the first Korotkoff sound heard?

A

Peak systolic pressure

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6
Q

When is the second Korotkoff sound heard?

A

Minimum diastolic pressure

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7
Q

What is mean arterial blood pressure?

A

The average arterial blood pressure during a full cardiac cycle including contraction and relaxation of the heart

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8
Q

How can MAP be worked out?

A

[(2 x diastolic pressure) + systolic pressure] / 3
OR
DBP + 1/3rd pulse pressure

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9
Q

What is pulse pressure?

A

Difference between systolic and diastolic pressure

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10
Q

What is the normal range and normal value of MABP?

A

Range- 70-105mmHg

Value- 90mmHg

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11
Q

A MAP of at least 60mmHg is needed for what?

A

To adequately perfuse essential organs e.g. coronary arteries, kidneys and brain

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12
Q

What can happen if MAP is too high?

A

Place extra strain on the heart and damage the blood vessels

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13
Q

What is the TPR?

A

The sum resistance of all peripheral vasculature in the systemic circulation

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14
Q

What are the major resistance vessels?

A

Arterioles

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15
Q

What does parasympathetic stimulation to control the BP act on and what does it do?

A

Acts on the heart to reduce HR, CO and hence MABP

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16
Q

What does sympathetic stimulation to control the BP act on?

A

Heart, veins and arterioles

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17
Q

How does sympathetic stimulation to the heart increase the BP?

A

Increases HR, CO and MAP

Increases FoC, SV, CO and MAP

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18
Q

How does sympathetic stimulation acting on the arterioles increase the BP?

A

Vasoconstriction, increased TPR and BP

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19
Q

How does sympathetic stimulation acting on the veins increase the BP?

A

Vasoconstriction, increased VR, SV, CO and MAP

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20
Q

Any change in BP will be sensed by the ? (pressure sensors) which will then inform the ? (control centre)

A

Baroreceptors

Medulla

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21
Q

What are the effectors involved in the baroreceptor reflex and what do they mediate?

A

Heart- HR and SV

Blood vessels- TPR

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22
Q

What type of feedback mechanism is the baroreceptor reflex?

A

Negative

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23
Q

Where are the baroreceptors?

A

Aortic arch and carotid sinus

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24
Q

The baroreceptors in the aortic arch send signal to the medulla via what cranial nerve?

A

X- vagus

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25
The baroreceptors in the carotid sinus send signal to the medulla via what cranial nerve?
IX- glossopharyngeal
26
What happens to the rate of carotid sinus afferent nerve firing if BP increases or decreases?
BP increases- increases | BP decreases- decreases
27
What happens to the rate of vagal efferent afferent nerve firing if BP increases or decreases?
BP increases- increases | BP decreases- decreases
28
What happens to the rate of cardiac sympathetic efferent nerve firing if BP increases or decreases?
BP increases- decrease | BP decreases- increase
29
What happens to the rate of sympathetic vasoconstrictor nerve firing if BP increases or decreases?
BP increases- decreases | BP decreases- increases
30
What change in BP causes vasoconstriction/vasodilation?
Vasoconstriction- decreased MAP | Vasodilation- increased MAP
31
What type of MAP control are the baroreceptors involved in?
Short term moment to moment
32
What causes the MAP to decrease when a person stands up from a lying position?
Decreased venous return
33
When the MAP decreases, what happens to the firing of the baroreceptors?
Firing decreases
34
What happens when the baroreceptor firing decreases?
Increased sympathetic tone and decreased vagal tone Increased HR and SV Sympathetic constrictor tone increases TPR, VR and SV
35
What causes postural hypotension?
Failure of baroreceptor reflex when going from horizontal to vertical
36
What happens to the baroreceptor reflex if high blood pressure is sustained?
Firing will decrease and the receptors will effectively 'reset'
37
What controls MABP in the long term?
Blood volume
38
How is blood volume controlled?
By controlling the extracellular fluid volume
39
What is the extracellular fluid made up of?
Interstitial fluid volume and plasma volume
40
What happens if plasma volume fails?
Compensatory mechanisms move fluid from the interstitial fluid compartment
41
The ECFV is affected by ?, some ? act to regulate this
Affected by Na+ or H2O deficit or excess | Regulated by some hormones
42
What does the RAAS system regulate?
Plasma volume, TPR, MABP
43
Where is renin released from?
The kidneys
44
What does renin stimulate?
The formation of angiotensin I in the blood from angiotensinogen
45
Where is angiotensinogen produced?
Liver
46
What happens to angiotensin I in the RAAS system?
It is converted to angiotensin II by angiotensin converting enzyme (ACE)
47
What is ACE produced by?
Pulmonary vascular endothelium
48
What does angiotensin II stimulate release of?
Aldosterone
49
Where does aldosterone come from?
Adrenal cortex
50
As well as stimulating production of aldosterone, what other effects does angiotensin II have?
Increases TPR by systemic vasoconstriction | Stimulates thirst and ADH release
51
What is aldosterone?
A steroid hormone
52
What does aldosterone do?
Acts on the kidneys to increase water and salt retention to increase the plasma volume
53
The RAAS system is regulated by mechanisms which stimulate ? (specifically ?)
Renin release from the kidneys | Juxtaglomerular apparatus
54
What are some examples of changes that would stimulate the RAAS system?
Renal artery hypotension as a result of systemic hypotension Stimulation of renal sympathetic nerves Decreased Na+ in tubular fluid
55
What is the specialised kidney tubule cell which senses changes that regulate the RAAS system?
Macula densa
56
What is atrial natriuretic peptide?
A peptide stored in atrial muscle cells
57
What is ANP released in response to?
Atrial distension (hypovolaemia)
58
What are the 3 actions of ANP?
Excretion of salt and water to reduce blood volume and hence blood pressure Act as a vasodilator to decrease BP Decrease renin release and counteract RAAS
59
What is ADH?
A peptide hormone
60
Where is ADH synthesised and where is it stored?
Synthesised in the hypothalamus and stored in the posterior pituitary gland
61
What triggers synthesis of ADH?
Decrease in ECFV or increase in ECF osmolarity
62
What is extracellular fluid osmolarity monitored by?
Osmoreceptors close to the hypothalamus
63
What does ADH act on and what is the main action?
On the kidneys to increase reabsorption of water
64
How does ADH increasing water reabsorption affect BP?
Increase ECFV and hence CO and BP | Acts as a vasoconstrictor to increase TPR and BP
65
When is the effect of ADH on BP very important?
Hypovolemic shock

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