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Cardiovascular I > Regulation of BP > Flashcards

Regulation of BP Flashcards

1
Q

What are the general classifications of CV regulators?

A

Neural
Vascular
Hormonal
Local

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2
Q

What are the two general classifications of neural regulators of the CVS?

A

Autonomic
Reflex

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3
Q

What a reflex mechanisms for neural regulation of the CVS?

A

Baroreceptor
Bainbridge
Volume
Chemoreceptors
Pulmonary
Somatosympathetic

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4
Q

Where are the baroreceptors?

A

Carotid sinus
Aortic arch

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5
Q

What are the medullary CV centers?

A

Nucleus ambiguus
Pressor area
Depressor area
Vasomotor centers
Nucleus of tractus solitarius

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6
Q

What is the CV function of nucleus of tractus solitarius?

A

Medullary relay center for cardiorespiratory and afferents

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7
Q

What is the CV function of the nucleus ambiguus?

A

Cardioinhibitory center
Receives afferents from nucleus of tractus solitarius

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8
Q

What is the CV function of the pressor area?

A

Glutaminergic neurons that exert excitatory effect on spinal sympathetic neurons

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9
Q

What is the CV function of the depressor area?

A

Stimulate GABA-secreting inhibitory neurons to decrease sympathetic activity

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10
Q

What are the vasomotor centers associated with CVS and their main functions?

A

Caudal ventrolateral medulla - depressor area
Rostral ventrolateral medulla - pressor area

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11
Q

When is carotid sinus massage used clinically?

A

To interrupt paroxysmal atrial tachycardia

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12
Q

What will happen to BP if NTS is destroyed bilaterally?

A

Severe HTN, possibly fatal

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13
Q

How quickly can baroreceptors reset if exposed to a new pressure continuously?

A

1-2 days

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14
Q

What are atrial stretch receptors and their function?

A

Low pressure receptors that provide information about circulating blood volume
Type A - during atrial systole only
Type B - during late atrial diastole

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15
Q

What is the Bainbridge relfex?

A

Initial slow HR or infusion increases venous return which stimulates tachycardia producing stretch receptor to increase HR

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16
Q

What is the volume reflex?

A

Decreased blood volume in atria decreases atrial stretch which decreases the release of ANP –> decreased secretion in kidney and increased ADH production –> increased ADH increases kidney retention
Main result: increase blood volume to increase BP

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17
Q

What is another name of the coronary chemoreflex?

A

Bezold-Jarisch reflex

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18
Q

What is the coronary chemoreflex?

A

Chemical stimulation of afferents in LV baroreceptors stimulates respiratory center and cardiac depressor area –> results in tachypnea, hypotension, and bradycardia which then results in reflex apnea due to CO2 loss in hyperventilation

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19
Q

What are the general distributions of ANS to the heart?

A

R vagus to SA node
L vagus to AV node
R SyNS trunks to SA node
L SyNS trunks to AV node

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20
Q

What are the results of sympathetic stimulation of heart?

A

Increased HR/chronotropy
Increased force of contraction/inotropy
Increased conduction/dromotropy
Increased excitability/bathmotropy

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21
Q

What are the results of parasympathetic stimulation of the heart?

A

Decreased HR
Decreased force of contraction of atria
Decreased conduction
Decreased excitability

22
Q

What is the result of cutting vagal supply to the heart?

A

Increased HR to 150-180 bpm

23
Q

What will occur if both adrenergic and cholinergic systems are blocked to the heart?

A

HR stabilizes around 100 bpm

24
Q

What is the response to sympathetic stimulation to the vessels?

A

Skeletal muscle vessels dilate
Secretion in sweat glands
Release of epinephrine
Skin, renal and GI vessels constrict

25
Q

What is the effect of arteriolar constriction on BP?

A

Increase diastolic BP by increasing peripheral resistance

26
Q

What is the effect of venoconstriction on BP?

A

Increases systolic BP by increasing venous return and therefore increasing CO

27
Q

What is the effect of arteriolar dilatation on BP?

A

Decreases diastolic BP by decreasing peripheral resistance

28
Q

What is the effect of venodilatation on BP?

A

Decreases systolic BP by decreasing venous return and therefore decreasing CO

29
Q

Where are peripheral chemoreceptors located?

A

Carotid bodies
Aortic bodies

30
Q

Where are the central chemoreceptors located?

A

Ventrolateral medullary surface near the exit of CN IX and X

31
Q

What are Meyer waves?

A

Slow, regular oscillations in arterial pressure that occur about 1 every 20-40 seconds during hypotension

32
Q

What are Traube-Hering waves?

A

Fluctuations in BP synchronized with respiration

33
Q

What acts as an emergency arterial pressure control system?

A

CNS ischemic response

34
Q

What is the Cushing reflex?

A

Increased intracranial pressure that constricts arterioles causing ischemia results in baroreceptor reflex induced bradycardia

35
Q

What are the main points that indicate a Cushing reaction?

A

Triad of HTN, bradycardia, and respiratory depression

36
Q

What is the general function of pulmonary baroreceptors?

A

Minimize arterial pressure changes in response to change in blood volume

37
Q

What is the capillary fluid shift mechanism in relation to BP?

A

Significant decrease in BP decreases hydrostatic pressure in capillaries drawing more fluid in from interstitial spaces to increase blood volume and thereby increase BP

38
Q

What is another name for the hormonal mechanism of BP regulation?

A

Renin-angiotensin-aldosterone system

39
Q

What is renin?

A

Production in kidneys stimulated by low BP
Catalyzes the change of angiotensinogen from the liver into angiotensin I

40
Q

What is angiotensin converting enzyme?

A

Converts angiotensin I into angiotensin II

41
Q

What are the functions of angiotensin II?

A

Vasoconstriction
Increases free fluid to preserve renal function in hypovolemia
Increases aldosterone secretion from adrenal glands
Increases ADH release form posterior pituitary
Increases PCT Na/H exchanger activity
Stimulates hypothalamus to increase thirst

42
Q

What is pressure natriuresis?

A

Effect of arterial pressure on renal excretion of sodium
Long-term control of HTN

43
Q

What are conditions that can trigger renin release?

A

Coarctation of aorta
Renal A stenosis
CKD

44
Q

What are the rapid control mechanisms of BP?

A

Baroreceptors
Chemoreceptors
CNS ischemic response

45
Q

What are the intermediate control mechanisms of BP?

A

Capillary fluid shift
Stress relaxation and reverse stress relaxation

46
Q

What are the long-term control mechanisms of BP?

A

Hormonal mechanism
Renal mechanisms - changing excretion

47
Q

What is the Valsalva maneuver?

A

Forcefully expiring against a closed glottis to change intrathoracic pressure to effect venous return, CO, arterial pressure, and HR

48
Q

What is phase 1 of the Valsalva maneuver?

A

Intrathoracic pressure becomes very positive due to compression from contracting rib cage and full lungs

49
Q

What is the result of phase 1 of the Valsalva maneuver?

A

Venous compression and increase in RA pressure impedes venous return –> reduces preload
Decrease in CO
Transient increase in aortic pressure
Decrease in HR

50
Q

What occurs during phase 2 of the Valsalva maneuver?

A

HR increases
Aortic pressure falls

51
Q

What occurs during phase 3 of Valsalva maneuver?

A

Normal breathing resumes
Aortic pressure briefly decreases reflexively
HR briefly increases reflexively

Cardiovascular I (20 decks)

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