S2 L1.2: SAH: Principal Mechanisms

Question 1

Amount of volume inside blood vessels

Answer 1

Intravascular Volume

Question 2

T/F: Intravascular volume is a primary determinant of arterial pressure over the long term.

Answer 2

True

Question 3

Statement 1: If you decrease extracellular fluid volume, there is an associated increase in blood pressure
Statement 2: Alterations in total extracellular fluid volume are associated with proportional changes of blood volume

a. TF
b. FT
c. TT
d. FF

Answer 3

b. FT
If you increase extracellular fluid volume, there is an associated increase in blood pressure

Question 4

Primary determinant of the extracellular fluid volume

Answer 4

Sodium

Question 5

Statement 1: Where sodium goes water goes/ sodium attracts water
Statement 2: Body absorbs a lot of water resulting to hypertension

a. TF
b. FT
c. TT
d. FF

Answer 5

c. TT

Question 6

When NaCl intake exceeds the capacity of the kidney to excrete sodium, __ __ initially expands and __ __ increases

Answer 6

1. Vascular Volume
2. Cardiac Output

Question 7

Maintains cardiovascular homeostasis

Answer 7

Autonomic Nervous System

Question 8

Autonomic Nervous System controlls all the involuntary things in the body (3)

Answer 8

1. Blood Pressure
2. Volume
3. Chemoreceptor signals

Question 9

Three endogenous catecholamines (Fight or flight hormones)

Answer 9

Norepinepherine
Epinephrine
Dopamine

Question 10

Cardiovascular Regulation

Contraction of the blood vessels

Answer 10

Tonic

Question 11

Cardiovascular Regulation

Overtime, sometimes excretes and sometimes they don’t

Answer 11

Phasic

Question 12

Circadian Rhythm

Statement 1: When we sleep and rest, the blood pressure and heart rate goes down
Statement 2: When we are about to wake up, there is a surge of catecholamines resulting to increase in hr and bp

a. TF
b. FT
c. TT
d. FF

Answer 12

c. TT

Throughout the day, it subsides and goes
back to resting period

Question 13

Reflexes that modulated blood pressure over the short term

Answer 13

Adrenergic reflexes

Fight or flight move (Increase BP & HR)

Question 14

T/F: Adrenergic function, in concert with hormonal and volume-related factors, contributes to the long-term regulation of arterial pressure

Answer 14

True

Question 15

Synthesized by adrenergic neurons

Answer 15

Noripinephrine and Dopamine

Question 16

Taken back in a promise called Reuptake Mechanism

Answer 16

Synaptic Cleft

Question 17

Method of Release:
Norepinephrine and Dopamine

Answer 17

1. Initially stored in vesicles within the neuron
2. It is then released into the synaptic cleft and to receptor sits on target tissues.
3. It is then either metabolized or taken up into the neuron by an active reuptake process.

Question 18

Synthesized in the adrenal medulla and released into the circulation upon adrenal stimulation

Answer 18

Epinephrine

Question 19

This catecholamine does not get stored anywhere else

Answer 19

Epinephrine

Question 20

Receptor that perceive the pressure.
Several reflexes modulate blood presure on a pressure on min-to-min basis

Answer 20

Baroreceptors

Question 21

Where are the stretch sensitive sensory nerve endings located?

Answer 21

In the carotid Sinuses and the Aortic Arch

Question 22

Rate of firing of these baroreceptors with arterial pressure

Increase or decrease?

Answer 22

Increase

Question 23

Decrease of sympathetic outflow results in a ___ of arterial pressure and heart rate.

Answer 23

Decrease

Question 24

Primary mechanism for rapid buffering of acute fluctuations of arterial pressure that may occur during __?

Answer 24

Postural changes, behavioral or physiological stress, and changes in blood volume

Question 25

When the baroreceptors are stretched, what would it interpret?

Answer 25

An increase in pressure

Question 26

Response of the Baroreceptors when they are stretched

Answer 26

Cascade of events that would **bring down BP eventually and normalize it** if BP increases (minute-to-minute basis)

Question 27

T/F: Patients with autonomic neuropathy and impaired baroreflex function may have extremely labile blood pressures with difficult-to-control episodic blood pressure spikes.

Answer 27

True

Question 28

Statement 1: Baroreceptors deteriorate in elderly and can have autonomic neuropathy Statement 2: Their bodies cannot adapt immediately which causes them to be asymptomatic with changes in position (esp in ADLs) because their nerves are problematic. a. TF b. FT c. TT d. FF

Answer 28

a. TF Their bodies cannot adapt immediately which causes them to be symptomatic

Question 29

Hormone synthesized in the segment of the renal afferent renal arteriole that abuts the glomerulus and a group of sensory cells located at the distal end of the loop of Henle, the macula densa

Answer 29

Renin

Question 30

# Primary Stimuli for Renin Secretion This stimuli leads to hyponatremia

Answer 30

↓ NaCl transport in the thick ascending limb of the loop of Henle | Renin’s job is to increase sodium in the body

Question 31

# Primary Stimuli for Renin Secretion ↓ pressure or stretch within the ___ ___ ___ (baroreceptor mechanism)

Answer 31

Renal Afferent Aretriole

Question 32

Less fluid entering the kidney → detected by __ cells → renin secretion

Answer 32

JG Cells

Question 33

T/F: Renin's job is to also decrease fluid

Answer 33

False (Increase) ↑ sodium → water follows (normal mechanism during dehydration)

Question 34

T/F: ↑ sodium → Less urine formation

Answer 34

True D/t kidneys reabsorbing back the water that should come out as urine

Question 35

# Primary Stimuli for Renin Secretion Renin-secreting cells via β1 adrenoreceptors are stimulated by which system? | Clue: Nervousness and agitation stimulates renin

Answer 35

Sympathetic Nervous System

Question 36

Does stimulating renin add to the elevation in BP?

Answer 36

Yes ↑ sodium reabsorption → ↑ water absorption (more water circulating in the system) → expect elevated BP

Question 37

# Renal Pathology Review Where the blood enters the kidneys, circulates in the capillary tuft; gets cleansed in this system

Answer 37

Afferent Arteriole

Question 38

# Renal Pathology Review Wwhere further processing of the urine takes place until it finally forms urine

Answer 38

Tubular System

Question 39

# Renal Pathology Review Renin is inhibited by the ff except: a. ↓ NaCl transport in the thick ascending limb of the loop of Henle b. ↑ stretch within the renal afferent arteriole, and by β1 receptor blockade c. May be modulated by a number of humoral factors, including angiotensin II

Answer 39

A. Should be increase since it is inhibition

Question 40

T/F: Beta receptor blockers like metoprolol, nebivolol and carvedilol are antihypertensive agents causing renin inhibition → preventing increase in BP

Answer 40

True

Question 41

T/F: Renin stimulates the release of angiotensin II

Answer 41

True

Question 42

A potent vasoconstrictor in response to low renal arterial pressure or low concentration of filtered sodium in kidneys

Answer 42

Angiotensin II

Question 43

Angiotensin is responsible of the ff except: a. ↑ intracellular calcium/blood vessel wall constriction b. ↑ sympathetic nervous system activity c. Inhibits vasopressin release d. Stimulates aldosterone

Answer 43

C. Inhibits vasopressin release | Angiotensin II increases the blood pressure

Question 44

Statement 1: When done excessively, BP will rise excessively causing hypertension Statement 2: Angiotensin I = found in the kidneys and goes to the lungs to become angiotensin II a. TF b. FT c. TT d. FF

Answer 44

TT

Question 45

A potent mineralocorticoid that increases sodium reabsorption and promoted water retention

Answer 45

Aldosterone

Question 46

Statement 1: Aldosterone may also enlarge the heart and lead to Cardiac hypertrophy Statement 2: It can also enhance intracellular matrix and collagen deposition within the myocardium a. TF b. FT c. TT d. FF

Answer 46

a. TF Extracellular

Question 47

Sort the events in order a. The angiotensinogen peptide gives way to the release of angiotensin I (AI) b. The angiotensin converting enzyme (ACE) that is found in the lungs will convert AI to angiotensin II (AII) c. Under normal conditions, AII will stimulate adrenal cortex to secrete aldosterone & pituitary gland resulting to renal sodium & fluid retention in order to maintain homeostasis d. Excessive AII will be sensed by renin to stop its production (NEGATIVE FEEDBACK MECHANISM) e. AII promotes cardiac & vascular hypertrophy, systemic vasoconstriction, & inc blood volume ↓ f. Stimuli (i.e., sympathetic stimulation, hypotension, dec sodium delivery) causes the kidneys to secrete renin

Answer 47

F→A→B→E→C→D

Question 48

Statement 1: Vascular radius and compliance of resistance arteries are also important determinants of venous pressure Statement 2: In hypertensive patients, structural, mechanical, or functional changes may increase lumen diameter of small arteries and arterioles a. TF b. FT c. TT d. FF

Answer 48

d. FF 1. Arterial Pressure 2. Reduce Lumar Diameter

Question 49

T/F: Radius goes smaller, BP goes up

Answer 49

True Smaller caliber blood vessels repeated constriction will release hypertension

Question 50

What are the main determinant of BP

Answer 50

Arterioles

Question 51

When an arteriole is flexoble or compliant, it can accomodate huge volume of blood without ___?

Answer 51

Increasing the BP

Question 52

T/F: As we grow old, component of blood vessels also changes and impact negatively on compliance of arteries → arteries become more rigid

Answer 52

True

Question 53

Refers to geometric alterations in the vessel wall without changing vessel volume and results in ↓ lumen size, ↑ peripheral resistance

Answer 53

Remodelling

Question 54

Type of remodelling that has increased cell number, increased cell size, and increased deposition of intercellular matrix

Answer 54

Hypertrophic Remodelling

Question 55

This type of remodelling has no change in the amount of material in the vessel wall; just becomes rigid

Answer 55

Eutrophic Remodelling

Question 56

Programmed Cell Death

Answer 56

Apoptosis

Question 57

T/F: Lumen diameter is also related to elasticity of the vessel

Answer 57

True A high degree of elasticity can accommodate an increase of volume with relatively little change of pressure

Question 58

True or False: During Exercise ↑ venous return (sympathetic and muscle pumping)

Answer 58

True

Question 59

True or False: During Exercise ↑ parasympathetic, ↓ sympathetic stimulation

Answer 59

False ↓ parasympathetic, ↑ sympathetic stimulation

Question 60

True or False: During Exercise ↑SV,HR,CO

Answer 60

True

Question 61

True or False: During Exercise Local metabolites dilate arterioles, ↑ regional blood flow

Answer 61

True

Question 62

True or False: During Exercise Modest ↑SBP, no change in DBP

Answer 62

True

Question 63

True or False: During Exercise Significantly ↑ systemic vascular resistance

Answer 63

False Significantly ↓ systemic vascular resistance

Question 64

True or False: During Exercise oxygen consumption 20x

Answer 64

True