W7/8 Cardiovascular system Flashcards

Inc lectures - Blood pressure and CVS continuum (123 cards)

1
Q

What are the 3 components of the CVS?

A

Blood, Vessels, Heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the blood transport? (5)

A
  • O2, CO2 and other gases movement
  • Nutrients
  • Electrolytes
  • Metabolic waste
  • Hormones, Cytokines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the function of the blood in protection?

A
  • Immune response (Antibodies, complement proteins, WBC)
  • Blood loss-Clotting (platelets)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the functions of the blood relating to Regulation?

A
  • Body temp
  • pH
  • Circulatory body fluid volume/concentration (osmosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristics of blood:
Type of fluid tissue?
Colours?
Blood volume?

A

A liquid connective tissue (only fluid tissue in human body)
A sticky viscous opaque fluid
Scarlet red: High oxygen (in artery)
Dark Red: Low oxygen (in vein)
Blood volume: 1.2 to 1.5 gallons: 8-10% of body weight
Male: 5-6 L and Female 4.5 L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the blood made up of? (%)

A

55% Plasma
1% Buffy coat (platelets, leukocytes)
44% Solids (RBC- Erythrocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the blood plasma made of? (5)

A

90% water
10% soluble components

Plasma proteins- Albumin, globulin, fibrinogen
- Nutrients- Glucose, Amino acids, Cholesterol
- Gases- O2, CO2, traces (little bit <1%)
- Electrolytes- Sodium, Potassium, Chlorides & others
- Metabolic wastes- Urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Haematopoiesis definition

A

Haem- Relating to blood
Poiesis- Formation of/Production of
(Formation of blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the functions of Haematopoietic stem cells/ Haemocytoblast?
What determines the type of cell formed?
What do the produced cells enter through?

A
  • Formation of RBC, WBC and Platelets
  • Hormonal/Growth factors determine the type of cells
  • Produced cells enter through blood sinusoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Definitions
Leucopoiesis
Erythropoiesis:
Thrombopoiesis:

A

Formation of WBC

Production of Red blood
cells/erythrocytes

Production of platelets/ Thrombocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the difference between Granulocytes and Agranulocytes?

A

Obvious granules (light microscope)
No obvious granules (light microscope)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 types of granulocytes?
What type of cells are they?

A

Neutrophils
Eosinophils
Basophils

These are all polymorphonuclear cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give a description of a Neutrophil:
-What do they act against?

A

Type of granulocyte;
-Major Abundant/Common type
-Larger cells
-3-4 segments/lobes of nucleus
-Smaller granules

Bacterial Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the appearance of Eosinophils:

What do they fight against?

A

-Larger granules
-2 lobes of nucleus with thick strand of chromatin

Parasitic Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the appearance of Basophils:
-nucleus shape
-what they respond to

A

Huge granules
Horseshoe shaped nucleus
2 big lobes joined together
Migrate into the tissue, Mast cells
Histamine- Proinflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are Polymorphonuclear cells? (literally)

The type of immune cell that has what..?

A

A type of immune cell that has granules (small particles) with enzymes that are released during infections, allergic reactions, and asthma. Neutrophils, eosinophils, and basophils are polymorphonuclear leukocytes.

Under a light microscope- Granules are seen so called granulocytes

More than one, Many different structure of cells/ morphology, relating mostly to the nucleus

e.g. Neutrophils- 3/4 lobes nucleus with thin chromatin strands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the 3 types of Agranulocytes?

A

Monocytes
Thrombocytes
Lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

-Describe the appearance of Thrombocytes: (platelets)
-Function?

A

-Fragments/Platelets
-Contains no nucleus
-Contains mitochondria (require ATP)

-They help form blood clots to slow or stop bleeding and to help wounds heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the appearance of Monocytes:

A

Type of Agranulocyte:
-Horse shoe lobed nucleus
-Migrate into tissue,
-Differentiate into Macrophages
-Phagocytosis- Bacteria
-Dendritic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the types of lymphocytes? (4)

A
  1. B- Lymphocytes (Plasma cells or Natural killer)
  2. T helper
  3. T Suppressor
    - All produce antibodies to fight viral infection
  4. T-Cytoxic
    - Cancer cells

B cells require T helper cells to signal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does HIV target?

-If HIV isn’t treated, it can lead to AIDS

A

HIV targets T-helper cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the terms for:
-Low WBC Count:
-High WBC Count:

A

Penia- Deficiency/not enough

Philia- Surplus/ excess cytosis: increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What could occur from a low WBC count? (3)

A

Leucopenia- low wbc count
- risk of infection
- sepsis and lethal

Neutropenia -low neutrophils
-Risk of bacterial infections

Thrombocytopenia -low platelets
-the risk of blood loss
-an autoimmune condition in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Differential white cell count examples

A

Leucocytosis : Sign of Infection
Neutrophilia?
(Neutrophil Leucocytosis)

  • Sign of bacterial Infection
    Eosinophilia?
  • Sign of parasitic Infection
    Lymphocytosis?
  • Sign of viral Infection
    Monocytosis?
    Sign of bacterial Infection in tissues, TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Red blood cells features:
Biconcave- no nucleus and organelles (Large surface area for exchange) (Anaerobic ATP synthesis, don’t use O2) 97% of RBC is Haemoglobin – Gas Transport: Oxygen (Reversible binding) Contain Spectrin, a plasma membrane protein- (Flexibility of shape- to get through smaller capillaries)
26
What is the structure of Haemoglobin?
Composed of 4 globins/polypeptides, 2 alpha and 2 beta. Haem contains a central Iron. Each Fe2+ binds to one O2. Each haemoglobin molecule can carry 4 O2 molecules
27
Oxyhaemoglobin meaning and colour: Deoxyhaemoglobin meaning and colour
When Hb is binded to O2- Bright red When Hb is not bonded to O2- Dark Red
28
Is haemophilia related to RBC? If Hb has only one Fe2+ how does it bind to 4 O2?
29
Erythropoiesis definition:
Production and maturation of RBC- ~15 days
30
What is the regulation of Erythropoiesis: What produces erythrocytes?
* Hormonal (Negative Feedback Axis) * Kidney becomes hypoxic (renal arterial oxygen drops) triggering EPO release Erythropoietin (released from kidney) stimulates Erythropoiesis. It stimulates bone marrow to produce erythrocytes. Erythrocytes increase O2 transport to the kidney and block EPO release
31
Hypoxia definition Causes Symptoms
Low oxygen levels in body tissues Causes: Haemorrhage/Injury, Iron deficiency. High altitude or Lung disease (Pneumonia) Symptoms: Confusion, restlessness, DIB, rapid HR, bluish skin Can be life-threatening
32
What is the Oxygen sensor in the kidney called?
Hypoxia- inducible factor
33
Explain the regulation of Erythropoiesis:
* Hormonal (Negative Feedback Axis) * Kidney becomes hypoxic (renal arterial oxygen drops) triggering EPO release * Erythropoietin (EPO) stimulate the red bone marrow to produce erythrocytes * Erythrocytes increases O2 transport to the kidney and block EPO release Testosterone enhances EPO production, (result in higher RBC in Males) * High EPO: Erythrocytes mature faster * Increase haematocrit, dehydration and blood viscosity (clotting, stroke, heart failure)
34
What is anaemia?
(Low haemoglobin) - A condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues.
35
What is Thalassemia?
-Globin chain in Hb is absent or malfunction -RBC become thin, delicate and lack Hb -Mild to Severe subtypes- Blood transfusions -Predominantly in Mediterranean ethnics
36
What are two conditions that can result because of problems with red blood cells?
Thalassemia and Sickle cell anaemia
37
Sickle cell anaemia: What is it? Symptoms?
-Mutation in Hb: one amino acid is wrong in the globin B chain (6th AA- Glutamic acid in normal RBC whereas 6th AA is Valine in sickle RBC) -Sickle RBC is crescent-shaped - O2 levels are low - Crescent shape block flow in the blood vessels and leads to stroke and other vascular diseases -Very fatigue, lots of pain, challenged with work/exercise -Predominantly in African ethnics
38
What is Polycythaemia?
- Too many red blood cells in the blood Bone Marrow Cancer, People living in Highlands (low O2 in high altitude) Too thick too many cells increase the viscosity - Stroke -Coronary artery disease -Renal disease
39
What is haemostasis?
A physiological process to stop bleeding (clot) (Blood coagulation) Literally blood staying still
40
What are the Haemostasis steps? (3) What type of feedback mechanism?
1. VASCULAR SPASM - pain reflux, constriction of smooth muscle, triggers clotting chemicals/factors needed and directed to a site of injury. 2. Platelet Activation- Plug Endothelial Damage Exposed Collagen Platelets stick to exposed collagen- are activated Platelets stimulate ADP, Thromboxane (clotting factor) A2 and Serotonin Von Willebrand Factor- Stabilises collagen-platelet adhesion 3. Coagulation- Patch Clotting factors/procoagulants in Liver Vitamin K, the biosynthesis clotting factors Plasma proteins I to XIII X-A, Prothrombin Activator converts into X Prothrombin then Thrombin then Fibrinogen (Insoluble) and Fibrin (soluble) and Fibrin (Mesh) This is a positive feedback mechanism
41
What is thromboxane?
A clotting factor
42
What is Thrombosis?
Blood clotting (Thrombus) in arteries, veins or capillaries
43
What is an Embolism?
Blockage in an artery, caused by a foreign body e.g. a blood clot (embolus) Blood clot/endogenous materials (Embolus) moving in the blood vessel and obstructing blood flow
44
Fate of clot and vessel healing: What is the process? What occurs in fibrinolysis?
Clot retraction concurrent with vessel repair: 1. The actin and myosin in platelets contract and pull on fibrin strands 2. Platelet-derived growth factor (PDGF) -Stimulate smooth muscle and fibroblast division 3. Vascular endothelial growth factor (VEGF) -Rebuild endothelial lining by multiplying endothelial cells Fibrinolysis Plasminogen, =plasma protein trapped in clot is converted into Plasmin which digests Fibrin
45
Haemostasis disorders (3)
Thromboembolism Unregulated Bleeding Disseminated Intravascular Coagulation (DIC)
46
Blood groups
A- Antigen A and B O group- No antigens (Universal donor) A+ AB- Universal recipient as can recieve RBC from any blood type
47
Why are red blood cell counts higher in males?
Androgen levels such as Testosterone are higher (Which stimulates the release of EPO)
48
Which renal hormone triggers the red blood cells levels formation in bone marrow
Erythropoetin
49
What are the 3 types of circulation?
Pulmonary, Systemic, Coronary
50
What is the function of an Artery? What is the structure of an artery?
Carries blood AWAY from the heart to the rest of the body Consists of: Lumen Tunica Interna/Intima Tunica Media Tunica externa NO valves
51
Give a brief description of: Tunica Interna/Intima Tunica Media Tunica externa
Tunica Interna/Intima- Flat layer, smooth squamous endothelium, smooth flow of blood. Tunica externa- Thick layer w elastic tissues, stretch in and out. Handle the pressure (more in larger arteries) Bright Red
52
What is the function of a Vein? What is the structure of a Vein?
Carries blood TOWARDS Lumen- Slightly wider than artery Externa Smooth muscle and Elastic fibres Intima- Endothelial layer No elastic adventia Valves to prevent back flow/ Handle low pressure 8-10mmHg Dark Red
53
What are the 3 types of capillaries?
Continuous Fenestrated Sinusoids
54
What is a Continuous capillary?
Found in Smooth and Skeletal muscle Continuous arrangement BBB- Very tight junction with an Intercellular cleft (This restricts toxin exchanges)
55
Where are fenestrated capillaries found? They allow a higher permeability of what?
Found in Intestinal villi, kidney glomeruli & endocrine cells Higher permeability of larger biomolecules
56
What is a Sinusoid capillary?
Found in Red bone marrow and liver Huge molecules perfusion Blood cells, proteins and wastes
57
What is the structure of a capillary?
Bundle of smooth muscles spread out pre-capillaries (provide elasticity) Sphincters (pre-capillary) Vasotone-dilation- More blood into capillary (metabolic demand- Exercise) apillary (200-400um in diameter) Capillary walls are lined with endothelial cells (5-10 um in diameter) for smooth flow Various cell types around a blood vessel Complex regulation * Metabolic demand * Hormonal * Temperature and many others
58
Heart (the life pump)
Size: ~ 14 cm long; 9 cm wide (fist of your hand) Weight : 300-500 gms Heartbeat: 70-100/min= 115000/day = ~3.5 billion in lifetime Volume of blood pumped in a day = ~9000 L
59
What is pericardium? What is myocardium? What is endocardium?
Pericardium Fibrous layer- Outermost layer - provides elasticity and protects Myocardium- Cardiac muscle (contract and relax) Endocardium- Innermost layer Septum- Divides heart 4 Pulmonary veins
60
What can be a symptom of a congenital disease related to your Septum?
Poorly developed septum= Heart murmurs
61
LubbDubb
Sound when atrioventricular and semilunar valves shut S1= Lubb S2= Dubb
62
Where does the Brachial artery take blood to?
Brachial artery- Takes blood to hands Cephalid vein- Drains blood into VC Carotid artery- Takes blood to brain Jugular vein- Drains blood into VC Hepatic artery- Takes blood to liver Hepatic vein- Drains blood Femoral artery/Vein- Lower body/legs
63
Why do we have a Hepatic portal vein? (No direct drain from GI/Intestines into veins)
Toxins must be removed first Processed by liver first
64
Describe Venous return (flow of blood back to the heart's right atrium) (3) (SAQ)
1. Calf/skeletal muscle pump (coordinated contraction of muscle) 2. Pulsatile arteries adjacent to vein complement the muscle pump/pressure and venous return 3. Respiratory (Thoracic pump) - Interpleural pressure Breath In (inspiration) - Diaphragm compresses abdominal cavity - Increase in pressure so pushes blood from abdomen cavity to thorax - Reduced pressure in the thorax sucks blood from the abdominal cavity to the thorax Breathing Out (expiration) -
65
Problems with Venous return can cause...
Pulmonary embolisms Varicose Veins (chronic vein valve failure)
66
What is coronary circulation?
Two tiny arteries leaving out the aorta Profuse blood to myocardium Handles high pressure (irrespective of heart contraction or relaxation)
67
Describe the autoregulatory processes controlling the rate of oxygen exchange between the microcirculation and tissue (6)
Pre-Capillary Sphincters: Less Oxygen (& metabolic) demand in tissues Myogenic response
68
What can occur due to problems with coronary circulation?
Blockage leads to the major cardiac problem- Heart attack Coronary Thrombosis- Myocardial Infarction
69
Capillary Perfusion: Microcirculation (Tissue fluid)
* O2, CO2 and other gases movement * Nutrients * Electrolytes * Metabolic waste * Hormones, Cytokines High hydrostatic pressure, low oncotic/osmotic pressure at arteriole end, Low hydrostatic pressure at venue end (Starling forces)
70
Autoregulation of perfusion: What are stimulated?
-CO2 , potassium (K+) or hydrogen (H+) ions (acidic pH) -Lactic acid (by-products of cell metabolism) -Histamine (Inflammation) Body temp 1.Stimulate endothelial cells to release endothelin (peptides) 2.Platelet secretions and prostaglandins 3.Vasoconstriction of pre-capillary sphincters
71
What is the myogenic response?
Reflex response of the afferent arterioles to changes in BP Stretching of the smooth muscle in the walls of arterioles Blood flow (High): Stretch Blood flow (low): Constrict Localised protective function to maintain the blood flow: Ischemia (hypoxia) Vs Excessive perfusion Stimulate endothelial cells to release NO Vasodilation of precapillary
72
What is systole and diastole? (Haemodynamic flow/Cardiac Cycle)
Systole- Heart contraction Diastole- Heart relaxation
73
Sino Atrial (SA) Node (Pace maker)-
Specialised electrically active Myocardial tissue-Atria Intrinsic/electrical unstable- Physiological origin of contraction Spontaneous depolarisation, 90-100 times/min Generates electrical activity-Impulse
74
Where is the SAN and AVN?
SAN located in LHS of heart AVN located in RHS of heart
75
What is the AVN?
Specialised electrically active Myocardial tissue- Atria-Ventricular mid line Generates electrical activity-Impulse Intrinsic/electrical unstable- Spontaneous depolarisation, Lower than SA (40-60 times/min)
76
What is the Bundle of His? (AV bundle)
Collect and carry to higher and lower part of the ventricles (Apex); 20-40 times/min
77
What are Purkinge Fibres?
Specialised myocardium for electrical conduction (not contraction) towards contractile myocytes (cardiac cells)
78
What are the key properties of cardiac muscle? (4)
1.Auto-rhythmicity - Ability to initiate heartbeat (at a regular pace w/o external stimuli) 2.Excitability - Ability to respond to stimuli, generate and process AP 3.Conductivity - Ability to conduct&transmit impulse through cardiac tissue 4.Contractility - Ability to contract in response to stimulation
79
Briefly describe the structure of Cardiac muscle.
Striated type, branched muscle fibers (myofibrils) contains single nucleus, many mitochondria and T-tubules * Connected by intercalated disks Gap junctions- Depolarisation between cells Desmosomes- Hold fibers together during contraction
80
Describe excitation-contraction coupling in contractile myocytes:
1. AP from adjacent cell excites myocytes and trigger membrane depolarisation in T-tubules 2. Ca2+ enters the cells via voltage-gated channels and it enters the cells 3. Ca2+ binds to Ryanodine receptor (RYR) and induce Ca2+ release from Sarcoplasmic Etc 4. Ca2+ binds to troponin and triggers actino-myosin complex and contraction 5. Ca2+ unbind from troponin and pumped back into SR 6. Calcium unbinding cause relaxation and excess Ca2+ exchanged with Na+ 7. Na+ gradient is maintained by sodium- potassium- ATPase pump.
81
What is the definition of myogenic?
Originating in muscle tissue (rather than from nerve impulses).
82
What are the different Sinus Rhythms (ECG)?
P wave- Atrial contraction- a delay happens Q R S- Ventricular systole T- Ventricular relaxation/diastole
83
How long does a cardiac cycle last? What is a regular HR?
0.8 secs 70-100 BPM (75 BPM)
84
How do you calculate BPM?
60/ Cardiac cycle length
85
What is Sinus bradychardia?
HR <60BPM Patient is usually asymptomatic and no treatment required. Give advice re antihypertensives (beta-blockers or calcium channel blockers)
86
What is sinus tachycardia?
Rate is > 100bpm, but not usually > 130bpm at rest *Occurs normally in exercise / stress. *Patient is usually asymptomatic. *Hypovolaemia / underlying medical problems
87
What is Sinus Arrhythmia?
Regularly irregular sinus rhythm
88
What is Sinus Arrhythmia?
Regularly irregular sinus rhythm
89
What is blood pressure by definition?
* Pressure exerted on the walls blood vessel (largely referred to Arterial pressure) * Measured in mmHg * BP varies with age and pathological conditions Systolic BP: MAP during heart contraction Diastolic BP: MAP during heart relaxation
90
What is Autoregulation?
Changes in blood flow detected by the local receptors during micro perfusion
91
What are the terms for normal, high and low bp?
Normotension, Hypertension and Hypotension
92
If the bp drops below 120/80mmHg it is considered..?
Low bp or hypotension
93
What are baroreceptors? Where are they located?
Pressure receptors Carotid sinus and Aortic arch
94
What is autoregulation?
Changes in blood flow detected by the local receptors during micro perfusion.
95
What is neural regulation?
Short-term regulation of blood pressure, especially in responses to transient changes in arterial pressure, via baroreflex mechanisms
96
What is included in hormonal regulation?
* Renin-Angiotensin-Aldosterone * Anti-diuretic hormone (ADH; arginine vasopressin) * Atrial natriuretic hormone/peptide/factor * Erythropoietin * Adrenaline/Noradrenaline
97
What happens in neural regulation when the bp is high?
Baroreceptors fire signals to the CVC in the brain This enhances the vagal activity which suppresses the heart rate. The sympathetic cardiac activity decreases heart rate and decreases heart contraction Due to both of these, cardiac output decreases. Blood pressure falls and homeostasis restored. CVC- Sympathetic vasomotor activity= vasodilation
98
What happens in neural regulation when the bp is LOW? (hypotension)
The low arterial blood pressure is recognised by baroreceptors which slow down their firing rates to the cardiovascular centre CVC increase signals sent down sympathetic cardiac activity and vagal activity decreases. This increases heart contraction and also increases heart rate. This increases the cardiac output The CVC also cause sympathetic vasomotor activity causes vasoconstriction
99
What does Aldosterone do?
Sodium reabsorption Osmotic pressure Water reabsorption (water moves in direction of sodium) Intravascular volume Venous return Cardia output
100
What is Antidiuretic hormone (ADH or Vasopressin)? What is the function of ADH? ADH= dehydrated
- ADH is secreted by the cells in the hypothalamus, transported to the posterior pituitary and stored until nervous stimuli - ADH signals kidneys to reabsorb more water - Prevent the loss of fluids in the urine - Increase overall fluid levels - ADH constricts peripheral vessels - Restore blood volume and pressure
101
What is Hypovolemia? What does it trigger?
Increase in tissue fluid osmolarity (loss of blood volume) trigger ADH release
102
What is Atrial Natriuretic Hormone/peptide? [ANH] (opposite effect to ADH) Atrial- Atria Natri- Sodium
- Secreted by cells in the atria of the heart (B-type ANH by ventricle) - Natriuretic hormones are antagonists to angiotensin ll - Prevent aldosterone release - Promotes loss of sodium and water from the kidneys - Suppress renin, aldosterone and ADH production and release - Promotes LOSS OF FLUID from the body - Blood volume and blood pressure drop - Restore blood volume
103
How is Low blood pressure regulated by hormonal regulation?
Sensed by kidney. Renal hypoperfusion. Granular cells (juxtaglomerular) stimulate production of/ release of hormone Renin. Liver synthesises Angiotensinogen. Converted into Angiotensin l and ll by ACE Lungs- Angiotensin-converting enzyme (ACE) is created and secreted (Angiotensin ll is a vasoconstrictor which is what we need to inc bp it also stimulates aldosterone release from the adrenal cortex)
104
What is Angiotensin ll?
It is a peptide hormone and can act as a vasoconstrictor (constriction of vascular smooth muscle) causes arteries to constrict and inc blood pressure.Inc peripheral resistance. It stimulates Aldosterone release from adrenal cortex
105
What is Aldosterone?
The regulator of sodium and water homeostasis (in kidney) Inc sodium reabsorption
106
What is the RAAS?
Renin-Angiotensin-Aldosterone System
107
How is high bp regulated by hormonal regulation (RAAS)?
Kidney senses high bp Juxtaglomerular (Granular cells) stop Renin production So no Angiotensin l and ll created so vasodilation occurs and peripheral resistance is reduced No stimulus for adrenal cortex to stimulate aldosterone, so sodium is lost in urine and is excreted from kidney. No sodium reabsorption, Less osmotic pressure, less water reabsorption, intravascular volume decreases, venous return decreases and cardiac output decreases.
108
What is Starlings law?
Decreased venous return means decreased cardiac output.
109
What do catecholamines do? What are some examples?
Adrenaline and Noradrenaline Released by the adrenal medulla Enhance and extend the body’s sympathetic activity (“fight-or-flight” response) Increases Heart rate Force of contraction Vasoconstriction (non essential organs) Energy mobilisation to liver, muscle and heart
110
What are other endocrine hormones that modulate BP?
Noradrenaline, adrenaline Erythropoetin
111
What is erythropoietin?
Blood flow and/or oxygen levels decrease (hypoxia) EPO is released by the kidneys EPO stimulates the production of erythrocytes by erythropoiesis within the bone marrow Increases- blood viscosity, resistance and pressure Decreases blood flow
112
What is the cardiac output formula?
CO= SV x HR Stroke volume X Heart Rate
113
What is the blood pressure formula?
BP= CO x PR Blood pressure= Cardiac output x Peripheral resistance
114
What is Hypovolemia Causes of hypovolemia?
Low blood volume Haemorrhage Dehydration Diarrhoea Burns Diuretics
115
What are risks of high blood pressure? (8 conditions)
Heart disease Heart attacks Heart failure Peripheral arterial disease Strokes Aortic aneurysms Kidney disease Vascular dementia
116
What are diuretics?
Drugs that increase the excretion of urine.
117
What can lead to decreased cardiac output? (5)
Valves disease Ischemia Myopathy Pulmonary hypertension Pericardial disease
118
What can lead to decreased heart rate? (4)
Arrythmias Sinus bradycardia AV nodal block Ventricular fibrillation
119
What are the symptoms of hypotension?
*Light headedness or dizziness. *feeling sick. *blurred vision. *generally feeling weak. *confusion. *fainting.
120
What are the symptoms of hypertension? (8)
Severe headaches Nosebleed Fatigue or confusion Vision problems Chest pain DIB Irregular heartbeat Blood in the urine
121
What leads to an increase in Hypertension?
Sodium homeostasis: -Renal disease -Nephropathy -Reduced nephron number -GFR (these inc stroke volume) Hormonal imbalance: Renin Angiotensin II Aldosterone Erythropoietin Adrenaline/Noradrenaline (these all increase heart rate/bp) Systemic vasoconstriction: Stress Autonomic dysfunction (inc peripheral resistance) Structural dysfunctions: Obesity Endothelial dysfunction Altered cell membrane Venous constriction (inc peripheral resistance)
122
What's the difference between a thrombus and embolus? (thrombosis and embolism)
Thrombosis- Blood clotting (Thrombus) in arteries, veins or capillaries Embolus- Blood clot/endogenous materials (Embolus) moving in the blood vessel and obstructing blood flow
123
What type of regulation is the regulation of erythropoietin? When there is hypoxia, what does the kidney release? What causes hypoxia? (3) How is erythropoietin regulated? (2)
Hormonal (negative feedback axis) Erythropoietin Causes: haemorrhage or injury,iron deficiency, high altitude or lung disease (pneumonia) 1. EPO stimulates the red bone marrow to produce erythrocytes (vasoconstrictor) 2. Erythrocytes increase of trans;let tkt the kidney and block EPO release Inc: blood viscosity, resistance and pressure Dec: Blood flow (slows it down so blood has more time to take oxygen from lungs)