P1 Spring Organs 2011-02-03 (Blood Pressure Regulation)

Front 1

Equation for blood pressure?

Back 1

BP = TPR * CO

Front 2

What can SNS so compared to PSNS?

Back 2

SNS:
-constrict arterioles (↑TPR)
-constrict veins
-↑heartrate
-↑heart contractility
PSNS:
-↓heartrate

Front 3

What are the steps during reflex bradycardia?

Back 3

When BP↑ :
1. Baroreceptors fire↑
2. Vasomotor center ↑PSNS and ↓SNS
3. ↓CO and ↓TPR
4. ↓BP (due to #3)

Front 4

What causes vasovagal syncope?

Back 4

Cortex tells hypothalamus tells medula (and VMC) to:
↑PSNS and ↓SNS
which ↓CO and ↓TPR
and ↓BP
which ↓cerebral blood flow, resulting in unconciousness

Front 5

Purpose of baroreceptors?

Back 5

To stabilize blood pressure

Front 6

What is orthostatic hypotension?

Back 6

-When your baroreceptors + vasomotor center (vmc) are unable to stabilize your blood pressure during changes in body posture (like getting up quickly).

Front 7

What shifts the renal function curve to the right?

Back 7

-Kidney problems, or things that cause kidney problems (like diabetes)
-Angiotensin 2 or anything that operates on the kidneys to cause fluid and Na+ retention, to increase blood pressure.

Front 8

What does excess salt intake cause?

Back 8

-↑thirst
-↑ADH
Both of which inc blood volume and blood pressure.

Front 9

Determinants of long term blood pressure?

Back 9

1. Salt intake
2. Renal function curve

Front 10

List the steps in the creation of angiotensin 2.

Back 10

1. Liver makes angiotensinogen
2. Angiotensinogen converted to angiotensin 1 by renin, which is produced by the kidneys
3. The lungs produce ACE, which converts angio 1 to angio 2.

Front 11

List things that cause the release of renin from the kidneys.

Back 11

1. Low blood pressure
2. Low blood volume
3. Blood/fluid loss

Front 12

List 5 things that angiotensin 2 does.

Back 12

1. Constricts arterioles (↑TPR)
2. ↑sympathetic activity
3. Stimulates release of ADH from the pituitary gland.
4. Stimulates the release of aldosterone from the adrenal cortex.
5. Stimulates the kidneys to retain Na+ and water.
NOTE: all of these inc blood pressure.

Front 13

List things that shift the renal function curve to the right.

Back 13

1. Angiotensin 2 (Na+/water ret. and VC)
2. ↑SNS (Na+/water ret. and VC)
3. Aldosterone (Na+/water ret.)
4. Endothelin (VC)

Front 14

List things that shift the renal function curve to the left.

Back 14

1. Atrial natriuretic peptide (Na+/water excretion)
2. Dopamine (Na+/water excretion and VD)
3. Nitric oxide (VD)
4. Bradykinin (VD)

Front 15

List things that hypertension can cause.

Back 15

1. Heart failure (eg de/compensated)
2. Stroke
3. Kidney failure

Front 16

List the types and subtypes of hypertension.

Back 16

1. Primary/essential HT (95%)
2. Secondary HT (5%)
a. Preeclampsia
b. Primary aldosteronism
c. Pheochromocytoma
d. Renal HT

Front 17

What is pheochromocytoma?

Back 17

A tumor of the adrenal medulla.
Causes ↑NOR/EPI which ↑BP

Front 18

What is primary aldosteronism?

Back 18

When the adrenal cortex secretes too much aldosterone.
Causes too much Na+/water retention which ↑BP

Front 19

What is preeclampsia?

Back 19

During pregnancy, the placenta releases toxin that damages endothelial cells that preduce nitric oxide.
↓NO causes ↑BP

Front 20

What is renal HT?

Back 20

When the artery to the kidney is blocked, the kidney senses low BP and retains more Na+/water.
↑BP

Front 21

List the risk factors for primary HT.

Back 21

-Excessive salt intake (↑BP)
-Obesity (↑BP)
-Stress (↑SNS, which ↑BP)

Front 22

What characterizes well established HT?

Back 22

1. Normal CO
2. Normal Na+/water excretion
3. Sustained/high TPR
4. High BP
BP = CO * TPR

Front 23

List treatment for HT.

Back 23

-Diuretics (lowers blood vol)
-SNS inhibitors (lowers TPR, and renin production)
-VDs
-ACE inhibitors

Front 24

List vasoconstrictors that influence TPR.

Back 24

1. Angiotensin 2
2. Endothelin
3. Vasopression (ADH)
4. NOR/EPI (me)