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Ch. 12 D&E
| Question | Answer |
|---|---|
| MAP =...F =..>... | CO x TPR...delta P/R > CO = MAP / TPR > MAP = CO x TPR |
| if you change the CO or TPR you... | change MAP |
| changing the CO can happen through | ^ HR, ^ EDV (venous return), ^ Ejection fraction (all three of these ^ CO and MAP), ^ afterload (decrease CO and MAP) |
| changing the TPR (tpr stands for..?) happens through | dilating arterioles (decrease resistance to decrease map) or constric arterioles (^ resistance and ^ MAP) |
| systemic MAP...but... | > pulmonary MAP...systemic CO = pulmonary CO (must pump equal volumes) |
| systemic TPR | > pulmonary TPR (pulmonary arterioles have less resistance) |
| CO and TPR are | directly related to MAP |
| regulation of MAP primarly through | arterial baroreceptors |
| arterial baroreceptors are located in the | aortic arch (immediate measurement of pressure) and carotid sinuses (enough pressure to get blood to the brain) |
| action of baroreceptors | ^ MAP > ^ barorecedptor firing, ^ pulse pressure > ^ baroreceptor firing |
| other baroreceptors are located in the | heart, pulmonary vessels and large systemic veins |
| what recieves signals from baroreceptors? and what is its function? | medulla...basic body functions |
| arterial baroreceptor reflex performs | short-term regulation (lie down and then stand up = dizzy = receptors don't receive pressure drop right away) |
| arterial baroreceptor reflex: ^ baroreceptor firing > | decreases symp output> ^ parasymp |
| arterial baroreceptor reflex: decrease baroreceptor firing > | ^ symp output > decrease parasymp |
| effects of hemorrhage in arterial baroreceptor reflex | the problem is that the hemorhhage means you lose blood which decreases pressure (look at fig) and the solution is to increase symp and dec. parasymp |
| the baroreceptor reflex can be considered | neg feedback |
| blood volume is | directly related blood pressure |
| blood vol. - blood pressure relationship is a...and it performs... | neg feedback system...long term regulation (modify plasma or blood volume) |
| blood vol - blood pressure: ^ vol > | ^ pressure > dec volume through regulation in the kidney |
| regulation in the kidney means you either | do salt/water retention (^ vol and pressure) or salt/water excretion (dec vol and pressure) |
| other reflexes and responses to regulate MAP include | arterial O2 & CO2 concentrations, blood flow to the brain, body position and mood |
| arterial O2 and CO2 concentrations are monitored through...and the predicted effects if dec O2 and ^ CO2? | systemic arterial blood...symp works faster > ^ MAP |
| blood flow to the brain: predicted effects if dec flow to brain | symp takes over to ^ pressure |
| body position: predicted effects if ^ effects of gravity | dec pressure initially, then ^ it |
| mood: predicted effects w/ symp activation? parasymp? | excitation, fear, stress or relaxed |
| hypotension is | low blood pressure related to body size/cardio fitness/ genetics (no set #s) |
| hypotension can be caused by | hemorrhage, excess salt/water loss, weakened heart, anaphylactic shock, vasovagal syncope |
| hemorrhage immediate effects include | dec SV, dec CO(due to dec SV), dec MAP(due to dec SV and measured directly through baroreceptors) |
| hemorrhages trigger the | baroreceptor reflex (dec firing > ^ symp stimulation) |
| baroreceptor reflex causes | ^ SV (bec ^ contractility), ^ HR (sa can get to threshod faster), ^CO, ^ TPR(vasoconstriction), ^ MAP |
| additional compensation for hemorrhage include | autotransfusion and kidney function |
| autotransfusion increases | interstitial fluid return to blood stream > ^ blood volume |
| kidney function is a ...that involves... | longer term fix to keep plasma volume high...angiotensin II(salt/water retention) and vasopressin (water retention) |
| blood cell replacement also helps during...through... | hemorrhage...erythropoiesis and the production of erythropoietin |
| excess salt and water loss (cause of hypotension) involves...like through.. | fluid loss...sweating, burns, GI tract disorders |
| weakened heart can't | develop contractilitiy and pressure |
| anaphylactic shock involves | allergies and IgE which activates basophils and ^ histamine so there is a whole body inflammatory response |
| vasovagal snycope is a...resulting in... | strong emotion...fainting (dec BP) |
| shock is... | another cause of hypotension that is the inability to get blood to organs > organ damage > could lead to problems in other systems |
| shock decreases | blood flow and resulting damage to organs |
| 3 types of shock | hypovolemic (dec blood fluid vol), low-resistance shock (dec TPR - anaphylactic shock) and cardiogenic shock (innefective heart/dec cardiac function) |
| hypertension is | high blood pressure |
| what defines pre hypertension and hypertension | 120/80-129/89...140/90+ |
| problems associated with hypertension | left ventricle hypertrophy, atherosclerosis, heart attack, cerebral hemorrhage and stroke, kidney disease |
| left ventricle hypertrophy means that...and there is ^ | the muscle enlarges but the tissue is non-productive...afterload > ^ workload of left vent |
| atherosclerosis means | the laying down of fatty plaque (directly related to hypertension) |
| heart attack means | heart needs to work harder - can you provide enough O2 to the heart |
| cerebral hemorrhage and stroke | ^ pressure in vessels > ^ chance of rupturing vessels and clot in the brain |
| primary hypertension is also called...and the cause is... | idiopathic...unknown (inherent to the person) |
| treatment for primary hypertension | (same as if you do know the cause), dec NA intake to reduce plasma vol |
| another treatment for primary hyper. is to take | diuretics which ^ excretion of water in the kidney |
| treatment for primary hypertension also includes...which... | calcium channels blockers (reduce ability of arterioles to vasoconstrict)...dec Ca2 influx to smooth muscles of vessels |
| the calcium channel blockers may be linked to | increased risk of heart attacks |
| last treatment for primary hypertension is | beta-adrenergic receptor blockers that respond to symp system and they dec effect of NE on heart > dec CO |
| renal hypertension is when there is a problem with | kidney, secretes too much renin and angiotensin II |
| excess renin and angiotensin II > | vasoconstriction > effects TPR > effects CO |
| treatment for renal hypertension include | ACE inhibitors: angiotensin-converting enzyme inhibitor |
| congestive heart failure is | inadequate cardiac ouput |
| congestive heart failure can either be | diastolic dysfuncion or systolic |
| diastolic dysfunction is a problem | filling the heart |
| diastolic dysfunction decreases | ventricular compliance > dec vent filling > dec EDV |
| diastolic dysfunction is often associated with | hypertension and leads to ventricular hypertrophy |
| diastolic dysfunction: ventricular hypertrophy changes | characteristics of the myocardium (the tissue is not effective at contracting) |
| systolic dysfunction is a problem...and it dec... | contracting...contractility > dec SV |
| systolic dysfunction results in | ventricular damage but no hypertrophy |
| serious consequences of diastolic and systolic dysfunction | hypertension and progressive heart failure and edema |
| hypertension and progressive heart failure result from a dec | response of the baroreceptors (sensory receptor adaptation) > ^ symp system activity > 4 different things |
| dec response of baroreceptors > ^ symp system activity >... | ^ vasoconstriction > ^ blood pressure |
| dec response of baroreceptors > ^ symp system activity which ^... | angiotensin II and vasopressin > ^ vasoconstriction and blood pressure |
| dec response of the baroreceptor also leads to... | ^ fluid retention > ^ blood plasma volume > ^ blood pressure |
| lastly, dec reponse of the baroreceptors > ^ symp system activity > | ^ blood plasma vol > ^ EDV > ^ frank-starling mechanism > initially ^ then dec heart contractility |
| edema -esp...- is a problem with | pulmonary edema...left ventricle |
| edema increases | salt and water retention in the kidney > ^ blood volume and pressure > ^ bulk flow loss to interstitial fluids (tissues) |
| edema is failure of the | left ventricle > dec output of left ventricle > ^pressure in pulmonary vessels > ^ bulk flow loss in lungs |
| edema means there is a possibility that | there is uneven CO between left and right ventricles (blood stays in the pulmonary tissues which accumulates in the lungs - causes pneumonia) |
| treatment for congestive heart failure includ3 | diuretics, cardiac ionotropic drugs (digitalis), vasodilator drugs and beta-adrenergic receptor blockers |
| diuretics get rid of...by | pressure...dec afterload and edema |
| cardiac ionotropic drugs, also called...increase | digitalis...cytostolic ca concentraction to ^ contractility |
| cardiac ionotropic drugs only | treat the symptoms |
| vasodilator drugs dec | afterload and TPR |
| vasodilator drugs include | ACE inhibitors or inhibit symp system input |
| ACE inhibitors keep | angiotensin out so there is less vasoconstriction and retention in the kidneys) |
| beta-adrenergic receptor blockers may block | excessive release of ca in the heart which could cause myocardial cell death |
| coronary artery disease is | ischemia (low blood flow) in the heart |
| symptoms of coronary artery disease include | angina (chest pain from little oxygen supply) |
| cause of coronary artery disease include | atherosclerosis |
| atherosclerosis involves | fatty streak deposits (cholesterol in coronary arteries), collection of macrophages (clean up fatty streaks), thickening of the artery wall with smooth muscle and CT (stop inflammatory response of macrophages) counterintuitive |
| effects of coronary artery dieases | reduced blood flow (ischemia), excess production of endothelial vasoconstrictors, may cause coronary thrombus |
| reduced blood flow(ischemia) increases | resistance to flow |
| coronary artery disease may cause coronary thrombus which is the | total occlusion of vessel > heart attack |
| risk factors associated with coronary artery disease and heart attack | high cholesterol, high levels of amino acid homocysteine, obesity, sedentary lifestyle, smoking, menopause for women |
| high cholesterol involves... | high level of LDL ( < 100) and low level of HDL (> 60) and ratio |
| LDL gets...and HDL facilitates.. | cholesterol into blood...cholesterol out of blood |
| high levels of amino acid homocysteine damages the | endothelium of blood vessels - inappropriate inflammatory response |
| obesity and a sedentary lifestyle involves what risks | heart health, blood pressure, diabetes and cholesterol |
| smoking increases...bec of | BP...heart health, blood pressure, toxins(impact endothelial cells) |
| menopause for women is a risk factor for coronary artery disease and heart attack bec | reduced blood hormones |
| treatment for coronary artery disease and heart attacks include | dieting, drugs, vitamins, control obesity, have an active lifestyle and stop smoking |
| diets control | cholesterol (lower level of LDL and raise level of HDL - weight control |
| drugs (cholesterol) - ...reduce the ability of the... | statins...liver to produce cholesterol |
| drugs (cholesterol) - ...prevent.... | bile acid sequesterants...bile from aiding in fat digestion and absorption |
| vitamins include | folate (folic acid, B vitamin) that reduce levels of the amino acid homocysteine and also vintamin E which is an antioxidant |
| drugs that treat coronary artery disease and heart attacks include | vasodilators, beta blockers, clot disrupting drugs |
| vasodilators would be things like...and are used when... | nitroglycerin...blood flow is the issue |
| beta blockers block... | beta-adrenergic receptors (symp system) |
| beta blockers dec | blood pressure and cardiac output |
| clot disrupting drugs are things like | aspirin (cox inhibitors that block platelet thromboxane formation) and tPA - tissue plasminogen activator (plasmin breaks down fibrin) |
| angioplasticity is the insertion of a | balloon in the artery to relieve coronary artery disease |
| coronary stents are | sleeves that keep the artery open |
| the last form of treatment for the coronary artery disease is to perform | coronary bypass |
| heart attacks are caused by | total occlusion (coronary arterial disease - can progress from this) and can be caused from an embolism |
| symptoms of heart attack include | pain (jaw, neck, back, shoulders, right arm), weakness, shortness of breath, vomitting and sweating |
| during a heart attack there is increased...from... | plasma concentration of myocardial creatine kinse and troponin...damaged cells |
| another symptom of heart attack is | ventricular fibrillation |
| treatment for heart attack include | CPR & defibrillation to restore regular heartbeat and also clot busting drugs like tPA |
| changes in blood flow and distribution during exercise goes from...and the major changes include | 5 L/min resting > 35 L/m max...skeletal muscle (73%), skin 11 %, heart 4 % |
| changes in cardiovascular functions during exercise | increase symp activity |
| increases in cardiovascular functions include | ^ HR & SV > ^ CO, ^ SV & ejection speed > ^ pulse pressure |
| decreases in cardiovascular functions include | ^ vasodilation > dec TPR > more blood flow to muscles |
| increases and decreases in cardiovascular functions happen as a result of | symp activity |
| body wide mechanisms during exercise include | arterial baroreceptors and medullary cardiovascular center |
| arterial baroreceptors reset | homeostatic set point |
| medullary cardiovascular center monitors...and keeps... | body activity...set point high |
| during exercise your...is at maximal consumption | o2...(vo2 max) |
| factors determing VO2 max | co = hr x sv (bec blood has to get to cells - how well the heart can circulate blood) |
| avg resting CO = | 72 bpm x 0.07 L/beat = 5.0 L/min |
| the trained athlete has a more | effecient heart beat (dec HR resting, ^ SV) |
| the trained athlete has increases in | blood vol, vessels to skeletal muscle, musculature of ventricles(productive), EDV(^return and stretch) and ejection fraction |
| endurance in the trained athelete has an increase in | efficiency of muscle metabolism because they can utilize o2 better, ^ mitochondria, ^ capillaries for more access to o2 and removal of waste products, ^ ability to deliver o2 |
Created by:
handrzej
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