PCB3703 - Cardiovascular pt.2 - UCF Ahangari

What separates the L. and R. atria and the L. & R. ventricles?

A wall of muscle called the septum

Which chamber of the heart is the largest and strongest chamber in your heart that is only about 1/2 an inch thick, but has enough force to push blood through the aortic valve and into your body?

L. Ventricle

controls blood flow from the right ventricle into the pulmonary arteries, which carry blood to your lungs to pick up O2

A. tricuspid valve

B. pulmonary valve

C. mitral valve

D. aortic valve

B. pulmonary valve

opens the way for O2 rich blood to pass from the L. ventricle to the aorta, your body's largest artery, where it is delivered from the rest of your body.

A. tricuspid valve

B. pulmonary valve

C. mitral valve

D. aortic valve

D. aortic valve

lets O2 rich blood from your lungs pass from the L. atrium into the L. ventricle

A. tricuspid valve

B. pulmonary valve

C. mitral valve

D. aortic valve

C. mitral valve (AKA bicuspid)

regulates blood flow between the R. atrium & R. ventricle.

A. tricuspid valve

B. pulmonary valve

C. mitral valve

D. aortic valve

A. tricuspid valve

_________________ blood is in the R. atrium, what does that mean it has instead?

deoxygenated blood ; it has CO2

is blood in the pulmonary artery deoxygenated or oxygenated?

deoxygenated

is blood in the pulmonary vein deoxygenated or oxygenated?

oxygenated

is blood oxygenated or deoxygenated in the L. atrium?

oxygenated

is oxygenated or deoxygenated blood in the aorta?

oxygenated

The portion of the cardiovascular system which carries oxygenated blood away from the heart, to the body, and returns deoxygenated blood back to the heart.

a. Systemic Circulation

b. Pulmonary Circulation

a. Systemic Circulation

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connection between heart and entire body

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Oxygenated blood from the lungs leaves the left heart through the aorta, from where it is distributed to the body's organs and tissues, which absorb the oxygen, through a complex network of arteries, arterioles, and capillaries. The deoxygenated blood is then collected by venules, from where it flows first into veins, and then into the inferior and superior venae cavae, which return it to the right heart, completing the systemic cycle. The blood is then re-oxygenated through the pulmonary circulation before returning again to the systemic circulation.

The portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart.

a. Systemic Circulation

b. Pulmonary Circulation

b. Pulmonary Circulation

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Oxygen-depleted blood from the body leaves the right heart through the pulmonary arteries, which carry it to the lungs, where red blood cells release carbon dioxide and pick up oxygen during respiration. The oxygenated blood then leaves the lungs through the pulmonary veins, which return it to the left heart, completing the pulmonary cycle. The blood is then distributed to the body through the systemic circulation before returning again to the pulmonary circulation.

There is NO smooth muscle in capillaries, what do they have instead?

pores, which are where gas exchange, absorption, & secretion occur

Where do we have total peripheral resistance & why?

in artery & capillary because they have smaller diameters than the aorta, which projects blood into artery & capillary

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Pressure in aorta is much higher than venous pressure from left ventricle contraction to eject a large volume of blood. Aorta has 100 mmHg but with arteries, with smaller diameter, being 50% lower (50 mmHg). Arterioles and capillaries both have pressure dropping to 20 mmHg because it is smaller and has more interstitial area and has resistance. Total peripheral resistance (TPR) which would increase pressure in arteries and aorta.

Blood pressure = cardiac output x TPR

What is the pressure difference in the aorta, arteries, and arterioles/capillaries?

aorta - 100 mmHg

artery - 50 mmHg

arterioles/capillary - 20 mmHg

what is the formula for blood pressure?

cardiac output x total peripheral resistance

Are the walls thicker in veins or arteries? Why?

arteries

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Wall of aorta has smooth muscles under control autonomic nervous system. The pressure in the aorta comes from the left ventricle contraction about 100 mmHg. The wall of aorta and arteries are thicker than venous system because they have more elastic fibers.

arteries deliver ___________ blood to the tissues

oxygenated

T/F : Arteries are thick-walled, with extensive elastic tissue and smooth muscle. They are under high pressure.

true!

What is the blood volume contained in arteries called?

stressed volume

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Because the pressure is higher for arterial system (aorta and arteries), the name of blood is called stressed volume (because it's under high pressure). Arteries has 50 mmHg and arterioles and capillaries have 20 mmHg

What are the smallest branches of the arteries?

arterioles

Arterioles are the site of the highest _____________ in the cardiovascular system.

resistance

Arterioles have a smooth muscle wall that is extensively innervated by what?

ANS (autonomic nervous system)

Does alpha-1/beta-2 control vasoconstriction/vasodilation?

alpha-1 : vasoconstriction

beta-2 : vasodilation

Where is alpha-1 & beta-2 located?

Alpha1-Adrenergic receptors are found on the arterioles of the skin, splanchnic, and renal circulations.

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Beta2-Adrenergic receptors are found on arterioles of skeletal muscle.

Capillaries consist of a single layer of _________________________ surrounded by a ______________________.

Capillaries consist of a single layer of endothelial cells surrounded by basal lamina

T/F : Capilaries are thin-walled and are the site of exchange of nutrients, water, and gases.

true!

What is the pressure in veins?

4 mmHg

Veins have thinner walls and arteries, what does the mean in terms of blood capacity for veins?

the capacity of blood is higher in veins than arteries due to their thinner walls (thin walls --> more blood inside)

Venules are formed from merged ____________.

capillaries

Veins progressively merge to form _____________________.

larger veins

what is the largest vein and its function?

vena cava (SVC/IVC) returns blood to the heart

T/F : Veins are thin walled and under low pressure. The contain the highest proportion of blood in the cardiovascular system.

true!

What is the blood volume contained in veins called?

unstressed volume

Veins have __________________ receptiors.

veins have alpha-1 adrenergic receptors

Velocity is directly proportional to ____________________________ and inversely proportional to the ____________________________ at any level of the cardiovascular system.

Velocity is directly proportional to blood flow and inversely proportional to the cross-sectional area at any level of the cardiovascular system

-

For example, blood flow velocity is higher in the aorta than in the sum of all of the capillaries . The lower velocity of blood flow in the capillaries optimizes conditions for exchange of substances across the capillary wall

Blood flows from ________________ pressure to ___________ pressure.

high;low

What does blood flow depend on?

TPR & Cardiac output

What is blood flow inversely proportional to?

resistance of blood vessels

What is resistance directly proportional to? (2 things)

Resistance is directly proportional to the viscosity of the blood. For example, increasing viscosity by increasing hematocrit will increase resistance and decrease blood flow. ALSO! to length & diameter of vessel

T/F : there is resistance in capillaries and veins

FALSE! Veins DO NOT show resistance. Capillary & arteriole show resistance because they are smaller and have intersectional area

What is the distensibility of blood vessels?

capacitance (complience)

Capacitance (compliance is inversely related to _____________. The greater

the amount of elastic tissue in a blood vessel, the higher the elastance, and the lower the compliance

Capacitance (compliance is inversely related to elastance. The greater

the amount of elastic tissue in a blood vessel, the higher the elastance, and the lower the compliance

Capacitance (compliance) is directly proportional to ____________ and inversely proportional to ______________.

Capacitance (compliance) is directly proportional to volume and inversely proportional to pressure

What describes how volume changes in response to a change in pressure?

capacitance (compliance)

Is capacitance (compliance) greater in the arteries or veins?

much greater for veins than for arteries. As a result, more blood volume is contained in the veins (unstressed volume) than in the arteries (stressed volume).

What does changes in capacitance of veins produce?

Changes in the capacitance of the veins produce changes in unstressed volume. For example, a decrease in venous capacitance decreases unstressed volume increases stressed volume by shifting blood from the veins to the arteries.

How does capacitance of arteries change?

Capacitance of the arteries decreases with age, as a person ages, the arteries become stiffer and less distensible.

How does bloodflow change as blood flows through the systemic circulation?

As blood flows through the systemic circulation, pressure decreases progressively because of the resistance to blood flow.

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Thus, pressure is highest in the aorta and large arteries and lowest in the vena cavae.

Where does the largest decrease in pressure occur?

The largest decrease in pressure occurs across the arterioles because they are the site of highest resistance

Compare average pressure in the systemic circulation of the aorta, arterioles, capillaries, and vena cava.

AORTA : 100 mmHG

ARTERIOLES : 50 mmHg

CAPILLARIES : 20 mmHg

Vena Cava : 4 mmHg

What is BP? Is it constant or pulsatile?

Blood pressure (BP) is a force exerted by circulating blood on the walls of blood vessels.

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is not constant during a cardiac cycle. It is pulsatile.

-

REVIEW :

BP is the pressure is force of vessel walls. The pressure comes by ventricular contraction and relaxation. The formula for BP Is Cardiac Output x TPR. TPR is in the arterioles & capillary (NOT ARTERY). TPR is the total resistance which exists in capillary and arteriole because they are smaller in diameter, and have more intersectional area. For those reasons, they show resistance to blood flow. When resistance is high in capillary and arteriole, it builds up pressure in the aorta.

Describes sytsolic or diastolic :

the highest arterial pressure during a cardiac cycle. & is measured after the heart contracts and blood is ejected into the arterial system

systolic pressure

Describes systolic or diastolic :

the lowest arterial pressure during a cardiac cycle. & is measured when the heart relaxed and blood is returning to the heart via the veins

diastolic pressure

What is pulse pressure?

the difference between the systolic and diastolic pressures

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As blood is ejected from the left ventricle into the arterial system, systolic pressure increases because of the relatively low capacitance of the arteries. Because diastolic pressure remains unchanged during ventricular systole, the pulse pressure increases to the same extent as the systolic pressure. Decreases in capacitance, such those that occur with the aging process, cause

increases in pulse pressure

What is the most important determinant of pulse pressure?

stroke volume

How is mean arterial pressure calculated?

can be calculated approximately as diastolic pressure plus one-third of pulse pressure

T/F : Venous pressure is very low. The veins have a high capacitance and therefore, can hold large volumes of blood at low pressure.

TRUE

Atrial pressure is lower/higher than venous pressure

lower

How is left atrial pressure estimated?

Left atrial pressure is estimated by the pulmonary wedge pressure. A catheter, inserted into the smallest branches of the pulmonary artery, makes almost direct contact with the pulmonary capillaries. The measured pulmonary capillary pressure is approximately equal to the left atrial pressure

Any factor which leads to vasoconstriction or vaso-abstraction leads to ___________________.

hypertension

Hpertension can be ____________ or _______________. Which is of unknown etiology?

Primary or Secondary ; Primary's etiology is unknown

What environmental factors can lead to primary hypertension?

diet & lifestyle

People with stress can have a higher risk for primary HTN, why?

people with stress have high risks for hypertension. cortisol controls stress. when someone has stress, their cortisol levels increase. At the same time, their TPR increases, and increases systolic & diastolic pressure. Cortisol contorls TPR, systolic pressure, and diastolic pressure. That is why this patient may have risk for hypertension

Consuming a lot of salty food can increase the risk for primary HTN, why?

Salty foods increase blood pressure. The mechanism of this is : Na+ is important for depolarization phase of the target cell. Depolarization with Na+ opens the Ca2+ channels & Ca2+ enters into the cell. Ca2+ is important for any muscle contraction. There is smooth muscle in the blood vessel (tunica media).

renin-angiotensin-aldosterone is a hormone which increases ___________.

BP & blood Na+ (hypernatremia)

-

When we have low BP & low blood Na+, the renin-angiotensin-aldosterone increases BP & blood Na+.

Obesity, which is associated with endocrine hormone disorder like ____________________, has risk for hypertension

T2 diabetes mellitus

How does the sympathetic NS increase risk for primary hypertension

The stimulation of sympathetic nervous system is Alpha-1, which is involved in blood pressure. Overstimulation of the sympathetic nervous system means that overstimulation of a-1 receptor, which causes vasoconstriction of the blood vessels by NE.

Renin-angiotensin-aldosterone is a hormone that does what?

increases BP & blood Na+ (hypernatremia) when those levels are low

What are the natural vasodilators in our body?

prostoglandin & bradykinin

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deficiency of these leads to primary hypertension

T/F : Secondary HTN is caused by conditions that affect your kidneys, arteries, heart, or endocrine system. It can also occur during pregnancy.

TRUE

T/F : these are the hormones associated with secondary HTN :

* Cortisol

* NE

* Epinephrine

* PTH

* Aldosterone

* T3 & T4

* Calcitonin

* Prostaglandins

true

What is calcitonin & what does a deficiency cause?

calcitonin lowers blood Ca2+

-

A deficiency can cause secondary HTN

What are the 2 parts of the adrenal gland?

1. adrenal medulla

2. adrenal cortex

What hormones are associated with the adrenal cortex?

1. aldosterone

2. cortisol

3. androgen

(C.A.C.A)

What hormones are associated with the adrenal medulla?

1. adrenaline

2. noradrenaline

(M.A.N)

When is aldosterone secreted?

when BP is low

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Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

When BP & Na+ are low, ___________________ is secreted from the kidney, which converts _________________ into __________________.

When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1.

-

Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

______________________ from lung converts Ag1 to __________.

ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2

-

Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

Ag2 has 2 functions, what are they?

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex)

-

Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : _______, _______, ______, & ________.

Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

-

Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

H+ & K+ into urine leads to increased blood _____ & _____.

H+ & K+ into urine leads to increased blood Na+ & BP

-

Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

Oversecretion of aldosterone leads to _____________ & _____________.

Oversecretion of aldosterone leads to hypernatremia & HTN

-

Aldosterone is secreted when BP is low. When BP & Na+ are low, renin is secreted from the kidney, which converts angiotensinogen into angiotensin 1. ACE (angiotensin converting enzyme) from lung converts Ag1 to Ag2.

Ag2 has 2 functions (vasoconstriction; increase aldosterone secretion from cortex). Aldosterone gets carried to nephron of kidney. Then, the aldosterone binds to nephron's tubule, it leads to reabsorption of : Na+, K+, H20, Bicarb.

H+ & K+ into urine leads to increased blood Na+ & BP

Oversecretion of aldosterone leads to hypernatremia & HTN

Cortisol controls ___________, maintains blood _________, increases ___________, increases ___________, & increases ______________ pressure.

Cortisol controls stress, maintains blood glucose, increases apetite, increases TPR, & increases systolic/diastolic pressure.

A tumor of the adrenal gland can lead to secondary hypertension by oversecreting what 5 things?

1. Aldosterone

2. Cortisol

3. Adrenaline

4. Na+

5. Androgen

What is cushing syndrome a result of?

oversecretion of cortisol (& aldosterone)

What are the signs/symptoms of Cushing Syndrome?

1. moon face

2. hyperglycemia

3. obesity (Big belly/abdomen)

4. anxiety

5. affected immune system (cortison acts as an anti-inflammatory. oversecretion means it cannot control the inflammation)

What would the blood test of a patient look like with Cushing Syndrome?

INCREASED : cortisol, Na+, glucose, bicarb

DECREASED : K+ & H+

-

there would be increased glucose becasue hyperglycemia is a symptom of Cushing Syndrome!

What is another name for hyperaldosteronism?

Conn's Disease

What is hyperaldosteronism? What are the signs?

tumor in aldosterone-producing cells in adrenal cortex which leads to secondary hypertension

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has all common HTN signs

What would a blood test look like for a patient with hyperaldosteronism?

INCREASED :

Na+, Bicarb

DECREASED :

K+, H+

What is pheochromocytoma? What does it lead to an oversecretion of?

tumor of adrenal medulla

-

oversecretion of NA & adrenaline

Pheochromocytoma has the same common HTN sign except what 2 important things?

1. palpitation

2. excess sweating

T/F : there is no increase/decrease of Na+/K+ in pheochromocytoma. That means if there is an increase/decrease of Na+/K+, it would be a result of an aldosterone issue, Conn's Disease, or Cushing's Syndrome

true

Kidney disease can lead to secondary hypertension because it is important for ____________ . Urine is extra fluid buildup from kidney. Patients are at risk for hypertension if they have kidney cysts, kidney tumor, kidney infection, or T1/T2 diabetes.

filtration

What kind of drugs lead to increased systolic/diastolic pressure & increased arterial resistance.

corticosteroids (EX : prednisone)

____________ is a synthetic cortison used for dermatitis, whihc is a skin problem from autoimmune disease. This patient takes this medication their entire life. Taking this extra cortisol will increase BP. Cortisol increases TPR & BP.

prednisone

How do nonsteroidal anti-inflammatory drugs (motrin, aleve), weight loss drugs (meridia), and birth control pills lead to secondary hypertension? ALSO! salt water retention, sympathetic activity, and loss of renal vasodilation.

effect BV wall & increase BP

What is coarction of the aorta? Where will a pateint with this have hypertension specifically? What are they at risk for?

birth defect with narrowed aorta

-

hypertension in head & neck

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risk for rupture of BV (esp in cerebral arterial) & intracranial hemorrhage