Looks like no one added any tags here yet for you.
What are examples of vasodilator metabolites?
CO2, K+, adenosine
What is the role of vasodilator metabolites?
ensure increased blood flow necessary to support increased tissue activity
What hormone causes platelet aggregation and vasoconstriction?
Thromboxane A2
What hormone promotes vasodilation?
prostacyclin
What promotes irreversible inhibition of cyclooxygenase?
ASA
Why is ASA valuable in preventing MIs, angina, and strokes?
reduces intravascular clotting for prolonged periods
What catalyzes the synthesis of NO from arginine?
nitric oxide synthase (NOS)
Where is NOS1 found?
nervous system
Where is NOS2 found?
macrophages and related immune cells
Where is NO3 found?
endothelial cells
What activates NOS2?
cytokines
What activates NOS1 and NOS3?
agents that increase intracellular Ca2+
*includes vasodilators acetylcholine an bradykinin
What hormones are the principal vasoconstrictors?
NE, epi
What hormones are the principal vasodilators?
VIP, Kinins, Natriuretic peptides
NO stemming from NOS3 produces cGMP which in turn does what?
mediates relaxation of vascular smooth muscle
If NO doesn’t relieve pain is it likely to be a cardiac issue?
no
What neurotransmitter is a regulator of blood flow, keeps the vascular system dilated, and is responsible for reactive hyperemia?
NO
What is the most potent vasoconstrictor agent?
endothelin-1 (ET-1)
What produces ET-1?
endothelial cells
What contributes to extracellular matrix remodeling in vascular, cardia, and kidney disease?
ET-1
What kinins are potent vasodilators?
bradykinin and lysyl-bradykinin
How do kinins increased blood flow?
producing vasodilation
Which hormone is secreted from the atria when atrial myocytes are stretched?
ANP
Which hormone is secreted by the ventricular myocytes and is a marker of HF?
BNP
Which type of hormone is an additional form of natriuretic peptide found in humans?
CNP
In a healthy person, what should the BNP level be at rest?
<100
Where is renin secreted from?
kidneys
Where is vasopressin secreted from?
hypothalamus
How does vasopressin increase BP?
reabsorbs more water → inc BV
What effects to noradrenergic vasomotor nerves have?
arteriolar constriction → inc BP
inhibits vagal stimulation → dec HR and dec CO
What effects do sympathetic noradregergic nerves have?
inc force and rate of contractility
inc BP, inc SV, inc CO
Where are baroreceptors controlling vasomotor discharge located?
carotid sinuses and aortic arch on arterial side
wall of great veins and cardiac atria on venous side
What accelerates atherosclerosis?
genetic and environmental factors
What vascular disease is characterized by localized fibrous thickenings of the arterial walls with calcified plaques?
atherosclerosis
How do fatty streaks form?
LDL oxidized → recognized by scavenger receptors → receptors uptake into macrophages → foam cells → fatty streaks
What cells form fatty streak in arteries?
foam cells
When do fatty streaks appear in the aorta?
1st decade of life
When do fatty streaks appear in the coronary arteries?
2nd decade of life
What do fatty streaks appear in the cerebral arteries?
3rd and 4th decade of life
What are the deleterious effects of oxidized LDLs?
inhibition of NO production
release of pro inflammatory cytokines
What forms as plaques mature?
fibrous caps
*need to keep stable
What happens if you infuse acetylcholine via catheter into normal coronary arteries?
vessels dilate
What happens if you infuse acetylcholine via catheter into arteries with atherosclerosis?
vessels constrict
What are dietary cholesterol and triglycerides packed into?
chylomicrons
What causes chylomicrons to release triglycerides?
lipoprotein lipase
What do VLDLs turn into after donating triglycerides?
IDLs and LDLs
Where do HDLs transport cholesterol to?
liver
What is the ideal range for HDL?
>40
*higher = better
Atherosclerosis causes angina pectoris when it narrow the lumen of a coronary artery by ____
>75%
What happens if there is an arterial blockage at the site of atherosclerotic plaques within the cerebral circulation?
thrombotic strokes
What can lead to the rupture of the abdominal aorta?
aneurysmal dilation
What does atherosclerotic plaque cause when lodged in the renal vessels?
renovascular hypertension
What is it called when there are blockages in the legs causing fatigue and pain when walking?
intermittent claudication
What reduces a women’s risk of developing atherosclerosis by increasing cholesterol removal?
estrogen
When increased in plasma levels, what is associated with accelerated atherosclerosis?
homocysteine
How much does smoking increase the chances of men developing ischemic heart disease compared to nonsmokers?
70%
How can the atherosclerotic process be reversed?
lower cholesterol and TRG; increase HDL
What has the greatest effect in reducing the incidence of stroke?
lowering hypertension
What diseases increase chances of developing atherosclerosis?
DM, hypothyroidism, nephrotic syndrome
What is the cause of essential (primary) HTN?
unknown
What is the cause of secondary HTN?
renal HTN, Cushing’s, pheochromocytoma, estrogen
What causes pill HTN?
OC
At what point is BP officially classified as hypertension?
>140/90
Symptoms of HTN?
usually none (silent killer)
What leads to the development of HTN?
inc PVR
prolonged inc in CO
inc BV
inc plasma renin activity
If left untreated, HTN can decrease life expectancy by how much?
10-20 yrs
Complications of HTN
MI, CHF, stroke, HTN encephalopathy, renal failure
How do you manage HTN?
B-blockers, ACE inhibitors, Ca channel blocker, diuretics
Causes of HTN:
coarctation of the aorta, salt sensitivity, renal abnormalities, renin-angiotensin abnormalities, adrenal disorders, obesity
What percentage of AA are salt sensitive and have essential hypertension?
55%
Pheochromocytoma is a tumor located where?
adrenal medulla
What disease is characterized by excess glucocorticoid?
Cushing’s
What disease is caused by a tumor in the adrenal cortex causing a large secretion of aldosterone?
Conn’s disease (hyperaldosteronism)
What are the 4 groups of shock?
hypovolemic, distributive, cardiogenic, obstructive
What causes the skin to be cool, pale, and clammy during shock?
vasoconstriction
At what pressure do carotid and aortic baroreceptors susceptible to fail?
~70 mmHg
Baroreceptors increase levels of what vasopressor hormones?
AT II, epi, NE, vasopressin
What is the reason behind hypovolemic shock?
inadequate volume to fill vascular system
What are some causes of hypovolemic shock?
hemorrhage, trauma, surgery, burns, fluid loss
In shock, the skin is cold, pale, and clammy expect for?
distributive shock
What are the three types of distributive shock?
anaphylactic, neurogenic, septic
What causes the skin to be warm in distributive shock?
vasodilation
What type of shock is caused by large amounts of histamine causing vasodilation and low BP?
distributive: anaphylactic
What type of shock is seen in head/spine injuries and is marked by a sudden loss of autonomic activity leading to vasodilation, pooling of blood in veins, and syncope?
distributive: neurogenic
What form of shock is the most common form of death in ICU’s?
distributive: septic
What type of shock results from inadequate pumping of the heart to meet resting metabolic demands?
cardiogenic
What additional symptoms are present in Cardiogenic shock?
congestion of lungs and viscera
What is the usual cause of cardiogenic shock?
LV infarct
DVTs increase risk for ___
pulmonary emboli
What are the two causes of obstructive shock?
pulm/vascular and mechanical
What causes mechanical obstructive shock?
filling (preload) problem
tension pneumothorax, pericardial tamponade, constrictive pericarditis, restrictive cardiomyopathy
What causes pulmonary/vascular obstructive shock?
right sided failure from a massive PE or pulmonary HTN
What vasoactive mediators are released in pulm/vascular obstructive shock?
serotonin and thromboxane → vasoconstriction
What is a stationary clot formed within a vessel or chamber of the heart?
thrombus
What vessels are the most commonly involved with a thrombus?
coronary arteries, cerebral arteries, mesenteric arteries, renal arteries
Thrombosis risk factors:
immobilization, metabolic syndrome, advanced age, tobacco use, previous thrombosis, cancer
What are the three factors of Virchow’s triad for a DVT?
venous stasis, vessel wall injury & inflammation, hypercoagulability
What are the possible outcomes for a thrombus?
lysis, propagation, organization, canalization, embolization
Symptoms of a DVT
unilateral swelling, heat and tenderness, ± Homan’s sign (squeeze calf for pain)
What causes PAD?
atherosclerosis