Arterial Blood Pressure Overview

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Questions and Answers

Which of the following factors primarily determines systolic blood pressure?

  • Vessel radius
  • Blood viscosity
  • Total peripheral resistance
  • Cardiac output (correct)

What is the main function of the chemoreceptor reflex in blood pressure regulation?

  • To regulate blood viscosity
  • To inhibit vasomotor centers
  • To stimulate heart rate increase
  • To detect changes in blood gas levels (correct)

Which type of mechanism acts within seconds to regulate blood pressure?

  • Long-term mechanisms
  • Neural mechanisms
  • Very rapid mechanisms (correct)
  • Hormonal mechanisms

What happens to heart rate when blood pressure is elevated due to the baroreceptor reflex?

<p>It decreases (B)</p> Signup and view all the answers

Which of the following is NOT a long-term mechanism of blood pressure regulation?

<p>Baroreceptor reflex (C)</p> Signup and view all the answers

In response to a sudden drop in blood pressure, which of the following responses is initiated by baroreceptors?

<p>Increased heart rate (C)</p> Signup and view all the answers

Which component of total peripheral resistance is most affected by changes in vessel radius?

<p>Arteriolar contraction (D)</p> Signup and view all the answers

The aortic sinus and carotid sinus contain which of the following receptors that help regulate blood pressure?

<p>Baroreceptors (D)</p> Signup and view all the answers

What primarily determines systolic blood pressure?

<p>The elasticity of the blood vessel (A), The pumping of blood by the heart (D)</p> Signup and view all the answers

What does diastolic blood pressure depend on?

<p>The peripheral resistance (D)</p> Signup and view all the answers

How is pulse pressure calculated?

<p>Systolic pressure - Diastolic pressure (C)</p> Signup and view all the answers

What factors contribute to mean systemic arterial pressure (MSAP)?

<p>Diastolic pressure and pulse pressure (C)</p> Signup and view all the answers

Which physiological change is expected to affect blood pressure after menopause?

<p>Blood pressure generally increases (C)</p> Signup and view all the answers

How does exercise generally affect blood pressure?

<p>Elevates both systolic and diastolic pressure (C)</p> Signup and view all the answers

What is the likely impact of gravity on mean blood pressure?

<p>Decreases blood pressure by 0.77 mmHg for every cm above heart level (D)</p> Signup and view all the answers

What happens to systolic blood pressure during the inspiration phase of respiration?

<p>It decreases by approximately 10 mmHg (D)</p> Signup and view all the answers

What is the primary function of peripheral chemoreceptors in regulating blood pressure?

<p>To monitor changes in blood gas levels (A)</p> Signup and view all the answers

Which of the following factors stimulates peripheral chemoreceptors?

<p>Increase in H+ (Low pH) (A)</p> Signup and view all the answers

What immediate physiological response occurs due to stimulation of the central nervous system by low blood pressure?

<p>Increased sympathetic discharge (D)</p> Signup and view all the answers

What role does Renin-Angiotensin II play in blood pressure regulation?

<p>It increases blood pressure via vasoconstriction (D)</p> Signup and view all the answers

How does ADH affect blood pressure during hypotension?

<p>Stimulates water retention to increase blood volume (A)</p> Signup and view all the answers

What is the result of capillary fluid shift during hypotension?

<p>Increased plasma volume (C)</p> Signup and view all the answers

Which mechanism is considered less rapid in regulating blood pressure?

<p>Hormonal vasoconstriction (B)</p> Signup and view all the answers

What effect do catecholamines have during episodes of hypotension?

<p>Promote vasoconstriction and increase cardiac output (C)</p> Signup and view all the answers

What is the normal range for systolic blood pressure?

<p>Lower than 120 mmHg (C)</p> Signup and view all the answers

What primarily affects diastolic blood pressure?

<p>Peripheral resistance (B)</p> Signup and view all the answers

How is pulse pressure calculated?

<p>Systolic pressure minus diastolic pressure (D)</p> Signup and view all the answers

What is the mean systemic arterial pressure (MSAP) formula?

<p>Diastolic pressure plus 1/3 pulse pressure (D)</p> Signup and view all the answers

What physiological factor decreases diastolic blood pressure during hard exercise?

<p>Vasodilation in active muscles (D)</p> Signup and view all the answers

At what age do females tend to have a higher blood pressure compared to males?

<p>After menopause (C)</p> Signup and view all the answers

How much does blood pressure change for every cm above or below the heart level?

<p>+0.77 mmHg (D)</p> Signup and view all the answers

What occurs during inspiration that affects blood pressure?

<p>Reduction of approximately 10 mmHg (D)</p> Signup and view all the answers

Which of the following is NOT a component influencing systolic blood pressure?

<p>Peripheral resistance (D)</p> Signup and view all the answers

What additional factor is considered when calculating mean arterial pressure?

<p>1/3 of the pulse pressure (B)</p> Signup and view all the answers

Which condition stimulates peripheral chemoreceptors to increase sympathetic discharge?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary effect of the CNS ischemic response when blood pressure decreases?

<p>Increase in sympathetic discharge to blood vessels (D)</p> Signup and view all the answers

What triggers the release of vasopressin during hypotension?

<p>Stress and low blood pressure (A)</p> Signup and view all the answers

How does catecholamines affect cardiac output during hypotension?

<p>They lead to vasoconstriction and increase cardiac output (B)</p> Signup and view all the answers

What role does angiotensin II play in the regulation of blood pressure?

<p>It acts as a potent vasoconstrictor (A)</p> Signup and view all the answers

What is an immediate consequence of low blood pressure on the central nervous system?

<p>Enhanced vasoconstriction responses (C)</p> Signup and view all the answers

How does capillary fluid shift contribute to blood pressure regulation during hypotension?

<p>It increases blood volume and arterial blood pressure (C)</p> Signup and view all the answers

Which mechanism is classified as a less rapid means of regulating blood pressure?

<p>Hormonal responses (B)</p> Signup and view all the answers

What immediate physiological response is observed when blood pressure decreases?

<p>Vasoconstriction occurs to increase blood pressure (C)</p> Signup and view all the answers

What effect does hypotension have on fluid movement within the body?

<p>Increased movement of fluids from tissues to the blood vessels (A)</p> Signup and view all the answers

What happens to the heart's stroke volume when a person stands up suddenly?

<p>It decreases due to reduced venous return. (C)</p> Signup and view all the answers

Which centers of the CNS are inhibited by the baroreceptors reflex when blood pressure is elevated?

<p>Cardio-stimulatory center and vasomotor center. (A)</p> Signup and view all the answers

Which physiological changes occur in response to high blood pressure according to the baroreceptors reflex?

<p>Decreased heart rate and vasodilation. (C)</p> Signup and view all the answers

What role does total peripheral resistance play in blood pressure regulation?

<p>It affects diastolic more than systolic blood pressure. (D)</p> Signup and view all the answers

Which mechanism enhances blood pressure over a longer time frame?

<p>Hormonal mechanisms. (D)</p> Signup and view all the answers

In response to low blood pressure, what is expected to occur?

<p>Decreased vasodilation and increased heart rate. (C)</p> Signup and view all the answers

What physiological sensor is primarily responsible for detecting changes in arterial blood pressure?

<p>Baroreceptors. (D)</p> Signup and view all the answers

What effect does increased blood viscosity have on diastolic blood pressure?

<p>It increases diastolic blood pressure. (D)</p> Signup and view all the answers

What type of receptors are primarily involved in the baroreceptor reflex?

<p>Stretch receptors located in the carotid sinus and aortic sinus. (D)</p> Signup and view all the answers

Which neurotransmitter is most likely involved in increasing heart rate during low blood pressure conditions?

<p>Epinephrine. (C)</p> Signup and view all the answers

Flashcards

Systolic Blood Pressure

The maximum pressure in blood vessels during the heart's contraction (systole).

Diastolic Blood Pressure

The minimum pressure in blood vessels during the heart's relaxation (diastole).

Pulse Pressure

The difference between systolic and diastolic blood pressure.

Mean Arterial Pressure (MAP)

The average pressure in the arteries during a cardiac cycle.

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Normal Systolic Pressure

Below 120 mmHg (up to 90 mmHg).

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Normal Diastolic Pressure

Below 80 mmHg (up to 60 mmHg).

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Arterial Blood Pressure

The force exerted by blood against the walls of arteries.

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Blood Pressure Units

Measured in mmHg (millimeters of mercury).

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Factors Affecting Blood Pressure

Variables like age, sex, gravity, exercise, and respiration influence blood pressure.

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Pulsus Paradoxus

A decrease in systolic blood pressure during inhalation, typically greater than 10 mmHg.

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Peripheral Chemoreceptors

Sensory receptors located in the carotid and aortic bodies that detect changes in blood gases and pH.

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Stimuli for Chemoreceptors

Decreased oxygen (PaO2), increased carbon dioxide (PaCO2), and increased hydrogen ions (low pH) stimulate peripheral chemoreceptors.

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Chemoreceptor Reflex

A reflex response to changes in blood chemistry that adjusts autonomic output to the heart and blood vessels to maintain blood pressure.

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CNS Ischemic Response

A reflex triggered by reduced blood flow to the brain, causing vasoconstriction and increased blood pressure.

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Vasoconstriction

The narrowing of blood vessels to manage blood pressure.

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ADH (Vasopressin)

A peptide hormone that causes vasoconstriction to increase blood pressure during hypotension.

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Catecholamines

Norepinephrine and epinephrine, hormones stimulating vasoconstriction and increasing heart rate, thus increasing blood pressure.

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Renin-Angiotensin II System

A complex cascade involving renin, angiotensin I, angiotensin II, triggering vasoconstriction and increasing blood pressure.

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Capillary Fluid Shift

Movement of fluids between blood vessels and tissues during hypotension to maintain blood volume and pressure.

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Postprandial hypotension

A temporary drop in blood pressure after eating, often due to blood diverting to the gastrointestinal tract (GIT).

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Factors determining arterial blood pressure (ABP)

Cardiac output (COP) and total peripheral resistance (PR) determine ABP. COP is heart rate multiplied by stroke volume. PR is dictated by blood vessel radius and viscosity.

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Cardiac output (COP)

The amount of blood pumped by the heart per minute. Determined by Heart Rate and Stroke Volume.

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Total peripheral resistance (PR)

The resistance to blood flow in the circulatory system. Determined by blood vessel diameter and blood thickness.

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Baroreceptors reflex

An autonomic reflex response to changes in blood pressure, mediated by stretch receptors in blood vessels. Maintains stable blood pressure by adjusting heart rate and vessel tone.

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Baroreceptors location

Stretch receptors in the carotid sinus and aortic arch.

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Baroreceptor reflex effect (high BP)

Decreased heart rate, decreased stroke volume and vasodilation in response to high blood pressure.

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Baroreceptor reflex effect (low BP)

Increased heart rate, increased stroke volume and vasoconstriction in response to low blood pressure.

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Neural Mechanisms of BP regulation

Fastest mechanisms for adjusting blood pressure, acting within seconds, primarily through the nervous system.

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Hormonal Mechanisms of BP regulation

Mechanisms adjusting blood pressure relatively quickly, within minutes, primarily through hormones.

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Long Term Mechanisms of BP regulation

Mechanisms that adjust blood pressure over hours to days, primarily by affecting blood volume.

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Systolic BP

Highest blood pressure during heart contraction (systole).

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Diastolic BP

Lowest blood pressure during heart relaxation (diastole).

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Pulse Pressure

Difference between systolic and diastolic BP.

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Mean Arterial Pressure

Average blood pressure during a cardiac cycle.

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Normal Systolic BP

Below 120 mmHg (up to 90 mmHg)

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Normal Diastolic BP

Below 80 mmHg (up to 60 mmHg)

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Arterial Blood Pressure

The force blood exerts on artery walls.

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Blood Pressure Units

Measured in mmHg (millimeters of mercury).

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Factors affecting Blood Pressure

Age, sex, gravity, exercise, and respiration influence arterial blood pressure.

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Pulsus Paradoxus

Drop in systolic pressure during breathing.

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Mean Systemic Arterial BP

Average pressure driving blood to tissues.

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Peripheral Chemoreceptors

Sensory receptors in the carotid and aortic bodies that detect changes in blood gases (O2 & CO2) and pH.

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Chemoreceptor Reflex

A reflex response to changes in blood chemistry; it adjusts heart and blood vessel activity to maintain blood pressure.

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CNS Ischemic Response

A reflex triggered by reduced blood flow to the brain; it leads to vasoconstriction and increased blood pressure.

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Vasoconstriction

Narrowing of blood vessels, which increases blood pressure.

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ADH (Vasopressin)

A hormone that causes vasoconstriction to increase blood pressure, particularly during low blood pressure situations.

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Catecholamines

Hormones (norepinephrine and epinephrine) that cause vasoconstriction and increase heart rate, boosting blood pressure.

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Renin-Angiotensin II System

A cascade of reactions involving renin and angiotensin, leading to vasoconstriction and elevated blood pressure; it's often triggered by low blood sodium or low renal blood flow.

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Capillary Fluid Shift

Fluid movement between blood vessels and tissues to adjust blood volume and blood pressure, particularly during low blood pressure.

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Postprandial hypotension

A temporary drop in blood pressure after eating, often due to blood shifting to the gastrointestinal tract (GIT).

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Factors determining arterial blood pressure

Cardiac output (COP) and total peripheral resistance (PR) determine arterial blood pressure. COP is the product of heart rate and stroke volume. PR is determined by blood vessel radius and blood viscosity.

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Cardiac Output (COP)

The amount of blood pumped by the heart per minute.

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Total Peripheral Resistance (PR)

The resistance to blood flow in the circulatory system.

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Baroreceptors reflex

An autonomic reflex response to changes in blood pressure, mediated by stretch receptors in blood vessels, quickly adjusting heart rate and vessel tone to maintain stable blood pressure.

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Baroreceptors location

Located in the carotid sinus and aortic arch.

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Baroreceptor reflex effect (high BP)

Decreased heart rate, decreased stroke volume, and vasodilation in response to high blood pressure.

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Baroreceptor reflex effect (low BP)

Increased heart rate, increased stroke volume, and vasoconstriction in response to low blood pressure.

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Neural Mechanisms of BP regulation

The fastest mechanisms for adjusting blood pressure, acting within seconds, controlled primarily by the nervous system.

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Hormonal Mechanisms of BP regulation

Mechanisms adjusting blood pressure relatively quickly (within minutes), primarily controlled by hormones.

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Study Notes

Arterial Blood Pressure

  • Arterial blood pressure is the force exerted by blood on the walls of blood vessels.
  • A sphygmomanometer is a device used to measure blood pressure.
  • Systolic blood pressure is the maximum pressure during the contraction (systole) phase of the heartbeat.
  • Diastolic blood pressure is the minimum pressure during the relaxation (diastole) phase of the heartbeat.
  • Pulse pressure is the difference between systolic and diastolic pressures.
  • Mean arterial pressure (MAP) is the average pressure in the arteries over the cardiac cycle.
  • Normal systolic blood pressure is less than 120 mm Hg.
  • Normal diastolic blood pressure is less than 80 mm Hg.

Objectives

  • Students will be able to evaluate rapid and less rapid mechanisms involved in regulating blood pressure, including neural and hormonal mechanisms.

Blood Pressure Categories (American Heart Association)

  • Normal: Systolic < 120 and Diastolic < 80 mm Hg
  • Elevated: Systolic 120-129 and Diastolic < 80 mm Hg
  • High Blood Pressure (Hypertension) Stage 1: Systolic 130-139 or Diastolic 80-89 mm Hg
  • High Blood Pressure (Hypertension) Stage 2: Systolic 140 or higher or Diastolic 90 or higher mm Hg
  • Hypertensive Crisis: Systolic > 180 and/or Diastolic > 120 mm Hg (consult your doctor immediately)

Physiological Variations of Arterial Blood Pressure

  • Age: Normal blood pressure values change with age, increasing gradually. See the provided table.
  • Sex: Before menopause, females tend to have lower blood pressure than males. Post-menopause, blood pressure in females often goes up.

Effects of Gravity, Exercise, and Respiration

  • Gravity: Blood pressure changes by approximately 0.77 mmHg for every centimeter above or below the heart level.
  • Exercise: Generally increases both systolic and diastolic blood pressure. Hard isotonic exercise tends to decrease diastolic blood pressure.
  • Respiration: Inspiration (inhaling) reduces blood pressure about 10 mm Hg. Expiration (exhaling) reverses the change. Pulsus paradoxus is a reduction in systolic blood pressure over 10 mm Hg during inspiration.

Effect of Meals

  • Blood flow to the gastrointestinal tract (GIT) increases after eating, which can lead to a temporary drop in blood pressure in some individuals.

Factors Determining Arterial Blood Pressure

  • Blood pressure (BP) is determined by cardiac output (COP) and total peripheral resistance (PR). (F=AP/R). The equation is Mean SAP=COP X PR
  • COP depends on heart rate and stroke volume.
  • PR depends on radius of blood vessels and blood viscosity.

Mechanisms of Blood Pressure Regulation

  • Very rapid mechanisms: Act within seconds (neural). Examples are baroreceptors reflex, chemoreceptors reflex, and CNS ischemic response.
  • Less rapid mechanisms: Act within minutes (hormonal). Examples are hormonal vasoconstriction (ADH, catecholamines, renin-angiotensin II), and capillary fluid shift.
  • Long term mechanisms: Act within hours or days (mostly hormonal).  Examples are long-term effects that can influence blood volume, and therefore blood pressure.

Baroreceptor Reflex

  • Receptors: Stretch receptors located in the carotid sinus and aortic arch. These receptors detect changes in blood pressure.
  • Afferents: Impulses travel via the glossopharyngeal and vagus nerves to the medulla.
  • Centers: The vasomotor center (VMC), cardio-stimulatory center (CC), and cardio-inhibitory center (CIC) in the medulla.
  • Efferents & Effectors: The sympathetic nervous system and parasympathetic nervous system regulate heart rate and blood vessel diameter to adjust blood pressure.

Chemoreceptor Reflex

  • Location: Peripheral chemoreceptors are located in the carotid and aortic bodies.
  • Stimuli: Stimulated by a decrease in arterial oxygen, an increase in arterial carbon dioxide, or a decrease in blood pH.
  • Effect: Increase sympathetic outflow to increase blood pressure.

CNS Ischemic Response

  • Stimulus: A decrease in blood pressure reduces blood flow to the brain, leading to CO2 accumulation.
  • Effect: The vasomotor center (VMC) is sensitive to CO2 and increases sympathetic discharge, causing vasoconstriction and an increase in blood pressure.

Hormones Affecting Blood Pressure (Less Rapid Mechanisms)

  • ADH (Vasopressin): A peptide hormone that causes vasoconstriction, helping to raise blood pressure in response to hypotension or stress.
  • Catecholamines (epinephrine and norepinephrine): Released from the sympathetic neurons and adrenal medulla. They cause vasoconstriction and increase cardiac output.
  • Renin-angiotensin II: A system activated by hypotension, renal ischemia, or sympathetic stimulation. Renin activates a cascade that ultimately leads to vasoconstriction to increase blood pressure.

Capillary Fluid Shift (Less Rapid Mechanism)

  • Hypotension causes fluid to shift from the tissue spaces into the intravascular compartment (blood vessels).
  • This increases blood volume, which in turn increases COP (capillary osmotic pressure), and raises blood pressure.

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