Physiology Chapter: Nervous & Cardiac Systems

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Questions and Answers

What defines isolated systolic hypertension (ISH)?

  • SBP > 140 mm Hg and DBP < 100 mm Hg
  • SBP < 140 mm Hg and DBP < 90 mm Hg
  • SBP > 140 mm Hg and DBP < 90 mm Hg (correct)
  • SBP > 120 mm Hg and DBP < 80 mm Hg

Which statement best describes the role of pulse pressure in cardiovascular health?

  • Pulse pressure is only influenced by diastolic blood pressure.
  • Pulse pressure is irrelevant to cardiovascular morbidity.
  • Higher pulse pressures correlate with increased risk of arterial wall stiffness. (correct)
  • Higher pulse pressures are linked to improved cardiovascular function.

Which systems are included in the peripheral nervous system (PNS)?

  • Only the sensory nerves connected to the brain
  • Exclusively the autonomic nervous system paralleled with the CNS
  • Nerves that extend from the CNS to limbs and organs (correct)
  • The brain and spinal cord exclusively

What is the primary function of the afferent nervous system?

<p>To relay nerve signals from the PNS to the CNS (B)</p> Signup and view all the answers

Which portion of the nervous system is primarily responsible for controlling heart rate?

<p>Autonomic nervous system (C)</p> Signup and view all the answers

What does the efferent nervous system encompass?

<p>Both autonomic and somatic motor functions (B)</p> Signup and view all the answers

Which statement is incorrect regarding the somatic nervous system?

<p>It is responsible for reflexes independent of conscious control. (D)</p> Signup and view all the answers

During increased physical activity, what occurs immediately through the autonomic nervous system?

<p>Increase in heart rate and oxygen delivery to muscles (C)</p> Signup and view all the answers

What is the first step in the synthesis of catecholamines?

<p>Importing of tyrosine from extracellular fluid (D)</p> Signup and view all the answers

In which type of neurons does catecholamine biosynthesis terminate with the production of dopamine?

<p>Dopaminergic neurons (B)</p> Signup and view all the answers

Which enzyme directly facilitates the conversion of norepinephrine to epinephrine?

<p>DA-β-hydroxylase (B)</p> Signup and view all the answers

What is a significant feature of catecholamine biosynthesis in relation to drug design?

<p>It has multiple enzymes that can be drug targets. (B)</p> Signup and view all the answers

Which of the following is a precursor molecule in the synthesis of catecholamines?

<p>Tyrosine (A)</p> Signup and view all the answers

What is the main neurotransmitter produced in sympathetic postganglionic neurons?

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

What further modification occurs to norepinephrine in the adrenal medulla?

<p>It is converted to epinephrine. (D)</p> Signup and view all the answers

Which of the following enzymes is involved in the inactivation of norepinephrine?

<p>Both B and C (A)</p> Signup and view all the answers

What primarily contributes to the alteration of blood pressure in short-term neural controls?

<p>Altering peripheral resistance and cardiac output (B)</p> Signup and view all the answers

Which mechanism is responsible for detecting an increase in blood pressure via baroreceptors?

<p>Vasodilation and decreased peripheral resistance (B)</p> Signup and view all the answers

How do chemoreceptors contribute to blood pressure regulation?

<p>By monitoring oxygen content and blood pH (A)</p> Signup and view all the answers

What initiates the vasomotor center to trigger vasoconstriction during blood pressure reduction?

<p>Signal from baroreceptors (D)</p> Signup and view all the answers

Which type of control is responsible for long-term blood pressure regulation?

<p>Renal mechanisms affecting blood volume (B)</p> Signup and view all the answers

In the case of exercise, how does blood distribution change?

<p>Less blood is delivered to the gastrointestinal tract (A)</p> Signup and view all the answers

What type of feedback mechanism is primarily involved in the baroreceptor response?

<p>Negative feedback to stabilize blood pressure (C)</p> Signup and view all the answers

What role do higher brain centers play in blood pressure regulation?

<p>Supply inputs that influence sympathetic nervous activity (A)</p> Signup and view all the answers

What type of nerve fibers are responsible for transmitting signals in the autonomic nervous system?

<p>Preganglionic and postganglionic fibers (C)</p> Signup and view all the answers

What structure acts as clusters of cell bodies where preganglionic and postganglionic fibers connect?

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

How are neurotransmitters released when a nerve signal terminates at the postganglionic nerve fibers?

<p>Through receptor activation (A)</p> Signup and view all the answers

Which division of the autonomic nervous system is primarily responsible for increasing heart rate in response to stress?

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

What is the main function of the neurotransmitters released at the organ being innervated?

<p>To transfer nerve signals (B)</p> Signup and view all the answers

During the autonomic nervous system signal propagation, what manner do nerve signals travel through the fibers?

<p>Via action potential propagation (D)</p> Signup and view all the answers

Which of the following is NOT a role of the autonomic nervous system?

<p>Controlling voluntary muscle movements (A)</p> Signup and view all the answers

How do neurotransmitters from a postganglionic nerve fiber reach distant sites?

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

Which factor is primarily responsible for the vasoconstriction of smooth muscle in the vasculature?

<p>Excess stimulation of the RAAS (D)</p> Signup and view all the answers

What effect does stimulation of the b1-receptors have on the heart?

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

The dysfunction of baroreceptors can lead to which of the following outcomes?

<p>Decreased blood pressure regulation (D)</p> Signup and view all the answers

Which neurological area is NOT associated with increasing blood pressure when stimulated?

<p>Vagal nuclei (A)</p> Signup and view all the answers

How does hyperinsulinemia contribute to increased blood pressure?

<p>By increasing renal sodium retention (C)</p> Signup and view all the answers

What is the likely physiological consequence of excess norepinephrine release from presynaptic neurons?

<p>Increased cardiac output (A)</p> Signup and view all the answers

Which of the following statements regarding a2-receptors is accurate?

<p>They block norepinephrine release. (C)</p> Signup and view all the answers

Genetic alterations of cell membranes can affect which aspect of blood pressure regulation?

<p>Alter adrenergic receptor responsiveness (A)</p> Signup and view all the answers

What are the bulbous swellings along the nerve terminal that contain neurotransmitter vesicles called?

<p>Varicosities (A)</p> Signup and view all the answers

Which of the following features contributes to the synchronization of smooth muscle contractions?

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

What is the main structural component of a thin filament in smooth muscle contraction?

<p>Polymers of actin molecules (A)</p> Signup and view all the answers

Which site on the myosin head is crucial for ATP splitting during smooth muscle contraction?

<p>Myosin ATPase site (B)</p> Signup and view all the answers

What allows smooth muscle to maintain contraction with low energy costs?

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

What primarily influences smooth muscle activity, apart from autonomic neurotransmitters?

<p>Calcium channel permeability (C)</p> Signup and view all the answers

How does a smooth muscle contraction occur in relation to filament movement?

<p>Thin filaments slide inward over thick filaments (A)</p> Signup and view all the answers

What is a key characteristic of smooth muscle contraction compared to skeletal muscle contraction?

<p>It can maintain tension for longer durations (D)</p> Signup and view all the answers

What causes an increase in cardiac output?

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

Which of the following is a direct influencer of cardiac output?

<p>Stroke volume and heart rate (D)</p> Signup and view all the answers

Which two factors primarily influence mean arterial pressure (MAP)?

<p>Cardiac output and total peripheral resistance (B)</p> Signup and view all the answers

Through which valve does blood flow from the right atrium into the right ventricle?

<p>Tricuspid valve (B)</p> Signup and view all the answers

Which chamber of the heart is responsible for receiving oxygenated blood from the lungs?

<p>Left atrium (C)</p> Signup and view all the answers

During ventricular systole, what happens to the semilunar valves?

<p>Open to allow blood ejection into the aorta and pulmonary artery (D)</p> Signup and view all the answers

How does afterload influence stroke volume?

<p>Increasing the force required to eject blood (C)</p> Signup and view all the answers

What primarily determines total peripheral resistance (TPR)?

<p>Vessel radius and blood viscosity (C)</p> Signup and view all the answers

Vasodilation of arterioles causes which of the following effects?

<p>Decreased TPR and reduced MAP (B)</p> Signup and view all the answers

How does sympathetic stimulation affect blood pressure?

<p>Increases heart rate and vasoconstriction (A)</p> Signup and view all the answers

Which description best explains primary hypertension?

<p>Persistent activation of the RAAS and sympathetic nervous system (B)</p> Signup and view all the answers

What is the primary way that pulse pressure is defined?

<p>The difference between systolic and diastolic pressure (D)</p> Signup and view all the answers

What effect does an increase in cardiac output have on mean arterial pressure (MAP) when TPR is constant?

<p>MAP increases proportionally (C)</p> Signup and view all the answers

Which enzyme is responsible for synthesizing nitric oxide in endothelial cells?

<p>Nitric oxide synthase (B)</p> Signup and view all the answers

How does endothelial dysfunction contribute to hypertension?

<p>Promoting vasoconstriction and inflammation (D)</p> Signup and view all the answers

Which effect characterizes angiotensin II's role in blood pressure regulation?

<p>Promotes vasoconstriction and stimulating aldosterone release (B)</p> Signup and view all the answers

What is a key characteristic of primary hypertension development?

<p>Increased sympathetic output and overactivation of the RAAS (C)</p> Signup and view all the answers

Activation of alpha-1 adrenergic receptors leads to which response?

<p>Vasoconstriction and increased TPR (D)</p> Signup and view all the answers

What role does aldosterone play in hypertension?

<p>Increasing sodium retention and blood volume (D)</p> Signup and view all the answers

Which response describes the relationship between mean arterial pressure (MAP), cardiac output (CO), and total peripheral resistance (TPR)?

<p>MAP = CO x TPR (B)</p> Signup and view all the answers

Which factor is primarily associated with genetic contributors to hypertension?

<p>Sodium retention and increased blood pressure (C)</p> Signup and view all the answers

What is the primary neurotransmitter of the parasympathetic nervous system and its action on receptors?

<p>Acetylcholine acting on muscarinic receptors (B)</p> Signup and view all the answers

Which mechanism describes the effect of increased preload on stroke volume in the heart?

<p>It enhances stroke volume via the Frank-Starling mechanism. (A)</p> Signup and view all the answers

Which of the following accurately describes afterload and its impact on cardiac function?

<p>Increased afterload reduces stroke volume by raising end-systolic volume. (D)</p> Signup and view all the answers

How does the role of calcium in smooth muscle contraction primarily impact the process?

<p>Calcium interacts with calmodulin to activate myosin light chain kinase. (A)</p> Signup and view all the answers

Which neurotransmitters are involved in adrenergic transmission?

<p>Norepinephrine and epinephrine (A)</p> Signup and view all the answers

What is the physiological significance of the Frank-Starling Law?

<p>It indicates that higher venous return directly correlates to increased stroke volume. (D)</p> Signup and view all the answers

What factors primarily influence resistance to blood flow in the circulatory system?

<p>Vessel length, vessel diameter, and blood viscosity (A)</p> Signup and view all the answers

What role does the sympathetic nervous system play in physiological responses?

<p>Stimulates the 'fight or flight' response by increasing heart rate and contractility (C)</p> Signup and view all the answers

How does vessel diameter affect resistance in the circulatory system?

<p>Resistance is inversely proportional to the fourth power of the radius. (D)</p> Signup and view all the answers

What is the primary function of baroreceptors?

<p>Detect changes in blood pressure. (B)</p> Signup and view all the answers

Which factor primarily contributes to the renin release in the kidneys?

<p>Decreased renal perfusion or sodium levels. (A)</p> Signup and view all the answers

What role does nitric oxide (NO) play in the regulation of vascular tone?

<p>It activates guanylate cyclase, promoting vasodilation. (A)</p> Signup and view all the answers

What effect does preload have on stroke volume according to the Frank-Starling mechanism?

<p>Increases stroke volume through myocardial contractility enhancement. (B)</p> Signup and view all the answers

Which condition is characterized by persistent blood pressure of 140/90 mmHg or higher?

<p>Primary hypertension (A)</p> Signup and view all the answers

Which mechanism primarily influences total peripheral resistance (TPR)?

<p>Diameter of arterioles (D)</p> Signup and view all the answers

Which effect does angiotensin II have on the cardiovascular system?

<p>Induces vasoconstriction and stimulates aldosterone release. (D)</p> Signup and view all the answers

How does endothelial dysfunction affect hypertension?

<p>Leads to increased vascular resistance. (C)</p> Signup and view all the answers

What is the consequence of increased sympathetic nervous system overactivity?

<p>Vasoconstriction and increased cardiac output. (C)</p> Signup and view all the answers

Which receptor is primarily responsible for inducing vasodilation in skeletal muscle?

<p>Beta-2 adrenergic receptor (B)</p> Signup and view all the answers

What does increased pulse pressure indicate regarding cardiovascular health?

<p>Increased arterial stiffness. (B)</p> Signup and view all the answers

What role does aldosterone play in blood pressure regulation?

<p>It stimulates water retention leading to increased blood volume. (D)</p> Signup and view all the answers

In the context of cardiac output, what components must be considered?

<p>Heart rate and stroke volume. (D)</p> Signup and view all the answers

Which of the following mechanisms is primarily responsible for the regulation of blood pressure over the long term?

<p>Renin-Angiotensin-Aldosterone System (RAAS). (A)</p> Signup and view all the answers

What neurotransmitter primarily mediates the actions of the sympathetic nervous system?

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

How does increased preload affect stroke volume?

<p>It enhances stroke volume through the Frank-Starling mechanism. (C)</p> Signup and view all the answers

Which of the following best describes afterload?

<p>The resistance the heart must overcome to eject blood. (D)</p> Signup and view all the answers

What is the role of calcium in smooth muscle contraction?

<p>Calcium binds to calmodulin, activating MLCK to promote contraction. (D)</p> Signup and view all the answers

Which receptors are primarily involved in the vasoconstriction of non-essential tissues during sympathetic activation?

<p>Alpha-1 receptors (B)</p> Signup and view all the answers

How is the force of contraction related to cardiac muscle fiber length according to the Frank-Starling Law?

<p>It is directly proportional to fiber length up to a limit. (B)</p> Signup and view all the answers

Which factor is NOT a part of adrenergic transmission?

<p>Acetylcholine (A)</p> Signup and view all the answers

What effect does an increase in vessel length have on blood flow resistance?

<p>It increases resistance to blood flow. (B)</p> Signup and view all the answers

What is the primary action of alpha-2 adrenergic receptors in the presynaptic terminals?

<p>Inhibiting the release of norepinephrine (B)</p> Signup and view all the answers

Which of the following best describes the effect of beta-1 adrenergic receptors on the kidneys?

<p>Stimulation of renin release (C)</p> Signup and view all the answers

What is a consequence of unmanaged hypertension affecting the brain?

<p>Stroke and cognitive decline (A)</p> Signup and view all the answers

Beta-2 adrenergic receptors primarily induce which type of physiological change?

<p>Vasodilation in specific vascular beds (D)</p> Signup and view all the answers

Which condition is likely to result from prolonged stimulation of beta-1 adrenergic receptors?

<p>Heart failure and hypertrophy (A)</p> Signup and view all the answers

Which statement accurately describes the mechanism of alpha-2 receptors compared to alpha-1 receptors?

<p>Alpha-2 receptors inhibit norepinephrine release. (D)</p> Signup and view all the answers

How do alpha-2 adrenergic receptors influence overall sympathetic activity?

<p>They act as an autoregulatory feedback mechanism. (D)</p> Signup and view all the answers

What is the interaction between beta-1 adrenergic receptors and the cardiac output?

<p>They increase cardiac output by stimulating heart contractility. (D)</p> Signup and view all the answers

What effect does increased sympathetic output have on blood pressure?

<p>It increases heart rate and contractility. (C)</p> Signup and view all the answers

How does an increase in blood viscosity affect vascular resistance?

<p>It increases resistance. (B)</p> Signup and view all the answers

In the context of RAAS, what triggers the release of renin?

<p>Decreased renal perfusion. (B)</p> Signup and view all the answers

What is the role of endothelial cells in regulating vascular tone?

<p>They release both vasodilators and vasoconstrictors. (D)</p> Signup and view all the answers

What defines the concept of Total Peripheral Resistance (TPR)?

<p>The combined resistance across the entire systemic circulation. (C)</p> Signup and view all the answers

Which mechanism does nitric oxide utilize to induce vasodilation?

<p>Activates guanylate cyclase. (D)</p> Signup and view all the answers

What primary component influences stroke volume according to the cardiac output equation?

<p>Preload, afterload, and contractility. (B)</p> Signup and view all the answers

What does persistent hypertension indicate about underlying mechanisms?

<p>There is typically a combination of genetic and environmental factors. (B)</p> Signup and view all the answers

What happens during the isovolumetric contraction phase of the cardiac cycle?

<p>Valves are closed, and ventricles contract without changing volume. (B)</p> Signup and view all the answers

What effect does vasoconstriction have on total peripheral resistance?

<p>It increases TPR. (A)</p> Signup and view all the answers

How does increased vascular tone relate to adrenergic receptor activity?

<p>It increases with alpha-1 receptor stimulation. (D)</p> Signup and view all the answers

What is the primary influence on mean arterial pressure (MAP)?

<p>It is influenced by both cardiac output and total peripheral resistance. (C)</p> Signup and view all the answers

What defines the role of baroreceptors in blood pressure regulation?

<p>They modulate sympathetic and parasympathetic responses based on blood pressure levels. (C)</p> Signup and view all the answers

Flashcards

Isolated Systolic Hypertension (ISH)

High systolic blood pressure (SBP) but normal diastolic blood pressure (DBP).

Pulse Pressure

Difference between systolic and diastolic blood pressure.

Central Nervous System (CNS)

Brain and spinal cord.

Peripheral Nervous System (PNS)

Nerves that connect to limbs and organs.

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Afferent Nervous System

Carries signals to the CNS.

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Efferent Nervous System

Carries signals from the CNS.

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Autonomic Nervous System

Controls involuntary functions (e.g., heart rate).

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Somatic Nervous System

Controls voluntary movements (e.g., walking).

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Preganglionic fibers

Nerve fibers in the autonomic nervous system that connect to postganglionic fibers at ganglia.

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Postganglionic fibers

Nerve fibers in the autonomic nervous system that connect to organs or glands.

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Ganglia

Clusters of cell bodies where preganglionic and postganglionic fibers connect.

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Neurotransmitters

Chemical messengers that transmit nerve signals across synapses.

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Autonomic nervous system

Part of the nervous system controlling involuntary functions like heart rate.

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Parasympathetic division

One of the two divisions of the autonomic nervous system, often associated with rest and digest functions

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Sympathetic division

The other division of the autonomic nervous system, often associated with fight-or-flight responses.

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Efferent autonomic nervous system

Carries signals from the central nervous system to organs, such as heart.

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Catecholamine Synthesis

The process of creating catecholamines (like dopamine and norepinephrine) within neurons.

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Tyrosine

The amino acid that is the precursor for catecholamine synthesis.

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Dopamine (DA)

A catecholamine produced in dopaminergic neurons, often in the brain.

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Norepinephrine (NE)

A catecholamine produced in many sympathetic neurons.

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Epinephrine

A catecholamine derived from norepinephrine in some cases.

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Biosynthesis Pathways

The complex series of chemical reactions to synthesize catecholamines.

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Vesicle Fused With Presynaptic Membrane

The process of neurotransmitter vesicles merging with the exterior membrane of the neuron.

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Catecholamine Inactivation

The process of destroying or removing catecholamines from the synapse.

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Blood Pressure Regulation

Mechanisms that maintain stable blood pressure despite changes in variables.

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Short-Term Blood Pressure Control

Mechanisms that rapidly adjust blood pressure, primarily by altering peripheral resistance and cardiac output.

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Neural Blood Vessel Control (vasomotor center)

Cluster of neurons in medulla controlling blood vessel diameter via vasoconstriction/vasodilation.

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Baroreceptors

Neural receptors in aortic arch and major arteries sensitive to blood pressure changes.

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Long-Term Blood Pressure Control

Mechanisms that adjust blood volume (and thus blood pressure) over time.

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Peripheral Resistance

Opposition to blood flow in the blood vessels.

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Vasoconstriction

Narrowing of blood vessels.

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Cardiac Output

Amount of blood pumped by the heart per minute.

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Varicosities

Bulbous swellings along nerve fibres, containing neurotransmitter vesicles, innervating smooth muscle.

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Smooth Muscle Contraction

Slow, synchronized contractions of sheets of smooth muscle cells connected by gap junctions.

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Sliding Filament Mechanism

Mechanism of smooth muscle contraction, where thin filaments slide over thick filaments.

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Thin Filament

Made of actin polymers, crucial in smooth muscle contraction

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Thick Filament

Composed of myosin molecules, lying lengthwise and having cross-bridges.

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Cross-Bridges

Myosin heads with actin-binding and ATPase sites, crucial for muscle contraction.

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Smooth Muscle Contraction Cycle

Takes longer (10-30 times) than skeletal muscle contraction and can maintain tension without fatigue.

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Calcium Channels

Crucial for smooth muscle contraction; their permeability increases by various means.They are in plasma membranes and sarcoplasmic reticulum

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Autonomic Dysfunction

Problems with the part of the nervous system that controls involuntary functions, potentially leading to high blood pressure.

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Adrenergic Receptor

A type of receptor that plays a role in controlling blood pressure when stimulated.

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Baroreceptor Dysfunction

Problems with the baroreceptors, sensors that detect blood pressure changes, can lead to blood pressure problems.

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CNS Stimulation

Specific parts of the brain can be over-stimulated, leading to increased blood pressure.

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RAAS

A system in the body that regulates blood pressure and fluid balance, that can be activated in a way to cause excessive pressure.

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Vasoconstriction

Narrowing of blood vessels, often leading to increased blood pressure.

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Increased Cardiac Output

The heart is pumping blood faster and/or with more force, pushing more blood through vessels, leading to increased blood pressure

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Peripheral Resistance

Blood vessels are constricted (narrowed). This causes blood flow to be more challenging (increased resistance), thereby influencing blood pressure.

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Objective

A clear, specific statement outlining what you aim to achieve, including measurable outcomes, timeframes, and relevance to goals.

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SMART Objectives

Objectives that are Specific, Measurable, Achievable, Relevant, and Time-bound.

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Metrics

Quantifiable measures that track progress towards achieving an objective.

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Potential challenges

Obstacles or difficulties that might arise while working towards an objective.

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Regular Review

Periodic assessments of progress made towards objectives, allowing for adjustments and course corrections.

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Specific Objectives

Objectives clearly state the exact action or outcome to be achieved, avoiding ambiguity.

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Measurable Objectives

Objectives incorporate metrics to track progress and evaluate success, often involving quantifiable data.

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Achievable Objectives

Objectives are realistic and attainable given available resources, timelines, and constraints.

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Relevant Objectives

Objectives align directly with the overall project goals and priorities.

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Time-bound Objectives

Objectives include a defined timeframe or deadline for completion or achieving results.

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Focus and Direction

Well-defined objectives provide clarity for all stakeholders, ensuring everyone understands the intended outcomes.

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Performance Evaluation

Objectives act as benchmarks for evaluating progress and success, clearly outlining criteria for success or failure.

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Cardiac Output Equation

Cardiac output (CO) is the amount of blood pumped by the heart per minute. It is calculated by multiplying the heart rate (HR) by the stroke volume (SV): CO = HR x SV

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Factors Increasing Cardiac Output

Cardiac output increases when either the heart rate or stroke volume increases.

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Mean Arterial Pressure (MAP)

MAP is the average pressure in the arteries during a single cardiac cycle. It is calculated by: MAP = Diastolic Pressure + 1/3(Systolic Pressure - Diastolic Pressure)

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MAP Influencing Factors

MAP is primarily influenced by cardiac output and total peripheral resistance (TPR). Higher CO or TPR increases MAP.

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Tricuspid Valve

The valve located between the right atrium and right ventricle. It prevents backflow of blood from the ventricle into the atrium during ventricular contraction.

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Left Atrium

The chamber of the heart that receives oxygenated blood from the lungs. This blood then passes to the left ventricle.

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Semilunar Valves during Systole

During ventricular systole (contraction), the aortic and pulmonary semilunar valves open to allow blood to be ejected into the aorta and pulmonary artery.

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Isovolumetric Contraction

This phase happens at the beginning of ventricular contraction. All heart valves are closed, and ventricular pressure rises as the muscles contract, but no blood is ejected yet.

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TPR

Total Peripheral Resistance: the overall resistance to blood flow in the circulatory system.

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Vasodilation of arterioles

Widening of small arteries, reducing resistance to blood flow.

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Sympathetic stimulation on Blood Pressure

Increases heart rate and constricts blood vessels, causing increased blood pressure.

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Parasympathetic stimulation on Blood Pressure

Slows heart rate and promotes vasodilation, decreasing blood pressure.

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Primary Hypertension

High blood pressure without a known underlying cause, often linked to lifestyle factors.

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Secondary Hypertension

High blood pressure caused by a specific underlying condition.

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Elevated Pulse Pressure

Indicates increased arterial stiffness and higher risk of cardiovascular problems.

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MAP and Cardiac Output Increase

If cardiac output increases while TPR remains constant, MAP (Mean Arterial Pressure) also increases proportionally.

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MAP equation

MAP (Mean Arterial Pressure) = Cardiac Output x Total Peripheral Resistance

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Endothelial Dysfunction in Hypertension

Impaired function of the inner lining of blood vessels, contributing to high blood pressure.

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Impaired Endothelial Cells in Hypertension

Contribute to hypertension by promoting vasoconstriction and inflammation.

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Nitric Oxide and Vasodilation

Nitric oxide relaxes vascular smooth muscle, causing vasodilation and reduced blood pressure.

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Nitric Oxide Synthase (NOS)

The enzyme responsible for producing nitric oxide in endothelial cells.

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Alpha-1 Adrenergic Receptor Activation

Causes vasoconstriction and increased total peripheral resistance, raising blood pressure.

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Sympathetic Nervous System

The division of the autonomic nervous system that activates the 'fight or flight' response. It increases heart rate, contractility, and bronchodilation. It causes vasoconstriction in non-essential tissues and vasodilation in skeletal muscle.

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Parasympathetic Nervous System

The division of the autonomic nervous system that promotes 'rest and digest' activities. It slows heart rate, increases digestive secretions, enhances intestinal motility, and facilitates urination.

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What is the role of calcium in smooth muscle contraction?

Calcium binds to calmodulin, forming a calcium-calmodulin complex. This activates myosin light chain kinase (MLCK), which phosphorylates myosin, enabling actin-myosin interaction and contraction. Smooth muscle contraction is terminated when calcium levels decrease, allowing dephosphorylation of myosin by myosin light chain phosphatase.

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Preload

The initial stretch of ventricular myocardium caused by end-diastolic volume (EDV). Increased preload enhances stroke volume via the Frank-Starling mechanism.

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Afterload

The resistance the heart must overcome to eject blood (e.g., aortic pressure). Increased afterload reduces stroke volume by increasing end-systolic volume (ESV).

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Frank-Starling Law of the Heart

The Frank-Starling Law states that the force of contraction is proportional to the initial length (stretch) of cardiac muscle fibers. Increased venous return enhances EDV, stretching fibers and increasing stroke volume up to a physiological limit.

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Blood Viscosity

The thickness or stickiness of blood. Higher viscosity increases resistance to blood flow.

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How does vessel diameter influence resistance to blood flow?

Narrower vessels offer greater resistance to blood flow. Wider vessels allow easier blood flow with less resistance.

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Vessel Length

The longer the blood vessel, the greater the resistance to blood flow. This is because blood has to travel further, encountering more friction.

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Vessel Diameter

The smaller the diameter of a blood vessel, the greater the resistance to blood flow. This is because the blood has less space to move through.

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Renin-Angiotensin-Aldosterone System (RAAS)

A hormonal system that regulates blood pressure and fluid balance. It is activated when blood pressure or sodium levels decrease, causing vasoconstriction and water retention.

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Angiotensin II

A powerful vasoconstrictor that increases blood pressure by narrowing blood vessels. It also stimulates the release of aldosterone, which promotes water retention.

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Endothelial Cells

The cells that line the inside of blood vessels. They release substances that regulate vascular tone, controlling the diameter of blood vessels.

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Nitric Oxide (NO)

A vasodilator released by endothelial cells that relaxes smooth muscle, widening blood vessels and reducing blood pressure.

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Cardiac Output (CO)

The volume of blood pumped by the heart per minute. It is calculated by multiplying heart rate by stroke volume.

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Total Peripheral Resistance (TPR)

The overall resistance to blood flow in the circulatory system, primarily influenced by the diameter of arterioles.

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Hypertension

A persistent blood pressure reading of 140/90 mmHg or higher. It is a major risk factor for heart disease, stroke, and kidney failure.

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Endothelial Dysfunction

A condition where the inner lining of blood vessels is damaged, leading to reduced NO production, increased vasoconstriction, and increased risk of hypertension.

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Frank-Starling Law

The heart pumps more strongly when it's filled with more blood. Like a stretched rubber band, the heart can contract more forcefully.

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Calcium's Role in Smooth Muscle

Calcium triggers smooth muscle contraction by activating a protein that allows muscle fibers to slide past each other

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Left Ventricular Hypertrophy

The thickening of the left ventricle wall, a result of the heart working harder to pump blood against increased resistance due to hypertension.

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Heart Failure

When the heart can't pump blood efficiently due to damage from chronic hypertension.

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Stroke

Damage to the brain from a blocked or ruptured blood vessel, potentially caused by hypertension.

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Chronic Kidney Disease

A long-term condition where the kidneys don't filter waste properly, often linked to hypertension.

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Aneurysm

A bulging or weakened area in a blood vessel, potentially caused by hypertension.

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Arterial Damage

Damage to the walls of arteries due to chronic high pressure, leading to hardening and narrowing of vessels.

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Alpha-2 Adrenergic Receptors

Receptors in the sympathetic nervous system primarily responsible for inhibiting the release of norepinephrine, which helps regulate blood pressure.

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Beta-1 Adrenergic Receptors

Receptors in the sympathetic nervous system that increase heart rate, contractility, and release of the hormone renin, all of which raise blood pressure.

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Study Notes

Learning Objectives

  • Summarize the general function of the parasympathetic and sympathetic nervous systems
  • Differentiate between neurotransmitters and receptors of the parasympathetic and sympathetic systems
  • Compare and contrast cholinergic and adrenergic transmission
  • Describe the biosynthesis and degradation of catecholamines and acetylcholine
  • List the different cholinergic and adrenergic receptors
  • Interpret equations for mean arterial pressure and cardiac output (e.g., define the relationship between stroke volume and cardiac output)
  • Calculate mean arterial pressure
  • Diagram the pathway of blood through the chambers of the heart and peripheral circulatory system
  • Compare and contrast the function of myocardial contractile cells and autorhythmic cells
  • During each phase of the cardiac cycle, compare and contrast ventricular pressure and blood volume in atria and ventricles
  • Define end diastolic volume, end systolic volume, isovolumetric contraction, and isovolumetric relaxation
  • Explain the influence of the parasympathetic and sympathetic nervous system on heart rate and stroke volume
  • Describe factors that regulate stroke volume (preload, contractility, and afterload)
  • Describe the length-tension relationship (Frank-Starling relationship)
  • Compare the structure and function of arteries, arterioles, capillaries, venules, and veins
  • Compare the influence of blood viscosity, vessel length, and vessel diameter on resistance
  • Describe the relationship between cardiac output, blood flow, blood pressure, and resistance
  • Outline the baroreceptor reflex
  • Compare and contrast hormones and their effect on blood pressure (epinephrine, norepinephrine, angiotensin II, ADH, ANP, aldosterone)
  • Illustrate the structure and organization of vascular smooth muscle
  • Outline the steps of smooth muscle contraction (emphasis on Ca2+)
  • Describe the role of smooth muscle cells in influencing vascular tone
  • Illustrate the role of the autonomic nervous system and other mediators on vascular resistance
  • Describe the physiological responses of the autonomic nervous system, the renin-angiotensin-aldosterone system (RAAS), and the kidneys for the regulation of blood pressure
  • Identify pathogenic mechanisms that increase cardiac output and total peripheral resistance
  • Describe the role of peripheral autoregulatory mechanisms, endothelial cells, and electrolytes in the pathophysiology of hypertension

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