Arterial Pressure Regulation 2 تفريغ PDF

Control of arterial pressure II Doctor explanation Key information If you have any Abbreviation Writer: Khalid AlKhawfi questions or concerns regarding...

Control of arterial pressure II Doctor explanation Key information If you have any Abbreviation Writer: Khalid AlKhawfi questions or concerns regarding Explanation this document. Writer: Ali AlShakhs 219-220 notes Mnemonic Book Deleted References Very easy lecture, no Dr Shuja Kazi worries.. MBBS, M.Phil (Physiology) Department of Biomedical Sciences [email protected]  The Goals of our learning are: 🢝To understand the regulationof blood pressure Short TermReflexes 🢝List the components of the baroreceptor reflex 🢝Tounderstand the role of Kidneys in blood pressure regulation 2 Blood pressure = Cardiac output * Total peripheral Resistance is the resistance hemodynamic of the vascular system. Its resistance depends on the length, viscosity, and radius on the blood vessel. Revision Resistance is directly proportional with length and viscosity, and inversely proportional with radius The greater vascular resistance, the greater mean arterial pressure.  Notch Systolic pressure caused by closer of aortic valve Mean pressure Diastolic pressure Clinically arterial BPis expressed as Systolic over Diastolic Pressure NormalRange Systolic in 100-140/ Diastolic 60-90 mmHg(Non-Diabetic Adults) Systolic in 100-130/ Diastolic 60-85 mmHg(DiabeticAdults) Next slide.. Mean arterial pressure = 90-100mmHg  1- In the diabetic patient, the blood pressure will be slightly 2- The mean arterial pressure in your lower because the diabetes text book is about 93mmHg, but it mellitus is one of the major risk differs slightly in some books, so factors for the coronary artery we can say 90-100 mmHg. disease. People who have diabetes may experience postural hypotension, or low blood pressure occurring when going from sitting or lying down to standing up. This may happen due to a type of nerve damage called autonomic neuropathy.  1 1 2 2 3 4 5 6 Next slide.. ‫هنا‬  1- 2- Mean arterial pressure In the vascular system the blood is flowing, depends on two factors: but the TPR system will oppose the flow of Total peripheral the blood, it resists the flow of the blood. In resistance and cardiac other words, it resists the contractile function output. of the heart. 3- ‫أرجع و شوف الترقيم اللي‬ ‫بالساليدة الماضية عشان تربط‬ This TPR depends on many things: ^‫^بنفس اللون‬ 1- Autonomic nervous system (ANS): the sympathetic nervous system can constrict the blood vessel (vasoconstriction). 2-There many hormones can cause vasoconstriction such as epinephrine, norepinephrine and angiotensin II. 3-Viscosity will increase in polycythemia and hyperproteinemia, leading to increase in resistance. 4-Angiogenesis will contribute to increase the length, leading to increase in resistance. 5-The fourth power of the radius is inversely proportional with resistance according to Poiseuille law, so if you decrease the radius, you will increase the resistance 16 times. 6-It will be covered in next slides.  4- For the cardiac output, it depends in two factors: 1-Heart rate: A-Autonomic nervous system, like sympathetic and parasympathetic. B-Various hormone can stimulate the beta 1 receptor in the heart. C-There are vessels in medulla oblongata involvement in central nervous system can stimulate in increasing or decreasing the function of heart. ‫أرجع و شوف الترقيم‬ ^‫اللي ^بنفس اللون‬ 2- Stroke volume. It is the amount of blood pumped from the ventricles in one contraction in each beat. A-An increase in end diastolic volume EDV, leading to increase the preload on the heart, leading to increase the amount of blood ejected from the ventricle (stroke volume). The EDV depends on the venous return, and the venous return depends on many factors, one of the major factor is the kidney, the kidney will run the aldosterone, angiotensin and ADH. These hormones have the direct effect in increasing the venous return.  The respiratory muscle squeezes the capillaries and increase filling the right side of the heart while inspiration. ‫ارجع وشوف اخرمرة ههه‬ The skeletal muscle pump like gastrocnemius muscle... ‫ نفس اللون‬.. You: High BPany age but more common > 35 hypertension could be in any age , but it tends to be in those who are older than Could be physiological conditions like 35 years old. exercise and pregnancy. Prevalent in Obese Risk factors Heavy drinkers Because prolonged drinking cause stiffness in the bold vessels. Females using birth control pills Because the pills increase the viscosity of the blood.  Asymptomatic or presents with complications The signs of hypertension only occur when there are complications. Why Is It Important to Control Blood Pressure ? I prefer putting slides from 219 ‫في هذي النقطة‬ Long Term Short Term (Role of Kidneys)  Short term: it is regulating the mean arterial pressure in every second & all the time, but it will regulate the pressure for only a continuous few minutes “ that’s why we call it short term”. For example, when you change your posture (stand up suddenly after having been lying down ), the arterial pressure in the brain will be reduced. As a result, the short-term receptors will send signals for the CNS (medulla) & then they will increase the pressure in the brain by vasoconstriction and others that we will discus about them later. ( If the pressure doesn’t become normal for a long time, then long-term response will start to work ). Long term: when the short-term responses can’t handle the regulation of the mean arterial blood pressure the long-term responses or the kidneys will work. So, we have a system called RAAS ( Renin-Angiotensin- Aldosterone System). So, when the pressure decreases the renin will be secreted from the kidney by “J-G cells” then the renin will convert angiotensinogen (plasma protein produced by the liver) to angiotensin 1. Then, angiotensin 1 will go to the lungs & the lunges produce enzyme called “Angiotensin converting enzyme” and this enzyme will convert angiotensin 1 to angiotensin 2 Angiotensin 2 can: 1- cause vasoconstriction ( it’s the strongest vasoconstrictor in the body) 2- stimulate the secretion of Aldosterone & ADH. 3- stimulating the feeling of thirst.  Baro= pressure Receptor= sensing The doctor just went throw them fast, so I will put also slides from Med219 also. Barroreceptor Chemoreceptor (MAP