-the pressure exe :e

by··· the blood agai'! ! ~ I

- .. ' I

the walls of the I

vessels

-

"00 p .. ESSUR GRADIENT

.. lood pressure is a hydrostatic pressure

·-ach blood vessel has it's own blood pressure value

"The pressure in the systemic blood vessels falls continuously from the aorta until the blood r·· -enters the heart in the right atrium

(fJ ...I W en UJ w

>

._

.... ' ...

Arterial Blood prjs&yre

. ~-

Pressure of blood against arterialwalls Types:

1. Systolic pressure:maximum durln 9 hi e- a rt's -C'-- 0--- ntra Ct'-'·I·O- n

. ,: I I , .' , __ I. _ _ _ ii, I .' _ .; -. - _' _ _ _ i ,- _ - • . _ -' . .

2. Diastolic: pressure during the heart's relaxation or filling phase

3. Pulse pressure:difference between systolic and diastolic

4. Mean arterial pressure: 1/3 pulse pressure plus diastolic pressure

.. (MAP = 1/3 PP + OBP)

Blood pressure = cardiac output

x peripheral vascular resistance

(BP=CO x PVR)

-

Primary determinant of systolic B/P is cardiac output.

Primary determinant of diastolic B/P is peripheral resistance.

C di . ·

.armac output IS

determined by:

.. stroke volume -heart rate

-venous capacitance

(capability of veins to, return blood to the heart)

• .... ardlac output

. I' eral vascular resistance

, rt '., I: I til . lt

-:,' -- 'I_' -lerll,8 e' :as:];CI_-y

-Blood volume

-Blood viscosity

-Age

-Weight

.iEmo't,io:ns

E··

., ,xerClse

VE

In small vein .... ~~ nd v . nule .. there are no . ul .... ion s.

In large vein· leading to th .. heart ijugul · r) pulsations reflect back from right atr~ a

contra cti on"~ I

8,lood flow back to '_- eart depend· on: -vessel wall to ~

-pumping action of~ keleal

mu _ cles

-negative thoracic pr ..... .... ure

durlnc l · t·

unng In .. plralon

--_._-----

--~--~-

. ,a, a

! a oncotic

.._,_ fii::1 ~i , ~ 1,_1 I' ,-, - :ure causes

, ,

,'- Ii -I' '1'-,' !_'_il ,:he vascular

,,'. Iii! i \,1''1, ' interstitium

,III :1, ! edema ..

p. ,,' ssure draws (. ssues i nto the

,·"te., , which may · '" ::~,' ", '" '. "food pressure.

Regulati()n of Cardiac Function an.d.BloodP'ressu're

-Autonomic Nervous System

-Peripheral baroreceptors

-Stretch receptors

AUTONOMIC NERVOU.S SYSTEM

- - -. - - -

REGULATION

*Heart rate: chronotropic

effect *Myocardial contractility: inQtrQpic effect *Conduction velocity *Peripheral vascular resistance: arterial & venous constriction

& di atlon

._ Parasympathetic branch:

;. -,

:: dorsal motor of vag. us

,.._.

::. -innervate: atria, ventricles,

...

~"'1,jl'l

& conduction system

-L elease acetylchot:ne:

i" ":;! lblts S~,~,_ r 1,-> ,e ' -~o 81 ", '~ "

Ilea; ,-' r i - ~ '8

-1,".'5· -'5' ·8', ." I ,--~. ';i'--'~'-, fe, I', ' e ' -1.--'" - - I - ,

, : " '._ '. _ ~ _I _ _ _ - _ _ c' '- I ,'- r ,I

- - ,-- --

~~.~~-,,- ,

I I t

I

I ,

I

f F'~

I~ ~ ~

-- -- -----~ ~

Involuntary responses

_l<'_ --- .. ~

:: -release norepi nepl .. rl .; e:

...,..,

:::-increases heart rate

!I>~

:= -Increases co' . ductlo

~I ~"'o:oax

~Sl.::;~:: speed thru AV no ·e

.~ i.'!!fIF

· t t-I·'ty

-mcreases con racn I:,'~

of atria & ventricles -increases perlphera vasoconatrlctlon

SNS INF UENC'8 ADR' iA ACTIV:TY

-release of catecholamines

-norepinephrine & epinephrine

influence adrenergic receptors in heart and blood vessels -lyges of receptors:

-algha: in peripheral arteries

& veins (vasocontriction) ·,b'ieta1 : located in heart: increase heart rate and myocardial contractility

·,beta 2: arterial & bronchlal walls: dilates smooth musc vasodilation of arterial vessels &bro,nc'hial di1lat· on

SNS INFLUENCES ADRENAL ACTIVITY

** In general:

- epinephrine influences alpha and beta 2 receptors

\

- norepinephrine influences alpha and beta 1 receptors

-----~iIIiiiiiiIiiiii ................... · • I·' ·es 0 eceptors

:':f I·C a rch &

s)

Stretlfh receptors:

-located in terminal" ,ectl!on ,,~

of vena cava and right atrium

-respond to pressure changes which reflect blood volume

·d'ecrease blood volume causes less stretch and decrease B/I~:'

-fewer impuses to eNS

-sympathefc response cau ->:'

vasoconstriction and f s IP

I. .. bl d- I~

I ']In,c:rease lin: : _', 1100' v,o,, um ~~

more stretch lner a 'e~"'" B"-:-,/P-.---

',_' ' I _ ... ,., .... "".', ," ,!" _II i _ _i,' - ',' , '-:.' '~ , •

d dill t"·· "

-an _. vasa l:aJon:rom vag

(p-' aras Y-"'m""p' 'at"h-" elt""I·C~··)''-'' ir-~' 's·"p-o· "'n-" - ".

,,',' " '~_i'_-,' ,.,"'~,' I_'!' ,'_ i '~, i'_i I' __ ._ I "',' ' . " ',"'i ' .. ' "',, :':,,-:'2' _-

-to ~ - ,- _.' -;- I ,'. ,.-.( I III·IC a: :r--' C·" h·· a'·,'_ n_, d .. j i,.

_ ..' _ "', _ '_, __ ' '"~. ,I, I _ I Co • _

earone I' 101 lies

-second 1- -' I·' 5'S"-·0·· sensltlve

_ '-,"'~~I' Ii .; " '" i_" U':_ e, . - i~" ,s', . " ". i' ' ',,'. '_I:

to' i creased carbon dloxlde and decreased arterial pH (acldemia)

-lmpulses to CI I ": medulla

in"'_-,-r ease lor decrease

r-'--'s-· ',,-- " ratio ' s' ·

I, . . .' I 1 I' -. I

- ' .. "'_,-' _I :, ,"',"_' __ "'.1,

lncr .•. ...., '. . •• r decrease

epinephrine and norepi from adrenal medul '8 -antidiuretic hormone (ADH)

terl ltult

pos error pmntary

(ot B/P causes .... ADH and

. ulo and t IP)

(.t B/P cauees- . ADH and + ulo and I B/P)

-ren in-a ng iotens i naldosteron:emechalnism

Renin-angiotensin-aldosterone mechanism

Renin (kidney): secreted in response to decrease in

renal blood flow and sympath stimutatlon

-stimulates conversion from angiotensin I to angiotensin II in the lungs (vasoconstriction)

-stimulates release of aldosterone which causes sodium and water retention by the kidneys;

causes increase in B/P

by increasing blood volume

Cerebral cortical input·

anger, fear, pain, exciement

Body temperature: fever

Serum electrolyte levels

Medications

HY"- 'P--'E--'R' TE--'- 'N'c;SIIO'-"N'

" ,- < __c, ~_ _ i '_' i, '_ 'Ii ','

Prehypertensien: 120-139/ 80,-,89

High:

Stage 1: 1401-,159/90-,99 Stage 2: 1,60'>/100>

,Types:

Esscntlaltprlmaryddiopathic)

90°/ M', -, - d jfi." "ab" -1-/"- on

u 1'0,0 nna _,e'D, ,.

Symptoms: none "Silent killer" headache, dizziness, blurred vision, blackouts, irritability, fatigue, nervousness

****Persons with hypertension develop coronary heart disease at a rate 2 - 3 x greater than those with normal blood pressure.

Malignant hypertension: rapidly progressive severe hypertension

Hypertensive crisis: lifethreatening; severe headache, blurred vision, confusion (nitroprusside, nitroglycerin)

'.~

TREATMENTS

Dl t Ie :

L d'·

I - I ' I I" I':' I

..... ow so' ,Ium

Low 'saturated fat «30%) Calorie restricted if overwt Ad,eqo,ate potassium

Limit alcohol

Review saturated/nonsaturated fats

(LD' L- " • H- D'~' L')'

i _ •. , :s" : :, ~' s "

EXERCIS,E: ,30-45minute-:

. ~ .

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