Term
| How do you dx hypertension? |
|
Definition
-elevated bp on two or more visits
(except malignant hypertension when diastolyic >120mm Hg) |
|
|
Term
| What is consideredn prehypertension? |
|
Definition
Systolic: 120-139 mmHg
Diastolic: 80-89 mmHg |
|
|
Term
| What is the classification for Stage I HTN? |
|
Definition
SBP: 140-159mmHg
DBP: 90-99 mmHg |
|
|
Term
| What is the classification for Stage II HTN? |
|
Definition
SBP: >160 mmHg
DBP: >100mmHg |
|
|
Term
| What are the causes of essential HTN? |
|
Definition
-idiopathic
-no short term problems |
|
|
Term
| What are the secondary HTN? |
|
Definition
-renal
-endocrine
-cardiovascular
-neurologic
-etc |
|
|
Term
| What are the complications of HTN? |
|
Definition
-faster atherosclerosis
-stroke
-LV hypertrophy with heart failure
-aortic dissection
-renal failure
-retinopathy
-hypertensive encephalopathy |
|
|
Term
| What are the major factors for BP? |
|
Definition
|
|
Term
| What does total peripheral resistance depend on? |
|
Definition
-determined at arterioles
-depends on arteriolar wall thickness and changes in vessel lumen diameter |
|
|
Term
| What things influence hypertension in TPR? |
|
Definition
-humoral factors
-local tissue factors
-role of autoregulation |
|
|
Term
| What factors increase BP? |
|
Definition
Renin-Angiotensin-Aldosterone
ADH
ANS
NE
|
|
|
Term
| What factors decrease BP? |
|
Definition
|
|
Term
|
Definition
| released from the kidney and stimulates B-adrenoceptors causing renal artery hypotension and decreased sodium delivery |
|
|
Term
| What does angiotensin II do? |
|
Definition
| stimulates the adrenal cortex to release aldosterone so get increased sodium reabsorption and fluid |
|
|
Term
| What stimulates the hypothalamus to release ADH? |
|
Definition
-increased plasma osmolarity
-pain
-stress
-hypoxia
-heart failure
-vol decrease |
|
|
Term
| How does the ANS affect BP? |
|
Definition
| receives information from the baroreceptor in the carotid and the aortic arch-info relayed to the vasomotor center of the brainstem and get hypotension |
|
|
Term
|
Definition
-increase heart rate and contractility
-vasoconstriction
-increase CO and systemic vascular resistance
-increase in arterial BP |
|
|
Term
|
Definition
secreted by heart cells in response to distension (increased blood volume)- binds to kidney and increases sodium excretion
-decreases aldosterone release by the adrenals
-increases glomerular filtration rate
-decrease renin release
-GET WATER LOSS
|
|
|
Term
|
Definition
-it is released by endothelial cells
-potent vasodilator, inhibits platelet adhesion and aggregation
-surpress vascular smooth muscle migration and proliferation |
|
|
Term
|
Definition
| leakage of plasma components across vascular endothelium and excessive extracellular matrix production by smooth muscle cells |
|
|
Term
| What is arteriosclerosis? |
|
Definition
| eosinophilic hyaline thickening of the walls of the arterioles and luminal narrowing |
|
|
Term
| What is hyperplastic arteriolosclerosis? |
|
Definition
onionskin, concentric thickening of arteriolar walls with profressive narrowing of the lumina
can get necrosis |
|
|
Term
| What could you get in hypertensive retinopathy? |
|
Definition
-focal constriction of microvasculature
-microinfarcts (cotton wool spots)
-superficial (flame) hemorrhages |
|
|
Term
| What are some charcteristics of HTN heart disease? |
|
Definition
-increased left ventricular thickness without dilatation
-increased cardiac weight disproportional to size
-eventual impairment of diastolic filing |
|
|
Term
| How much should a person's heart weigh? |
|
Definition
| twice the person's weight in grams |
|
|
Term
| What is the typical diameter of the leftand right ventricle? |
|
Definition
|
|
Term
| What happens to the heart in HTN? |
|
Definition
-make more protein and filaments
-increase in myofiber size
-express more genes (ANF)
-switch from adult contractile proteins to fetal or neonatal
-increase in beta myosin heavy chain expression for slower/more energy contraction
-hypertrophy wall is thick-so decrease EDV and SV |
|
|
Term
| What happens to the myocytes in HTN? |
|
Definition
| nuclear and cytologic enlargement |
|
|
Term
| What must be present to dx malignant hypertension? |
|
Definition
| papilledema-optic disk swelling secondary to elevated intracranial pressure |
|
|
Term
| What are the common clinical presentations for a hypertensive emergency? |
|
Definition
-cerebral infarct
-pulmonary edema
-hypertensive encephalopathy
-congestive heart failure
-intracranial hemorrhage
-aortic dissection
-eclampsia |
|
|
Term
|
Definition
| RV hypertrophy and or dilattaion due to pulmonary hypertension |
|
|
Term
| What causes Cor Pulmonale? |
|
Definition
-diseases of the pulmonary parenchyma
-pulmonary vessel disease
-disorder affecting chest movement
-disorder inducing pulmonary arteriolar constriction |
|
|
Term
| What happens in acute Cor Pulmonale? |
|
Definition
-occurs secondary to massive pulmonary embolism
-RV dilated without hypertrophy |
|
|
