Chapter 16

the pressure differences between the L and R sides of the heart that produce gradient allowing systemic movement of the blood

it is produced by the force of left ventricular contraction overcoming the resistance of the aorta to open the aortic valve

• CO = SV (stroke volume) X HR (heart rate) 
• End-diastolic volume is preload
• systemic vascular resistant is the afterload

the afterload is determined by radius of arteries and degree of vessel compliance

• systolic bp
• diastolic bp
• SV (stroke volume) - primary influences systolic pressure
• SVR (systemic vascular resistance) - for diastolic pressure

• avg pressure within circulatory system thru-out cardiac cycle 
• MAP =

radial artery

intraarterial catheter to transduce arterial fluid pulsations into electrical signals/waveforms

• via brachial artery using stethoscope and sphygmomanometer or automated oscillometric system 
• Korotkoff sounds

by neural, humoral, and renal factors

• changes in bp mediated thru activation of sympathetic nervous system 
• -results in release of nt: epinephrine & norepinephrine 
• -vasomotor center indirectly activated via baroreceptor

• α₁ receptors in smooth muscle of arterioles 
• β₁ receptors of the heart

• ^ in extracellular fluid vol. = ^ CO and SVR = elevated BP 
• -^ serum sodium level = ^ osmolality = ^ ADH secretion 
• -RAAS: renin-angiotensin-aldosterone system are important regulator of bp

• angiotensin II produces ^ in SVR
• -Atrial natriuretic peptides (ANP) cause kidneys to ^ sodium and water excretion by ^ glomerular filtrate rate 
• -intrarenal arteriolar constriction leads to ^ tubular reabsorption of sodium and water

• suprachiasmatic nuclei in brain govern daily variations in bodily functions 
• neural and hormonal regulation and lifestyle influences

• primary diagnosis 
• -^morbidity and mortality associated w/ heart disease, kidney disease, peripheral vascular disease, and stroke

a range of pressures between normal and stage 1 hyptertension in an effort to initiate interventions early enough to prevent/deter progression of disease process

• <120 / <80
• 120-139 / 80-89

• idiopathic disorder 
• common form of hypertension

• end organ damage,
• -^ myocardial work results in HF 
• -glomerular damage results in kidney failure 
• -affects microcirculation of eyes 
• -^ pressure in cerebral vasculature can result in hemorrhage

• attributed to specific identifiable pathology/condition 
• -common form in children <10 yrs of age

• sudden ^ in either or both systolic or diastolic bp with evidence of end-organ damage
• -use of parenteral antihypertensive agents under close monitoring

• similar bp elevation without evidence of end-organ damage 
• -oral medications

• orthostatic (postural) hypotension is a decrease in systolic bp when moving to an upright position 
• -excessive ^ in heart rate (by 15-20 beats/minute) may also be diagnostic

• -prob. w/ vasomotor/baroreceptor response 
• -adverse effect of drug therapy 
• -arterial stiffness 
• -vol. depletion 
• -secondary disease process

• medication history,
• -slow positional changes,
• -avoid hot environments,
• -hydrate,
• -avoid large/carbohydrate-heavy meals
• -when symptoms begin, squatting/bending forward or crossing legs may reduce effects