NRS 313 Lecture Notes - Lecture 7: Atherosclerosis, Jugular Vein, Angiotensin-Converting Enzyme
27 May 2018
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MAP and RAAS
• Renin Angiotensin Aldosterone System
o Drop in MAP.
o Normal is 65-110 mmhg
o Systolic - diastolic blood pressure = pulse pressure
o 1/3 of pulse pressure.
o MAP= 1/3 of pulse pressure to diastolic blood pressure
o If it is below 65 it is below adequate levels to perfuse the kidney
• When cells within the kidney sense a low perfusion pressure, juxtoglumerular cells will secrete
Renin.
o Renin gets into vascular system and goes to the liver.
o In liver we have angiotensinogen where the lover produces Angiotensin I
o Angiotensin I enters the vascular system and circulates through the vasculature in the
lings
o Angiotensin I encounters Angiotensin converting enzyme (ACE)
o This enzyme converts AI in to AII.
o Three things happen
▪ AII will circulate through the vascular system around the pituitary gland and
attach receptors.
• AII attaches to receptors, we get the release of ADH
• ADH will cause the reabsorbing of water
• When water is reabsorbed, vascular volume increases, raising blood
pressure
▪ AII does vasoconstriction of arteries in the periphery.
• It enters blood supply and attaches to Angiotensin receptors on
endothelial cells and this will cause vasoconstriction
• This increase resistance in the peripheral arteries
• This resistance leads to an increase in blood pressure
▪ AII also circulates and attaches to Angiotensin receptors on the adrenal glands
• The adrenal glands release Aldosterone
o Reasor sodiu so that sodiu wo’t e exreted ad will e
reabsorbed into the blood supply. Water comes with it. The
volume in the vascular system increase contributing to increase
in blood pressure
o Cause excretion of K+
Preload/Afterload
• Blood enters through the superior/inferior vena cava into the right atrium. Through the tricuspid
valve into the right ventricle. Out the pulmonic valve and into the lungs. Blood comes back in
the left atrium through the mitral valve into the left ventricle. Through the aortic valve to the
periphery
• Preload: the amount of blood in the ventricle during diastole AND the amount of blood volume
returning to the ventricles
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Document Summary
Map and raas: renin angiotensin aldosterone system, drop in map, normal is 65-110 mmhg, systolic - diastolic blood pressure = pulse pressure, 1/3 of pulse pressure, map= 1/3 of pulse pressure to diastolic blood pressure. If it is below 65 it is below adequate levels to perfuse the kidney: when cells within the kidney sense a low perfusion pressure, juxtoglumerular cells will secrete. Renin: renin gets into vascular system and goes to the liver. The volume in the vascular system increase contributing to increase in blood pressure: cause excretion of k+ Preload/afterload: blood enters through the superior/inferior vena cava into the right atrium. Through the tricuspid valve into the right ventricle. Out the pulmonic valve and into the lungs. Blood comes back in the left atrium through the mitral valve into the left ventricle. Problem with preload and after load: left ventricle, resistance in periphery, build up of plaque atherosclerosis, blood flow meets resistance over time create excess after load.
