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    6 CVS Regulation

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    Disha Suvarna
    Short term regulation of blood pressure involves baroreceptor and chemoreceptor reflexes. The baroreceptor reflex controls blood pressure between 60-160 mmHg by sensing stretch in carotid sinus and aortic arch, and stimulating the vasomotor center to increase or decrease sympathetic outflow and heart rate. Below 60 mmHg, chemoreceptors sense low oxygen and activate the vasomotor center to increase sympathetic activity and raise blood pressure. Long term regulation involves the kidneys and renin-angiotensin-aldosterone system which adjust fluid levels over days and weeks to maintain normal blood pressure.

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    6 CVS Regulation

    Uploaded by

    Disha Suvarna
    33 views55 pages
    Short term regulation of blood pressure involves baroreceptor and chemoreceptor reflexes. The baroreceptor reflex controls blood pressure between 60-160 mmHg by sensing stretch in carotid sinus and aortic arch, and stimulating the vasomotor center to increase or decrease sympathetic outflow and heart rate. Below 60 mmHg, chemoreceptors sense low oxygen and activate the vasomotor center to increase sympathetic activity and raise blood pressure. Long term regulation involves the kidneys and renin-angiotensin-aldosterone system which adjust fluid levels over days and weeks to maintain normal blood pressure.

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    6 CVS regulation

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    Short term regulation of blood pressure involves baroreceptor and chemoreceptor reflexes. The baroreceptor reflex controls blood pressure between 60-160 mmHg by sensing stretch in carotid sinus and aortic arch, and stimulating the vasomotor center to increase or decrease sympathetic outflow and heart rate. Below 60 mmHg, chemoreceptors sense low oxygen and activate the vasomotor center to increase sympathetic activity and raise blood pressure. Long term regulation involves the kidneys and renin-angiotensin-aldosterone system which adjust fluid levels over days and weeks to maintain normal blood pressure.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    33 views55 pages

    6 CVS Regulation

    Uploaded by

    Disha Suvarna
    Short term regulation of blood pressure involves baroreceptor and chemoreceptor reflexes. The baroreceptor reflex controls blood pressure between 60-160 mmHg by sensing stretch in carotid sinus and aortic arch, and stimulating the vasomotor center to increase or decrease sympathetic outflow and heart rate. Below 60 mmHg, chemoreceptors sense low oxygen and activate the vasomotor center to increase sympathetic activity and raise blood pressure. Long term regulation involves the kidneys and renin-angiotensin-aldosterone system which adjust fluid levels over days and weeks to maintain normal blood pressure.

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    © All Rights Reserved
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    of 55

    CVS

    Blood pressure
    &
    Regulation of arterial blood pressure (ABP)
    Contents:
    1) Definition and normal values
    2) Variations
    a) Physiological Variations
    b) Pathological Variations
    3) Determinants of arterial blood pressure
    a) Central factors,
    b) Peripheral factors
    Contents contd:
    4) Regulation of arterial blood pressure
    a) Nervous mechanism
    b) Renal mechanism
    c) Hormonal mechanism
    d) Local mechanism
    OR

    a) Short term control (Baroreceptors reflex,


    Chemoreceptor and Circulating hormones) and

    b) Long term control (Kidneys and Renin- Angiotensin


    Aldosterone mechanism)
    Hemodynamics
    • Mean Volum Blood Flow:
    This is the volume of blood flow into the region of the circulatory system in a given unit of
    time.
    Q =VxA
    Types of blood flow:
    1. Laminar/Stream line flow
    2. Turbulent flow

    Reynold’s number:
    NR =PDV/ŋ
    P=density of blood
    D= diameter of vessel
    V= velocity of blood flow
    Ŋ= viscosity
     Factors maintaining the volume of blood flow:

    • Pressure gradient
    • Resistance to blood flow
    • Viscosity of blood
    • Velocity of blood flow

     Hagen – Poiseuille equation:

    (P 1-P2) x r4
    Q=
    8L x ŋ

     Windkessel Effect
    TYPES OF BLOOD VESSELS
    • WINDKESSEL(Distensible) VESSELS
    • RESISTANCE VESSELS
    • EXCHANGE VESSELS
    • CAPACITANCE VESSELS
    • SHUNT (Thoroughfare) VESSELS
    WINDKESSEL(Distensible) VESSELS

    • Eg: Aorta, Pul.artery &their large branches

    • WINDKESSEL means Elastic reservoir

    • Due to the elastic recoil of the arteries pulsatile flow


    of blood is converted into a steady flow in the
    capillaries
    RESISTANCE VESSELS
    • Eg: Arterioles , Metarterioles, Pre-capillary sphincters
    • Main site of Peripheral resistance- Arterioles
    • R-1/r4
    • Vessels of skin & skeletal muscle offer max. resistence
    • Metarterioles, Pre-capillary sphincters determine the size
    of the open capillary area
    • Radius-
    Neurogenic factors- sym. Constrictor fibers
    Local factors – constrictors –serotonin ,low temp,
    Dilators- hypoxia,hypercapnia,increase in temp,decrease in pH
    EXCHANGE VESSELS
    • Eg: Capillaries
    • 3 types of capillaries
    *Continuos(nonfenestrated) *Fenestrated-
    Renal glomeruli,glands
    *Discontinuous(sinusoids) –bone
    marrow,liver&Spleen
    CAPACITANCE VESSELS
    • Eg:Venules,veins
    • Venous valves –unidirectional flow
    • Venous pressure - central venous
    pressure (CVP)-Rt.atrial pressure -4-6 mmHg
    peripheral venous pressure-10mmHg
    SHUNT (Thoroughfare) VESSELS

    • A-V Shunts or A-V anastomoses


    • Bypass capillaries
    • Important in body temp. regulation
    • Skin, fingers, toes, palms etc
    TYPES OF BLOOD FLOW
    • LAMINAR FLOW:
    • TURBULENT FLOW:
    REYNOLD’S NUMBER
    • Is the measure for the tendency for the
    turbulence to occur.
    • Re=V.D.p/n
    • V=Velocity , D=Diameter, p(rho)=density,
    n(eta)=viscosity.
    • Turbulence occurs if the Reynolds number is
    more than 2000
    Arterial Blood Pressure
    • Significance:
    1. To ensure the blood flow to various organs
    2. Plays important role in exchange of nutrients
    and gases across the capillaries
    3. Required for urine formation
    4. Required for formation of the lymph
    Definition:
    It is the lateral force or pressure exerted by the
    contained column of blood on the walls of
    the blood vessels.

    Normal adult = 120/80mmHg


    (20-40)

    120 systole Range= 90- 140mmHg


    80 diastole Range = 60- 90mmHg
    Arterial blood pressure is expressed in four different terms

    1. Systolic BP (SBP) defined as maximun BP in the arteries


    attainable during systole

    Normal 120±20 mmHg

    Mainly contributed by :
    1. Force of heart beat
    2. Normal blood volume
    3. Cardiac output
    Normal Range = 90-140mmHg
    2. Diastolic BP(DBP): defined as minimun
    pressure that is obtained at the end of the
    ventricular diastole

    Normal Value = 60-90mmHg

    1. Represents a constant load on the arterial walls


    2. Index to peripheral resistance (hence more important)
    3. Responsible for the flow of blood in the vessels during
    diastole
    4. Responsible for maximum blood flow through coronary
    arteries during diastole
    3. Pulse pressure (PP): denotes difference
    between systolic and diastolic pressure
    PP= SBP- DBP =40 mmHg

    4. Mean Arterial Pressure(MABP):


    MABP= DBP + 1/3 PP
    = 95mmHg
    Component Definition Features N values
    (mm Hg)

    SBP Max pressure during Undergoes fluctuations Range


    systole Shows degree of work 100-130
    done by heart & pres. Av 120
    Bld vessel walls to take
    DBP Min pressure during More Stable Range
    diastole Reflects P R 60- 80
    Constant load for heart Av 70
    PP S B P- D B P Determines pulse Av
    volume 40
    PP- S HTN

    MBP Avg pressure thruout Same in all organs & is Range


    C.Cycle pres. Head 95- 100
    Cv reflexes sensitive to
    it
    Factors affecting arterial BP
    • Age
    • Sex
    • Body built
    • Diurnal variation
    • Exercise
    • Emotions
    • Gravity
    • Hereditary
    • Meals
    • Sleep
    • Posture
    Factors affecting B.P
    • 1. Age
    SBP(mm Hg) DBP(mm Hg)
    Newborn: 20-60
    At 30 days: 80
    12 years: 105 50
    17 years: 120 60
    60 years: 140 90
    • Gender : Females <menopause
    • SBP is 4-5mm Hg lesser than Males of same age
    after menopause SBP is 4-5 mm Hg more

    Body built : Obesity can increase B.P

    Climate : Cold- Vasoconstriction - SBP & DBP


    Warm- Vasodilation - SBP & DBP
    • Diurinal Variation : Fluctuation of 5-10 mm Hg
    common, peak values at afternoon, lowest at
    early morning

    Exercise : Mild Moderate Severe


    SBP + ++ +++

    DBP -/ + + ++

    After 5 min of stoppage- B.P normal


    • Emotions:
    Excitement, fear & worry - CO & SBP

    Gravity : Pressure in BV above heart level is


    increased by 0.77 mmHg for each cm vertical
    height & in BV below heart, it is decreased by
    same factor
    ( MBP in a cerebral vessel = 62 mmHg, while in
    an artery in foot is 177 mm Hg)
    • Hereditary tendencies :
    Familial tendencies of hypotension &
    hypertension with SBP are common

    Meals :Increase BP due


    A) to pressure over heart due to distended
    abdomen increases H.R,
    B) increased release of epinephrine
    Sleep:
    • SBP falls in early hours of sleep by 15-30 mm Hg
    due to vasodilation,
    • disturbed sleep increases SBP due to Sk. Muscle
    tensioning and resultant sympathetic discharge

    Posture:
    • Standing posture- SBP decreases & DBP increases
    • Sitting posture- normal
    • Sleeping posture- SBP increases & DBP decreases
    Determinants of arterial BP
    BP = CO x TPR
    Cardiac
    Total peripheral
    Output Resistance

    • CO
    Velocity
    = HR ofX SV
    blood flow
    • Viscosity of blood
    • Elasticity of the vessel wall
    Korotkoff’s sounds
    SBP – 120 mmHg Tapping sound 1

    106 Murmur 2

    96 loud banging sound 3

    86 muffling Sound 4

    DBP - 80 No sound 5
    • 1. Define blood pressure. Explain short term
    and long term regulation of blood pressure.
    (10 marks)
    BP Regulatory mechanisms:

    A) Rapidly acting mechanisms:-


    1) Baroreceptor reflex
    2) Chemoreceptor reflex
    3) Cushings reflex /CNS ischemic response

    Baroreceptor zone 160mmHg

    Chemoreceptor zone 60

    Cushing reflex zone 40


    B) Intermediate acting mechanisms:

    1 Capillary fluid shift mechanism

    2 Stress relaxation mechanism

    3 Reverse stress mechanism.


    C) Long term acting mechanisms:

    • 1 Direct mechanism. {Renal fluid mechanism.}

    • 2 Indirect mechanism. {Renin -angiotensin,


    aldosterone }
    VASOMOTOR CENTER
    • Vasoconstrictor area
    – Anterolateral portions of the upper medulla
    • Vasodilator area
    – Anterolateral portions of the lower medulla
    • Sensory area
    – Posterolateral portions of the medulla and lower
    pons (Nucleus Tractus Solitarius)
    Short term regulatory mechanism:

    1. Baroreceptor reflex: (mareys’ reflex): (60-160mmHg)

     Mechano –receptors and respond to stretch


     Carotid sinus reflex
     Aortic sinus reflex
     Exception to Marey’s reflex - exercise
    emotions
    exposure to hot environment
    BP

    Stimulation of Baroreceptors
    (carotid sinus and arortic arch)

    NTS

    Inhibition of VMC Stimulation of CIC

    SNS Vagus

    Symp.tone Vagal tone

    Blood vessals Adrenal medulla Heart

    Vasodialation Catecholamines Secretion Bradycardia


    Venodilation

    Net effect: peripheral resistance


    Myocardial contractility
    HR
    BP
    2. Chemoreceptor reflexes:

    receptors are – carotid body


    aortic body

    Respond to chemicals – a) hypoxia


    b) hypercapnea
    c) Acidosis
    Chemoreceptor mechanism:-( <60 mm Hg MBP)
    Arterial B.P

    Reduced blood flow to chemoreceptors

    Hypoxia & Hypercapnia of chemoreceptors

    Stimulation of chemoreceptors

    Stimulation of vasomotor centre & inhibition of vagal nucleus

    Heart rate & Vasoconstriction( P.R.)

    Arterial B.P
    Cushing reflex:
    Increased Intracranial pressure ischemia of the brain.

    BP (<40mmHg) (or) Intracranial pressure

    Cerebral hypoxia , hypercapnea

    Stimulation of Vasomotor centre

    SNS action

    Heart rate & vasoconstriction ( P.R.)

    Arterial B.P.
    Intermediate term regulatory mechn.
    Act by altering blood volume, are functional from few days-a month
    Begin to act in few minutes & reach full function in few hours

    Stress relaxation:

    BP blood vessels are stretched stress relaxation

    BP EBV(effective blood volume) capacity

    Capillary fluid shift phenomenon:


    Renal mechanism (long term regulation):

    • Kidneys plays an important role in the long


    term Regulation of arterial blood pressure.
    • The neural mechanism adapts to the altered
    pressure and looses the sensitivity for the
    changes
    • in such conditions renal mechanism operates
    efficiently to regulate the arterial blood
    pressure.
    Kidneys Regulates arterial blood pressure by 2
    ways
    1) By regulation of ECF volume
    2) Renin- Angiotensin Aldosterone
    mechanism
    By regulation of ECF volume:
    Increased BP –> excessive water and sodium
    excretion—>decreased ECF volume and blood
    volume –>normal ABP.
    Renin- Angiotensin Aldosterone mechanism: Stimuli for Renin secretion
    Applied Physiology
    Pathological Variations:
    Hypertension and Hypotension

    1) Hypertension-persistent elevation of systemic ABP


    above normal level
    There are two types
    • Essential ( primary) and secondary HTN

    • Essential ( primary) is again two types

     Benign ( BP 200/100mm of Hg) and


     Malignant (Accelerated) HTN
    Applied Physiology contd
    Hypotension ( BP less than 90 systolic)
    Primary and secondary
    secondary due to Tabes Dorsalis, Syringomyelia,
    Diabetic neuropathy

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