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THE CARDIOVASCULAR SYSTEM LECTURE 6: REGULATION OF BLOOD PRESSURE Dr. Eamonn O’Connor Allied Health Sciences Lecture Outline 1 Determinants of Mean Arterial Pressure Regulation of Mean Arterial Pressure Control of Blood Pressure by Arterial Baroreceptors Baroreceptor reflex Hormonal control of Mean Arterial Pressure AHS Physiology - Cardiovascular System 11-12 1 Determinants of Mean Arterial Pressure 2 Mean arterial pressure determined by: Heart rate Stroke volume Total peripheral resistance MAP = CO x TPR CO = HR x SV MAP = HR x SV x TPR AHS Physiology - Cardiovascular System 11-12 Regulation of MAP 3 Flow = pressure gradient / resistance CO = MAP / TPR Therefore MAP = CO x TPR MAP = HR x SV x TPR TPR = Total peripheral resistance Combined Consider resistance of all blood vessels the importance of vasodilation & vasoconstriction This means that MAP is completely determined by HR, SV, and TPR AHS Physiology - Cardiovascular System 11-12 2 Effects of Cardiac Output on MAP 4 AHS Physiology - Cardiovascular System 11-12 Figure 14.25a, b Effect of Total Peripheral Resistance on MAP 5 AHS Physiology - Cardiovascular System 11-12 Figure 14.25a, c 3 Blood Pressure: Mean Arterial Pressure 6 MAP = driving force for blood flow F = ΔP/R Regulating MAP critical to normal function MAP < normal Hypotension Inadequate MAP blood flow to tissues > normal Hypertension Stress on heart and walls of blood vessels AHS Physiology - Cardiovascular System 11-12 Short and Long-Term Regulation of MAP 7 Short-term regulation – seconds to minutes Involves heart and blood vessels Primarily neural control Long-term regulation – minutes to days Regulate blood volume Involves kidneys Primarily hormonal control AHS Physiology - Cardiovascular System 11-12 4 Neural Control of MAP 8 Negative feedback loops Detector = baroreceptors Integration Center = cardiovascular centers in the brainstem Controllers = autonomic nervous system Effectors = heart and blood vessels AHS Physiology - Cardiovascular System 11-12 Arterial Baroreceptors 9 Baroreceptors = stretch receptors Arterial baroreceptors High pressure baroreceptors Sinoaortic baroreceptors Location Carotid sinus Aortic arch AHS Physiology - Cardiovascular System 11-12 Figure 14.26 5 Response of Baroreceptors 10 AHS Physiology - Cardiovascular System 11-12 Figure 14.27 Cardiovascular Control Center 11 Medulla oblongata Integration center for blood pressure regulation AHS Physiology - Cardiovascular System 11-12 6 Cardiac and Venous Baroreceptors 12 Location Walls of large systemic veins Walls of the atria Low pressure baroreceptors = volume receptors Decrease in blood volume activates receptors triggering responses that act in parallel with baroreceptor reflex AHS Physiology - Cardiovascular System 11-12 Cardiovascular Control Center 13 Output Sympathetic nervous system Parasympathetic nervous system AHS Physiology - Cardiovascular System 11-12 7 Autonomic Output to Cardiovascular Effectors 14 Parasympathetic input to: SA node (decrease HR) AV node Sympathetic input to: SA node (increase HR) AV node Ventricular myocardium (increase contractility) Arterioles (increase resistance) Veins (increase venomotor tone) AHS Physiology - Cardiovascular System 11-12 15 Major Neural Pathways in the Control of Cardiovascular Function AHS Physiology - Cardiovascular System 11-12 Figure 14.28 8 Components of Baroreceptor Reflex 16 Baroreceptor reflex = Negative feedback loop Function: Maintain BP (MAP) at normal levels Detectors = baroreceptors Afferents = nerves Integration center = cardiovascular control center Efferents = autonomic nervous system Effectors = heart, arterioles, veins AHS Physiology - Cardiovascular System 11-12 Example of the Baroreceptor Reflex 17 A person who had been lying down stands up quickly: Gravity causes venous pooling in the legs. This causes a decrease in VR, causing a decrease in CO This causes a decrease in blood pressure. Baroreceptors sense the decrease: reflex occurs The reflex causes increased sympathetic and decreased parasympathetic activity. CO and TPR are increased. Blood pressure is increased back to normal. AHS Physiology - Cardiovascular System 11-12 9 18 Baroreceptor Reflex in Response to a Decrease in MAP MAP Arterial baroreceptors Frequency of action potentials conducted to CNS Cardiovascular control center Parasympathetic activity SA node Sympathetic activity Ventricular myocardium Action potential frequency Contractility Veins Venomotor tone Arterioles Vasoconstriction Compliance Venous pressure Negative feedback EDV HR SV TPR MAP AHS Physiology - Cardiovascular System 11-12 Figure 14.29 Hormonal Control of MAP 19 Epinephrine: Released by adrenal medulla in response to sympathetic activity Increases mean arterial pressure Acts on heart Increases Increases Acts on smooth muscle of arterioles Increases Acts HR SV TPR on smooth muscle of veins Increases venomotor tone AHS Physiology - Cardiovascular System 11-12 10 Vasopressin and Angiotensin II 20 Vasoconstrictors Increase TPR Increase MAP AHS Physiology - Cardiovascular System 11-12 Summary of Cardiovascular Physiology 21 AHS Physiology - Cardiovascular System 11-12 Figure 13.2 11