regulation of arterial blood pressure terms sbp dbp pp map
TRANSCRIPT
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REGULATION OF REGULATION OF ARTERIAL ARTERIAL
BLOOD PRESSUREBLOOD PRESSURE
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TERMSTERMS
•SBP
•DBP
•PP
•MAP
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PHYSIOLOGICAL PHYSIOLOGICAL VARIATIONSVARIATIONS
•AGE•SEX•BODY BUILT•RACE•DIURNAL
VARIATIONS•POSTURE
•AFTER MEALS
•DURING SLEEP
•AFTER EXERCISE
•EMOTIONAL CONDITIONS
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DETERMINANTS OF DETERMINANTS OF ARTERIAL BLOOD ARTERIAL BLOOD
PRESSUREPRESSURE
•AP = CO x TPR
•CO = SV x HR
•SV = EDV ( – ) ESV
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DETERMINANTS OF ARTERIAL BLOOD PRESSURE
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REGULATION OF ARTERIAL REGULATION OF ARTERIAL BLOOD PRESSUREBLOOD PRESSURE
Regulation of Blood Pressure
NervousMechanism
Renal Mechanism
HormonalMechanism
LocalMechanism
By Vasomotor Center and Impulses
from Periphery
By Regulation
of ECF Volume and
renin – angiotensin mechanism
By Vasocons--trictor and Vasodilator Hormones
By Local Vasocons-
-trictors and Vasodilators
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REGULATION OF ARTERIAL REGULATION OF ARTERIAL BLOOD PRESSUREBLOOD PRESSURE
•SHORT-TERM CONTROL(IN SEC – MIN)
• INTERMEDIATE-TERM CONTROL
(30 MIN – HOURS)
•LONG – TERM CONTROL
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SHORT-TERM CONTROL OF SHORT-TERM CONTROL OF APAP
•CNS ISCHAEMIC RESPONSE
•BARORECEPTOR REFLEX
•CHEMORECEPTOR REFLEX
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CUSHING REFLEX
Gross hypotension or increased ICP
Decreased cerebral blood flow or decreased blood flow to VMC
Hypoxia and hypercapnia at VMC
Strong stimulation of VMC
Intense vasoconstriction
Increased pressure in carotid sinus
Activation of baroreceptor reflex
Reflex bradycardia
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REGULATION OF BLOOD REGULATION OF BLOOD PRESSURE BY PRESSURE BY
BARORECEPTOR MECHANISMBARORECEPTOR MECHANISMIncrease in Blood Pressure
Baroreceptors
Stimulation
Impulses via IX and X Cranial Nerves
Normal Blood Pressure
Dilatation of blood vessels
Bradycardia and reduction in cardiac output
Decrease in vasomotor tone
Increase in vagal tone
Inhibition of vasoconstrictor area
Stimulation of vasodilator area
Nucleus of tractus solitarius
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BARORECEPTOR REFLEXES TO RESTORE BLOOD PRESSURE TO NORMAL
When blood pressure becomes elevated above normal
Carotid sinus and aortic arch receptor potential
Rate of firing in afferent nervesCardiovascular center
Sympathetic cardiac nerve activity
and
Sympathetic vasoconstrictor nerve activity
and
Parasympathetic nerve activity
Heart rate
and
stroke volume
and
arteriolar and venous vasodilation
Cardiac output
and
total peripheral resistance
Blood pressure decreased toward normal
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BARORECEPTOR REFLEXES TO RESTORE BLOOD PRESSURE TO NORMAL
When blood pressure falls below normal
Carotid sinus and aortic arch receptor potential
Rate of firing in afferent nervesCardiovascular center
Sympathetic cardiac nerve activity
and
sympathetic vasoconstrictor nerve activity
and
parasympathetic nerve activity
Heart rate
and
stroke volume
and
arteriolar and venous vasoconstriction
Cardiac output
and
total peripheral resistance
Blood pressure increased toward normal
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BARORECEPTOR REFLEX
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CHEMORECEPTOR REFLEX
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INTERMEDIATE CONTROL INTERMEDIATE CONTROL OF APOF AP
•RENIN - ANGIOTENSIN – VASOCONSTRICTOR MECH.
•STRESS RELAXATION OF VASCULATURE
•FLUID – SHIFT THROUGH THE CAPILLARY WALL
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REGULATION OF BLOOD REGULATION OF BLOOD PRESSURE BY RENIN-PRESSURE BY RENIN-
ANGIOTENSIN MECHANISMANGIOTENSIN MECHANISM
Decrease in Blood Pressure
Stimulation
Juxtaglomerular apparatus
Renin
Angiotensinogen Angiotensin I
Converting enzyme
Angiotensin II
Normal Blood Pressure
Vasoconstriction
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SITES OF PRODUCTION
Renin - J.G Cells of
Kidney
Angiotensinogen - Liver Cells
ACE - Lungs
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LONG – TERM CONTROL OF LONG – TERM CONTROL OF APAP
•RENAL FLUID SHIFT (THROUGH ADH / VOLUME RECEPTORS)
•RENIN – ANGIOTENSIN – ALDOSTERONE MECH.
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RESTORATION OF FLUID VOLUME OF THE BODY BY ADH IN VOLUME DEPLETION STATE. [NTS: NUCLEUS
TRACTUS SOLITARIOUS]
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Sequential events by which increased salt intake increases the arterial
pressure.Increased salt intake
Increased extracellular volume
Increased arterial pressure
Decreased renin and angiotensin
Decreased renal retention of salt and water
Return of extracellular volume almost to normal
Return of arterial pressure almost to normal
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LOCAL MECH. FOR CONTROL LOCAL MECH. FOR CONTROL OF APOF AP
A. Vasodilatos1. EDRF
2. Bradykinin3. Histamine4. ANP5. VIP6. Substance P
7. Prostacyclin8. Adenosine
9. K+
10. Acidosis [ CO2]
11. Hypercapnia12. Hypoxia13. Temperature
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B. Vasoconstrictors
1. Endothelin-12. Angiotensin II3. Norepinephrine4. ADH5. Serotonin6. Thromboxane A27. Neuropeptide-Y8. Cold
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HORMONAL MECH. FOR HORMONAL MECH. FOR CONTROL OF APCONTROL OF AP
•HORMONES RAISING AP–ADRENALINE–NORADRENALINE–THYROXINE–ALDOSTERONE–VASOPRESSIN–ANGIOTENSIN–SEROTONIN
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HORMONAL MECH. FOR HORMONAL MECH. FOR CONTROL OF APCONTROL OF AP
•HORMONES DECREASING AP–VIP–BRADY KININ–PROSTAGLANDIN–HISTAMINE–ACETYLCHOLINE–ANP
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PATHOLOGICAL PATHOLOGICAL VARIATIONSVARIATIONS
•HYPERTENSION
•HYPOTENSION
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