TRANS Chapter Title: Nervous Regulation of the Circulation, and Rapid Control of Arterial Pressure

Reference: Guyton & Hall Textbook of Medical Physiology

NERVOUS REGULATION OF THE CIRCULATION ▪ Vasodilator area

Autonomic Nervous System
▪ Sympathetic - most important of the autonomic NS
o Vasomotor nerve fibers pass through thoracic spinal nerves and
L11-L2 spinal nerves → sympathetic chain → 2 routes:
▪ Sympathetic nerves
▪ Spinal nerves
▪ Parasympathetic - regulation of heart function
SYMPATHETIC INNERVATION OF THE BLOOD VESSELS
▪ Distribution: all except capillaries
▪ Precapillary sphincters and metarterioles are innervated (mesenteric
blood vessels)
▪ Small arteries and arterioles: resistance to blood flow and  rate
of blood flow
▪ Large vessels (veins): volume of these vessels
▪ Effect is especially powerful in kidneys, intestines, spleen, and skin
▪ Less potent in skeletal muscle and the brain
▪ Sympathetic Nerve Fibers to the Heart
o Stimulation markedly  heart activity:  heart rate and enhancing
its strength and  volume of pumping.
▪ Norepinephrine
▪ Sympathetic Vasoconstrictor Transmitter Substance
▪ Secreted at the endings of vasoconstrictor nerves
▪ Acts directly on alpha adrenergic receptors to cause vasoconstriction
▪ Adrenal Medullae
o Sympathetic impulses → cause medullae to secrete both epinephrine
and norepinephrine → carried in blood stream → act directly on blood
vessels → vasoconstriction
o Epinephrine that causes vasodilation: “beta” adrenergic receptor
stimulatory effect--- which dilates rather than constricts certain
vessels.
▪ Sympathetic Vasodilator System
▪ Sympathetic nerves to skeletal muscles carry sympathetic vasodilator
fibers and constrictor fibers.
o Cats: dilator fibers release acetylcholine
o Primates: vasodilator effect is caused by epinephrine exciting specific
beta-adrenergic receptors in muscles.
o Principal area of control: Anterior hypothalamus
PARASYMPATHETIC CONTROL OF HEART FUNCTION (HEART
RATE)
▪ Minor role in vascular regulation
▪ Most important circulatory effect: control heart rate
o Medulla →parasympathetic nerve fibers → Vagus nerves → heart
o  heart rate and slight  heart muscle contractility
▪ Emotional Fainting—Vasovagal Syncope
o Vasodilator reaction (anterior hypothalamus→vagus→heart) that cause
fainting
o Muscle vasodilator system becomes activated
o Vagal cardio inhibitory center → transmits strong signals to heart →
slow heart rate = arterial pressure →  blood flow to brain →loss
consciousness
SYMPATHETIC VASOCONSTRICTOR SYSTEM
Vasomotor Center in the Brain
▪ Location: reticular substance (medulla) and lower third of pons
▪ Parasympathetic impulses: vagus nerves to heart
▪ Sympathetic impulses: spinal cord and peripheral sympathetic
nerves
▪ Vasoconstrictor area
o Bilateral; anterolateral portions of upper medulla
o Excite preganglionic vasoconstrictor neurons of the sympathetic
nervous system.
o Sympathetic vasoconstrictor tone
▪ Slow firing of signal; 2 impulses/ second
▪ Maintains vasomotor tone (a partial state of contraction in the
blood vessels)
o Bilateral; anterolateral portions of lower medulla
o Inhibit vasoconstrictor activity causing vasodilation
▪ Sensory area
o “Reflex” Control
o Bilateral; tractus solitarius (posterolateral portions of medulla and
lower pons)
o Receive sensory nerve signals through vagus and glossopharyngeal
nerves
o Output signals control activities of both vasoconstrictor and vasodilator
areas of the vasomotor center
▪ 
Control of Heart Activity by Vasomotor Center
o Lateral portions: transmit sympathetic impulse to increase heart
rate and contractility; Vasoconstriction: Heart rate and strength
of contraction
o Medial portions: sends signals to adjacent dorsal motor nuclei of
vagus nerve transmiting parasympathetic impulse to decrease heart
rate and contractility; Vasodilation:  Heart rate and  strength of
contraction
▪ Control of Vasomotor Center by Higher Nervous Centers
o Reticular substance of the pons
▪ lateral and superior portions – excitation
▪ medial and inferior portions - inhibition
o Hypothalamus (control vasoconstrictor system)
▪ posterolateral portions – excitation
▪ anterior portion – mild excitation or inhibition
o Cerebral cortex
▪ motor cortex – excitate vasomotor system
o Either excite or inhibit
▪ Anterior Temporal Lobe
▪ Frontal Cortex
▪ Cingulate Gyrus
▪ Amygdala
▪ Septum
▪ Hippocampus
Rapid Control of Arterial Pressure
o Rapid increases in arterial pressure – sympathetic vasoconstrictor and
cardioaccelerator functions are stimulated together.
o Reciprocal inhibition of parasympathetic vagal inhibitory signals to the
heart.
o Three major changes occur simultaneously:
✓ Arterioles are constricted =  total peripheral resistance → 
arterial pressure
✓ Veins especially are strongly constricted = displaces blood
towards the heart →  volume of blood in the heart → arterial
pressure
✓ Heart is directly stimulated by autonomic nervous system→
enhancing cardiac pumping.
o Caused by:  heart rate;  contractile force of the heart;
 volumes of blood pumped
Increase in Arterial Pressure
o  blood flow → local vasodilation
o Simultaneous  of arterial pressure (sympathetic stimulation)
o Heavy exercise: 30-40%  arterial pressure → 2x  blood flow
o Extreme fright (Alarm reaction): 27-100 mmHg  in arterial
pressure within seconds
Reflex Mechanisms for Maintaining Normal Arterial Pressure
▪ Subconscious special nervous control mechanisms: Negative feedback
reflex mechanisms
o Baroreceptor Reflexes
▪ Best known of the nervous mechanisms for arterial pressure control
▪ Initiated by stretch receptors (baroreceptors or
pressoreceptors) located at the walls of large systemic arteries.
▪ Spray-type nerve endings, extremely abundant in:
• Internal carotid artery (slightly above carotid bifurcation)-- an
area known as carotid sinus

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 TRANS Chapter Title: Nervous Regulation of the Circulation, and Rapid Control of Arterial Pressure

Reference: Guyton & Hall Textbook of Medical Physiology

o Signals transmission: small Hering’s nerves → ▪  blood flow in lower brain stem → CO2 in brain → cerebral ischemia
glossopharyngeal nerves (high neck) → tractus solitarius → Vasoconstrictor and cardioaccelerator become strongly excited → 
(medulla) systemic arterial pressure
o Response occurs at arterial pressures above 60mmHg; ▪ “Cushing Reaction”
maximum at 180 mmHg o Reaction to increased pressure around the brain
• Aortic arch o Special type of CNS ischemic response that results from increased
o Signals transmission: vagus nerves and tractus solitarius pressure of the CSF around the brain in the cranial vault.
o Response occurs at arterial pressures 30mmHg and above. o Helps protect vital centers of the brain from loss of nutrition if ever
▪  arterial pressure → stretches the baroreceptors → transmit the CSF pressure rises high enough to compress the cerebral arteries.
signals to CNS → “Feedback” signals are sent back vai autonomic
NS →  arterial pressure Special Features of Nervous Control of Arterial Pressure
Increasing Cardiac Output and Arterial Pressure
Circulatory Reflex: Initiated by Baroreceptors ▪ Skeletal nerves and muscle’s play roles in circulatory responses:
▪ Secondary signals: ▪ Abdominal Compression Reflex
o Inhibit the vasoconstrictor center of the medulla o Baroreceptor or chemoreceptor reflex → nerve signals through skeletal
o Excite the vagal parasympathetic center nerves to skeletal muscles → particularly to the abdominal muscles -→
▪ Net effects: compresses venous reservoirs → helping to translocate blood out of
o Vasodilation of the veins and arterioles =  peripheral resistance the abdominal vascular reservoirs toward the heart.
o Decreased heart rate and strength of heart contraction =  cardiac o Result:  quantities of blood for heart to pump; cardiac output;
output arterial pressure
Changes in Body Posture: Function of Baroreceptor ▪ Skeletal Muscle Contraction During Exercise
▪ Immediately on standing: arterial pressure (head and upper body)  --- o Causes increased cardiac output (5-7x) and arterial pressure (100 to
loss of consciousness if markedly reduced. 130-160mmHg increase from normal)
▪ Immediate reflex: strong sympathetic discharge → minimizes decrease o During exercise → compress blood vessels throughout the bod →
in pressure translocate blood from peripheral vessels into the heart and lungs →
Pressure “Buffer”: Baroreceptor system  cardiac output
▪ Pressure Buffer System: Baroreceptor system opposes either
increases or decreases in arterial pressure Respiratory Waves in the Arterial Pressure
▪ Buffer Nerves: nerves from the baroreceptors. ▪ Respiratory wave: arterial pressure is 4-6 mmHg
▪ Primary purpose: reduce the minute-by-minute variation in arterial ▪ Result from several different effects:
pressure ▪ “Breathing signals” from medulla “spill over” into the vasomotor
Chemoreceptor Reflex: center with each respiratory cycle.
▪ Chemosensitive cells sensitive to  O2,  CO2, and  H+ ion ▪ Inspiration: thoracic pressure becomes more negative than usual,
▪ Location: two carotid bodies and one to three aortic bodies (blood vessels in chest to expand) ---  blood returning to the left
▪ Critically  arterial pressure → slow blood flow → O2,  CO2, and  side of the heart → momentarily decreases cardiac output and arterial
H+ ion → stimulates chemoreceptor pressure.
▪ Excite the vasomotor center → elevates arterial pressure to normal ▪ Pressure changes during respiration → excite vascular and atrial
▪ Not as powerful controller until pressure falls below 80mmHg stretch receptors→  arterial pressure during the early part of
Atrial and Pulmonary Artery Reflexes expiration and  arterial pressure during the remainder of respiratory
▪ Regulate arterial pressure cycle.
▪ Atria and pulmonary arteries –low-pressure receptors ▪ Deep respiration: blood pressure can rise and fall (20 mmHg per
▪ Play an important role in minimizing arterial pressure changes in respiratory cycle)
response to changes in blood volume.
▪ 300 mL of blood infused:
o All receptors intact: 15mm Hg
o Arterial baroreceptors denervated: 40mm Hg
o Low-pressure receptors are also denervated: 100 mm Hg
Volume Reflex:
▪ Atrial reflexes that activate the kidneys
▪ Signal transmission: atria → hypothalamus →  secretion of ADH
▪ Effects:  GFR and  Reabsorption (loss of fluid) blood volume
o  afferent arteriolar resistance →  glomerular capillary pressure →
 filtration of fluid into the kidney tubules
o  ADH → reabsorption of water from the tubules
Bainbridge Reflex:
▪ Atrial reflex control of heart rate
▪ Sinus Node:  atrial pressure = heart rate (15%)
▪ Bainbridge: 40-64% increase
▪ Helps prevent damming of blood in veins, atria, and pulmonary
circulation.
CNS Ischemic Response:
▪ Control of arterial pressure by the Vasomotor Center in response to
diminished brain blood flow.
▪ One of the most powerful of all the activators of the sympathetic
vasoconstrictor system.
▪ “Last ditch stand” pressure control mechanism: an emergency pressure
control system that acts rapidly and very powerfully to prevent further
decrease in arterial pressure whenever blood flow to the brain decreases
dangerously close to the lethal level.
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