ARTERIAL

PRESSURE Short
Term Regulation
Mean Arterial Pressure (MAP)

⮚Average pressure in arteries through out cardiac

cycle
⮚Mean driving force propelling the blood through
micro vessels
⮚MAP = DBP + 1/3 of pulse pressure
⮚MAP = 80 + 13 = 93 mm Hg
Mean Arterial Pressure
(MAP)
⮚M.A.P must be closely regulated due to two
reasons:
1. To ensure sufficient driving pressure

2. To avoid extra work load on heart & possible risk

of vascular rupture
ARTERIAL PRESSURE
⮚The force exerted by the blood against any unit
area of the arterial vessel wall
Depends on:
1. Blood volume within the vessel
2. Compliance of the vessel wall
• B.P = SBP/DBP (mmHg) = 120/80 mm Hg
Determinants of blood pressure

Mean Arterial Pressure=

Cardiac Output X Total Peripheral Resistance

Pa = CO x TPR
 Determinants of blood pressure
1. Cardiac output: SV x HR
⮚ Balance between Sympathetic & parasympathetic
nervous system activity

2. Total peripheral resistance

⮚ Intrinsic mechanisms (myogenic &metabolic)
⮚ Extrinsic (ANS activity & hormones)

3. Blood volume:
⮚ Renin Angiotensin Aldosterone System- Vasopressin
⮚ Passive fluid shift
Nervous regulation of
circulation
• Sympathetic
nervous system
is important in
control of
circulation.
• Parasympathetic
nervous system
is important in
regulating heart
function.
Vasomotor Centre(VMC)
Vasomotor Center in the
Brain
⮚located bilaterally in reticular center of

medulla and lower 1/3 pons

⮚VMC transmits impulses downward through

the cord to almost all blood vessels.

⮚Transmits parasympathetic impulses through

Vagus nerve to Heart.

Vasomotor Center in the
Brain
⮚Vasomotor center
M
o ⮚Vasoconstrictor area (upper
t
o anterolateral medulla)
r

a ⮚Vasodilator area (lower

r
e anterolateral medulla)
a
s
⮚Sensory area – b/l nucleus of tractus

solitarius-medulla oblongata

(terminus of IX & X cranial nerves)

Vasomotor Center in the
Brain
⮚Vasomotor center- Vascular control

⮚Vasoconstrictor area C1 (upper

anterolateral medulla)

⮚Sympathetic stimulation (VC neurons)

⮚Vasodilator area A1 (lower

anterolateral medulla)

⮚Sympathetic inhibition (inhibit VC

activity)--VD
Vasomotor Center in the
Brain
⮚Vasomotor center- Cardiac control

⮚Cardio stimulatory center

⮚lateral portion of VMC
⮚Excitatory sympathetic impulses to
heart- ↑HR,↑ contractility

⮚Cardio inhibitory center

⮚medial portion of VMC

⮚Parasympathetic impulses via vagus-

↓HR & contractility
Vasomotor Center in the
⮚Vasomotor center
Brain
⮚Sensory area A2–
⮚Posterolateral portion of Medulla & Lower pons—

⮚ b/l nucleus of tractus solitarius

⮚Receive Sensory inputs through Vagus &

Glossopharyngeal Nerves.

⮚Control Vasoconstrictor & vasodilator Areas e.g.: Reflex

control of B.P
Vasomotor Center in the Brain
⮚Inputs
⮚From higher centers
⮚Cerebral cortex, limbic system, hypothalamus
⮚From periphery
⮚Baroreceptors
⮚Chemoreceptors
⮚Direct stimulation :
⮚CO2, Hypoxia
⮚Outputs
⮚To heart, arteries and veins through autonomic
nervous system
Vasomotor Center in the Brain

⮚Organs affected are

⮚Heart
⮚Arteries
⮚Veins
⮚Response
⮚Constriction of arterioles- vasoconstriction
⮚Constriction of veins-vaso constriction
⮚Direct effect on heart --↑HR,↑ contractility
Vasomotor Center in the Brain
Vasomotor tone
⮚Definition: continuous partial state of
contraction of blood vessels
⮚Under normal conditions, Vasoconstrictor Area
of V.M.C has a continuous rate of firing @ 1-2
impulses/sec– impulses to VC nerve fibers of the
body
⮚responsible for Sympathetic Vasoconstrictor
Tone
 Vasomotor Discharge
⮚↑ Vasomotor Discharge:
⮚Arteriolar Constriction, ↑ B.P
⮚Vasoconstriction : Translocates Blood &↑ Venous Return

⮚↑ H. Rate, ↑ Stroke vol, ↑ C.O

⮚↓Vasomotor Discharge:
⮚Vasodilatation, ↓ B.P,
⮚↑ Blood vol in reservoirs, ↓Venous Return

⮚↓ H. Rate
Vasovagal Syncope….emotional fainting
Emotiona
l Cortex
Stress

hypothalamus

Decreased Medulla Increased Vagal Output

Sympathetic Powerful activation of
Output VD center

Total Peripheral Venous Return

Resistance, VD in Cardiac Output
Skeletal muscles

Arterial Pressure

Cerebral
blood flow

Loss of Consciousness
Regulation Of Blood Pressure
Regulation of blood pressure
1. Short term regulation
⮚Rapid regulation of MAP - within seconds
⮚Nervous regulation - autonomic reflexes

⮚Acts by altering CO and TPR

2. Long term regulation

⮚Slow regulation of MAP - within minutes, hours, days or
months
⮚Hormonally mediated
⮚Through regulation of blood volume by kidneys
Regulation of Arterial Pressure
A. Rapid control of arterial pressure - Role
of the nervous system:
1. Arterial baroreceptor reflex
2. Chemoreceptor reflex
3. Low pressure receptors
⮚Volume reflex
⮚Bainbridge reflex
4. CNS ischemic response
B. Long term control of arterial pressure:
1. Thirst mechanism
2. Renal body fluid mechanism
A. Rapid control of arterial pressure
⮚Regulates minute to minute variations in blood pressure
⮚Responds within seconds

⮚Accomplished by : Alterations in CO and TPR by

⮚Autonomic sympathetic reflexes

⮚Baroreceptor reflex

⮚Chemoreceptor reflex

⮚CNS ischemic response

⮚Cushing reaction respond to decrease in cerebral blood

A. Rapid control of arterial
pressure
⮚Act via Autonomic nervous system reflexes by
⮚i. STIMULATING

vasoconstrictor & cardio accelerator functions

⮚ii. RECIPROCAL INHIBITION

of parasympathetic (Vagus) nerve

⮚Response begins:
⮚In seconds (5-15 sec)
1. ARTERIAL BARORECEPTOR
REFLEX -pressoreceptors

Spray type
nerve endings
Activation of baroreceptors
• Not stimulated at all between 0 to 60 mm Hg
• Respond progressively but more rapidly between 60
to 180 mm Hg, most sensitive at 100mmHg
• Carotid receptors operate
at pressure levels about
30 mm Hg higher than
aortic receptors
• Respond much more to a
rapidly changing pressure
Pressure “buffer” function of the
baroreceptor control system
⮚PRESSURE BUFFER SYSTEM; opposes either increases or
decreases in arterial pressure thereby reducing daily
variations in arterial pressure

⮚A primary purpose of the arterial baroreceptor

system is to reduce the minute by minute variation
in arterial pressure
• Firing rate in the afferent neuron from the carotid sinus
baroreceptor in relation to the magnitude of mean arterial
pressure.
Respond much more to a rapidly changing pressure
rather than stationary pressures
Respond much more to a rapidly changing pressure
rather than stationary pressures
Functions of baroreceptors: BP maintenance during changes
in body posture; disorder leads to Orthostatic hypotension
Adaptation of baroreceptors
⮚ Baroreceptors tend to reset in 1 to 2 days to the pressure
level to which they are exposed
⮚ Do not contribute to long-term blood pressure regulation.
⮚ Rise of mean arterial pressure leads to increase in rate of
baroreceptor impulses within seconds
⮚ The rate of firing diminishes:

I. considerably during the next few minutes

II. much more slowly during the next 1-2 days
III. returns to nearly normal level after 1-2 days with
mean arterial pressure still at increased level
 2. CHEMORECEPTOR REFLEX
⮚Chemosensitive cells : sensitive to O2
lack, CO2 excess and H+ excess
⮚Chemoreceptor organs:
⮚ 2 carotid bodies, one of which lies in the
bifurcation of each common carotid
artery
⮚ 1 to 3 aortic bodies adjacent to the aorta
⮚Supplied with an abundant blood flow
through a small nutrient artery
⮚Activated when the arterial
pressure falls below 80 mm Hg.
Chemoreceptor reflex
Important at low pressure levels ≥ 30 mmHg < 80 mmHg
3. LOW-PRESSURE RECEPTORS
⮚Stretch receptors in the walls of atria and pulmonary
arteries
⮚Respond to blood volume changes (↓↑), if denervated
mark increase in arterial pressure
⮚ Volume reflex: ‘Atrial reflex to kidneys’
⮚Detect increases in blood pressure in the low pressure
areas of the circulation caused by increase in volume
⮚ Bainbridge reflex ‘Atrial reflex to control heart rate’
⮚Elicit reflexes parallel to the baroreceptor reflexes to
make the total reflex system more potent
 Atrial reflex to kidneys
The Volume Reflex
Stretch of the atria due to increased blood volume

Reflex dilation of the afferent Decrease Secretion of anti-

arterioles in kidneys diuretic hormone by
hypothalamus
Capillary pressure rises
Decrease re-absorption
of water
Increase in filtration of Increase release of
fluid by the kidney ANP

increases salt and water loss by kidney

Brings the arterial pressure back toward normal

Bainbridge Reflex
⮚Increase in atrial pressure increases heart rate (40-60%)
⮚Prevents damming of blood in veins, atria and pulmonary
circulation.
⮚Stretch of atria sends signals to Vasomotor center →
↑sympathetic & ↓ vagal activity → increased heart rate &
contractility

Vasomoto Heart
Atrial Vagal rate
Stretch r
receptors afferents Center
Contractility

Atrial reflex to control heart rate

4. CNS ISCHEMIC RESPONSE
⮚“Last ditch stand”
⮚CNS Ischemic response is activated
in response to cerebral ischemia
CO2, lactic acid and other acidic
substances buildup One of the
most powerful activators of the
sympathetic vasoconstrictor
system.
CNS Ischemic Response
ONE OF THE MOST POWERFUL OF ALL THE ACTIVATORS OF THE
SYMPATHETIC VASOCONSTRICTOR SYSTEM.
Importance of the CNS Ischemic
Response
• Activated when arterial pressure falls down to 60 mm Hg or below

• Greatest degree of stimulation at a pressure of 15 to 20 mm Hg.

• Operates AS AN EMERGENCY PRESSURE CONTROL SYSTEM –
• 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.
• INTENSE SYMPATHETIC VASOCONSTRICTION
• The degree of sympathetic vasoconstriction caused by intense
cerebral ischemia is often so great that some of the peripheral
vessels become totally or almost totally occluded
 Cerebrospinal fluid pressure rises to equal the arterial pressure

Compresses the whole brain as well as the arteries in the brain and cuts
off the blood supply

CNS ischemic response initiated that causes the arterial pressure to rise

Blood will flow once again into the vessels of the brain to relieve the
brain ischemia

Helps protect the vital centers of the brain from loss of nutrition if ever
the CSF pressure rises high enough to compress the cerebral arteries
OTHER REFLEXES
• Skeletal muscle contraction during exercise
• Abdominal compression reflex
• Compression of abdominal muscles- translocate blood out
of abdominal vascular reservoirs towards heart
• Seen in paralyzed patients prone to hypotensive episodes
whose skeletal muscles have been paralyzed