REGULATION OF

VISCERAL ACTIVITY
WAYNE MANANA
BDS(UZ),BA,MDS(OMFS)
FACILITATOR ; DR W. MURITHI
COMPONENTS OF A CONTROLLED SYSTEM

 sensor
 Afferent pathway
 Controller/ intergrator
 Efferent pathway
 Effector
 Controlled variable
Mechanisms of visceral activity control

 Can be
 Negative feedback(most common)
 Positive feedback e.g release of cck, secretin
 Feedforward e.g exercise, salivation, gastric secretion
 Can also be
 Involuntary/ automatic
 voluntary
 Can be
 Endocrine
 Paracrine
 Neuronal/ nervous
Major visceral activity

 Cardiovascular system
 Respiratory system
 Gastrointestinal system
 Renal system
 Genitourinary system
LEVELS OR HIERACHY OF REGULATION

 Spinal cord
 Bladder reflexes
 Medulla(vital centres)
 CVS and RS
 Vomiting, coughing, gagging, sneezing, swallowing
 Hypothalamus
 Satiety, hunger, thirst,
 Midbrain-pupillary and accommodation reflexes
 Basal nuclei and cortex-modulation of brain stem
Spinal cord(defecation/voiding)
MEDULLARY LEVEL
REGULATION OF CVS

 Can be
 Neural(rapid pressure changes e.g postural changes)
 Endocrine( delayed response)
 paracrine
 Regulation occurs at
 Local tissue level(autoregulation)
 Systemic/ general
 CONTROLLED VARIABLES
 Blood pressure
 Oxygen and nutrients to the tissues
 Carbon dioxide, H+, metabolites from tissues
 Temperature(thermoregulation)
Receptors cvs
 Baroreceptors
 Stretch receptors in the tunica adventia
 High pressure baroreceptors
 Carotid sinus
 Aortic arch receptors
 Low pressure baroreceptors(cardiopulmonary
receptors)
 Rt and lt atrium(Type A and Type B) receptors
 Pulmonary vessels receptors
 Ventricular walls
Baroreceptors cont
 More sensitive to pulsatile pressure than to constant
pressure
 Chronic hypo/hypertension “resets” the
baroreceptors
 Carotid sinus- linear relationship in response
between 70 and 150mmHg
chemoreceptors
 Peripheral chemoreceptors mainly exert their effect
on resp system but their stimulation also causes
vasoconstriction
 Hypoxia produces hyperpnea and increases
catecholamine release
Afferent pathway
 Carotid sinus
 Glossopharyngeal(carotid sinus nerve)
 Aortic arch
 Vagus(aortic depressor nerve)
 Neurotransmitter
 glutamate
Basic pathways; medullary bp control
Medullary control of heart rate by vagus
Other afferents to th RVLM
 excitatory
 Limbic cortex that relay in the hypothalamus
 Mesencephalic periaquaductal gray
 Brainstem reticular formation
 Pain pathways
 Somatic afferent(somatosympathetic reflex..exercise)
Afferent cont..
 Inhibitory
 Cortex via hypothalamus
 Caudal medullary raphe
 Lung inflation afferents
Efferent and effector
 ANS to smooth muscles(mainly arterioles) via
endothelial cells
 Ach binds to end cells and they is increased
intracellular calcium which activate NOS3 which
activates guanyly cyclase then relaxation smooth
muscle
 Expt capillaries and venules
 Noradrenegic expt muscles
 Cardiac receives both PS and S
autoregulation
 Myogenic theory of autoregulation
 Metabolic theory of autoregulation
 Stagnation built-up of metabolites
 Metabolites have vasodilator effect e.g low O2, Low
pH, inreases CO2, hyperosmolarity, rise in temp,
hyperkalaemia a feature, lactate, histamine, adenosine,
NO(EDRF),bradykinin, CO
 vasoconstriction 5-HT from plts in injured,histamine
via H1, sub P, VIP, ET
REGULATION OF RS
 Can be voluntary or involuntary
 Can be neuronally or chemically controlled
 The controlled variable is pO2, pCO2 and pH
chemoreceptors
 Chemoreceptors
 Carotid bodies (more important)
 Aortic bodies
 Medullary chemoreceptors(R/CVM)
 Close to NTS,hypothalamus, locus ceruleus
 Glomus cells(type 1) with K+-sensitive O2
channels and L-type Ca2+ channels
 Stimulated by low O2, CN-,nicotine, lobeline,
hyperkalaemia,
Non-chemical receptors
 Myelinated
 Slow adapting type(herring-breuer relexes)
 Rapidly adapting type(irritant receptors)
 Non-myelinated(J receptors)
 Pulmonary C fibers
 Bronchial C fibers
afferent
 Afferent
 Vagus (aortic body and the non-chemical receptors)
 Glossopharyngeal (carotid body)
 Have D2 receptors
contollers
 4 contollers
 Pre-BOTC
 Dorsal and Ventral
groups of resp
 Pneumotaxic
centre
 DRG and VRG both
found in the medulla and
project to the pre-BOTC
 Pneumataxic center
modifies the Pre-BOTC.
PC located in the medial
parabrachial and kolliker
nuclei of th dorsolat pons
 PC fxn not known but
probably switching btwn
insp and exp
OTHER AFFERENTS
 Reticular formation
 Propioceptors
 Limbic system, hypothalamus
 Baroreceptors
 Cerebral cortex
efferents
 Voluntary
 Corticospinal to accesory muscles of resp and
intercostal muscles
 Automatic
 Cervical via phrenic nerve goes to the diaphragm
 Thoracic via intercostal nerves goes th intercostal
muscles
 Sympathetic(B2) causes brochodilation & vasoC
 Parasymp(vagus) opposes symp
COUGHING AND SNEEZING
 Triggered my irritation of resp mucosa
 Coughing begins by deep insp followed by forced
exp.
 Intrapulmonary pressure increases to 100mmHg or
more, glottis open, outflow at 965km/hr(600mi/hr)
 Sneezing similar expt glottis continuosly open and
initiated by pain fibers of trigeminal nerve(nasal
epithelium)
REGULATION OF GIT
 Regulation can be
 neural,(intrinsic and extrinsic)
 endocrine and paracrine
 Controlled variable is secretion and motility with
an ultimate goal of efficient digestion, absorption
and assimilation
 Git like the “little brain”
 Regulation of salivation(prototype for glands)

 Feed forward and

feedback
 Symp alpha-1 causes
thick viscous, Beta
causes amylase
secretion
vomiting
HYPOTHALAMUS LEVEL
VISCERAL FUNCTION OF HYPOTHALAMUS
FUNCTIONS CONT..
Role of hypothalamus in;
 Posterior pituitary(oxytocin/VP)
 Appetitive mechanisms
 Hunger and satiety
 thirst
 Relation to
 Autonomic function
 Cyclic phenomenon
HUNGER AND SATIETY
 Appetite depends on interaction btwn
 Satiety centre(ventromedial nucleus)
 Feeding centre(bed nucleus of forebrain bundle at its
junction with the pallidohypothalamic fibres)
 Leptin and more 20 proteins/pptides have been
implicated in the regulation of appetite
HUNGER AND SATIETY
AFFERENT MECHANISMS HYPOTHESIS

 Lipostatic hypothesis
 Humoral signal(leptin) from adipose produced
proportional to fat, acts on hypoTh to inhib apt
 Gut peptide hypothesis
 Food in GIT stimulates hormones to inhib hypoTh
 Glucostatic hypothesis
 Thermostatic hypothesis
 Fall in temp below set pt stimulate apt and vice versa
 LEPTIN (lipostatic hypothesis)
 167aas, o/b gene(leptin) and
d/b gene(receptor)
 Acts on the hypoTh to decrease
food intake by
 Decrease th activity of
neuropepptide Y neurons
 Increase th activity of POMC
from neurons
 Leptin acts on arcuate
nuclei(can be destroyed by
gold thioglucose)
 Competes for CB1 receptor
wth cannabinoids
 GHRELIN
 28 aas pptide wth n-
octanyl on serine 3
residues
 Antagonizes the action of
leptin
 Produced by stomach to
act on th arcuate nuclei to
stimulate appetite
 Stimulates GH release
Other peptides
 Peptide YY3-26(PYY)
 From small intestines and colon to inhibit appetite
 GIT hormones
 CCK, secretin, somatostatin, gastrin, GRP
 THIRST
 Triggered by
 hypovolaemia
 hyperosm
 Psychological
 Osmoreceptors located in th ant
hypoTh in th circumventricular
organs
 subfornical organ and OVLT
have receptors for Angiotensin
II
 Baroreceptor reflex
mechanisms also involved in
triggering thirst in hypovoelemic
Thirst-osmolarity relationship
Other factors affecting water intake
 Prandial water drinking
 Psychological/ habit
 Increased plasma osmolarity
 GIT hormones acting on the hypothalamus
 Ant cerebral artery injuries,lesions in the ant
hypoTh, altered state of unconsciousness, high
protein diet, pharyngeal mucosa drying
 Pharyngeal gastrointestinal “metering” probably
involved in satisfaction of thirst
CONTROL OF POST PITUITARY FXN
OXYTOCIN AND VASOPRESSIN
 Nonapptides neural hormones
with terminal disulphide ring
 Synthesized by magnocellular
neurons(Herring bodies
granules) in the paraventricular
and supra-optic nuclei
 Other species have lysine-VP
 Also found in gonads,
thymus,adrenal cortex,
suprachiasmatic N, brainstem
& spinal cord(T.boutons)
CHEMISTRY OF VP AND OXYTOCIN

 An AP in the magnocellular neurons triggers a Ca2+

mediated exocytosis of both VP and oxytocin
Physiologic action of VP
 Release is phasic bursting non-synchronous and
mantains a prolonged output increase in VP
 Causes water retention in excess of solute by acting
on collecting duct
 VIA Receptors
 G protein coupled to increase IC Ca2+ and mediates
vasoC.(at high levels because at low level causes a
decrease in CO by acting on th area postrema)
 Also found in the liver(glycogenolysis), brain&cord(NT)
Receptors cont…
 V1B(also calledV3) is a G protein coupled to
increase IC Ca2+ found in the ant pituitary to
release ACTH.
 V2 receptor
 is a Gs protein coupled that triggers to increase cAMP
 found on the principal cells of the collecting duct
 Facilitates insertion of aquaporin-2 into the apical
membrane
Relationship btwn osm/BP and VP
 VP
 T1/2 of18mins and
inactivated in the liver
 Regulated by OVLT
receptors but the
threshold for thirst is
slightly higher
 Significant changes
occur even if osm
changes by 1%
oxytocin
 Acts via G protein coupled receptors on the
myometrium, breast myoepithelial cells and ovary
to trigger increase in I.C Ca2+ .
 Milk ejection reflex(neuroendocrine reflex)
 Many hormones cause breast growth and secretion but
ejection is entirely due to oxytocin
 Tactile/stretch receptors on the nipple trigger a high
frequency, synchronous discharge of Oxytocin
 Emotions and genital stimulation stimulate release but
alcohol inhib
Other actions of oxytocin
 Stimulate uterine contraction. Inhibited by
progesterone(competitive inhib on oxytocin
receptors) and activated by estrogen
 Coitus stretch stimulate uterine contraction to
facilitate mvnt of sperm.
 circulating levels elevated at ejaculation ???
contraction of vas deferens smooth muscle??
QUOTE OF THE DAY
 WHAT IS NOT WORTH DYING FOR IS NOT
WORTHY LIVING FOR

 HYPOTHALAMUS REGULATES BUT GOD

CONTROLS