心血管调节.ppt

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1、心血管调节现在学习的是第1页，共31页现在学习的是第2页，共31页 现在学习的是第3页，共31页Baroreceptor Reflex现在学习的是第4页，共31页Fig 2现在学习的是第5页，共31页Figure 2:Arterial mechanoreceptors of the carotid sinus and aortic arch.The nerve fibers from the carotid sinus form the sinus nerve,which joins the vagus and sympathetic to form the vagosympathetic t

2、runk.The afferent fibers from the receptors are myelinated(-)and unmyelinated(-).The nerves terminate in the solitary tract nucleus.Changes in the activity of those mechanoreceptors caused by alterations in the arterial blood pressure result in appropriate adjustments in the vagal and sympathetic ou

3、tflow to the heart,and the sympathetic outflow to the resistance and capacitance vessels.These adjustments buffer changes in the arterial blood pressure.NE=norepinephrine.Ach=acetylcholine.SA=sinus node.AV=atrioventricular node.(Redrawn from Shepherd and Vanhoutte.The Human Cardiovascular System Fac

4、ts and Concepts.Raven Press,1979.)现在学习的是第6页，共31页FIGURE 1 现在学习的是第7页，共31页现在学习的是第8页，共31页FIGURE 5现在学习的是第9页，共31页Figure 5:Hemodynamic effects of a decrease in activity of the mechanoreceptors in the carotid sinus,aortic arch,and cardiopulmonary region.The continuous inhibition of the solitary tract nucleu

5、s in the medulla of the brain is lessened,and there is increases sympathetic outflow to the heart and blood vessels and decreased vagal activity to the heart.The constriction of the systemic vascular beds results in an increase in total systemic vascular resistance.The cardiac output is maintained b

6、y the increased rate and contractility,and maintenance of its filling pressure by the reflex constriction of the systemic veins.The coronary flow is increased bt the increased products of metabolism of the myocardial cells and by activation of beta-receptors.The systolic and diastolic pressures are

7、increased so an adequate perfusion pressure to the brain and coronary vessels is sustained.If the decreased pressure is due to hemorrhage,the cardiac output decreases in spite of the increase in rate and contractility because the venoconstriction is unable to provide an adequate filling pressure owi

8、ng to the continuing blood loss.ACh=acetylcholine.NE=norepinephrine.PRU=peripheral resistance units.(Redrawn from Shepherd and Vanhoutte.The Human Cardiovascular System Facts and Concepts.Raven Press,1979.)现在学习的是第10页，共31页 Figure 6:Regulation of Mean Systemic Arterial Pressure现在学习的是第11页，共31页Constrict

9、ion of the resistance vessels in muscle,kidney,splanchnic beds,and skin so that the total peripheral resistance(TPR)increases.2)Constriction of the splanchnic veins.The resulting mobilization of blood is assisted by passive expulsion following constriction of the resistance vessels.This helps mainta

10、in the appropriate venous return and hence filling pressure(preload)of the heart.3)Increase in heart rate and myocardial contractility due to increased sympathetic and decreased vagal activity.The cardiac output can therefore be maintained or elevated.When the arterial blood pressure increases,the r

11、everse occurs.(See Figure 6-similar to Figure 1)现在学习的是第12页，共31页Increased baroreceptor activity increases parasympathetic activity to the heart.Baroreceptor activation suppresses sympathetic tone to the heart and blood vesselsThe Baroreceptor Reflex现在学习的是第13页，共31页二 Carotid body and aortic body chemor

12、eceptor reflex(一)反射弧的组成:chemoreceptor 传入出神经和中枢 窦N、vagus nerve M孤束核 MRN 元(+)和CVN元(交感缩血管神 经元(+)、心迷走神经元(+).(二)反射效应:直接-R深 频率;HR血管收缩(brain and heart除外).整体-HRCO;brain and heart blood flow ,腹腔内脏和肾 blood flow ABP(PO2 肾上腺髓质分泌E、NE).(三)生理意义:主要RM调节,一般情况下对心血管活动不起明显调节作用,只有在PO2、ABP 60mmHg、窒息、酸中毒等时 才发挥明显调节(参与机体应急状态

13、循环功能调节,维持ABP,实现血液再分配调节).现在学习的是第14页，共31页Chemoreceptors现在学习的是第15页，共31页三Cardiovascular reflex of cardiopulmonary receptor (一)反射弧的组成:cardiopulmonary receptor(低压力、高压力和容量 receptor).传入出神经和中枢 适宜刺激(壁的机械牵张、化学物 质)、心迷走神经tone,心交感神经tone,angiotensin II释 放(-).(二)反射效应:HRCO PR ABP ,renal blood flow排水钠.(三)生理意义:主要调节血量及

14、体液的量和成分.现在学习的是第16页，共31页Inspiration heart rateExpiration heart rateRespiratory Sinus Arrhythmia现在学习的是第17页，共31页3.2.1 Epinephrine or adrenaline and norepinephrine or noradrenaline 一来源 主肾上腺髓质分泌(E80%、NE20%),次肾上腺素能神经末梢释放NE.二调节 对整体生理功能调节(可动员机体许多器官参与);对某种特定的刺激表 现为一定整合型式的反应.三作用 Epinephrine or adrenaline nore

15、pinephrine or noradrenaline 次 主 主 次 1 2 现在学习的是第18页，共31页现在学习的是第19页，共31页现在学习的是第20页，共31页现在学习的是第21页，共31页3.2.2Renin-angiotensin system一来源 肾的近球细胞合成和分泌.二调节 肾血流量;血浆晶体渗透压.三作用 见Fig.4-现在学习的是第22页，共31页现在学习的是第23页，共31页现在学习的是第24页，共31页3.2.3Vasopressin一来源 下丘脑视上核和室旁核神经元合成.二调节 血浆晶体渗透压;循环血量.三作用 肾的远曲和集合管促进水的重吸收;血管平滑肌收缩.见

16、Fig.4-现在学习的是第25页，共31页现在学习的是第26页，共31页现在学习的是第27页，共31页Extracellular Fluid Volume and Blood Pressure现在学习的是第28页，共31页3.2.4Atrial natriuretic peptide一来源 心房肌细胞合成 二调节 心房壁牵拉；血容量；三作用 见Fig.4-现在学习的是第29页，共31页现在学习的是第30页，共31页3.3.1 Autoregulation of metabolismautoregulation;see microcirculation.3.3.2 肌源性autoregulation3.4 Long term regulation of arterial blood pressure定义;renal-body fluid mechanism;影响该机制的主要因素 vasopressin;renin-angiotensin aldosterone system 现在学习的是第31页，共31页