心血管调节课件.ppt

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1、心血管调节第1页，此课件共31页哦第2页，此课件共31页哦第3页，此课件共31页哦Baroreceptor Reflex第4页，此课件共31页哦Fig2第5页，此课件共31页哦Figure 2:Arterialmechanoreceptorsofthecarotidsinusandaorticarch.Thenervefibersfromthecarotidsinusformthesinusnerve,whichjoinsthevagusandsympathetictoformthevagosympathetictrunk.Theafferentfibersfromthereceptorsar

2、emyelinated(-)andunmyelinated(-).Thenervesterminateinthesolitarytractnucleus.Changesintheactivityofthosemechanoreceptorscausedbyalterationsinthearterialbloodpressureresultinappropriateadjustmentsinthevagalandsympatheticoutflowtotheheart,andthesympatheticoutflowtotheresistanceandcapacitancevessels.Th

3、eseadjustmentsbufferchangesinthearterialbloodpressure.NE=norepinephrine.Ach=acetylcholine.SA=sinusnode.AV=atrioventricularnode.(RedrawnfromShepherdandVanhoutte.TheHumanCardiovascularSystemFactsandConcepts.RavenPress,1979.)第6页，此课件共31页哦FIGURE 1 第7页，此课件共31页哦第8页，此课件共31页哦FIGURE 5第9页，此课件共31页哦Figure 5:Hemo

4、dynamiceffectsofadecreaseinactivityofthemechanoreceptorsinthecarotidsinus,aorticarch,andcardiopulmonaryregion.Thecontinuousinhibitionofthesolitarytractnucleusinthemedullaofthebrainislessened,andthereisincreasessympatheticoutflowtotheheartandbloodvesselsanddecreasedvagalactivitytotheheart.Theconstric

5、tionofthesystemicvascularbedsresultsinanincreaseintotalsystemicvascularresistance.Thecardiacoutputismaintainedbytheincreasedrateandcontractility,andmaintenanceofitsfillingpressurebythereflexconstrictionofthesystemicveins.Thecoronaryflowisincreasedbttheincreasedproductsofmetabolismofthemyocardialcell

6、sandbyactivationofbeta-receptors.Thesystolicanddiastolicpressuresareincreasedsoanadequateperfusionpressuretothebrainandcoronaryvesselsissustained.Ifthedecreasedpressureisduetohemorrhage,thecardiacoutputdecreasesinspiteoftheincreaseinrateandcontractilitybecausethevenoconstrictionisunabletoprovideanad

7、equatefillingpressureowingtothecontinuingbloodloss.ACh=acetylcholine.NE=norepinephrine.PRU=peripheralresistanceunits.(RedrawnfromShepherdandVanhoutte.TheHumanCardiovascularSystemFactsandConcepts.RavenPress,1979.)第10页，此课件共31页哦 Figure 6:Regulation of Mean Systemic Arterial Pressure第11页，此课件共31页哦1)Const

8、rictionoftheresistancevesselsinmuscle,kidney,splanchnicbeds,andskinsothatthetotalperipheralresistance(TPR)increases.2)Constrictionofthesplanchnicveins.Theresultingmobilizationofbloodisassistedbypassiveexpulsionfollowingconstrictionoftheresistancevessels.Thishelpsmaintaintheappropriatevenous return a

9、ndhencefilling pressure(preload)oftheheart.3)Increaseinheartrateandmyocardialcontractilityduetoincreasedsympatheticanddecreasedvagalactivity.Thecardiacoutputcanthereforebemaintainedorelevated.Whenthearterialbloodpressureincreases,thereverseoccurs.(See Figure 6-similartoFigure1)第12页，此课件共31页哦Increased

10、baroreceptoractivityincreasesparasympatheticactivitytotheheart.BaroreceptoractivationsuppressessympathetictonetotheheartandbloodvesselsThe Baroreceptor Reflex第13页，此课件共31页哦二Carotidbodyandaorticbodychemoreceptorreflex(一)反射弧的组成:chemoreceptor传入出神经和中枢窦N、vagusnerveM孤束核MRN元(+)和CVN元(交感缩血管神经元(+)、心迷走神经元(+).(二

11、)反射效应:直接-R深频率;HR血管收缩(brainandheart除外).整体-HRCO;brainandheartbloodflow,腹腔内脏和肾bloodflowABP(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、ABP60mmHg、窒息、酸中毒等时才发挥明显调节(参与机体应急状态循环功能调节,维持ABP,实现血液再分配调节).第14页，此课件共31页哦Chemoreceptors第15页，此课件共31页哦三Cardiovascularreflexofcardiopulmonaryreceptor(一)反射弧的组成:

12、cardiopulmonaryreceptor(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,angiotensinII释放(-).(二)反射效应:HRCOPRABP,renalbloodflow排水钠.(三)生理意义:主要调节血量及体液的量和成分.第16页，此课件共31页哦InspirationheartrateExpirationheartrateRespiratory Sinus Arrhythmia第17页，此课件共31页哦3.2.1Epinephrineoradrenalineandnorepine

13、phrineornoradrenaline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Epinephrineoradrenalinenorepinephrineornoradrenaline次主主次12第18页，此课件共31页哦第19页，此课件共31页哦第20页，此课件共31页哦第21页，此课件共31页哦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-第22页，此课件共3

14、1页哦第23页，此课件共31页哦第24页，此课件共31页哦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Fig.4-第25页，此课件共31页哦第26页，此课件共31页哦第27页，此课件共31页哦Extracellular Fluid Volume and Blood Pressure第28页，此课件共31页哦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-第29页，此课件共31页哦第30页，此课件共31页哦3.3.1Autoregulationofmetabolismautoregulation;seemicrocirculation.3.3.2肌源性autoregulation3.4Longtermregulationofarterialbloodpressure定义;renal-bodyfluidmechanism;影响该机制的主要因素vasopressin;renin-angiotensinaldosteronesystem 第31页，此课件共31页哦