FSG332

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Study unit 3.1

• Arterial blood pressure control

– The sympathetic nervous system control of blood pressure
– Renal-body fluid system control of arterial blood pressure
– Renin-angiotensin system control of arterial blood pressure

• Practical aspects of sphygmomanometry

• Outcomes
– Explain the role of pressure diuresis and pressure natriuresis in the renal-
body fluid system and how it relates to blood pressure control.
– Discuss the renin-angiotensin system in detail and explain how it
influences arterial blood pressure.
– Discuss how the body would compensate in scenarios of either low- or high
blood pressure.

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 Factors influencing Blood pressure
Mean arterial
blood pressure

Cardiac Output Total Peripheral

Respiratory resistance
activity

Stroke
Heart rate Cardiac Arteriolar Blood
volume
suction effect radius viscosity

Local Number of
Skeletal
Venous return metabolic red blood
muscle activity
control cells

Extrinsic
Blood volume vasoconstrictor
control
Sympathetic
activity and
epinephrine
Bulk flow of
Parasympathetic
interstitial fluid
activity and
acetylcholine Vasopressin Renin-
Salt and water
angiotensin-aldosterone
balance 3
system (RAAS)
 Local factors influencing Blood pressure
Mean arterial
blood pressure
Vasodilation
Oxygen ↓
Total Peripheral
Carbon dioxide ↑ resistance
Acids (lactate) ↑
K+ ↑
Arteriolar
Osmolarity ↑ radius
Adenosine ↑
Prostaglandins ↑ Skeletal Local
muscle activity control

Factor Effect
Substance Effect Source
Heat Vasodilation
Endothelin Vasoconstriction Endothelial cells
Nitric oxide Vasodilation Endothelial cells Cold

Histamine Vasodilation Some circulating white blood cells Shear Vasodilation

Specialized connective tissue cells stress
Stretch Vasoconstriction
 Sympathetic and parasympathetic factors influencing Blood pressure
Mean arterial
blood pressure

Cardiac Output

Stroke
Heart rate
volume
β1
muscurinic

Venous return
Epinephrine binds to β1 receptors
Increases heart rate
increases Cardiac Output
Increases Blood Pressure
Sympathetic
activity and
epinephrine
Parasympathetic
activity and Acetylcholine binds to muscurinic receptors
acetylcholine Decreases heart rate
Decreases Cardiac Output
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Decreases Blood Pressure
 Sympathetic and parasympathetic factors influencing Blood pressure
Mean arterial
blood pressure
Total Peripheral
resistance

Arteriolar
radius

Epinephrine and norepinephrine bind to

α1 receptors on arteriolar smooth muscle cells
Vasoconstrictor
Increases total peripheral resistance
Increases Blood Pressure Extrinsic
vasoconstrictor
control
Sympathetic
activity and
epinephrine
Epinephrine binds to β2 receptors on arteriolar smooth muscle
on HEART AND SKELTAL muscle cells
Vasodilation
Decreases total peripheral resistance 6

Increases blood flow to muscles and heart

 Renin-angiotensin-aldosterone system
Mean arterial
blood pressure

Cardiac Output Angiotensinogen Total Peripheral

Synthesized in the liver
Renin resistance
Made in juxtaglomerular
cells of efferent arterioles in
Stroke response to low blood
volume Arteriolar
pressure
Angiotensin I radius
Angiotensin
Venous return
Converting
Angiotensin II Enzyme (ACE)
Produced in lungs
Bulk flow of Extrinsic
Blood volume vasoconstrictor
interstitial fluid
control
AT1 receptor
Aldosterone
increases permeability of renal
tubules to sodium, increases
Vasopressin Renin-
reabsorption of sodium Salt and water
angiotensin-aldosterone
balance
system (RAAS) 7
 Bulk flow of interstitial fluid
Mean arterial
blood pressure
• Bulk flow: Mass movement as a result of hydrostatic or osmotic
Cardiac Output pressure gradients
• Filtration: fluid movement out of capillaries: hydrostatic pressure
• Absorption: fluid movement into capillaries: osmotic pressure

Stroke
volume

Venous return

Blood volume

Bulk flow of Interstitial fluid

interstitial fluid

Salt and water

balance 8
 Pressure diuresis and Pressure natriuresis
Mean arterial
blood pressure

Cardiac Output Increased Blood pressure

Stroke
volume
Increased diuresis Increased natriuresis
(urine output) (sodium loss via urine)
Decreases blood volume Changes salt and water
Venous return Decreases blood pressure balance.
Increases interstitial fluid,
decreases osmolarity of
Blood volume blood, decreases blood
volume.
Decreases blood pressure.
Bulk flow of
interstitial fluid

Salt and water

balance 9
 Blood Pressure control

• Short term:
– Quick (within seconds) adjustments of cardiac output and total peripheral resistance
• Baroreceptor reflex
• Sympathetic vs parasympathetic

• Long term:
– Adjusting blood volume (minutes to days)
• Restoring salt and water balance
– Vasopressin
– Renin-angiotensin-aldosterone system

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 Baroreceptor reflex and its effect of blood pressure

• Cardiovascular control center (CVCC)

• Baroreceptor reflex
– Baroreceptors in the carotid arteries and aorta

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Figure 15.14a ESSENTIALS – Cardiovascular Control Slide 10

KEY
Medullary
cardiovascular
Stimulus
control
Sensor center

Integrating center

Output signal
Change
Target in blood
pressure

Parasympathetic
neurons
Carotid and aortic
baroreceptors

Sympathetic
neurons SA node

Ventricles

FIGURE QUESTION
Name the neurotransmitters
Veins and receptors for each of
Arterioles the target tissues.

© 2013 Pearson Education, Inc.

Figure 15.14b ESSENTIALS – Cardiovascular Control

Blood
The baroreceptor reflex pressure

This map shows the reflex

response to an increase in Firing of baroreceptors in
mean arterial pressure. carotid arteries and aorta

Sensory neurons

Cardiovascular
control center
in medulla
oblongata

Sympathetic output Parasympathetic output

less NE released more ACh on

muscarinic receptor
KEY
-receptor  1-receptor  1-receptor
Stimulus
Arteriolar smooth muscle Ventricular myocardium SA node
Sensor
Afferent pathway
Vasodilation Force of contraction Heart rate Integrating center
Output signal
Target
Peripheral resistance Cardiac output
Tissue response

Systemic response

Blood Negative
pressure feedback
Baroreceptor reflex and its effect of blood pressure

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Effects of sympathetic and parasympathetic stimuli on blood
pressure

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 Difference between hyper- and hypotension
Practical aspects of sphygmomanometry

• Normal blood pressure:

– 90-120 systole over 60- 80 diastole mm of mercury (mmHg)

• Hypertension:
– Higher than 130 systole over higher than 80 mmHg diastole.

• Hypotension:
– less than 90 diastole over less than 60 mmHg diastole

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