心血管调节(xie)
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－ Innervate almost all the blood vessels in the body.
NE +αreceptor →Vasoconstriction
skin >skeletal muscle, viscera >coronary, cerebral vessel (2)Vasodilator fibers (cholinergic fiber)
Ⅰ. Nervous
Regulation
1. Innervations of the Heart (peripheral innervation) 2. Innervations of Peripheral Blood Vessels (1)Vasoconstrictor nerve fibers (sympathetic adrenergic fiber)
Formation of the interstitial fluid
Effective Filtration Pressure = (Capillary Pressure + Interstitial Colloid Osmotic Pressure) – (Plasma Colloid Osmotic Pressure + Interstitial Hydrostatic Pressure) （crystal pressure？）
Ⅰ. Nervous
Regulation
3. Cardiovascular Centers in Medulla Oblongata
Cardiovascular Center
Spinal cord Medulla oblongata Pons Hypothalamus Cerebellum Cerebral
Ⅰ. Nervous
Regulation 心血管中枢
3. Cardiovascular Centers in Medulla Oblongata （1）脊髓 （2）延髓
（基本中枢，至少包括四个部位）
－缩血管区
①延髓头端腹外侧区（RVLM）
rostral ventrolateral ຫໍສະໝຸດ Baiduedulla
②延髓尾端腹外侧区（CVLM） －舒血管区 caudal ventrolateral medulla ③孤束核（NTS） －传入神经接替站
Ⅰ. Nervous Regulation autonomic nervous system
Sympathetic nerve system
Parasympathetic nerve system ( reflex )
Cardiovascular activities
cardiac sympathetic nerve
Tonus
Heart rate: 75 Cardiac vagus nerve (x): 150-180 Cardiac sympathetic nerve (x x): 100
Tonus
Cardiac vagal tone Cardiac sympathetic tone Sympathetic vasoconstrictor tone (1-3 times / sec.) The tone come from central
① Vasoconstrictor area （RVLM） (Cl area) 交感紧张中枢 A. Cardiac sympathetic center B. Sympathetic vasoconstrictor center / vasomotor center ② Vasodilator area （CVLM） (Al area) 交感抑制中枢 It inhibit the action of Cl area. ③ Cardiac vagus center 心迷走中枢 dorsal motor nucleus of vagus （DMV）迷走背核, ambiguus (animal) 疑核 ④ Relay station of afferent nerve 传入接替站 nucleus of solitary tract (NTS) 孤束核 It can receive and integrate afferent impulses and then affect other centers, providing “baroreceptor reflex”.
Section 4 Cardiovascular Control
I. Nervous regulation
II.
Humoral regulation
І Neural regulation
• • Reflex Reflex arc
Receptor Afferent nerve fiber Reflex center Efferent nerve fiber Effector
Mechanism of vagus nerve actions
Cardiac vagus nerve
↓
ACh + M2 receptor (cAMP ↓, cGMP ↑)
↓
permeability to K+↑, Ca2+↓ → K+ outflow↑, [Ca2+]i↓
↓
Heart rate, Cardiac output ↓
Ⅰ. Nervous
Regulation
( “cardiac inhibitory nerve”)
1. Innervations of the Heart (peripheral innervation)
( 2) Cardiac vagus nerve
Effect
Negative chronotropic action (decrease heart rate) Negative dromotropic action (decrease A-V conduction) Negative inotropic action (decrease contraction force)
nucleus tractus solitarius
④迷走背核（DMV）、疑核（NA）－心抑制区 dorsal motor nucleus of vagus nucleus ambiguus
Ⅰ. Nervous
Regulation
3. Cardiovascular Centers in Medulla Oblongata
positive inotropic action
正性变力作用
positive chronotropic action
正性变时作用
positive dromotropic action
正性变传导作用
Stimulation of sympathetic nerve
Mechanism of sympathetic nerve actions
① Parasympathetic vasodilator fiber in very few vessels ② Sympathetic vasodilator fiber in skeletal muscles vessels
ACh + M receptor→Vasodilation
③Dorsal root vasodilator fiber (axon reflex)
Cardiac vagus nerve → ACh binds M2 receptor ↓ Permeability to K+↑, Ca2+↓ → → K+ outflow↑, [Ca2+]i↓ ①Level of resting potential↑ excitability↓ 0 phase ↓ conductility↓ ②In SA node: maximum repolarization potential ↑ Threshold potential level ↑ K十outflow in phase 4↑ →autorhythmicity ↓ → HR↓ Phase 4 If ↓ ③ Velocity of repolarization↑ ↓ Duration of action plateau (phase2)↓ ↓ Ca2+ inflow ↓→(Ca2+)i ↓→ contractility↓ ↑ ④ACh directly inhibits release of Ca2+ from SR.
Activation of β1 receptors by NE ↓ Membrane permeability to Ca2+, Na+ ↑
①In rhythmic cells: Na+ infIow in phase 4↑→ K+ outflow decrease↑→ velocity of autopolarization↑→ autorhythmicity↑→HR↑ ②In AV node: Ca2+ infIow in phase 0↑→ conductivity↑↗ gap junction ↑ ③Ca2+ inflow and release by SR↑→ (Ca2+)i↑→ force↑ affinity of myosin to actin ↑ ④ affinity of troponin to Ca2+↓ uptake of Ca2+ by SR↑ → (Ca2+)i ↓fast 3 Na+ - Ca2+ exchange↑ ( relaxation velocity↑to match the fast contraction)
(1) Cardiac sympathetic nerve
Effect:
3 positive actions
Positive chronotropic action (increase heart rate ) Positive dromotropic action (increase conduction ) Positive inotropic action (increase contraction force )
Ⅰ. Nervous
Regulation
1. Innervations of the Heart (peripheral innervation) (1) Cardiac sympathetic nerve
Innervation
Ⅰ. Nervous
Regulation
1. Innervations of the Heart (peripheral innervation)
（1）Baroreceptor reflex
( depressor reflex ）
Reflex arc:
Receptor and its stimulus Afferent pathway Reflex center Efferent pathway Effector
Endings of cardiac sympathetic nerve ↓ Norepinepherine (NE) +β1 receptors (cAMP ↑) ↓ membrane permeability to Ca2+, Na+ ↑
↓ Heart rate, Cardiac output ↑
Ⅰ. Nervous
Regulation
心血管反射
4. Cardiovascular Reflex
(1)Baroreceptor reflex 降压反射 (压力感受器反射) (depressor reflex) (2) Cardiopulmonary receptor reflex 心肺感受器反射 (volumic receptor reflex (low baroreceptor reflex) (3)Chemoreceptor reflex 化学感受器反射 (mainly control respiration) (4)Other cardiovascular reflex Visceral receptor reflex Somatocardoivascular reflex Brain ischemia response (abnormal reflex)
NE +αreceptor →Vasoconstriction
skin >skeletal muscle, viscera >coronary, cerebral vessel (2)Vasodilator fibers (cholinergic fiber)
Ⅰ. Nervous
Regulation
1. Innervations of the Heart (peripheral innervation) 2. Innervations of Peripheral Blood Vessels (1)Vasoconstrictor nerve fibers (sympathetic adrenergic fiber)
Formation of the interstitial fluid
Effective Filtration Pressure = (Capillary Pressure + Interstitial Colloid Osmotic Pressure) – (Plasma Colloid Osmotic Pressure + Interstitial Hydrostatic Pressure) （crystal pressure？）
Ⅰ. Nervous
Regulation
3. Cardiovascular Centers in Medulla Oblongata
Cardiovascular Center
Spinal cord Medulla oblongata Pons Hypothalamus Cerebellum Cerebral
Ⅰ. Nervous
Regulation 心血管中枢
3. Cardiovascular Centers in Medulla Oblongata （1）脊髓 （2）延髓
（基本中枢，至少包括四个部位）
－缩血管区
①延髓头端腹外侧区（RVLM）
rostral ventrolateral ຫໍສະໝຸດ Baiduedulla
②延髓尾端腹外侧区（CVLM） －舒血管区 caudal ventrolateral medulla ③孤束核（NTS） －传入神经接替站
Ⅰ. Nervous Regulation autonomic nervous system
Sympathetic nerve system
Parasympathetic nerve system ( reflex )
Cardiovascular activities
cardiac sympathetic nerve
Tonus
Heart rate: 75 Cardiac vagus nerve (x): 150-180 Cardiac sympathetic nerve (x x): 100
Tonus
Cardiac vagal tone Cardiac sympathetic tone Sympathetic vasoconstrictor tone (1-3 times / sec.) The tone come from central
① Vasoconstrictor area （RVLM） (Cl area) 交感紧张中枢 A. Cardiac sympathetic center B. Sympathetic vasoconstrictor center / vasomotor center ② Vasodilator area （CVLM） (Al area) 交感抑制中枢 It inhibit the action of Cl area. ③ Cardiac vagus center 心迷走中枢 dorsal motor nucleus of vagus （DMV）迷走背核, ambiguus (animal) 疑核 ④ Relay station of afferent nerve 传入接替站 nucleus of solitary tract (NTS) 孤束核 It can receive and integrate afferent impulses and then affect other centers, providing “baroreceptor reflex”.
Section 4 Cardiovascular Control
I. Nervous regulation
II.
Humoral regulation
І Neural regulation
• • Reflex Reflex arc
Receptor Afferent nerve fiber Reflex center Efferent nerve fiber Effector
Mechanism of vagus nerve actions
Cardiac vagus nerve
↓
ACh + M2 receptor (cAMP ↓, cGMP ↑)
↓
permeability to K+↑, Ca2+↓ → K+ outflow↑, [Ca2+]i↓
↓
Heart rate, Cardiac output ↓
Ⅰ. Nervous
Regulation
( “cardiac inhibitory nerve”)
1. Innervations of the Heart (peripheral innervation)
( 2) Cardiac vagus nerve
Effect
Negative chronotropic action (decrease heart rate) Negative dromotropic action (decrease A-V conduction) Negative inotropic action (decrease contraction force)
nucleus tractus solitarius
④迷走背核（DMV）、疑核（NA）－心抑制区 dorsal motor nucleus of vagus nucleus ambiguus
Ⅰ. Nervous
Regulation
3. Cardiovascular Centers in Medulla Oblongata
positive inotropic action
正性变力作用
positive chronotropic action
正性变时作用
positive dromotropic action
正性变传导作用
Stimulation of sympathetic nerve
Mechanism of sympathetic nerve actions
① Parasympathetic vasodilator fiber in very few vessels ② Sympathetic vasodilator fiber in skeletal muscles vessels
ACh + M receptor→Vasodilation
③Dorsal root vasodilator fiber (axon reflex)
Cardiac vagus nerve → ACh binds M2 receptor ↓ Permeability to K+↑, Ca2+↓ → → K+ outflow↑, [Ca2+]i↓ ①Level of resting potential↑ excitability↓ 0 phase ↓ conductility↓ ②In SA node: maximum repolarization potential ↑ Threshold potential level ↑ K十outflow in phase 4↑ →autorhythmicity ↓ → HR↓ Phase 4 If ↓ ③ Velocity of repolarization↑ ↓ Duration of action plateau (phase2)↓ ↓ Ca2+ inflow ↓→(Ca2+)i ↓→ contractility↓ ↑ ④ACh directly inhibits release of Ca2+ from SR.
Activation of β1 receptors by NE ↓ Membrane permeability to Ca2+, Na+ ↑
①In rhythmic cells: Na+ infIow in phase 4↑→ K+ outflow decrease↑→ velocity of autopolarization↑→ autorhythmicity↑→HR↑ ②In AV node: Ca2+ infIow in phase 0↑→ conductivity↑↗ gap junction ↑ ③Ca2+ inflow and release by SR↑→ (Ca2+)i↑→ force↑ affinity of myosin to actin ↑ ④ affinity of troponin to Ca2+↓ uptake of Ca2+ by SR↑ → (Ca2+)i ↓fast 3 Na+ - Ca2+ exchange↑ ( relaxation velocity↑to match the fast contraction)
(1) Cardiac sympathetic nerve
Effect:
3 positive actions
Positive chronotropic action (increase heart rate ) Positive dromotropic action (increase conduction ) Positive inotropic action (increase contraction force )
Ⅰ. Nervous
Regulation
1. Innervations of the Heart (peripheral innervation) (1) Cardiac sympathetic nerve
Innervation
Ⅰ. Nervous
Regulation
1. Innervations of the Heart (peripheral innervation)
（1）Baroreceptor reflex
( depressor reflex ）
Reflex arc:
Receptor and its stimulus Afferent pathway Reflex center Efferent pathway Effector
Endings of cardiac sympathetic nerve ↓ Norepinepherine (NE) +β1 receptors (cAMP ↑) ↓ membrane permeability to Ca2+, Na+ ↑
↓ Heart rate, Cardiac output ↑
Ⅰ. Nervous
Regulation
心血管反射
4. Cardiovascular Reflex
(1)Baroreceptor reflex 降压反射 (压力感受器反射) (depressor reflex) (2) Cardiopulmonary receptor reflex 心肺感受器反射 (volumic receptor reflex (low baroreceptor reflex) (3)Chemoreceptor reflex 化学感受器反射 (mainly control respiration) (4)Other cardiovascular reflex Visceral receptor reflex Somatocardoivascular reflex Brain ischemia response (abnormal reflex)