NEUROHUMORAL REGULATION OF THE CARDIOVASCULAR SYSTEM

Dr. Mariano J. Rey

1. To understand the role of each reflex system in the overall control of the circulation.

2. To understand the regulatory role of the autonomic nervous system on the circulation.

3. To understand the hormonal contribution to the regulation of the circulation.

   Outline

   1. Historical Background
   • A. Galen - nerves distribute "animal spirit"
   • B. Cannon - "homeostasis depends on the sympathetic system"
   • C. Bainbridge - increase in volume / increase in heart rate
   2. The System of Reflexes
   • A. Baroreceptors
   • B. Chemoreceptors
   • C. Volume (stretch) receptors
   • D. Bainbridge reflex
   • E. Cushing Reflex
   3. Heart Rate Regulation
   • A. Neural Regulators
   • (1) Sympathetics
   • (2) Parasympathetics
   • (3) Central Factors
   • B. Cardiac Receptors
   • (1) Atrial Receptors
   • (2) Ventricular Receptors
   • C. The Respiratory Cycle
   4. 4. Myocardial Performance Regulation
   • A. Neural Regulators
   • (1) Sympathetics
   • (2) Parasympathetics
   • B. Hormonal regulators
   • (1) endocrine (adrenal and thyroid)
   • (2) glucagon and insulin
   5. 5. Peripheral Circulation Regulation
   • A. Intrinsic Regulators
   • (1) Smooth Muscle
   • (2) Endothelium
   • (3) Metabolism
   • B. External Regulators
   • (1) Neural
   • a. sympathetics
   • b. parasympathetics
   • (2) Humoral
   • a. angiotensin
   • b. atrial natriuretic factor
   • c. anti-diuretic hormone (ADH)
   For Review
   Define or Explain
   • active vs. reactive hyperemia
   • alpha vs. beta adrenergic effects
   • myogenic vs. metabolic regulation
   Case Studies
   The case in Chapter 25 - Regulation of the Heartbeat (pages 46-47) discusses the regulatory function of the autonomic nervous system and the baroreceptor reflex (pages 153-154).

   The Chapter 29 case (pages 55-56) - Thromboangiitis Obliterans - leads to a discussion (pages 162-163) of the neurohumoral control of the circulation.

   Case 2 in Chapter 32 - Hemorrhage and Shock - (pages 61-62) with its discussion (pages 171-172) addresses the responses of the regulatory systems to acute changes in the circulation.

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