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1- Altering the cardiac properties that affect the cardiac output 2- regulation of blood flow by changing the diameter of the arterioles (the resistant vessels)
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Objectives: n By the end of this lecture the students should be able to: n 1. List the local regulatory component of regional blood flow. n 2. Explain the importance of Laplace law in myogenic autoregulation n 3. List the examples of metabolic autoregualtion. n 4. Describe the mechanism of each. n 5. Outline the substances secreted from the vascular endothelium.
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1- Autoregulation
2-Endothelial mediated
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Local regulation
1- Autoregulation
It is the capacity of tissues to regulate their own blood flow. Most vascular beds have an intrinsic capacity to compensate for moderate changes in perfusion pressure by changing the vascular resistance, so that blood flow remains relatively constant.
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Local regulation
1- Autoregulation
a)Myogenic autoregulation
b)Metabolic autoregulation
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Local autoregulation
a)Myogenic autoregulation
Myogenic regulation is the intrinsic contractile response of vascular smooth muscle to stretch. As the pressure rises, the blood vessels are distended and the vascular smooth muscle fibers contract.
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Local autoregulation
a)Myogenic autoregulation
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Local autoregulation
a)Myogenic autoregulation
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Local regulation
b)Metabolic autoregulation
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Local autoregulation
b)Metabolic autoregulation
decrease in oxygen tension and acidosis Increase in CO2tension, its action is most pronounced in skin and brain. Rise in temperature in active tissues. K+ and lactate in skeletal muscle. Histamine in injured tissues. Adenosine in cardiac muscle
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Examples of vasodilators
Local autoregulation
b)Metabolic autoregulation
Local autoregulation
b)Metabolic autoregulation
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Local autoregulation
b)Metabolic autoregulation
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Local autoregulation
b)Metabolic autoregulation
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Local autoregulation
b)Metabolic autoregulation
Long term Last for days or years In young persons, this degree of readjustment is usually very exact; in old persons it is only partial. The underlying mechanisms of increased blood flow include
Local regulation
2- Endothelial mediated
prostacycli n
Thromboxane A2
Local regulation
2- Endothelial mediated
Local regulation
2- Endothelial mediated
Endothelins
Three Endothelins are identified (1, 2, and 3). Endothelin-1, produced by endothelial cells, is one of the most potent vasoconstrictors. Veins are more sensitive than arteries. It acts as a paracrine factor. 3/18/12
nervous regulation
Hormonal regulation
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a)Vasoconstrictors b)Vasodilators 1- epinephrine and 1- kinins norepinephrine 2- atrial natriuretic 2- vasopressin peptide 3- renin- angiotensin II
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Sympathetic stimulation
These hormones can reach some parts of the circulation that have no sympathetic 3/18/12 nervous supply at all, including the very minute vessels such as the metarterioles.
Epinephrine
Norepinephrine
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Renin-AngiotensinAldosterone Mechanism
Decreased extracellular fluid volume
Increased 3/18/12 BP
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2- systemic regulation of blood flow b- Nervous control Innervation of the blood vessels
1- sympathetic adrenergic nerve fibers (vasomotor tone) 2- sympathetic cholinergic nerve fibers 3- parasympathetic cholinergic nerves 3/18/12
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Heart rate
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(C.C., hypothalamus, limbic system and respiratory centers) Atrial stretch receptors
Increased temperature
Cardiovascula r centers
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Adrenaline
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2- indirect effect through chemoreceptors stimulation of respiratory center and increased ventilation
Causes of tachycardia in moderate hypoxia or hypercapnea
Hypoxia hypercapnia
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tachycardia