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It is the lateral pressure exerted by circulating blood on the walls of systemic arteries.
1.AGE
B.P varies with age New born systolic B.P --40mm Hg After 06 months --70-80mm Hg 12 years --100 mm Hg Adolescence --120mm Hg Old Age --140mm Hg
2. DIURNAL VARIATION
Early morning minimum Late evening --increases in 5 10mm Hg
3.SEX
Before menopause B.P is lower in females as compared to males.
After menopause B.P is higher in females as compared to males. Cause: Estrogens lower plasma cholesterol level in female prevent atherosclerosis.
4.MEALS
6.SLEEP
During deep sleep B.P Decreased B.P Increased
7.OBESITY
Obese Increased B.P
8.EMOTIONS
Anxiety B.P Increased
9.RACES
(In some races) Increased B.P
10.EXERCISE
B.P Increased
BY SPHYGMOMANOMETER.
Principle: The air pressure outside artery is balanced against blood pressure inside the artery. When air pressure is increased the artery is compressed. When air pressure is released there is partial occlusion of artery. This produces sound below the cuff.
1. SHORT TERM REGULATION: This maintains B.P when there are rapid and momentary changes in B.P e.g during: Postural changes, Diurnal variation Sudden loss of blood from body.
1. Nervous mech:
They are rapidly acting. They are activated in seconds.
Baroreceptors are only for short term regulation, undergo adaptation in 24 to 48 hours
So if a change in B.P persists for more then 48 hours baroreceptors do not remain effective,
As seen in hypertensive patients, in these patients baroreceptors reset at higher pressure.
Baroreceptors maintain B.P during postural changes. Baroreceptors minimize diurnal variation in B.P. Baroreceptor mech is called pressure buffer system. Oppose changes in the B.P. The sensory nerves which carry impulse from baroreceptors are called pressure buffer nerves e.g hearing nerve and sensory nerve of vagi.
HIGH B.P
PARASYM More A.Ch at muscarinic receptor Beta1 receptor Vent.myocar Less force of contr Less C.O
SA Node
Less H.Rate
LOW B.P
Blood flow to the brain decreases ischemia of brain ( including vasomotor centre)
Ischemia of neurons of vasomotor centre occurs From vasomotor centre discharge excessively occurs along sympathetic nerves this leads to
Tachycardia Vasoconstriction
This response is one the most powerful stimulant of the sympathetic vasoconstrictor nerves. This response is the last attempt of body to safe life, called last ditch response.
CUSHING REFLEX: Cushing reflex is a specialized CNS ischemic response . When intracranial pressure become so high compresses the cerebral arteries ischemia of brain ischemic neurons in vasomotor centre discharge excessively increased peripharal resistance ,increased B.P, increases the cerebral blood flow although intracranial pressure is high.
It is a protective mech to maintain cerebral blood flow when intracranial pressure becomes very high. In cushings reflex intracranial pressure. stimulus is increased
Normal intracranial pressure -10-12 cm of H2O When ICP is beyond 45cm of H2O cushing reflex is initiated.
CHEMORECEPTORS: The chemoreceptor helps to maintain blood pressure when its falls below 60mm Hg. When B.P is low the blood flow in body is sluggish: P02 decreased. PCO2 increased. Ph decreased.
So the chemoreceptors in carotid and aortic bodies are stimulated impulses goes to vasomotor center tachycardica incr peripheral vasoconstriction incr B.P
VASOCONSTRICTION
When B.P falls there is symp. Stimulation. Veins are constricted mean systemic filling pressure & venouse return incr cardiac output incr B.P incr.
INCREASED CONTRACTION OF SKELETAL MUSCLES:When B.P falls symp stimulation incr force of skeletal muscle contraction including abdominal and thoracic muscles this leads to incr VENOUS RETURN incr CARDIAC OUTPUT incr B.P
Catecholamines:When B.P decreased symp stimulation large amount of catecholamines are released from adrenal medulla. Which produces same CVS effects as the effects produced by sympathetic stimulation increased peripheral resistance increased heart rate.
b) Renin angiotensin mechanism:When B.P falls to low value renal blood flow decr glomerular pressure decr ( normal is 60 mm Hg) conc. of Na+ and Cl at macula densa decr release of rennin from juxta glomerular cells.
Once released in blood persists for hour. Juxtaglomerular cells release RENNIN. Rennin acts on angiotensionogen to form angiotensen-I goes to lung capillaries angiotensen-II formed which remains for few minutes.
CONSTANTLY PRODUCES
LIVER
ANGIOTENSINOGEN IN PLASMA
ANGIOTENSIN 1
DECAPEPTIDE IN PLASMA
CONTAIN ANGIOTENSIN-CONVERTING ENZYME (A.C.E) ANGIOTENSIN 2 OCTAPEPTIDE IN PLASMA CIRCULATES IN BLOOD FOR FEW MIN.
Arterioles
VMC
Hypothalamus
Adrenal cortex
ALDOSTERONE
ADH
THIRST
Na reabs
B.P
3. MISCALLENEOUS MECHANISMIS 1. Capillary fluid shift When B.P incr CAPILLARY PRESSURE incr incr fluid passes from blood to interstitial spaces blood vol dec decr VENOUS RETURN decr B.P
When B.P dec capillary pressure dec less fluid passed from blood to interstitial spaces blood volume incr incr venous return incr B.P.
STRESS RELAXATION:When the changes in B.P are due to changes in blood volume, there are changes in the size of blood vessels so that B.P is regulated. e.g A pt. receives 2 liter of blood transfusion B.P increased within 01 hour it comes back to normal Mechanism involved STRESS RELAXATION Brings B.P back to normal
Stress Relaxation.
The smooth muscle in vessel wall undergo relaxation incr blood vol can be accomodated. B.P falls back to normal. This property of stress relaxation is property of smooth muscles.
Smooth muscle can change its size without change in pressure. e.g smooth muscle in stomach wall relaxes to allow extra food volume without increase pressure.
IMPORTANT:
One factor for SHOCK development is disparity b/w blood vol. & capacity of vascular system.
In NEUROGENIC SHOCK, blood vol is same but because of loss of vasomotor tone disparity shock. In neurogenic shock reverse stress relaxation cant prevent shock because of loss of Vasomotor tone disparity b/w blood vol. & capacity of vascular system.
When B.P falls renal blood flow dec GLOMERULAR PRESSURE dec GLOMERULAR FILTERATION RATE dec dec lost of salt and water or salt and water retension blood vol inc venous return & cardiac output inc B.P incr.
When blood pressure changes there are marked changes in urinary output. Suppose B.P incr to 200 mmHg inc urinary output. When B.P is 60 mmHg Anuria
Suppose B.P ?
SYMP impulses to kidney are inhibited V.D in kidney salt & water loss. RENIN-ANGIOTENSIN will not be activated. ADH & ALDOSTERONE are not activated. Net effect: amount of salt & water loss in urine.
B.P decreased - Increased SYMP IMPULSES to kidney VASOCONSTRICTION More RENNIN ANGIOTENSINE
ADH mech( water reabsorbed)