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Updated: Jul 28 2020

Autoregulation

Images
https://upload.medbullets.com/topic/108025/images/renal autoregulation.jpg
https://upload.medbullets.com/topic/108025/images/jg apparatus.jpg
https://upload.medbullets.com/topic/108025/images/tubuloglomerularfeedback.jpg
  • Introduction
    • Autoregulation is a mechanism that ensures constant blood flow to organs, despite changing resistance (perfusion pressures) in the blood vessels
      • 2 hypotheses explain autoregulation
        • myogenic hypothesis
        • metabolic hypothesis
      • recall that blood flow (Q) = (change in pressure [P])/resistance (R)
  • Hypotheses of Autoregulation
    • Myogenic hypothesis
      • when the vascular smooth muscle is stretched (like when arterial pressure is increased), the smooth muscle contracts (increases resistance)
        • when there is an increase in blood pressure, the myogenic reflex causes smooth muscle contraction in order to maintain flow
    • Metabolic hypothesis
      • O2 delivery to a tissue is matched to O2 consumption of that tissue
        • this is accomplished by changing the resistance (and blood flow) of the arterioles
      • metabolic activity causes tissues to produce metabolites, including vasodilators
        • CO2, H+, K+, lactate, and adenosine
      • ↑ metabolic demand → ↑ O2 demand → vasodilation → ↓ resistance
        • this results in ↑ blood flow
      • Autoregulation of Organs
      • Organ
      • Factors Determining Autoregulation
      • Heart
      • Local metabolites
        • pO2, adenosine, pCO2, and NO
      • Brain
      • Local metabolites
        • pCO2 andpH
      • Kidneys
      • Myogenic hypothesis
        • tubuloglomerular feedback
      • Lungs
      • Local metabolites
        • pO2→ vasoconstriction
      • Skeletal muscles
      • Local metabolites
        • lactate,K+, and adenosine
      • Skin
      • Sympathetic innervation
  • Organ-Specific Autoregulation
    • Heart
      • most sensitive to
        • pO2, adenosine, pCO2, and NO
        • adenosine results in coronary vasodilation
      • ↑ myocardial contractility → ↑ O2 demand and consumption → vasodilation → ↑ blood flow
    • Brain
      • most sensitive to
        • pCO2 and pH
      • ↑ pCO2 → ↓ pH → vasodilation→ ↑ blood flow to remove excess CO2
    • Kidneys
      • myogenic hypothesis
      • tubuloglomerular feedback
        • ↑ renal arteriole pressure → ↑ blood flow
          • ↑ glomerular filtration rate (GFR)
        • ↑ GFR increases delivery of solute and water to juxtaglomerular apparatus (JGA)
          • JGA secretes vasoactive substance
            • constriction of afferent arterioles
            • returns renal blood flow and GFR back to normal
    • Lungs
      • most sensitive to
        • low pO2, which causes vasoconstriction NOT vasodilation
          • the only organ in which low pO2 causes vasoconstriction
          • causes only well-ventilated areas to be perfused to maximize areas of gas exchange
    • Skeletal muscles
      • most sensitive to
        • vasoactive metabolites during exercise (e.g., lactate, K+, and adenosine)
        • sympathetic innervation at rest
          • recall that α1 receptors cause vasoconstrict and β2 receptors cause vasodilation
    • Skin
      • most sensitive to sympathetic innervation
        • ↓ body temperature → α1 receptors vasoconstrict
          • ↓ blood flow → retention of heat
        • ↑ body temperature → inhibition of cutaneous vasoconstriction
          • ↑ blood flow from warm core to cutaneous vessels → dissipation of heat
      • plays a major role in the regulation of body temperature
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