Baroreceptors (or baroceptors) are sensors located in the blood vessels of several mammals.[1] They are a type of mechanoreceptor that detects the pressure of blood flowing through them, and can send messages to the central nervous system to increase or decrease total peripheral resistance and cardiac output. Baroreceptors act immediately as part of a negative feedback system called the baroreflex,[2] as soon as there is a change from the usual mean arterial blood pressure, returning the pressure to a normal level. They are an example of a short-term blood pressure regulation mechanism. Baroreceptors detect the amount of stretch of the blood vessel walls, and send the signal to the nervous system in response to this stretch.[1] The nucleus tractus solitarius in the medulla oblongata recognizes changes in the firing rate of action potentials from the baroreceptors, and influences cardiac output and systemic vascular resistance through changes in the autonomic nervous system.
Baroreceptors can be divided into two categories: high-pressure arterial baroreceptors and low-pressure baroreceptors (also known as cardiopulmonary[3] or volume receptors[4]).
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Arterial baroreceptors are located in the transverse aortic arch and the carotid sinuses of the left and right internal carotid arteries. The baroreceptors found within the aortic arch monitor the pressure of blood delivered to the systemic circuit, and the baroreceptors within the carotid arteries monitor the pressure of the blood being delivered to the brain.[1]
Arterial baroreceptors are stretch receptors that are stimulated by distortion of the arterial wall when pressure changes. The baroreceptors can identify the changes in both the average blood pressure or the rate of change in pressure with each arterial pulse. Action potentials triggered in the baroreceptor ending are then conducted to the brainstem where central terminations (synapses) transmit this information to neurons within the solitary nucleus. Reflex responses from such baroreceptor activity can trigger increases or decreases in the heart rate. Arterial baroreceptor sensory endings are simple, sprayed nerve endings that lie in the tunica adventitia of the artery. An increase in the mean arterial pressure increases depolarization of these sensory endings, which results in action potentials. These action potentials are conducted to the solitary nucleus in the central nervous system by axons and have a reflex effect on the cardiovascular system through autonomic neurons.[5] Hormone secretions that target the heart and blood vessels are affected by the stimulation of baroreceptors.
At normal resting blood pressures, baroreceptors discharge with each heart beat. If blood pressure falls, such as on orthostatic hypotension or in hypovolaemic shock, baroreceptor firing rate decreases and baroreceptor reflexes act to help restore blood pressure by increasing heart rate. Signals from the carotid baroreceptors are sent via the glossopharyngeal nerve (cranial nerve IX). Signals from the aortic baroreceptors travel through the vagus nerve (cranial nerve X).[6] Arterial baroreceptors inform reflexes about arterial blood pressure but other stretch receptors in the large veins and right atrium convey information about the low pressure parts of the circulatory system.
Baroreceptors respond very quickly to maintain a stable blood pressure, but their responses diminish with time and thus are most effective for conveying short term changes in blood pressure. In people with essential hypertension the baroreceptors and their reflexes change and function to maintain the elevated blood pressure as if normal. The receptors then become less sensitive to change.[7]
The low-pressure baroreceptors, are found in large systemic veins, in pulmonary vessels, and in the walls of the right atrium and ventricles of the heart (the atrial volume receptors).[4] The low-pressure baroreceptors are involved with the regulation of blood volume. The blood volume determines the mean pressure throughout the system, in particular in the venous side where most of the blood is held.
The low-pressure baroreceptors have both circulatory and renal effects; they produce changes in hormone secretion, resulting in profound effects on the retention of salt and water; they also influence intake of salt and water. The renal effects allow the receptors to change the mean pressure in the system in the long term.
Denervating these receptors 'fools' the body into thinking that it has too low blood volume and initiates mechanisms that retain fluid and so push up the blood pressure to a higher level than it would otherwise have.
Baroreceptors are integral to the body’s function: Pressure changes in the blood vessels would not be detected as quickly as in the presence of baroreceptors. When baroreceptors are not working, blood pressure continues to increase, but, within an hour, the blood pressure returns to normal as other blood pressure regulatory systems take over.[8]
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