Baroreceptor

Baroreceptors (or archaically, pressoreceptors) are sensors located in the carotid sinus (at the bifurcation of external and
internal carotids) and in the aortic arch. They sense the blood pressure and relay the information to the brain, so that a proper
blood pressure can be maintained.

Baroreceptors are a type of mechanoreceptor sensory neuron that are excited by a stretch of the blood vessel. Thus, increases in
the pressure of blood vessel triggers increased action potential generation rates and provides information to the central nervous
system. This sensory information is used primarily in autonomic reflexes that in turn influence the heart cardiac output and
vascular smooth muscle to influence total peripheral resistance.[1] 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
toward a normal level. These reflexes help regulate short-term blood pressure. The solitary nucleus in the medulla oblongata of
the brain recognizes changes in the firing rate of action potentials from the baroreceptors, and influences cardiac output and
systemic vascular resistance.

Baroreceptors can be divided into two categories based on the type of blood vessel in which they are located: high-pressure
arterial baroreceptors and low-pressure baroreceptors (also known as cardiopulmonary[3] or volume receptors[4]).

Contents
Arterial baroreceptors
Low-pressure baroreceptors
Baroreceptor dysfunction
See also
References
External links

Arterial baroreceptors
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 directly conducted to the brainstem where central
terminations (synapses) transmit this information to neurons within the solitary nucleus[5] which lies in the medulla. Reflex
responses from such baroreceptor activity can trigger increases or decreases in the heart rate. Arterial baroreceptor sensory
endings are simple, splayed 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.[6] 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).[7] Carotid sinus baroreceptors are
responsive to both increases or decreases in arterial pressure, while aortic arch baroreceptors are only responsive to increases in
arterial pressure.[5] 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.[8]

Electrical stimulation of baroreceptors has been found to activate the baroreflex, reducing sympathetic tone throughout the body
and thereby reducing blood pressure in patients with resistant hypertension.[9]

Low-pressure baroreceptors
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.

Baroreceptor dysfunction
Baroreceptors are integral to the body's function: Pressure changes in the blood vessels would not be detected as quickly in the
absence 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.[10]

Baroreceptors can also become oversensitive in some people (usually the carotid baroreceptors in older males). This can lead to
bradycardia, dizziness and fainting (syncope) from touching the neck (often whilst shaving). This is an important cause to
exclude in men having pre-syncope or syncope symptoms.

See also
Atrial volume receptors

References
1. Heesch, C. M. (December 1999). "Reflexes that control cardiovascular function". The American Journal of
Physiology. 277 (6 Pt 2): S234–243. doi:10.1152/advances.1999.277.6.S234 (https://doi.org/10.1152%2Fadvanc
es.1999.277.6.S234). ISSN 0002-9513 (https://www.worldcat.org/issn/0002-9513). PMID 10644250 (https://www.
ncbi.nlm.nih.gov/pubmed/10644250).
2. Stanfield, CL; Germann, WJ. (2008) Principles of Human Physiology, Pearson Benjamin Cummings. 3rd edition,
pp.427.
3. Levy, MN; Pappano, AJ. (2007) Cardiovascular Physiology, Mosby Elsevier. 9th edition, pp.172.
 4. Stanfield, CL; Germann, WJ. (2008) Principles of Human Physiology, Pearson Benjamin Cummings. 3rd edition,
pp.430-431.
5. 1947-, Costanzo, Linda S.,. Physiology (https://www.worldcat.org/oclc/965761862). Preceded by: Costanzo,
Linda S., 1947- (Sixth ed.). Philadelphia, PA. ISBN 9780323511896. OCLC 965761862 (https://www.worldcat.or
g/oclc/965761862).
6. Stanfield, CL; Germann, WJ. (2008) Principles of Human Physiology, Pearson Benjamin Cummings. 3rd edition,
pp.424-425.
7. Bray, JJ; Cragg, PA; Macknight, ADC; Mills, RG. (1999) Lecture Notes on Human Physiology, Blackwell
Publishing. 4th edition, pp.379.
8. Levy, MN; Pappano, AJ. (2007) Cardiovascular Physiology, Mosby Elsevier. 9th edition, pp.171.
9. Wallbach, M; Koziolek, MJ (9 November 2017). "Baroreceptors in the carotid and hypertension-systematic review
and meta-analysis of the effects of baroreflex activation therapy on blood pressure". Nephrology, Dialysis,
Transplantation. doi:10.1093/ndt/gfx279 (https://doi.org/10.1093%2Fndt%2Fgfx279). PMID 29136223 (https://ww
w.ncbi.nlm.nih.gov/pubmed/29136223).
10. Guyton, Arthur C. (1991). "Blood Pressure Control-Special Role of the Kidneys and Body Fluids". Science. 252
(5014): 1813–1816. doi:10.1126/science.2063193 (https://doi.org/10.1126%2Fscience.2063193).
JSTOR 2875873 (https://www.jstor.org/stable/2875873).

External links
Baroreceptors (https://meshb.nlm.nih.gov/record/ui?name=Baroreceptors) at the US National Library of Medicine
Medical Subject Headings (MeSH)

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