My some review points and images before exam. - medicalspirit

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http://www.youtube.com/watch?v=S93-PqJeT...re=related

http://www.youtube.com/watch?v=FYtnahYwM...re=related

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http://highered.mcgraw-hill.com/sites/00...ation.html

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1. The carotid sinus baroreceptor is innervated by CN IX (not X). Carotid sinus responds to both increase and decrease in blood pressure
2. The aortic arch baroreceptors are innervated by CN X. Aortic arch only responds to increase in blood pressure.

Therefore, the response in carotid massage is will be a bit different from physiological increase in blood pressure, all though the end result is the same:
1. Carotid sinus massage: increase pressure on carotid artery --> increase stretch --> increase afferent CN IX firing --> signal thru nucleus tractus solitarus in medulla--> increase parasympathetic outflow to heart via CN X firing---> decrease heart rate

2. Physiologic increase in blood pressure: both carotid and aortic baroreceptors involved- they both send signals to the medulla with the effect as explained above.

each time you massage carotid bodies the inhibitory influence which the nerves have on sympathetic outflow will be enhanced, which means reinforcement of the inhibition of the inhibitory impulses.

to make things simple the sympathetic stimulus to heart is inhibited.
which would decrease the heart rate as well as causing reduced firing rate of Sa node as well as increased block of conduction thru Av node.

This is the principle behind using carotid sinus massage in proxysmal supraventricular tachycardia.

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http://www.zuniv.net/physiology/book/images/24-6.jpg

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http://www.zuniv.net/physiology/book/chapter24.html

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http://highered.mcgraw-hill.com/sites/00...ssure.html


http://www.cvphysiology.com/Blood%20Pressure/BP014.htm

* Rapid increase in fraction of inspired oxygen can lead to respiratory failure in pt. w/ COPD.

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histamine is a major effotor of anaphylaxis BUT Tryptase is also released in excess and used as a marker of mast cell activation: type 1 hypersensitivity

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http://highered.mcgraw-hill.com/sites/00...uiz_2.html

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http://www.cvphysiology.com/Arrhythmias/A009.htm

http://www.muschealth.com/video/Default....7&type=rel

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http://people.eku.edu/ritchisong/301notes2.htm