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Stimulus
Cardiac output
regulation
Baroreceptor
reflex
Valsalva
maneuver
Oculo cardiac
reflex
Celiac reflex
Traction on the
extraocular muscles
(especially medial
rectus) or pressure on
the globe causes an
afferent response via
the trigeminal nerve
(CNV) and results in an
efferent vagal response
via the vagus nerve
(CNX)
Traction or pressure on
structures within
abdominal and thoracic
cavities causes vagal
nerve stimulation
Response
Anesthesia
considerations
Many of the factors that
affect CO also affect the
MAP. Some of the
reflexes are listed below
and they alter the CO are
described.
The baroreceptor
response is inhibited by
volatile anesthetic
agents in a dosedependent manner and
results in a decreased
ability of the
baroreceptors to respond
to BP changes when
these agents are used.
Bradycardia,
hypotension, and
arrhythmias
Bradycardia,
hypotension and apnea.
Bainbridge
reflex
Hypervolemia,
increased venous
return causes
stimulation of atrial
stretch receptors
Cushing reflex
Increased intracranial
pressure resulting in
cerebral ischemia
Sympathetic nervous
stimulation resulting in
increased BP
Chemoreceptor
reflex
Decreased oxygen
saturation, increased
CO2, increased
hydrogen ion
concentration;
peripheral
chemoreceptors
located in the carotid
body and aortic arch.
Increased respiratory
drive, increased blood
pressure