Reflex
In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus.
Reflexes are found with varying levels of complexity in organisms with a nervous system. A reflex occurs ...
bradycardia is a
bradycardia
Bradycardia, also called bradyarrhythmia, is a resting heart rate under 60 beats per minute (BPM). While bradycardia can result from various pathological processes, it is commonly a physiological response to cardiovascular conditioning or due ...
(decrease in
heart rate
Heart rate is the frequency of the cardiac cycle, heartbeat measured by the number of contractions of the heart per minute (''beats per minute'', or bpm). The heart rate varies according to the body's Human body, physical needs, including the nee ...
) in response to the
baroreceptor reflex
The baroreflex or baroreceptor reflex is one of the body's homeostatic mechanisms that helps to maintain blood pressure at nearly constant levels. The baroreflex provides a rapid negative feedback loop in which an elevated blood pressure cause ...
, one of the body's homeostatic mechanisms for preventing abnormal increases in
blood pressure
Blood pressure (BP) is the pressure of Circulatory system, circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term ...
. In the presence of high
mean arterial pressure
In medicine, the mean arterial pressure (MAP) is an average calculated blood pressure in an individual during a single cardiac cycle. Although methods of estimating MAP vary, a common calculation is to take one-third of the pulse pressure (the d ...
, the baroreceptor reflex produces a reflex bradycardia as a method of decreasing blood pressure by decreasing
cardiac output
In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: tha ...
.
Blood pressure
Blood pressure (BP) is the pressure of Circulatory system, circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term ...
(BP) is determined by cardiac output (CO) and
total peripheral resistance (TPR), as represented by the formula . Cardiac output (CO) is affected by two factors, the heart rate (HR) and the
stroke volume
In cardiovascular physiology, stroke volume (SV) is the volume of blood pumped from the ventricle (heart), ventricle per beat. Stroke volume is calculated using measurements of ventricle volumes from an Echocardiography, echocardiogram and subtra ...
(SV), the volume of blood pumped from one
ventricle of the heart with each beat (, therefore ). In reflex bradycardia, blood pressure is reduced by decreasing cardiac output (CO) via a decrease in heart rate (HR).
An increase in blood pressure can be caused by increased cardiac output, increased total peripheral resistance, or both.
The
baroreceptor
Baroreceptors (or archaically, pressoreceptors) are stretch receptors that sense blood pressure. Thus, increases in the pressure of blood vessel triggers increased action potential generation rates and provides information to the central nervous s ...
s in the
carotid sinus
In human anatomy, the carotid sinus is a dilated area at the base of the internal carotid artery just superior to the bifurcation of the internal carotid and external carotid at the level of the superior border of thyroid cartilage. The carot ...
sense this increase in blood pressure and relay the information to the
cardiovascular centres in the
medulla oblongata
The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involun ...
. In order to maintain
homeostasis
In biology, homeostasis (British English, British also homoeostasis; ) is the state of steady internal physics, physical and chemistry, chemical conditions maintained by organism, living systems. This is the condition of optimal functioning fo ...
, the cardiovascular centres activate the
parasympathetic nervous system
The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system.
The autonomic nervous system is responsible for regulat ...
. Via the
vagus nerve
The vagus nerve, also known as the tenth cranial nerve (CN X), plays a crucial role in the autonomic nervous system, which is responsible for regulating involuntary functions within the human body. This nerve carries both sensory and motor fibe ...
, the parasympathetic nervous system stimulates neurons that release the neurotransmitter
acetylcholine
Acetylcholine (ACh) is an organic compound that functions in the brain and body of many types of animals (including humans) as a neurotransmitter. Its name is derived from its chemical structure: it is an ester of acetic acid and choline. Par ...
(ACh) at synapses with
cardiac muscle cells. Acetylcholine then binds to
M2 muscarinic receptors, causing the decrease in heart rate that is referred to as reflex bradycardia.
The M
2 muscarinic receptors decrease the heart rate by inhibiting
depolarization
In biology, depolarization or hypopolarization is a change within a cell (biology), cell, during which the cell undergoes a shift in electric charge distribution, resulting in less negative charge inside the cell compared to the outside. Depolar ...
of the
sinoatrial node
The sinoatrial node (also known as the sinuatrial node, SA node, sinus node or Keith–Flack node) is an ellipse, oval shaped region of special cardiac muscle in the upper back wall of the right atrium made up of Cell (biology), cells known as pa ...
via
Gi protein-
coupled receptors and through modulation of
muscarinic potassium channels. Additionally, M
2 receptors reduce the contractile forces of the atrial cardiac muscle and reduce the conduction velocity of the
atrioventricular node
The atrioventricular node (AV node, or Aschoff-Tawara node) electrically connects the heart's atria and ventricles to coordinate beating in the top of the heart; it is part of the electrical conduction system of the heart. The AV node lies at the ...
(AV node). However, M
2 receptors have no effect on the contractile forces of the ventricular muscle.
Stimuli causing reflex bradycardia include:
*
Oculocardiac reflex[
* Sympathetic response to intracranial hypertension][ Page 254]
* Systemically administered norepinephrine
Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...
(α-adrenergic effects on systemic vasculature exceed the effects of β1-adrenergic effects on the heart)
References
{{Cardiovascular physiology
Cardiovascular physiology