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When Joslin moved rapidly from a supine (lying) position to a standing position, there was a brief, initial decrease in arterial pressure that caused her light-headedness. Describe the sequence of events that produced this transient fall in arterial pressure. Orthostatic hypotension is the phenomenon whereby arterial pressure decreases when one stands up. When a person suddenly moves from a supine (lying) position to a standing position, blood pools in the veins of the legs. (Because the capacitance, or compliance, of the veins is high, they can hold large volumes of blood.) This pooling decreases venous return to the heart, which decreases cardiac output by the FrankStarling mechanism. (The FrankStarling mechanism describes the relationship between venous return and cardiac output. Increases in venous return lead to increases in end-diastolic volume. Up to a point, increases in end-diastolic volume lead to increases in cardiac output. Conversely, decreases in venous return lead to decreases in cardiac output.) Because arterial pressure is affected by the volume of blood in the arteries, a decrease in cardiac output (i.e., less blood is pumped into the arterial system) causes a decrease in arterial pressure. 2. Why did the decrease in arterial pressure cause Joslin to feel lightheaded? Hide Answer When Joslin stood up quickly, she felt light-headed because a brief period of cerebral ischemia occurred as a result of the decrease in arterial pressure. The autoregulatory range for cerebral blood flow is 60 to 140 mm Hg. In other words, cerebral blood flow is maintained constant as long as arterial pressure is greater than 60 mm Hg and less than 140 mm Hg. When Joslin stood up, her arterial pressure briefly decreased below this critical autoregulatory range. As a result, cerebral blood flow decreased, and she felt light-headed.

3. Joslins

light-headedness was only transient because a reflex was initiated that rapidly restored arterial pressure to normal. Describe the specific effects of this reflex on heart rate, myocardial contractility, TPR, and capacitance of the veins. What receptors are involved in each of these responses? Hide Answer Baroreceptors located in the carotid sinus and the aortic arch sensed the decrease in arterial pressure. The baroreceptor reflex then orchestrated a series of compensatory responses, including increased sympathetic outflow to the heart and blood vessels. There are four consequences of this increased sympathetic outflow: Increased heart rate (the sensation of a racing heart), a positive chronotropic effect mediated by !1-adrenergic receptors in the sinoatrial node. Increased contractility of the ventricles, a positive inotropic effect mediated by !1-adrenergic receptors in the ventricular muscle. Increased arteriolar constriction, mediated by "1adrenergic receptors on vascular smooth muscle of the arterioles. Increased venoconstriction, mediated by "1-adrenergic receptors on vascular smooth muscle of the veins.
4. How

does each component of the reflex (e.g., the effect on heart rate) help to restore arterial pressure? (Hint: It may help to write the equation that relates arterial pressure, cardiac output, and TPR.) Hide Answer All of the components of the baroreceptor reflex contributed to the restoration of Joslins arterial pressure (Fig. 28).

5. In

addition to the reflex correction of blood pressure, the fact that Joslin walked to the bathroom helped return her arterial pressure to normal. How did walking help? Show Answer As Joslin walked toward the bathroom, the muscular activity compressed the veins in her legs and decreased venous capacitance (i.e., the volume of

blood the veins can hold). This compression, combined with sympathetic venoconstriction, increased venous return to the heart and cardiac output.