Decreases heart rate sympathetic or parasympathetic

Decreases heart rate sympathetic or parasympathetic

Understanding:

•  The heart rate can be increased or decreased by impulses brought to the heart through two nerves from the 

    medulla of the brain

    
While the basal heart rate is determined within the heart by the pacemaker, it can be regulated by external signals

  • Nerve signals from the brain can trigger rapid changes, while endocrine signals can trigger more sustained changes
  • Changes to blood pressure levels or CO2 concentrations (and thereby blood pH) will trigger changes in heart rate

Nerve Signalling

The pacemaker is under autonomic (involuntary) control from the brain, specifically the medulla oblongata (brain stem)

Two nerves connected to the medulla regulate heart rate by either speeding it up or slowing it down:

  • The sympathetic nerve releases the neurotransmitter noradrenaline (a.k.a. norepinephrine) to increase heart rate
  • The parasympathetic nerve (vagus nerve) releases the neurotransmitter acetylcholine to decrease heart rate

Decreases heart rate sympathetic or parasympathetic

Understanding:

•  Epinephrine increases the heart rate to prepare for vigorous physical activity

    
Hormonal Signalling

Hormones are chemical messengers released into the bloodstream that act specifically on distant target sites (like the heart)

Heart rate can undergo a sustained increase in response to hormonal signalling in order to prepare for vigorous physical activity

  • The hormone adrenaline (a.k.a. epinephrine) is released from the adrenal glands (located above the kidneys)
  • Adrenaline increases heart rate by activating the same chemical pathways as the neurotransmitter noradrenaline

Regulation of Heart Rate

Decreases heart rate sympathetic or parasympathetic

  • 1 The Autonomic Nervous System
    • 1.1 Parasympathetic
    • 1.2 Sympathetic
  • 2 Baroreceptor Reflex
  • 3 Hormonal Control
  • 4 Clinical Relevance – Tachycardia

The heart rate is established by the Sinoatrial Node (SAN) – the pacemaker of the cardiac muscle. In the absence of any influences, the SAN pacing rate would be 100 bpm, however, heart rate and cardiac output must be able to vary in response to the needs of the body.

By influencing the cells in the SAN, nerve impulses and hormones can affect the speed at which the SAN generates an electrical impulse. This affects the heart rate (or chronotrophy), which in turn affects the cardiac output. In this article, we will discuss how hormones and nerve impulses work to control the heart rate.

The Autonomic Nervous System

The autonomic nervous system (ANS) is responsible for controlling many physiological functions. It induces the force of contraction of the heart and its heart rate. In addition, it controls the peripheral resistance of blood vessels. The ANS has both sympathetic and parasympathetic divisions that work together to maintain balance.

Parasympathetic

The parasympathetic input into the heart is via the vagus nerve (CN X). The vagus nerve forms synapses with postganglionic cells in SAN and AVN (atrioventricular node). When stimulated, acetylcholine binds on to M₂ receptors, which act to decrease the slope of the pacemaker potential. This leads to a decrease in heart rate (a negative chronotropic effect).

Sympathetic

The sympathetic input into the heart is via the postganglionic fibres from the sympathetic trunk which innervate the SAN and AVN. The postganglionic fibres release noradrenaline, which acts on B₁ adrenoreceptors to increase the slope of the pacemaker potential. This increases the heart rate (a positive chronotropic effect), as well as the force of contraction (positive inotropic effect).

The parasympathetic input on the SAN dominates at rest, giving a normal resting heart rate of around 60bpm. A reduction in parasympathetic outflow results in an initial increase in heart rate, reaching over 100bmp. This is further brought about by an increase in sympathetic outflow.

By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

Decreases heart rate sympathetic or parasympathetic

Fig 1 – Diagram showing an overview of autonomic innervation to the heart.

Baroreceptor Reflex

Baroreceptors are mechanoreceptors located in both the carotid sinus and the aortic arch. They are sensitive to changes in stretch and tension in the arterial wall. Additionally, they detect changes in arterial pressure and communicate this to the medulla oblongata in the brainstem. The medullary centres in the brain are responsible for the overall output of the autonomic nervous system, and use the information fed back from baroreceptors to coordinate a response:

  • If an increase in arterial pressure is detected, the parasympathetic pathway is activated to reduce the heart rate. This, along with increasing vasodilation of vessels, acts to reduce the arterial pressure.
  • If a decrease in arterial pressure is detected, the sympathetic pathway is activated to increase the heart rate and the contractility of the heart. This, along with increasing vasoconstriction of vessels, acts to increase the arterial pressure.

    By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

    Decreases heart rate sympathetic or parasympathetic

    Fig 2 – Diagram showing the action of the baroreceptor reflex.

Hormonal Control

Hormones also have the ability to affect the heart rate. For example, adrenaline is released from the medulla of adrenal glands during times of stress. This results in a number of effects that occur during a stress response such as an increase in heart rate.

Clinical Relevance – Tachycardia

Tachycardia is defined as a heart rate that exceeds the normal resting rate (over 100 beats per minute). This can be normal in the case of exercise, however, tachycardia at rest is generally due to causes such as:

  • Anxiety
  • Infection
  • Hypoglycaemia
  • Hypovolaemia
  • Hyperthyroidism
  • Problems with conductance in the heart

Tachycardias due to conductance within the heart can be classified as narrow or wide complex tachycardia depending on the length of the QRS complex on an ECG. Narrow complex tachycardias include sinus tachycardia, atrial fibrillation and atrial flutter. Wide complex tachycardias include ventricular tachycardia and Wolff-Parkinson-White Syndrome.

In the case of narrow complex tachycardias, vagal manoeuvres or IV adenosine can be used to attempt to revert to a normal rhythm. If the patient is haemodynamically unstable then DC cardioversion may be necessary.

For broad complex tachycardias, amiodarone can be given if a patient is stable, however, if a patient is unstable DC cardioversion may be needed. It is important to note that in the case of Wolff-Parkinson-White syndrome with atrial fibrillation, AV node blocking drugs must not be used as they will increase conduction down the abnormal pathway.

Some disorders such as atrial fibrillation can be rate controlled using drugs such as beta-blockers, with accompanying anti-coagulative measures.

By User:MoodyGroove (en.wikipedia.org) CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Decreases heart rate sympathetic or parasympathetic

Fig 3 – ECG showing Sinus Tachycardia with a heart rate of 150bpm.

Is increased heart rate sympathetic or parasympathetic?

The sympathetic nervous system increases heart rate, whereas the parasympathetic nervous system suppresses it.

Does sympathetic stimulation decrease heart rate?

The sympathetic nervous system releases norepinephrine (NE) while the parasympathetic nervous system releases acetylcholine (ACh). Sympathetic stimulation increases heart rate and myocardial contractility.

What decreases heart rate sympathetic or parasympathetic quizlet?

The parasympathetic nervous system increases digestive activity and decreases heart rate. The sympathetic nervous system increases blood pressure, dilates bronchioles, stimulates the adrenal medulla to release its hormones, and causes ejaculation.