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The kidney is innervated with efferent sympathetic nerve fibers reaching the renal vasculature, the tubules, the juxtaglomerular granular cells, and the renal pelvic wall. The renal sensory nerves are mainly found in the renal pelvic wall. Increases in efferent renal sympathetic nerve activity reduce renal blood flow and urinary sodium excretion by activation of α1-adrenoceptors and increase renin secretion rate by activation of β1-adrenoceptors. In response to normal physiological stimulation, changes in efferent renal sympathetic nerve activity contribute importantly to homeostatic regulation of sodium and water balance. The renal mechanosensory nerves are activated by stretch of the renal pelvic tissue produced by increases in renal pelvic tissue of a magnitude that may occur during increased urine flow rate. Activation of the sensory nerves elicits an inhibitory renorenal reflex response consisting of decreases in efferent renal sympathetic nerve activity leading to natriuresis. Increasing efferent sympathetic nerve activity increases afferent renal nerve activity which, in turn, decreases efferent renal sympathetic nerve activity by activation of the renorenal reflexes. Thus, activation of the afferent renal nerves buffers changes in efferent renal sympathetic nerve activity in the overall goal of maintaining sodium balance. In pathological conditions of sodium retention, impairment of the inhibitory renorenal reflexes contributes to an inappropriately increased efferent renal sympathetic nerve activity in the presence of sodium retention. In states of renal disease or injury, there is a shift from inhibitory to excitatory reflexes originating in the kidney. Studies in essential hypertensive patients have shown that renal denervation results in long-term reduction in arterial pressure, suggesting an important role for the efferent and afferent renal nerves in hypertension. Table of Contents: Part I: Efferent Renal Sympathetic Nerves / Introduction / Neuroanatomy / Neural Control of Renal Hemodynamics / Neural Control of Renal Tubular Function / Neural Control of Renin Secretion Rate / Part II: Afferent Renal Sensory Nerves / Introduction / Neuroanatomy / Renorenal Reflexes / Mechanisms Involved in the Activation of Afferent Renal Sensory Nerves / Part III: Pathophysiological States / Efferent Renal Sympathetic Nerves / Afferent Renal Sensory Nerves / Conclusions / References
Edited by R.H. Andrews.
A practical guide to working with the principles of polyvagal theory beyond the therapy session. Deb Dana is the foremost translator of polyvagal theory into clinical practice. Here, in her third book on this groundbreaking theory, she provides therapists with a grab bag of polyvagal-informed exercises for their clients, to use both within and between sessions. These exercises offer readily understandable explanations of the ways the autonomic nervous system directs daily living. They use the principles of polyvagal theory to guide clients to safely connect to their autonomic responses and navigate daily experiences in new ways. The exercises are designed to be introduced over time in a variety of clinical sessions with accompanying exercises appropriate for use by clients between sessions to enhance the therapeutic change process. Essential reading for any therapist who wants to take their polyvagal knowledge to the next level and is looking for easy ways to deliver polyvagal solutions with their clients.
The gastrointestinal tract is a long, muscular tube responsible for the digestion of food, assimilation of nutrients and elimination of waste. This is achieved by secretion of digestive enzymes and absorption from the intestinal lumen, with different regions playing specific roles in the processing of specific nutrients. These regions come into play sequentially as ingested material is moved along the length of the GI tract by contractions of the muscle layers. In some regions like the oesophagus transit it rapid and measured in seconds while in others like the colon transit is measured in hours and even days, commensurate with the relative slow fermentation that takes place in the large bowel. An hierarchy of controls, neural and endocrine, serve to regulate the various cellular targets that exist in the gut wall. These include muscle cells for contraction and epithelial cells for secretion and absorption. However, there are complex interactions between these digestive mechanisms and other mechanisms that regulate blood flow, immune function, endocrine secretion and food intake. These ensure a fine balance between the ostensibly conflicting tasks of digestion and absorption and protection from potentially harmful ingested materials. They match assimilation of nutrients with hunger and satiety and they ensure that regions of the GI tract that are meters apart work together in a coordinated fashion to match these diverse functions to the digestive needs of the individual. This ebook will provide an overview of the neural mechanisms that control gastrointestinal function. Table of Contents: Neural Control of Gastrointestinal Function / Cells and Tissues / Enteric Nervous System / From Gut to CNS: Extrinsic Sensory Innervation / Sympathetic Innervation of the Gut / Parasympathetic Innervation of the Gut / Integration of Function / References
Each of nine contributions presents an overview of the nervous control of autonomic outflow to a particular organ or system, while maintaining an integrated approach to describing the simultaneous control of several outflows in response to different physiological situations. The authors describe a neurophysiological, neuropharmacological, and neuroanatomical approach to problems. Reference to relevant studies in humans, as well as animal work, is also provided. Annotation copyrighted by Book News, Inc., Portland, OR