carotid sinus hypersensitivity

WordNet

1. commit a sin; violate a law of God or a moral law (同)transgress, trespass
2. violent and excited activity; "they began to fight like sin" (同)hell
3. estrangement from god (同)sinfulness, wickedness
4. an act that is regarded by theologians as a transgression of Gods will (同)sinning
5. the 21st letter of the Hebrew alphabet
6. of or relating to either of the two major arteries supplying blood to the head and neck
7. pathological sensitivity
8. extreme sensitivity
9. any of various air-filled cavities especially in the bones of the skull

PrepTutorEJDIC

1. 〈U〉(宗教・道徳上の)『罪』 / 〈C〉(宗教・道徳上の)『罪の行為』,罪悪 / 〈C〉《特におどけて》違反(過失)の行為 / (宗教・道徳上の)おきてを破る,罪を犯す / (…に)違反(過失)をする,背く《+『against』+『名』》
2. sine
3. 頚(けい)動脈 / 頚動脈の
4. 過敏,過敏症
5. 洞(どう)(骨や組織の中の穴・くぼみなど);静脈洞

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/03 14:05:42」(JST)

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[Wiki en表示]

Carotid sinus
Arteries of the neck. The carotid sinus is at the origin of the internal carotid artery.
Details
Latin	sinus caroticus
Artery	carotid artery
Nerve	branch of glossopharyngeal nerve to carotid sinus
Identifiers
MeSH	A07.231.114.186.456
Dorlands /Elsevier	s_12/12738619
TA	A12.2.04.008
FMA	50094
Anatomical terminology

In human anatomy, the carotid sinus (or carotid bulb) is a dilated area at the base of the internal carotid just superior to the bifurcation of the common carotid at the level of the superior border of thyroid cartilage. The carotid sinus is sensitive to pressure changes in the arterial blood at this level. It is the major baroreception site in humans and most mammals.

Structure

The carotid sinus is the reflex area of the carotid artery, consisting of various nerve receptors for baroregulation (pressure regulation of the body in sync to external conditions).

Function

The carotid sinus contains numerous baroreceptors which function as a "sampling area" for many homeostatic mechanisms for maintaining blood pressure. The carotid sinus baroreceptors are innervated by the sinus nerve of Hering, which is a branch of cranial nerve IX (glossopharyngeal nerve). The glossopharyngeal nerve synapses in the nucleus tractus solitarii (NTS) located in the medulla oblongata of the brainstem. The NTS indirectly modulates the activity of sympathetic and parasympathetic (vagal) neurons in the medulla and pons through the hypothalamus. These neurons then regulate the autonomic control of the heart and blood vessels. The aortic arch baroreceptors are innervated by the aortic nerve (Nerve of Cyon), which combines with CN X (vagus nerve) and travels to the NTS.

Clinical significance

It is a sensitive site of the body which can cause lethal effects to the body (rapid increase in blood pressure, cerebral ischemia, etc.) upon strong stimulation manually or by other means, eg. Transcutaneous electrical nerve stimulation in any of the three modes.

Disease

The carotid sinus often has atherosclerotic plaques because of disturbed hemodynamics (low wall shear stress, flow reversal/recirculation). Since these plaques, if large and unstable, predispose to ischemic strokes and transient ischemic attacks, carotid endarterectomies are frequently done for prophylaxis.

The carotid sinus can be oversensitive to manual stimulation, a condition known as carotid sinus hypersensitivity, carotid sinus syndrome or carotid sinus syncope, in which manual stimulation causes large changes in heart rate and/or blood pressure. This classically presents as a patient who has "fainted" on several occasions while shaving, or in some other way coming into contact with their carotid sinus.

Carotid sinus syndrome is a temporary loss of consciousness that sometimes accompanies convulsive seizures because of the intensity of the carotid sinus reflex when pressure builds in one or both carotid sinuses.

Carotid sinus massage

See also: Czermak-Hering test

Massage of the carotid sinus, carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. Like the valsalva maneuver, it is a therapy for SVT. It is less effective than pharmaceutical management of SVT with verapamil or adenosine though is still the preferred first line of treatment in a hemodynamically stable patient

Carotid sinus reflex death

Carotid sinus reflex death is a potential etiology of sudden death in which manual stimulation of the carotid sinus allegedly causes strong glossopharyngeal nerve (Vagus nerve is for aortic arch baroreceptors) impulses leading to terminal cardiac arrest. Carotid sinus reflex death has been pointed out as a possible cause of death in cases of strangulation, hanging and autoerotic strangulation, but such deductions remain controversial. Studies have also suggested that the carotid sinus reflex can be a contributing factor in other mechanisms of death by reducing blood pressure and heart rate, especially in the elderly or in people suffering from carotid sinus hypersensitivity. A carotid massage can also possibly dislodge a thrombus, or some plaque. This could lead to any number of life-threatening effects, including stroke.

In martial arts and self defense

Stimulation of the carotid sinus via a slap or a strike, to induce (usually temporary, but sometimes lethal) loss of consciousness is an effective self defense technique, and is often taught in martial arts such as karate and Krav Maga.

See also

• Carotid body
• Baroreflex

References

Additional Images

• Carotid sinus

External links

• lesson5 at The Anatomy Lesson by Wesley Norman (Georgetown University) (livingneck)

UpToDate Contents

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• 1. 頸動脈洞過敏症 carotid sinus hypersensitivity
• 2. 失神患者のマネージメント management of the patient with syncope
• 3. 迷走神経刺激法 vagal maneuvers
• 4. 成人における失神の評価 evaluation of syncope in adults
• 5. 反射性失神 reflex syncope

English Journal

• The Association of Cardiovascular Disorders and Falls: A Systematic Review.

• Jansen S1, Bhangu J2, de Rooij S3, Daams J4, Kenny RA5, van der Velde N1.
• Journal of the American Medical Directors Association.J Am Med Dir Assoc.2015 Oct 8. pii: S1525-8610(15)00562-9. doi: 10.1016/j.jamda.2015.08.022. [Epub ahead of print]
• OBJECTIVE: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care.DESIGN: Systematic review.DATA SOURC
• PMID 26455926

• Carotid sinus syndrome.

• Amin V1, Pavri BB.
• Cardiology in review.Cardiol Rev.2015 May-Jun;23(3):130-4. doi: 10.1097/CRD.0000000000000041.
• Carotid sinus hypersensitivity, first described less than 65 years ago, is an important and often undiagnosed cause of syncope in the elderly. Its pathophysiology is complex and certain aspects are not completely understood. The timely diagnosis and treatment of this condition can improve morbidity
• PMID 25211534

• [Syncope: physiopathology, diagnosis and therapy].

• Piccirillo G1, Moscucci F1, Magrì D2.
• La Clinica terapeutica.Clin Ter.2015;166(3):e216-33. doi: 10.7417/T.2015.1857.
• Nowadays, syncope still generates complicated challenges for clinicians for the alarm it arises in patients and, at the same time, for the multiple causes it has determined by. In almost one third of cases, syncope is neuromediated, in young subjects in vasovagal, whereas in elderly is often determi
• PMID 26152635

Japanese Journal

• 失神発作を初発症状とした上咽頭癌の1症例

• 卯月 彩,嶋根 俊和,秋山 理央,林 武史,池田 賢一郎,五味渕 寛,小林 斉,三邉 武幸
• 頭頸部外科 = Journal of Japan Society for Head and Neck Surgery 21(3), 241-245, 2012-02-28
• NAID 10031190343

• 失神発作を初発症状とした上咽頭癌の1症例

• 卯月 彩,嶋根 俊和,秋山 理央,林 武史,池田 賢一郎,五味渕 寛,小林 斉,三邉 武幸
• 頭頸部外科 21(3), 241-245, 2012
• … 頭頸部癌は頸部リンパ節転移が多く認められ，この転移巣による物理的な頸動脈圧迫で失神発作（頸動脈洞過敏症候群：Carotid Sinus Hypersensitivity Syndrome以下CSHS）を起こすことは報告されているが，ほとんどは末期癌患者であり初発症状として失神発作を起こした症例は少ない。 …
• NAID 130002137068

Related Links

• Carotid Sinus Hypersensitivity - Emedicine Medscape

10 Apr 2013 ... Carotid sinus hypersensitivity (CSH) is an exaggerated response to carotid sinus baroreceptor stimulation. ... Although baroreceptor function usually diminishes with age, some people experience hypersensitive carotid ...

• Carotid Sinus Hypersensitivity | Doctor | Patient.co.uk

Carotid sinus hypersensitivity (CSH) is an exaggerated response to carotid sinus baroreceptor stimulation. It is defined by the response to gentle carotid...

Related Pictures

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★リンクテーブル★

リンク元	「頸動脈洞過敏症」
関連記事	「carotid」「hypersensitivity」

「頸動脈洞過敏症」

　　[★]

英

carotid sinus hypersensitivity

「carotid」

　　[★]

• adj.

• 頚動脈の、頸動脈の

関

carotid artery

　 　

「hypersensitivity」

　　[★] アレルギー