NERVOUS CONTROL OF CUTANEOUS CIRCULATION

Journal/Book: British Medical Bulletin 1963 Vol. 19 No. 2 (Peripheral Circulation in Man) pages 110-114. 1963;

Abstract: R. H. Fox M.B. B.S. O. G. Edholm B.Sc. M.B. B.S. Division of Human Physiology Medical Research Council Laboratories Hampstead London 1 Nervous control of hand blood flow 2 Nervous control of forearm skin blood flow 3 Vasodilatation and sweating 4 Vasomotor control in other skin areas 5 Interaction between neural vascular control and local temperature 6 Central nervous system control 7 Vasomotor control in the new-born References This review is confined to studies concerned with the circulation through the skin in man and animal work is mentioned only where relevant. In view of the considerable volume of work in this field many aspects have had to be omitted. Vasoconstrictor and vasodilator nerves were first described more than a century ago (Bernard 1852 1858; Brown-Séquard 1852) and ever since then controversy over their modes of action and their relative importance in the vasomotor regulation of blood flow through different tissues has continued. The slow progress in our understanding of the mechanisms in human skin is due in part to the necessary limitations of the experimental techniques to relatively non-injurious procedure. Furthermore the differences in the vasomotor innervation of the skin in man and animals have proved to be particularly striking. Temperature changes in skin have been widely used as an indirect index of skin blood flow. However it has been shown that skin temperatures can be very misleading (Burton 1948; Cooper Cross Greenfield Hamilton & Scarborough 1949; Fetcher Hall & Shaub 1949). The most direct method of measuring blood flow in man is by the venous occlusion plethysmograph; its use is confined to the extremities so these have received much more attention than other skin areas. There have been two assumptions made by workers in this field which have proved unjustified and have been the cause of much confusion. The first of these was that the skin of the body as a whole would have one type of vasomotor control. The second was that blood-flow changes through the forearm as a whole could be considered to reflect muscle vessel responses just as-because in the forearm and hand the dominant tissues are muscle and skin respectively-changes in hand blood flow were considered to represent skin vessel responses. ... ___MH

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