Cardiovascular reflex responses to cutaneous and visceral stimuli in spinal man

1. A study has been made of the effects of pinprick and a cold pack applied to the skin above and below the level of denervation, deep inspiration, squeezing the chest, and bladder percussion in non-bedridden patients with chronic, closed, complete, localized transection of the cervical spinal cord. Variables studied were blood pressure, heart rate, calf blood flow, hand blood flow and occluded vein pressure in the hand and foot.2. Cutaneous stimuli above the lesion, mental arithmetic and noise from gunshot produced no response.3. Pinprick and cold applied below the lesion usually produced an increase in mean arterial pressure, little change in pulse pressure or heart rate, clear decreases in calf and hand blood flow, and occasional venoconstriction.4. Deep inspiration produced an initial rise in blood pressure and heart rate which was sometimes followed by a decrease in one or both. Squeezing the chest usually produced an increase in blood pressure and a decrease in heart rate. Both stimuli caused decreases in calf and hand blood flow and venoconstriction, the latter being more common after squeezing the chest.5. Bladder percussion produced contraction of the wall of the bladder and this was regularly associated with increased arterial mean and pulse pressures, a decreased heart rate and calf and hand blood flow, and venoconstriction. The responses occurred whether or not the bladder was full and whether or not a rise of intravesical pressure occurred.