Figure 18-18 Anatomic configuration of the baroreceptor reflex. Pressure receptors in the wall of the carotid sinuses and aorta detect arterial pressure changes in the circulation. These signals are conveyed to afferent receptive regions of the medulla through the Hering and vagus nerves. Output from effector portions of the medulla modulates peripheral tone and heart rate. The increase in blood pressure results in increased activation of the reflex (right), which effects a decrease in blood pressure. (From Campagna JA, Carter C: Clinical relevance of the Bezold-Jarisch reflex. Anesthesiology 98:1250–1260, 2003.)