Chapter 8: Control of Ventilation Flashcards

1
Q

Where does the normal rhythmic pattern of breathing originate?

A

Brainstem

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2
Q

When do expiratory neurons fire? Significantly, when do they not fire?

A

During forceful breathing. The expiratory area of the medulla is quiescent during quiet breathing.

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3
Q

Where is the pneumotaxic center located?

A

Upper pons

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4
Q

What facet of breathing does the pneumotaxic center regulate?

A

Appears to “switch off” or inhibit inspiration - this regulates inspiratory volume, and secondarily, respiratory rate

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5
Q

Where is the apneustic center located?

A

Lower pons

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6
Q

What is the apparent function of the apneustic center?

A

Impulses from the apneustic center have an excitatory effect on the inspiratory area of the medulla.

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7
Q

What happens to a person in whom the apneustic center is damaged?

A

Abnormal breathing pattern - prolonged inspiratory gasps (apneuses) interrupted by transient expiratory efforts

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8
Q

What part of the brain can override the respiratory center?

A

Cortex

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9
Q

Which is more difficult, voluntary hyperventilation or voluntary hypoventilation?

A

Voluntary hypoventilation

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10
Q

What nerves carry output from the respiratory center?

A

Phrenic nerves (C3-C5) control the diaphragm, other nerves from the spinal column carry signals to the intracostals, abdominals, and accessory muscles such as the SCM

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11
Q

Where are the central chemoreceptors located?

A

Ventral surface of the medulla

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12
Q

What medium surrounds the central chemoreceptors?

A

Brain ECF

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13
Q

To what stimulus are the central chemoreceptors responsive?

A

CO2, indirectly, but no O2. CO2 diffuses across the BBB all the way to CSF, pH in CSF goes down, H+ signal is then seen in the ECF, trigerring the central chemoreceptors.

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14
Q

How quickly do H+ and HCO3- diffuse across the BBB?

A

Not at all. pH response is modulated by CO2 diffusion only

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15
Q

Which is more pH-responsive to changes in [CO2], blood or CSF?

A

CSF - does not have nearly the buffering capacity that blood has

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16
Q

Describe the stimuli for the peripheral chemoreceptors

A

Carotid bodies - CO2, O2, and pH

Aortic bodies - CO2 and O2 (not pH)

17
Q

Which chemoreceptors react more quickly to changes in PCO2?

A

Peripheral

18
Q

Which receptors are more important for regulating ventilation in response to PCO2?

A

Central

19
Q

How does ventilatory response to PCO2 change during sleep?

A

Decreases

20
Q

In a patient with chronic hypoxia, how does ventilation response change?

A

In chronic hypoxia, compensation for abnormally high PCO2 through renal mechanisms (bicarb) means the central receptors are “tricked” into being comfortable with an abnormally high PCO2. Thus, hypoxia is the only stimulation to breathe. Treating this condition with oxygen results in a patient suffering from depressed ventilatory drive, despite high PCO2

21
Q

What is the most important stimulus controlling the level of resting ventilation?

A

The pH of CSF on central chemoreceptors

22
Q

What paradoxical conditions are observed during moderate exercise? Why is this paradoxical?

A

Arterial PO2 increases
Arterial PCO2 decreases
Arterial pH is normal

This is paradoxical b/c we’re not sure what is stimulating heavy breathing during exercise! Might be joint motion, lots of theories

23
Q

What reflex helps to inflate the newborn lung?

A

Hering-Breuer inflation reflex

24
Q

What condition may contribute to SIDS?

A

Uncoordinated respiratory muscle activity, especially during sleep, i.e., thoracic muscles try to inspire while the abdominal muscles expire

25
Q

What is the Hering-Breuer inflation reflex?

A

Mechanism by which pulmonary stretch receptors in the smooth muscle of airways prevent over-inflation of the lungs during large inspirations

26
Q

What nerve carries the signals of the Hering-Breuer reflex?

A

Large myelinated fibers in the vagus nerve