Control of Respiration

Question 1

Dorsal Respiratory Group

Answer 1

Inspiration; generates AP during inspiration with phrenic nerve and intercostal nerves

Question 2

Pneumotaxic Center

Answer 2

inhibits Dorsal Respiratory Group; this “turns off” inspiration

Question 3

Apneustic Center

Answer 3

overrides inhibitory input of Pneumotaxic center to help DRG prolong inspiration

Question 4

Ventral Respiratory Group

Answer 4

neurons active during FORCED expiration and inspiration

Question 5

What are the three types of lung receptors?

Answer 5

1. ) Stretch receptors - (Hering-Breuer reflex) in airways
2. ) Irritant receptors - from inhaling irritants: decrease TV while increasing respiratory rate (fast/shallow breathes)
3. ) Juxtacapillary Receptors - next to pulmonary capillaries and are sensitive to excessive fluid; pneumonia (decreases TV)

Question 6

When is the Hering-Breuer reflex activated and what does it inhibit?

Answer 6

Activated from stretch during inspiration;

Inhibits Dorsal Respiratory Group which results in expiration

Question 7

What do peripheral chemoreceptors monitor?

Answer 7

Arterial PO2 and [H+], maybe some CO2…

Question 8

What do central chemoreceptors monitor?

Answer 8

ONLY CO2 because it crosses blood-brain barrier, and is sensitive to changes in CSF [H+]

Question 9

Where are peripheral chemoreceptors found and how do they work?

Answer 9

The carotid and aortic bodies.

Work via negative feedback, when PO2 level is low, we breathe more in

Question 10

Where are central chemoreceptors and how do they work?

Answer 10

Near respiratory centers in the brainstem.

Very sensitive to small changes in arterial PCO2 about a normal range

Question 11

How do PO2 levels effect ventilation?

Answer 11

Does not really effect it until levels are very low (40mmHg)

Question 12

How do PCO2 levels effect ventilation?

Answer 12

More CO2 in blood, the more you breathe (very sensitive central chemoreceptors)

Question 13

How do [H+] levels effect ventilation?

Answer 13

Similar to PCO2

Question 14

What can COPD do to monitoring levels of O2 and CO2 levels?

Answer 14

Disrupts set-point and makes it higher, the body adapts by closely monitoring O2 levels, not CO2 like it should!

Question 15

What does increasing exercise intensity do to O2?

Answer 15

Does not really change because you breathe in and out to compensate!

Question 16

What does increasing exercise intensity do to CO2?

Answer 16

CO2 actually decreases because we breathe more!

Question 17

What does increasing exercise intensity do to [H+]?

Answer 17

Not big change until lactic threshold is reached, then [H+] in blood rises

Question 18

What does Cheyne-Strokes breathing look like, and what could cause it?

Answer 18

Waves all over the place;

Brain trauma or severe heart failure

Question 19

What does apneustic breathing look like and why does it occur?

Answer 19

Long, large periods of inspiration (sighs) because apneustic center overrides pneumotaxic center to let DRG do its thang

Question 20

What is obstructive sleep apnea? And what is it associated with?

Answer 20

Closing of pharynx during inspiration and arousal by respiratory drive. Associated with obesity

Question 21

What increases the incidence of sleep apnea?

Answer 21

Surgery or daytime drowsiness

Question 22

You may use a splint or CPAP if you have sleep apnea because it is a ______________ problem.

Answer 22

Structural

Question 23

Volume limitation has to do with (restrictive/obstructive) diseases:

Answer 23

Restrictive

Question 24

Flow limitation has to do with (restrictive/obstructive) diseases:

Answer 24

Obstructive (limit flow through airways)

Question 25

What happens to FVC and FEV during Restrictive disease?

Answer 25

BOTH decrease proportionally (small upside down ice cream cone)

Question 26

What happens to FVC and FEV during Obstructive disease?

Answer 26

FVC either decreases or remains the same, and FEV decreases by double!

Question 27

When is obstructive disease most problematic and why?

Answer 27

During expiration because thats when airways shrink

Question 28

What are some examples of obstructive diseases?

Answer 28

• Chronic bronchitis
• Asthma
• Emphysema
• Cystic Fibrosis

Question 29

What are common symptoms of COPD?

Answer 29

Coughing, wheezing, mucus, and exertion dyspnea

Question 30

Characteristics of COPD:

Answer 30

• Inflammation of lining of small airways
• Increased mucus production / impaired clearance
• Mucosal Thickening
• Bronchiolar Constriction (increases resistance)
• Tissue Destruction

Question 31

COPD effects on lung function:

Answer 31

1. ) Loss of elastic recoil in smaller airways and alveoli (too much compliance)
2. ) Tendency for airways to collapse (dynamic compression)
3. ) Air trapping and lung hyperinflation (barrel chest)
4. ) Loss of Capillary bed and SA
5. ) Poor O2 delivery and CO2 clearance

Question 32

What is cor pulmonale?

Answer 32

Heart disease/failure caused by lung dysfunction

Question 33

What causes Chronic Bronchitis and what is it?

Answer 33

SMOKING
When the airways are irritated so they produce more mucus. This could even increase size of mucus glands, cause goblet cell hyperplasia, and ciliary dysfunction

Question 34

What indicates chronic bronchitis?

Answer 34

Sputum producing cough on most days for 3 months during 2 consecutive years. (So… STOP smoking)

Question 35

Emphysema is indicated by centriacina and panacinar, which one is where you lose alveoli number because they fuse together?

Answer 35

Panacinar, other one has to do with bronchioles becoming too large

Question 36

How to treat Emphysema?

Answer 36

Stop smoking, medications (B2 agonists, corticosteroids, anticholinergics), O2 therapy, lung transplant, and pulmonary rehab.

Question 37

Asthma is an increased production of? What does this do?

Answer 37

Mucus (edema in airways) causes an acute inflammatory response

Question 38

Asthma has “triggers” so it is…

Answer 38

Reversible

Question 39

Mast cell degranulation causes what?

Answer 39

Exercise induced asthma

Question 40

Although a person could have all three subcategories of COPD, which two commonly overlap?

Answer 40

Emphysema and Chronic Bronchitis

Question 41

Corticosteroids

Answer 41

powerful anti-inflammatory effects; drug of choice for persistent asthma. MANY side effects (osteoporosis??)

Question 42

Sympathomimetics

Answer 42

selective B2-agonists ideal; peripheral vasoconstriction and bronchodilation (Albuterol)

Question 43

Parasympatholytics

Answer 43

Anticholinergics; usually used in COPD

Question 44

Antihistamines

Answer 44

block allergic response, good for asthma (but not inflammation, induced bronchospasm more)

Question 45

What is bronchiectasis?

Answer 45

abnormal dilation of airways from infection;
cured with antibiotics
- causes via Cystic fibrosis

Question 46

Cystic fibrosis is an inherited and is multi-system disease whose abnormality is from:

Answer 46

Chloride ion transporter (changes balance of lung secretions to make them viscous and sticky)

Question 47

Cystic fibrosis is a disorder of:

Answer 47

Exocrine gland function (usually pancreas, liver, intestines, and reproductive organs)

Question 48

Restrictive lung dysfunction causes the work of breathing to and is caused via

Answer 48

increase 
MANY systems (anything that can restrict breathing)

Question 49

Ciliary dysfunction/mucus overproduction relates to:

Answer 49

Chronic Bronchitis

Question 50

Loss of alveolar surface area relates to:

Answer 50

Emphysema

Question 51

Excessive mucus and bronchoconstriction relates to:

Answer 51

Asthma