Control of ventilation Flashcards

1
Q

what does ventilatory control require the stimulation of?

A

skeletal muscle of inspiration ie diaphragm, external intercostals (contract to elevate ribs)

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2
Q

what does ventilatory control physically occur by

A
phrenic nerve (to diaphragm) think DIAPHR-ENIC
intercostal nerves (to external intercostal muscles)
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3
Q

what are the respiratory centres in the brain and what do they govern

A

pons and medulla

the rate and depth of respiration

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4
Q

is ventilatory control subconscious?

A

yes but it can be subject to voluntary modulation

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5
Q

what is breathing entirely dependent on

A

signalling from the brain

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6
Q

what crosses the blood brain barrier when PCO2 increases

A

CO2

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7
Q

what do central chemoreceptors monitor indirectly in the CSF

A

PCO2

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8
Q

common drugs that depress the respiratory centre

A

Barbiturates and opioids

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9
Q

examples of sitmuli that influence activity of respiratory centres

A

emotion

Voluntary over-ride (conscious decisions)

Mechano-sensory input from the thorax

chemoreceptor input

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10
Q

what is the most important stimuli

A

chemoreceptor input

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11
Q

what 2 types of chemoreceptors are there?

A

central and peripheral chemoreceptors

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12
Q

where are central chemoreceptors found and what do they respond to

A

in the medulla

respond directly to H+ (derived from CO2)

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13
Q

which are the primary ventilatory drive?

A

central chemoreceptors

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14
Q

where are peripheral chemoreceptors found and what do they respond to

A

carotid and aortic bodies

clusters of cells located on the common carotid artery and the aortic arch

respond primarily to plasma [H+] and PO2 (less so to PCO2)

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15
Q

which are the secondary ventilatory drive?

A

peripheral chemoreceptors

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16
Q

what parts of the body do the ventral respiratory group of neurons (VRG) supply?

A

Tongue, pharnyx, larynx, expiratory muscles

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17
Q

what parts of the body do the dorsal respiratory group of neurons (DRG) supply?

A

inspiratory muscles via the phrenic and intercostal nerves

18
Q

what do central chemoreceptors detect around the brain

A

changes in H+ concentration in CSF

19
Q

why do H+ levels rise in CSF

A

due to raised CO2 levels, so raised PCO2 when these rise H+ conc also rises

20
Q

what is a raised PCO2 called

A

hypercapnea

21
Q

how does hyperventilation occur? mention PCO2, H+ and chemoreceptors

A

ventilation is reflexly inhibited by a decrease in arterial PCO2
this reduces CSF H+ conc and as a result, switches off central chemoreceptors

22
Q

True or false: central chemoreceptors don’t respond to direct changes in plasma [H+] because of the blood brain barrier

A

true

23
Q

what happens when arterial PCO2 increases

A

CO2 moves across the blood brain barrier (gases can, not H+ as it is an ion)

24
Q

what does PCO2 form in the CSF after passing through blood brain barrier

A

produces bicarbonate and H+

the receptors then respond to this increase in H+

25
Q

what happens at the respiratory centres when PCO2 increases?

A

the respiratory centres increase ventilation rate

26
Q

what change do peripheral chemoreceptors detect?

A

changes in arterial PO2 and H+ concentration

27
Q

what happens when there is a significant fall in arterial PO2 or a rise in H+ conc?

A

Reflex stimularterialation of ventilation

28
Q

if you have chronic lung disease how does your body detect changes in PO2

A

In people with chronic lung disease their PCO2 is chronically elevated so they become desensitised to PCO2 and instead rely on changes in PO2

29
Q

where are peripheral chemoreceptors found

A

carotid and aortic bodies

30
Q

if plasma pH falls ([H+] increases) what happens?

A

ventilation will be stimulated (acidosis)

31
Q

if plasma pH rises ([H+] decreases) what happens?

A

e.g.vomiting (alkalosis), ventilation will be inhibited

32
Q

CO2 to carbonate equation

A

CO2 + H20 –> H2CO3 –> HCO3- + H+

33
Q

why can a person have a huge amount of voluntary control over breathing?

A

Descending neural pathways from cerebral cortex to respiratory motor neurons

34
Q

True or false: Respiration is inhibited during swallowing to avoid aspiration of food or fluids into the airways.

A

True

35
Q

what is the vagus nerve

A

the 10th cranial nerve and interfaces with parasympathetic control of the lungs

36
Q

what follows swallowing?

A

Swallowing is followed by an expiration in order that any particles are dislodged outwards from the region of the glottis.

37
Q

what will happen to resp rate in an anaemic patient with a blood oxygen content half the normal value

A

stay the same

38
Q

What is anaemia

A

number of red blood cells or the amount of haemoglobin in red blood cells is less than normal- means less binding sites as less haemoglobin.

39
Q

examples of other aspects of control of breathing

A

breath holding
hyperventilation
you cannot override involuntary stimuli such as PCO2 or H+ conc
decending neural pathways from cerebral cortex to respiratory motor neurons

40
Q

What are accessory muscles of inspiration and when are they used?

A

sternocleidomastoid (contracts to elevate sternum)
pectoralis major and minor (push/pull ribs inwards/outwards)
serratus anterior (on side of rib cage)
latissimus dorsi (large muscle on the back)
serratus posterior superior.

typically only used under conditions of high metabolic demand (e.g. exercise) or respiratory dysfunction (e.g. an asthma attack).