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FBS2 > Control of Ventilation > Flashcards

Control of Ventilation Flashcards

1
Q

What is eupnoea?

A

Normal breathing

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2
Q

What is apneusis?

A

Deep gasping inspiration and holding breath in then quick release

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3
Q

What does the pneumotaxic centre in the pons do?

A

Inhibits inspiratory phase

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4
Q

What does the apneustic centre in the pons do?

A

Prolongs inspiration

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5
Q

What are the 4 main respiratory nuclei in the medulla?

A
  1. Dorsal respiratory group (in nucleus tractus solitarius)
  2. Ventral respiratory group
  3. Pre-Botzinger complex
  4. Botzinger complex
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6
Q

Which respiratory nucleus is thought to be the key centre of respiratory rhythmogenesis?

A

pre-Botzinger complex

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7
Q

What kind of neurones does the dorsal respiratory group contain?

A

Inspiratory neurons

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8
Q

What kind of neurones does the ventral respiratory group contain?

A

Expiratory neurons

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9
Q

Where are the stretch receptors that affect breathing located?

A

Smooth muscle of the bronchial walls

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10
Q

What do the stretch receptors do to affect respiration?

A

Make inspiration shorter
Delay next respiratory cycle
(Negative feedback)

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11
Q

What is the name of the reflex where inflation of the lungs inhibits inspiration?

A

Hering-Breuer inflation reflex

Not in play in normal breathing but important in babies

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12
Q

What is the name of the reflex where deflation augments inspiration?

A

Deflation reflex

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13
Q

What do the juxtapulmonary receptors do?

A

In alveolar/bronchial walls, close to capillaries
Often activated in response to irritants or pulmonary embolism/oedema
Cause apnoea/rapid shallow breathing - cause breathlessness

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14
Q

What do the irritant receptors do?

A

Throughout airways between epithelial cells

Protective reflex - stops other irritants getting down

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15
Q

Which receptors are responsible for the deep breaths seen every 5-20 mins at rest preventing slow collapse of lungs during quiet breathing?

A

Irritant receptors

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16
Q

What do proprioceptive afferents do in the respiratory system?

A

Muscle spindles/Golgi tendon organs stimulated by change in length of muscles
Important for dealing with increased load and optimising tidal volume/frequency

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17
Q

How does pain receptor stimulation affect breathing?

A

Causes brief apnoea followed by increased breathing

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18
Q

Describe the ventilatory response to CO2 graph?

A

Linear relationship between alveolar PCO2 and ventilation up to a point then depression of respiratory centre - acidosis interferes with neural function (breathe less)
This depression also occurs in severe hypoxia

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19
Q

What happens at very low levels of CO2 on the ventilation graph?

A

Ventilation levels off

Never stop breathing all together

20
Q

What is the relationship between PACO2 and alveolar ventilation ?

A

Inverse proportion

Halving ventilation rate doubles PACO2

21
Q

What happens to the CO2 ventilation graph in metabolic alkalosis?

A

It shifts to the right (parallel straight line)

22
Q

What happens to the CO2 ventilation graph in metabolic acidosis?

A

It shifts to the left (parallel straight line)

23
Q

What does the ventilation pO2 graph look like?

A

Non linear

Ventilation only really increases when O2 conc is less than 8kPa

24
Q

What is the significance of the 8kPa on the O2 ventilation graph?

A

Same pressure that Hb has reduced affinity for O2 - O2 comes off Hb at that pressure - breathe more at this point

25
Q

How does hypercapnia change the O2 ventilation graph?

A

Shifts it up - higher ventilation rate for any conc of O2

Synergistic - combined effect greater than individual effects

26
Q

What are the 2 types of chemoreceptors?

A

Central

Peripheral

27
Q

What determines the interstitial pH (around the chemoreceptors)?

A

Diffusion of CO2 from the blood

Diffusion of HCO3- from CSF

28
Q

What do the central chemoreceptors respond to?

A

pH of CSF

29
Q

What is the [H+] proportional to at the central chemoreceptor?

A

pco2/ [HCO3-]

30
Q

How much of response to raised pCo2 are central chemoreceptors responsible for?

A

80%

31
Q

How quick is the response of central chemoreceptors?

A

Slow - 20 s

32
Q

What occurs during prolonged hypercapnia?

A

CSF pH returns to normal
Ventilatory drive decreases
E.g. in COPD patients

33
Q

What occurs at altitude to CSF composition?

A

CSF intially alkaline (breathe off lots of CO2 because of increased hypoxic drive)
CSF returns to normal and drive increases

34
Q

What are people at altitude at risk of?

A

Hypobaric hypoxia

35
Q

What are the 2 types of peripheral chemoreceptor?

A

Aortic bodies

Carotid bodies

36
Q

What are the aortic bodies innervated by?

A

Vagus nerve

37
Q

What are the carotid bodies innervated by?

A

Carotid sinus nerve

38
Q

What are the two types of cells found in peripheral chemoreceptors?

A 
Type 1 (glomus cells)
Type 2 (sheath cells)
39
Q

What do type 1 (glomus cells) do?

A

Rich in neurotransmitters

Contact axons

40
Q

What do type 2 (sheath cells) do?

A

Enclose type 1 cells

41
Q

How quick is the response of peripheral chemoreceptors?

A

Very fast - respond breath by breath

42
Q

What do central chemoreceptors respond to?

A

Arterial pCO2

43
Q

Give examples of loss of CO2 drive

A

Chronic hypercapnia
Adaptation
Don’t give them oxygen for prolonged time - taking away respiratory drive

44
Q

What is Cheyne-Stokes respiration?

A

Rapid breathing then pauses
Sats oscillate
Heart failure/stroke/altitude sickness

45
Q

What is central sleep apnoea?

A

Breathing stops during sleep

Do a sleep study

46
Q

What is obstructive sleep apnoea?

A

Lose muscle tone in neck
Fat around neck obstructs airway
Aroused and oxygen sats returns to normal when awoken

FBS2 (16 decks)

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