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Respiratory 3 > Control of Ventilation > Flashcards

Control of Ventilation Flashcards

1
Q

What part of the CNS contains the central pattern generator for breathing?

A

Brainstem (medulla)

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2
Q

Control of Ventilation/Respiration is regulated through

A

negative feedback system in three basic elements:

  1. Central Controller (medulla, pons)
  2. Effectors (respiratory muscles)
  3. Sensors (chemoreceptors)
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3
Q

Emotional status and voluntary input can affect breathing rate (True or False)

A

True

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4
Q

Basic principles of respiration were first established by who?

A

Galen of Pergamon (2nd century) while studying gladiator injuries

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5
Q

The neurons in the medulla are mainly divided into what two groups?

A
  1. Dorsal Respiratory Group (DRG)

2. Ventral Respiratory Group (VRG)

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6
Q

Which respiratory group contains BOTH inspiratory and expiratory neurons; project to phrenic, intercostals and abdominal neurons?

A

VRG

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7
Q

Which respiratory group contains the Botzinger complex (site where normal breathing rhythm originates)?

A

VRG

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8
Q

Breathing rhythm activity of the pre-Botzinger complex is relayed to the roots of _________ cranial nerve and then finally related to the _______ via that nerve.

A
  • Hypoglossal nerve

- breathing muscles (muscles of the tongue, nares, and pharynx)

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9
Q

Hypoglossal nerve is ___th cranial nerve

A

12

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10
Q

Respiratory group that has the Nucleus Tractus Solitarius

A

Dorsal Respiratory Group

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11
Q

Respiratory group that contains mainly INSPIRATORY neurons; main SENSORY nucleus (receives inputs from peripheral receptors); some neurons project directly to motor neurons that control respiratory muscles

A

Dorsal Respiratory Group

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12
Q

located in the pons (PRG); center that can cause gasping (apnuestic breathing); NOT essential for normal respiratory rhythm, but can modulate

A

Apneustic Center

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13
Q

located in the pons (PRG); center that promotes rhythmic breathing; NOT essential for normal respiratory rhythm, but can modulate

A

Pneumotaxic Center

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14
Q

Prolonged inspiration and short expiration; gasping

A

Apneustic breathing

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15
Q

What are the major effector (motor) neurons that innervate the respiratory muscles?

A
  1. Phrenic Motor Neurons: located in C2-C5 and project to diaphragm
  2. Thoracic Motor Neurons: located in T1-T12 and project to intercostals
  3. Lumbar Motor Neurons: located in lumbar region and project to abdominals
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16
Q

Injury above or at ______ requires permanent mechanical ventilator

A

C2-C5

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17
Q

What are the major sensors of respiration?

A
  1. Peripheral Chemoreceptors
  2. The carotid body
  3. Central Chemoreceptors
  4. Pulmonary Stretch Receptors
  5. Pulmonary Irritant Receptors
  6. J Receptors
  7. Others (PMP)
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18
Q

What picks up changes in blood oxygen, carbon dioxide and pH?

A

Peripheral Chemoreceptors (located in carotid body and aortic arch)

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19
Q

Afferent (sensory) fibers of the carotid body join with what cranial nerve to carry signals to the brain

A

Glossopharyngeal (IX)

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20
Q

Main stimulus for peripheral chemoreceptors to increase firing in order to increase ventilation

A

PaO2 <60mmHg

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21
Q

What would happen to the ventilatory response to low oxygen if nerve IX was damaged?

A

Glossopharyngeal nerve cannot carry signals to the brain, requiring mechanical ventilator

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22
Q

chemoreceptor located at common carotid; has large and fenestrated blood supply; communicates with glossopharyngeal nerve (IX) to stimulate medullary centers and ventilation; mechanism of action may involve glomus cell

A

Carotid body

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23
Q

Highly metabolic cells that require large amount of oxygen; low oxygen triggers secretion of neurotransmitters that activate glossopharyngeal nerve to stimulate medullary centers to increase ventilation

A

Glomus cell

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24
Q

Acute exposure to low O2 results in

A
  1. Rapid Hyperventilation (Increased amplitude and frequency of ventilation)
  2. Decreased end tidal CO2 (enhanced ventilation eliminated excess CO2)
  3. Sudden period of apnea (cessation of ventilation) when high O2 is administered.
25
Q

Decreasing percent O2 leads to

A

increased respiratory rate

26
Q

________ chemoreceptors mainly sense oxygen

A

Peripheral

27
Q

________ chemoreceptors mainly sense CO2 and H+ (pH)

A

Central

28
Q

When peripheral chemoreceptors are denervated, the response to CO2 and low pH remains intact thanks to central chemoreceptors (True or False)

A

True

29
Q

Chemoreceptors that are located in the ventrolateral medulla and in the raphe; sensitive to CO2 and pH; monitors via CSF status (Central or Peripheral)

A

Central Chemoreceptors

30
Q

CSF is made by and enters via _______ and drains via ______

A

choroid plexus; arachnoid villi

31
Q

What makes CSF sensitive to changes in CO2 (and therefore pH)?

A

The composition of CSF is controlled by the blood brain barrier, making CSF low protein content. This decreases buffering power of CSF and therefore changes in PaCO2 (and therefore pH as well) are readily reflected in the CSF.

32
Q

CSF pH is regulated by

A

PaCO2

33
Q

Increased _______ (shifts CO2 into making H+ and HCO3- by the kidneys) decreases pH, stimulating central chemoreceptors to drive ventilation

A

PaCO2

34
Q

CO2 at high levels has a _____ effect and may trigger severe hypoventilation

A

narcotic

35
Q

Why is CO2 such a good regulator for ventilation via the central chemoreceptors

A

Strong, inverse relationship between ventilation and CO2 (halving ventilation doubles CO2)

36
Q

Acute exposure to high CO2 results in

A
  1. GRADUAL hyperventilation (gradual increased amplitude and frequency of ventilation)
  2. Removal of high CO2 stimulus does NOT result in sudden apnea.
37
Q

Exposure to high CO2 results in ______ equilibration of CSF pH compared to exposure to low O2.

A

slower/gradual

38
Q

Why do changes in CO2 conc. have a gradual effect on ventilation?

A

Due to relatively slow equilibration of CSF pH versus rapid sensation of O2 by highly active carotid body

39
Q

receptors involved in ventilation control; located in airway smooth muscle (bronchioles); afferents via VAGUS nerve; stimulated by stretching and inhibits ventilation; protects lungs from overinflating

A

Pulmonary Stretch Receptors

40
Q

Reflex seen in pulmonary stretch receptors; stretching/overinflation stimulates receptors, inhibiting ventilation

A

Hering-Breuer reflex

41
Q

What receptors are “slowly adapting”, meaning it maintains firing rate for entire length of stimulus (don’t desensitize)?

A

Stretch Receptors

42
Q

Severing the vagus nerve would increase _____ since afferent input from pulmonary stretch receptors (which prevents over-inflation) is removed.

A

tidal volume

43
Q

Receptors involved in ventilation control; afferent innervation via myelinated VAGUS nerve; located in airway epithelial cells; stimulated by noxious gases, smoke, dust or cold air; increases ventilation, bronchoconstriction and coughing

A

Pulmonary Irritant Receptors

44
Q

What receptors are stimulated by histamine in asthma?

A

Irritant Receptors

45
Q

What receptors are “rapidly adapting”, meaning it

desensitizes even while stimulus remains?

A

Irritant Receptors

46
Q

Receptors involved in ventilation control; via VAGUS nerve; located in pulmonary capillary external wall; rapid response to blood-borne substances (endotoxin), pulmonary congestion or edema; involved in dyspnea

A

Juxta-capillary “J” Receptors

47
Q

Activation of what receptors causes transient apnea followed by shallow breathing, bronchoconstriction, and mucus secretion?

A

Juxta-capillary “J” Receptors

48
Q

Receptor involved in dyspnea with pulmonary vascular congestion or edema, seen in Left sided HF and interstitial lung disease (ILD)

A

Juxta-capillary “J” Receptors

49
Q

Other receptors that play a role in coordination and regulation of ventilation, helping match ventilation to metabolic demands.

A
  1. Thoracic wall and skeletal muscle spindles
  2. Joint mechanoreceptors
  3. Pain and temperature receptors
50
Q

the sensation of changes in body position and effort expended

A

proprioception

51
Q

Inputs from many of the peripheral and central receptors terminated in

A

DRG

52
Q

When PACO2 is increased at low PAO2, higher rates of ventilation are seen than at regular levels of PAO2 (True or False)

A

True

53
Q

When PAO2 becomes lower at high PACO2, higher rates of ventilation are seen than at normal levels of PACO2
(True or False)

A

True

54
Q

At normal levels of CO2, the response to hypoxia does not become profound until PAO2 is _______

A

less than 60 mmHg

55
Q

Significant increase in ventilation during exercise is not due to low O2, high CO2, or low pH
(True or False)

A

True (still not well understood)

56
Q

Increased ventilation during exercise is initially driven by ___________, but during strenuous levels of exercise, ventilation is driven by ____________

A
  • Anticipation from higher cortical centers and exercising muscles
  • low pH (due to lactic acid) when anaerobic threshold is reached
57
Q

______ cause alveolar and arterial PCO2 to rise and PO2 to decrease and arterial pH to decrease

A

Hypoventilation

58
Q

Causes of hypoventilation

A
  • Drugs/anesthesia
  • CNS damage/disease (infection, ALS, trauma)
  • Muscular (myasthenia gravis, dystrophy)
  • Upper airway obstruction
59
Q

Where is the normal rhythm for ventilation believed to originate?

A

Pre-Botzinger Complex

Respiratory 3 (4 decks)

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