control on ventilation Flashcards
what is hyperinflation , what is it associated with and what can it cause
- abnormal increase in the volume of air in the lungs due to air trapping
- commonly associated with COPD and asthma
- air trapping occurs due to the increased resistance in the airways of the lungs which prevents air being fully exhaled
- hyperinflation can also cause respiratory muscle shortening as a inflated lung pushes the diaphragm down and flattens it
why does obesity contribute to impaired ventilation
- with obesity you have smaller lung volumes
- increased airway resistance and therefore increased work of breathing
- obesity therefore can be an extrinsic cause of restrictive lung disease and it can also cause type 2 respiratory failure
where are central chemoreceptors found and what are their role
- found in the medulla of the brain
- roles is to detect changes in carbon dioxide levels, PH in the CSF
- this can result in signals being sent to the lungs from respiratory centre of the brain to either decrease or increase breathing rate
what are the list of sensors which are involved in respiratory control
- peripheral chemoreceptors
- central chemoreceptors
- cerebral cortex
- pontine respiratory centre
- pulmonary inputs (stretch receptors, j receptors, irritant receptors)
what is the chemical control of ventilation
- plasma carbon dioxide increase
- carbon dioxide crosses brain blood vessel barrier into CSF
- stimulus is [H+] in css stimulates central chemoreceptors
- increases minute ventilation
- few buffers in CSF so small changes in carbon dioxide concentration results in large changes in [H+] and CSF PH
- response (20second) increase ventilation
- result return to normal CO2
what is the relationship between partial pressure of carbon dioxide and ventilation
- increasing partial pressure of carbon dioxide increases ventilation however at very low partial pressures of carbon dioxide increasing the concentration has no effect on ventilation
what is the stimuli for peripheral chemoreceptors
- partial pressure of oxygen and to a lesser extent partial pressure of carbon dioxide/[H+]
- response is second- increase in ventilation
- result return to normal PaO2
- peripheral chemoreceptors found in carotid and aortic bodies
- account less to increasing ventilation
what is the relationship between partial pressure of oxygen and ventilation
- at very low partial pressures of oxygen decreasing oxygen massively increases ventilation
- however at normal/high oxygen levels changes to the partial pressure of oxygen has no effect on ventilation
what shifts the carbon dioxide response curve to the left
- low ph (metabolic acidosis), hypoxia
- shift to the left suggests increase sensitivity
what shifts carbon dioxide ventilation curve to the right
- right shift suggests decreased sensitivity so extreme values required for body to respond
- causes COPD (elevated carbon dioxide levels, chemoreceptors resist to tolerate high carbon dioxide levels)
what are some mechanical influence of ventilation and the receptors involved
- irritant receptors (sense-dust, chemicals)
- stretch receptors (sense- lung inflation)
- J receptors (sense- pulmonary oedema from heart failure, stretch, chemicals)
- muscle joint receptors (sense-chest wall position, muscle tension)
what are some other sensors for ventilation
- temperature- skin heating can cause hyperventilation
- pain- hyperventilation
- diving reflex- decreased hr
what is the body response to exercise in terms of ventilation
- ventilation increases immediately and matches the increased oxygen uptake and carbon dioxide output
- venous carbon dioxide goes up during exercise but not arterial
- driven by muscle/temp receptors
what is the loop gain
- how well the respiratory system responds to changes in blood gases such as oxygen and carbon dioxide levels
- has a controller gain which measures changes in ventilation with regards to changes in carbon dioxide levels (sensitivity of brain stems respiratory centre to changes in arterial carbon dioxide)
- plan paint- measures how effectively changes in ventilation affect gas exchange in the lungs and blood