L20: Control Of Breathing

Question 1

What happens when you transects between the medulla and spinal cord

Answer 1

Ventilation stops

Question 2

What are the 2 extremes of breathing

Answer 2

Driven by metabolic system

Driven by behavioural system

Question 3

Which patient present with breathing only due to metabolic system

Answer 3

Locked in syndrome

Question 4

What is the locked in system a consequence of

Answer 4

Stroke

Question 5

What happens to a patient in the locked in syndrome

Answer 5

Patient is unable to move voluntarily expect eyes

Regular breathing is driven by metabolic system (involuntary control)

Question 6

Which patient only breath due to their behavioural system (only breath when aware)

Answer 6

Ondine’s curse

Question 7

What is Ondine’s curse a result of

Answer 7

Medullary tumour

Question 8

What does a patient with Ondine’s curse require at night

Answer 8

Mechanical ventilation

Question 9

What does a patient with Ondine’s curse require mechanical ventilation at night

Answer 9

They are not aware of their breathing when they sleep

Question 10

What is the metabolic system regulated by

Answer 10

Feedback system of paco2

Question 11

What is the behavioural system regulated by

Answer 11

Feedforward system of speech, cough etc.

Question 12

Where is the metabolic system controlled in the brain

Answer 12

Brain stem

Question 13

Where is the behavioural system controlled in the brain

Answer 13

Cortex

Question 14

Which information regulated the feedback system of the metabolic system in the brain stem

Answer 14

Chemical

Mechanical

Question 15

What are 3 phases to breathing

Answer 15

Inspiratory phase (I)
Post inspiratory phase (PI)
E-2 phase

Question 16

What happens to the diaphragm in the inspiratory phase

Answer 16

Contracts

Question 17

What happens to the diaphragm in the post expiratory phase

Answer 17

Gradually relaxes

Question 18

What happens to the diaphragm in the E-2 phase

Answer 18

Silent

Question 19

At which phase of breathing does the accessory respiratory muscle contract

Answer 19

E-2 phase

Question 20

What type of control is the metabolic system

Answer 20

Automatic

Question 21

Where are the automatic respiratory neurones located

Answer 21

Brainstem

Question 22

What are the automatic neurones called

Answer 22

Dorsal respiratory group
Ventral respiratory group
Pontine respiratory group
Botzinger complex

Question 23

Which automatic respiratory neurones controls both inspiration and expiration

Answer 23

Ventral respiratory group (VRG)

Pontine respiratory group (PRG)

Question 24

Which automatic respiratory neurone controls expiration only

Answer 24

Botzinger complex

Question 25

Which automatic respiratory Neurone controls inspiration only

Answer 25

Dorsal respiratory group (DRG)

Question 26

Which neurone increases the contraction of the diaphragm

Answer 26

DRG

Question 27

What happens when we need to increase inspiration

Answer 27

VRG inspiration component is active to it drives to the activity of inspiration accessory muscle

Question 28

Which neurone is activated to drive expiration

Answer 28

Botzinger complex

Question 29

What does the botzinger complex do to activate the expiratory accessory muscles

Answer 29

Excites the VRG expiration complex

Question 30

To stop expiration and ispiration occuring at the same time what occurs

Answer 30

Inhibitory activity

Question 31

Which neurone allow inihbitory drive for expiration

Answer 31

DRG

Question 32

Which neurones allow inihbitory drive for inspiration

Answer 32

Botzinger complex | VRG expiration component

Question 33

What does the pontine respiratory group do

Answer 33

Influence the timing of breaths

Question 34

Apart from sensory information from mechanoreceptors and chemoreceptors what other factors drive the DRG activity

Answer 34

Higher centres

Question 35

What senses feed into the higher centre

Answer 35

Temperature Pain Emotion Movement

Question 36

What type of control is the behavioural system

Answer 36

Voluntary

Question 37

Does the cerebral cortex which is driven by the behaviour system control the activity of the brainstem nuclei

Answer 37

No

Question 38

Which situation can affect the brain activity

Answer 38

``` Exercise High altitude Respiratory stimulants (drugs) Sleep Depressed ventilation drugs ```

Question 39

Which drugs stimulate respiration

Answer 39

Doxapram Progesterone Aminophylline

Question 40

What does the respiratory stimulants do

Answer 40

Increase ventilation and reduce paco2

Question 41

How does sleep affect breathing

Answer 41

Decreased response to hypoxia and hypercapnia | Decreased responce to mechanoreceptors

Question 42

Which drugs depress ventilation

Answer 42

``` Anaesthetic Barbiturates Opioids Benzodiazepines Alcohol ```