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Physiology Part 2 > Lec 38 Control of Ventilation > Flashcards

Lec 38 Control of Ventilation Flashcards

1
Q

What is PaCO2 when you voluntarily hyperventilate?

A

20 torr, low

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2
Q

What is PaCO2 when you hold your breath?

A

55 torr, very high

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3
Q

What is PaCO2 when you fall asleep?

A

45 torr, a little high

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4
Q

what is PaCO2 when you exercise?

A

40 torr, normal

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5
Q

Where is the respiratory generator

A

the medulla

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6
Q

What happens to breathing if you make cut below medulla [so entire brainstem gone]?

A

stop breathing without medulla

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7
Q

what happens if you make cut above pons [so still have pons, medulla, spinal cord but no cortex?

A

get normal breathing

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8
Q

What are two main inspiratory muscles?

A
  • external intercostals

- diaphragm

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9
Q

is external or internal intercostal expiratory muscle?

A

internal is expiratory

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10
Q

What is the pre-BOT complex?

A

acts as pacemaker for respiration in medulla

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11
Q

What 3 places are chemoreceptors located? which is most important

A

most important: in medulla

- also in carotid body and aortic body

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12
Q

What are 4 types of lung receptors

A
  • stretch receptors
  • J receptors
  • irritant receptors
  • chest wall receptors
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13
Q

Where are central chemoreceptors? what do they respond to?

A
  • near surface of medulla on brain side of blood brain barrier
  • fast response to small changes in CO2 [also respond to H+ but not as strongly]
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14
Q

Where are the peripheral chemoreceptors? What do they respond to?

A
  • in carotid bodies and aortic bodies
  • respond mostly to oxygen
  • some respond to CO2
  • also respond to changes in arterial pressure
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15
Q

What does increased CO2 do to minute ventilation?

A

increases minute ventilation

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16
Q

What is normal minute ventilation?

A

5 L/min

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17
Q

What is hypercapnic drive? value?

A
  • the drive to decrease CO2
  • normal value 2 L/min/Torr
    means for every 1 torr you increase PCO3 by, you will increase minute ventilation by 2 L/min
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18
Q

What is shape of hypercapnic drive curve compared with hypoxic drive?

A

hypercapnic: linear
hypoxic:

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19
Q

When does hypoxic drive kick in?

A

pretty much kicks in at 60 mmHg

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20
Q

At what PO2 do you lose consciousness?

A

35 mmHg

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21
Q

What 2 things mediate hypoxic drive?

A
  • carotid bodies

- aortic body

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22
Q

Can you be hypoxic with no dyspnea?

A

yes – this is very common since hypoxic drive is weak until very low [less than 60] PO2

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23
Q

When do stretch receptors increase firing? where are they located? function?

A
  • increase firing with stretch [inflation] of lung
  • located in airway smooth muscle
  • decrease respiratory frequency
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24
Q

What is hering-breuer reflex?

A
  • hyperinflation of lung causes apnea, inhibits inspiration so you exhale
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25
Q

What is the afferent part of stretch receptors?

A

vagus

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26
Q

What do irritant receptors in lung respond to? where are there located? What action?

A
  • respond to chemical or mechanical irritation of airway [smoke, chem, dust, cold air]
  • in receptors in superficial lining of airways
  • increase respiratory frequencey
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27
Q

What is afferent part of irritant receptors?

28
Q

What is afferent part of juxtacapillary receptors?

29
Q

What do juxtacapillary [J] receptors respond to?

A
  • pulmonary vascular congestion
  • interstitial inflammation
  • chemicals in pulm circulation
  • pulmonary hypertension
  • lung deflation
30
Q

Where are chest wall receptors? what do they respond to?

A
  • muscle spindles of intercostals, chest wall

- gives info about work of breathing –> if you are working too hard to breath it tells your brain

31
Q

what is afferent part of chest wall receptors?

A
  • spinal nerves
32
Q

What are the two different general reasons for elevated PaCO2? Examples of each

A

Can’t do: your body physically can’t get rid of the CO2
- bad lungs, bad muscles

won’t do: your body is capable but not doing it, things that mess up CO2 drive
- drugs, medications, sleep related, ondine’s curse

33
Q

Which stage of sleep takes up 50% of sleep time?

A

stage 2 non-rem sleep

34
Q

What are the 3 stages of non-rem sleep?

A

stage 1: light sleep, easily arousable
stage 2: about 50% of sleep time
stage 3: slow wave or delta sleep

35
Q

What is deepest/most refreshing stage of sleep?

36
Q

What is REM sleep?

A
  • brain active, muscles nearly paralyzed including respiratory muscles
  • paradoxical sleep
  • dreaming sleep
  • most cardiac and respiratory instability
37
Q

What does increased CO2 do to minute ventilation?

A

increases minute ventilation

38
Q

What is normal minute ventilation?

39
Q

What is hypercapnic drive? value?

A
  • the drive to decrease CO2
  • normal value 2 L/min/Torr
    means for every 1 torr you increase PCO3 by, you will increase minute ventilation by 2 L/min
40
Q

What is shape of hypercapnic drive curve compared with hypoxic drive?

A

hypercapnic: linear
hypoxic:

41
Q

When does hypoxic drive kick in?

A

pretty much kicks in at 60 mmHg

42
Q

At what PO2 do you lose consciousness?

43
Q

What 2 things mediate hypoxic drive?

A
  • carotid bodies

- aortic body

44
Q

Can you be hypoxic with no dyspnea?

A

yes – this is very common since hypoxic drive is weak until very low [less than 60] PO2

45
Q

What is voluntary hyperventilation?

A
  • forcing yourself to hyperventilate to lower CO2 so you can hold breath longer
  • what forces you to breathe when you are swimming is the CO2
  • have more time breath holding before CO2 becomes unbearable but not much more O2 to consume
46
Q

What is hering-breuer reflex?

A
  • hyperinflation of lung causes apnea, inhibits inspiration so you exhale
47
Q

What is the afferent part of stretch receptors?

48
Q

What do irritant receptors in lung respond to? where are there located? What action?

A
  • respond to chemical or mechanical irritation of airway [smoke, chem, dust, cold air]
  • in receptors in superficial lining of airways
  • increase respiratory frequencey
49
Q

What is afferent part of irritant receptors?

50
Q

What is afferent part of juxtacapillary receptors?

51
Q

What do juxtacapillary [J] receptors respond to?

A
  • pulmonary vascular congestion
  • interstitial inflammation
  • chemicals in pulm circulation
  • pulmonary hypertension
  • lung deflation
52
Q

Where are chest wall receptors? what do they respond to?

A
  • muscle spindles of intercostals, chest wall

- gives info about work of breathing –> if you are working too hard to breath it tells your brain

53
Q

what is afferent part of chest wall receptors?

A
  • spinal nerves
54
Q

What are the two different general reasons for elevated PaCO2? Examples of each

A

Can’t do: your body physically can’t get rid of the CO2
- bad lungs, bad muscles

won’t do: your body is capable but not doing it, things that mess up CO2 drive
- drugs, medications, sleep related, ondine’s curse

55
Q

Which stage of sleep takes up 50% of sleep time?

A

stage 2 non-rem sleep

56
Q

What are the 3 stages of non-rem sleep?

A

stage 1: light sleep, easily arousable
stage 2: about 50% of sleep time
stage 3: slow wave or delta sleep

57
Q

What is deepest/most refreshing stage of sleep?

58
Q

What is REM sleep?

A
  • brain active, muscles nearly paralyzed including respiratory muscles
  • paradoxical sleep
  • dreaming sleep
  • most cardiac and respiratory instability
59
Q

What does sleep do to ventilatory drive

60
Q

What happens to breathing in slow wave [stage 3] sleep?

A

very regular breathing [ and heartbeat]

body on autopilot

61
Q

What happens to ventilatory drive in REM sleep? muscle tone?

A
  • biggest decrease in ventilatory drive
  • greater dependence on diaphragmatic function
  • decreased muscle tone
62
Q

What happens to PCO2 on transition to sleep?

A

rises 2-6 torr

63
Q

What is definition of sleep apnea?

A

stopping breathing for at least 10 seconds at least 10 times per hour

64
Q

What are two types of sleep apnea? which is more common

A

central: ventilatory drive problem
- ex. obesity

obstructive = more common

65
Q

What is ondine’s curse?

A
  • rare disease
  • congenital central hypoventilation syndrome
  • defect in PHOX2b gene
66
Q

What is Cheyne-Stokes respiration? What is example of why it happens

A
  • periodic breathing wtih central apneas
  • best ex: CHF with increased circulation time so get delayed thermostat = delayed/slow to turn on and then slow to turn off
  • receptors not working really well
67
Q

What happens to CO2 and O2 in volutnary hyperventilation?

A
  • very decreased CO2

- increased PaO2, not much actual increase in content of oxygen in blood

Physiology Part 2 (19 decks)

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