PBL 2 - control of breathing Flashcards

1
Q

why do we need to control breathing?

A
  • regulate gas exchange
  • execute behavioural acts
  • maintain airways and lung function
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2
Q

what is the somatic motor innervation of the pharynx and larynx supplied by?

A

cranial nerves

  • glossopharyngeal (IX)
  • vagus (X)
  • spinal accessory (XI)
  • hypoglossal (XII) (tongue)
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3
Q

what are the pump muscles?

A

diaphragm, intercostal muscles, abdominal muscles

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4
Q

what is the somatic motor innervation of the pump muscles?

A

diaphragm: phrenic nerve (from cranial plexus C3-C5)
intercostal muscles: T1-T12
abdominal muscles: forced expiration: thoracic, lumbar (predominantly)

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5
Q

what is the name of the pacemaker region in the brain and where is it? what does it do?

A

Pre-Botzinger in medulla of brainstem — generates a respiratory rhythm in isolation with no sensory input

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6
Q

what respiratory groups are there?

A
  • ventral and dorsal respiratory groups if the medulla (pattern generation)
  • pontine respiratory groups in pons (respiratory pattern)
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7
Q

where are peripheral chemoreceptors detected?

A

carotid bodies (bifurcation of common carotid artery in neck), aortic arch

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8
Q

what do the peripheral chemoreceptors detect?

A

drop in pH, rise in PCO2, drop in PO2 (hypoxia)

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9
Q

where are the central chemoreceptors?

A

on the surface of the medulla

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10
Q

what do the central chemoreceptors detect?

A

rise in PCO2, not pH, not hypoxia

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11
Q

what do the central chemoreceptors respond to to increase ventilation?

A

respond to an increase in H+ in the CSF which increases ventilation (cerebrospinal fluid)

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12
Q

levels of what is the main driver of breathing?

A

CO2 from the blood

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13
Q

what can and cannot pass the blood brain barrier?

A

HCO3 and H+ cannot, but CO2 can diffuse into the extracellular space of the brain

CO2 + H2O —> HCO3- + H+ — this H+ is detected by the central chemoreceptor

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14
Q

what happens to ventilation at high levels of CO2?

A

has an affect on the CNS - acts as an anaesthetic so ventilation plateaus, become sleepier

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15
Q

what is the effect of low oxygen on ventilation?

A

increases ventilation

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16
Q

sensory input of nose

A

trigeminal (V)

17
Q

sensory input of pharynx

A
  • glossopharyngeal (IX)

- vagus (X)

18
Q

sensory input of larynx

A
  • vagus (X)
19
Q

sensory input of lungs

A

vagus (X)

20
Q

sensory input of chest wall (muscles + tissues)

A

spinal nerves

21
Q

where are the pulmonary stretch receptors and what do they respond to?

A
  • mainly in trachea and main bronchi

- respond to lung inflation

22
Q

where are the irritant receptors and what do they respond to?

A
  • in naso-pharynx, larynx, trachea and bronchi

- respond to mechanical, chemical irritant stimuli, inflammatory mediators

23
Q

what are c-fibres, where are they and what do they respond to? (juxtacapillary receptors)

A
  • receptors “free” nerve endings
  • in larynx, trachea, bronchi, lungs (J-receptors) (conducting airways)
  • respond to chemical irritant stimuli, inflammatory mediators, lung oedema (J-receptors)
24
Q

what does the motor cortex of the brain drive?

A

drives voluntary muscles and voluntary motor movements

25
Q

voluntary breathing produces brain activity within what?

A

the motor homunculus

26
Q

what is upper airway patency maintained by?

A
  1. neuromuscular forces — dilator muscles actively dilate and/or stiffen the pharynx — keep airway open, contraction of muscles
  2. extraluminal forces — gravitational forces, adipose tissue — reduce/collapse patency
27
Q

what is apnoea?

A

the cessation of breathing

28
Q

how do PaCO2 and O2 saturation levels change at night?

A

alveolar ventilation decreases:

  • PaCO2 increases
  • O2 saturation decreases