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Phys Exam 4 > Respiratory 5 > Flashcards

Respiratory 5 Flashcards

1
Q

The ultimate goal of respiration is to maintain proper concentrations of what 3 things in the tissues?

A

O2, CO2 and H+

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2
Q

Excess CO2 or H+activates respiratory centers to _____ alveolar ventilation.

A

increase

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3
Q

Decreased O2 ____ alveolar ventilation

A

increases

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4
Q

Decreased O2 increases alveolar ventilation. However, it does not directly impact central respiratory centers but instead acts on ______ that relay the signal to the central respiratory center.

A

peripheral chemoreceptors

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5
Q

Involves descending input from the thalamus and cerebral cortex, can bypass the respiratory control centers in pons & medulla–Activated during talking, sneezing, singing, swallowing, coughing, defecation, anxiety, fear, etc.

A

Corticospinal tract

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6
Q

Primarily controlled by changes in PCO2•Less sensitive to PO2 and H+•Pulmonary mechanical receptors–Activated by Respiratory Centers in the pons & medulla (ex. DRG and VRG)

A

Ventrolateral tract–

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7
Q

What are the 2 Medullary Respiratory Centers:

A

–Dorsal Respiratory Group (DRG)

–Ventral Respiratory Group (VRG)

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8
Q

What are the 2 Pontine Respiratory Groups

A

–Pneumotaxic Center

–Apneustic Center

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9
Q

–Inspiratory Center
–Receives afferent input from Cranial Nerves IX (chemoreceptor) and X (chemoreceptor & mechanoreceptor)
–Provides excitatory inspiratory stimuli to phrenic motor neurons
–Sets the basic rhythm for breathing by setting the frequency of inspiration

A

Dorsal Respiratory Group: DRG

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10
Q

What 2 CN give afferents to DRG?

A

CN IX and X

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11
Q

Mostly involved in expiration–Primarily responsible for expiration•Expiration is normally a passive process, so these neurons are quiescent during normal breathing•Activated when forceful expiration is required

A

Ventral Respiratory Group: VRG

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12
Q

_____ is normally a passive process, so these neurons are quiescent during normal breathing

A

Expiration

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13
Q

The ________ are the only Receptors Sensitive to O2

A

Peripheral Chemoreceptors

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14
Q

The Peripheral Chemoreceptors are stimulated by what things?

A

Decrease O2
INcrease in CO2
INcrease in H+

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15
Q

What does O2 must fall to to cause a response by peripheral chemoreceptors?

A

60 mmHg

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16
Q

The central chemoreceptors are stimulated by what?

A

Increase in H+ when CO2 is increased

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17
Q

Afferent (sensory) information regulates the activity of the _________ via central and peripheral chemoreceptors and also mechanoreceptors

A

medullary inspiratory center (DRG)

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18
Q

MOST important for minute-to-minute control of breathing•Located on ventral surface of medulla•Activation stimulates the DRG• are VERY sensitive to changes in pH of CSF

A

Central Chemoreceptors

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19
Q

Activation of central chemoreceptors stimulate the _____

A

DRG

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20
Q

Central Chemoreceptors are VERY sensitive to changes in ___ or _____

A

pH of CSF

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21
Q

If AV increases, DRG recruits _____

A

VRG

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22
Q

What causes DRG to recruit VRG?

A

AV increases

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23
Q

Chemoreceptors in the CSF are only sensitive to changes in ____ concentration.

A

H+

24
Q

INcrease in H+ leads to ___ in AV

A

INcrease

25
Q

When CSF [H+] _______, there is an increase in respiratory volume and rate

A

increases

26
Q

_____ is permeable to the Blood Brain Barrier

A

CO2

27
Q

In the CSF, CO2 is converted to H+ and HCO3- via ______

A

Carbonic Anhydrase

28
Q

The H+ produced in the CSF activates the ______ which stimulates the DRG

A

Central Chemoreceptors

29
Q

The effect of a change in CO2 is _____ acutely

A

potent

30
Q

The effect of a change in CO2 is _____ chronically

A

diminished

31
Q

Central Chemoreceptors are most effective within _____ days after a change in central CO2.

A

1-2 days

32
Q

Why are central chemoreceptors most effective within 1-2 days after a change in central CO2?

A

–the kidneys will have begun to compensate, reabsorbing HCO3-
–HCO3- has slowly diffused through the BBB and CSF barriers to buffer H+

33
Q

A danger for patients with chronic respiratory problems is that the kidney and buffer mechanisms compensate for the elevated PaCO2 (and H+) so that they no longer stimulate the medullary respiratory centers. Then the ______ -the only receptors that sample oxygen content—become critical for respiratory control.

A

peripheral chemoreceptors

34
Q

What 2 CN are associated with peripheral chemoreceptors?

A

CN IX and X

35
Q

where are the receptors for peripheral chemoreceptors located?

A

Carotid and aortic bodies

36
Q

______ are sensitive to low PaO2, high CO2, and low pH; larger response if both O2 is low and CO2 is high

A

Peripheral chemoreceptors

37
Q

What are the 3 conditions that peripheral chemoreceptors are sensitive to?

A

Low PaO2, High PaCO2, and Low pH

38
Q

What are the only receptors sensitive to O2 concentrations in the brainstem?

A

Peripheral chemoreceptors

39
Q

At PaO2 < _____mmHg, there is a LARGE increase in alveolar ventilation due to the ____ chemoreceptors?

A

60 mmHg; peripheral chemorectors

40
Q

Increases in PaCO2 increase the rate of firing of _____ to increase respiration

A

both aortic and carotid bodies

41
Q

Decreases in arterial pH increase the rate of _____

A

carotid bodies

42
Q

Hypoxemia enhances the response to _______

A

PaCO2.

43
Q

Are central or peripheral responses to changes in PaCO2 stronger?

A

Central

44
Q

Which chemoreceptors respond more quickly to changes in PaCO2?

A

Peripheral

45
Q

If PaCO2, does alveolar ventilation increase or decrease?

A

Increase

46
Q

Does sleep increase or decrease CO2?AV?

A

Increases both

47
Q

Do opioids increase or decrease CO2?AV?

A

Increase both

48
Q

Does DKA increase or decrease CO2?AV?

A

Decrease both

49
Q

Does DKA show an enhanced or decreased response to PaCO2?

A

Enhanced response

50
Q

Does sleep and opioids show an enhanced or decreased response to PaCO2?

A

Decreased response

51
Q

Most inhaled anesthetics cause respiratory depression by inhibiting the DRG and abolish/attenuate the response to ____ and _____

A

hypoxemia (decreased O2) and hypercarbia (increase CO2)

52
Q

Nitrous oxide actually _______ respiratory rate (tachypnea) and ________ tidal volume (via central stimulation) so there is minimal change in minute ventilation and PaCO2 levels.

A

increases respiratory rate (tachypnea) and decreases tidal volume (via central stimulation)

53
Q

Does nitrous oxide cause a large or small change in minute ventilation and PaCO2 levels?

A

Small change

54
Q

Hypoxic drive is ______ by nitrous oxide

A

decreased

55
Q

Nitrous oxide ______ pulmonary vascular resistance

A

increases

Phys Exam 4 (6 decks)

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