Respiratory 5 Flashcards

1
Q

Ventilation is subject gl modulation and control by…

A

CNS

Chemical factors

Peripheral factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the sensors of the respiratory system?

A

Chemoreceptors(central and peripheral)

Mechanoreceptors(joint, muscle and pulmonary receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the effectors of the respiratory system?

A

Respiratory muscles-diaphragm, intercostals, abdominal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the parts of the respiratory control center?

A

Pons and medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What controls voluntary control of the respiratory system?

A

Cerebrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What parameters are monitored in the respiratory system?

A

PCO2

  • pH
  • PO2
  • Stretch
  • Irritation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the neural control centers of the respiratory system?

A

Cerebrum- voluntary control

Medulla oblangata- basic rhythmic pattern of breathing

  • Dorsal Respiratory Group(DRG)
  • Ventral Respiratoru Group(VRG)
  • Central Pattern Generator

Pons

  • Pneumonic center
  • Apneuistic center

Emotional centers- anxiety, fear, rage

  • Hypothalamus
  • Limbuc system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe Dorsal Respiratory Group(DRG)

A
  • Inspiratory (I) neurons
  • Inspiratory center
  • Motor neuron control of diaphragm and external intercostal muscles
  • Maintains a constant breathing rhythm
  • Functions mainly in quiet inspiration
  • When DRG activity ceases- expiration occurs
  • Input is from the vagus and glossopharyngeal nerves and output is via phrenology nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the ventral respiratory Group (DRG)

A
Intense inspiration (I+) neurons
Expiration (E) neurons
  • Functions mainly in forced breathing
  • Activate expiratory and inspiratory centers
  • Motir neuron control of accessory respiratory muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe Central Pattern Generator

A
  • Pre-Botzinger complex-contained within the DRG and VRG complex
  • Pacemaker- like activity seen in experiments, exact description is uncertain
  • Injury abolishes rhythmic breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe VRG & DRG activity

A

Pattern of activity the DRG & VRG neurons is “ramp-like” I.e. Action potential frequency increases gradually till it reaches a crescendo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Pneumonic center?

A
  • Upper pons
  • Decreases the depth and duration if inspiration
  • Possibly involved in regulation of inspiratory volume and therefore respiratory rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the apneustic center

A
  • Lower pons
  • Sends signals to prevent switching off of inspiration
  • Increases the depth and duration of inspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the typ3s of chemoreceptors?

A

Central and peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where are central chemoreceptors located?

A

In the ventral surface of the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the effects of the central chemoreceptors ?

A

Responds to a change in PaCO2 and pH of the Cerebrospinal fluid(CSF)

  • CSF is separated from the blood by the blood brain barrier which is largely impermeable to H+ and HCO3-
  • Therefore metabolic acidosis or alkalosis has relatively little effect of CSF pH
  • The blood brain barrier is very permeable to O2 to. CO2
  • PCO2 has a strong effect on CSF pH and is therefore a powerful stimulus for ventilation
17
Q

What is the most important chemical controller of ventilation?

A

Carbon dioxide

If CSF CO2 levels are high if blood CO2 levels are high

Results in increased breathing rate and ventilation

18
Q

Where are peripheral chemoreceptors located?

A

In the carotid and aortic bodies

19
Q

Describe peripheral carotid bodies

A

Detect changes in PaCO2, PaO2 and pH

Carotid body

  • Small (2 mm) sensory organ
  • Bifurcation of the carotid artery
  • Afferents feed CNS via theglossopharyngeal nerves

Aortic body
-Multiple bodies along aorta- afferents feed CNS via vagus nerve

Glomus cells- site of chemoreception

20
Q

What is the Glomulusvcell response to increased PCO2 & H+?

A

Increased PaCO2
Causes acidification which also causes depolarization
-Increased ventilatory drive

Increased H+
Causes acid loading into cell-depolarization
-Increased ventilatory drive

21
Q

What is the Glomus cell response to hypoxia?

A

Decreased PaO2
-depolarizes glomus cell stimulates afferents to the CNS

-Increased ventilatory drive

22
Q

What are the respiratory reflex pathways?

A
  • Pulmonary stretch pathways
  • Irritant receptors
  • J receptors
  • Proprioceptors
23
Q

Describe the action of stretch recept9rs

A

Lie in the smooth muscle layer of the airways

Fire in the proportionate response to extent of inflation

-Pulmonary stretch associated with lung inflation terminate inspiration in a reflex that prevents over inflation of the lung -Hering Breuer reflex

24
Q

Describe the action of the muscle and joint receptors

A

Located in th3 chest wall

Sense chest wall movement and the effort involved in breathing

-Stimulates increased force of inspiration and expiration

Limb joints have similar effects during exercise

25
Q

Describe the action of irritant receptors

A

Located in the epithelium of large conducting airways

  • Senses, dust, chemicals, smoke, ammonia, cold air
  • Effect is to stimulate bronchoconstriction, mucus secretion and coughing
  • Protects the respiratory zone
26
Q

Describe the juxtapulmonary capillary receptors

A
  • J receptors, located in alveolar walls
  • Unmyelinated nerve fibers(C fibers)
  • Senses chemicals, stretch, pulmonary edema
  • Causes bronchoconstriction, mucus secretion and shallow breathing
27
Q

Describe the integrated ventilatory response

A

Changes in PaCO2, pH, and PaO2 rarely occur in isolation

  • Changes in activity and the environment initiate the integrated ventilatory response that involve changes in the cardiopulmonary system
  • Respiratiry center is forced to make choices about an appropriate ventilatory response
  • Generally output from the respiratory center is designed to optimize PaCO2 but, changes in the other parameters influence system sensitivity
28
Q

How do chemoreceptors respond to the integrated response?

A
  • Carotid response: detect increased PaCO2 but only increase ventilation slightly (20%) ; immediate response
  • Central chemoreceptors detect PaCO2 and dominates the ventilatory response within minutes
  • PaCO2 of arterial blood is an extremely potent ventilatory stimulus

Modest changes in PaO2 has little effect on ventilation (must be below 60 mm Hg)

-The response to PaCO2 is potentiated by low PaO2

29
Q

What are the responses of the integrated response?

A
  • Increased ventilation—> PaO2 increases and PaCO2 falls
  • Respiratory control centers seek to optimize PaCO2
  • Mild hypoxia is overridden to stabilize CO2
  • Comditions that decrease PaO2 usually result in increased PaCO2 and lowered pH
30
Q

What is the clinical correlation of PaCO2?

A

In some chronic diseases, where PaCO2 is high but pH compensated, the hypoxia drive becomes more important (since the PCO2 response is largely due to change in pH)

-Example: In patients with an acute exacerbation of COPD, administering O2 may help normalize PaO2 but can suppress respiration

A titrated oxygen therapy has to be done for these patients

31
Q

Explain the control of respiration at low oxygen tensions: high altitude

A
  1. Decreased barometric pressure
  2. Decreased PIO2
  3. Decreased PAO2(hypoxia)
  4. Decreased PaO2(hypoxemia)
  5. Increased chemoreceptor activity, pulmonary vasoconstriction
  6. Hyperventilation, increased cardiac output
  7. In hours to days—> increased PAO2 and PaO2, decreased PACO2(hypocapnia & respiratory alkalos8s)
  8. Increased 2,3 DPG
  9. Months to years- increased erythropoietin, angiogenesis, ventricular remodeling
32
Q

Explain the control of respiration during exercise

A
  1. Mild to moderate exercise- increased oxygen consumption and CO2 production - stretching of muscles and tendons
  2. Increased ventilation, increased CO2 removal
  3. Unchanged arterial pH
  4. Increased intensity-lactic acid formation, further increase in ventilation, increased cardiac output
  5. Metabolic acidosis ensues, tidal volume continues to increase until it is limited or exhaustion. Occurs