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SF3- EXAM 2 > Respiratory Control > Flashcards

Respiratory Control Flashcards

1
Q

_____________ refers to the generation and regulation of rhythmic breathing and its modification by input of information from higer brain centers and specialized sensory receptors.

A

Ventilatory control

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2
Q

_________ is to minimize work.

A

Mechanical perspective

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3
Q

________ is to maintain blood gas levels and specifically to regulate arterial PCO2.

A

Physiological perspective

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4
Q

What are the three goals of breathing?

A
  • Minimize work- Mechanical perspective
  • Maintain blood gas levels and to regulate arterial pCO2- Physiological perspective
  • Maintain the acid-base environment of the brain trhough the effects of ventilation on arterial pCO2
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5
Q

What are the elements of the respiratory control system?

A
  • Sensors
    • ​Monitor blood, CSF and lung volume/stretch
  • Controller
    • ​Integrates and coordinates the information and sends signals to the effectors
  • Effectors
    • ​Produce change in ventilatory pattern
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6
Q

____________ is demonstrated with breath holding.

A

Voluntary control

NOTE: Voluntary control competes with involuntary mechanisms. Automatic control eventually overpowers the voluntary efforts thereby limiting the duration of the breath.

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7
Q

The pneumotaxic center is found in the ________.

A

Upper Pons

*This center inhibites inspiration

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8
Q

Separation of the _______ and _______ allow rhythmic breathing to ensue.

A

Pons; medulla

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9
Q

What is the effect of transection of the upper pons on respiration?

A

Decreased frequency and increased tidal volume (apneusis)

REMEMBER: The pneumotaxic center is found in the pons and functions to inhipit inspiration

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10
Q

What affects would transection across the lower pons have on respiration?

A

Gasping (with or wothout intact vagus)

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11
Q

What affects would transection across thelower medulla have on respiration?

A

Complete respiratory arrest (apnea)

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12
Q

Pre-Botzinger Complex

A

the main location of the rhythmic pattern generation circuitry involved in breathing.

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13
Q

Dorsal respiratory group located in the dorsomedial region of the medulla is primarily involved in _________.

A

Inspiration

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14
Q

What nucleus is found in the dorsal respiratory group? What is is role in respiration?

A

Nuclus Tractus Solitarii

  • Integrates inputs from the 9th and 10th cranial nerves
  • Responds to inflation/irritant recepts of the lungs and airways
  • Receives info about PO2, PCO2, and pH from peripheral chemoreceptors and systemic BP
  • Receives info from pulmonary stretch receptors
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15
Q

Types of respiratory neurons

A
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16
Q

Ventral Resiratory group is located in the ventrolateral region of the medulla and has a major influence on __________.

A

Expiration

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17
Q

What nuclei are found in the ventral respiratory group?

A
  • Rostral nucleus retrofacialis
  • Caudal nucleus retroambiguus
  • Nucleus paraambiguus
  • Inspiratory and expiratory neurons
    • Primary function is to drive spinal respiratory neurons innervating the intercostal and abdominals or upper airway muscles of inspiration
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18
Q

Which nucleus of the VRG has connections to the contralateral external intercostals, and to i-cells and E-cells within the medulla?

A

Nucleus Retroambiguus

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19
Q

The VRG nucleus is made primarily of vagal motor neurons that inenrvate the laryngeal and pharyngeal muscles and activate during both inspiration and expiration.

A

Paraambiguus

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20
Q

____________ center is comprised of the Kolliker-Fuse and nucleus parabrachialis medialis and the fine tuning centers.

A

Pneumotaxic

  • Located in the upper pons
  • Premature termination of inspiratory ramp
  • Shorten of inspiration that results in frquency modulation of breathing
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21
Q

The apneustic center is located in the _______.

A

Lower pons

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22
Q

Phases of the respiratory cycle

A

Inspiration

  • Ramp-like increase in inspiratory neuron firing rate

Off Switch

  • Rapid Decline in inspiratory neuron firing rate

Exhalation

  • Paradoxical increase in inspiratory neuron firing that brakes the expiratory phase
  • Cells become silent in Phase II
23
Q

Where are peripheral chemoreceptors located?

A

Carotid bodies (CN IX)

Aortic bodies (CN X)

24
Q

Peripheral recepheral receptors are uniquely sensitive to ________.

A

Oxygen

NOTE: PO2 does not play a significant role in the regulation of normal ventilation until levels decrease below 60 mmHg

25
Q

What are peripheral receptors activated by?

A
  • Acidic pH
  • Increased PaCO2
  • Decreased PaO2
26
Q

What function do carotid bodies play in respiration?

A
  • Type II cells, glomus, found within carotid bodies contain large numbers of synaptic vessels that contian neurotransmitters.
  • The neurotransmitters are released in response to increased PCO2, increased H+, decreased PO2 in the arterial blood
  • The neurotransmitters act on adjacent nerve terminals and signals from these terminals are transmitted to the medullary respiratory control center through the carotid sinus nerve
27
Q

What’s the cascade of events involved in carotid body O2 sensor stimuation by a decreased in PaO2?

A
  1. Low PO2
  2. K+ Channels to close
  3. Cell depolarizes
  4. Ca2+ channels open and Ca2+ enters
  5. Exocytosis of dopamine-containing vesicles
  6. Signals to medullary centers to increase ventilation
28
Q

Central chemoreceptors are located within the _____ and respond to pH of ________.

A

Medulla; CSF

29
Q

How is pH the most potent and primary stimulus of central chemoreceptors, if H+ can’t cross the blood brain barrier?

A
  • CO2 crossed the blood brain barrier
  • CO2 binds with H2O to produce carbonic acid
  • Carbonic acid dissociates to HCO3- and H+

*So an increase in CO2 leads to and increase in H+, which decreases the pH

30
Q

HCO3- is controlled by the _________.

A

Choroid plexus

31
Q

During inspiration, the activity of inspiratory neurons increases steadily, apparently through a __________ mechanism.

A

Positive feedback

32
Q

The ventilatory response to hypercapnia is enhanced by _______.

A

Hypoxia

33
Q

Peripheral chemoreceptors are important to patients with what conditions?

A

COPD

Chronic lung disease

REMEMBER: In these conditions, CO2 retention is inevitable. Ventilation will need to be increased to maintain balance

34
Q

Pulmonary receptors are ________ (slow/fast) adapting.

A

Slow

35
Q

Herring- Breaur reflex

A
  • Protects against over-expansion of the lung during strenous exercise
  • Stimulated by increased lung volume
  • Mediated by vagal afferents located within the smooth muscle of large and small airways
  • Triggers the cut-off switch to abruptly terminate inspiratory activity
36
Q

Tidal volume in excess of ____ liter causes the lung-stretch receptors to signal the brainstem to shut-off inspiration.

A

1

37
Q

Diving reflex

A
  • Cold water on the nose and facial region triggers apnea and bradycardia.
  • Provides protection from aspiration of water during the initial stages of drowning
38
Q

Sneeze reflex

A
  • Triggered by activation receptors in the nose
  • Triggers deep inspiration followed by an explosive expiration trhough the nose
  • Helps to remove foreign materail
39
Q

Aspiration or sniff reflex

A

Elicited by stimulation of mechanical receptors in nasopharynx to the pharynx.

40
Q

Where are irritant receptors found?

A

Trachea

41
Q

Irritant recepts impulses are transmitted via __________.

A

Myelinated vagal afferents

42
Q

Results of irritant receptor stimulation

A
  • Increased airway resistance
  • Relex apnea
  • Coughing

NOTE: Irritant receptors are referred to as rapidly adapting pulmonary stretch receptors

43
Q

Slow adapting pulmonary stretch receptors transmit info via __________

A

Myelinated vagal afferents

44
Q

Slowly adapting pulmonary stretch receptors are activated by _________

A

Lung inflation

NOTE: These receptors are significant in people with OPD

45
Q

Juxta-alveolar receptors transmit info via __________.

A

Unmyelinated vagal C-fibers

46
Q

What type of breathing are Juxta-alveolar receptors involved in?

A

Rapid, shallow breathing

*As seen in pulmonary edema

47
Q

Where are sensory receptors found?

A
  • Intercostal and rib joint
  • Accessory muscles of respiration
  • Tendons
48
Q

Sensory receptors respond to _______.

A

Changes in length and tension of the respiratory muscles

*These receptors participate in terminating inspiration

49
Q

Apneustic breathing

A

Sustained inspiration separated by brief periods of exhalation

50
Q

Cheyne-Stokes Respiration is common in people with what conditions?

A
  • Head trauma
  • CNS disease state
  • Increased intracranial pressure
51
Q

Cheyne-Stokes Respiration

A

Characterized by varying tidal volume and respiratory frequency that progressively increase over several breaths

52
Q

Central alveolar Hypoventilation (Odine’s Curse)

A
  • Must be conscious to take a breath
  • Suffiecient “voluntary” control over ventilation
  • Distractions result in severe hypoventilation or apnea
53
Q

Treatment for Odine’s Curse

A

Diaphragmatic pacing

Mechanical ventiltion

SF3- EXAM 2 (11 decks)

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