Ventilatory Control Flashcards

1
Q

Breathing Pattern - Inspiration

A

Progressive increases in diaphragm activation
Lungs fill a constant rate until end of tidal volume
Activation of inspiratory muscles ceases

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

Breathing Pattern - Expiration

A

Relaxation of Inspiratory muscles (dia relaxes)
Elastic recoil allows for passive expiration
Activation of inspiratory muscles controls rate of expiration

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

Feedforward Control

A

Ventilation adjustment based on exercise (muscle contraction) or motor activity
Apparent particularly at onset of exercise
Doesnt require much, it just does it…but with exercise the feedforward sys stimulates ventilatory response proportional to amount of muscle you have contracting

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

Feedback Control

A

Allows for matching of response to some control value

Requires a sensor, and a comparator (sensor, controller, and effector)

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

Pre-Botzinger Complex

A

Rhythmic inspiration initiated by pacemakeer cells in the PBC
Located in the medulla
Stimulates ventilation and inhalation to occur
Between lateral reticular nucleus and nucleus ambiguous

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

Respiratory Centers

A
  1. Medullary respiratory center - the rhythm generator

2. Pntine (pneumotaxic) respiratory group: fine tuning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medullary Respiratory Center

A

PBC - initiates inspiration
Dorsal Respiratory Group - Stimulates to diaphragm - activates phrenic and allows for continuous inspiration
Ventral Respiratory Group - Stimualtes the intercostal and abdominal muscles - When respiratory drive inc (exercise) VRG is recruited, contributes to inhalation and exhalation, sends powerful signal for forceful exhalation

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

Pontine Respiratory Group

A

Transmits signal to the inspiratory area to limit inspiration
Controls the switch off point of the inspiratory ramp
Causes the shut off of inspiration - so shuts down DRG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Normal Breathing Pattern Firing

A

PBC - initiate inhale
DRG - inhale
PRG - shut down DRG and leads to passive exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the things that we are sensing and what is the effector response

A

Chemoreceptors
Mechanoreceptors
Input from working muscle (spindles)
Response - phrenic and other muscles for respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Reflex - Pulmonary Stretch Receptors

A
Mechanoreceptors
Located in smooth muscle airways
Slowly adapting receptors - they will fire anytime there is a stretch and say when need to shut down inspiration so can stop to exhale and can have another inhale (inhibits the DRG)
Increases resp rate
Prolongs expiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Reflex - Chest Wall Proprioceptors

A

Muscle spindle and GTOs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Reflex - Irritant Receptors

A

Located btw airway epithelial cells in larger airways
Rapidly adapting receptor - firing is proportional to lung volume amount and rate of change
Responds to chemical and mechanical stimuli
Cough reflex. sneezing, bronchoconstriction, rapid breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reflex - Juxtacapillary Receptors (C fiber endings)

A

Unmyelinated and serve protective function
Give feeling of dyspnea
Two groups
1. Pulmonary C fibers - located next to alveoli and are sensitive to mechanical events (edema)
2. Bronchial C fibers - located in airways, responsive to inflammatory events

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

Reflex - Central Chemoreceptors

A

Located in medulla and are sensitive to H+ in the ISF
H+ can’t cross, so CO2 crosses, binds with water, and then is converted into H+ and HCO3-
HCO3- is buffer in CSF

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

Reflex - Peripheral Chemoreceptors

A

Located in carotid and aortic bodies

Unlike central, they are sensitive to PaO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

More sensitive driver for ventilation

A

CO2
If hold breath, inc response from CO2
People hyperventialte before holding breath so that CO2 gets low so that then you dont get a sens of needing to breathe for longer period of time

18
Q

As you inc arterial PCO2

A

(normally at 40)

As inc, sensed by central chemoreceptors

19
Q

PO2, as you drop ventilation…

A

100, as drop ventilation, not much of anything is happening until at hypoxic level of like 60 or so and this is sensed by the peripheral chemoreceptors

20
Q

Kidneys vs. Lungs

A

Kidneys = Bicarbonate Control
Lungs = pCO2 control
Acid/base balance - kidneys and lungs play role in keeping this balance

21
Q

Acid Base Chemistry - Acid

A

Proton Donor

H+ - molecule that can liberate H+ ions

22
Q

Acid Base Chemistry - Base

A

Proton Acceptor
Molecule that is capable of combining with H+
Bicarbonate –> Carbonic Acid

23
Q

Buffer

A

Minimizes pH changes but doesn’t add or remove acid from the body
Bicarbonate is Ex

24
Q

pH

A

Measure of H+ ion concentration

The more acid = the lower the pH

25
Normal pH
7.4
26
Abnormal pH
Inhibit ATP production | Interfere with muscle contraction
27
Acid Base balance is maintained by
buffers - Release H+ ions when pH is high - Accept H+ ions when pH is low
28
Tolerable limits for pH Muscle Urine
6.9 - 7.5 Muscle with normal breathing = 7-7.1 Urine = 4.5-8
29
Acidosis
A lot of H+ 1. Resp. Acidosis (Inc pCO2) 2. Metabolic Acidosis (dec HCO3-)
30
Alkalosis
1. Resp Alkalosis (dec PCO2) | 2. Metablic Alkalosis (inc. HCO3-)
31
Respiratory
Issue with CO2 Acidosis = high pCO2 (comp with raise bicarb) Alkalosis = low pCO2 (comp with low bicarb)
32
Metabolic
Issue with Bicarbonate Acidosis = low bicarb (comp with low pCO2) Alkalosis = high bicarb (comp with raise pCO2)
33
1st line of defense against acid-base status
Intra and Extracellular buffers Immediate Ex = Buffers
34
2nd line of defense against acid base status
respiratory compensations 1 to 15 minutes Ex: blowing out more CO2
35
3rd line of defense against acid base status
kidney compensations Most powerful hours to days kidney can alter how much acid or base we have
36
Buffers
Combine with acid or base to buffer Intracellular = bicarbonate and proteins Extracellular = bicarbonate and phosphates
37
Bicarbonate Buffering System
Can go either way Eqn to the right = to the tissues, more acid produced and buffer with bicarb Eqn to the left = go to lungs, excrete CO2 by blowing out
38
Respiratory Compensations
2nd line of defense Inc Ventilation, exhale more CO2 Stimulated by inc H+ (acidic) --> so this reduces H+ and blood pCO2 CO2 exhalation has to match CO2 production though Need carbonic anahydrase
39
Renal Compensation
3rd line of defense Urinary excretion of H+ (acid) and sometime bicarb Kidneys dont excrete free H+ - 2/3 of it is excreted with ammonia Most bicarb filtered in kidneys is reabsorbed back into the bloodstream
40
What is decreased at altitude
Decreased O2 diffusion | Decreased pO2 in the air as go to altitude
41
Hyperventialtion shifts the curve...
Left - pH going up Hypoxemia --> paO2 is low --> peripheral chemo --> hyperventilate --> Inc PaO2 and dec PaCO2 --> resp alkalosis --> Inc pH