Control of Ventilation Flashcards

1
Q

What are the muscles of inspiration?

A

The diaphragm and external intercostals

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2
Q

What are the expiration muscles?

A

Inner intercostal and abdominals (usually not required as PASSIVE)

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3
Q

What are the respiratory centre in the brain?

A

Signals sent from Medulla and Pons

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4
Q

What is the role of respiratory centres?

A

Medulla and Pons - set autonomic rhythm of breathing through co-ordinating the firing of smooth and repetitive bursts of APs in DRG - travel to inspiratory muscles

Will adjust the rhythm in response to stimuli

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5
Q

What is the ventral respiratory group (VRG)?

A

Nerves that innervate the muscles of expiration and innervates the larynx, pharynx (keeps airways patent) and tongue

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6
Q

What can modulate rhythm in respiratory centres?

A
  • Emotion
  • Voluntary over-side
  • Mechano-sensory input from thorax (stretch reflex) - fire when thoracic cavity too full and send neg. feedback to prevent over inflation
  • Chemoreceptors detect chemical composition in blood (PCO2, PO2, pH) - centres initiate change in breathing pattern to restore original pH
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7
Q

Describe central chemoreceptors

A

Located in medulla
Activated by changes in [H+] in CSF around brain (directly reflects PCO2)
Primary ventilatory drive
Cause reflex stim. of breathing after rise in [H+] (driven by raised PCO2 - hypercapnia) and rise versa (decrease in hyperventilation)

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8
Q

Describe mechanism of central chemoreceptors

A
  1. When arterial PCO2 increases, CO2 crosses blood brain barrier
  2. Central chemoreceptors monitor PCO2 indirectly in CSF
  3. Once it has crossed, it converts into HCO2 and H+ - and receptors respond to H+
  4. Feedback via resp. centres INCREASES ventilation in response to INCREASED arterial PCO2 (decreased PCO2 = decreased ventilation)
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9
Q

Describe peripheral chemoreceptors

A
  • Located in the carotid and aortic bodies
  • Responds to plasma [H+] and PO2 (made through processes and not just CO2)
  • SECOND ventilatory drive

Cause reflex stim. of ventilation in response to decrease in PO2 or rise in [H+]

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10
Q

What is the effect of pH on ventilation, stimulated by peripheral chemoreceptors?

A

Decrease in pH ([h+] increase - acidosis) ventilation stimulated

Increase in pH ([H+] falls - alkalosis) ventilated inhibited

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11
Q

Drug effect on resp. centres

A
  • Barbiturates and opioids depress resp. centre - overdoes can lead to death due to resp. failure
  • Nitrous oxide (light anaesthetic) blunts peripheral chemoreceptor response to falling PaO2 - problem in lung disease where patient on hypoxic drive
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12
Q

Which nerves innervate the muscle of inspiration?

A

Phrenic to the diaphragm

Intercostal nerves to the external IC muscles

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13
Q

What is the Dorsal Respiratory Group (DRG)?

A

Nerves that innervate the inspiratory muscles via the phrenic and vagus nerve

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14
Q

What is the most significant input to the Respiratory Centres?

A

Chemoreceptor input

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15
Q

What is the general action of chemoreceptors

A

Maintains blood gas homeostasis

CO2 is main stimulus for change

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16
Q

During hyperventilation, how do central chemoreceptors affect ventilation?

A

Low CO2 therefore ventilation reflexly inhibited

17
Q

During hypoventilation, how do central chemoreceptors affect ventilation?

A

High CO2, increases ventilation to increase pH

18
Q

What is the equation for breakdown of CO2 once it has crossed the blood brain barrier?

A

CO2 + H2O -> H2CO3 -> H+ + HCO2

19
Q

What are the steps in the mechanism of peripheral chemoreceptors?

A
  1. A stimulus (i.e. low PO2) inactivates K channels, causing the receptor cell to depolarise
  2. Depolarisation opens voltage-gated Ca2+ channels
  3. Ca2+ enters and then leaves by exocytosis onto the sensory neutron
  4. Neurotransmitter initiates AP in sensory neurons, signalling to increase ventilation
20
Q

What can cause significant arterial PO2 to decrease under 60mmHg to stimulate peripheral chemoreceptors?

A

High altitude or COPD