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Respiratory > 7. Breathing Rate and Homeostasis > Flashcards

7. Breathing Rate and Homeostasis Flashcards

1
Q

what is the SOLE PURPOSE of the LUNGS

A

VENTILATION

  • Inpiration: O2 enters
  • Expiration: CO2 leaves
  • altering respiratory rate and depth (unconsciously irrespective of activity)
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2
Q

BREATHING feedback loop

A

Sensors -> Controller (brain) -> Effectors (respiratory muscles)

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3
Q

components of the RHYTHM of VENTILATION

A
  • RESPIRATORY CENTRE
  • AUTONOMIC NERVOUS SYSTEM
  • PHRENIC NERVE regulated inspiratory muscles
    Diaphragm, External Intercostals
  • INTRATHORACIC CHNAGES (increase volume, decrease pressure)
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4
Q

RHYTHM of the ACTION POTENTIALS in VENTILATION

A

Respiratory Centre in MEDULLA triggers Action Potentials via PHRENIC NERVE
- INSPIRATION
ACTIVE, pulses, muscle contractions, change thoracic cavity volume (increases)

EXPIRATION: Impulses STOP
muscles relax, decrease thoracic volume -> air IN

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5
Q

what does the PONS in the brain regulate

A

MEDULLA

  • APNEUSTIC CENTRE : GASP (sudden need for more O2)
  • PNEUMOTAXIC CENTRE: ‘FINE-TUNING’
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6
Q

what does the CORTEX in the brain regulate

A

VOLUNTARY OVERRIDE (Holding Breath)

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7
Q

what does the HYPOTHALAMUS in the brain regulate

A

‘EMOTIONAL’ BREATHING

(when crying, laughing)

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8
Q

EXTERNAL INTERCOSTAL MUSCLES are INNERVATED by which nerves and which spinal nerves derived from

A

INTERCOSTAL NERVES - T1-T11

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9
Q

DIAPHRAGM is INNERVATED by which Nerve and which spinal nerves derived from

A

PHRENIC NERVE - C3,C4,C5

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10
Q

what is the NAME of this equation

CO2 + H20 <-> H2CO3 <-> H+ + HCO3-

A

HANDERSON-HASSELBALCH equation

  • KEY for blood maintaining steady state / pH
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11
Q

in HANDERSON-HASSELBALCH equation what is the LUNG / RESPIRATORY Component and what is the KIDNEY / METABOLIC component

A

LUNG/RESPIRATORY: CO2 + H2O side

KIDNEY/METABOLIC: H+ + HCO3- side

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12
Q

where is CO2 carried

A

either DISSOLVED in BLOOD
or
carried as HCO3-

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13
Q

EQUILIBRIUM: what happens to the HANDERSON-HASSELBALCH equation when there is a RISE in CO2

A

moves to the RIGHT

  • MORE H+ (ACID) / HCO3- (BASE) production
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14
Q

WHERE is the CENTRAL CHEMORECEPTOR

A

VENTRAL LATERAL MEDULLA

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15
Q

WHERE are the PERIPHERAL CHEMORECEPTORS MAINLY

A

mainly AROUND HEART

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16
Q

what does CENTRAL CHEMORECEPTOR detect

A

Blood pH

  • Exquisitely SENSITIVE to CO2
  • detects CHANGES in H+ (pH) in CEREBROSPINAL FLUID (CSF)
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17
Q

what do PERIPHERAL CHEMORECEPTORS MOSTLY respond to

A

O2 LEVELS

18
Q

why is CO2 MOST IMPORTANT

A

by CHANGING H+ in BRAIN

O2 only relevant when very low

19
Q

types of PERIPHERAL CHEMORECEPTORS

A

CAROTID bodies : detect changes PCO2, pO2, pH

AORTIC bodies: detect changes pCO2, pO2

20
Q

CHEMORECEPTORS DRIVE..

A

RESPIRATORY RATE

eg if high CO2, increased respiratory rate to remove

21
Q

name the OTHER RECEPTORS in the LUNG (back up systems)

A
  • STRETCH Receptors (HERING-BRUER REFLEX)
    inhibit inspiration if excessive
  • IRRITANT Receptors
    trigger to help cough
  • J-Receptors
  • BRONCHIAL C-FIBERS
    Constrict airways, Shallow breathing / Tachypnoea (rapid and shallow) (alter breathing pattern)
22
Q

how do KIDNEYS CONTROL ACID-BASE BALANCE

A
  • HCO3- REABSORPTION
    85% in PCT (using carbonic anhydrase)
  • H+ EXCRETION
    combined with buffers eg ammonia -> ammonium NH4+ (generates HCO3-)
23
Q

how can KIDNEYS GENERATE HCO3- (name)

A

DE NOVO

24
Q

HCO3- REABSORPTION in KIDNEYS takes place where

A

MAINLY PCT

25
Q

Why is BREATHING HOMEOSTASIS important in clinical practice

A

look at BLOOD GASES

  • use to quantify how sick patient is
  • use to Treat and Monitor Effectiveness of treatment
26
Q

which Blood Gas can you interpret O2 from

A

ARTERIAL

(cannot interpret from Capillary

27
Q

when looking at ACID-BASE STATUS on a BLOOD GAS what 4 questions do you ask

A
  1. is the pH normal, high, low?
  2. is the pCO2 normal, high, low?
  3. is the HCO3- normal, high, low?
  4. has there been any COMPENSATION?
28
Q

EFFECT of CO2 on BLOOD

A

INCREASES ACIDITY (decrease pH)
- H+

29
Q

when looking at ACID-BASE STATUS on a BLOOD GAS what 4 results can you get

A
  1. ACIDOSIS or ALKALOSIS or Normal
  2. RESPIRATORY (lungs ie if high CO2), METABOLIC (kidneys ie if high HCO3-) or MIXED (both high)
  3. COMPENSATED or not
  4. FULL or PARTIAL COMPENSATION
30
Q

what does it mean if the pH is NORMAL but CO2 or HCO3- is ABNORMAL

A

if pH NORMAL: FULLY COMPENSATED

if high CO2, kidneys should compensate by high HCO3- (more reabsorption)

if pH ABNORMAL, but some compensation shown then only PARTIAL

31
Q

how should LUNGS work to DECREASE high CO2 levels

A

INCREASE BREATHING RATE to expel CO2
eg panting

if high CO2 then problem in Lungs - RESPIRATORY

32
Q

how should KIDNEYS work to DECREASE High HCO3- levels or INCREASE

A

LESS REABSORPTION of HCO3- so MORE EXCRETION in URINE

INCREASE by MORE REABSORPTION into BLOOD (buffer H+) (i.e. if high CO2)

secondary system
- compensate for lungs

33
Q

when do LUNGS COMPENSATE for KIDNEYS

A

when LOW HCO3- and LOW pH (not due to high CO2 so must be kidneys)

  • LOW CO2 to compensate

METABOLIC ACIDOSIS

34
Q

when is there both a RESPIRATORY and METABOLIC problem

A

when HIGH CO2 and LOW HCO3-

  • KIDNEYS NOT COMPENSATING for Lungs high CO2

-> low pH

35
Q

how are BLOOD GASES in ALTITUDE

A
  • HIGH pH
  • LOW CO2
  • NORMAL HCO3-

UNCOMPENDATED RESPIRATORY ALKALOSIS

36
Q

what are the conditions in ALTITUDE

A

LOW OXYGEN (PaO2)

(sensed by peripheral chemoreceptors)

  • HYPERVENTILATION : breathe faster to increase O2
    -> more CO2 out so decrease CO2
    -> detected by Central Chemoreceptors which try to stop breathing to increase CO2
    -> low O2 (cycle)
37
Q

how the body RESPONDS to ALTITUDE

A
  • HYPERVENTILATION : breathe faster to increase O2
    -> more CO2 out so decrease CO2
    -> detected by Central Chemoreceptors which try to stop breathing to increase CO2
    -> low O2 (cycle)

long-term:
- KIDNEYS PRODUCE MORE ERYTHROPOEITIN so INCREASE RBC (try to hold more O2)

  • ANAEROBIC RESPIRATION
    INCREASE MITOCHONDIRA SIZE
  • Hb O2 DISSOCIATION CURVE shifts RIGHT for better UNLOADING O2
38
Q

how does HAEMOGLOBIN respond to OXYGEN LEVELS

A

OXYGEN DISSOCIATION CURVE shifts to the RIGHT
- LOWER AFFINITY for O2
- BETTER UNLOADING of O2 for use in tissues
(when high CO2 / acidosis)

(when alkalosis)
LEFT SHIFT : DECREASED AFFINITY
Hb pick up MORE O2 but LESS AVAILABLE to CELLS

39
Q

what is the BREATHING FEEDBACK LOOP controlled by

A

CHEMORECEPTORS

40
Q

how should CO2 and HCO3- be

A

in EQUILIBRIUM

41
Q

in FULLY COMPENSATED ACIDOSIS how should pH, PCO2 and HCO3- levels be

A

pH : NORMAL (compensated)
PCO2 : LOW (lungs compensating by increasing ventilation so more CO2 removed)
HCO3- : HIGH (kidneys compensating by increasing HCO3- reabsorption which buffers H+)

42
Q

in FULLY COMPENSATED ALKALOSIS how should pH, PCO2 and HCO3- levels be

A

pH: NORMAL (compensated)
PCO2: HIGH (Lungs compensating by slowing breathing rate so less CO2 is removed)
HCO3-: LOW (Kidneys compensating, less HCO3- reabsorption as there is low H+ so no need to buffer)

Respiratory (16 decks)

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