control of ventilation Flashcards

1
Q

what does ventilatory control require

A

stimulation of the skeletal muscles of inspiration which occurs via the phrenic and intercostal nerves

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2
Q

where does ventilatory control reside

A

centres in the pons and medulla

entirely dependent on signalling from the brain

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3
Q

is ventilatory control conscious or subconscious

A

subconscious

can be subject to voluntary modulation

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4
Q

what happens if the spinal cord is severed above C3-5

A

this is above the origin of the phrenic nerve

breathing ceases

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5
Q

what do the respiratory centres do

A
  1. set an automatic rhythm of breathing through co-ordinating the firing of smooth muscle and repetitive bursts of action potentials in the dorsal respiratory group - travel to inspiratory muscles
  2. adjust this rhythm in response to stimuli
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6
Q

what modulates the rhythm of the respiratory centres

A
  1. emotion (via limbic system)
  2. voluntary over-ride (higher centres)
  3. mechano-sensory input from the thorax (prevents alveolar damage)
  4. chemical composition of the blood (detected by chemoreceptors)
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7
Q

central chemoreceptors

A

located in medulla
respond directly to [H+] (directly reflects PCO2)
1y ventilatory drive

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8
Q

how to central chemoreceptors respond to increase in PaCO2 (hypercapnea)

A

CO2 crosses blood brain barrier (not H+)
central chemoreceptors monitor PCO2 indirectly from CSF
HCO3- and H+ are formed, receptors respond to H+
feeback via resp centres, increased ventilation
reduced PaCO2, reduced ventilation rate
10% PaCO2 increase = 100% increase in ventilation

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9
Q

peripheral chemoreceptors

A

carotid and aortic bodies
respond to plasma [H+] (any source, not just CO2) and PO2 (arterial)
2y ventilatory drive
cause reflex stimulation of ventilation following significant change

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10
Q

ventilation is reflexly inhibited by…

A

reduced arterial PCO2
(reduced CSF [H+]
hyperventilation

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11
Q

ventilatory drive in chronic lung disease

A

most people rely on CO2 levels for stimulation of ventilation
in chronic lung disease PCO2 is chronically elevated
patients become desensitised to PCO2
rely on changes in PO2 to drive ventilation
HYPOXIC DRIVE

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12
Q

what happens when PO2 falls below 60mmHg

A

we are much more sensitive to changes in PO2

peripheral chemoreceptors significantly increase ventilation

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13
Q

changes in plasma pH and their effects on ventilation

A

reduced plasma pH - stimulates ventilation

increased plasma pH - inhibits ventilation (retain CO2 to increase [H+]

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14
Q

descending neural pathways and control of breathing

A

descending neural pathways from the cerebral cortex to respiratory motor neurons allow a large degree of voluntary control over breathing

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15
Q

can involuntary stimuli be over-ridden

A

e.g. arterial PCO2, [H+]

NO, they cannot be overidden

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16
Q

breath holding is an example of ..

A

a control of breathing

17
Q

hyperventilation and control of breathing

A

ventilation is reflexly inhibited by an increase in arterial PO2/decrease in arterial PCO2/[H+]

18
Q

impact of swallowing on respiration

A

respiration is inhibited during swallowing
avoids aspiration of food/fluid into the airways

swallowing is followed by an expiration in order that any particles are dislodged outwards from the region of the glottis

19
Q

name 4 drugs that affect the resp centres

A

barbiturates
opioids
gaseous anaesthetic agents
nitrous oxide

20
Q

how do barbiturates and opioids affect the respiratory centres

A

depress resp centre

overdose often results in death as a result of resp failure

21
Q

how do gaseous anaesthetic agents affect the resp centers

A

increase RR
decrease TV
decrease AV

22
Q

how does NO affect the resp centres

A

common sedative/light anaesthetic agent
blunts peripheral chemoreceptor response to falling PaO2
problematic in chronic lung disease cases where individuals are on hypoxic drive
administering oxygen to these patients aggravates the situation