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Cardio AP > Unit 4/Chapter 11: Ventilation > Flashcards

Unit 4/Chapter 11: Ventilation Flashcards

(71 cards)

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1
Q

Where do neural impulses for ventilation originate?

A

Medulla oblongata

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2
Q

What happens with transection below medulla?

A

Ventilation ceases

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3
Q

What happens with transection above pons?

A

Rhythmic breathing

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4
Q

The heart lies where, behind the sternum?

A

Mediastinum

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5
Q

Which group contains respiratory neurons

A

Dorsal respiratory group (DRG)

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6
Q

Where do respiratory neurons in the DRG send impulses?

A

Phrenic and external intercostal motor neurons

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7
Q

Which nerves transmit lung sensory impulses to the DRG to modify the medulla’s basic breathing pattern?

A

Vagus X and glossopharyngeal IX

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8
Q

What are the 2 inspiratory neuron population of the DRG?

A
  1. Inhibited by deep lung inflation- inflation stops
  2. Excited by lung inflation-inflation continues
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9
Q

What are the 2 nuclei in the medulla where the VRG is located?

A

Nucleus ambiguous
Nucleus retro ambiguous

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10
Q

What do inspiratory neurons in the VRG innervate (supply organs with nerves)?

A

laryngeal and pharyngeal muscles via the vagus nerve
abduction of the vocal chords

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11
Q

Caudal expiratory stimulation of the VRG to _?

A

Internal intercostal and abdominal muscles

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12
Q

What provides the main stimulus for inspiration?

A

The DRG

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13
Q

What group contains both inspiratory and expiratory neurons?

A

Ventral Respiratory Group (VRG)

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14
Q

Rostral inspiratory stimulation of the VRG to_?

A

diaphragm and external intercostal muscles

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15
Q

What is the Botzinger complex?

A

Neurons that inhibit inspiratory impulses

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16
Q

Botzinger/prebotzinger complex may have a role in what?

A

rhythmic breathing pattern

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17
Q

2 major theories of rhythm generation

A

pacemaker hypothesis
network hypothesis

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18
Q

What is the inspiratory ramp signal?

A

gradual firing of impulses after expiration ends that get progressively stronger and cause a gradual inflation of the lung

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19
Q

What happens with the inspiratory ramp signal during exercise?

A

It becomes steeper and lungs fill more rapidly

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20
Q

What are the two Pontine Centers?

A

1.Apneustic center 2.Pneumotaxic center

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21
Q

What does the apneustic center do?

A

Sends signals to the DRG
prevents inspiratory neurons from being switched off

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22
Q

What is apneusis?

A

Prolonged inspiratory gasps interrupted by occasional expirations

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23
Q

What does the pneumotaxic center do?

A

Controls length of inspiration

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24
Q

What does a strong signal from the pneumotaxic center do?

A

short inspiratory time - increase RR

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25
What does a weak signal from the pneumotaxic center do?
prolongs inspiratory time - increase tidal volume
26
What effect does the lack of pneumotaxic and stretch receptor neurons have on ventilation?
Causes long deep inspiratory gasps
27
What do pontine impulses do?
Fine-tune medullary rhythm
28
Hering-Breuer reflex is activated by what?
large tidal volumes of .8 - 1 L
29
Hering-Breuer reflex regulates rate and depth during what?
Exercise
30
Hering-Breuer inflation reflex - low lung compliance with increased inspiratory effort leads to?
Faster breathing rate
31
Hering - Breuer deflation reflex - what stimulates breathing?
Sudden lung collapse or irritant
32
What is the pathway from the lung to the medulla called?
Vagus nerve
33
What does the Head's Paradoxical Reflex do?
Causes a rapid inspiration creating a gasp in infants and sighs in adults
34
Irritant receptors in lungs are what?
rapidly adapting - stop firing after response to stimulus
35
Vasovagal reflexes are found on both ______________ and ______________ neurons?
Sensory and motor
36
Vasovagal reflexes are responsible for what?
bronchoconstriction, coughing, sneezing, tachypnea, glottic narrowing, bradycardia
37
J-receptors (juxtapulmonary capillary receptors) are what?
C fibers in the lung parenchyma near the pulmonary capillaries
38
J receptors are stimulated by
pneumonia, CHF, pulmonary edema
39
J receptor stimulation causes
- Rapid, shallow breathing - Sensation of dyspnea - Glottic narrowing (expiratory grunting)
40
Peripheral Proprioceptors _?
Found in muscles, tendons, joints, and pain receptors Movement stimulates hyperpnea
41
Muscle spindles are?
Muscle stretch sensitive and located in diaphragm and intercostal muscles
42
Which stimulates central chemoreceptors more quickly and elicits more increase in ventilation? Increase in PCO2 or H+?
Increase in PCO2 due to the blood brain barrier being impenetrable to H+. Hypoxemia becomes a more prominent stimulus for ventilation
43
Central (medullary) chemoreceptors are stimulated by ______________, not by ____________ or ____________
H+ ions CO2 O2
44
What can cross the blood brain barrier easily, raising the H+ concentration of CSF?
CO2
45
VA increases _____-_____ L/min for every _______mmHg increase in _____________
2-3 1 PaCO2
46
What is the principal minute to minute stimulus for ventilation mediated through central chemoreceptors?
PaCO2
47
What is the primary mediator of minute to minute breathing drive in humans?
PaCO2
48
Even maximal hyperventilation cannot raise the PaO2 higher than what?
125 - 130 mmHg
49
Arterial hypoxemia does not stimulate ventilation until PO2 reaches which level?
<60 mmHg
50
The chronically high PaCO2 in a patient with COPD who has compensated respiratory acidosis does not stimulate central chemoreceptors - why?
pH is normal HCO3- buffers H+
51
Peripheral chemoreceptors are located
Carotid and aortic bodies
52
peripheral chemoreceptors are sensitive to __________ directly and ___________ indirectly
H+ CO2
53
peripheral chemoreceptors are responsible for ______-______% of ventilatory response to hypercapnia
20-30
54
peripheral chemoreceptors respond ________x faster to H+ than central chemoreceptors and give a quick response to ___________ ____________
5 metabolic acidosis
55
A sudden increase in CO2 results in what?
increase in H+ in CSF increase in ventilation
56
A gradual increase in CO2 results in
renal retention of HCO3- normal pH
57
severe COPD patients experience a ___________ increase in CO2 and ______________. What is the minute to minute breathing stimulus?
gradual hypoxemia hypoxemia
58
What is oxygen induced hypercapnia?
acute increase in PaCO2 when O2 is given to chronically hypoxemic/hypercapnic patients with COPD
59
What is the medullary response to acute increase in CO2 in chronic hypercapnia?
central chemoreceptors have less stimulation - H+ buffered in CSF ventilatory response to CO2 depressed buffer capacity increased because of HCO3 retention
60
During exercise, CO2 production and O2 consumption may increase ____________x
20
61
Stages of ventilatory response to exercise
onset adjustment steady state
62
Gradual increase in breathing rate and volume followed by gradual decrease followed by apnea is known as what?
Cheyne - Stokes breathing
63
Gradual increase in breathing rate followed by gradual decrease to apnea but volume remans the same is known as ?
Biots breathing
64
prolonged gasping inspiration caused by pons damage known as?
apneustic breathing
65
continuous deep breathing - caused by damage to the pons is?
central reflex hypernea
66
continuous shallow breathing - caused by head trauma, brain hypoxia, narcotic suppression
central reflex hypopnea
67
Increase in CO2 can do what to brain vessels?
increase cerebral blood flow
68
To sustain cerebral blood flow, a cerebral perfusion pressure of _________mmHg must be maintained
60
69
What do authors advaise against in traumatic brain injury patients
hyperventilation to a PACO2 of less than 30 mmHg
70
What can hyperventilation of a TBI patient cause?
cerebral ischemia
71
In a TBI patient, for every ______mmHg acute reduction in PaCO2 (between 20 - 60 mmHg) there is a _______% reduction in Cerebral Blood Flow.
1;3

Cardio AP (5 decks)

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