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    15-Respiratory Control 2024

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    15-Respiratory Control 2024

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    15-Respiratory control 2024

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    15-Respiratory Control 2024

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    You are on page 1of 18

    Control of Breathing

    Tepmanas Bupha-Intr DVM., PhD. CSCS


    Department of Physiology,
    Faculty of Science, Mahidol University
    Respiratory Control
    • Spontaneous breathing is produced by rhythmic
    discharges of motor neurons to respiratory muscles.
    • Two neural mechanisms regulate respiration:
    Voluntary mechanism:
    • located in cerebral cortex (primary motor cortex)
    • sends impulses to respiratory motor neurons via
    corticospinal tracts (Bypass medullary neuron)

    Automatic mechanism:
    • Run by pacemaker cells in medulla.
    • Activates motor neurons in cervical & thoracic spinal cord.
    (Bulbospinal tracts)
    Voluntary Control
    • Voluntary respiration is controlled by
    cerebral cortex.
    • Limbic system + hypothalamus alter
    pattern of breathing in emotional stress
    such as fear and rage.
    • Output directly to motor neurons that
    control skeletal muscles associated with
    respiration (corticospinal tract)
    • Output to medullary respiratory system
    then to motor neurons in spinal cord
    • Is overridden by hypoxemia/hypercepnea
    Respiratory Control Center
    • Pontine respiratory system modifies information into
    the medullary center and regulates transition from
    inspiration to expiration
    • Pneumotaxic center responding in inhibit inhalation at apneustic
    center and DRG (the frequency increase)
    • Apneustic center promoting inhalation by stimulating DRG
    • Medullary respiratory system
    • Dorsal respiratory group (DRG) receiving sensory information
    and sends information to VRG & main respiratory muscles,
    mainly control cycle of breath.
    • Ventral respiratory group (VRG) initiating neural impulses for
    forced breathing via the spinal cord accessory muscles. [contain
    both inspiratory and expiratory neurons, but mainly effect on
    expiration]
    Respiratory Control Center

    Pneumotatic

    inhibit
    Apneustic
    VRG DRG

    Vagus
    Nerves
    Motor
    Nerves

    Dorsal Respiratory group:


    • Relating to N. tractus solitarius
    • Afferent input from pons, CN-IX, CN-X
    • Efferent output to VRG + inspiratory muscles
    Ventral Respiratory Group

    Control dilator of larynx,


    pharynx, tongue

    Fine tuning expiratory


    function

    Control motor neuron to


    Inspiratory muscles
    (opposite site)

    Control motor neuron to


    expiratory muscles
    (opposite site)
    Respiratory Inputs
    Pneumotactic center
    • Higher Brain (speaking,
    laughing, crying, eating…)

    Apneustic center
    • Pneumotatic center
    • Lung stretch receptor

    DRG
    • Apneustic center
    • Central chemoreceptors
    • Peripheral chemoreceptors
    • Lung stretch receptor

    VRG
    • Pontine centers and DRG
    Respiratory Rhythmicity
    Quiet Breathing (activation of DRG)
    • DRG (activated for 2 sec.) stimulates motor neurons of
    inspiratory muscles (diaphragm)
    • DRG inspiratory neurons inactivated (for 3 sec.) →
    Allowing passive exhalation.
    • VRG is low active during quiet breathing.

    Altered Breathing Rate and Depth


    • Sensory inputs (chemo, baro, proprio, etc.) into DRG
    • Rate varies by altering inspiration vs expiration times
    • Depth varied by engaging accessory muscles (VRG)
    Respiratory Input
    sensory information into the CNS
    • Sensory Modifiers of Respiratory Center Activities
    • Chemoreceptors are sensitive to PaCO2, PaO2, or pH of blood or
    cerebrospinal fluid
    • Baroreceptors in aortic or carotid sinuses are sensitive to changes in
    blood pressure
    • Stretch receptors respond to changes in lung volume
    • Proprioceptors from the periphery – signals indicating position in
    space of limbs
    • Irritating physical or chemical stimuli in nasal cavity, larynx, or
    bronchial tree - COUGHING AND SNEEZING
    • Other sensations including pain, changes in body temperature,
    abnormal visceral sensations
    Respiratory Sensors
    • Peripheral chemoreceptors
    • monitors changes in PO2, PCO2, H+, and K+ in blood
    • monitors changes pH either induced by PCO2 or
    metabolic acidosis (kidney failure)
    • in carotid or aortic bodies (in carotid & aortic blood
    vessels)

    • Central chemoreceptors
    • monitors changes in pH due to changes in blood PCO2
    in the CSF – sensitive to 5 mmHg change
    • on ventrolateral surface of medulla oblongata
    • increased blood PCO2 causes a decrease in CSF pH
    • No PaO2 receptors
    Respiratory Response
    • Increased PaCO2 → increased ventilation
    • Acidic condition enhances ventilation response to CO2
    • Decreased PaO2 also enhanced ventilation response to CO2
    Respiratory Response
    • Decreased PaO2 → increased ventilation
    • PaCO2 enhanced ventilation in response to decreased O2
    • PaO2 must decreased below 70 mmHg to increase ventilation

    PaO2
    Respiratory Reflex
    Hering–Breuer inflation reflex

    Lung Inflation (Full) Dorsal Respiratory


    Group (DRG)

    Vagus Nerve
    Stretch receptors Ventral Respiratory
    Group (VRG)
    in bronchi and
    bronchiole
    Inspiration
    Respiratory Reflex
    Irritant receptors
    • Nerve ending locating between epithelia of respiratory
    tract (Trachea & Large Airways)
    • Signal sends to myelinated vagus nerve and reflex in
    increasing airway resistance, apnea, coughing
    Juxta-alveolar (J) receptors
    • Sensory receptors locating between alveolar and
    capillary sending a signal through non-myelinated vagal
    C fiber
    • Response to chemicals and fluid pressure (inflammation)
    • Reflex causes bronchoconstriction and apnea with rapid
    shallow breathing
    Acid-Base Control

    Respiration system has a function in regulating


    acid-base of whole body.
    Concept: H2O + CO2  H2CO3  H+ + HCO3-

    Volatile acids
    • Easily move from liquid to gas state
    • Within the body
    • Lung can remove
    • H2CO3 + renal enzyme → H2O + CO2 (both of which are
    exhaled)
    • Carbon dioxide is therefore considered an acid

    As CO2 rises, there is more acid → respiratory acidosis

    As CO2 drops, there is less acid → respiratory alkalosis


    Acid Imbalance
    • Too much CO2 leads to decreased pH and an acid condition
    • Too little CO2 leads to increased pH and an alkaline condition
    • PaCO2
    • Amount of CO2 dissolved in the blood
    • Good indicator of respiratory and ventilatory function

    Base Imbalance
    • Major base in body is bicarbonate (HCO3-)
    • Regulated by the kidneys (metabolic)
    • Too little HCO3- causes decrease in pH and acid conditions
    • Too much HCO3- causes increase in pH and alkaline
    conditions
    Acid-Base Imbalance
    Acidemia – Blood is more acid than normal (pH < 7.35)

    Alkalemia – Blood is more alkaline than normal (pH > 7.45)

    Respiratory Imbalance
    Respiratory mechanisms involve either
    • Retention of excess carbon dioxide
    • Retention of insufficient carbon dioxide

    Over- or Under-ventilation or respiration abnormalities are


    the main causes of this imbalance
    PHYSIO
    LOGY
    tepmanas.bup@mahidol.ac.th

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