Respiratory System: Control of Breathing

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Questions and Answers

How does increased activity of skeletal muscles during exercise directly relate to the respiratory system's homeostatic contribution?

  • By decreasing the depth, but increasing the rate, of breathing.
  • By decreasing the rate, but increasing the depth, of breathing.
  • By decreasing both rate and depth of breathing.
  • By increasing rate and depth of breathing. (correct)

How do the lungs contribute to the endocrine system, specifically regarding blood pressure regulation?

  • By secreting atrial natriuretic peptide (ANP), which lowers blood volume.
  • By releasing erythropoietin, which stimulates red blood cell production.
  • By synthesizing and releasing epinephrine during periods of stress.
  • By producing angiotensin-converting enzyme (ACE), which is involved in angiotensin II formation (correct)

During inhalation, how does the respiratory pump mechanism assist the cardiovascular system?

  • By increasing arterial blood pressure
  • By aiding in venous blood return to the heart. (correct)
  • By decreasing pulmonary blood flow.
  • By increasing the amount of blood ejected from the heart.

How does the respiratory system contribute to the acid-base balance in body fluids?

<p>By expelling carbon dioxide. (A)</p> Signup and view all the answers

What is the primary physiological stimulus that leads to the control of ventilation by affecting breathing rate and depth?

<p>Changes in carbon dioxide, oxygen and pH levels (B)</p> Signup and view all the answers

What is the primary role of chemoreceptors in the context of respiratory control?

<p>Detecting and responding to changes in blood pH, $P_{O_2}$, and $P_{CO_2}$. (B)</p> Signup and view all the answers

If the brainstem is severed below the medulla oblongata, what is the expected outcome regarding respiration?

<p>Breathing ceases entirely (C)</p> Signup and view all the answers

What is the consequence of separating the pons from the medulla?

<p>Breathing becomes gasping and irregular. (B)</p> Signup and view all the answers

Which of the following best describes the function of the ventral respiratory group (VRG)?

<p>Controls accessory muscles during forced breathing. (B)</p> Signup and view all the answers

What physiological response would occur if the central chemoreceptors detect a significant decrease in the pH of cerebrospinal fluid (CSF)?

<p>Increased rate and depth of breathing (D)</p> Signup and view all the answers

How does carbon dioxide get transported to the lungs?

<p>Dissolved in plasma, as bicarbonate ions, and bound to hemoglobin. (C)</p> Signup and view all the answers

How does carbon monoxide (CO) affect oxygen transport by haemoglobin?

<p>Reduces the amount of oxygen bound (B)</p> Signup and view all the answers

What does the Bohr effect describe regarding oxygen saturation?

<p>The influence of carbon dioxide and pH on oxygen saturation. (B)</p> Signup and view all the answers

What is the effect of 2,3-diphosphoglycerate (DPG) on the oxygen-haemoglobin dissociation curve, and under what conditions is this effect typically observed?

<p>Causes a right shift, decreasing oxygen affinity, seen during exercise. (A)</p> Signup and view all the answers

An individual is at high altitude. How do peripheral chemoreceptors respond to predict Ventilation?

<p>Decrease alveolar $P_{O_2}$ in blood is sensed by periphal chemoreceptors and Ventilation will increase (D)</p> Signup and view all the answers

Why is decreased $P_{O_2}$ not as effective at firing ventilation than increased $P_{CO_2}$?

<p>Carbon dioxide’s response to altered pH has a main control on ventilation via central chemoreceptors. (D)</p> Signup and view all the answers

Under what condition might vascular stasis stimulate peripheral chemoreceptors?

<p>Decreased blood flow to the carotid and decrease is oxygen delivery. (A)</p> Signup and view all the answers

What impact do baroreceptors have on ventilation?

<p>Baroreceptors have a minor influence on regulating ventilation. (A)</p> Signup and view all the answers

What would you expect to happen if there are afferent fibres in stimulated by an increased arterial blood pressure?

<p>It will trigger a decrease in ventilation (D)</p> Signup and view all the answers

What best describes how “Compliance” influences ventilation?

<p>Compliance is the measure of ease of lung expansion (A)</p> Signup and view all the answers

Which of the following most accurately describes the location of the central chemoreceptors that influence respiratory control?

<p>Located on the ventro-lateral surface of the medulla oblongata. (B)</p> Signup and view all the answers

Which of the following is a primary function of central chemoreceptors?

<p>Monitoring composition of the cerebrospinal fluid. (CSF) (C)</p> Signup and view all the answers

Which of the following changes are most likely to stimulate central chemoreceptors and, as a result, increase ventilation?

<p>A rise in arterial $P_{CO_2}$ and drop in the pH (B)</p> Signup and view all the answers

Under certain conditions, chronic retention of which gas reduces the sensitivity of the body’s respiratory center?

<p>Chronic retention of Carbon dioxide (C)</p> Signup and view all the answers

Apart from carbon dioxide retention, which condition would directly impact chemoreceptors?

<p>Diabetic ketoacidosis (C)</p> Signup and view all the answers

What is the effect of anaesthetics on ventilation?

<p>Affecting chemoreceptors - which will lead to reduce ventilation (A)</p> Signup and view all the answers

Why is there high blood flow in the carotid body & aortic arch in peripheral chemoreceptors?

<p>To provide a high sampling rate for blood gases. (A)</p> Signup and view all the answers

What blood $P_{O_2}$ condition will trigger most effectively action planning of peripheral ventilation: HIGH OR LOW?

<p>When arterial blood Oxygen tensions is Low. (B)</p> Signup and view all the answers

What is the average breaths per minute an adult would take at rest?

<p>From 12 to 15 breaths. 500mLs per breath. (D)</p> Signup and view all the answers

What do stretch receptors respond to?

<p>Expansion of the lungs. Inflation inhibits neurones in response in respiratory centre via vagus nerve (D)</p> Signup and view all the answers

What is the function of airway smooth muscle?

<p>ASM constriction &amp; Mucus secretion (C)</p> Signup and view all the answers

How do impulses influence "drives” motor neuron?

<p>These conscious change travel via corticospinal tract. (C)</p> Signup and view all the answers

What happens inside the lungs during inhalation?

<p>Diaphragm flattens, External intercostal muscles contract, Volume of thoracic cavity increases, Lungs expand (B)</p> Signup and view all the answers

How does the body facilitate inhalation?

<p>Air flows down pressure gradient (C)</p> Signup and view all the answers

According to elastic recoil of the lungs, where does the breathing occur?

<p>Occurs with the elastic recoil of the diaphragm, external intercostal muscles contract and the lungs (D)</p> Signup and view all the answers

Relating to forced breathing, in what stage will diaphragms contract?

<p>The diaphragm contracts with external intercostal muscles during their most active stage (B)</p> Signup and view all the answers

Relating to the homeostatic components of the respiration control system, identify the correct effector

<p>Muscles of inhalation and exhalation contract (D)</p> Signup and view all the answers

How would holding your breath typically affect arterial blood gas levels and pH?

<p>Increase $P_{CO_2}$, decrease $P_{O_2}$, decrease pH (D)</p> Signup and view all the answers

How does the cooperative binding of oxygen to haemoglobin affect oxygen saturation?

<p>Increases oxygen saturation by increasing haemoglobin's affinity for oxygen as more molecules bind. (A)</p> Signup and view all the answers

What is the primary role of the Dorsal Respiratory Group (DRG) during quiet breathing?

<p>Stimulating the diaphragm and external intercostal muscles. (A)</p> Signup and view all the answers

In scenarios of increased metabolic demand, such as during intense exercise, how does the body ensure adequate oxygen supply to tissues?

<p>By increasing both the rate and depth of ventilation to enhance oxygen uptake and carbon dioxide removal. (D)</p> Signup and view all the answers

How do central chemoreceptors respond to a sustained increase in arterial $P_{CO_2}$?

<p>They increase ventilation rate to expel excess carbon dioxide. (C)</p> Signup and view all the answers

What is the functional significance of the extensive network of capillaries surrounding the alveoli in the lungs?

<p>To maximize the surface area available for gas exchange. (B)</p> Signup and view all the answers

What is the effect of increased levels of 2,3-diphosphoglycerate (DPG) on the oxygen-hemoglobin dissociation curve?

<p>Shifts the curve to the right, decreasing hemoglobin's affinity for oxygen. (D)</p> Signup and view all the answers

How does the Bohr effect influence oxygen unloading during exercise?

<p>It increases $P_{CO_2}$ and decreases pH, facilitating oxygen unloading. (B)</p> Signup and view all the answers

What mechanisms enable the carriage of carbon dioxide to the lungs?

<p>As bicarbonate ions, bound to hemoglobin, and dissolved carbon dioxide. (C)</p> Signup and view all the answers

During forced breathing, what role do the inspiratory muscles play, and how is this coordinated?

<p>Both the diaphragm and accessory muscles are used and the Dorsal Respiratory Group signals. (A)</p> Signup and view all the answers

If central chemoreceptors primarily detect changes in pH of the cerebrospinal fluid (CSF), how does systemic hypercapnia (increased arterial $P_{CO_2}$) lead to their activation?

<p>Carbon dioxide crosses the blood-brain barrier and is converted to carbonic acid, which decreases the pH of the CSF. (C)</p> Signup and view all the answers

What is the primary function of Angiotensin-Converting Enzyme (ACE) that is released from endothelial cells of alveolar capillaries?

<p>To convert angiotensin I to angiotensin II, which helps regulate blood pressure. (A)</p> Signup and view all the answers

How do stretch receptors in lung tissues affect the control of breathing during forced ventilation?

<p>Inhibit inspiration and promotes expiration via VRG stimulation. (C)</p> Signup and view all the answers

In what scenario would vascular stasis most likely stimulate peripheral chemoreceptors?

<p>Reduced blood flow which leads to local hypoxia and acidosis. (A)</p> Signup and view all the answers

What physiological advantage is conferred by the sigmoidal shape of the oxygen-haemoglobin dissociation curve?

<p>It allows for relatively constant $O_2$ saturation despite changes. (C)</p> Signup and view all the answers

How does anaemia affect firing of peripheral chemoreceptors?

<p>Haemoglobin saturation is normal therefore no extra firing. (D)</p> Signup and view all the answers

The respiratory system helps counteract blood acidity by directly:

<p>Adjusting the rate of ventilation (C)</p> Signup and view all the answers

What is the influence of baroreceptors on ventilation?

<p>Overall minor influence. (C)</p> Signup and view all the answers

Why is the blood flow in the carotid body & aortic arch high?

<p>Quickly detect changes. (C)</p> Signup and view all the answers

Following severing of the brainstem below the medulla oblongata, what is the predicted outcome for ventilation?

<p>Loss of all ventilation. (A)</p> Signup and view all the answers

During exercise, the ______ system supports increased activity of skeletal muscles by increasing the rate and depth of breathing.

<p>muscular</p> Signup and view all the answers

The respiratory system contributes to overall homeostasis by providing oxygen and removing ______.

<p>carbon dioxide</p> Signup and view all the answers

The ______ system works with the respiratory system to regulate the pH of body fluids.

<p>urinary</p> Signup and view all the answers

The average time an adult can hold their breath is more influenced by the build-up of blood-acidifying ______ than the lack of oxygen.

<p>carbon dioxide</p> Signup and view all the answers

[Blank] are sensors that monitor blood pH, $PaO_2$, and $PaCO_2$ levels to control respiration.

<p>chemoreceptors</p> Signup and view all the answers

The efficiency of gas exchange in the lungs depends on both alveolar distribution and ______ in all parts of the lungs.

<p>blood flow</p> Signup and view all the answers

Endothelial cells of alveolar capillaries release ______, which plays a role in blood pressure regulation.

<p>angiotensin converting enzyme</p> Signup and view all the answers

The percentage saturation of hemoglobin indicates how much ______ is bound to hemoglobin compared to its maximum capacity.

<p>oxygen</p> Signup and view all the answers

Compared to oxygen, carbon dioxide is 24 times more ______, which means it doesn't require a carrier to be transported in the blood.

<p>soluble</p> Signup and view all the answers

Hemoglobin (Hb) binds 98% of oxygen, forming ______ ($HbO_2$).

<p>oxyhemoglobin</p> Signup and view all the answers

According to ______, carbon dioxide unbinds from hemoglobin and diffuses out of the RBC.

<p>the law of mass action</p> Signup and view all the answers

The ______ describes the shift in the hemoglobin saturation curve due to changes in pH.

<p>bohr effect</p> Signup and view all the answers

Steady state alveolar ventilation is equal to ______.

<p>$PCO_2$</p> Signup and view all the answers

An increase in 2,3-diphosphoglycerate (DPG) causes the oxygen-hemoglobin dissociation curve to shift to the ______.

<p>right</p> Signup and view all the answers

[Blank] enables the Cl shift, facilitating the transport of carbon dioxide in the blood.

<p>carbonic anhydrase</p> Signup and view all the answers

The medulla oblongata, which controls respiration, is fine-tuned by neurons in the ______.

<p>pons</p> Signup and view all the answers

The ______ pattern of respiration refers to the automatic control of inspiratory and expiratory muscles by neurons in the medulla.

<p>central</p> Signup and view all the answers

The ______ cortex, the origin of voluntary control, additionally influences the respiratory center.

<p>cerebral</p> Signup and view all the answers

Severing the brainstem below the ______ results in no breathing.

<p>medulla</p> Signup and view all the answers

The medulla oblongata coordinates quiet and forced breathing, and controls the ______ of ventilation.

<p>frequency</p> Signup and view all the answers

The ______ respiratory group controls the diaphragm and external intercostal muscles.

<p>dorsal</p> Signup and view all the answers

Respond to changes in blood pressure are ______, located in the carotid body and aortic arch.

<p>baroreceptors</p> Signup and view all the answers

Central chemoreceptors are most effective in altering ventilation due to their responsiveness to changes in ______ concentration.

<p>hydrogen ion</p> Signup and view all the answers

Peripheral chemoreceptors respond to low arterial $PO_2$, a condition known as ______.

<p>hypoxia</p> Signup and view all the answers

At very high altitude, ventilation is increased due to the decreased alveolar $PO_2$; there is also a larger ______ in $O_2$ loading into the blood.

<p>difference</p> Signup and view all the answers

[Blank] is when dissolved $PO_2$ is the same, but there is low $O_2$ carrying capacity, does not trigger firing. (Hb content/capacity differs)

<p>anaemia</p> Signup and view all the answers

If vascular stasis (decreased blood flow to the carotid body) occurs, ______ chemoreceptors will be stimulated.

<p>peripheral</p> Signup and view all the answers

An impulse inhibits respiration via the respiratory centre via the medulla is called ______.

<p>baroreceptors</p> Signup and view all the answers

In a normal individual, airway resistance to airflow occurs in the ______ airways.

<p>larger</p> Signup and view all the answers

[Blank] is a measure of the ease of lung expansion.

<p>compliance</p> Signup and view all the answers

The term volume describes a relationship between amount of carbon dioxide produced and oxygen absorbed.

<p>respiratory quotient</p> Signup and view all the answers

The medulla responds to hypercapnia which results in an increase of what component in cerebral spinal fluid [CSF]?

<p>hydrogen ions</p> Signup and view all the answers

The average adult takes ______ to ______ breaths per minute to move approximately ~ 6 L of air.

<p>12, 15</p> Signup and view all the answers

External intercostal muscles ______, which increases the volume of the thoracic cavity.

<p>contract</p> Signup and view all the answers

In forced breathing stimulates the VRG and apneustic center to begin ______.

<p>expiration</p> Signup and view all the answers

The impulses mediating conscious change travel via the ______.

<p>corticospinal tract</p> Signup and view all the answers

[Blank] are bags that are elastic, but lack muscle that would allow them to expand or contract themselves.

<p>lungs</p> Signup and view all the answers

[Blank] monitor $PCO_2$, pH and, $PO_2$ of arterial blood, moderating rhythm of breathing.

<p>chemoreceptors</p> Signup and view all the answers

A shift to the right indicates a ______ affinity of hemoglobin for oxygen, facilitating oxygen release to tissues.

<p>decreased</p> Signup and view all the answers

[Blank] are found in the muscular portion of the walls of the bronchi and bronchioles - prevent over-inflation.

<p>stretch receptors</p> Signup and view all the answers

During inhalations, the respiratory pump aids the return of ______ blood to the heart.

<p>venous</p> Signup and view all the answers

The lungs contain ______-converting enzyme (ACE), which catalyzes the formation of angiotensin II from angiotensin I.

<p>angiotensin</p> Signup and view all the answers

The nose contains receptors for the sense of smell, known as ______.

<p>olfaction</p> Signup and view all the answers

Together, the respiratory and ______ systems regulate pH, which ensures the body can maintain acid-base balance

<p>urinary</p> Signup and view all the answers

The average time an adult can hold their breath it is more related to the build-up of blood-acidifying ______ than the lack of oxygen.

<p>carbon dioxide</p> Signup and view all the answers

The amount of oxygen bound to hemoglobin depends on the plasma O2 and the amount of ______.

<p>hemoglobin</p> Signup and view all the answers

A shift in the hemoglobin saturation curve resulting from a pH change is known as the ______ effect.

<p>bohr</p> Signup and view all the answers

H+ ions bind hemoglobin molecules and (reversibly) cause a ______ change.

<p>shape</p> Signup and view all the answers

An increase of 2,3-diphosphoglycerate shifts the curve to the ______ under conditions such as exercise, drop in blood pH, and increase in the thyroid hormones.

<p>right</p> Signup and view all the answers

Approximately 70% of the CO2 load is converted to bicarbonate and ______.

<p>H+</p> Signup and view all the answers

The relationship between amount of carbon dioxide produced and oxygen absorbed is known as the ______.

<p>respiratory quotient</p> Signup and view all the answers

[Blank] can be described as increased rate and depth of breathing supporting increased activity of skeletal muscles during exercise.

<p>muscular system</p> Signup and view all the answers

The average ventilation is at rest 12 and 15 breaths per minute ~______ mLs air at each breath ~ 6 L per minute.

<p>500</p> Signup and view all the answers

The medulla oblongata and pons ______ ventilation in the respiratory system.

<p>coordinate</p> Signup and view all the answers

The two control centers are Dorsal Respiratory Group and ______ Respiratory Group.

<p>ventral</p> Signup and view all the answers

The carotid and aortic bodies are locations of ______ chemoreceptors.

<p>peripheral</p> Signup and view all the answers

Activation of ______ influences elastic recoil of the lungs, thus promoting quiet exhalation.

<p>diaphragm</p> Signup and view all the answers

A main control is by central chemoreceptors in response to altered ______.

<p>pH</p> Signup and view all the answers

In forced breathing only, the expansion of lungs inhibits neurones in respiratory centre via ______ nerve.

<p>vagus</p> Signup and view all the answers

Compared to central chemoreceptors, decreased PO₂ is not as powerful stimulator of ______.

<p>respiration</p> Signup and view all the answers

Flashcards

What is the function of capillaries surrounding the alveoli?

A network of capillaries that surround the alveoli in the lungs, facilitating gas exchange.

What is Angiotensin Converting Enzyme (ACE)?

The enzyme released by endothelial cells of alveolar capillaries that catalyzes the conversion of angiotensin I to angiotensin II.

How is gas transport controlled in the body?

Carried in blood and controlled by the lungs and cardiovascular system.

What is the effect of oxygen binding to Hb?

Binding of one molecule of oxygen (O₂) to hemoglobin makes it easier for subsequent O₂ molecules to bind.

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What is the Bohr Effect?

A shift in the hemoglobin saturation curve due to changes in pH.

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How does decreasing pH affect O2 saturation?

Decreasing pH causes decreased O₂ saturation, shifting the oxygen dissociation curve to the right.

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What is 2,3-Diphosphoglycerate (DPG)?

Metabolite in erythrocytes that acts as an inhibitor and causes a rightward shift in the oxygen dissociation curve.

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What dictates the amount of time a human can hold their breath?

The average time an adult can hold their breath is between 30 and 60 seconds, primarily due to the buildup of blood-acidifying carbon dioxide (CO2).

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What key factor maintains homeostasis and control of respiration?

Maintains blood pH, PaO2, and PaCO2

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What is the Dorsal Respiratory Group (DRG)?

A group of neurons in the medulla oblongata responsible for controlling the diaphragm and external intercostal muscles during quiet breathing.

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What is the Ventral Respiratory Group (VRG)?

A group of neurons in the medulla oblongata responsible for controlling accessory inspiratory and expiratory muscles during forced breathing.

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What do chemoreceptors respond to?

Respond to changes in arterial PCO2, PO2, and [H+].

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What is the role of central chemoreceptors?

Located in the medulla oblongata to cause a response to hypercapnia.

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What is a key factor the medulla responds to?

Responds only to a rise in Hydrogen concentration

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What are peripheral chemoreceptors?

Located in the carotid body and aortic arch and are activated when PO2 gets below 60 mm Hg.

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What describes lung compliance?

The measure of the ability of the lungs to stretch and expand.

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What is normal/quiet breathing?

Involves using diaphragm and intercostal muscles

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What is forceful breathing?

Uses diaphragm, intercostal muscles and accessory muscles to increase the amount of air intake into the lungs

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What are stretch receptors?

Found in the muscular portion of the walls of the bronchi and bronchioles, stimulating the VRG and apneustic center which stimulates expiration.

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What is the rate of ventilation?

At rest 12 and 15 breaths per minute -500 mLs air at each breath ~ 6 L per minute

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Breath Holding Duration

The average time an adult can hold their breath is between 30 and 60 seconds, most dependent on levels of blood-acidifying carbon dioxide.

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Chemoreceptors

Specialized cells that detect changes in arterial carbon dioxide, oxygen, and pH levels.

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Central Chemoreceptors

Receptors located in the medulla oblongata, monitor cerebrospinal fluid composition.

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Peripheral Chemoreceptors

Located in the carotid body and aortic arch; activated when PO₂ falls significantly, leading to increased ventilation.

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Baroreceptors

Receptors that measure changes in blood pressure. Located in carotid body and aortic arch.

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Lung Stretch Receptors

Receptors that detect lung volume and prevent over-inflation.

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Lung Compliance

A measure of the ease with which the lungs can be expanded under pressure.

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Medulla Neurons

Inspiratory (diaphragm) and expiratory muscles (internal intercostals) are controlled by these neurons.

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Pons Function

Integrating sensory information to fine-tune respiratory signals.

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Chemoreceptors function

Detects O2 and CO2 levels in the blood and alters ventilation.

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Automatic Breathing

Ventilation pattern where inspiratory and expiratory muscles are controlled by neurons in the medulla.

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Central Chemoreceptor Location

Located on the ventro-lateral surface of the medulla oblongata.

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Medulla's Role

Integration of sensory info, coordinates quiet and forced breathing, controls frequency of ventilation.

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Inflation Reflex

Respond to expansion of the lungs and are involved in forced breathing.

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Pons Function

Influenced by O₂/CO₂ requirements and controls volume & depth of ventilation.

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Airway resistance

Air distribution resistance that is uneven, and in normal individuals located in larger airways.

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Lung tissue

Lungs are elastic bags resembling balloons and lack muscle to contract themselves.

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Ventilation Volume

The volume of air entering or leaving the lungs per minute.

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Study Notes

  • The respiratory system covers the respiratory system anatomy, mechanisms of ventilation, respiration in health and disease, gaseous transport and the control of respiration.

Learning Outcomes

  • Identify the physiological stimuli that trigger control of ventilation and explain a stimuli's effect on depth and rate of breathing
  • Describe quiet breathing control with reference to receptors and pathways of communication
  • Explain different hypoxia types and apply them to everyday scenarios
  • Describe the control that occurs to return this back to normal breathing homeostasis
  • Explain forced breathing control with crosstalk between DRG and VRG areas

Control of Breathing

  • The average adult can hold their breath for 30-60 seconds
  • Breath holding relates more to blood-acidifying carbon dioxide build-up than lack of oxygen

Arterial Blood

  • Arterial Pco2, PO2, and pH are key for respiratory homeostasis and control.

Lung Perfusion

  • Blood is supplied via pulmonary and systemic circulations
  • Gas exchange depends on the alveolar distribution and blood flow in the lungs parts
  • Capillaries in the lungs measure 1,600 km if placed end to end
  • Lungs have low resistance
  • Lung are affected by gravity

Blood Supply

  • Blood goes from the right side of the heart to the rest of the body
  • The alveoli are surrounded by a network of capillaries
  • Lung has lobules supplied by an arteriole and venule
  • Alveolar capillaries' endothelial cells release Angiotensin Converting Enzyme (ACE).

Haemoglobin and Oxygen

  • Oxygen bound to Hb relies on plasma O2 and the amount of haemoglobin present

Carbon Dioxide Transport

  • CO2 is carried from tissues to the lungs
  • CO2 diffuses from cell to blood across the alveolar membrane because of the pressure gradient
  • CO2 is 24x more soluble than O2 and uses no carrier

Gas Transport

  • Lungs/cardiovascular system control carried blood
  • Hemoglobin binds 98% of O2, forming oxyhemoglobin HbO2
  • Oxygen binding to Hb is cooperative, increasing carrying capacity 70X
  • Binding one O2 molecule enables easier subsequent binding of molecules
  • PO2 determines Oxygen-Hb binding
  • Hemoglobin include iron core and 4 haem groups
  • Each haem group binds one molecule of O2

Haemoglobin Saturation

  • Pco2 measures 45mm Hg, pH measures 7.35-7.45, and a temperature of 37C
  • Hemoglobin saturation has a sigmoidal shape related to O2
  • The amount of O2 in the blood isn't affected in the lungs by PO2 fluctuations (100-60mm Hg)
  • The curve is steep at the tissues' PO2, having a larger effect on gas exchange to release CO2 from the tissues

Effect of pH

  • A shift in the hemoglobin saturation curve is the Bohr effect
  • Extended periods of low oxygen cause chronic hypoxia
  • H+ ions that bind hemoglobin molecules cause a shape change, decreasing the "grip" on O2 molecules
  • Decreasing pH (increasing H+ ions) reduce O2 saturation and makes shift in the dissociation curve

Respiratory Quotient

  • Respiratory Quotient (RQ) relates the carbon dioxide amount produced with the oxygen amount absorbed (VA/Q)
  • Steady state alveolar ventilation = PCO2
  • A value of infinity means ventilation and no perfusion
  • A value of 0 means perfusion but no ventilation
  • Steady state -actual values measure 0.7-1.0

2,3-Diphosphoglycerate (DPG)

  • 2,3-Diphosphoglycerate acts as inhibitor
  • 2,3-Diphosphoglycerate binds to Haemoglobin structure
  • 2,3-Diphosphoglycerate can trigger a curve shift the to right during exercise, drop in blood pH and with increase of thyroid hormones and growth hormone
  • Foetal Haemoglobin has poor binding of 2,3 DPG, supporting higher affinity for O2 than the mother

Carbon Dioxide Transport

  • 7% dissolved in blood, 70% converted to bicarbonate ions and 23% bound to hemoglobin
  • Carbonic anhydrase speeds up in the Cl- shift
  • Hemoglobin binds H+
  • Hb + CO2 = carbaminohemoglobin

What Controls Respiration?

  • Central pattern mechanism involves the medulla and fine-tuned by Pons
  • Voluntary mechanism involves the cerebral cortex, and influences respiratory center

Respiratory Centers

  • Severing the brainstem below the medulla triggers no breathing
  • Separating the medulla from the Pons can trigger gasping/irregular depth
  • The medulla supports primary control

Central Control

  • Sensory info is integrated in the Pons to fine tune signals to and from the respiratory center
  • Inspiratory and expiratory muscles are controlled by neurons in the medulla
  • The medulla serves as the pacemaker
  • The medulla coordinates quiet and forced breathing
  • The medulla controls ventilation frequency.
  • The Pons manages volume and depth of ventilation
  • The Pons is influenced by O2/CO2 requirements

Medulla Oblongata - Respiratory Control

  • Dorsal Respiratory Group (DRG) control the diaphragm and external intercostal muscles during inspiration and expiration in quiet breathing
  • Ventral Respiratory Group (VRG) controls accessory inspiratory and expiratory muscles during inspiration/expiration during forced breathing

Chemoreceptors and Baroreceptors

  • Chemoreceptors respond to changes in Pco2, Po2 and [H+]
  • Chemoreceptors are location in the central and peripheral locations
  • Chemoreceptors are effective in altering ventilation

Ventilation - Chemistry

  • Medulla responds to hypercapnia, or a increase of [H+] in the cerebral spinal fluid
  • Impacts the rate and depth of breathing

Central Chemoreceptors

  • Central chemoreceptors are located on the ventro-lateral surface of the medulla oblongata
  • Central chemoreceptors monitor composition of the cerebrospinal fluid (CSF)
  • Only respond to a rise in [H+] and Pco2
  • Stimulation by way of the DRG increases depth and rate of respiration

Affecting Chemoreceptors

  • Chronic CO2 retention reduces respiratory centre sensitivity
  • H+ is also increased by non-respiratory causes like diabetic ketoacidosis
  • Sleep, age, narcotics, alcohol, anaesthetics and some drugs affect the chemoreceptors

Peripheral Chemoreceptors

  • Peripheral chemoreceptors are located in the carotid body and aortic arch
  • The carotid body and aortic arch feature high blood flow

Peripheral Chemoreceptors

  • Respond to low arterial PO2, known as Hypoxia
  • Decreased PO2 triggers firing and increased ventilation
  • Anemia (low O2 carrying capacity) does not trigger in this case because dissolved PO2 is the same

Firing of Peripheral Chemoreceptors

  • Chemoreceptors only switch on when PO2 gets below 60 mm Hg in oxygenated blood
  • Decreased PO2 is not as powerful as increased PCO2 for respiration as a stimulator
  • Main control comes from central chemoreceptors with altered pH

Peripheral Chemoreceptors

  • At high altitudes, alveolar PO2 can get below 40 mm Hg, increasing ventilation and affecting the oxygen loading into the blood

Other Stimulators

  • Peripheral chemoreceptors also react to vascular stasis, cyanide, nicotine and increases in [K+]

Baroreceptors

  • Afferent fibres in the carotid sinuses, aortic arch, atria and ventricles, stimulated by↑ blood pressure
  • Impulses inhibit respiration via respiratory centre in medulla
  • Decreasesiing BP triggers increased ventilation
  • Increasing BP triggers decreased ventilation
  • Overall, the influence is very minor

Ventilation

  • Lungs act as elastic bags resembling balloons
  • Lungs lack muscle to expand/contract themselves

Ventilation Rate

  • At rest, ventilation rate occurs between 12 and 15 breaths per minute with ~500 mLs of air at each breath, roughly 6L per minute
  • Children tend to breathe faster
  • Involves anatomical dead space
  • Increasing CO2 increases ventilation
  • Decreasing CO2 decreases ventilation

Spirometry

  • Ventilation of alveoli relies on tidal volume, airway resistance and compliance

Ventilation - Compliance/Airway Resistance

  • Compliance measures ease in lung expansion
  • Distribution of air in lungs is uneven
  • Airway resistance to airflow in a normal individual is in larger airways
  • Disease airway resistance can occur in peripheral airways

Neural Control of Breathing

  • Complex distribution and organization occurs at the respiratory centre
  • Upper motor neurones drive the lower motor neurones
  • Travel in the corticospinal tract support with consciously changing breathing patterns

Ventilation - Inhalation

  • Inhalation involves the diaphragm flattening, external intercostal muscles contracting
  • Inhalation increases thoracic cavity volume and expands lungs
  • Air flows down a pressure gradient into lungs

Control of Normal Quiet Breathing

  • The Dorsal respiratory group (DRG) is active for 2 seconds and the inactive for 3 seconds.
  • Diaphragm contracts with external intercostal muscles during their phase
  • Diaphragm then relaxes with external intercostal muscles being less active
  • Lungs recoil as a result.

Control of Forced Breathing

  • Dorsal respiratory group (DRG) contracts diaphragm and external intercostal muscles
  • Ventral respiratory group (VRG) activates accessory muscles

Forced Breathing

  • Baroreceptors in the DRG, Inspiratory VRG and Expiratory VRG help with forced breathing as well as Chemoreceptors

Stretch Receptors

  • Stretch receptors in muscular walls of bronchi/bronchiole prevent over-inflation
  • They reflect lung volume
  • Respond in the lungs to inflation, in respiratory centre neurones go via the vegus nerve
  • Occurs with forced breathing ONLY
  • Stimulate the VRG and apneustic centre to stimulate expiration

Airway Pharmacology

  • Airways have afferent (sensory) and efferent (motor) nerves
  • Airways also have cholinergic and noradrenergic innervation

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