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RESPIRATION
By
Dr. M. Anthony David, MD
Professor of Physiology
RESPIRATORY CONTROL: A
SCHEMA
SENSORS
RECEPTORS
F INPUT
E
E
D
CENTER
F
E
B E
OUTPUT
A D
C B EFFECTORS
K A
C
K
VENTILATION
PONTO MEDULLARY
RESPIRATORY CENTERS
EXPIRATORY NEURONS
INFERIOR COLLICULUS
PNEUMOTAXIC CENTER
MEDULLA
OBLONGATA PRE BOTTZINGER COMPLEX
DORSAL GROUP OF R NEURONS
VENTRAL GROUP OF R NEURONS
SPINAL CORD
RESPIRATORY CENTERS
1. PNEUMOTAXIC CENTER:
• Location: Upper Pons
• Absence causes APNEUSTIC
BREATHING (Esp when the vagi are
cut)
• Curtails inspiratory activity & thus can
increase the rate of respiration
APNEUSTIC CENTER
Location: Lower Pons
Stimulates the Inspiratory Center
and increases Inspiration
Gets feed back from Vagi & other
Centers.
MEDULLARY RESPIRATORY
CENTERS
DORSAL GROUP VENTRAL GROUP
Neurons diffusely Has both
located in the NTS Inspiratory &
All neurons are of Expiratory neurons
the Inspiratory Expiratory neurons
type found at Caudal &
Generates the Rostral ends.
Inspiratory Ramp Inspiratory neurons
Signal found in the central
Is autorhythmic area.
RESPIRATORY CONTROL
ORGANIZATION:MODERN CONCEPT
INSPIRATION
DECREASED TIME
FOR INSPIRATION
STRETCH OF THE AIRWAYS
INCREASED
RESPIRATORY RATE
HB INFLATION REFLEX
I
N
S
P
I
R
A
T
I
O
N
T
I 0.5 lts 1.0 Ltrs 1.5 lts 2.0 lts 2.5 lts 3.0lts 3.5lts
M
TIDAL VOLUME in Liters
E
HB DEFLATION REFLEX
Excessive deflation of the lungs
causes Inspiration.
This reflex prevents Atelectasis.
Atelectasis is the collapse of the
lungs.
This reflex also opens up collapsed
portions of the lung.
CHEMICAL CONTROL:THE
THREE MAIN ‘CHEMICALS’
OXYGEN
• PO2 levels in blood.
CARBON DIOXIDE:
• PCO2 levels in blood.
HYDROGEN ION:
• Concentration in blood.
CO2 & [H+] act centrally while the
Oxygen levels act on the peripheral
chemoreceptors.
RESPIRATORY
CHEMORECEPTORS
CENTRAL:
CHEMORECEPTOR ZONE:
• BILATERAL
• LOCATED IN THE MEDULLA
• JUST BENEATH IT’S VENTRAL SURFACE
• HIGHLY SENSITIVE TO PCO2 AND [H+]
FUNCTIONS BY STIMULATING THE
RESPIRATORY CENTERS:
• DRG,VRG & PTC.
CENTRAL
CHEMORECEPTORS
PRIMARY STIMULUS:
• [H+]
PERHAPS THE ONLY IMPORTANT
DIRECT STIMULUS FOR THE CENTRAL
CHEMORECEPTOR CELLS (MEDULLARY
CHEMORECEPTORS)
But these ions do not cross the Blood
Brain Barrier
So, the blood PCO2 level has more
effect as CO2 readily crosses the BBB.
STIMULATION BY
CARBONDIOXIDE
Is not direct.
Even the indirect effect of CO2 is most
potent. Why?
Because CO2 easily crosses the BBB.
Once it is across the BBB,
CO2 + H2O H2CO3 H+ + HCO3-
These increased H+ ions in the brain
stimulate the medullary
chemoreceptors.
QUANTITATIVE EFFECT OF
H+ IONS
The stimulatory effect of H+ ions
increases in the first few hours.
It then decreases in the next 1 to 2
days.
It comes down to about 1/5th the
initial effect.
This is due to Renal readjustment of
[H+] in the circulating blood.
QUANTITATIVE EFFECT OF
H+ IONS
The kidneys increase blood HCO3.
This bicarbonate binds with the free
H+ ions in the blood & decreases their
concentration.
Bicarbonate also diffuses slowly past
the BBB and decreases the H+ ions in
the brain.
Therefore the effect of H+ ions is:
• POTENT: Acutely
• WEAK : Chronically.
EFFECT OF CO2
Change in PCO2 between 35 to
75mmHg causes peak increase in
alveolar ventilation.