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Lesson 7

Objectives • Identify where in the brain the basic rhythm of is generated.

• Specify the key sources of sensory information to the medullary that modify its output to the respiratory muscles.

• Provide examples of modification arising from pontine structures . central & peripheral

• Describe the sequence of events by which changes in

arterial levels PCO2, PO2 & pH stimulate ventilation.

5) Explain why increases in arterial hydrogen ion concentration do not stimulate the .

Respiration Lesson 7

• What is it that the respiratory control system controls?

• What is the primary drive to breathe in man at rest?

• What is the primary stimulus to increase ventilation during exercise?

1 Control of Breathing

Components of the neural control system What is controlled?

respiratory center : medulla

respiratory muscles

movement of chest wall & ventilation alveolar-capillary membrane

arterial PCO2 , PO2 , pH

Control of Breathing

Respiratory Centres in the establish a rhythmic breathing pattern

Whereas the heart can generate its own rhythm due to intrinsic pacemaker activity, the respiratory muscles are skeletal and are innervated by spinal nerves which require neural stimulation.

The rhythmic neural activity that establishes the normal breathing pattern arises in the PreBötzinger medulla complex

2 Control of Breathing

Breathing Is Initiated in the Medulla

The Medullary Respiratory Centres consist of the:

PreBötzinger Complex Most researchers currently believe that this is the source of the respiratory rhythm

PreBötzinger complex

Control of Breathing

Breathing Is Initiated in the Medulla The Medullary Respiratory Centres consist of the:

Dorsal Respiratory Group These cells reside in the nucleus tractus solitarius. They receive sensory information from lung mechanoreceptors and peripheral arterial chemoreceptors which they relay to the PreBötzinger Complex They receive motor output from PreBötzinger the PreBötzinger Complex which complex they relay to the phrenic motor nucleus (which resides in the 3rd, 4th and 5th cervical segments of the spinal cord

3 Control of Breathing

PreBötzinger complex

The Diaphragram Is Innervated by Phrenic Nerves

Control of Breathing

Breathing Is Initiated in the Medulla The Medullary Respiratory Centres consist of the:

Ventral Respiratory Group

Receives motor output from the PreBötzinger Complex which it relays to the motor nuclei of the intercostal and abdominal muscles in the thoracic and lumbar segments of the spinal PreBötzinger cord complex

4 Control of Breathing

PreBötzinger complex

The Intercostal Muscles are Innervated by Thoracic Spinal Nerves

Control of Breathing

Hering-Breuer Reflex

respiratory center : medulla

spinal cord mechanoreceptors

respiratory muscles

movement of chest wall & lungs ventilation

Mechanoreceptors in the lungs (pulmonary stretch receptors = PSR) sense the rate and volume of inflation and act to prevent the lungs from over inflating. They act to terminate inspiration and promote expiration.

5 Control of Breathing

Breathing Is Initiated in the Medulla The Medullary Respiratory Centres consist of the:

Pneumotaxic Centre

These provide a tonic excitatory input to the PreBötzinger Complex

They also act like the PSR and serve to help terminate inspiration and promote expiration PreBötzinger complex

Control of Breathing

Breathing Is Initiated in the Medulla The Medullary Respiratory Centres consist of the:

Apneustic Centre

There is no apneustic centre

However, if the pneumotaxic centre is removed along with input from the PSR, a pattern of prolonged inspiratory gasps occurs called apneusis

PreBötzinger If the is then removed, complex breathing returns towards a normal pattern

6 Control of Breathing

Pons

respiratory center : medulla chemoreceptor

spinal cord mechanoreceptors

respiratory muscles

movement of chest wall & lungs ventilation alveolar-capillary membrane gas exchange

PCO2 , PO2 , pH

Control of Breathing

CHEMORECEPTORS

• peripheral chemoreceptors

• central chemoreceptors

7 Control of Breathing

Peripheral Chemoreceptors

Carotid Bodies

& Aortic Bodies*

Control of Breathing

Note:

These receptors do not begin to

respond strongly until PO2 falls below 60 mmHg (i.e. they are not strongly stimulated during resting breathing at sea level)

Remember - this corresponds to the plateau region of the equilibrium curve

8 Control of Breathing

Thus these receptors do not begin to stimulate breathing strongly until Hb begins to desaturate significantly

Large decreases in O2 act on other nervous tissue to reduce activity – which could set up a vicious cycle of respiratory depression if not for the action of the carotid bodies

Control of Breathing

Peripheral Chemoreceptors

9 Control of Breathing

CO2/pH Chemoreceptors

PreBötzinger complex

CO2/pH provides the primary stimulus to breathe at rest acting via both peripheral and central chemoreceptors

Control of Breathing

Central Chemoreceptors

The central chemoreceptors are located a few millimeters below the ventral surface of the medulla

stimulated by: small changes (few mm Hg) in

arterial PCO2 via the associated changes in [H+] in the brain ECF

PreBötzinger complex

10 Control of Breathing

Peripheral Chemoreceptors

Peripherally, CO2/pH acts on the same chemoreceptor cells in

the as O2.

The peripheral receptors provide a rapid initial response

to changes in arterial CO2/pH until the central receptors take over and provide a sustained response.

Control of Breathing

CO2 Chemoreceptors

2 3 sustained response

1

Rapid, initial response

11 Control of Breathing

CO2 Chemoreceptors

Despite the fact both peripheral and central chemoreceptors respond to change in pH – the response to changes in arterial pH are due exclusively to stimulation of the peripheral chemoreceptors

Control of Breathing

12 Control of Breathing

Examples of Non-co2 (Metabolic) Acidosis That Stimulate Ventilation Through Peripheral Chemoreceptors

• In health: lactic acidosis of intense exercise

• In disease states: ketoacidosis in diabetes mellitus

Control of Breathing

Chemoreceptors & Negative Feedback

13 Control of Breathing

Exercise alters ventilation through a variety of different means

1) Blood gases usually do not change

2) Feedforward from locomotor control centres 3) Reflexes originating from joints and muscle receptors (neural and humoral)

4) Increases in body temperature

5) Release of epinephrine

Control of Breathing

Ventilation can be influenced by factors other than the need for gas exchange

higher brain regions Pons

respiratory center : MEDULLA chemoreceptor

mechanoreceptors spinal cord respiratory muscles

movement of chest wall & lungs ventilation alveolar-capillary membrane gas exchange

arterial blood PCO2 , PO2 , pH

14