REGULATION OF RESPIRATION

By Dr. M. Anthony David, MD Professor of Physiology

RESPIRATORY CONTROL: A SCHEMA
SENSORS RECEPTORS
F E E D B A C K INPUT

CENTER
F E E D B A C K

OUTPUT

EFFECTORS

VENTILATION

PONTO MEDULLARY RESPIRATORY CENTERS
ALL ARE PAIRED & INTERCONNECTED

INSPIRATORY NEURONS EXPIRATORY NEURONS INFERIOR COLLICULUS PNEUMOTAXIC CENTER PONS MEDULLA OBLONGATA APNEUSTIC CENTER 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 Neurons diffusely located in the NTS All neurons are of the Inspiratory type Generates the Inspiratory Ramp Signal Is autorhythmic

VENTRAL GROUP Has both Inspiratory & Expiratory neurons Expiratory neurons found at Caudal & Rostral ends. Inspiratory neurons found in the central area.

RESPIRATORY CONTROL ORGANIZATION:MODERN CONCEPT

All the respiratory centers are termed as the BULBOPONTINE RESPIRATORY NEURONAL COMPLEX There is an inspiratory ramp generator called Respiratory Control Pattern Generator: Pre Bottzinger Complex

RESPIRATORY CONTROL ORGANIZATION:MODERN CONCEPT

The Inspiratory Off switch(IOS) is fine tuned by PTC & the chemoreceptor drive. Both Neural & Chemical controls are well coordinated.

PERIPHERAL INFLUENCES ON RESPIRATORY CONTROL

LUNG OR PULMONARY RECEPTORS:
• Receptors in and around the lungs.

CHEMORECEPTORS
• Peripheral Chemoreceptors • Central Chemoreceptors.

PERIPHERAL INFLUENCES

The four influences from the lungs are:
• Pulmonary stretch receptors • Lung irritant receptors • J receptors • Proprioceptors

Along with the chemoreceptors, these receptors send information to the respiratory centers.

HERING BREUER(HB) REFLEX
 

It is a ‘Volume’ reflex. Receptors are located in between the smooth muscles of the small airways. These receptors are unmyelinated nerve endings. They are stimulated by the change of shape of the Airways.

HB INFLATION REFLEX
A NEGATIVE FEEDBACK SERVOCONTROL SYSTEM

INSPIRATION TIDAL VOLUME >1lt 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 M E
0.5 lts 1.0 Ltrs 1.5 lts 2.0 lts 2.5 lts 3.0lts 3.5lts

TIDAL VOLUME in Liters

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+ + HCO3These 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. Change in the normal range causes less than tenth of change in alveolar ventilation.

EFFECT OF OXYGEN

The partial pressure of Oxygen has no effect on the medullary chemoreceptors. It only has an effect on the peripheral chemoreceptors.

PERIPHERAL CHEMORECEPTORS

There are two pairs of chemoreceptors: • Aortic Bodies: located at the arch of aorta. • Carotid bodies: located at the branching of the common carotid arteries. Their functions are: • To detect changes in the PO2 • To transmit nervous signals to the Respiratory Centers.

PERIPHERAL CHEMORECEPTORS
 

These bodies have two types of special cells called glomus cells. The type 2 glomus cells have special ion channels sensitive to PO2. They fire the nerve endings and send signals via: • Aortic bodies: Vagi. • Carotid bodies: Hering nerve & Glossopharyngeal nerve.

PERIPHERAL CHEMORECEPTORS

Both these bodies receive their own special blood supply through minute arteries, directly from the trunk. Their blood flow is roughly 20 times their own weight. THEY ARE ALL THE TIME EXPOSED ONLY TO ARTERIAL BLOOD.  PO2 stimulates these chemoreceptors strongly.

ARTERIAL PO2 & IMPULSES IN AORTIC BODY

 PO2 especially between 60 and 30mm Hg strongly stimulates the carotid bodies. This is the range wherein the Hb saturation decreases.

EFFECT OF PO2
 

When PCO2 & [H+] are kept constantly normal, There is no effect if the PO2 is >100mmHg If it falls below 100mmHg, ventilation doubles upto 60 mmHg. It increases upto 5 times at very low PO2 levels

CO2 & H
 

+

They also stimulate the peripheral chemoreceptors. But their effects on the central or medullary chemoreceptors are more powerful. PCO2 stimulates the peripheral chemoreceptors 5 times as rapidly as it stimulates the central ones. So this is responsible for the rapid response to CO2 at the onset of exercise.