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DR NILESH KATE
MBBS,MD
ASSOCIATE PROF
DEPT. OF PHYSIOLOGY
REGULATION
OF
RESPIRATION.
OBJECTIVES
 Introduction.
 Neural Regulation.
 Automatic control.
 Afferent impulses to respiratory centre.
 Chemical regulation.
 Chemoreceptors.
 Effect of pO2, pCO2 & H+ ion conc on respiration.
 Applied aspects.
Friday, June 17, 2016
INTRODUCTION.
 The normal rate of respiration in
adults is 12-18/min,
 Tidal volume of approx. 500 ml.
 Adjusted to the requirements of
the body.
 Spontaneous respiration -
rhythmic discharge of motor
neurons that innervate the
respiratory muscles.
Friday, June 17, 2016
CONTROL MECHANISMS.
 Automatic control as
an involuntary
function.
 Located in medullary
& pontine centres.
 Functional
significance – breath
without conscious
effort as in sleep.
Friday, June 17, 2016
CONTROL MECHANISMS.
 Voluntary control.
 Located in cerebral
cortex.
 Functional
significance – facilitate
acts like talking, singing,
swimming, laughing,
breath holding &
hyperventilation.
Friday, June 17, 2016
FUNCTIONS OF RESPIRATORY
CENTRES.
 Genesis of normal
respiratory
spontaneous rhythm.
 Control rate & depth
of respiration.
Friday, June 17, 2016
REGULATION.
 Neural
 Automatic control.
 Afferent impulses to respiratory centre.
 Chemical.
 Chemoreceptors
 Effect of Po2, Pco2 &pH.
Friday, June 17, 2016
AUTOMATIC CONTROL.
 Medullary respiratory
centres.
 Pontine respiratory
centre.
 Reticular activating
system.
Friday, June 17, 2016
MEDULLARY RESPIRATORY
CENTRES.
 Dorsal respiratory
group of neurons.
 Ventral respiratory
group of neurons.
Friday, June 17, 2016
DORSAL RESPIRATORY GROUP OF
NEURONS..
 NTS (Nucleus of Tractus
Solitarius)
 I neurons – Discharge
during inspiration only.
Friday, June 17, 2016
CENTRAL INSPIRATORY
ACTIVITY NEURONS.(RΑ)
 Central inspiratory
activity neurons.(Rα)
 Inspiratory pump.
 Ramp signal.
 Inspiratory off-switch
(IOS) neurons.
 Terminate inspiratory
Ramp.
 Integrator neurons. (Rβ)
 Other neurons.(P cells)
Friday, June 17, 2016
INTEGRATOR NEURONS. (RΒ)
 Excitatory inputs.
 Cerebral cortex.
 Pneumotaxic
centre.
 Vagal afferents
from stretch
receptors.
 Inhibitory inputs.
 Apneustic centre.
Friday, June 17, 2016
VENTRAL RESPIRATORY GROUP
OF NEURONS.
 Caudal part or nucleus
Retroambigualis
(NRA)
 E neurons
 Bulbospinal expiratory
Premotor neurons.
 Intermediate part.
 I neurons.
 N. Parambigualis
 Most Rostral part.(NRF)
 Botzinger complex (E
neurons)
Friday, June 17, 2016
VENTRAL RESPIRATORY GROUP
OF NEURONS.
 Interactions of I & E
neurons.
 Role of VRG neurons.
 Totally inactive in
quiet breathing.
 Active during forceful
respiration.
 Example -- During
exercise
 Reciprocal
innervations.
Friday, June 17, 2016
PONTINE RESPIRATORY
CENTRE.
 Apneustic Centre (APN)
 Inhibitory neurons
bilaterally in pons.
 APN – Integrator – IOS
 Prevent switch off of ramp
from CIA
 Increases depth & duration
– Apneusis.
 Normally kept inhibited by
vagus & Pneumotaxic centre
Friday, June 17, 2016
PONTINE RESPIRATORY
CENTRE.
 Pneumotaxic centre.
(PNC)
 In N. Parabrachialis in
upper pons.
 Excite integrator N &
inhibits Apneustic C.
 Increases rate of breathing.
 So Rhythm by DRG, rate &
depth controlled by
APN,PNC.
Friday, June 17, 2016
RETICULAR ACTIVATING
SYSTEM.
 Increases respiratory
drive.
 During sleep – RAS
activity decreases –
respiratory drive
decreases – alveolar
ventilation decreases
– raise Pco2.
Friday, June 17, 2016
AFFERENT IMPULSES TO
RESPIRATORY CENTRE.
 From higher centre.
 From non-chemical receptors.
 From chemical receptors.
Friday, June 17, 2016
Friday, June 17, 2016
FROM HIGHER CENTRE.
 Voluntary control
system.
 Controlled by Neocortex
 Bypasses medullary
respiratory centres &
project directly to spinal
respiratory neurons.
 For talking, singing,
swimming & breath
holding.
 Limbic control
system.
 Limbic system –
pontomedullary
respiratory neurons.
 So alter during pain &
emotional stimuli.
Friday, June 17, 2016
FROM NON-CHEMICAL RECEPTORS.
 From Pulmonary stretch receptors (Hering-
Breuer Reflex)
 From J-Receptors.
 From Irritant receptors in the respiratory tract.
 From Proprioceptors..
 From Chest wall stretch receptors.
 From Baroceptors.
 From Thermoceptors.
Friday, June 17, 2016
Friday, June 17, 2016
FROM PULMONARY STRETCH RECEPTORS
(HERING-BREUER REFLEX)
 Lung inflation –
stimulation of
stretch receptors in
bronchi & bronchioles
– vagi –
pontomedullary
respiratory centers –
inhibit respiration.
 Only when TV > 1-1.5L
Friday, June 17, 2016
Friday, June 17, 2016
Friday, June 17, 2016
FROM J-RECEPTORS.
 Indian physiologist A.S
Paintal 1954.
 Juxtapulmonary capillary
receptors. (unmyelinated
vagal afferents)
 Sensitive to increase in
content of interstitial fluid
between capillary
endothelium & alveolar
epithelium.
 Stimulation causes
apnoea,
hyperventilation,
bradycardia ,
hypotension &
weakness of skeletal
muscles.
Friday, June 17, 2016
FROM IRRITANT RECEPTORS IN
THE RESPIRATORY TRACT.
 Cough reflex.
 Sneezing reflex.
 Hering-Breuer
deflation reflex.
 Reflex tachypnoea &
bronchoconstriction.
 Deglutition reflex.
Friday, June 17, 2016
FROM PROPRIOCEPTORS.
 Stimulate inspiratory neurons – increase rate &
depth of respiration.
 Increases ventilation during exercise.
Friday, June 17, 2016
FROM CHEST WALL STRETCH
RECEPTORS.
 In muscle spindles of
intercostal muscles
 Co-ordinate breathing
during change in posture
& during speech.
 Intercostal to intercostal
reflex.
 Intercostal to Phrenic
reflex.
Friday, June 17, 2016
FROM BAROCEPTORS.
 Raise BP – stimulate
Baroreceptors in
carotid sinus & aortic
arch.
 Inhibition of
respiration.
Friday, June 17, 2016
FROM THERMOCEPTORS.
 2 types, warm & cold.
 Warm receptors – via
somatic afferent
nerves – cerebral
cortex –
hyperventilation.
(Heat loss mechanism)
 E.g. Panting in Dogs.
Friday, June 17, 2016
FROM CHEMICAL RECEPTORS.
CHEMORECEPTORS.
 Peripheral
 Central.
 Pulmonary & Myocardial.
Friday, June 17, 2016
PERIPHERAL CHEMORECEPTORS.
 Location - carotid bodies &
aortic bodies.
 Structure.
 Capsule – surrounding
bodies.
 Sinusoidal large capillaries
below capsule
 Epithelial cells – type I
(Glomus cells) like
chromaffin cells contains
catecholamine.
 Type II (Glial cells).
Friday, June 17, 2016
PERIPHERAL CHEMORECEPTORS.
 Mechanism
 Less Po2 – decreases
activity of K channels –
decrease K efflux –
depolarization of glomus
cells – open L-type ca
channels – Ca influx –
release neurotransmitter
& stimulate afferent
nerve.
Friday, June 17, 2016
FACTORS STIMULATING
 O2 tension V o2
content.
 Elevated Pco2
 H+ conc.
 Hyperkalemia.
 Asphyxia.
 Functions
 Carotid bodies
increases both rate &
depth, aortic bodies
only rate of
respiration.
Friday, June 17, 2016
CENTRAL CHEMORECEPTORS.
 Location – beneath
ventral surface of
medulla.
 Innervations –
project directly to
respiratory centres
deeper to central
chemoreceptors.
 Mechanism.
 Co2 crosses BBB – in
CSF
 co2 + H2O – H2CO3
 H2CO3 ------H+ HCO3
 H+ ion stimulate
central
chemoreceptors.
Friday, June 17, 2016
Friday, June 17, 2016
Friday, June 17, 2016
PULMONARY & MYOCARDIAL
CHEMORECEPTORS.
 Location – pulmonary &
coronary blood vessels.
 Innervations – by Vagus
(X) nerve.
 Characteristics & effects.
 Caused by injection of
veratridine or nicotine
 Causes – bradycardia,
hypotension, apnoea
followed by tachypnoea.
Friday, June 17, 2016
Friday, June 17, 2016
EFFECT OF PO2, PCO2 & H+ ION
CONC ON RESPIRATION.
Friday, June 17, 2016
EFFECT OF HYPOXIA
 Normal arterial Po2 is
100 mm Hg. Decrease
in Po2 causes Hypoxic
Hypoxia.
 A decrease in arterial
Po2
 Po2 100-60mm Hg. –
breaking effect of CO2.
 Po2 below 60 mm Hg.
Friday, June 17, 2016
EFFECT OF HYPERCAPNIA.
 Normal pco2 – 40 mm Hg.
 Effect of Hypercapnia.
 Co2 Narcosis when PCO2 >
50 mmHg.
 Leads to depress CNS,
Respiratory centre,
headache, confusion,
convulsion, coma & Death.
Friday, June 17, 2016
EFFECT OF ARTERIAL pH
 Increase H+ ion conc.
(metabolic acidosis)-
leads to
hyperventilation. In
DKA, renal failure,
severe exercise.
 Decrease H+ ion conc.
(metabolic alkalosis)
 Primary pulmonary
hypoventilation
causes respiratory
acidosis.
 Primary pulmonary
Hyperventilation
causes respiratory
alkalosis.
Friday, June 17, 2016
EFFECT OF HYPERVENTILATION.
 Hypoventilation.
 Apnoea.
 Periodic breathing
(chynes-stokes
breathing)
Friday, June 17, 2016
EFFECT OF SLEEP ON
RESPIRATION.
 Apnoea for brief
period (10 sec)
 Sleep apnoea
syndrome.
Friday, June 17, 2016
Thank
You

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REGULATION OF RESPIRATION

  • 1. DR NILESH KATE MBBS,MD ASSOCIATE PROF DEPT. OF PHYSIOLOGY REGULATION OF RESPIRATION.
  • 2. OBJECTIVES  Introduction.  Neural Regulation.  Automatic control.  Afferent impulses to respiratory centre.  Chemical regulation.  Chemoreceptors.  Effect of pO2, pCO2 & H+ ion conc on respiration.  Applied aspects. Friday, June 17, 2016
  • 3. INTRODUCTION.  The normal rate of respiration in adults is 12-18/min,  Tidal volume of approx. 500 ml.  Adjusted to the requirements of the body.  Spontaneous respiration - rhythmic discharge of motor neurons that innervate the respiratory muscles. Friday, June 17, 2016
  • 4. CONTROL MECHANISMS.  Automatic control as an involuntary function.  Located in medullary & pontine centres.  Functional significance – breath without conscious effort as in sleep. Friday, June 17, 2016
  • 5. CONTROL MECHANISMS.  Voluntary control.  Located in cerebral cortex.  Functional significance – facilitate acts like talking, singing, swimming, laughing, breath holding & hyperventilation. Friday, June 17, 2016
  • 6. FUNCTIONS OF RESPIRATORY CENTRES.  Genesis of normal respiratory spontaneous rhythm.  Control rate & depth of respiration. Friday, June 17, 2016
  • 7. REGULATION.  Neural  Automatic control.  Afferent impulses to respiratory centre.  Chemical.  Chemoreceptors  Effect of Po2, Pco2 &pH. Friday, June 17, 2016
  • 8. AUTOMATIC CONTROL.  Medullary respiratory centres.  Pontine respiratory centre.  Reticular activating system. Friday, June 17, 2016
  • 9. MEDULLARY RESPIRATORY CENTRES.  Dorsal respiratory group of neurons.  Ventral respiratory group of neurons. Friday, June 17, 2016
  • 10. DORSAL RESPIRATORY GROUP OF NEURONS..  NTS (Nucleus of Tractus Solitarius)  I neurons – Discharge during inspiration only. Friday, June 17, 2016
  • 11. CENTRAL INSPIRATORY ACTIVITY NEURONS.(RΑ)  Central inspiratory activity neurons.(Rα)  Inspiratory pump.  Ramp signal.  Inspiratory off-switch (IOS) neurons.  Terminate inspiratory Ramp.  Integrator neurons. (Rβ)  Other neurons.(P cells) Friday, June 17, 2016
  • 12. INTEGRATOR NEURONS. (RΒ)  Excitatory inputs.  Cerebral cortex.  Pneumotaxic centre.  Vagal afferents from stretch receptors.  Inhibitory inputs.  Apneustic centre. Friday, June 17, 2016
  • 13. VENTRAL RESPIRATORY GROUP OF NEURONS.  Caudal part or nucleus Retroambigualis (NRA)  E neurons  Bulbospinal expiratory Premotor neurons.  Intermediate part.  I neurons.  N. Parambigualis  Most Rostral part.(NRF)  Botzinger complex (E neurons) Friday, June 17, 2016
  • 14. VENTRAL RESPIRATORY GROUP OF NEURONS.  Interactions of I & E neurons.  Role of VRG neurons.  Totally inactive in quiet breathing.  Active during forceful respiration.  Example -- During exercise  Reciprocal innervations. Friday, June 17, 2016
  • 15. PONTINE RESPIRATORY CENTRE.  Apneustic Centre (APN)  Inhibitory neurons bilaterally in pons.  APN – Integrator – IOS  Prevent switch off of ramp from CIA  Increases depth & duration – Apneusis.  Normally kept inhibited by vagus & Pneumotaxic centre Friday, June 17, 2016
  • 16. PONTINE RESPIRATORY CENTRE.  Pneumotaxic centre. (PNC)  In N. Parabrachialis in upper pons.  Excite integrator N & inhibits Apneustic C.  Increases rate of breathing.  So Rhythm by DRG, rate & depth controlled by APN,PNC. Friday, June 17, 2016
  • 17. RETICULAR ACTIVATING SYSTEM.  Increases respiratory drive.  During sleep – RAS activity decreases – respiratory drive decreases – alveolar ventilation decreases – raise Pco2. Friday, June 17, 2016
  • 18. AFFERENT IMPULSES TO RESPIRATORY CENTRE.  From higher centre.  From non-chemical receptors.  From chemical receptors. Friday, June 17, 2016
  • 20. FROM HIGHER CENTRE.  Voluntary control system.  Controlled by Neocortex  Bypasses medullary respiratory centres & project directly to spinal respiratory neurons.  For talking, singing, swimming & breath holding.  Limbic control system.  Limbic system – pontomedullary respiratory neurons.  So alter during pain & emotional stimuli. Friday, June 17, 2016
  • 21. FROM NON-CHEMICAL RECEPTORS.  From Pulmonary stretch receptors (Hering- Breuer Reflex)  From J-Receptors.  From Irritant receptors in the respiratory tract.  From Proprioceptors..  From Chest wall stretch receptors.  From Baroceptors.  From Thermoceptors. Friday, June 17, 2016
  • 23. FROM PULMONARY STRETCH RECEPTORS (HERING-BREUER REFLEX)  Lung inflation – stimulation of stretch receptors in bronchi & bronchioles – vagi – pontomedullary respiratory centers – inhibit respiration.  Only when TV > 1-1.5L Friday, June 17, 2016
  • 26. FROM J-RECEPTORS.  Indian physiologist A.S Paintal 1954.  Juxtapulmonary capillary receptors. (unmyelinated vagal afferents)  Sensitive to increase in content of interstitial fluid between capillary endothelium & alveolar epithelium.  Stimulation causes apnoea, hyperventilation, bradycardia , hypotension & weakness of skeletal muscles. Friday, June 17, 2016
  • 27. FROM IRRITANT RECEPTORS IN THE RESPIRATORY TRACT.  Cough reflex.  Sneezing reflex.  Hering-Breuer deflation reflex.  Reflex tachypnoea & bronchoconstriction.  Deglutition reflex. Friday, June 17, 2016
  • 28. FROM PROPRIOCEPTORS.  Stimulate inspiratory neurons – increase rate & depth of respiration.  Increases ventilation during exercise. Friday, June 17, 2016
  • 29. FROM CHEST WALL STRETCH RECEPTORS.  In muscle spindles of intercostal muscles  Co-ordinate breathing during change in posture & during speech.  Intercostal to intercostal reflex.  Intercostal to Phrenic reflex. Friday, June 17, 2016
  • 30. FROM BAROCEPTORS.  Raise BP – stimulate Baroreceptors in carotid sinus & aortic arch.  Inhibition of respiration. Friday, June 17, 2016
  • 31. FROM THERMOCEPTORS.  2 types, warm & cold.  Warm receptors – via somatic afferent nerves – cerebral cortex – hyperventilation. (Heat loss mechanism)  E.g. Panting in Dogs. Friday, June 17, 2016
  • 32. FROM CHEMICAL RECEPTORS. CHEMORECEPTORS.  Peripheral  Central.  Pulmonary & Myocardial. Friday, June 17, 2016
  • 33. PERIPHERAL CHEMORECEPTORS.  Location - carotid bodies & aortic bodies.  Structure.  Capsule – surrounding bodies.  Sinusoidal large capillaries below capsule  Epithelial cells – type I (Glomus cells) like chromaffin cells contains catecholamine.  Type II (Glial cells). Friday, June 17, 2016
  • 34. PERIPHERAL CHEMORECEPTORS.  Mechanism  Less Po2 – decreases activity of K channels – decrease K efflux – depolarization of glomus cells – open L-type ca channels – Ca influx – release neurotransmitter & stimulate afferent nerve. Friday, June 17, 2016
  • 35. FACTORS STIMULATING  O2 tension V o2 content.  Elevated Pco2  H+ conc.  Hyperkalemia.  Asphyxia.  Functions  Carotid bodies increases both rate & depth, aortic bodies only rate of respiration. Friday, June 17, 2016
  • 36. CENTRAL CHEMORECEPTORS.  Location – beneath ventral surface of medulla.  Innervations – project directly to respiratory centres deeper to central chemoreceptors.  Mechanism.  Co2 crosses BBB – in CSF  co2 + H2O – H2CO3  H2CO3 ------H+ HCO3  H+ ion stimulate central chemoreceptors. Friday, June 17, 2016
  • 39. PULMONARY & MYOCARDIAL CHEMORECEPTORS.  Location – pulmonary & coronary blood vessels.  Innervations – by Vagus (X) nerve.  Characteristics & effects.  Caused by injection of veratridine or nicotine  Causes – bradycardia, hypotension, apnoea followed by tachypnoea. Friday, June 17, 2016
  • 41. EFFECT OF PO2, PCO2 & H+ ION CONC ON RESPIRATION. Friday, June 17, 2016
  • 42. EFFECT OF HYPOXIA  Normal arterial Po2 is 100 mm Hg. Decrease in Po2 causes Hypoxic Hypoxia.  A decrease in arterial Po2  Po2 100-60mm Hg. – breaking effect of CO2.  Po2 below 60 mm Hg. Friday, June 17, 2016
  • 43. EFFECT OF HYPERCAPNIA.  Normal pco2 – 40 mm Hg.  Effect of Hypercapnia.  Co2 Narcosis when PCO2 > 50 mmHg.  Leads to depress CNS, Respiratory centre, headache, confusion, convulsion, coma & Death. Friday, June 17, 2016
  • 44. EFFECT OF ARTERIAL pH  Increase H+ ion conc. (metabolic acidosis)- leads to hyperventilation. In DKA, renal failure, severe exercise.  Decrease H+ ion conc. (metabolic alkalosis)  Primary pulmonary hypoventilation causes respiratory acidosis.  Primary pulmonary Hyperventilation causes respiratory alkalosis. Friday, June 17, 2016
  • 45. EFFECT OF HYPERVENTILATION.  Hypoventilation.  Apnoea.  Periodic breathing (chynes-stokes breathing) Friday, June 17, 2016
  • 46. EFFECT OF SLEEP ON RESPIRATION.  Apnoea for brief period (10 sec)  Sleep apnoea syndrome. Friday, June 17, 2016