Lecture 3, neural and chemical control of breathing

Page 1: Overview

  • Key structures involved in respiration: Hypothalamus, Midbrain, Cerebellum, Pituitary Gland, Pneumotaxic Area, Apneustic Area, Dorsal Respiratory Group (DRG), Medulla, and Ventral Respiratory Group (VRG).

  • Presented by Dr. Lucy Privitera.

Page 2: Learning Objectives

  1. Brainstem Role: Discuss the organization and function of respiratory centers in controlling ventilation.

  2. Sensors and Effectors: Explain the sensors and effectors involved in neural and chemical control of ventilation.

  3. CO2-HCO3 Buffer System: Describe its role in chemical control of breathing and pH homeostasis.

  4. Chemoreceptors: Compare the location, function, innervation, and differences between peripheral and central chemoreceptors.

  5. Graph Interpretation: Analyze how changes in arterial oxygen (PaO2) and carbon dioxide (PaCO2) levels affect ventilation.

Page 3: Homeostatic Control of Breathing

  • Major components include the Medulla, Pons, Spinal Cord.

  • Control System: Utilizes Peripheral and Central Chemoreceptors for sensing, and involves respiratory muscles, including the diaphragm.

  • Receptor/Effectors: Mechanoreceptors and chemoreceptors help maintain balance in breathing.

Page 4: Nervous System Control Overview

  • Ventilation Control: Managed by groups of neurons in the brainstem (Medulla and Pons).

  • Neuronal Groups:

    1. Dorsal Respiratory Group (DRG)

    2. Ventral Respiratory Group (VRG)

    3. Apneustic Center

    4. Pneumotaxic Center

Page 5: Nervous System Control of Ventilation (Continued)

  • Reiterates neuron groups affecting breathing control.

  • Emphasizes the divisions within the brainstem affecting respiratory regulation.

Page 6: Pattern Generator in Ventilation Control

  • Basic Respiratory Rhythm: Set by the central pattern generator in the VRG (pre-Bötzinger complex).

  • DRG: Receives inputs from sensors through cranial nerves, activates diaphragm and intercostal muscles for inspiration.

  • Function of DRG: Coordinates respiratory signals; integrates information from chemoreceptors and mechanoreceptors.

Page 7: VRG Functionality

  • Primary Roles: Coordinating accessory muscles for inspiration and expiration.

  • Ventilation Adjustment: More active during physical exertion or respiratory distress.

Page 8: Fine Tuning Ventilation Control

  • Pontine Respiratory Center: Includes Pneumotaxic and Apneustic centers; regulate transition between inhalation and exhalation, influence breathing rate.

Page 9: Chemical Control of Ventilation

  • Respiratory centers automatically regulate breathing rhythms subconsciously, adjusting based on PO2, PCO2, and pH levels.

  • Chemoreceptors in peripheral and central locations sense varying gas levels to modulate ventilation.

Page 10: Chemical Control Overview

  • Key centers: Medulla, Pons, Spinal Cord; highlighting the roles of peripheral and central chemoreceptors in breathing control.

Page 11: Peripheral Chemoreceptors

  • Carotid Bodies: Located at the bifurcation of common carotid arteries; respond to changes in arterial PO2, PCO2, and pH.

  • Aortic Bodies: Located in the thoracic aortic arch; similarly responsive to arterial gas levels.

Page 12: Glomus Cells and Hypoxaemia

  • Mechanism: Hypoxaemia causes potassium channel closure in glomus cells, leading to depolarization and release of neurotransmitters, signaling respiratory control centers.

Page 13: Nerve Supply to Chemoreceptors

  • The carotid body is influenced by parasympathetic and sympathetic nervous systems, modulating sensitivity to oxygen levels.

Page 14: Carotid Body Functionality

  • Nerve impulse firing rate correlates with arterial PO2 levels; significant increases in firing are noted below PO2 of 60 mmHg.

Page 15: Responses to Inhaled CO2

  • Increased sensitivity to CO2 in conditions of low oxygen; higher ventilation at lower levels of oxygen in blood.

Page 16: Responses to Inhaled O2

  • Little respiratory system response to low oxygen without CO2 elevation; hypercapnia enhances sensitivity to hypoxaemia.

Page 17: Summary of Graph Interpretations

  • Main Drive: Hypercapnia (increase in CO2) is the primary driver for ventilation under normal oxygen conditions.

  • Highlighted importance of PO2 levels in determining respiratory effort.

Page 18: Peripheral Chemoreceptor Responses

  • Low levels of PO2 and/or high PCO2 increase ventilation; this also relates to acidosis, where ventilation helps to restore pH balance.

Page 19: Blood pH Homeostasis

  • Normal blood pH maintained by various buffers, critical for physiological functions; both acidosis and alkalosis can disrupt cellular functions.

Page 20: Bicarbonate Buffer System

  • The major extracellular buffer within the body; described through reversible reaction of CO2 and water forming bicarbonate and protons.

Page 21: Kidney and Lung Responses in pH Homeostasis

  • Kidneys regulate bicarbonate levels over days; lungs can quickly adjust CO2 levels to correct pH disturbances in minutes.

Page 22: pH Compensation via Ventilation

  • Relationship between CO2, bicarbonate, and protons illustrated; ventilation can adjust rapidly to correct metabolic acidosis.

Page 23: Summary of Peripheral Chemoreceptors

  • Carotid and aortic bodies respond chiefly to arterial PO2; greater sensitivity noted in hypoxaemic conditions.

Page 24: Central Chemoreceptors

  • Located in the ventral medulla, monitor changes in arterial PCO2 and reflect changes in pH indirectly, but not PO2 directly.

Page 25: Mechanism of Central Chemoreceptor Response

  • CC respond to pH changes in CSF due to CO2 levels; rapid diffusion of CO2 through the blood-brain barrier is critical in their function.

Page 26: Sensing Mechanisms of Central Chemoreceptors

  • CO2 enters the CSF freely, altering pH and thus increasing ventilation; chronic conditions require compensation by the kidneys.

Page 27: CNS Compensation for Chronic Conditions

  • Choroid plexus aids in regulating CSF composition; crucial for understanding respiratory responses.

Page 28: Choroid Plexus Functionality

  • Specialized tissue facilitates the regulated passage of substances into CSF; lacking protein means lower buffering capacity than blood.

Page 29: Compensation in Chronic Hypercapnia

  • Chronic high CO2 leads to increased bicarbonate reabsorption and synthesis over time, gradually normalizing pH levels.

Page 30: Chronic Hypocapnia and Buffers

  • Rare condition with hyperventilation; compensation mechanisms adjust bicarbonate transport to normalize pH levels over days.

Page 31: Timeframe for Compensation

  • Defining the timeline for bicarbonate adjustments in CSF and kidneys demonstrates the chronic nature of acid-base disturbances.

Page 32: Pulmonary Receptors in Breathing Control

  • Stretch Receptors: Protect against over-inflation; inhibited when lungs are fully inflated.

  • Irritant Receptors: Trigger cough reflex to clear large objects from airways.

  • J-receptors: Response to pulmonary pathologies; stimulate increased ventilation.

Page 33: Responses to pCO2 and pO2

  • Arterial PCO2 is the primary trigger for respiratory changes; peripheral receptors mainly respond to hypoxaemia.

Page 34: Inputs Affecting Respiratory Control

  • Multiple inputs from higher brain centers and various receptors signal to the respiratory centers.

Page 35: Summary of Respiratory Control Components

  • Integrates mechanoreceptors, chemoreceptors, and muscle proprioceptors in coordinating breathing.

Page 36: Conclusion

  • Review of respiratory control mechanisms and their importance in maintaining homeostasis.