Control of Ventilation
Control of Ventilation
Early Experiments and Medullary Control
- In the 1940s, Lundstedt conducted an experiment involving a pontomedullary transection (separation of the pons and medulla oblongata).
- Lundstedt observed that breathing continued, but with an abnormal gasping pattern.
- Later observations indicated that relatively normal breathing could occur after transection at this level.
- The gasping observed by Lundstedt was likely due to surgical damage to the respiratory center in the medulla.
- Most neurophysiologists believe the primary respiratory center is in the medulla.
- Other sites, including the pons, primarily shape the respiratory output to produce a normal breathing pattern.
Fine-Tuning of Respiratory Rhythm
- The medulla can generate a basic respiratory rhythm, but higher CNS centers and sensory inputs fine-tune it.
- The pons contains neurons that influence respiratory output.
- A mid-pons transection has a modest effect, leading to:
- Increase in tidal volume.
- Slight decrease in respiratory rate.
- Bilateral vagotomy (interrupting the vagus nerves):
- The vagus nerves carry sensory information from pulmonary stretch receptors.
- Bilateral vagotomy has a similar, but smaller, effect compared to a mid-pons transection.
- Combining mid-pons transection with bilateral vagotomy causes:
- Prolonged inspiratory effort, termed inspiratory apneosis.
- This is terminated by a brief expiration.
Brainstem Transections and Pontine Centers
- Brainstem transection above the pons does not alter basic respiratory patterns.
- These observations led to the hypothesis that:
- The caudal pons contains an apneutic center, which can cause apneosis.
- The rostral pons contains a pneumotaxic center, which prevents apneosis.
- It was believed that the medulla, apneutic center, and pneumotaxic center are all required for normal breathing.
- This viewpoint, while common in literature, is not universally accepted among respiratory physiologists.
Respiratory Centers in the Brainstem
- Dorsal Respiratory Group (DRG):
- Primarily contains inspiratory neurons.
- Extends about one-third the length of the medulla.
- Located bilaterally (on both sides) around the nucleus tractus solitarius.
- The nucleus tractus solitarius receives sensory input from all viscera of the thorax and abdomen.
- Plays a role in the control of the autonomic nervous system.
- The nucleus tractus solitarius is viscerotopically organized.
- The respiratory portion is ventrolateral to the tractus solitarius, beneath the floor of the fourth ventricle.
- Neurons in the nucleus tractus solitarius and adjacent neurons in the dorsal medulla make up the DRG.
- Ventral Respiratory Group (VRG):
- Contains both inspiratory and expiratory neurons.
- Ventral to the DRG, about midway between the dorsal and ventral surfaces of the medulla.
- Lies within and around a series of nuclei that form a column of neurons.
- Extends from the pons nearly to the spinal cord, making it considerably longer than the DRG.