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Control mechanism of breathing

1. neural control mechanism of brainstem


2. chemical control - haemoreceptors
3. reflex mechanism – adjust breathing
4. suprapontin mechanism – voluntary

Hypoxia – tissue, hypoxemia – blood

Factors controling breathing:


Respiratory center: input: higher brain centers, output: respiratory muscles.
CO2 surplus decrease pH, lack of increases.
Lung strechreceptors
chemoreceptors – lack of O2

Respiratory centers in the medulla and cerebral cortex control voluntary breathing.
Parameters measured at aorta: O2, CO2, pH
Inspiratory centers connected external intercostal muscles, diaphragm
Expiratory muscles connect from lung stretch receptors, to intercostal muscles, abdominal muscles.

Brainstem respiratory centers

Dorsal respiratory group


– contain only inspiratory neurons
– relay station of many respiratory reflexes
– activates the main inspiratory muscles

Ventral group
– contains both inspiratory and expiratory neurons
– provides motor innervation of auxillary respiratory muscles.

Brainstem neural mechanism

Structures participating in breathing

Pneumotaxic center – inhibits the lower apneustic center. After its elimination apneustic breathing
develops

Apeneustic center – after its elimination breathing is practically normal. Occasionally gasping
develops.

Chemical control of breathing


chemoreceptors

Central: H-zones under the ventral, surface of lateral part of medulla


Peripheral: carotid bodies – innervation glossopharyngeal
Aortic bodies – vagus
Peripheral receptors react to increase in pCO2 (hyperkapnia) and acidosis (pH<7.35)
Provide also impulses mediating sensation of breaking point, indicating when there is a strong desire to
breath again.

Defense and elimination of irritants from airways:


Protecting and defensive respiratory reflexes

Protect the respiratory system against damaging and toxic substances – Kratschmers apnoeic reflex.

Sneezing, cough, sniffing, aspiration reflex from the nasopharynx, hiccough, yawing

Lung receptors:
slowly adapting receptors:
– stimulus – gradual increase of lung volume (mechanoreceptors)
– afferente impulses via the vagus to respiratory center, where they inhibit the activity of
inspiratory neurons
– Hering – breuer reflex – inflation reflex, deflation

Rapidly adapting receptors


– located between epithelial cells of airways
– stimulated mechanically or chemically
– activation causes coughing, sneezing, bronchoconstriction, secretion
– their activation in the lungs can cause hyperpnoe (increased volume of ventilation)

Reflex control of breathing


Juxtapulmonary-capillary receptors
– located close to pulmonary vessels
– react to hyperinflattion of the lungs and increase of water volume in the lungs – pulmonary
congestion
– their reflex reaction consists of apnoe, followed by polypnoe, bradycardia and hypotension, this
is called pulmonary chemoreflax.

Airway cleaning mechanism


1. coughing – expectoration, exhalation, swallowing
2. mucocilliary clearence
mucus: viscosity, elasticity, adhesivity, layers sol-gel
cilliary apparat: structure, movement of cilli-metachron frekvencia
MCT: regulation, age dependence, drenage
MCT and exhalates: SO2, H2SO4, Ozon, cig. Smoke
MCT a diseases: bronchitis, asthma, bronchiektsis, CF, system of immobile cilliary cleaning
mechanisms: closely cooperate against infection

High frequency jet ventilator


Paravent PATe

former millitary secret dedicated for paramedics treatment of toxic gases injury in the field.