Copyright 2011 by Saunders, an imprint of Elsevier Inc.

Regulation of Respiration

Slides by Robert L. Hester, PhD

UNIT VII
Chapter 41:
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Question
In which of the following conditions is alveolar PO
2

increased and alveolar PCO
2
decreased
A. Breathing air with 19% PO
2

B. Increased alveolar ventilation and unchanged
metabolism
C. Decreased alveolar ventilation and unchanged
metabolism
D. Increased metabolism and unchanged alveolar
ventilation
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Regulation of Respiration
Sensors
gather information
Central controller
integrate signals
Effectors
muscles
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Influences from Higher Centers
Cycle of
Inspiration
and
Expiration
Reflex from:
Arterial
Chemoreceptors
Central
Chemoreceptors
Reflexes from:
Lungs
Airways
Cardiovascular System
Muscle and joints
Skin
Muscles
of breathing
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Question
What is the effect of anemia on ventilation?
A. decrease ventilation
B. increase ventilation
C. no change in ventilation
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Respiratory Center
Figure 41-1
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Medullary Respiratory Center
Dorsal respiratory group
inspiration, intrinsic nerve activity
Pneumotaxic center: limit inspiration,
increase respiratory rate
modulate respiratory system
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Respiratory Center
Ventral Respiratory Group
Inactive during quiet respiration
Active respiration
Projections from the Dorsal Respiratory
Group

Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Lung receptors
Stretch Receptors
Located in smooth muscle of large and small airways
Minimize work of breathing by inhibiting large tidal
volumes
Hering-Breuer reflex
Irritant receptors
Nasal mucosa, upper airways, possibly alveoli
Bronchoconstriction
Cough, sneeze
J receptors
Located capillary wall, interstitium
Lung disease and edema (pulmonary congestion)
Rapid shallow breathing (tachypnea)
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Other Reflexes
Arterial Chemoreceptors
Hyperpnea, increased blood pressure
Arterial Baroreceptors
Stimulation by elevated blood pressure
results in brief apnea and bronchodilation
Muscles and Tendons
Muscles of respiration as well as skeletal
muscles, joints and tendons
Adjust ventilation to elevated workloads

Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Chemical Control of Respiration
Carbon Dioxide
central
Hydrogen Ions
central
Oxygen
peripheral
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Chemosensitive Area of Respiratory
Center
Figure 41-2
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Chemosensitive Area of Respiratory
Center
Blood
Brain Tissue
CO
2
CO
2
chemoreceptor
CSF
H
+
CO
2
HCO
3
-
HCO
3
-
slow
H
+
low protein
pH=7.32
PCO
2
=50
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Peripheral Chemoreceptors
Carotid body-bifurcation of the carotids
responds to oxygen (greatest Po
2
<100 mmHg)
-responds to carbon dioxide and hydrogen ion
0
200
400
600
800
0 200 400 600
Po
2
n
e
r
v
e

i
m
p
u
l
s
e
s

Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Question
Breathing CO acutely will __? __ respiration?
A. increase
B. decrease
C. not change
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Question
Breathing CO will not change respiration?
Arterial PO
2
does not change, PCO
2
does not
change
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Control of Respiration
V
e
n
t
i
l
a
t
i
o
n

pH
PCO
2
PCO
2
or H
+
Changes in arterial PCO
2
have greater effect than changes in arterial pH
central
peripheral
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Ventilation
PCO
2

PO
2

PCO
2
and PO
2

Hypoxic increase in ventilation inhibited by fall in PCO
2

V
e
n
t
i
l
a
t
i
o
n

PCO
2

0
1
2
3
4
5
6
160 140 120 100 80 60 40 20
0
5
10
15
20
25
30
35
40
45
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Carbon dioxide response curve at
different O
2
levels
A
l
v
e
o
l
a
r

V
e
n
t
i
l
a
t
i
o
n

PCO
2
30 35 40 45 50
PO
2
=100
PO
2
=50
PO
2
=35
5
10
15
20
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Carbon dioxide response curve under
different conditions
A
l
v
e
o
l
a
r

V
e
n
t
i
l
a
t
i
o
n

PCO
2
30 35 40 45 50
normal
sleep
Metabolic acidosis
5
10
15
55 60
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Summary
Carbon dioxide is major stimulus for increased
respiration
Acts on chemosensitive area through pH
Chemoreceptors are mainly affected by oxygen
If PCO
2
is constant low oxygen can be important
Questions?
Why is oxygens effect on respiration blunted?
Explain ventilatory drive during severe lung
disease
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Severe lung disease, COPD
Develop hypoxemia and hypercapnia
Respiratory drive due to oxygen
Renal control of acid-base balance
Treat with oxygen inhibits respiratory drive
High levels of PCO
2

Minimal levels of oxygen, monitor blood gases

CO
2
Retention
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
40
60
80
100
Normal
V/Q
< Normal
PO
2

PCO
2

PO
2

PCO
2

CO
2
retention
and hypoxemia
CO
2
elevated
and hypoxemia
PO
2

PCO
2

Increased
oxygen
Drive is due to O
2
Drive is due to CO
2
Decreased drive
CO
2
Retention
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Respiration During Exercise
Linear increase in ventilation with increasing
oxygen consumption
arterial PO
2
, PCO
2
and pH do not change in
correct direction to increase ventilation
PCO
2
may decrease slightly


Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Overflow of signals from cortex
Body movements
Increased body temperature
Designed to control PCO
2
Learned response


Conclusion: not sure the exact
mechanism responsible for increased
ventilation
Respiration During Exercise
Copyright 2011 by Saunders, an imprint of Elsevier Inc.
Other Factors to Influence Respiration
Voluntary control
Activity from vasomotor center
Body temperature
increased production of carbon dioxide
direct effect on respiratory center
Irritants
Anesthesia