control - CONTROL OF RESPIRATION Dr AJAY HANDA DEPT OF...

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CONTROL OF RESPIRATION Dr AJAY HANDA DEPT OF PULMONARY MEDICINE PGIMER
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CONTROL OF RESPIRATION INTRODUCTION COMPONENTS OF RESP CONTROL SENSORS RESPIRATORY CENTERS RESPONSE TO VARIOUS STIMULI SPECIAL SITUATIONS
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INTRODUCTION VENTILATION IS CONSTANTLY ADJUSTED TO MAINTAIN THE HOMEOSTASIS OF BLD GASES AND ARTERIAL pH VARIATIONS OF PaO2 <3-4 mm Hg AND EVEN LESS FOR PaCO2 TO EXPEND MINIMAL ENERGY IN THE WORK OF BREATHING
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SENSORS PERIPHERAL CHEMORECEPTORS CENTRAL CHEMORECEPTORS PULMONARY RECEPTORS CHEST WALL AND MUSCLE RECEPTORS
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PERIPHERAL CHEMORECEPTORS CAROTID BODIES AORTIC BODIES (SIGNIFICANCE ?) BIFURCATION OF COMMON CAROTID BLOOD SUPPLY-EXTERNAL CAROTID VENOUS DRAIN-INT JUGULAR NERVE SUPPLY- IX NERVE
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STRUCTURE 3 TYPES TYPE I -GLOMUS CELLS TYPE II -SUSTENTACULAR /SHEATH CELLS SENSORY NERVE CELLS
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CAROTID BODY RICH BLOOD SUPPLY(2L/100G/MIN) UTILIZES DISSOLVED O2 FROM BLOOD UNLIKE OTHER TISSUES SENSES CHANGES IN Pa O2 HENCE NOT AFFECTED BY CONDITIONS IN WHICH PaO2 (N) MILD ANEMIA CO POISONING
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CHEMOTRANSDUCTION O2 BINDS CELL MEMB K+ CHANNEL CLOSING OF K+ CHANNEL DEPOLARIZATION OF THE CELL OPENING OF Ca++ CHANNEL NEUROTRANSMITTER RELEASE DEPOLARIZES THE CAROTID SINUS NERVE STIMULATES THE MEDULLA (DRG)
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CHEMORECEPTORS RESPOND TO PaO2 AND H+ CONCENTRATION (pH), PaCO2 90% VENTILATORY RESPONSE TO HYPOXEMIA- CAROTID BODY 10% RESPONSE -FROM AORTIC BODIES VE INCREASED TIDAL VOLUME
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CHEMORECEPTORS RESPONSE TO HYPERCAPNIA 20-50% CAROTID BODIES 50-80% CENTRAL CHEMORECEPTORS
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EFFECT OF PaO2 CHEMORECEPTORS CONTRIBUTES LITTLE TO EUPNEIC VENTILATION (10-15%) NO CHANGE CAROTID BODY ACTIVITY TILL PaO2 < 75mmHg VENTILATION MARKEDLY INCREASED WHEN PaO2 <50mmHg
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EFFECT OF Pa O2 ON CHEMORECEPTORS
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EFFECTS OF PACO2 VENTILATION INCREASES IN LINEAR MANNER WITH PaCO2 HYPOXEMIA INCREASES THE SLOPE OF VENTILATORY RESPONSE TO PaCO2
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VENTILATORY RESPONSE TO ALV CO2
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EFFECT OF PaO2 CO2 POTENTIATES VENTILATORY RESPONSE TO HYPOXEMIA BOTH HYPOXEMIC AND HYPERCAPNIC RESPONSES DECREASE WITH AGEING AND EXERCISE TRAINING
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VENTILATORY RESPONSE TO ALV O2
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EFFECTS OF PaCO2 RAPID PHASE - RAPID INCREASE IN VE WITHIN SECONDS DUE TO ACIDIFICATION OF CSF SLOWER PHASE - DUE TO BUILDUP OF H+ IONS IN MEDULLARY INTERSTITIUM CHRONIC HYPERCAPNIA - WEAKER EFFECT DUE TO RENAL RETENTION OF HCO3 WHICH REDUCES THE H+
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EFFECT OF PaCO2 & pH ON VENTILATION
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BILATERAL CAROTID BODY RESECTION CAROTID ENDARTERECTOMY REDUCES MIN VENTILATION(VE) RESTING PaCO2 2-4 mm Hg ELIMINATES VENTILATORY TO
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.

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control - CONTROL OF RESPIRATION Dr AJAY HANDA DEPT OF...

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