Control of ventilation

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Respiratory drive
)

The control of ventilation is the physiological mechanisms involved in the control of breathing, which is the movement of air into and out of the lungs. Ventilation facilitates respiration. Respiration refers to the utilization of oxygen and balancing of carbon dioxide by the body as a whole, or by individual cells in cellular respiration.[1]

The most important function of breathing is the supplying of oxygen to the body and balancing of the carbon dioxide levels. Under most conditions, the partial pressure of carbon dioxide (PCO2), or concentration of carbon dioxide, controls the respiratory rate.

The

medullar respiratory groups of the respiratory center.[3]
Information from the peripheral chemoreceptors is conveyed along nerves to the respiratory groups of the respiratory center. There are four respiratory groups, two in the medulla and two in the
pontine respiratory group
.

  1. Dorsal respiratory group
    – in the medulla
  2. Ventral respiratory group
    – in the medulla
  3. Pneumotaxic center
    – various nuclei of the pons
  4. Apneustic center
    – nucleus of the pons

From the respiratory center, the muscles of respiration, in particular the diaphragm,[4] are activated to cause air to move in and out of the lungs.

Control of respiratory rhythm

Ventilatory pattern

Respiratory centre and its groups of neurons

Breathing is normally an unconscious, involuntary, automatic process. The pattern of motor stimuli during breathing can be divided into an inhalation stage and an exhalation stage. Inhalation shows a sudden, ramped increase in motor discharge to the respiratory muscles (and the pharyngeal constrictor muscles).[5] Before the end of inhalation, there is a decline in, and end of motor discharge. Exhalation is usually silent, except at high respiratory rates.

The

pulmonary stretch receptors, and other mechanoreceptors in the lungs.[3][6] as well as signals from the cerebral cortex and hypothalamus
.

Control of ventilatory pattern

Ventilation is normally unconscious and automatic, but can be overridden by conscious alternative patterns.[3] Thus the emotions can cause yawning, laughing, sighing (etc.), social communication causes speech, song and whistling, while entirely voluntary overrides are used to blow out candles, and breath holding (for instance, to swim underwater). Hyperventilation may be entirely voluntary or in response to emotional agitation or anxiety, when it can cause the distressing hyperventilation syndrome. The voluntary control can also influence other functions such as the heart rate as in yoga practices and meditation.[7]

The ventilatory pattern is also temporarily modified by complex reflexes such as sneezing, straining, burping, coughing and vomiting.

Determinants of ventilatory rate

Ventilatory rate (

hypoxia. These levels are sensed by central chemoreceptors on the surface of the medulla oblongata for decreased pH (indirectly from the increase of carbon dioxide in cerebrospinal fluid), and the peripheral chemoreceptors in the arterial blood for oxygen and carbon dioxide. Afferent neurons from the peripheral chemoreceptors are via the glossopharyngeal nerve (CN IX) and the vagus nerve
(CN X).

The concentration of carbon dioxide (CO2) rises in the blood when the metabolic use of oxygen (O2), and the production of CO2 is increased during, for example, exercise. The CO2 in the blood is transported largely as bicarbonate (HCO3) ions, by conversion first to carbonic acid (H2CO3), by the enzyme carbonic anhydrase, and then by disassociation of this acid to H+ and HCO3. Build-up of CO2 therefore causes an equivalent build-up of the disassociated hydrogen ions, which, by definition, decreases the pH of the blood. The pH sensors on the brain stem immediately respond to this fall in pH, causing the respiratory center to increase the rate and depth of breathing. The consequence is that the partial pressure of CO2 (PCO2) does not change from rest going into exercise. During very short-term bouts of intense exercise the release of lactic acid into the blood by the exercising muscles causes a fall in the blood plasma pH, independently of the rise in the PCO2, and this will stimulate pulmonary ventilation sufficiently to keep the blood pH constant at the expense of a lowered PCO2.

Mechanical stimulation of the lungs can trigger certain reflexes as discovered in animal studies. In humans, these seem to be more important in neonates and ventilated patients, but of little relevance in health. The tone of respiratory muscle is believed to be modulated by muscle spindles via a reflex arc involving the spinal cord.

Drugs can greatly influence the rate of respiration.

amphetamines can cause hyperventilation
.

Pregnancy tends to increase ventilation (lowering plasma carbon dioxide tension below normal values). This is due to increased progesterone levels and results in enhanced gas exchange in the placenta.

Feedback control

Receptors play important roles in the regulation of respiration and include the central and peripheral chemoreceptors, and pulmonary stretch receptors, a type of mechanoreceptor
.

References

  1. .
  2. ^ .
  3. ^ .
  4. ^ Tortora, G. J. and Derrickson, B. H., (2009). Principles of Anatomy and Physiology – Maintenance and continuity of the human body. 12th Edition. Danvers: Wiley
  5. PMID 10722858
    .
  6. .
  7. . Retrieved 17 July 2014.
  8. ^ Coates EL, Li A, Nattie EE. Widespread sites of brain stem ventilatory chemoreceptors. J Appl Physiol. 75(1):5–14, 1984.
  9. ^ Cordovez JM, Clausen C, Moore LC, Solomon, IC. A mathematical model of pH(i) regulation in central CO2 chemoreception. Adv Exp Med Biol. 605:306–311, 2008.

Further reading

External links