REGULATION OF
RESPIRATION
Dr Mohamed Hassan
MBBS, PhD Candidate
THE RESPIRATORY CENTRE
• PRESENT IN BRAIN STEM
• MEDULLARY RESPIRATORY
CENTRE(RHYTHMICTY
CENTRE)
• PONTINE RESPIRATORY
GROUP:
APNEUSTIC
PNEMOTAXIC
MEDULLARY RESPIRATORY
NEURONS
(RHYTHMICITY CENTRE)
2 DISTINCT GROUPS OF NEURONS;
I. THE DORSAL INSPIRATORY GROUP (DIG)
II. THE VENTRAL EXPIRATORY GROUP (VEG)
• THE 2 GROUPS ARE BILATERALLY PAIRED
• THERE IS CROSS COMMUNICATION BETWEEN THEM
RESPONSIBLE FOR INITIATION & REGULATION OF BREATHING
MEDULLARY RESPIRATORY NEURONS
DORSAL RESPIRATORY GROUP (DRG)
• INSPIRATORY NEURONS THAT DISCHARGE DURING INSPIRATION & STOP
DISCHARGING DURING EXPIRATION (RESPIRATORY RHYTHM GENERATOR)
• THEY GENERATE A RAMP SIGNAL;
THEY INITIATE INSPIRATION WITH A WEAK BURST OF ACTION POTENTIALS
THAT GRADUALLY INCREASE IN AMPLITUDE, THEN CEASES FOR THE NEXT
3 SEC. UNTIL A NEW CYCLE BEGINS
• THIS PROVIDES A GRADUAL INCREASE IN LUNG VOLUME DURING
INSPIRATION
INPUT & OUTPUT OF DRG
Apneustic centre Pneumotaxic centre
Central
chemoreceptors + - Peripheral
chemoreceptors
DRG
Spinal motoneurons
Cervical (3,4,5) & Thoracic (1-12)
VENTRAL RESPIRATORY GROUP (VRG)
• Anterolateral To DRG
• Activated During Heavy Breathing; E.G. Exercise
• During Such Conditions, The Increased Activity Of Inspiratory Neurons Activates The
VRG
• In Turn, The Activated VRG Discharge:
- Inhibits Inspiratory Group
- Stimulates The Muscles Of Expiration; Internal Intercostals, Abdominal Recti.
PONTINE RESPIRATORY
CENTRES
APNEUSTIC CENTRE:
• In The Lower 1/3 Close
To Medullary Groups
• Sends Stimulatory
Discharge To Inspiratory
Neurons Promoting
Inspiration
• Removal Of Its
Stimulatory Effect→
Respiration Becomes
Shallow & Irregular
PNEUMOTAXIC CENTRE
• In Upper 2/3 Of Pons
• Its Major Role Is Regulation Of
Respiratory Volume & Rate
• Controlling Cessation Of
Inspiratory Ramp Signal From
DIG;
• Switch-off DIG & Apneustic
Centre → Expiration Occurs
• Hypoactivation Of This Centre
→Prolonged Deep Inspiration
With Limited Brief Expiration
• Hyperactivation →Shallow
Inspiration
CHEMICAL CONTROL OF RESPIRATION
• CHEMICAL REGULATION OF ACTIVITY OF RESPIRATORY CENTRE WHICH
INVOLVES 2 PATHWAYS:
1- CENTRAL CHEMORECEPTOR PATHWAY
2- PERIPHERAL (ARTERIAL) CHEMORECEPTOR PATHWAY
• THESE CHEMORECEPTORS SENSE CHANGES IN PaCO2, PaO2 & PH
Central Chemoreceptors Pathway
Its Receptors: Central Chemosensitive Area
• Lying Just Beneath Ventral
Surface Of Medulla
• Relaying Most Important
Sensory Input About
Changes In Their Close
Environment To
Respiratory Centre In
Medulla & Pons
• Most Sensitive To Change
In Paco2 ,H+ Conc., But
Not To Pao2
• Under Normal Conditions, ~75-85% Of Respiratory Drive Is Due To Stimulation Of Central
Chemoreceptors By Paco2
• However, The Direct Stimulant For Neurons Of Central Chemoreceptors Is Only H+ Ions
• But H+ Can Not Cross Blood Brain Barrier While CO2 Can
• So, How Central Chemoreceptors Are Stimulated By An Increase In Arterial PCO2?
PERIPHERAL CHEMORECEPTOR PATHWAY
Peripheral
chemoreceptors
are the only
sensors detecting a
fall in PO2
Stimulation Of Peripheral Chemoreceptors
• The Carotid & Aortic Bodies Are
Sensitive To
Fall In Pao2,
An Increase In Paco2 Or H+
Concentration
• They Maximally Stimulated When
Pao2 Decreases Below 50-60mm Hg
• They Detect Changes In Dissolved O2
But Not In The O2 That Is Bound To
Hb (E.G. In Anaemia There Is Normal
Pao2 But Reduced Content Of O2
Bound To Hb)
EFFECT OF A DECREASED PAO2
HERING-BREUER INFLATION REFLEX
• Stretch Receptors Located In The Muscular Portions Of The Walls Of The Bronchi And
Bronchioles Through The Lungs Transmit Signals Through The Vagus Into The Dorsal
Respiratory Group Of Neurons When The Lungs Become Over Stretched.
• When The Lungs Become Over Inflated The Stretch Receptors Activate A Feedback Response
That Switches Off The Inspiratory Ramp And Stops Further Inspiration.
• The Hering-breuer Reflex Is A Protective Mechanism For Preventing Excess Lung Inflation.
Other Factors That Affect Respiration
1.Voluntary Control of Breathing “Cortical
Influence”
• Through Descending Tracts From The Cerebral Cortex To Motor Neurons Of The Respiratory
Muscles (Dorsolateral Corticospinal Tracts)
• This Provides CNS The Ability To Override The Automatic Regulation Of Respiration For
Short Time E.G. Holding Breath But The Involuntary Control Will Take Over (↑ PCO2, H+),
Or Deliberate Hyperventilation (↓PCO2)
Other Factors That Affect Respiration
2. J-RECEPTOR REFLEX
• Pulmonary Emboli Or Oedema Or Congestion → Stimulation Of Juxtapulmonary-
capillaries Receptors →Impulses Along Vagal Afferent → Respiratory Centre → Rapid
Shallow Breathing
• These Receptors Are Responsible For The Sensation Of Air Hunger (Dyspnea; Shortness
Of Breath).
Other Factors That Affect Respiration
3.Cough, Sneezing Reflexes
• Dust, Smoking, Irritant Substances → Stimulation Of Irritant Receptors In Upper
Airways (Nose, Larynx, Bronchi)→afferent Signals Via Vagus (Larynx, Cough}) Or
Trigeminal Or Olfactory (Nose, Sneezing) → Respiratory Centre → Deep Inspiration
Followed By Forced Expiration Against Closed Glottis →Opening Of Glottis →Forceful
Outflow Of Air (Help Removal Of Irritants).
Other Factors That Affect Respiration
• Temperature: Increases Respiratory Rate
• Pain: Sudden Pain Decreases, Prolonged Pain Increases Rate
• Alcohol: Decreases Rate
• Exercise; Increases Breathing Rate
• Swallowing Or Vomiting
• Fear And Anger
Other Factors That Affect Respiration
• EMOTIONAL ACTIVITY
• SPEAKING, SINGING A SONG, SWIMMING
Medullary Respiratory Centers
91+19
NORMAL RESPIRATORY RATES
• INFANT 30-60
• TODDLER 24-40
• PRESCHOOLER 22-34
• SCHOOL-AGE CHILD 18-30
• ADOLESCENT 12-16
• ADULT 10-20
EFFECTS OF AGING
• VITAL CAPACITY AND MAXIMUM MINUTE VENTILATION
DECREASE
• RESIDUAL VOLUME AND DEAD SPACE INCREASE
• ABILITY TO REMOVE MUCUS FROM RESPIRATORY
PASSAGEWAYS DECREASES
• GAS EXCHANGE ACROSS RESPIRATORY MEMBRANE IS
REDUCED
