Chemoreceptors

The automatic control of breathing is also influenced by input from receptors sensitive to the
chemical composition of the blood. There are two groups of chemoreceptors that respond to changes
in blood PCO2 , pH, and PO2 . These are the central chemoreceptors in the medulla oblongata and the
peripheral chemoreceptors.

peripheral chemoreceptors
 The peripheral chemoreceptors include the aortic bodies, located around the aortic arch, and
the carotid bodies, located in each common carotid artery at the point where it branches into
the internal and external carotid arteries.
 The peripheral chemoreceptors control breathing indirectly via sensory nerve fibers to the
medulla.
 The aortic bodies send sensory information to the medulla in the vagus nerve (X); the carotid
bodies stimulate sensory fibers in the glossopharyngeal nerve (IX).
 The aortic and carotid bodies should not be confused with the aortic and carotid sinuses that
are located within these arteries. The aortic and carotid sinuses contain receptors that monitor
the blood pressure.

Chemoreceptors in the Medulla

 The chemoreceptors most sensitive to changes in the arterial PCO2 are located in the ventral
area of the medulla oblongata, near the exit of the ninth and tenth cranial nerves.
 These chemoreceptor neurons are anatomically separate from, but synaptically communicate
with, the neurons of the respiratory control center in the medulla.
 An increase in arterial PCO2 causes a rise in the H+ concentration of the blood as a result of
increased carbonic acid concentrations. The H+ in the blood, however, cannot cross the blood-
brain barrier, and thus cannot influence the medullary chemoreceptors. Carbon dioxide in the
arterial blood can cross the blood-brain barrier and, through the formation of carbonic acid, can
lower the pH of cerebrospinal fluid.
 This fall in cerebrospinal fluid pH directly stimulates the chemoreceptors in the medulla when
there is a rise in arterial PCO2 . The chemoreceptors in the medulla are ultimately responsible
for 70% to 80% of the increased ventilation that occurs in response to a sustained rise in arterial
PCO2 . This response, however, takes several minutes. The immediate increase in ventilation
that occurs when PCO2 rises is produced by stimulation of the peripheral chemoreceptors.
Definisi Asma Bronkial dan Asma Eksaserbasi
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is
defined by the history of respiratory symptoms, such as wheeze, shortness of breath, chest tightness
and cough, that vary over time and in intensity, together with variable expiratory airflow limitation.
Airflow limitation may later become persistent.

Exacerbations of asthma are episodes characterized by a progressive increase in symptoms of

shortness of breath, cough, wheezing or chest tightness and progressive decrease in lung function,
i.e. they represent a change from the patient's usual status that is sufficient to require a change in
treatment. Exacerbations may occur in patients with a pre-existing diasnosis of asthma or,
Occasionally, as the first presentation of asthma.