Regulation of respiration

Dr Renu Yadav
Associate Professor
 Learning Objective
Students will be able to …
1.List the regulatory centers for respiration
2.Explain the role of various centers on respiration
3.List the factors affecting the respiratory center
4.Explain the respiratory reflexes
 Control of respiration

• Neural
1. voluntary control
cerebral cortex, Hypothalamus, Limbic system
2. automatic control
medulla oblongata and pons

• Chemical
1.Chemoreceptors located in medulla oblongata(central)
2.Chemoreceptors located in aortic and carotid bodies
(peripheral)
Peripheral chemoreceptors
Classification of central chemoreceptors
 Respiratory control centers

1. Cortical Voluntary control

Hypothalamus and limbic system
2. Medullary Respiratory Centers
a. DRG - dorsal respiratory group neurons
b. VRG - ventral respiratory group neurons
c. central pattern generator
3. Pontine Centers:
a. Pneumotaxic Center - located in upper pons (“off switch”)
b. Apneustic Center - located in lower pons (prevents turn-
off)- hypothetical
4. Pulmonary Receptors
a. Pulmonary stretch receptors (Hering-Breuer reflex)
 Function of Medullary respiratory group

It is divided into two major collections of neurons

1. Dorsal respiratory group,
–located in the dorsal portion of the medulla, which mainly causes
inspiration;
• Most of its neurons are located within the nucleus of the tractus
solitarius (NTS)
• The dorsal respiratory group of neurons plays the most fundamental
role in the control of respiration
2. Ventral respiratory group,
–located in the ventrolateral part of the medulla, which mainly causes
inspiration and forceful expiration
– It is inactive in quiet breathing but is important in stimulating
abdominal expiratory muscles during levels of high respiratory
demand.
 Central pattern generator

• Between ventral
and dorsal group
of neurons.
• CPG is present in
Pre Botzinger
complex
• Between nucleus
ambigus and
lateral reticular
nucleus
Regulation of respiration
 Function of Pontine center

A. The pneumotaxic center,

• –located dorsally in the superior portion of the
pons, which mainly controls rate and depth of
breathing.
• –transmits signals to the inspiratory area.
• –"switch-off" point of the inspiratory ramp, thus
controlling phase of the lung cycle.

B. Apneustic center: excitation of inspiratory neurons

Switch-off
area
Regulation of respiration
 Regulation of center
Apneustic center
excites inspiratory
neuron
Pneumotaxic center
inhibits apneustic -
vagus
center
Pneumotaxic center
Inhibits inspiratory
neurons

Vagus inhibits
apneustic center
Regulation of respiration
Rhythm of respiration
Quiet Breathing
 Inspiratory signal

• The nervous signal that is transmitted to the inspiratory muscles,

mainly the diaphragm, is not an instantaneous burst of action
potentials.

• Instead, it begins weakly and increases steadily in a ramp manner

for about 2 seconds in normal respiration

• Then it ceases abruptly for approximately the next 3 seconds,

• which turns off the excitation of the diaphragm and allows
elastic recoil of the lungs the chest wall to cause expiration.

• The inspiratory signal begins again for another cycle;

• Thus, the inspiratory signal is a ramp signal.

 Role of vagus nerve

• Inhibits inspiration
• Carries afferent fibers from lung and airways.
• During inspiration, stretching of lung parenchyma
increases discharge of afferent fibers
• It inhibits medullary neurons
• Therefore, magnitude of inspiration increases
following vagotomy and vagal stimulation results in
inhibition of respiration.
• vagotomy following lesion of pneumotaxic center
results in apneusis
Functions of autonomic control center
Effect of transection
 Chemoreceptors

A. Central chemoreceptors
–Medulla
• sensitive to increase in PCO2 of arterial blood
• Increase in CSF and brain interstitial fluid H+ concentration is a
direct effect (the H+ concentration of blood is an indirect effect)
B. Peripheral chemoreceptors
–Aortic and carotid bodies
• Highly sensitive to decrease in PO2 of arterial blood
• However, they also sense increase in PCO2 and decreased
pH(acidity)
 Central chemoreceptors

• Hydrogen ions may be the only

important direct stimulus for these
neuron if it is in Cerebro Spinal
Fluid
BUT
• hydrogen ions do not easily cross
the blood-brain barrier
• whereas CO2 easily passes blood
brain barrier (lipid soluble)
• Effect in stimulating the chemo
sensitive neurons is high with
changes in carbon dioxide
compared to changes in hydrogen
ion concentration in blood but H+
in CSF itself has faster response.
Central Chemoreceptors

= H2CO3
 Peripheral chemoreceptor

The carotid bodies

• bilaterally in the
bifurcations of the
common carotid
arteries
• the glossopharyngeal
nerves
Aortic bodies
• The vagus nerve
 Role of Oxygen in Respiratory Control

• Carotid and Aortic bodies.

• Peripheral Chemoreceptors (PO2 below 70
mm Hg), Hypoxia, pCO2, H+
• The chemoreceptors transmit nervous signals
to the respiratory center in the brain to help
regulate respiratory activity.
26
 Respiratory Acidosis and Alkalosis;

Normal PCO2 fluctuates

• Respiratory Acidosisbetween 35 and 45 mmHg
(elevated CO2 greater than
45mmHg)
• Depression of respiratory
centers via narcotic, drugs,
anesthetics
• CNS disease and depression,
trauma (brain damage)
• Interference with respiratory
muscles by disease, drugs,
toxins
• lung disease (pneumonia)
• Respiratory Alkalosis
(less than 35mmHg-
lowered CO2)
• Hyperventilation
psychological (fear, pain)
• Overventilation on
mechanical respirator
• Ascent to high altitudes
• Fever
Mechanism of depolarization of receptors
Hypoxia

Inhibition of oxygen sensitive potassium

channels (glomus cells)

Decreased K efflux

Depolarization of glomus cell

Opening of voltage gated calcium

channels, Influx of calcium ion

release of dopamine (neurotransmitter)

Glomus cells Dopamine acts on IX and X

cranial nerve

Action potential propagates to DRG

Peripheral receptors
 Reflexes
Effect of Irritant Receptors in the Airways.
The epithelium of
• the trachea, bronchi, and bronchioles is supplied with sensory nerve endings
pulmonary irritant receptors
• Causes coughing and sneezing due to some irritants eg. dust, pollens,
• They may also cause bronchial constriction in diseases like asthma and
emphysema.

Function of Lung “J Receptors.”

A few sensory nerve
• In the alveolar walls in juxtaposition to the pulmonary capillaries
• Hence the name “J receptors”.
• They are stimulated especially when the pulmonary capillaries become
engorged with blood or when pulmonary edema or congestive heart failure
occurs.
 Hering-Breuer inflation Reflex

Increasing lung inflation

↓
Stimulates stretch receptors (slowly adapting
receptors)
↓
Respiratory center
↓
Exhalation
To prevent lung’s distention beyond normal range
Hering –Breur deflation Reflex
 Heads Paradoxical Reflexes

❖ Head and paradoxical reflex: Inflation of lungs under

certain condition further stimulate inflation of lungs.
❖ Rapidly adapting pulmonary stretch receptors
❖ It contradicts the Hering –Breuer deflation Reflex.
❖ It is important in first breathe of the babies.
 Reference books required

• USMLE Step 1 Lecture notes (Kaplan medical physiology)-

2021

• Ganong's Review of Medical Physiology 26th ed 2019

• Guyton and Hall Physiology 13th Ed 2016

• BRS Physiology (Linda S Costanza, 7th Edition)

• Understanding medical Physiology (Bijlani, 4th edition)

 Practice Quizzes

Intravenous lactic acid increases ventilation. The

immediate receptors responsible for this effect are
located in..
A. Medulla oblongata.
B. Carotid bodies.
C. Lung parenchyma.
D. Aortic baroreceptors.
E. Trachea and large bronchi
Automatic control center of respiration has the
property for generating the spontaneous respiration
which completely ceases after;
A. bilateralvagotomy.
B. transection of the brainstem above the pons.
C. transection of the brainstem at the caudal
end of the medulla.
D. bilateralvagotomy combined with transection of
the brainstem at superiorborder of pons.
E. Destruction of aortic and carotid bodies
When respiratory drive for increased pulmonary ventilation becomes greater
than normal, a special set of respiratory neurons that are inactive during
normal quiet breathing becomes active, contributing to the respiratory drive.
These neurons are in which of the following structures?
A. Apneustic center
B. Dorsal respiratory group
C. Nucleus of the tractus solitarius
D. Pneumotaxic center
E. Ventral respiratory group
An 18-year-old male is thrown from his motorcycle and suffers a complete transection of the
brainstem above the pons. As a result, which of the following will most likely occur?

A. All breathing movements will cease

B. The Hering-Breuer reflex will be abolished

C. The central chemoreceptors will no longer be able to exert any control over ventilation

D. The peripheral chemoreceptors will no longer be able to exert any control over ventilation

E. The limbic system will no longer be able to exert any control over ventilation
If a physician plan to stimulate the respiratory center which of
the following is the direct stimulant for chemoreceptors in the
medulla?
a. CO2 from the blood.
b. H+ from the blood
c. H+ in cerebrospinal fluid
d. decreased arterial PO2
e. Hypoxia
Answers: B, C, E, E, C