Control of Breathing

Dr. Thamir Al-khlaiwi

Physiology department
talkhlaiwi@KSU.EDU.SA
 Objectives
• By the end of this lecture you should be able to: -
• Understand the role of the medulla oblongata in
determining the basic pattern of respiratory activity.
• List some factors that can modify the basic breathing
pattern like e.g.
• A- The Hering-Breuer reflexes, B- The
proprioreceptor reflexes, C- the protective reflexes,
like the irritant, and the J-receptors.
• Understand the respiratory consequences of changing
PO2, PCO2, and PH.
• Describe the locations and roles of the peripheral and
central chemoreceptors.
• Compare and contrast metabolic and respiratory acidosis
and metabolic and respiratory alkalosis.
The overall processes of External
Respiration
 Control of rate and depth of respiration

• Arterial PO2:
When PO2 is VERY low (Hypoxia): ventilation increases.
• Arterial PCO2:
The most important regulator of ventilation is PCO2,
small increases in PCO2: greatly increases ventilation.
• Arterial pH:
As hydrogen ions increase (acidosis), alveolar ventilation
increases.
 CONTROL OF VENTILATION

 Several mechanisms are involved which can be grouped

into two main categories which are closely integrated:-

1- Nervous control mechanism.​

2- Chemical control mechanism.​

 RESPIRATORY NEURONAL CENTER

 Composed of several groups

of neurons.
 Located in the entire length
of the medulla and pons.
 Can be divided into four
major groups of neurons:-
1-Dorsal respiratory group​.
2-Ventral respiratory group​.
3-The apneustic center​.
4-The pneumotaxic center.​
 Medullary Respiratory centers
1. Inspiratory area (Dorsal Respiratory Group)-DRG:
-Determines basic rhythm of breathing (rhythmicity center).
-Causes contraction of diaphragm and external intercostals.
-The rhythmicity center received impulses from:
1-Higher brain centers.
2-Centers in the brain stem (medulla and pons).
3-Special receptors (respiratory reflexes).
-The rhythmicity center sends excitatory impulses via
the intercostal and phrenic nerves to the external intercostal muscles
and diaphragm.
-The medullary respiratory center stimulates basic inspiration for
about 2 seconds and then basic expiration for about 3 seconds (5sec/
breath = 12breaths/min).
2. Expiratory area (Ventral Respiratory Group)-VRG:

-Although it contains both inspiratory and expiratory

neurons, It is inactive during normal quiet breathing.
-Activated by inspiratory area during forceful breathing.
-Causes contraction of the internal intercostals and
abdominal muscles ( mainly expiratory).
 Pontine Respiratory centers

1. Apneustic area:
Stimulates inspiratory area of medulla to prolong inhalation.
Therefore, slow respiration and prolonged respiratory cycles will
result if it is stimulated. It receives inhibitory impulses from the
sensory vagal fibers and inhibitory impulses from
the pneumotaxic center.
2. Pneumotaxic area:
It transmits inhibitory impulses to the apneustic center and to
the inspiratory area to switch off inspiration.
Therefore, breathing is more rapid when pneumotaxic area is active.
 Hering-Breuer inflation reflex
• When the lung becomes overstretched
(tidal volume is about 1.5 L), stretch
receptors located in the wall of
bronchi and bronchioles transmit
signals through vagus nerve to DRG
producing effect similar to
pneumotaxic center stimulation.
• Switches off inspiratory signals and
thus stops further inspiration .
• This reflex also increases the rate of
respiration as does the pneumotaxic
center.
• This reflex appears to be mainly a
protective mechanism for preventing
excess lung inflation
CHEMICAL CONTROL OF VENTILATION

The rhythmicity center is affected by chemical

changes in the blood via two types
of chemoreceptors:-

1-Peripheral chemoreceptors​.
2-Central chemoreceptors​.
 Chemical Control of Respiration
Peripheral and central chemoreceptors

Peripheral chemoreceptors Central chemoreceptors

 Peripheral chemoreceptors:

• Located mainly in the carotid and aortic bodies, but may

be found anywhere in the circulatory system.​
• When stimulated, send excitatory impulses to
the rhythmicity center
(via glossopharyngeal and vagus nerves)​.
• Highly sensitive to changes in arterial PO2 and to a lesser
extent to PCO2 and pH.​
• Fall of PO2, rise in PCO2 and fall of pH, stimulate
the chemoreceptors to increase ventilation​.
 Respiratory control by peripheral
chemoreceptors in carotid and aortic bodies

 Normal PO2, PCO2 and pH, low grade

of tonic activity in the nerves.​
 ↓ PCO2 and ↑ pH causes low tonic
activity which cause decrease ventilation​
 In metabolic acidosis:
↓ pH causes increase in ventilation to wash
out CO2 and to bring pH to normal.​
 In metabolic alkalosis:
↑ pH causes decrease ventilation,
CO2 retained in the blood to compensate.​
 Peripheral Chemoreceptor System Activity—
Role of Oxygen in Respiratory Control
• Most of the chemoreceptors are in
the carotid bodies. However, a few
are also in the aortic bodies.
• When oxygen concentration in the
arterial blood falls below normal,
the chemoreceptors become strongly
stimulated.
• Impulse rate is particularly sensitive
to changes in arterial Po2 in the
range of 60 down to 30 mm Hg.
• Under these conditions, low arterial
Po2 obviously drives the ventilatory
process quite strongly.
 CENTRAL CHEMORECEPTORS

• Most probably located on the ventrolateral surface of medulla

oblongata (which is bathed with cerebrospinal fluid)​

• Highly sensitive to the hydrogen ion concentration of the

CSF(cereprospinal fluid).

• evoked by arterial PCO2 (CO2 can freely cross the blood-brain

barrier(BBB) into CSF, while BBB is relatively impermeable
to H+ and HCO-3 ions)​
 Effect of CO2 on central chemoreceptors

Although carbon dioxide has

little direct effect in stimulating
the neurons in the
chemosensitive area, it does
have a potent indirect effect. It
does this by reacting with the
water of the tissues to form
carbonic acid, which
dissociates into hydrogen and
bicarbonate ions; the hydrogen
ions then have a potent direct
stimulatory effect on
respiration.
 Why does CO2 have a more potent effect in stimulating
chemosensitive neurons than do blood H ions?

Blood- brain barrier is nearly

impermeable to H+ ions, but CO2
passes this barrier very easily. When
the blood PCO2 increases, so does the
PCO2 of both the interstitial fluid of the
medulla and the CSF. In these fluids,
the CO2 reacts with the water to form
new H+ ions. More H+ ions are
released into the respiratory
chemosensitive sensory area of the
medulla when the blood CO2
concentration increases than when the
blood H+ ion increases. For this
reason, respiratory center activity is
increased very strongly by changes in
blood CO2.
 A change in CO2 concentration has a potent acute effect
on controlling respiratory drive but only a weak chronic
effect after a few days’ adaptation.
• Excitation of the respiratory center by CO2 is great after the blood
CO2 first increases, but it gradually declines over the next 1 to 2
days.
• Part of this decline results from renal readjustment of the H+ ion
concentration in the circulating blood back toward normal after the
CO2 first increases.
• The kidneys increase the blood HCO3, which binds with H+ ions in
the blood and CSF to reduce their concentrations.
• Over a period of hours, the HCO3 ions slowly diffuse through the
BBB– CSF barriers and combine directly with the H+ ions adjacent
to the respiratory neurons as well, thus reducing the H+ ions back
to near normal.
 Effect of CO2 and H Ion Concentration on
Chemoreceptor Activity.
 An increase in either carbon dioxide concentration or hydrogen
ion concentration also excites the peripheral chemoreceptors
and, in this way, indirectly increases respiratory activity.

 There is one difference between the peripheral and central

effects of carbon dioxide: the stimulation of the peripheral
chemoreceptors occurs as much as five times as rapidly as
central stimulation, so that the peripheral chemoreceptors might
be especially important in increasing the rapidity of response to
carbon dioxide at the onset of exercise.
Summary of Chemoreceptor Control of
Breathing
Other Factors Influencing Respiration
 Cont. factors influencing respiration

• Effect of irritant receptors in the airways:

The epithelium in the trachea, bronchi, and bronchioles is
supplied by irritant receptors that are stimulated by irritants that
enters the respiratory airways causing coughing, sneezing and
bronchoconstriction in bronchial asthma and emphysema.
• Function of lung J receptors:
few receptors in the wall of the alveoli in juxta position to the
pulmonary capillaries. They are stimulated especially when the
pulmonary capillary becomes engorged by blood or when
pulmonary edema occurs e.g. in CHF, their stimulation cause the
patient feels dyspnea and increase in breathing rate.
Summary of factors affecting respiration
 Respiratory Acidosis Respiratory Alkalosis

• Hypoventilation. • Hyperventilation.
• Accumulation of CO2 in • Excessive loss of CO2.
the tissues. – PCO2 decreases
– PCO2 increases ( 35 mmHg).
– pH decreases. – pH increases.
 Metabolic Acidosis Metabolic Alkalosis
• Ingestion, infusion, or • Ingestion, infusion, or
production of a fixed acid. excessive renal reabsorption
• Decreased renal excretion of bases such as:
of hydrogen ions. bicarbonate.
• Loss of bicarbonate or other • Excessive loss of fixed acids
bases from the extracellular from the body.
compartment. • pH increases.
• Metabolic disorders such as:
diabetic ketoacidosis.

The respiratory system can compensate for metabolic

acidosis or alkalosis by altering alveolar ventilation