REGULATION OF

RESPIRATION
By
Dr. M. Anthony David, MD
Professor of Physiology
 RESPIRATORY CONTROL: A
SCHEMA
SENSORS
RECEPTORS
F INPUT
E
E
D
CENTER
F
E
B E
OUTPUT
A D

C B EFFECTORS
K A
C
K

VENTILATION
 PONTO MEDULLARY
RESPIRATORY CENTERS

ALL ARE PAIRED & INTERCONNECTED

 INSPIRATORY NEURONS

EXPIRATORY NEURONS

INFERIOR COLLICULUS

PNEUMOTAXIC CENTER

PONS APNEUSTIC CENTER

MEDULLA
OBLONGATA PRE BOTTZINGER COMPLEX
DORSAL GROUP OF R NEURONS
VENTRAL GROUP OF R NEURONS

SPINAL CORD
 RESPIRATORY CENTERS
1. PNEUMOTAXIC CENTER:
• Location: Upper Pons
• Absence causes APNEUSTIC
BREATHING (Esp when the vagi are
cut)
• Curtails inspiratory activity & thus can
increase the rate of respiration
 APNEUSTIC CENTER
 Location: Lower Pons
 Stimulates the Inspiratory Center
and increases Inspiration
 Gets feed back from Vagi & other
Centers.
 MEDULLARY RESPIRATORY
CENTERS
DORSAL GROUP VENTRAL GROUP
 Neurons diffusely  Has both
located in the NTS Inspiratory &
 All neurons are of Expiratory neurons
the Inspiratory  Expiratory neurons
type found at Caudal &
 Generates the Rostral ends.
Inspiratory Ramp  Inspiratory neurons
Signal found in the central
 Is autorhythmic area.
 RESPIRATORY CONTROL
ORGANIZATION:MODERN CONCEPT

 All the respiratory centers are termed as

the BULBOPONTINE RESPIRATORY
NEURONAL COMPLEX
 There is an inspiratory ramp generator
called Respiratory Control Pattern
Generator: Pre Bottzinger Complex
 RESPIRATORY CONTROL
ORGANIZATION:MODERN CONCEPT

 The Inspiratory Off switch(IOS) is

fine tuned by PTC & the
chemoreceptor drive.
 Both Neural & Chemical controls are
well coordinated.
 PERIPHERAL INFLUENCES ON
RESPIRATORY CONTROL

 LUNG OR PULMONARY RECEPTORS:

• Receptors in and around the lungs.
 CHEMORECEPTORS
• Peripheral Chemoreceptors
• Central Chemoreceptors.
 PERIPHERAL INFLUENCES
 The four influences from the lungs
are:
• Pulmonary stretch receptors
• Lung irritant receptors
• J receptors
• Proprioceptors
 Along with the chemoreceptors,
these receptors send information to
the respiratory centers.
 HERING BREUER(HB) REFLEX
 It is a ‘Volume’ reflex.
 Receptors are located in between the
smooth muscles of the small
airways.
 These receptors are unmyelinated
nerve endings.
 They are stimulated by the change of
shape of the Airways.
 HB INFLATION REFLEX
A NEGATIVE FEEDBACK SERVOCONTROL SYSTEM

INSPIRATION

TIDAL VOLUME >1lt

DECREASED TIME
FOR INSPIRATION
STRETCH OF THE AIRWAYS

INCREASED
RESPIRATORY RATE
 HB INFLATION REFLEX
I
N
S
P
I
R
A
T
I
O
N

T
I 0.5 lts 1.0 Ltrs 1.5 lts 2.0 lts 2.5 lts 3.0lts 3.5lts
M
TIDAL VOLUME in Liters
E
 HB DEFLATION REFLEX
 Excessive deflation of the lungs
causes Inspiration.
 This reflex prevents Atelectasis.
 Atelectasis is the collapse of the
lungs.
 This reflex also opens up collapsed
portions of the lung.
 CHEMICAL CONTROL:THE
THREE MAIN ‘CHEMICALS’
 OXYGEN
• PO2 levels in blood.
 CARBON DIOXIDE:
• PCO2 levels in blood.
 HYDROGEN ION:
• Concentration in blood.
CO2 & [H+] act centrally while the
Oxygen levels act on the peripheral
chemoreceptors.
 RESPIRATORY
CHEMORECEPTORS
 CENTRAL:
 CHEMORECEPTOR ZONE:
• BILATERAL
• LOCATED IN THE MEDULLA
• JUST BENEATH IT’S VENTRAL SURFACE
• HIGHLY SENSITIVE TO PCO2 AND [H+]
 FUNCTIONS BY STIMULATING THE
RESPIRATORY CENTERS:
• DRG,VRG & PTC.
 CENTRAL
CHEMORECEPTORS
 PRIMARY STIMULUS:
• [H+]
 PERHAPS THE ONLY IMPORTANT
DIRECT STIMULUS FOR THE CENTRAL
CHEMORECEPTOR CELLS (MEDULLARY
CHEMORECEPTORS)
 But these ions do not cross the Blood
Brain Barrier
 So, the blood PCO2 level has more
effect as CO2 readily crosses the BBB.
 STIMULATION BY
CARBONDIOXIDE
 Is not direct.
 Even the indirect effect of CO2 is most
potent. Why?
 Because CO2 easily crosses the BBB.
 Once it is across the BBB,
 CO2 + H2O H2CO3 H+ + HCO3-
 These increased H+ ions in the brain
stimulate the medullary
chemoreceptors.
 QUANTITATIVE EFFECT OF
H+ IONS
 The stimulatory effect of H+ ions
increases in the first few hours.
 It then decreases in the next 1 to 2
days.
 It comes down to about 1/5th the
initial effect.
 This is due to Renal readjustment of
[H+] in the circulating blood.
 QUANTITATIVE EFFECT OF
H+ IONS
 The kidneys increase blood HCO3.
 This bicarbonate binds with the free
H+ ions in the blood & decreases their
concentration.
 Bicarbonate also diffuses slowly past
the BBB and decreases the H+ ions in
the brain.
 Therefore the effect of H+ ions is:
• POTENT: Acutely
• WEAK : Chronically.
 EFFECT OF CO2
 Change in PCO2 between 35 to
75mmHg causes peak increase in
alveolar ventilation.

 Change in the normal range

causes less than tenth of change
in alveolar ventilation.
 EFFECT OF OXYGEN
 The partial pressure of
Oxygen has no effect on the
medullary chemoreceptors.

 It only has an effect on the

peripheral chemoreceptors.
 PERIPHERAL
CHEMORECEPTORS
 There are two pairs of chemoreceptors:
• Aortic Bodies: located at the arch of
aorta.
• Carotid bodies: located at the
branching of the common carotid
arteries.
 Their functions are:
• To detect changes in the PO2
• To transmit nervous signals to the
Respiratory Centers.
 PERIPHERAL
CHEMORECEPTORS
 These bodies have two types of
special cells called glomus cells.
 The type 2 glomus cells have special
ion channels sensitive to PO2.
 They fire the nerve endings and send
signals via:
• Aortic bodies: Vagi.
• Carotid bodies: Hering nerve &
Glossopharyngeal nerve.
 PERIPHERAL
CHEMORECEPTORS
 Both these bodies receive their own
special blood supply through minute
arteries, directly from the trunk.
 Their blood flow is roughly 20 times
their own weight.
 THEY ARE ALL THE TIME EXPOSED
ONLY TO ARTERIAL BLOOD.
  PO2 stimulates these
chemoreceptors strongly.
 ARTERIAL PO2 & IMPULSES
IN AORTIC BODY

  PO2 especially between 60 and

30mm Hg strongly stimulates the
carotid bodies.
 This is the range wherein the Hb
saturation decreases.
 EFFECT OF PO2
 When PCO2 & [H+] are kept
constantly normal,
 There is no effect if the PO2 is
>100mmHg
 If it falls below 100mmHg,
ventilation doubles upto 60
mmHg.
 It increases upto 5 times at very
low PO2 levels
 CO2 & H +

 They also stimulate the peripheral

chemoreceptors.
 But their effects on the central or
medullary chemoreceptors are more
powerful.
 PCO2 stimulates the peripheral
chemoreceptors 5 times as rapidly as
it stimulates the central ones.
 So this is responsible for the rapid
response to CO2 at the onset of
exercise.