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Pulmonary Physiology Part 3 [Neuronal Control]
Wacker 3/2 lecture -2 hrs
63
Physiology
Undergraduate 4
02/23/2011

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Term
Medulla, uses pacemaker neurons
Definition
what part of the brain GENERATES the signal to breathe? with what cells?
Term
normal breathing (inspiration)
Definition
what does the dorsal respiratory group control?
Term
both inspiration and expiration (especially important in activating the abdominals an internal intercostals when high levels of respiration are needed-so it's inactive during normal breathing typically)
Definition
what does the ventral respiratory group control?
Term
the Pons
Definition
what regulates or modulates breathing by releasing neurotransmitters to increase or decrease likelihood of an action potential?
Term
Higher brain areas like the hypothalmus

the limbic system (amygdala) = fear/emotion
Definition
besides the pons and medulla, what regulates breathing?
Term
in the glomus cells inside aortic bodies[aortic arch] and the carotid bodies[bifurcation of common carotid arteries]
Definition
where are the peripheral chemoreceptor reflexes?
Term
afferent of the vagus from the aortic body or glossopharyngeal from the carotid
Definition
if the aortic body detects hypoxia, what nerves tell the DRG to increase it's efferent output?
Term
VRG
Definition
DRG or VRG? which one activates abdominal muscles and internal intercostals?
Term
DRG
Definition
DRG or VRG? which activates the scalene, sternocleidomastoid, external intercostals, and diaphragm?
Term
primarily blood O2, but also CO2, and H+ ion concentration
Definition
what do the carotid and aortic bodies read?
Term
1)Potassium channels close to
2)depolarize the cell, 3)then voltage gated Ca++ channels open and
 4)calcium comes in to allow vessicle fusion so that
5) dopamine is exocytosed and received by the glossopharyngeal nerve which 7) signals the medullary centers to increase ventilation
Definition
whern there is low PO2 in a carotid body for example, a cascade of things happen, list what happens, in order.
Term
on the ventral surface of the medulla (influenced by CSF), respond only to changes in H+ and stimulate inspiratory neurons

DO NOT detect hypoxia, but these are more poweful in terms of their impact on changing respirations
Definition
where are the central chemoreceptors located, what do they detect?
Term
yes, indirectly with the production of bicarb from CO2 and H2O
Definition
does CO2 stimulate central chemoreceptors?
Term
pneumotaxic center (from the book)
Definition
located in the superior pons, helps control rate and pattern of breathing, transmits inhibitory signals to the dorsal respiratory group and so it limits inspiration and secondarily increases respiratory rate
Term
Hering-Breuer Reflex
Definition
prevents over inflation of the lungs
Term
DORSAL RESPIRATORY(inspiratory) GROUP, inhibits the "inspiratory ramp" and stops further inspiration
Definition
where does the hering Breuer reflex send vagal afferent nerves(stretch receptors) to regulate breathing?
Term
CO2, increases ventilation
Definition
Hydrogen ions do not easily cross the blood brain barrier, what does cross that allows stimulation of the central chemoreceptors? what does it do to ventilation when this is stimulated?
Term
no! the effect is reduced over time (you get desensitized to the effect) basically your body compensates for the increase in H+ ions
Definition
does CO2 stimulating the central chemoreceptors always stimulate it the same amount?
Term
NO! only signals in the peripheral chemoreceptors read O2 levels.   Central does detect H+ from CO2 indirectly though.
Definition
does lack of oxygen to the respiratory centers tell the respiratory centers to increase ventilation?
Term
nociceptors: sensory neurons (vagal afferents)stimulated by particles/gases send signals to the brainstem to create a vagal efferent signal causing bronchoconstriction, cough, or tachypnea(rapid SHALLOW breathing, so the object doesn't get further lodged into the lungs)
Definition
what are the protective reflexes of the lungs to irritant stimuli?
Term
vagal afferents(sensory)
Definition
if you superventilate a bunny by blowing into it's ventilater, what nerve will create action potentials and inhibit the dorsal inspiratory group?
Term
blowing inhibits the DRG (tell bunny stop breathing in so it's lungs don't kerplode with all the stretching) poking the heart excites the DRG by stimulating vagal afferents to it.
Definition
blowing in the tube to the bunny inhibits/excites the DRG, while poking it in the heart inhibits/excites the DRG
Term
central: low O2 does nothing, high H+ and indirectly high CO2 stimulate an afferent neuron to excite the DRG and increase ventilation

peripheral: low O2 mainly, and high CO2/H+ will tell the peripheral chemoreceptors to send dopamine to the medullary centers to increase ventilation (excite the DRG)
Definition
what do high CO2, high H+ and low PO2 do to central chemoreceptors? to peripheral?
Term
high brain centers, stimulate limbics, which goes to the medullary center
Definition
what do emotions stimulate to change the medullary breathing centers?
Term
DRG and VRG
Definition
what is in the medulla oblongata?
Term
ANS!

 para(vagus): bronchoconstrict
sympathetic(T1-T4): bronchodilate
Definition
the amygdala can stimulate the hypothalmus to stimulate what?
Term
perfusion does not change, but there is increased airway resistance that decreases ventilation V/Q DECREASES

note: it decreases initially until the hypoxic vasoconstriction takes over to balance out V/Q
Definition
what does asthma do to V/Q ratio? why?
Term
IgE, theses are the allergy response antibodies which develop from asthmatic's hypersensitivity to foreign substances in the air
Definition
wht type of antibodies form in large amounts with Asthma? why?
Term
induce smooth muscle contraction, cause edema, and mucus secretion
Definition
when mast cells release histamine, leukotrienes, and bradykinin, what happens to the lungs?
Term
increases, remember asthma is a disease of expiration, so they have issues exhaling and air is trapped in the chest

gives you a barrel shaped chest
Definition
what does Asthma do to functional residual capacity and residual volume? to your chest shape?
Term
80% in an asthmatic, their airway is OBSTRUCTED so it goes down to about 47%
Definition
what is normal forced expiratory volume in 1 second/forced expiratory vital capacity? in an asthmatic?
Term
increases it w/ asthma, COPD does nothing (remember FEV score is normally 80%, but in asthmatics its 47%)
Definition
what does albuterol do to FEV score in asthma? COPD?
Term
smoking
chronic infection
chronic obstruction
entrapment of air in alveoli
Definition
what causes Emphysema and COPD?
Term
COPD, Emphysema, chronic bronchitis
Definition
characterized by 1)increased airway resistance(V) 2)decrease in diffusing capacity of the lung (Q) 3)decrease in elasticity of alveoli 4)(alteration of V/Q ratios) 5) loss of capillaries due to loss of alveolar walls 6) hypoxia and hypercapnia(increased CO2) over time
Term
areas of the lung with bronchiolar obstruction have LOW V/Q
while areas of the lung with loss of alveolar walls have HIGH V/Q

p.530 of the textbook
Definition
what does emphysema/COPD do to V/Q ratio? (Just for you Kayla)
Term
it is decreased due to destruction of alveoli
Definition
what happens to Surface area of the lung with emphysema?
Term
resistance is much higher at pretty much all lung volumes, but not as bad at higher volumes, so people with COPD breather at higher lung volumes
Definition
in COPD, what happens to airway resistance?
Term
decreases ventilation, due to decreased compliance(inspiration is hard) and thickened alveolar membrane slows diffusion
Definition
what does fibrotic lung disease do to V/Q ratios?
Term
inhalation of fine particulate matter reaches the alveoli epithelium and cause inflammation leading to increased fibroblast and collagen production (scar tissue made)
Definition
cause of fibrotic lung disease (give sequential development)
Term
fibrotic lung disease
Definition
disease characterized by decreased compliance and fibrous scar tissue in alveoli
Term
O2 tanks, change PO2 so diffusion driving pressure increases (Fick's law of diffusion)
Definition
what is the treatment for COPD? why?
Term
premature birth, diabetic mothers, C-section birth, lack of surfactant production by child
Definition
cause of newborn respiratory distress syndrome:
Term
Newborn Respiratory Distress Syndrome
Definition
what is characterized by alveoli closing after expiration(Atelectasis) and lack of oxygen exchange?
Term
the collapse of part or (much less commonly) all of a lung.
Definition
what is atelectasis?
Term
Left Ventricular heart failure -> high systemic resistance to bloodflow over time -> left ventricle cannot meet work load -> blood pools in pulmonary system -> pulmonary pressure builds -> fluid collects in lungs (pulmonary edema)
Definition
give the sequential causes of congestive heart failure (start with left ventricular heart failure
Term
congestive heart failure
Definition
characterized by less oxygen exchange at the lungs, less O2 for the heart tissue, heart continues to get weaker and weaker
Term
blood pools in systemic (edema in the legs)
Definition
if you have right heart failure, what happens?
Term
lung susceptible to emboli (b/c blood from venous system dumps in there) -large emboli in pulmonary artery can cause ischemia
Definition
describe the causes of Pulmonary Embolism/Infarction
Term
Pulmonary Embolism/Infarction
Definition
characterized by reduced blood flow in pulmonary tissue, lung damage, and altered V/Q ratios
Term
veins, they go to the heart and then the lungs causin PE
Definition
where do blood clots form? where do they go?
Term
genetic (autosomal recessive)
CTFR(cystic fibrosis transmembrane conductance regulator) gene mutation, which messes up a chloride channel allowing

normally Cl is pumped out of the lung onto the surface to draw water out and thin out mucus
Definition
what causes cystic fibrosis?
Term
faulty CFTR = thick mucus
causes obstructions and infections
salty sweat
problems absorbing fats and fat soluble vitamins (kids used to die from failure to thrive because of this)
CF patients also are easily dehydrated and lose electrolytes
Definition
list the characteristics of Cystic fibrosis
Term
release elastase (may damage lung cells)
release DNA (thickens mucus)
Definition
what do neutrophils release as they die fighting a bacterial infection, and what does that do to the lung?
Term
it is a treatment for Cystic Fibrosis that cuts DNA (DNAse) that helps thin mucus
Definition
what does pulmozyme do?
Term
1)inhaling hypertonic saline solutions(draws out h2O to thin the mucus
2)steroids (reduces inflammatory response)
3)Pulmozyme
Definition
what are the treatments for cystic fibrosis?
Term
they inhale a lot of saline solution which helps draw water out and thin the mucus of the lungs
Definition
why are surfers more likely to have a better prognosis with Cystic Fibrosis?
Term
substitution of valine for a glutamic acid
(autosomal recessive)
Definition
what causes sickle cell?
Term
abnormally shaped RBC's, low binding capacity for O2, blockage of small capillaries and arterioles, Fatigue
Definition
what is Sickle Cell characterized by?
Term
NO, NO, NO, NO, NO!!!!!!!!!!!

sickle cell has to do with the O2 getting to the tissues and blocking capillaries from their weird shape, it has nothing to do with alveolar or arterial pressure!!!
Definition
does Sickle cell affect the A-a gradient?
Term
nicotinic
Definition
Myasthenia Gravis autoimmune disorder that causes antibody production to Ach ________ receptors
Term
decreased ACh receptors on skeletal muscles of respiratory system
decreased respiratory response to stimuli

(can cause hypoventilation)
Definition
what are the characteristics of Myasthenia Gravis?
Term
decreases Ach receptors
reduces folds
widens synaptic spaces
Definition
Myasthenia Gravis _______ Ach receptors, ________ folds, and _________ synaptic spaces
Term
steroids, receptor agonists, Ach-ase inhibitor(physostignine)
Definition
how do you treat myasthenia Gravis?
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