Download - Respiratory system part 1
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Respiratory System
• Presented By – Prof.Dr.R.R.Deshpande
Mobile – 922 68 10 630
05/02/23 Prof.Dr.R.R.Deshpande 1
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Sharir Kriya -- Paper I –Part B –Point 3
• Presented By – • Prof.Dr.R.R.Deshpande (M.D in Ayurvdic
Medicine & M.D. in Ayurvedic Physiology)• www.ayurvedicfriend.com• Mobile – 922 68 10 630• [email protected]
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Sharir Kriya Paper 1-Part B –Set 3
• Presented By –
• Dr.R.R.Deshpande
• Prof & HOD
• CARC ,Pune 44
05/02/23 Prof.Dr.R.R.Deshpande 3
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Sharir Kriya Text Books
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Sharir Kriya Hand Book – 1st to last year BAMS
• Best for Fast Revision • Paper 1,Paper 2• Practicals• Instruments• Histology• IMP Schlok• All basics of
Dodha,Dhatu & Mala
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Sharikriya Paper Practical Book• As per Very New
Syllabus formed By CCIM IN 2012
• Ayurvedic Practicals like Prakruti,sara,Agni
• Modern Haematological Practicals
• CNS & CVS Examination
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Clinical Examination
• Systemic Examination of 8 systems
• Ayurvedic Srotas Examination
• Clinical significance of Lab Tests & Radiology,USG,2D Echo
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Sharir Kriya Paper 1
• Book in English • Total CCIM Syllabus
covered • Chaukhamba Sanskrit
Pratisthan Publication • Popular Nationwide &
In Germany also• Dosha & Prakruti
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Sharir Kriya Paper 2
• Book in English • Total CCIM Syllabus
covered • Chaukhamba Sanskrit
Pratisthan Publication • Popular Nationwide &
In Germany also• Dhatu,Mala
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Prof.Dr.Deshpande’s Popular Links on Internet
• Just Start Internet on Desk top or Lap top or on your mobile . Copy Following Link & Paste as Web address –URL
• http://www.youtube.com/user/deshpande1959
• http://www.slideshare.net/rajendra9a/• http://www.mixcloud.com/jamdadey/
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Prof.Dr.Deshpande’s Popular Links on Internet
• Just Start Internet on Desk top or Lap top or on your mobile . Copy Following Link & Paste as Web address –URL
• http://professordeshpande.blogspot.in• http://professordrdeshpande.blogspot.in/• http://www.mixcloud.com/rajendra-deshpand
e• https://soundcloud.com/professor-deshpande
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Respiration
• Every organism requires a constant supply of energy.
• It is obtained from the oxidation of food molecules in every cell.
• In animals, the oxygen is supplied by a specialized system called as Respiratory System
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Functional anatomy of respiratory system
• Respiration in man occurs by lungs. So the process is termed as Pulmonary Respiration.
• Respiratory system consists of the following organs.
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Conducting organs
• 1) Nostrils & nasal chamber
• 2) Nasopharynx
• 3) Larynx
• 4) Trachea
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Main organs
• 5) Bronchi & bronchioles
• 6) Lungs & alveoli (air sacs)
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1) Nostrils & Nasal Chamber
• A pair of nostrils leads to nasal chamber / cavities.
• It is divided into right & left halves by a cartilage.
• It is differentiated in 3 parts as follows• Vestibular• Respiratory• Olfactory
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Vestibular Part
• It is the anterior most region of the nasal chamber lined by mucus & hairs.
• So dust particles are filtered & settled or caught in the mucus
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Respiratory Part
• It is the middle air conducting chamber with rich supply of blood capillaries
• This provides moisture by which air is made warm or cool & moist
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Sensory or Olfactory Part
• It is internally lined by olfactory epithelium for detection of smell.
• Vibrating cilia also push dust particles towards pharynx where it is swallowed into esophagus.
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Respiratory System
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2) Nasopharynx
• Nasal chamber opens into ---
• Nasopharynx where respiratory opening (glottis) & oesophageal opening (gullet) cross each other forming pharyngeal chisma.
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3) Larynx (Sound Box / Adams Apple)
• It is located in the neck region ventral to oesophagus.
• It contains vocal cords for producing sound of different pitch.
• Its anterior opening (glottis) is guarded by a cartilaginous flap epiglottis, which prevents the entry of food particles while swallowing.
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4) Trachea (Wind Pipe)
• It is about 11 cm long & 2. 5 cm broad tube supported by 16 - 20 complete C shaped cartilage rings which avoid the collapsing of trachea.
• It is internally lined by ciliated mucus membrane which propel dust particles towards larynx to oesophagus where they are swallowed.
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5) Bronchi & Bronchioles
• The distal end of trachea bifurcates into 2 bronchi. • Each bronchus is supported by complete
cartilaginous rings.• Each bronchus divide & re divide to form branching
system of bronchioles. • Cartilage rings are absent in bronchioles.• Each bronchiole terminates in alveolar duct.
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Bronchial Asthama
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Bronchial Asthama
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Bronchiectasis
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Bronchiectasis
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6) Lungs with Alveoli
• A pair of conical brownish gray, highly elastic & spongy organs situated in thoracic cavity by the side of the heart.
• Lungs are protected by rib - cage & intercostals muscles of thorax on lateral side & dome shaped muscular partition diaphragm on posterior side
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6) Lungs with Alveoli
• Lungs are covered by double pleural membranes - outer parietal & inner visceral pleural membranes.
• Inter pleural cavity filled by Pleural fluid.
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Lungs
• Right lung is divided into anterior, middle & posterior lobes
• Left lung is divided into 2 lobes - ant. & post. lobes
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Bronchus – Bronchiole - Alveoli
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Alveoli / Air - Sacs
• The spongy nature of lungs is due to alveoli or air - sacs.
• Lungs contain about 30 millions of air sacs arranged like bunches of grapes.
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Alveoli / Air - Sacs
• The walls of alveoli are very thin & composed of one cell thick layer.
• The alveoli are surrounded by fine network of capillaries to ensure an easy exchange of oxygen & carbon dioxide.
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Alveoli / Air - Sacs
• Pulmonary artery brings deoxygenated blood from the right ventricle of the heart to lungs
• Pulmonary vein carries oxygenated blood from the lungs to the left auricle of the heart
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Alveoli / Air - Sacs
• Inflation & deflation of the lungs ensures that regular exchange of gases takes place between the alveoli & the external air.
• This is dependent upon the arrangement of the pleura, the contraction & relaxation of the muscles of respiration & the elastic connective tissue.
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Emphysema
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Muscles of Respiration
• The expansion of the chest during inspiration occurs as a result of muscular activity, partly voluntary & partly involuntary.
• The main muscles of respiration in normal quiet breathing are the intercostal muscles & the diaphragm.
• During difficult or deep breathing they are assisted by the muscles of the neck, shoulders & abdomen
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1) Intercostal Muscles
• There are eleven pairs of intercostal muscles that occupy the space between the twelve pairs of ribs.
• They are arranged in 2 layers, the external & Internal intercostal muscles.
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1) Intercostal Muscles
• The first rib is fixed.
• Therefore, when the inter costal muscles contract, they pull all the other ribs towards the first rib.
• Because of the shape of the rib they move outwards when pulled upwards.
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1) Intercostal Muscles
• In this way the thoracic cavity is enlarged anterio - posterior & laterally.
• The inter costal muscles are stimulated to contract by the inter costal nerves
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2) Diaphragm
• The Diaphragm is a dome shaped structure separating the thoracic & abdominal cavities.
• It forms the floor of the thoracic cavity & roof of the abdominal cavity
• Consists of a central tendon from which muscle fibers radiate to be attached to the lower ribs & sternum & to the vertebral column by 2 cura
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2) Diaphragm• When the muscle of the Diaphragm is relaxed, the central
tendon is at the level of the 8th thoracic vertebra.
• When it contracts, its muscle fibres shorten & the central tendon is pulled downward enlarging the thoracic cavity in length.
• This decreases the pressure in the thoracic cavity & increases it in the abdominal & pelvic cavities.
• • The Diaphragm is supplied by the phrenic nerves.
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Costo Phrenic angle
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Muscles of Respiration
• The intercostal muscles & the Diaphragm contract simultaneously
• This ensures the enlargement of the thoracic cavity in all direction.
• From back to front, side to side & up to bottom.
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Cycle of Respiration
• This occurs 16 to 18 times / min. & consists of 3 phases.
• 1) Inspiration, 2) Expiration, 3) Pause
• As described previously, the visceral pleura is adherent to the lungs & the parietal pleura to the inner wall of the thorax & to the diaphragm.
• Between them there is a thin film of serous fluid.
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Important steps in Respiration Process
• 1) Ventilation
• 2) Diffusion
• 3) Perfusion
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Ventilation
• This is the rate at which air enters or leaves the lungs• It is of 2 types --Pulmonary ventilation - This is the
volume of air, moving in & out of respiratory tract in a given unit of time during quite breathing.
• This is also called as minute ventilation or Respiratory Minute Volume (RMV). Pulmonary ventilation is a cyclic process
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Pulmonary Ventilation
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Alveolar ventilation
• This is the amount of air utilized for gaseous exchange every minute.
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Inspiration
• When the capacity of the thoracic cavity is increased by simultaneous contraction of the intercostal muscles & the diaphragm, the parietal pleura moves with the wall of the thorax.
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Inspiration
• This reduces the pressure in the pleural cavity to a level considerably lower than atmospheric pressure.
• The visceral pleura follows the parietal pleura. • During this process, the lungs are stretched & the
pressure within the alveoli & in the air passages is reduced, drawing air into the lungs in an attempt to equalize the atmospheric & alveolar air pressures.
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Inspiration
• This process of inspiration is active because it requires expenditure of energy for muscle contraction
• The negative pressure created in the thoracic cavity
• This helps venous return to the heart • This is known as the respiratory pump
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Expiration
• Relaxation of the intercostal muscles & Diaphragm results in downwards & inward movement of the rib cage & elastic recoil of the lungs.
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Expiration
• As this occurs, the pressure of gases inside the thorax exceeds that in the atmosphere & therefore air is expelled from the respiratory tract.
• The lungs still contain some air & are prevented from complete collapse by the intact pleura.
• This process is passive as it does not require the expenditure of energy.
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Pause
• After expiration there is a pause before the next cycle begins.
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Physiological Variables Affecting Respiration
• Elasticity
• Loss of elasticity of the connective tissue in the lungs necessitates forced expiration & increased effort on inspiration
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Physiological Variables Affecting Respiration
• Compliance• This is a measure of the distensibility of the lungs i.e.
the effort required to inflate the alveoli.
• When compliance is low, the effort needed to inflate the lungs is greater than normal. eg. in some diseases where elasticity is reduced or when insufficient surfactant is present
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Changes in Thoracic Cavity
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Airflow Resistance
• When this is increased eg. in broncho constriction, more respiratory effort is required to inflate the lungs.
• Lung function tests are carried out to determine respiratory function & are based on the parameters outlined above.
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Composition of Air
• Atmospheric pressure at sea level is 760 mmHg.
• With the increase in height above sea level, atmospheric pressure is progressively reduced & at 18, 000 ft it is about half that at sea level.
• Under water, pressure increases by approximately 1 atmosphere per 10 m below sea level.
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Composition of Air
• Air is a mixture of gases, nitrogen, oxygen, carbon dioxide, water vapour & small quantities inert gases
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The Composition ofInspired & Expired Air
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Parietal Pressure of Gases
• Each gas in the mixture exerts a part of the total pressure proportional to its concentration, i.e. the partial pressure.
• This is denoted as PO2, PCO2.
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Parietal Pressure of Gases
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Alveolar air
• The composition of alveolar air remains fairly constant & is different from atmospheric air.
• It is saturated with water vapor & contains more carbon dioxide & less oxygen
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Alveolar air
• Saturation with water vapor provides 47 mmHg thus reducing the partial pressure of all the other gases present.
• Gaseous exchange between the alveoli & the blood stream (external respiration) is a continuous process as the alveoli are never empty so it is independent of the respiratory cycle.
• During each inspiration only some of the alveolar gases are exchanged.
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Expired Air
• This is a mixture of alveolar air & atmospheric air in the dead space.
• Its composition is shown in the table above.
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Diffusion of Gases
• Exchange of gases occurs when a difference in partial pressure exists across semi permeable membranes.
• Gases move by diffusion from the higher concentration to the lower concentration until equilibrium is established
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Diffusion of Gases
• Atmospheric nitrogen is not used by the body so its partial pressure remains unchanged & is the same in inspired & expired air, alveolar air & in the blood
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External Respiration
• This is exchange of gases by diffusion between the alveoli & the blood.
• Each alveolar wall is one cell thick & is surrounded by a network of tiny capillaries.
• The total area for gas exchange in the lungs is 70 to 80 sq. meters.
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External Respiration
• Carbon dioxide diffuses from venous blood along its concentration gradient into the alveoli until equilibrium with alveolar air is reached
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External Respiration
• When blood leaves the alveolar capillaries, the processed oxygen diffuses from the alveoli into the blood.
• The slow flow of blood through the capillaries increases the time available for diffusion & carbon dioxide concentrations are in equilibrium with those of alveolar air.
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External respiration – the entire change of gases between air & the
alveoli & the blood capillaries
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Internal Respiration
• This is exchange of gases between blood in the capillaries & the body cells.
• When there is a difference in partial pressures oxygen diffuses outwards from the arterial end of capillaries into the surrounding extracellular fluid then through cell walls
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Internal Respiration
• The process involved is that of diffusion from a higher concentration of oxygen in the blood to a lower concentration in the cells, i.e. the concentration gradient.
• Carbon dioxide diffuses from the cells into the extracellular fluid then the bloodstream towards the venous end of the capillary.
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Internal respiration – Exchange of gases between capillaries &
the tissues.
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O2 & CO2 carriage by blood
• Transport of Gases• 1) Transport of oxygen• O2 is transported from lungs to the tissues,
through arterial blood.• Transport occurs by 2 methods.• a) Oxyhaemoglobin Form• 98% of O2 is transported by binding with
Haemoglobin & forming Oxyhaemoglobin.
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Formation of oxyhaemoglobin
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Clinical Application
• In Anaemia / Co poisoning, O2 transport becomes less. This is called as 'Anaemic Hypoxia'.
• Hb4O8 → Oxyhemoglobin• Oxyhemoglobin is formed at lungs, then
transported to tissues.• At the tissue, O2 is liberated & Hb is made
free.
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O2 Dissociation curve
• It is S - shaped curve. At PO2 - 40 mm Hg. Curve is very sharp, indicating maximum dissociation of O2 from Hb at tissue level.
• Curve shift to the right (Bohr’s effect) when PCO2 increases, H+ ion increases & temperature increases.
• Shift to the left occurs, when PCO2 ↓, H+ ions ↓ & temperature ↓.
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b) Dissolved form
• Very little quantity of oxygen (2 %) is transported in dissolved form.
• The reason for this is solubility of O2 is very poor.
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2) Transport of CO2
• CO2 is transported from tissues to lungs, through venous blood.
• CO2 transport occurs in the following 3 ways.• a) Bicarbonate form• Major quantity of CO2 (93%) is transported by this
method. • Near tissue CO2 combines with the H2CO3, which
dissociated to form H+ & HCO3 -
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2) Transport of CO2
• These bicarbonates are transported to lungs. Near lungs opposite
• reaction occurs & CO2 & water vapour is liberated, which is thrown
• out through expiration. These bicarbonates These Bicarbonates are transported to lungs. Near lungs opposite reaction occurs & CO2 & water vapour is liberated, which is thrown out through expiration.
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2) Transport of CO2
• b) Carbamino compound• CO2 combines with plasma proteins to form
carbamino proteins (plasma)• CO2 also combines with Hb to form
carbamino - hemoglobin (in RBC’s)• These compounds are brought to the lung &
CO2 is liberated from them
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2) Transport of CO2
• c) Dissolved form• Less quantity of CO2 is dissolved in plasma &
red cell & is transported to the lungs through venous blood.
• Near lung CO2 is given out.
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Clinical Application
• When acidic metabolites accumulate, condition is called as ‘acidosis’ this may be due metabolic or respiratory or renal causes.
• Inj. Sodibicarb is used in this situation
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Regulation of Respiration
• 1) Nervous Control
• 2) Chemical Control
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Control of Respiration
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Nervous Regulation
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Functions of centers
• 1) DRGN - inspiratory centre• Main centre to regulate the respiration. They
produce action potential.
• Centre is connected to spinal cord, phrenic nerves, intercostal nerves & to inspiratory muscles.
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DRGN - inspiratory centre
• When signals are sent to inspiratory muscles they contract & inspiration occurs when centre stops functioning expiration occurs passively.
• In quite respiration, only this centre is active.
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2) VRGN - Expiratory centre
• Centre is connected to expiratory muscles (internal intercostal & abdominal muscles)
• It works only during exercise, reciprocal to DRGN (during exercise CO2 ↑, H+ ion ↑, formation of lactic acid & it is expelled out)
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Functions of centers
• 3) Apneustic centre• It is connected to inspiratory centre &
pneumotaxic centre.• 4) Pneumotaxic centre• It is also connected to inspiratory & apneustic
centre.• Last 2 centres maintain rhythmic function of
DRGN
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Different reflexes to control the process of Respiration
• 1) Herring, Breuer’s reflex (inflation reflex)• In the wall of Bronchi & pleura, stretch receptors are
present.• When inspiration takes place & chest expands, these
receptors are stimulated afferent impulses via vagus nerve go to DRGN which causes its inhibition. This reflex requires tidal volume of 1. 5 lit.
• So this reflex has no role in quiet respiration. It works only during exercise.
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2) Role of ‘J’ receptors
• Special Nerve endings are located between alveolus & pulmonary capillary.
• They are stimulated by pulmonary oedema & send afferent impulses through vagus to the Respiration
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Respiration Control
• 3) Lung irritant receptors • Located in bronchi irritant substances
stimulates these receptors & R. R.
• 4) Coughing reflex - Foreign particles in respiratory tract cause cough reflex.
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Respiration Control
• 5) Sneezing reflex - Irritation of nasal mucosa causes sneezing reflex.
• 6) Deglutition reflex - at the time of pharyngeal stage of deglutition, respiration stops temporarily (epiglottis )
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Control of cerebral cortex
• Higher centers can alter the act of respiration (Voluntary Control)
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Chemical regulation of Respiration
• 1) Role of CO2• Accumulation of CO2 increases R. R. • Peripheral chemoreceptors are located in carotid
body & aortic bodies. • These are sensitive for CO2, H+ ions & lack of O2 • CO2 stimulates the chemoreceptors afferent
impulses go via 9th & 10th cranial N. which stimulates DRGN & R. R.
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Chemical regulation of Respiration
• 2) Role of H+ ions• Excess H+ ions in the blood also stimulate the
respiration.• 3) Role of lack of O2• When PO2 is less than 60 mm of Hg. Afferent
impulses go to DRGN & R. R.
• Important note - CO2 is more potent stimulus for respiration than lack of O2.
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Functions of Respiration
• 1) To supply O2 & remove CO2 from the body.• 2) To regulate hydrogen ion concentration of
the blood.• 3) To increase arterial O2 tension.• 4) To help in the regulation of the body
temperature
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Prof.Dr.R.R.Deshpande
• Sharing of Knowledge
• FOR
• Propagating Ayurved
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