呼吸科呼吸系统课件4PPT课件下载推荐.ppt

呼吸科呼吸系统课件4PPT课件下载推荐.ppt

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5.4ControlofRespirationlBreathingisacriticalrobusthomeostaticprocessthatensuresadequatelevelsofoxygeninbloodandprovidesameanstoremovecarbondioxidefromthebody2022/11/51BasicRequirementsforRespiratoryRegulation2022/11/52lItmustbeautomaticlMaintenanceofCO2andO2levelsshouldnotdependonlevelsofconsciousnessoralertnesslItmustbeadaptabletotheneedsoftheorganismlTheremustbemechanismstocompensateforchangesinoxygenuptakeorCO2production.lItmustbesubjecttovoluntarycontrollTheremustbemechanismstovoluntarilyoverridetherespiratorycontrolmechanismsatleastforbriefperiodsoftimeRespiratoryCentersandtheBasicRespiratoryCenterlRespiratorycenterlBrainregionsorthespinalcordthatinvolveinthegenerationofrhythmicrespiratorypatternandtheregulationofrespiratorymovement;@#@theyarelocatedinthespinalcord,brainstem,cortex,thalamusetc.lBasicrespiratorycenterlBrainpartsthatareresponsibleforgenerationofbasicrespirationpatternslItislocatedinthebrainstemTheExperimentDonebyLumsdenintheCatConclusionsUpperpons-pneumotaxiccenter;@#@lowerpons-apneusticcenter（notaccepted）;@#@Spinalcord-Basicrespiratorycenter;@#@spinalcord:

@#@CutatBreathingpattern（vagusnerveintact）Breathingpattern（vagusnervecutoff）MidbrainandtheponsNearlynormalDeepandslowMidponsNearlynormalApneusticbreathingPonsandmedullaIrregularCheyne-StokesbreathingMedullaandthespinalcordNobreathingNobreathing2022/11/55Respiratory-RelatedNeuronsintheBasicRespiratoryCenterlDorsalrespiratorygroup（DRG）lLocatedinthedorsalregionofthenucleustractussolitariilMainlycontaininspiratoryneuronslGeneratebasicrhythmlVentralrespiratorygroup（VRG）lAcolumnofcellsinthegeneralregionofthenucleusambiguus.lIthousesbothinspiratoryandexpiratoryneuronslMostneuronsaresilentduringnormalquietrespirationPneumotaticcenterItactstolimitinspiration.Asaresult,itincreasestherateofbreathingIsthePre-BtzingerComplexEssentialfortheGenerationofBasicRespiratoryPattern?

@#@ModifiedfromBrain2011:

@#@134;@#@2435Medullaoblongata=延髓Pons=脑桥Lateralreticularnucleus（LRN）=外侧网状核XII=面神经Obex=栓、门MSA=multiplesystematrophySCA3=spinocerebellarataxiatype3MultipleSystemsAtrophyvs.SpinocerebellarAtaxia3PatientswithmultiplesystemsatrophypresentwithcentralrespiratorydeficitsbutwithoutswallowingproblemsPre-BtzingerComplexneuronsarereducedwhereasambigualmotoneuronsarepreserved.Patientswithspinocerebellarataxia3hasnocentralrespiratorydeficitsbutwithdysphagia,Pre-BtzingerComplexneuronsarepreserved,whereasambigualmotoneuronsarediminished.NeuralMechanismsunderlyingtheGenerationofRhythmicRespirationTwoHypothesesOscillatorytheoryorthepacemakerhypothesis（起步细胞学说）Networktheory（神经网络学说）OscillatoryTheoryPacemakerneuronsgeneratetherespiratoryrhythm（Smithetal.,Science,1991）.Neuronsinpre-BtzingercanBurstspontaneouslyRegularfiringinducedbycurrentinjectioninahippocampalgranulecellSpontaneousburstingInaratpre-BtzingerneuronNeuronsinpre-BtzingercanBurstspontaneouslyRegularfiringinducedbycurrentinjectioninahippocampalgranulecellSpontaneousburstingInaratpre-Btzingerneuron2022/11/512Basicrespiratorycenter（Medullaandpons）Voluntarycontrol（Cerebrum）SpinalmotorneuronsIntercostalsDiaphragm&@#@accessorymusclesMusclesofrespirationCentralChemoreceptorsPeripheralChemoreceptorsChemoreceptorsStretchreceptorsIrritantreceptorsJReceptorsMuscleproprioceptorsMechanoreceptorsPhrenicnervesothernerveslVoluntarycontrolofrespirationisneededinsuckling,swallowing,sniffing,chewing,coughing,vomitingandvocalization.lVoluntarycontroloverpulmonaryventilationoriginatesinthemotorcortexofcerebralfrontallobe.lTheimpulsesaretransmitteddownthecorticospinaltractstotherespiratoryneuronsinthespinalcord,bypassingthebrainstemrespiratorycenters.VoluntaryControlofBreathingCHEMICALCONTROLOFRESPIRATIONPeripheralChemoreceptorsystemCentralChemoreceptorsystemRespiratoryActivityisSensitivetoOxygen,CarbonDioxide,andHydrogenIonsintheBloodlTheoverallgoalofrespirationistomaintainproperconcentrationsofoxygen,carbondioxide,andhydrogenionsinthetissues.lRespiratoryactivityishighlysensitivetochangesineachofthese.lExcesscarbondioxideorexcesshydrogenionsinthebloodmainlyactonthecentralchemoreceptorsystemwhereashypoxiaactsentirelyontheperipheralchemoreceptorsystem.PeripheralChemosensoryReceptorSystem2022/11/516AfferentPathwaysCarotidbodiesCarotidsinusnerveglosopharyngial（IXCN）medullanearnucleustractussolitarius（NTS）AorticbodiesJointhevagus（XCN）medullanearnucleustractussolitarius（NTS）PeripheralChemoreceptorsshouldbeDistinguishedfromBaroreceptorslCarotidarterybodiesandaorticbodies:

@#@chemoreceptorslCarotidbodiesareatthedivisionofthecommoncarotidarteryintotheexternalandinternalcarotid.TheaorticbodyisontheaorticarchlCarotidarterysinusandaorticarc:

@#@baroreceptors（theyarewithinthewallsofthebloodvessels）lBaroreceptorssensethetensionofbloodvesselsFunctionsofPeripheralChemoreceptorslSensePO2,PCO2andH+inthearterialbloodlPrimarilysensitivetoarterialPO2hyperventilatio