Neurological Localization Of Respiration

The organ of control over breathing, the brain, orchestrates respiration through many layers of neural circuitry. From the respiratory-related muscles, peripheral receptors and nerves to brainstem, midbrain and cortical feedback loops, a variety of inputs augment and regulate ventilation and respiration. This multilayered control system permits for a variety of ventilatory patterns that can give clues to the site of potential neurological dysfunction (1) (Table 1).

The ventilatory cycle relies upon sensory inputs to estimate the somatic requirements. This sensory input is derived primarily from three components: (i) the vagus nerve relaying information from the pulmonary stretch receptors in the lung and aorta, (ii) the intercostals nerves and spinal cord relaying positional sense from the chest wall, (iii) and the chemoception. Chemoception utilizes two sensory areas: central and peripheral. Central chemoceptors are predominantly on the ventral aspect of the medulla. These receptors sense acid and carbon dioxide. The peripheral chemoceptors are in the aorta and carotid body and their information are relayed via the glossopharyngeal nerve. The carotid chemoceptors detect the oxygen content of the arterial blood. These sensors increase their firing rates when oxygen levels fall. These sensory nerves are typically myelinated but also convey some input via partially myelinated and unmyelinated axons. Processes such as diabetes

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