LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 224 ❚ 2. Know that both mechanical and chemical stimuli elicit responses from the rapidly adapting irritant receptors c. Reflex response 1. Know that the Hering-Breuer reflex is mediated by slowly adapting stretch receptors 2. Know that cough, bronchoconstriction, and increased mucus production are responses to stimulation of rapidly adapting irritant receptors 3. Know that hyperpnea is the dominant response to stimulation of rapidly adapting stretch receptors within the lung 4. Understand the role of irritant receptors in the adaptive response to adverse environmental stimuli 2. J receptors a. Know the anatomic location of the J receptors b. Know the stimuli for J-receptor activity c. Recognize the pattern of ventilatory response to stimulation of the J receptors b. Chest wall receptors 1. Types a. Know that muscle spindles innervated by gamma-afferent fibers are found in the intercostal muscles 2. Role a. Know that muscle spindles in the intercostal muscles are involved in respiratory compensation for increased work of breathing B. Central chemoreceptor 1. Location a. Know that central chemoreceptors are located in the medulla oblongata b. Know that central chemoreceptors are separated from arterial blood 2. Stimulus a. Recognize the pattern of response of the central chemoreceptors to increased arterial PCO2 b. Know that the central chemoreceptor accounts for more of the ventilatory response to carbon dioxide than the carotid bodies c. Know that central chemoreceptors respond to pH changes in cerebrospinal fluid (CSF) surrounding the medulla: arterial CO2 diffuses into the CSF, stimulating the chemoreceptors, which increases ventilation d. Know that central chemoreceptors stimulate a linear increase in minute ventilation as PaCO2 is increased e. Know that central chemoreceptor stimulation can be blunted by chronically increased PaCO2 as metabolic compensation restores blood pH towards normal f. Know that hypoxemia and acidemia accentuate the central chemoreceptor- stimulated ventilatory response to CO2 while hyperoxemia and alkalemia depress it C. Central neuronal control D. Factors that influence control of respiration 1. Development of control of respiration a. Fetal breathing activity 1. Identify factors that increase and decrease fetal breathing