Respiratory

Author(s):  
Mark Harrison

This chapter describes the pathophysiology of the respiratory system as it applies to Emergency Medicine, and in particular the Primary FRCEM examination. The chapter outlines the key details of the control of ventilation, reflexes, pressure, chemical, and irritant receptors, J receptors, pulmonary stretch receptors, Golgi tendon organs, muscle spindles, lung volumes, pulmonary mechanics, oxygen and carbon dioxide transport, DO2/VO2 relationships, carbon monoxide, pulse oximetry, effects of altitude, and dysbarism. This chapter is laid out exactly following the RCEM syllabus, to allow easy reference and consolidation of learning.

Author(s):  
Dr Mark Harrison

1.1 Control of ventilation, 436 1.2 Reflexes in ventilatory control, 437 1.3 Pressure, chemical, and irritant receptors, 438 1.4 J receptors, 438 1.5 Pulmonary stretch receptors, 438 1.6 Golgi tendon organs, 438 1.7 Muscle spindles, 438 1.8 Lung volumes, 438 1.9 Pulmonary mechanics, 439 1.10...


2013 ◽  
Vol 109 (4) ◽  
pp. 1126-1139 ◽  
Author(s):  
Dinant A. Kistemaker ◽  
Arthur J. Knoek Van Soest ◽  
Jeremy D. Wong ◽  
Isaac Kurtzer ◽  
Paul L. Gribble

Whereas muscle spindles play a prominent role in current theories of human motor control, Golgi tendon organs (GTO) and their associated tendons are often neglected. This is surprising since there is ample evidence that both tendons and GTOs contribute importantly to neuromusculoskeletal dynamics. Using detailed musculoskeletal models, we provide evidence that simple feedback using muscle spindles alone results in very poor control of joint position and movement since muscle spindles cannot sense changes in tendon length that occur with changes in muscle force. We propose that a combination of spindle and GTO afferents can provide an estimate of muscle-tendon complex length, which can be effectively used for low-level feedback during both postural and movement tasks. The feasibility of the proposed scheme was tested using detailed musculoskeletal models of the human arm. Responses to transient and static perturbations were simulated using a 1-degree-of-freedom (DOF) model of the arm and showed that the combined feedback enabled the system to respond faster, reach steady state faster, and achieve smaller static position errors. Finally, we incorporated the proposed scheme in an optimally controlled 2-DOF model of the arm for fast point-to-point shoulder and elbow movements. Simulations showed that the proposed feedback could be easily incorporated in the optimal control framework without complicating the computation of the optimal control solution, yet greatly enhancing the system's response to perturbations. The theoretical analyses in this study might furthermore provide insight about the strong physiological couplings found between muscle spindle and GTO afferents in the human nervous system.


Neuroscience ◽  
1978 ◽  
Vol 3 (2) ◽  
pp. 259-270 ◽  
Author(s):  
J.P. Lund ◽  
Frances J.R. Richmond ◽  
Christianne Touloumis ◽  
Y. Patry ◽  
Yves Lamarre

Author(s):  
David Chambers ◽  
Christopher Huang ◽  
Gareth Matthews

2018 ◽  
Vol 373 (1759) ◽  
pp. 20170327 ◽  
Author(s):  
Ronen Blecher ◽  
Lia Heinemann-Yerushalmi ◽  
Eran Assaraf ◽  
Nitzan Konstantin ◽  
Jens R. Chapman ◽  
...  

Muscle spindles and Golgi tendon organs (GTOs) are two types of sensory receptors that respond to changes in length or tension of skeletal muscles. These mechanosensors have long been known to participate in both proprioception and stretch reflex. Here, we present recent findings implicating these organs in maintenance of spine alignment as well as in realignment of fractured bones. These discoveries have been made in several mouse lines lacking functional mechanosensors in part or completely. In both studies, the absence of functional spindles and GTOs produced a more severe phenotype than that of spindles alone. Interestingly, the spinal curve phenotype, which appeared during peripubertal development, bears resemblance to the human condition adolescent idiopathic scoliosis. This similarity may contribute to the study of the disease by offering both an animal model and a clue as to its aetiology. Moreover, it raises the possibility that impaired proprioceptive signalling may be involved in the aetiology of other conditions. Overall, these new findings expand considerably the scope of involvement of proprioception in musculoskeletal development and function.This article is part of the Theo Murphy meeting issue ‘Mechanics of development’.


1986 ◽  
Vol 86 (9) ◽  
pp. 114-119
Author(s):  
John N Howell ◽  
Marc D. Binder ◽  
T. Richard Nichols ◽  
Gerald E Loeb

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