Abstract
The initiation of a breath is the consequence of the interaction of a complex set of neural inputs to the respiratory centers of the brain and the mechanical properties of the ventilatory pump. Automatic and volitional elements must be considered, as well as behavioral effects resulting from symptoms and psychological factors. A range of pathological conditions may alter different pieces of the respiratory system resulting in changes in respiratory pattern and, in some cases, gas exchange. This chapter will outline the physiology of the key neuromechanical components of the respiratory system responsible for initiation of the breath and review the tests that may be used to assess the system.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Selected References
Banzett RB, Lansing RW, Brown R, et al. “Air hunger” from increased PCO2 persists after complete neuromuscular block in humans. Respir Physiol. 1990;81(1):18.
Banzett RB, Lansing RW, Reid MB, Adams L, Brown R. “Air hunger” arising from increased PCO2 in mechanically ventilated quadriplegics. Respir Physiol. 1989;76:53–68.
Brusasco V, Crapo R, Viegi G, American Thoracic Society, European Respiratory Society. Coming together: the ATS/ERS consensus on clinical pulmonary function testing. Eur Respir J. 2005;26:1–2.
Burgess KR, Whitelaw WA. Reducing ventilatory response to carbon dioxide by breathing cold air. Am Rev Respir Dis. 1984;129:687–90.
Burke RE. Motor units: anatomy, physiology and functional organization. In: Brookhart JM, Mountcastle VB, editors. Handbook of physiology, Sec. 1, Vol. III, Part 1, The nervous system. Bethesda: American Physiological Society; 1981. p. 345–422.
Chronos N, Adams L, Guz A. Effect of hyperoxia and hypoxia on exercise-induced breathlessness in normal subjects. Clin Sci. 1988;74:531–7.
Datta AK, Shea SA, Horner RL, Guz A. The influence of induced hypocapnia and sleep on the endogenous respiratory rhythm in humans. J Physiol. 1991;440:17–33.
Dick TE, Kong FJ, Berger AJ. Correlation of recruitment order with axonal conduction velocity for supraspinally driven motor units. J Neurophysiol. 1987;57:245–59.
Edström L, Kugelberg E. Histochemical composition, distribution of fibers and fatiguability of single motor units. J Neurol Neurosurg Psychiatry. 1968;31:424–33.
Enad JG, Fournier M, Sieck GC. Oxidative capacity and capillary density of diaphragm motor units. J Appl Physiol. 1989;67:620–7.
Fournier M, Sieck GC. Mechanical properties of muscle units in the cat diaphragm. J Neurophysiol. 1988;59:1055–66.
Gandevia SC, Rothwell JC. Activation of the human diaphragm from the motor cortex. J Physiol. 1987;384:109–18.
Geiger PC, Cody MJ, Macken RL, Sieck GC. Maximum specific force depends on myosin heavy chain content in rat diaphragm muscle fibers. J Appl Physiol. 2000;89:695–703.
Geiger PC, Cody MJ, Sieck GC. Force-calcium relationship depends on myosin heavy chain and troponin isoforms in rat diaphragm muscle fibers. J Appl Physiol. 1999;87:1894–900.
Henneman E. Relation between size of neurons and their susceptibility to discharge. Science. 1957;126:1345–6.
Liddell EGT, Sherrington CS. Recruitment and some other factors of reflex inhibition. Proc R Soc Lond (Biol). 1925;97:488–518.
Liss HP, Grant BJB. The effect of nasal flow on breathlessness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1988;137:1285–8.
Lois JH, Rice CD, Yates BJ. Neural circuits controlling diaphragm function in the cat revealed by transneuronal tracing. J Appl Physiol (1985). 2009;106:138–52.
Manning HL, Basner R, Ringler J, et al. Effect of chest wall vibration on breathlessness in normal subjects. J Appl Physiol. 1991;71:175–81.
Manning HL, Shea SA, Schwartzstein RM, Lansing RW, Brown R, Banzett RB. Reduced tidal volume increases ‘air hunger’ at fixed PCO2 in ventilated quadriplegics. Respir Physiol. 1992;90:19–30.
Marazzini L, Cavestri R, Gori D, Gatti L, Longhini E. Difference between mouth and esophageal occlusion pressure during CO2 rebreathing in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1978;118:1027–33.
Matthews AW, Howell JB. The rate of isometric inspiratory pressure development as a measure of responsiveness to carbon dioxide in man. Clin Sci Mol Med. 1975;49:57–68.
McCloskey DI, Gandevia S, Potter EK, Colebatch JG. Muscle sense and effort; motor commands and judgments about muscular contractions. In: Desmedt JE, editor. Motor control mechanisms in health and disease. New York: Raven Press; 1983.
Miller MR, Crapo R, Hankinson J, et al; ATS/ERS Task Force. General considerations for lung function testing. Eur Respir J 2005;26:153–61.
Nattie E, Li A. Central chemoreception is a complex system function that involves multiple brain stem sites. J Appl Physiol (1985). 2009;106:1464–6.
O’Donnell DE, Sanii R, Anthonisen NR, Younes M. Effect of dynamic airway compression on breathing pattern and respiratory sensation in severe chronic obstructive pulmonary disease. Am Rev Respir Dis. 1987;135:912–8.
Rebuck AS, Campbell EJM. A clinical method for assessing the ventilatory response to hypoxia. Am Rev Respir Dis. 1974;109:345–54.
Schwartzstein RM, Lahive K, Pope A, Weinberger SE, Weiss JW. Cold facial stimulation reduces breathlessness induced in normal subjects. Am Rev Respir Dis. 1987;136:58–61.
Schwartzstein RM, Manning HL, Weiss JW, Weinberger SE. Dyspnea: a sensory experience. Lung. 1990;169:185–99.
Seven YB, Mantilla CB, Sieck GC. Recruitment of rat diaphragm motor units across motor behaviors with different levels of diaphragm activation. J Appl Physiol. 2014;117:1308–16.
Shea SA, Andres LP, Guz A, Banzett RB. Respiratory sensations in subjects who lack a ventilatory response to CO2. Respir Physiol. 1993;93(2):203–19.
Sieck GC, Han YS, Prakash YS, Jones KA. Cross-bridge cycling kinetics, actomyosin ATPase activity and myosin heavy chain isoforms in skeletal and smooth respiratory muscles. Comp Biochem Physiol. 1998;119:435–50.
Sieck GC. Neural control of the inspiratory pump. NIPS. 1991;6:260–4.
Sieck GC, Fournier M. Diaphragm motor unit recruitment during ventilatory and nonventilatory behaviors. J Appl Physiol. 1989;66:2539–45.
Smith JC, Ellenberger HH, Ballanyi K, Richter DW, Feldman JL. Pre-Botzinger complex: a brainstem region that may generate respiratory rhythm in mammals. Science. 1991;254:726–9.
Spence DPS, Graham DR, Ahmed J, Rees K, Pearson MG, Calverley PMA. Does cold air affect exercise capacity and dyspnea in stable chronic obstructive pulmonary disease? Chest. 1993;103:693–6.
Whitelaw WA, Derenne JP, Milic-Emili J. Occlusion pressure as a measure of respiratory center output in conscious man. Respir Physiol. 1975;23:181–99.
Author information
Authors and Affiliations
Corresponding authors
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Richards, J., Fogarty, M.J., Sieck, G.C., Schwartzstein, R.M. (2018). Initiating the Breath: The Drive to Breathe, Muscle Pump. In: Kaminsky, D., Irvin, C. (eds) Pulmonary Function Testing. Respiratory Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-94159-2_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-94159-2_8
Published:
Publisher Name: Humana Press, Cham
Print ISBN: 978-3-319-94158-5
Online ISBN: 978-3-319-94159-2
eBook Packages: MedicineMedicine (R0)