RT Book, Section A1 Levitzky, Michael G. A2 Levitzky, Michael A2 McDonough, Kathleen A2 Kaye, Alan David A2 Hall, Stanley SR Print(0) ID 1175535384 T1 Control of Breathing T2 Clinical Physiology in Anesthetic Practice YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781259641954 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1175535384 RD 2024/03/29 AB Breathing is spontaneously initiated in the central nervous system. Neurons in the brainstem automatically generate a cycle of inspiration and expiration. This spontaneously generated cycle of inspiration and expiration can be modified, altered, or even temporarily suppressed by a number of mechanisms. As shown in Figure 33-1, these include reflexes arising in the lungs, the airways, and the cardiovascular system; information from receptors in contact with the cerebrospinal fluid; and commands from higher centers of the brain such as the hypothalamus, the centers of speech, or other areas in the cortex. The centers that are responsible for the generation of the spontaneous rhythmicity of inspiration and expiration are, therefore, able to alter their activity to meet the increased metabolic demand on the respiratory system during exercise or may even be temporarily superseded or suppressed during speech or breath holding.