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More prolonged apneu- sis has developed when the lesions ex- tend caudally to involve the dorsolateral pontine nuclei Pontomedullary junction damage Patients have lesions at the lower pon- tine or high medullary level Medullary damage or dysfunction Follows lesions of the respiratory cen- terslocatedinthereticularformationof the dorsomedial part of the medulla and extending down to or just below the obex Respiratory patterns Eupneic, with sighs or yawns CheyneвStokes Sustained regular hyperventilation (despite the prolonged and rapid hy- perpnea, patients are hypocapnic and relatively hypoxic, and have pulmo- nary congestion, leading rapidly to pulmonary edema. Trocar location for laparoscopic splenectomy.
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