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Respiratory
System
What Are the
Lungs and Respiratory System?
At the top
of the respiratory system, the nostrils (also called
nares) act as the air intake, bringing air into the
nose, where it's warmed and humidified. Tiny hairs
called cilia (pronounced: sih-lee-uh) protect the nasal
passageways and other parts of the respiratory tract,
filtering out dust and other particles that enter the
nose through the breathed air.
Air can also
be taken in through the mouth. These two openings of the
airway (the nasal cavity and the mouth) meet at the
pharynx (pronounced: far-inks), or throat, at the back
of the nose and mouth. The pharynx is part of the
digestive system as well as the respiratory system
because it carries both food and air. At the bottom of
the pharynx, this pathway divides in two, one for food
(the esophagus, pronounced: ih-sah-fuh-gus, which leads
to the stomach) and the other for air. The epiglottis
(pronounced: eh-pih-glah-tus), a small flap of tissue,
covers the air-only passage when we swallow, keeping
food and liquid from going into our
lungs.
The larynx
(pronounced: lar-inks), or voice box, is the uppermost
part of the air-only pipe. This short tube contains a
pair of vocal cords, which vibrate to make sounds. The
trachea (pronounced: tray-kee-uh), or windpipe, extends
downward from the base of the larynx. It lies partly in
the neck and partly in the chest cavity. The walls of
the trachea are strengthened by stiff rings of cartilage
to keep it open. The trachea is also lined with cilia,
which sweep fluids and foreign particles out of the
airway so that they stay out of the
lungs.
At its
bottom end, the trachea divides into left and right air
tubes called bronchi (pronounced: brahn-ky), which
connect to the lungs. Within the lungs, the bronchi
branch into smaller bronchi and even smaller tubes
called bronchioles (pronounced: brahn-kee-olz).
Bronchioles end in tiny air sacs called alveoli
(pronounced: al-vee-oh-lie), where the exchange of
oxygen and carbon dioxide actually takes place. Each
lung houses about 300 to 400 million alveoli. The lungs
also contain elastic tissues that allow them to inflate
and deflate without losing shape and are encased by a
thin lining called the pleura (pronounced: plur-uh).
This network of alveoli, bronchioles, and bronchi is
known as the bronchial tree.
The chest
cavity, or thorax (pronounced: thor-aks), is the
airtight box that houses the bronchial tree, lungs,
heart, and other structures. The top and sides of the
thorax are formed by the ribs and attached muscles, and
the bottom is formed by a large muscle called the
diaphragm. The chest walls form a protective cage around
the lungs and other contents of the chest cavity.
Separating the chest from the abdomen, the diaphragm
(pronounced: die-uh-fram) plays a lead role in
breathing. It moves downward when we breathe in,
enlarging the chest cavity and pulling air in through
the nose or mouth. When we breathe out, the diaphragm
moves upward, forcing the chest cavity to get smaller
and pushing the gases in the lungs up and out of the
nose and mouth.
What Do the
Lungs and Respiratory System Do?
Even though
we can't see it, the air we breathe is made up of
several gases. Oxygen is the most important for keeping
us alive because body cells need it for energy and
growth. Without oxygen, the body's cells would
die.
Carbon
dioxide is the waste gas produced when carbon is
combined with oxygen as part of the energy-making
processes of the body. The lungs and respiratory system
allow oxygen in the air to be taken into the body, while
also enabling the body to get rid of carbon dioxide in
the air breathed out.
Respiration
is the set of events that results in the exchange of
oxygen from the environment and carbon dioxide from the
body's cells. The process of taking air into the lungs
is called inspiration, or inhalation, and the process of
breathing it out is called expiration, or
exhalation.
Air is
inhaled through the mouth or through the nose. Cilia
lining the nose and other parts of the upper respiratory
tract move back and forth, pushing foreign matter that
comes in with air (like dust) either toward the nostrils
to be expelled or toward the pharynx. The pharynx passes
the foreign matter along to the stomach to eventually be
eliminated by the body. As air is inhaled, the mucous
membranes of the nose and mouth warm and humidify the
air before it enters the lungs.
When we
breathe in, the diaphragm moves downward toward the
abdomen, and the rib muscles pull the ribs upward and
outward. In this way, the volume of the chest cavity is
increased. Air pressure in the chest cavity and lungs is
reduced, and because gas flows from high pressure to
low, air from the environment flows through the nose or
mouth into the lungs. In exhalation, the diaphragm moves
upward and the chest wall muscles relax, causing the
chest cavity to contract. Air pressure in the lungs
rises, so air flows from the lungs and up and out of
respiratory system through the nose or
mouth.
Every few
seconds, with each inhalation, air fills a large portion
of the millions of alveoli. In a process called
diffusion (pronounced: dih-fyoo-zhun), oxygen moves from
the alveoli to the blood through the capillaries (tiny
blood vessels, pronounced: kah-puh-ler-eez) lining the
alveolar walls. Once in the bloodstream, oxygen gets
picked up by a molecule called hemoglobin (pronounced:
hee-muh-glo-bun) in the red blood cells. This
oxygen-rich blood then flows back to the heart, which
pumps it through the arteries to oxygen-hungry tissues
throughout the body. In the tiny capillaries of the body
tissues, oxygen is freed from the hemoglobin and moves
into the cells. Carbon dioxide, which is produced during
the process of diffusion, moves out of these cells into
the capillaries, where most of it is dissolved in the
plasma of the blood. Blood rich in carbon dioxide then
returns to the heart via the veins. From the heart, this
blood is pumped to the lungs, where carbon dioxide
passes into the alveoli to be
exhaled.
What Can Go
Wrong With the Lungs and Respiratory System?
The
respiratory system is susceptible to a number of
diseases, and the lungs are prone to a wide range of
disorders caused by pollutants in the air. The most
common problems of the respiratory system
are:
Asthma. More than 20 million
people in the United States have asthma (pronounced:
az-muh), and it's the number-one reason for kids
chronically missing school. Asthma is a chronic
inflammatory lung disease that causes airways to tighten
and narrow. Often triggered by irritants in the air such
as cigarette smoke, asthma flares involve contraction
and swelling of the muscles lining the tiny airways. The
resulting narrowing of the airways prevents air from
flowing properly, causing wheezing and difficulty
breathing, sometimes to the point of being
life-threatening. Management of asthma starts with an
asthma management plan, which usually involves avoiding
asthma triggers and sometimes taking
medications.
Bronchiolitis. Not to be confused
with bronchitis, bronchiolitis (pronounced:
brahn-kee-oh-lie-tus) is an inflammation of the
bronchioles, the smallest branches of the bronchial
tree. Bronchiolitis affects mostly infants and young
children, and can cause wheezing and serious difficulty
breathing. It's usually caused by specific viruses in
the wintertime, including respiratory syncytial virus
(RSV).
Chronic obstructive pulmonary
disease (COPD). COPD is a term that describes two lung
diseases - emphysema and chronic
bronchitis.
- Long-term
smoking often causes emphysema (pronounced:
em-fuh-zee-muh), and although it seldom affects
children and teens, it's a condition that can have its
roots in the teen and childhood years. Learning to
talk to your kids about smoking is a key part of
preventing smoking-related diseases like emphysema and
lung cancer. In emphysema, the lungs produce an
excessive amount of mucus, and the alveoli become
damaged. It becomes difficult to breathe and get
enough oxygen into the blood.
- In
bronchitis (pronounced: brahn-ky-tus), a common
disease of adults and adolescents, the membranes
lining the larger bronchial tubes become inflamed, and
an excessive amount of mucus is produced. The person
develops a bad cough to get rid of the mucus.
Cigarette smoking is a major cause of chronic
bronchitis in teens.
Common
cold. Caused by over 200 different viruses that cause
inflammation in the upper respiratory tract, the common
cold is the most common respiratory infection. Symptoms
may include a mild fever, cough, headache, runny nose,
sneezing, and sore throat.
Cough.
A cough is a symptom of an illness, not an illness
itself. There are many different types of cough and many
different causes, ranging from not-so-serious to
life-threatening. Some of the more common causes
affecting children are the common cold, asthma,
sinusitis, seasonal allergies, croup, and pneumonia.
Among the most serious causes of cough in children and
adults are tuberculosis (TB) and pertussis (whooping
cough).
Cystic
fibrosis (CF). Affecting more than 30,000 children and
young adults in the United States, cystic fibrosis
(pronounced: sis-tik fy-bro-sus) is the most common
inherited disease affecting the lungs. Affecting
primarily the respiratory and digestive systems, CF
causes mucus in the body to be abnormally thick and
sticky. The mucus can clog the airways in the lungs and
make a person more vulnerable to bacterial
infections.
Lung
cancer. Caused by an abnormal growth of cells in the
lungs, lung cancer is a leading cause of death in the
United States and is usually caused by smoking
cigarettes. It starts in the lining of the bronchi, and
takes a long time to develop. Symptoms include a
persistent cough that may bring up blood, chest pain,
hoarseness, and shortness of breath. Radon gas exposure
(radon is a gas that occurs in soil and rocks) may also
be a cause of lung cancer. Radon is more likely to occur
in certain parts of the United States. You can check
your home's radon level by purchasing a radon kit at
your local home supply or hardware
store.
Pneumonia. Pneumonia (pronounced:
new-mo-nyuh) is an inflammation of the lungs that
usually occurs because of bacterial or viral infection.
Pneumonia causes fever and inflammation of lung tissue,
and makes breathing difficult because the lungs have to
work harder to transfer oxygen into the bloodstream and
remove carbon dioxide from the blood. Common causes of
pneumonia are influenza and infection with the bacterium
Streptococcus
pneumoniae.
Pulmonary hypertension. This
condition occurs when the blood pressure in the arteries
of the lungs is abnormally high, which means the heart
has to work harder to pump blood against the high
pressure. Pulmonary hypertension may occur in children
because of a heart defect present at birth or because of
a health condition such as HIV
infection.
Respiratory diseases of newborns.
Several respiratory conditions can affect a newborn baby
just starting to breathe for the first time. Younger
premature babies are at increased risk for conditions
such as:
- Respiratory distress syndrome of
the newborn. Babies born prematurely may not have
enough surfactant in the lungs. Surfactant helps to
keep the baby's alveoli open; without surfactant, the
lungs collapse and the baby is unable to breathe.
- Apnea of prematurity (AOP).
Apnea is a medical term that means someone has stopped
breathing. Apnea of prematurity (AOP) is a condition
in which premature infants stop breathing for 15 to 20
seconds during sleep. Apnea of prematurity generally
occurs after 2 days of life and up to a week of life.
The lower the infant's weight and level of prematurity
at birth, the more likely the child is to have AOP
spells.
- Bronchopulmonary dysplasia
(BPD). Bronchopulmonary dysplasia (pronounced:
brahn-ko-pul-muh-ner-ee dis-play-zhuh) involves
abnormal development of lung tissue. Sometimes called
chronic lung disease or CLD, it's a disease in infants
characterized by inflammation and scarring in the
lungs. It develops most often in premature babies who
are born with underdeveloped lungs.
Some other
respiratory conditions of the newborn
include:
- Meconium aspiration. Meconium
(pronounced: mih-ko-nee-um) aspiration occurs when a
newborn inhales (aspirates) a mixture of meconium
(baby's first feces, ordinarily passed after birth)
and amniotic fluid during labor and delivery. The
inhaled meconium can cause a partial or complete
blockage of the baby's airways.
- Persistent pulmonary
hypertension of the newborn (PPHN). In the uterus, a
baby's circulation bypasses the lungs. Normally, when
a baby is born and begins to breathe air, his or her
body quickly adapts and begins the process of
respiration. PPHN occurs when a baby's body doesn't
make the normal transition from fetal circulation to
newborn circulation. This condition can cause symptoms
such as rapid breathing, rapid heart rate, respiratory
distress, and cyanosis (blue-tinged skin).
- Transient tachypnea of the
newborn (TTN). Rapid breathing in a full-term newborn
(more than 60 breaths a minute) is called transient
tachypnea (pronounced: tah-kip-nee-uh).
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