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Respiratory System, in anatomy and physiology, organs that deliver oxygen to the circulatory system for

transport to all body cells. Oxygen is essential for cells, which use this vital substance to liberate the energy
needed for cellular activities. In addition to supplying oxygen, the respiratory system aids in removing of carbon
dioxide, preventing the lethal buildup of this waste product in body tissues. Day-in and day-out, without the
prompt of conscious thought, the respiratory system carries out its life-sustaining activities. If the respiratory
system’s tasks are interrupted for more than a few minutes, serious, irreversible damage to tissues occurs,
followed by the failure of all body systems, and ultimately, death.

While the intake of oxygen and removal of carbon dioxide are the primary functions of the respiratory system, it
plays other important roles in the body. The respiratory system helps regulate the balance of acid and base in
tissues, a process crucial for the normal functioning of cells. It protects the body against disease-causing
organisms and toxic substances inhaled with air. The respiratory system also houses the cells that detect smell,
and assists in the production of sounds for speech.

The respiratory and circulatory systems work together to deliver oxygen to cells and remove carbon dioxide in a
two-phase process called respiration. The first phase of respiration begins with breathing in, or inhalation.
Inhalation brings air from outside the body into the lungs. Oxygen in the air moves from the lungs through
blood vessels to the heart, which pumps the oxygen-rich blood to all parts of the body. Oxygen then moves
from the bloodstream into cells, which completes the first phase of respiration. In the cells, oxygen is used in a
separate energy-producing process called cellular respiration, which produces carbon dioxide as a byproduct.
The second phase of respiration begins with the movement of carbon dioxide from the cells to the bloodstream.
The bloodstream carries carbon dioxide to the heart, which pumps the carbon dioxide-laden blood to the lungs.
In the lungs, breathing out, or exhalation, removes carbon dioxide from the body, thus completing the
respiration cycle.

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The organs of the respiratory system extend from the nose to the lungs and are divided into the upper and lower
respiratory tracts. The upper respiratory tract consists of the nose and the pharynx, or throat. The lower
respiratory tract includes the larynx, or voice box; the trachea, or windpipe, which splits into two main branches
called bronchi; tiny branches of the bronchi called bronchioles; and the lungs, a pair of saclike, spongy organs.
The nose, pharynx, larynx, trachea, bronchi, and bronchioles conduct air to and from the lungs. The lungs
interact with the circulatory system to deliver oxygen and remove carbon dioxide.

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The flow of air from outside of the body to the lungs begins with the nose, which is divided into the left and
right nasal passages. The nasal passages are lined with a membrane composed primarily of one layer of flat,
closely packed cells called epithelial cells. Each epithelial cell is densely fringed with thousands of microscopic
cilia, fingerlike extensions of the cells. Interspersed among the epithelial cells are goblet cells, specialized cells
that produce mucus, a sticky, thick, moist fluid that coats the epithelial cells and the cilia. Numerous tiny blood
vessels called capillaries lie just under the mucous membrane, near the surface of the nasal passages. While
transporting air to the pharynx, the nasal passages play two critical roles: they filter the air to remove potentially
disease-causing particles; and they moisten and warm the air to protect the structures in the respiratory system.

Filtering prevents airborne bacteria, viruses, other potentially disease-causing substances from entering the
lungs, where they may cause infection. Filtering also eliminates smog and dust particles, which may clog the
narrow air passages in the smallest bronchioles. Coarse hairs found just inside the nostrils of the nose trap
airborne particles as they are inhaled. The particles drop down onto the mucous membrane lining the nasal
passages. The cilia embedded in the mucous membrane wave constantly, creating a current of mucus that
propels the particles out of the nose or downward to the pharynx. In the pharynx, the mucus is swallowed and
passed to the stomach, where the particles are destroyed by stomach acid. If more particles are in the nasal
passages than the cilia can handle, the particles build up on the mucus and irritate the membrane beneath it. This
irritation triggers a reflex that produces a sneeze to get rid of the polluted air.

The nasal passages also moisten and warm air to prevent it from damaging the delicate membranes of the lung.
The mucous membranes of the nasal passages release water vapor, which moistens the air as it passes over the
membranes. As air moves over the extensive capillaries in the nasal passages, it is warmed by the blood in the
capillaries. If the nose is blocked or “stuffy” due to a cold or allergies, a person is forced to breathe through the
mouth. This can be potentially harmful to the respiratory system membranes, since the mouth does not filter,
warm, or moisten air.

In addition to their role in the respiratory system, the nasal passages house cells called olfactory receptors,
which are involved in the sense of smell. When chemicals enter the nasal passages, they contact the olfactory
receptors. This triggers the receptors to send a signal to the brain, which creates the perception of smell.

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Air leaves the nasal passages and flows to the pharynx, a short, funnel-shaped tube about 13 cm (5 in) long that
transports air to the larynx. Like the nasal passages, the pharynx is lined with a protective mucous membrane
and ciliated cells that remove impurities from the air. In addition to serving as an air passage, the pharynx
houses the tonsils, lymphatic tissues that contain white blood cells. The white blood cells attack any disease-
causing organisms that escape the hairs, cilia, and mucus of the nasal passages and pharynx. The tonsils are
strategically located to prevent these organisms from moving further into the body. One tonsil, called the
adenoids, is found high in the rear wall of the pharynx. A pair of tonsils, the palatine tonsils, is located at the
back of the pharynx on either side of the tongue. Another pair, the lingual tonsils, is found deep in the pharynx
at the base of the tongue. In their battles with disease-causing organisms, the tonsils sometimes become swollen
with infection. When the adenoids are swollen, they block the flow of air from the nasal passages to the
pharynx, and a person must breathe through the mouth.

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Air moves from the pharynx to the larynx, a structure about 5 cm (2 in) long located approximately in the
middle of the neck. Several layers of cartilage, a tough and flexible tissue, comprise most of the larynx. A
protrusion in the cartilage called the Adam’s apple sometimes enlarges in males during puberty, creating a
prominent bulge visible on the neck.

While the primary role of the larynx is to transport air to the trachea, it also serves other functions. It plays a
primary role in producing sound; it prevents food and fluid from entering the air passage to cause choking; and
its mucous membranes and cilia-bearing cells help filter air. The cilia in the larynx waft airborne particles up
toward the pharynx to be swallowed.

Food and fluids from the pharynx usually are prevented from entering the larynx by the epiglottis, a thin,
leaflike tissue. The “stem” of the leaf attaches to the front and top of the larynx. When a person is breathing, the
epiglottis is held in a vertical position, like an open trap door. When a person swallows, however, a reflex
causes the larynx and the epiglottis to move toward each other, forming a protective seal, and food and fluids
are routed to the esophagus. If a person is eating or drinking too rapidly, or laughs while swallowing, the
swallowing reflex may not work, and food or fluid can enter the larynx. Food, fluid, or other substances in the
larynx initiate a cough reflex as the body attempts to clear the larynx of the obstruction. If the cough reflex does
not work, a person can choke, a life-threatening situation. The Heimlich maneuver is a technique used to clear a
blocked larynx (see First Aid). A surgical procedure called a tracheotomy is used to bypass the larynx and get
air to the trachea in extreme cases of choking.

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Trachea, Bronchi, and Bronchioles

Air passes from the larynx into the trachea, a tube about 12 to 15 cm (about 5 to 6 in) long located just below
the larynx. The trachea is formed of 15 to 20 C-shaped rings of cartilage. The sturdy cartilage rings hold the
trachea open, enabling air to pass freely at all times. The open part of the C-shaped cartilage lies at the back of
the trachea, and the ends of the “C” are connected by muscle tissue.

The base of the trachea is located a little below where the neck meets the trunk of the body. Here the trachea
branches into two tubes, the left and right bronchi, which deliver air to the left and right lungs, respectively.
Within the lungs, the bronchi branch into smaller tubes called bronchioles. The trachea, bronchi, and the first
few bronchioles contribute to the cleansing function of the respiratory system, for they, too, are lined with
mucous membranes and ciliated cells that move mucus upward to the pharynx.

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Human Lungs
The bronchioles divide many more times in the lungs to create an impressive tree with smaller and smaller
branches, some no larger than 0.5 mm (0.02 in) in diameter. These branches dead-end into tiny air sacs called
alveoli. The alveoli deliver oxygen to the circulatory system and remove carbon dioxide. Interspersed among
the alveoli are numerous macrophages, large white blood cells that patrol the alveoli and remove foreign
substances that have not been filtered out earlier. The macrophages are the last line of defense of the respiratory
system; their presence helps ensure that the alveoli are protected from infection so that they can carry out their
vital role.

The alveoli number about 150 million per lung and comprise most of the lung tissue. Alveoli resemble tiny,
collapsed balloons with thin elastic walls that expand as air flows into them and collapse when the air is
exhaled. Alveoli are arranged in grapelike clusters, and each cluster is surrounded by a dense hairnet of tiny,
thin-walled capillaries. The alveoli and capillaries are arranged in such a way that air in the wall of the alveoli is
only about 0.1 to 0.2 microns from the blood in the capillary. Since the concentration of oxygen is much higher
in the alveoli than in the capillaries, the oxygen diffuses from the alveoli to the capillaries. The oxygen flows
through the capillaries to larger vessels, which carry the oxygenated blood to the heart, where it is pumped to
the rest of the body.

Carbon dioxide that has been dumped into the bloodstream as a waste product from cells throughout the body
flows through the bloodstream to the heart, and then to the alveolar capillaries. The concentration of carbon
dioxide in the capillaries is much higher than in the alveoli, causing carbon dioxide to diffuse into the alveoli.
Exhalation forces the carbon dioxide back through the respiratory passages and then to the outside of the body.

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Diaphragm and Respiration

As the diaphragm contracts and moves downward, the pectoralis minor and intercostal muscles pull the rib cage outward. The
chest cavity expands, and air rushes into the lungs through the trachea to fill the resulting vacuum. When the diaphragm relaxes
to its normal, upwardly curving position, the lungs contract, and air is forced out.
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Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.
Diaphragm and Respiration

The flow of air in and out of the lungs is controlled by the nervous system, which ensures that humans breathe
in a regular pattern and at a regular rate. Breathing is carried out day and night by an unconscious process. It
begins with a cluster of nerve cells in the brain stem called the respiratory center. These cells send simultaneous
signals to the diaphragm and rib muscles, the muscles involved in inhalation. The diaphragm is a large, dome-
shaped muscle that lies just under the lungs. When the diaphragm is stimulated by a nervous impulse, it flattens.
The downward movement of the diaphragm expands the volume of the cavity that contains the lungs, the
thoracic cavity. When the rib muscles are stimulated, they also contract, pulling the rib cage up and out like the
handle of a pail. This movement also expands the thoracic cavity. The increased volume of the thoracic cavity
causes air to rush into the lungs. The nervous stimulation is brief, and when it ceases, the diaphragm and rib
muscles relax and exhalation occurs. Under normal conditions, the respiratory center emits signals 12 to 20
times a minute, causing a person to take 12 to 20 breaths a minute. Newborns breathe at a faster rate, about 30
to 50 breaths a minute.

The rhythm set by the respiratory center can be altered by conscious control. The breathing pattern changes
when a person sings or whistles, for example. A person also can alter the breathing pattern by holding the
breath. The cerebral cortex, the part of the brain involved in thinking, can send signals to the diaphragm and rib
muscles that temporarily override the signals from the respiratory center. The ability to hold one’s breath has
survival value. If a person encounters noxious fumes, for example, it is possible to avoid inhaling the fumes.

A person cannot hold the breath indefinitely, however. If exhalation does not occur, carbon dioxide accumulates
in the blood, which, in turn, causes the blood to become more acidic. Increased acidity interferes with the action
of enzymes, the specialized proteins that participate in virtually all biochemical reaction in the body. To prevent
the blood from becoming too acidic, the blood is monitored by special receptors called chemoreceptors, located
in the brainstem and in the blood vessels of the neck. If acid builds up in the blood, the chemoreceptors send
nervous signals to the respiratory center, which overrides the signals from the cerebral cortex and causes a
person to exhale and then resume breathing. These exhalations expel the carbon dioxide and bring the blood
acid level back to normal.

A person can exert some degree of control over the amount of air inhaled, with some limitations. To prevent the
lungs from bursting from overinflation, specialized cells in the lungs called stretch receptors measure the
volume of air in the lungs. When the volume reaches an unsafe threshold, the stretch receptors send signals to
the respiratory center, which shuts down the muscles of inhalation and halts the intake of air.

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The respiratory system can be damaged by a variety of chemicals found in the environment, ranging from
automobile fumes and industrial smoke to household cleaning products. Cigarette smoke, however, poses a
particularly serious threat to the respiratory system because of the tar and other substances that enter the lungs.
After a person smokes just one cigarette, for example, tar temporarily paralyzes the cilia of the upper and lower
respiratory tracts. The tar also temporarily immobilizes the macrophages in the alveoli of the lungs. With the
filtering and cleansing functions inactivated, the air passages and lungs are exposed not only to the irritating
effects of tar but also to airborne bacteria, viruses, and other particles. These, along with the tar, settle in the
mucous layers of the lungs. The paralyzed cilia recover after about one hour, but repeated smoking eventually
kills them. Repeated smoking also causes mucus to build up in the lungs and block the smaller air passages. The
blockage triggers a cough reflex—the familiar “smoker’s cough”—the lung’s effort to clear the airways. In
addition, tobacco smoke contains over 40 chemicals known to cause cancer. Smoking is responsible for almost
90 percent of lung cancer cases among men, and more than 70 percent among women (see Smoking).

Workers in occupations that produce impurities released into the air are at high risk for respiratory illnesses.
Sandblasters, stone cutters, quarry workers, miners, construction workers, people who install brake lining or
insulation, people who work in shipyards or on farms, and people who pick cotton are among those at risk. In
the United States, the Occupational Safety and Health Administration (OSHA) issues regulations that protect
workers—requiring air masks with filters for certain jobs, for example. The Environmental Protection Agency
(EPA) monitors and regulates the amount of pollutants released into the air. Despite these efforts, respiratory
illnesses remain higher among workers who have significant exposure to air pollutants (see Environmental and
Occupational Diseases).

Normal, everyday exposure to air pollution from cars and industrial emissions in the city also weakens the
respiratory system of city-dwellers. Even if a person does not smoke, the city air gradually changes pink,
healthy lung tissue to tissue darkened with particles of smog, dust, and other pollutants, making the lungs more
vulnerable to infection. While outdoor pollutants pose threats to the respiratory system, a far greater threat is
created by indoor air pollution. In homes and offices, a variety of substances, including cleaning compounds, air
fresheners, synthetic carpets and furniture, and certain construction materials, can emit hazardous gases, which
become highly concentrated in unventilated rooms. Individuals at greatest risk are those who spend most of
their time indoors, children, the elderly, and people with a history of respiratory illnesses. Like outdoor air
pollutants, indoor air pollutants weaken the lungs and invite infection. The long-term effects of air pollution are
difficult to measure, but may include cancer and other serious diseases.

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Cancerous Human Lung

This dissection of human lung tissue shows light-colored cancerous tissue in the center of the photograph. At
bottom center lies the heart. While normal lung tissue is light pink in color, the tissue surrounding the cancer is
black and airless, the result of a tarlike residue left by cigarette smoke. Most lung cancer begins in the cells
lining the main air passages, or bronchi. In their cancerous state, these cells lack the cilia that normally catch
and eliminate foreign particles inhaled into the lung. Mucous ordinarily cleared by bronchial cilia becomes
trapped, blocking air passages. Lung cancer accounts for the largest percentage of cancer deaths in the United
States, and cigarette smoking is directly responsible for the majority of these cases.

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Respiratory Distress Syndrome
Acute respiratory distress syndrome is one of two human diseases caused by hantavirus. Dust containing virus-infected rodent feces
becomes airborne and is inhaled. The virus embeds in the lungs where the infection begins. Flulike symptoms appear in about a
week, followed by the collection of fluid and white blood cells in the lungs, causing respiratory failure, then death.
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Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.

The diseases and disorders of the respiratory system can affect any part of the respiratory tract and range from
trivial to life-threatening. The nasal passages and pharynx, for example, are targets for the viruses that cause
colds. These viruses infiltrate and destroy the cells of the nasal passage membranes. The immune system fights
back by increasing blood flow to the area, bringing numerous virus-attacking white blood cells to the scene; this
causes the membranes to swell, resulting in the stuffy nose associated with colds. Mucous secretions increase in
response to the viral attack, creating the runny nose typical of colds. The infection can spread to the sinuses, the
membrane-lined cavities in the head, as well as the lower respiratory tract and the middle ear.

The respiratory system is also subject to allergic reactions such as hay fever and asthma, brought about when
the immune system is stimulated by pollen, dust, or other irritants. Hay fever is characterized by a runny nose,
watery eyes, and sneezing. It usually occurs seasonally in response to abundant pollen in the air. In asthma, a
person has difficulty breathing because the bronchi and bronchioles are temporarily constricted and inflamed.
An asthma attack is typically mild, but can be severe enough to be life threatening.

Laryngitis, an inflammation of the larynx, is caused by a viral infection, irritants such as cigarette smoke, or by
overuse of the voice. Laryngitis may cause hoarseness, or the voice may be reduced to a whisper until the
inflammation subsides. Bronchitis is an inflammation of the membranes that line the bronchi or bronchioles.
Bronchitis results from viral or bacterial infection or from irritating chemicals. Infections caused by bacteria or
viruses can lead to pneumonia, a potentially serious condition of the lungs in which fluid and inflammation
builds up in the alveoli, impeding the flow of oxygen and carbon dioxide between the capillaries and the alveoli.

Tuberculosis is caused by a bacterium that attacks the lungs and sometimes other body tissues as well. If
infections in the lungs are left untreated, the disease destroys lung tissue. In the past, antibiotics have controlled
tuberculosis, but recently, new antibiotic-resistant strains of the tuberculosis bacterium have evolved. These
new strains now pose a significant public health problem.
In emphysema the alveolar tissue is partially destroyed and the remaining alveoli are weakened and enlarge.
The bronchioles collapse on exhalation, trapping air in the alveoli. Over time this process impairs the ability to
exchange oxygen and carbon dioxide with the circulatory system, leading to breathing difficulties. A
noncontagious disease, emphysema results from multiple factors, including a genetic predisposition to the
condition, smog, cigarette smoke, and infection.

Lung cancer develops in individuals with a genetic predisposition to the disease who are exposed to cancer-
causing agents, such as tobacco smoke, asbestos, and uranium. Cancerous tumors may start in the bronchi,
bronchioles, or in the alveolar lung tissue. If lung cancer is detected before the cancer has spread to other parts
of the body, treatments are more effective, and the prognosis for full recovery is good. Unfortunately, 85
percent of lung cancer cases are diagnosed after the cancer has spread, and for these cases, the prognosis is very

Respiratory Distress Syndrome (RDS) is the name for a cluster of symptoms that indicate severe malfunctioning
of the lungs. In infants, RDS is termed Infant Respiratory Distress Syndrome (IRDS). Commonly found in
premature infants, IRDS results when the alveoli fail to fully expand during inhalation. Expansion of the alveoli
requires a chemical called surfactant, but in many premature infants, the alveoli are not developed enough to
produce this vital substance. IRDS is treated by administering air and surfactant through a breathing tube until
the alveoli begin producing surfactant on their own. Adult Respiratory Distress Syndrome (ARDS) results when
lungs are severely injured, for example, in an automobile accident, by poisonous gases, or as a response to
inflammation in the lungs. ARDS is a life-threatening condition with a survival rate of about 50 percent.

Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.