This article looks at the form and function of the lungs, diseases that affect the lungs,
and how to maintain healthy lungs.
Structure
The lungs not only enable us to breathe and talk, but they also support the cardiovascular system and help maintain pH in the
body, among others.
The lungs are located in the chest, behind the rib cage on either side of the heart. They
are roughly conical in shape with a rounded point at their apex and a flatter base
where they meet the diaphragm.
Although they are a pair, the lungs are not equal in size and shape.
The left lung has an indentation bordering where the heart resides, called the cardiac
notch. The right lung is shorter to allow space for the liver below.
Overall, the left lung has a slightly smaller weight and capacity than the right.
The lungs are surrounded by two membranes, known as the pulmonary pleurae. The
inner layer directly lines the outer surface of the lungs, and the outer layer is attached
to the inner wall of the rib cage.
The space between the two membranes is filled with pleural fluid.
Function
A spirometry test can show how well the lungs are working.
The lungs' main role is to bring in air from the atmosphere and pass oxygen into the
bloodstream. From there, it circulates to the rest of the body.
Help is required from structures outside of the lungs in order to breathe properly. To
breathe, we use the muscle of the diaphragm, the intercostal muscles (between the
ribs), the muscles of the abdomen, and sometimes even muscles in the neck.
The diaphragm is a muscle that is domed at the top and sits below the lungs. It powers
most of the work involved in breathing.
As it contracts, it moves down, allowing more space in the chest cavity and increasing
the lungs' capacity to expand. As the chest cavity volume increases, the pressure
inside goes down, and air is sucked in through the nose or mouth and down into the
lungs.
As the diaphragm relaxes and returns to its resting position, the lung volume decreases
because the pressure inside the chest cavity goes up, and the lungs expel the air.
The lungs are like bellows. As they expand, air is sucked in for oxygen. As they
compress, the exchanged carbon dioxide waste is pushed back out during exhalation.
When air enters the nose or mouth, it travels down the trachea, also called the
windpipe. After this, it reaches a section called the carina. At the carina, the windpipe
splits into two, creating two mainstem bronchi. One leads to the left lung and the other
to the right lung.
From there, like branches on a tree, the pipe-like bronchi split again into smaller
bronchi and then even smaller bronchioles. This ever-decreasing pipework eventually
terminates in the alveoli, which are little air sac endings.
Alveoli are minute sacs that are microscopic in size, each wrapped in a fine mesh of
capillaries.
Each human has around 700 million individual alveoli. The total surface area of
membrane that the alveoli provide is 70 meters squared. This is often said to be
around the size of half a tennis court.
After the lungs, the body takes oxygen out of the bloodstream to its other tissues as it
travels around the circulatory system.
The blood that has given up its oxygen in exchange for carbon dioxide from the
tissues then passes through the heart and travels to the lungs to reach the capillaries
surrounding the alveoli.
The alveoli now contain a new supply of oxygen that the person has breathed in. This
oxygen passes across a membrane, called the alveolar-capillary membrane, into the
bloodstream.
At the same time, the carbon dioxide that has collected in the bloodstream during its
travels around the body enters the alveoli. From there, it is breathed back out into the
atmosphere during exhalation.
Put simply, as the oxygen goes in, carbon dioxide comes out. This is gas exchange.
Spirometry: What to expect
Click here to discover how a doctor tests the function of the lungs.
READ NOW
Surfactant has both hydrophilic and hydrophobic regions. Hydrophilic regions are
attracted to water, and hydrophobic regions are repelled by water.
These include:
Each alveolus is like a plastic bag that is wet inside. If there were no surfactant, the
bag would collapse in on itself, and the internal sides would stick together. Surfactant
prevents this from happening to the alveoli.
Pulmonary surfactant carries out its role by reducing the amount of surface tension.
By doing this, it reduces the effort necessary to inflate the alveoli.
Before birth, surfactant production does not begin until the later weeks of gestation.
This is why babies who are born preterm have trouble breathing, referred to as infant
respiratory distress syndrome (RDS).
pH balance: Too much carbon dioxide can cause the body to become acidic. If the
lungs detect a rise in acidity, they increase the rate of ventilation to expel more of the
unwanted gas.
Filtering: The lungs filter small blood clots, and they can remove small air bubbles,
known as air embolisms, if they occur.
Protective: The lungs can act as a shock absorber for the heart in certain types of
collision.
Mucociliary clearance: The mucus that lines the respiratory passages traps dust
particles and bacteria. Tiny hair-like projections, known as cilia, move these particles
upward to a position where they can be coughed out or swallowed and destroyed by
the digestive system.
Blood reservoir: The lungs can vary how much blood they contain at any moment.
This function can be useful, for example, during exercise. The amount of blood the
lungs can contain can vary from 500 to 1,000 milliliters (ml). The lungs interact with
the heart and can help the heart function more efficiently.
Respiratory disease
Respiratory diseases can affect any part of the respiratory system, from the upper
respiratory tract to the bronchi and down into the alveoli.
Diseases of the respiratory system are common. Every year, there are millions of
cases of the common cold in the United States.
asthma
cystic fibrosis
acute respiratory distress syndrome
chronic obstructive pulmonary disease (COPD), including emphysema and chronic
bronchitis
COPD usually results from the damage that tobacco smoking causes to the lungs.
Asthma involves an obstructive narrowing and swelling of the airways and the
production of excess mucus. This triggers shortness of breath and wheezing.
Triggers include:
Upper respiratory tract infection: The most frequently contracted is the common
cold (viral). Others include laryngitis, pharyngitis, and tonsillitis.
Lower respiratory tract infection: The most common type is bacterial infection, and
espeially bacterial pneumonia. Other causes of lower respiratory tract infection
include viruses and fungi.
Complications can develop from these types of infections, including lung abscesses
and the spread of infection to the pleural cavity.
Tumors
Tumors of the respiratory system can be malignant or benign.
Malignant tumors: 14 percent of all new cancer diagnoses are primary lung cancer.
Lung cancer is the second most common type of cancer and the leading cause of
fatality from cancer in both men and women.
Most lung cancers are due to cigarette smoking. All the blood in the body travels from
the heart through the lungs, so the cancer can easily spread to other parts of the body.
Benign tumors: Benign tumors are a less common cause of respiratory disease. One
example is hamartoma. These can compress surrounding tissue, but they are usually
asymptomatic.
Pleural cavity diseases
The pleural cavity is the gap between the inner and outer pleural membranes that
encase the outside of the lungs.
Pleural effusion: Fluid builds up in the pleural cavity, often due to cancer in or near
the chest cavity. It could also be related to congestive heart failure or liver cirrhosis.
Other causes include inflammation of the pleura, which may occur with an infection.
Pneumothorax: This can result from trauma, for example, a bullet wound. Air inside
the pleural cavity is called a pneumothorax. This compresses the lungs, and when
severe, it causes them to collapse like a balloon.
Examples include:
Pulmonary artery embolism: A blood clot forms elsewhere in the body and travels
in the bloodstream to the heart and then to the lungs, where it becomes lodged. This
can result in sudden death. More rarely, an embolism can consist of fat, amniotic
fluid, or air.
Pulmonary edema: This most often results from congestive heart failure. Fluid leaks
from capillaries into the air spaces within the alveoli.
Pulmonary hemorrhage: Damaged and inflamed capillaries can leak blood into the
alveoli. A symptom may be the coughing up of blood.
Tips for good lung health
Ways of keeping the lungs healthy include:
Exercise: Aerobic exercise improves lung capacity, and staying fit can ward off other
diseases that might impact the lungs.
Check-ups: regular health checks, even when feeling well, can detect problems in the
early stages, when it is easier to treat them.
Avoiding pollutant exposure: Chemicals used in the garden or home can damage the
lungs. Wear a mask if using strong chemicals. Radon is a naturally occurring chemical
that has been linked to 21,000 lung cancer deaths a year in the U. S. Around 2,900 of
these people have never smoked.