Taurus – Physical – Throat: INMUNE-RESPIRATORY

The respiratory system fulfills a vital function for the human being: the oxygenation of the blood. The interrelation between its structure and function is what allows this objective to be fulfilled. In addition, it has other important functions unrelated to gas exchange.

The airway is classified into upper and lower (or superior and inferior), considering the cricoid cartilage as an anatomical landmark. From a functional point of view, the extrathoracic airway can be considered high and the intrathoracic airway low. The airway could also be considered to be composed of functional compartments: a proximal conduction zone, consisting of the tracheobronchial tree up to generation 16, a transition zone (generations 17 to 19) and a respiratory zone (generations 20 to 22), and finally the alveolar region.

There are several anatomical features of the upper airway, particularly of the nose, that allow it to fulfill its protective function. The axis of the nasal airway is oriented at 90º with respect to the trachea, allowing it to trap particles. The turbinates, highly vascularized structures with a large area of exposure, concentrate the air in a small stream, managing to heat, humidity and filter the air entering through the nose. The contribution of the upper airway to the total airway resistance is fundamental. On average, 50% of the airway resistance is in the nose, being in newborns up to 80%. This is why any compromise of the nasal airway dimensions (secretions, foreign body) in infants who are mainly nasal breathers will mean the appearance of accessory musculature use and costal retraction.

The pharynx is a collapsible area, formed by the pharyngeal constrictor muscles and the base of the tongue. To prevent the upper airway from collapsing during inspiration, undamaged muscle tone is essential. The larynx constitutes a complex area of the upper airway responsible for coordinating breathing with safe and effective swallowing and also for phonation. The tracheobronchial tree begins with the trachea, a fibromuscular tube with incomplete C-shaped cartilage rings towards the posterior area. The airway then divides dichotomously into 23 generations, which may vary in different individuals. There are several collateral ventilation channels in the airway. These are the interalveolar spaces or pores of Köhn and Lambert’s canals that communicate terminal bronchioles with the alveolus.

The lungs are conical in shape, their vertices reach the supraclavicular recesses and contact the brachial plexus and truncus arteriosus. The shape of the lungs has 3 faces: convex costal, concave diaphragmatic (dome) and mediastinal. The right and left lungs are enveloped in a pleural cavity of their own and separated by the mediastinum. The lung is covered by visceral pleura, which also enters the fissures and demarcates the lobes. The oblique fissure separates the upper lobe from the lower lobe on both sides. The horizontal fissure separates the upper lobe and middle lobe of the right lung. The lungs are soft, light and spongy, with elasticity to retract up to one third of their volume. The pulmonary fibrous support, formed by elastin and collagen, allows the distensibility and stability of both lungs.

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