The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs move upward and the rib cage expands, similarly expanding the thoracic cavity.
Each lung is surrounded by two membranes called plurae, which are separated by fluid. This fluid creates an adhesive force that causes the lungs to stretch as the thoracic cavity expands. The increased volume in the lungs reduces the pressure. When the pressure drops below atmospheric pressure, this produces a pressure gradient that moves air from the higher-pressure atmosphere into the lower-pressure lungs.
When the diaphragm and intercostal muscles relax, the volume of the lungs decreases, increasing the pressure in the lungs. As pressure increases beyond atmospheric pressure, the resulting pressure gradient pushes air out of the body. In this way, the cycle of inhaling and exhaling is maintained.
Boyle’s law states that, at a given temperature in a closed space, the pressure of a gas increases as the volume of its container decreases. Stated differently, pressure is inversely proportional to the volume. This law, combined with the movement of gas from higher-pressure to lower-pressure areas, explains why air is brought into the lungs when the diaphragm contracts.
The diaphragm contracts, moving downward and increasing the thoracic volume, but how does this increase the volume of the lungs? While bronchi and bronchioles are stiff and do not expand (although they can become blocked or inflamed), alveoli, tiny air sacs in the lungs, allow the lungs to increase in volume.
Pulmonary diseases decrease the flow of gas to and from the lungs and can be divided into two categories: restrictive and obstructive. Restrictive diseases, such as pulmonary fibrosis (scarring of the lung), restrict the expansion of the lungs. Obstructive diseases, like asthma, emphysema, and chronic bronchitis, obstruct the airway, limiting gas exchange.
The inner surfaces of alveoli are lined with fluid that contains surfactant, a mixture of phospholipids and lipoproteins. Surfactant reduces the surface tension of the alveolar fluid, preventing alveoli from collapsing and making it easier for alveoli to inflate with air.
Premature babies sometimes do not produce enough surfactant in their lungs, causing respiratory distress syndrome (RDS). Without sufficient surfactant, it takes a lot of energy to keep the alveoli open and filling repeatedly with air, making it difficult for babies with RDS to breath.
