1.

Introduction
Breathing is the process that moves air in and out of the lungs. Humans require oxygen to release energy via respiration, in the form of the metabolism of energy-rich molecules such as glucose. Breathing is only one process that delivers oxygen to where it is needed in the body and removes carbon dioxide. Another important process involves the movement of blood by the circulatory system. Gas exchange occurs in the pulmonary alveoli by passive diffusion of gases between the alveolar gas and the blood in lung capillaries. Once these dissolved gases are in the blood, the heart powers their flow around the body (via the circulatory system). The medical term for normal relaxed breathing is eupnea. In addition to removing carbon dioxide, breathing results in loss of water from the body. Exhaled air has a relative humidity of 100% because of water diffusing across the moist surface of breathing passages and alveoli.

2. Anatomy
2.1. The Lungs

To better understand how breathing works we first have to take a look on the anatomy of lungs. The lungs are the essential organs of respiration; they are two in number, placed one on either side within the thorax, and separated from each other by the heart and other contents of the mediastinum. The substance of the lung is of a light, porous, spongy texture; it floats in water, and crepitates when handled, owing to the presence of air in the alveoli; it is also highly elastic; hence the retracted state of these organs when they are removed from the closed cavity of the thorax. The surface is smooth, shining, and marked out into numerous polyhedral areas, indicating the lobules of the organ: each of these areas is crossed by numerous lighter lines. Each lung is conical in shape, and presents for examination an apex, a base, three borders, and two surfaces. The apex (apex pulmonis) is rounded, and extends into the root of the neck, reaching from 2.5 to 4 cm. above the level of the sternal end of the first rib. A sulcus produced by the subclavian artery as it curves in front of the pleura runs upward and lateralward immediately below the apex. The base (basis pulmonis) is broad, concave, and rests upon the convex surface of the diaphragm, which separates the right lung from the right lobe of the liver, and the left lung from the left lobe of the liver, the stomach, and the spleen. Since the diaphragm extends higher on 1

the right than on the left side, the concavity on the base of the right lung is deeper than that on the left. Laterally and behind, the base is bounded by a thin, sharp margin which projects for some distance into the phrenicocostal sinus of the pleura, between the lower ribs and the costal attachment of the diaphragm. The base of the lung descends during inspiration and ascends during expiration. The three borders and the two surfaces get their names from their position or from the adjacent organs. So, in a healty lung, we can find the inferior, posterior and anterior border as well as the costal and mediastinal sufaces.

2.2.

The Skeleton of the Thorax

The skeleton of the thorax or chest is an osseo-cartilaginous cage, containing and protecting the principal organs of respiration and circulation. It is conical in shape, being narrow above and broad below, flattened from before backward, and longer behind than in front. It is somewhat reniform on transverse section on account of the projection of the vertebral bodies into the cavity. The posterior surface is formed by the twelve thoracic vertebr and the posterior parts of the ribs. It is convex from above downward, and presents on either side of the middle line a deep groove, in consequence of the lateral and backward direction which the ribs take from their vertebral extremities to their angles. The anterior surface, formed by the sternum and costal cartilages, is flattened or slightly convex, and inclined from above downward and forward. The lateral surfaces are convex; they are formed by the ribs, separated from each other by the intercostal spaces, eleven in number, which are occupied by the Intercostal muscles and membranes. The upper opening of the thorax is reniform in shape, being broader from side to side than from before backward. It is formed by the first thoracic vertebra behind, the upper margin of the sternum in front, and the first rib on either side. It slopes downward and forward, so that the anterior part of the opening is on a lower level than the posterior. Its antero-posterior diameter is about 5 cm., and its transverse diameter about 10 cm. The lower opening is formed by the twelfth thoracic vertebra behind, by the eleventh and twelfth ribs at the sides, and in front by the cartilages of the tenth, ninth, eighth, and seventh ribs, which ascend on either side and form an angle, the subcostal angle, into the apex of which the xiphoid process projects. The lower opening is wider transversely than from before backward, and slopes obliquely downward and backward, it is closed by the diaphragm which forms the floor of the thorax. 2

2.3.

Muscles of Respiration

The various muscles of respiration aid in both inspiration and expiration, which require changes in the pressure within the thoracic cavity. The respiratory muscles work to achieve this by changing the dimensions of the thoracic cavity.

2.3.1. The intercostal muscles

The intercostal muscles are the muscle bands that surround and span between the ribs that alternately lift and compress the rib cage in order to permit respiration. There are two distinct muscle groups that form the intercostal muscles: the external and the internal intercostals. Both are supplied with blood and nerves by structures occupying the intercostal space, namely the thoracic spinal nerves, and the intercostal veins and arteries. These muscles and structures are aptly named since the term intercostal is derived from the Latin word costae, which translates to mean ribbed or rib-like. The external intercostal muscles consist of eleven muscles that envelop each side of the exterior of the rib cage from the back of the ribs and wrapping around where they are attached to the sternum in front. As these muscles extend toward the front of the ribs, they become tapered, and at this point are referred to as the anterior intercostal membranes. As a group, these muscles are thicker than their counterparts that form the internal intercostals. In addition, if you were to view an illustration of the rib cage from the rear, it would be apparent that these muscles are positioned on an angle, taking an obliquely downward and laterally outward direction that is opposite to the internal intercostals. The internal intercostals, eleven in all, are located on the anterior of the rib cage and are visible between the ribs. These muscles extend from the top of each rib and travel in an obliquely upward route from the sternum where they eventually form the posterior intercostal membranes that are attached to the spinal column.

2.3.2. The Thoracic Diaphragm

The Thoracic Diaphragm is a sheet of internal muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity (heart, lungs & ribs) from the abdominal cavity and performs an important function in respiration.

The diaphragm is a dome-shaped musculofibrous septum that separates the thoracic from the abdominal cavity, its convex upper surface forming the floor of the former, and its concave under surface forming the roof of the latter. Its peripheral part consists of muscular fibers that take origin from the circumference of the inferior thoracic aperture and converge to be inserted into a central tendon.

2.3.3. Accessory muscles of inspiration

There is some controversy as to which muscles may be considered accessory muscles of inspiration. The sternocleidomastoid and the scalene muscles (anterior, middle and posterior scalene) are typically considered accessory muscles of breathing . However the following muscles have also been observed contributing to the breathing: serratus anterior, pectoralis major & minor, upper trapezius, latissimus dorsi, erector spinae, iliocostalis lumborum, quadratus lumborum, serratus posterior superior and inferior, levatores costarum, transversus thoracis, subclavius. Scalene muscle activation coincides with the diaphragm even at rest in most humans, suggesting it could be considered a primary muscle of respiration.

3. Mechanics of Breathing
Breathing consists of two phases, inspiration and expiration.

3.1. Inspiration Atmospheric pressure, due to the weight of air, is the force that causes air to move into the lungs. At sea level, this is equal to 760 mm of mercury. Air pressure is exerted on all surfaces in contact with the air, and since people breathe air, the inside surfaces of their lungs also are subjected to pressure. In other words, the pressures on the inside of the lungs and alveoli and on the outside of the thoracic wall are about the same. If the pressure inside the lungs and alveoli decreases, outside air will be pushed into the airways by atmospheric pressure. That is what happens during inspiration. Muscle fibers in the dome-shaped diaphragm below the lungs are stimulated to contract by impulses carried on the phrenic nerves, which are associated with the cervical plexuses. As this happens, the diaphragm moves downward, the size of the thoracic cavity is enlarged , and the pressure within 4

the alveoli is reduced about 2 mm Hg below that of atmospheric pressure. In response to this decreased pressure, air is forced into the airways by atmospheric pressure, and the lungs expand.

While the diaphragm is contracting and moving downward, the external intercostal muscles between the ribs may be stimulated to contract. This action raises the ribs and elevates the sternum, so that the size of the thoracic cavity increases even more. As a result, the pressure inside is further reduced and more air is forced into the airways by the relatively greater atmospheric pressure. The expansion of the lungs is aided by the fact that the parietal pleura, on the inner wall of the thoracic cavity, and the visceral pleura, attached to the surface of the lungs, are separated only by a thin film of serous fluid. The water molecules in this fluid have a great attraction to one another, creating a force called surface tension. This force holds the moist surfaces of the pleural membranes tightly together. Consequently, when the thoracic wall is moved upward and outward by the action of the external intercostal muscles, the parietal pleura is moved too, and the visceral pleura follows it. This action helps to expand the lungs in all directions. The surface tension between the adjacent moist membranes is sufficient to cause the collapse of the alveoli, which have moist inner surfaces. Certain alveoli cells, however, synthesize a mixture of lipoproteins, called surfactant. Surfactant, which is secreted into the alveoli air spaces continuously, acts to reduce the surface tension and decreases the tendency of the alveoli to collapse, when the lung volume is low. The low pressure formed in the respiratory tract is power enough to collapse other hollow organs through which air passes. Therefore the organs of the upper and lower respiratory tract, excluding lungs, are rigid or semi-rigid to prevent obstruction of air flow. If a person needs to take a deeper breath than normal breath, the diaphragm and external intercostal muscles may be contracted to an even greater extent. Additional muscles, such as the pectoralis minors and sternocleidomastoids, can also be used to pull the thoracic cage farther upward and outward, enlarging the thoracic cavity and decreasing the internal pressure still more.

3.2. Expiration The forces responsible for normal expiration come from the elastic recoil of tissues and from surface tension. The lungs and thoracic wall, for example, contain a considerable amount of 5

elastic tissues, and as the lungs expand during inspiration, these tissues are stretched. As the diaphragm lowers, the abdominal organs beneath it are compressed. As the diaphragm and external intercostal muscles relax following inspiration, these elastic tissues cause the lungs and thoracic cage to recoil, and they return to their original shapes. Similarly, the abdominal organs spring back into their previous shapes, pushing the diaphragm upwards. At the same time, the surface tension that develops between the moist surfaces of the alveolar linings tend to cause a decrease in the diameter of the alveoli. Each of these factors tends to increase the alveolar pressure about 1 mm Hg above atmospheric pressure, so that the air inside the lungs is forced out through the respiratory passages. Thus, normal expiration is a passive process.

If a person needs to exhale more air than normal, the posterior internal intercostal muscles can be contracted. These muscles pull the ribs sternum downward and inward increasing the pressure in the lungs. Also, the abdominal wall muscles, including the external and internal obliques, transversus abdominis, and rectus abdominis, can be used to squeeze the abdominal organs inward. Thus, the abdominal wall muscles can cause pressure in the abdominal cavity to increase and force the diaphragm still higher against the lungs. As a result of these actions, additional air can be squeezed out of the lungs.

4. Control of Breathing
Breathing is one of the few bodily functions which, within limits, can be controlled both consciously and unconsciously. Conscious control of breathing is common in many forms of meditation, for example yoga. In swimming, cardio fitness, speech or vocal training, one learns to discipline one's breathing, initially consciously but later sub-consciously, for purposes other than life support. Human speech is also dependent on conscious breath control. Unconsciously, breathing is controlled by specialized centers in the brainstem, which automatically regulate the rate and depth of breathing depending on the bodys needs at any time. When carbon dioxide levels increase in the blood, it reacts with the water in blood, producing carbonic acid. Lactic acid produced by anaerobic respiration during exercise also lowers pH. The drop in the blood's pH stimulates chemoreceptors in the carotid and aortic bodies in the blood system to send nerve impulses to the respiration centre in the medulla oblongata and pons in the brain. These, in turn send nerve impulses through the phrenic and thoracic nerves to the diaphragm. 6

For instance, while exercising, the level of carbon dioxide in the blood increases due to increased cellular respiration by the muscles, which activates carotid and aortic bodies and the respiration center, which ultimately cause a higher rate of respiration. During rest, the level of carbon dioxide is lower, so breathing rate is lower. This ensures an appropriate amount of oxygen is delivered to the muscles and other organs. It is important to reiterate that it is the buildup of carbon dioxide making the blood acidic that elicits the desperation for a breath much more than lack of oxygen. It is not possible for a healthy person to voluntarily stop breathing indefinitely. If we do not inhale, the level of carbon dioxide builds up in our blood, and we experience overwhelming air hunger. This irrepressible reflex is not surprising given that without breathing, the body's internal oxygen levels drop dangerously low within minutes, leading to permanent brain damage followed eventually by death. However, there have been instances where people have survived for as long as two hours without air; this is only possible when submerged in cold water, as this triggers the mammalian diving reflex as well as putting the subject into a state of suspended animation. If a healthy person were to voluntarily stop breathing (i.e. hold his or her breath) for a long enough amount of time, he or she would lose consciousness, and the body would resume breathing on its own. Because of this one cannot commit suicide with this method, unless one's breathing was also restricted by something else.

5. Summary
Breathing is the process that moves air in and out of the lungs. The lungs are the essential organs of respiration. The skeleton of the thorax contains and protects the principal organs of respiration and circulation. The various muscles of respiration aid in both inspiration and expiration, which require changes in the pressure within the thoracic cavity. The respiratory muscles work to achieve this by changing the dimensions of the thoracic cavity. During inhalation the diaphragm is contracting and moving downward and the external intercostal muscles between the ribs contract. This action raises the ribs and elevates the sternum, so that the size of the thoracic cavity increases. Increase of the volume of the lungs reduces the internal pressure and the atmospheric air rushes in. The lungs and thoracic wall contain a considerable amount of elastic tissues, and as the lungs expand during inspiration, these tissues are stretched. The forces responsible for normal expiration come from these the elastic

recoil of tissues and from surface tension. Breathing is one of the few bodily functions which, within limits, can be controlled both consciously and unconsciously.

6. Conclusion
Breathing is a one of the most important bodily functions. It is suficive to say that man can survive weeks without food, days without water but only minutes without air. The understanding of the mechanics of breathing is inportant in diagnosis of many diseases concerning the respiratory system.

7. References
Greys Anatomy, 2007. The Lungs Human Anatomy [online] Available at: <http://www.theodora.com/anatomy/the_lungs.html> Yahoo Education, 2009. The Thorax - Gray's Anatomy of the Human Body [online] Available at: <http://education.yahoo.com/reference/gray/subjects/subject/26> wiseGEEK, 2011. What Are Intercostal Muscles? [online] Available at: <http://www.wisegeek.com/what-are-intercostal-muscles.htm> Wikipedia, 2011. Muscles of respiration [online] Available at: <http://en.wikipedia.org/wiki/Muscles_of_respiration> Wikipedia, 2011. Thoracic diaphragm [online] Available at: <http://en.wikipedia.org/wiki/Thoracic_diaphragm> Integrated Publishing, Mechanics of Breathing [online] Available at: <http://www.tpub.com/content/armymedical/md0532/md05320015.htm> Physioweb, The Mechanics of Breathing [online] Available at: <http://www.physioweb.org/respiration/respire_mechanics.html>