Breathing

"Breath" redirects here. For other uses, see Breath (disambiguation).

For other uses, see Breathing (disambiguation).

Breathing is the process that moves air in and out of the lungs, or the diffusion of oxygen and carbon dioxide to and from the external environment into and out of the blood through other respiratory organs such as gills. For organisms with lungs, breathing is also called pulmonary ventilation, which consists of inhalation (breathing in) and exhalation (breathing out). Breathing is one part of physiological respiration required to sustain life. Aerobic organisms such as birds, mammals, and reptiles require oxygen at cellular level to release energy by metabolizing energy-rich molecules such as fatty acids and glucose. This is often referred to as cellular respiration. Breathing is only one of the processes that delivers oxygen to where it is needed in the body and removes excess carbon dioxide. The next process in this chain of events is the transport of these gases throughout the body by the circulatory system, and then their uptake or release from the respiring cells. Breathing fulfills another vital function: that of regulating the pH of the extracellular fluids of the body. It is, in fact, this homeostatic function which determines the rate and depth of breathing. The medical term for normal relaxed breathing is eupnea.

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X-ray video of a female American alligator while breathing.

At the end of each exhalation the adult human lungs still contain 2.5 – 3.0 liters of air, termed the functional residual capacity (FRC). Breathing replaces only about 15% of this volume of gas with each breath. This ensures that the composition of the FRC changes very little during the breathing cycle, and remains significantly different from the composition of the ambient air. The partial pressures of the gases in the blood flowing through the alveolar capillaries equilibrate with the partial pressures of the gases in the FRC, ensuring that the $P_{{\mathrm {CO} }_{2}}$$P_{{\mathrm {CO} }_{2}}$,and $P_{{\mathrm {O} }_{2}}$$P_{{\mathrm{O}}_2}$ of the arterial blood, and therefore its pH, remain constant. The equilibration of the gases in the alveolar blood with those in the alveolar air (i.e. the gas exchange between the two) occurs by passive diffusion.

Breathing is used for a number of other subsidiary functions, such as speech, expression of the emotions (e.g. laughing. yawning etc.), and, in animals that cannot sweat through the skin, panting.

Mechanics

See also: Respiratory system § Gas exchange

The effect of the contraction of the accessory muscles of inhalation, pulling the front of the rib cage upwards. This increases the antero-posterior diameter of the thorax, contributing to the expansion in the volume of the chest. A similar effect causes the transverse diameter of the chest to increase, because not only do the ribs slant downwards from the back to the front, but, in the case of the lower ribs, also from the midline downwards to the sides of the chest.

A cartoon illustrating the mechanisms for forceful inhalation (left), and forceful exhalation (right). During forceful inhalation the diaphragm (the domed, almost horizontal structure in red, between the thoracic cavity (upper compartment) and abdominal cavity (lower compartment), contracts forcing the abdominal contents downwards, causing the abdomen to bulge outwards. At the same time the accessory muscles of inhalation cause the transverse diameter of the thorax to increase as described in the illustration of the movement of the ribs on the left. During forced exhalation the powerful muscles of the abdominal wall pull the lower edges of the rib cage downwards decreasing the antero-posterior and transverse diameters of the chest cavity, while at the same time forcing the abdominal organs up against the diaphragm causing it to bulge deeply into the chest.The force with which air can be expelled from the lungs is considerable greater than the force with which air can be inhaled. This is the result of the power of the muscles of the abdominal wall exceeding that of all the accessory muscles of inhalation. The most vigorous exhalatory efforts occur during coughing, sneezing and the blowing out of, for instance, candles.

In mammals, breathing in (inhalation) at rest is primarily due to the contraction and flattening of the diaphragm, a domed muscle that separates the thoracic cavity from the abdominal cavity. When the diaphragm contracts it pushes the abdominal organs downward, but since the pelvic floor prevents the lowermost abdominal organs from moving in that direction, the abdomen, in fact, bulges forwards (or outwards). In the process the size of the thoracic cavity has increased in volume (as has the volume of the body as a whole). This increased thoracic volume results in a fall in pressure in the thorax, which causes the expansion of the lungs. During exhalation (breathing out), at rest, the diaphragm relaxes, returning the chest and abdomen to a position which is determined by their anatomical elasticity (i.e. the position in the cadaver, or in an animal that has been given a muscle relaxant under anesthesia). This is the "resting mid-position" of the thorax when the lungs contain the functional residual capacity of air, which in the adult human has a volume of about 2.5 liters. Resting exhalation lasts about twice as long as inhalation because the diaphragm relaxes more gently than it contracts during inhalation. This prevents undue narrowing of the airways, from which the air escapes more easily than from the alveoli.

During heavy breathing (hyperventilation), as, for instance, during exercise, the "accessory muscles of inhalation" (of which the first to be recruited are the intercostal muscles, but include a large number of other muscles – see below) pull the ribs upwards, both in the front and on the sides. This increases the volume of the rib cage, adding to the volume increase caused by the descending diaphragm. During the ensuing exhalation the rib cage is actively pulled downwards (front and sides) by the abdominal muscles, which not only decreases the size of the rib cage, but also pushes the abdominal organs upwards against the diaphragm which consequently bulges deeply into the thorax. The end-exhalatory lung volume is now well below the resting mid-position and contains far less air than the resting "functional residual capacity". However, in a normal mammal, the lungs cannot be emptied completely. In an adult human there is always still at least 1 liter of residual air left in the lungs after maximum exhalation.

The entirely unconscious and automatic breathing on which the life of the animal depends can be temporarily over-ridden by conscious or emotion-driven movements of air in and out of the lungs. Speech in humans is generated by a specialized form of exhalation, but other forms of communication (e.g. crying, yelping, yawning, barking, baying, hissing, panting, sighing, shouting, laughing etc.) also rely on a balance between breathing for blood gas homeostasis and the emotional or other messages that need to be conveyed to the animal's conspecifics.

Ten muscles can be used for inhalation:

Diaphragm, Intercostal Muscles, Scalenes, Pectoralis Minor, Serratus Anterior, Sternocleidomastoid, Levator Costarum, Upper / Superior Trapezius, Latissimus Dorsi, and Subclavius.

Eight are used for forced exhalation:

Internal intercostal, Obliquus Internus, Obliquus Externus, Levator Ani, Triangularis Sterni, Transversalis, Pyramidalis, and Rectus Abdominus.

In amphibians, the process used is positive pressure ventilation. Muscles lower the floor of the oral cavity, enlarging it and drawing in air through the nostrils (which uses the same mechanics – pressure, volume, and diffusion – as a mammalian lung). With the nostrils and mouth closed, the floor of the oral cavity is forced up, which forces air down the trachea into the lungs.

Nasal

Nasal breathing is breathing through the nose. The importance of breathing through the nose rather than the mouth was recognized in the 19th century. Hendrik Zwaardemaker (1857–1930) studied this and invented a device to measure the amount of airflow through each nostril. This rhinomanometer used cold mirrors; more recent devices use acoustic technology.

Inhaled air is warmed and moistened by the wet, warm nasal mucosa, which consequently cools and dries. When warm, wet air from the lungs is breathed out through the nose, the cold hygroscopic mucus in the cool and dry nose re-captures some of the warmth and moisture from that exhaled air. In very cold weather the re-captured water my cause a "dripping nose".

Breathing out through the mouth into a cold environment indicates how much moisture the exhaled air can contain. However, breathing out through the nose recaptures much of the moisture, because the nose was cooled and dried when it warmed and moistened the air during inhalation. The exhaled air re-moistens and warms the nasal mucosa, thus drying out and cooling the air before it is expelled into the exterior. It is therefore more difficult to fog up a mirror by breathing on to it through the nose, than by breathing out on to it through the mouth.

The nasal passages consist of narrow slits, exposing a large area of mucous membrane to the air moving in (during inhalation) and out (during exhalation) through the nose during each breath. This has several effects. Firstly, the inhaled air takes up moisture from the wet mucus, and warmth from the underlying blood vessels, so that the air is very nearly saturated with water vapor and is at almost body temperature by the time it reaches the larynx. Part of this moisture and heat is recaptured as the exhaled air moves over the partially dried-out, and cooled mucus. The sticky mucus also traps much of the particulate matter that is breathed in, preventing it from reaching the lungs.

Secondly, the narrowness of the nasal passages ensures that the single largest resistance to airflow during breathing occurs in the nose. This plays an important role on preventing the collapse of the airways in the thorax during exhalation. As the volume of the thorax decreases during exhalation, air escapes far more easily from the larger pulmonary airways than from the alveoli, simply because their connection to the outside air is more direct than is the connection between the alveolar air and the ambient air. The decrease in volume of these airways is therefore more pronounced than the decrease in the volume of the alveoli – predisposing the airways to collapse during exhalation, particularly in chronic obstructive pulmonary disease and asthma. The high resistance to airflow through the nose prevents this easy emptying of the larger airways, thus keeping the air passages between the alveoli and the exterior open. The resistance to airflow at the exit to the outside air can be increased by breathing out through pursed lips (and not through the nose), a tactic commonly used by persons with chronic obstructive pulmonary disease and asthma.

A further function of the nose is that it contains the smell (or olfactory) sensors, which play a role in evaluating the food that is about to be eaten or is being chewed in the mouth (when smell contributes to the flavor of the food), as well as identifying pleasant and unpleasant odors in the environment.

Control

Main article: Respiratory system § Control

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

Conscious

Conscious control of breathing is common in many forms of meditation, specifically forms of yoga for example pranayama.

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.

Also breathing control is used in Buteyko method, an alternative physical therapy that proposes the use of breathing exercises as a treatment for asthma and other conditions.

Unconscious

Unconsciously, breathing is controlled by specialized centers in the brainstem, which automatically regulate the rate and depth of breathing depending on the body’s needs at any time. For instance, while exercising, the increased production of carbon dioxide by the exercising muscles tends to increase the alveolar (and therefore the arterial) $P_{{\mathrm {CO} }_{2}}$$P_{{\mathrm {CO} }_{2}}$. This is however immediately sensed by the $P_{{\mathrm {CO} }_{2}}$$P_{{\mathrm {CO} }_{2}}$ sensor on the medulla oblongata of the brain stem (as well as by the gas tension sensors in the aortic and carotid bodies). These blood gas chemoreceptors send nerve impulses to the respiratory center in the medulla oblongata and pons in the brain. This, in turn sends nerve impulses through the phrenic nerve and and other somatic motor nerves to the diaphragm and accessory muscles of inhalation and exhalation, increasing the rate and depth of breathing (hyperventilation). This keeps the arterial blood $P_{{\mathrm {CO} }_{2}}$$P_{{\mathrm {CO} }_{2}}$ and $P_{{\mathrm {O} }_{2}}$$P_{{\mathrm{O}}_2}$ virtually unchanged during the transition from rest to vigorous exercise.

Interaction

It is not possible for a healthy person to voluntarily stop breathing indefinitely. If one does not inhale, the level of carbon dioxide builds up in the blood, and one experiences 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 (e.g. water, see drowning).

Voluntary hyperventilation can cause arterial carbon dioxide levels to fall to dangerously low levels, leading to paresthesias (a sensation of "pins and needles") round the mouth and in the hands and feet, and a peculiar form of muscular spasms (tetany) of the hands, arms, feet and face. This is usually elicited by anxiety or agitation, and can be very distressing, causing the person to think that they are suffocating when, in fact, they are over-riding their blood gas homeostat, and over-breathing, causing the blood pH to rise to dangerously high levels. The symptoms are brought about by calcium being less soluble under alkaline conditions than under acidic conditions. Thus, during a hyperventilation-induced alkaemia the plasma ionized calcium (Ca²⁺) level falls, causing many proteins to change their tertiaty (or 3D) configuration. Among the proteins that are most prominently affected are the voltage gated sodium channels of nerve fibres – causing them to randomly generate inappropriate action potentials, which cause the abnormal sensations (paresthesias) and spontaneous muscle contractions (tetany).

Composition

The air we inhale is roughly composed of (by volume):

• 78.62% nitrogen
• 20.84% oxygen
• 0.96% argon
• 0.04% carbon dioxide
• 0.5% water vapour

In addition to air, underwater divers often breathe oxygen-rich or helium-rich gas mixtures. Oxygen and analgesic gases are sometimes given to patients under medical care. The atmosphere in space suits is pure oxygen. Also our reliance on this relatively small amount of oxygen can cause overactivity or euphoria in pure or oxygen-rich environments.

The permanent gases in gas we exhale are 4% to 5% by volume more carbon dioxide and 4% to 5% by volume less oxygen than was inhaled. This expired air typically composed of:

• 78.04% nitrogen
• 13.6% – 16% oxygen
• 4% – 5.3% carbon dioxide
• 1% argon and other gases

Additionally vapors and trace gases are present: 5% water vapor, several parts per million (ppm) of hydrogen and carbon monoxide, 1 part per million (ppm) of ammonia and less than 1 ppm of acetone, methanol, ethanol (unless ethanol has been ingested, in which case much higher concentrations would occur in the breath, cf. Breathalyzer) and other volatile organic compounds. Oxygen is used by the body for cellular respiration and other uses, and carbon dioxide is a product of these processes. The exact amount of exhaled oxygen and carbon dioxide when breathing and the amount of gases exhaled may vary based on diet, exercise and fitness.

Air pressure

Atmospheric air at altitude is at a lower pressure than at sea level due to the lesser weight of the air above. This lower pressure can lead to altitude sickness, or hypoxia.

Gases breathed underwater are at higher pressure than at sea level due to the added weight of water. This can lead to nitrogen narcosis, oxygen toxicity, or decompression sickness.

Cultural significance

In t'ai chi ch'uan, aerobic training is combined with breathing to exercise the diaphragm muscles and to train effective posture; making better use of the body's energy. In music, breath is used to play wind instruments and many aerophones. Laughter, physically, is simply repeated sharp breaths. Hiccups, yawns, and sneezes are other breath-related phenomena.

Ancients commonly linked the breath to a life force. The Hebrew Bible refers to God breathing the breath of life into clay to make Adam a living soul (nephesh). It also refers to the breath as returning to God when a mortal dies. The terms "spirit," "qi," "prana" and "psyche" are related to the concept of breath. Also cognate are Polynesian Mana and Hebrew ruach.

In his book Your Atomic Self: The Invisible Elements That Connect You to Everything Else in the Universe, excerpted in Wired Magazine, Curt Stager explores the atomic and molecular basis of links through which breathing connects humans and other Aerobic organisms of birds, mammals, and reptiles to the entire planet.

Common phrases in English relate to breathing e.g. "catch my breath", "took my breath away", "inspiration", "to expire".

See also

• Respiratory system
• Apnea (suspension of breathing)
• Breath gas analysis
• Breathing gas
• Buteyko method – breathing exercise (to treat asthma) that involves breathing through one's nose
• Carbon cycle
• Diaphragmatic breathing
• Kussmaul breathing
• Agonal breathing
• Cheyne-Stokes respiration
• Biot's respiration
• Mouth breathing
• Nose breathing
• Pneuma
• Prana
• Qi
• Respiratory rate
• Snoring
• Spirit
• Halitosis
• Liquid breathing

Further reading

• Parkes M (2006). "Breath-holding and its breakpoint". Exp Physiol. 91 (1): 1–15. doi:10.1113/expphysiol.2005.031625. PMID 16272264.  Full text