Laryngoscopic view of interior of larynx. (Trachea labeled at bottom.)
|Artery||tracheal branches of inferior thyroid artery|
|Vein||brachiocephalic vein, azygos vein accessory hemiazygos vein|
The trachea, colloquially called windpipe, is a tube that connects the pharynx and larynx to the lungs, allowing the passage of air, and so is present in all air-breathing animals with lungs. Only in the lungfish, where the lung is connected to the pharynx and the trachea, is it absent.
The human trachea has an inner diameter of about 25 millimetres (1 in) and a length of about 10 to 16 centimetres (4 to 6 in). It commences at the lower border of the larynx, level with the sixth cervical vertebra, and bifurcates into the primary bronchi at the vertebral level of thoracic vertebra T5, or up to two vertebrae lower or higher, depending on breathing. A ring of hyaline cartilage called the cricoid cartilage forms the inferior wall of the larynx and is attached to the top of trachea. The cricoid cartilage is the only complete ring of cartilage in the trachea.
There are from fifteen to twenty incomplete C-shaped tracheal rings of cartilage that reinforce the anterior and lateral sides of the trachea to protect and maintain the airway, leaving a membranous wall (pars membranacea) dorsally without cartilage. The trachealis muscle connects the ends of the incomplete rings and contracts during coughing, reducing the size of the lumen of the trachea to increase the air flow rate. The esophagus lies posteriorly to the trachea. The cartilaginous rings are incomplete to allow the trachea to collapse slightly so that food can pass down the esophagus. A flap-like epiglottis closes the opening to the larynx during swallowing to prevent swallowed matter from entering the trachea.
The trachea is lined with respiratory epithelium, which serves to moisten and protect the airways. It is lined with pseudostratified columnar epithelium with goblet cells that produce mucus. Mucus lines the ciliated cells of the trachea to trap inhaled foreign particles that the cilia then waft upward toward the larynx and then the pharynx where it can be either swallowed into the stomach or expelled as phlegm.
A tracheoesophageal fistula is a congenital defect in which the trachea and esophagus are abnormally connected.
Tracheal intubation refers to the insertion of a tube down the trachea. This procedure is commonly performed during surgery, in order to ensure a person receives enough oxygen when sedated. The tube inserted down the trachea is connected to a machine that monitors the airflow, oxygenation and several other metrics. This is often one of the responsibilities of an anesthetist during surgery.
In an emergency, or when tracheal intubation is deemed impossible, a tracheotomy is often performed to insert a tube for ventilation, usually when needed for particular types of surgery to be carried out so that the airway is kept open for sufficient time. Another less invasive method is used when a procedure can be carried out more quickly, or in an emergency situation, and this is a cricothyrotomy.
- Tracheomalacia (weakening of the tracheal cartilage)
- Tracheal collapse (in dogs)
- Tracheobronchial injury (perforation of the trachea or bronchi)
- Mounier-Kuhn syndrome (an abnormal enlargement of the trachea)
In birds, the trachea runs from the pharynx to the syrinx, from which the primary bronchi diverge. Swans have an unusually elongated trachea, part of which is coiled beneath the sternum; this may act as a resonator to amplify sound. In some birds, the tracheal rings are complete, and may even be ossified.
In amphibians, the trachea is normally extremely short, and leads directly into the lungs, without clear primary bronchi. A longer trachea is, however, found in some long-necked salamanders, and in caecilians. While there are irregular cartilagenous nodules on the amphibian trachea, these do not form the rings found in amniotes.
The invertebrate trachea refers to the open respiratory system composed of spiracles, tracheae, and tracheoles that terrestrial arthropods have to transport metabolic gases to and from tissues. The distribution of spiracles can vary greatly among the many orders of insects, but in general each segment of the body can have only one pair of spiracles, each of which connects to an atrium and has a relatively large tracheal tube behind it. The tracheae are invaginations of the cuticular exoskeleton that branch (anastomose) throughout the body with diameters from only a few micrometres up to 0.8 mm. The smallest tubes, tracheoles, penetrate cells and serve as sites of diffusion for water, oxygen, and carbon dioxide. Gas may be conducted through the respiratory system by means of active ventilation or passive diffusion. Unlike vertebrates, insects do not generally carry oxygen in their haemolymph. This is one of the factors that may limit their size.
A tracheal tube may contain ridge-like circumferential rings of taenidia in various geometries such as loops or helices. In the head, thorax, or abdomen, tracheae may also be connected to air sacs. Many insects, such as grasshoppers and bees, which actively pump the air sacs in their abdomen, are able to control the flow of air through their body. In some aquatic insects, the tracheae exchange gas through the body wall directly, in the form of a gill. Note that despite being internal, the tracheae of arthropods are shed during moulting (ecdysis).
In 2008, a Colombian woman received a trachea transplant using her own stem cells so her body would not reject the transplant. In June 2011, a team of surgeons led by Professor Paolo Macchiarini at the Karolinska University Hospital performed the first synthetic windpipe transplant on a 36-year-old Eritrean man, Andemariam Teklesenbet Beyene.
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