Trachea

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Trachea
Illu conducting passages.svg
Conducting passages.
Gray1204.png
Laryngoscopic view of interior of larynx. (Trachea labeled at bottom.)
Gray's p.1084
Artery tracheal branches of inferior thyroid artery
Vein brachiocephalic vein, azygos vein accessory hemiazygos vein
MeSH Trachea
Anatomical terminology

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.

Structure[edit]

In humans, the trachea passes ventrally to the esophagus, dorsally to the ascending aortic arch, but the left main bronchus from the trachea, passes ventrally to the descending aortic arch.

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 front and sides of the trachea to protect and maintain the airway. This leaves a membranous wall (pars membranacea) at the back, 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 rate of air flow. The esophagus lies posteriorly to the trachea. Circular bands of fibrous connective tissue called the annular ligaments of trachea join the tracheal rings together. 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.

Histology[edit]

The trachea is lined with pseudostratified columnar epithelium a type of epithelium with goblet cells that produce mucins the main component of mucus, to moisten and protect the airways.[1] 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.

Variation[edit]

Tracheal agenesis,[2] a rare birth defect in which the trachea fails to develop. The defect is normally fatal.

A tracheoesophageal fistula is a congenital defect in which the trachea and esophagus are abnormally connected.

Clinical significance[edit]

Inflammation[edit]

Inflammation of the trachea is known as tracheitis. When the trachea is inflammed as well as the larynx and bronchi, this is known as croup, which often causes a distinct, barking cough.

Intubation[edit]

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.

Other[edit]

Other animals[edit]

Allowing for variations in the length of the neck, the trachea in other mammals is, in general, similar to that in humans. Generally, it is also similar to the reptilian trachea.[3]

Vertebrates[edit]

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.[3]

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.[3]

The only vertebrate to have lungs, but no trachea, is Polypterus, in which the lungs arise directly from the pharynx.[3]

Invertebrates[edit]

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.[4] 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.[5] 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, or function essentially as normal, via a plastron. Note that despite being internal, the tracheae of arthropods are shed during moulting (ecdysis).[citation needed]

10 X Photograph of an histological sample of a human trachea coloured with hematoxylin and eosin.

History[edit]

In 2008, a Colombian woman received a trachea transplant using her own stem cells so her body would not reject the transplant.[6] 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.[7][8]

Additional images[edit]

References[edit]

  1. ^ Mescher AL, "Chapter 17. The Respiratory System" (Chapter). Mescher AL: Junqueira's Basic Histology: Text & Atlas, 12e: http://www.accessmedicine.com/content.aspx?aID=6182422.
  2. ^ Chiu, T.; Cuevas, D.; Cuevas, L.; Monteiro, C. (1990). "Tracheal agenesis". Southern medical journal 83 (8): 925–930. doi:10.1097/00007611-199008000-00018. PMID 2200137.  edit
  3. ^ a b c d Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body. Philadelphia, PA: Holt-Saunders International. pp. 336–337. ISBN 0-03-910284-X. 
  4. ^ Wasserthal, Lutz T. (1998). Chapter 25: The Open Hemolymph System of Holometabola and Its Relation to the Tracheal Space. In "Microscopic Anatomy of Invertebrates". Wiley-Liss, Inc. ISBN 0-471-15955-7.
  5. ^ Westneat, Mark W.; Betz, Oliver; Blob, Richard W.; Fezzaa, Kamel; Cooper, James W.; Lee, Wah-Keat (January 2003). "Tracheal Respiration in Insects Visualized with Synchrotron X-ray Imaging". Science 299 (5606): 558–560. doi:10.1126/science.1078008. PMID 12543973. 
  6. ^ "The top health stories of 2008 - CNN.com". CNN. 2008-12-26. Retrieved 2010-05-27. 
  7. ^ "Surgeons carry out first synthetic windpipe transplant". BBC News. 2011-07-07. Retrieved 2011-07-07. 
  8. ^ First Successful Transplantation of a Synthetic Tissue Engineered Windpipe. Karolinska University Hospital website, retrieved 8/7/2011.

Ligaments