Lung

Lung
Lungs diagram detailed.svg
Diagram of the human lungs with the respiratory tract visible, and different colours for each lobe
Heart-and-lungs.jpg
The human lungs flank the heart and great vessels in the chest cavity
Details
SystemRespiratory system
Identifiers
Latinpulmo
Greekπνεύμων (pneumon)
MeSHD008168
TAA06.5.01.001
FMA68877
Anatomical terminology

The lungs are the primary organs of the respiratory system in humans and many other animals including a few fish and some snails. In mammals and most other vertebrates, two lungs are located near the backbone on either side of the heart. Their function in the respiratory system is to extract oxygen from the atmosphere and transfer it into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere, in a process of gas exchange. Respiration is driven by different muscular systems in different species. Mammals, reptiles and birds use their different muscles to support and foster breathing. In early tetrapods, air was driven into the lungs by the pharyngeal muscles via buccal pumping, a mechanism still seen in amphibians. In humans, the main muscle of respiration that drives breathing is the diaphragm. The lungs also provide airflow that makes vocal sounds including human speech possible.

Humans have two lungs, a right lung and a left lung. They are situated within the thoracic cavity of the chest. The right lung is bigger than the left, which shares space in the chest with the heart. The lungs together weigh approximately 1.3 kilograms (2.9 lb), and the right is heavier. The lungs are part of the lower respiratory tract that begins at the trachea and branches into the bronchi and bronchioles, and which receive air breathed in via the conducting zone. The conducting zone ends at the terminal bronchioles. These divide into the respiratory bronchioles of the respiratory zone which divide into alveolar ducts that give rise to the microscopic alveoli, where gas exchange takes place. Together, the lungs contain approximately 2,400 kilometres (1,500 mi) of airways and 300 to 500 million alveoli. Each lung is enclosed within a pleural sac which allows the inner and outer walls to slide over each other whilst breathing takes place, without much friction. This sac also divides each lung into sections called lobes. The right lung has three lobes and the left has two. The lobes are further divided into bronchopulmonary segments and lobules. The lungs have a unique blood supply, receiving deoxygenated blood from the heart in the pulmonary circulation for the purposes of receiving oxygen and releasing carbon dioxide, and a separate supply of oxygenated blood to the tissue of the lungs, in the bronchial circulation.

The tissue of the lungs can be affected by a number of diseases, including pneumonia and lung cancer. Chronic obstructive pulmonary disease includes chronic bronchitis and previously termed emphysema, can be related to smoking or exposure to harmful substances such as coal dust, asbestos fibres and crystalline silica dust. Diseases such as bronchitis can also affect the respiratory tract. Medical terms related to the lung often begin with pulmo-, from the Latin pulmonarius (of the lungs) as in pulmonology, or with pneumo- (from Greek πνεύμων "lung") as in pneumonia.

In embryonic development, the lungs begin to develop as an outpouching of the foregut, a tube which goes on to form the upper part of the digestive system. When the lungs are formed the fetus is held in the fluid-filled amniotic sac and so they do not function to breathe. Blood is also diverted from the lungs through the ductus arteriosus. At birth however, air begins to pass through the lungs, and the diversionary duct closes, so that the lungs can begin to respire. The lungs only fully develop in early childhood.

Structure of the human lungs

"Meet the lungs" from the Khan academy

Anatomy

Illu bronchi lungs.jpg

The lungs are located in the chest on either side of the heart in the rib cage. They are conical in shape with a narrow rounded apex at the top, and a broad concave base that rests on the convex surface of the diaphragm.[1] The apex of the lung extends into the root of the neck, reaching shortly above the level of the sternal end of the first rib. The lungs stretch from close to the backbone in the rib cage to the front of the chest and downwards from the lower part of the trachea to the diaphragm.[1] The left lung shares space with the heart, and has an indentation in its border called the cardiac notch of the left lung to accommodate this.[2][3] The front and outer sides of the lungs face the ribs, which make light indentations on their surfaces. The medial surfaces of the lungs face towards the centre of the chest, and lie against the heart, great vessels, and the carina where the trachea divides into the two main bronchi.[3] The cardiac impression is an indentation formed on the surfaces of the lungs where they rest against the heart.

Both lungs have a central recession called the hilum at the root of the lung, where the blood vessels and airways pass into the lungs.[1] There are also bronchopulmonary lymph nodes on the hilum.[3]

The lungs are surrounded by the pulmonary pleurae. The pleurae are two serous membranes; the outer parietal pleura lines the inner wall of the rib cage and the inner visceral pleura directly lines the surface of the lungs. Between the pleurae is a potential space called the pleural cavity containing a thin layer of lubricating pleural fluid. Each lung is divided into lobes by the infoldings of the pleura as fissures. The fissures are double folds of pleura that section the lungs and help in their expansion.[4]

Lobes and bronchopulmonary segments [5]
Right lung Left lung
Upper
  • Apical
  • Anterior
  • Posterior
Middle
  • Medial
  • Lateral
Lower
  • Superior
  • Anterior
  • Posterior
  • Medial
  • Lateral
Upper
  • Anterior
  • Apicoposterior

Lower

  • Superior
  • Anterior
  • Posterior
  • Medial
  • Lateral

Lingula

  • Superior
  • Inferior

The main or primary bronchi enter the lungs at the hilum and initially branch into secondary bronchi also known as lobar bronchi that supply air to each lobe of the lung. The lobar bronchi branch into tertiary bronchi also known as segmental bronchi and these supply air to the further divisions of the lobes known as bronchopulmonary segments. Each bronchopulmonary segment has its own (segmental) bronchus and arterial supply.[6] Segments for the left and right lung are shown in the table.[5] The segmental anatomy is useful clinically for localising disease processes in the lungs.[5] A segment is a discrete unit that can be surgically removed without seriously affecting surrounding tissue.[7]

Right lung

The right lung has both more lobes and segments than the left. It is divided into three lobes, an upper, middle, and a lower, by two fissures, one oblique and one horizontal.[8] The upper, horizontal fissure, separates the upper from the middle lobe. It begins in the lower oblique fissure near the posterior border of the lung, and, running horizontally forward, cuts the anterior border on a level with the sternal end of the fourth costal cartilage; on the mediastinal surface it may be traced backward to the hilum.[1]

The lower, oblique fissure, separates the lower from the middle and upper lobes, and is closely aligned with the oblique fissure in the left lung.[1][4]

The mediastinal surface of the right lung is indented by a number of nearby structures. The heart sits in an impression called the cardiac impression. Above the hilum of the lung is an arched groove for the azygos vein, and above this is a wide groove for the superior vena cava and right brachiocephalic vein; behind this, and close to the top of the lung is a groove for the brachiocephalic artery. There is a groove for the esophagus behind the hilum and the pulmonary ligament, and near the lower part of the esophageal groove is a deeper groove for the inferior vena cava before it enters the heart.[3]

Left lung

The left lung is divided into two lobes, an upper and a lower, by the oblique fissure, which extends from the costal to the mediastinal surface of the lung both above and below the hilum.[1] The left lung, unlike the right, does not have a middle lobe, though it does have a homologous feature, a projection of the upper lobe termed the "lingula". Its name means "little tongue". The lingula on the left serves as an anatomic parallel to the right middle lobe, with both areas being predisposed to similar infections and anatomic complications.[9][10] There are two bronchopulmonary segments of the lingula: superior and inferior.[1]

The mediastinal surface of the left lung has a large cardiac impression where the heart sits. This is deeper and larger than that on the right lung, at which level the heart projects to the left.[3]

On the same surface, immediately above the hilum, is a well-marked curved groove for the aortic arch, and a groove below it for the descending aorta. The left subclavian artery, a branch off the aortic arch, sits in a groove from the arch to near the apex of the lung. A shallower groove in front of the artery and near the edge of the lung, lodges the left brachiocephalic vein. The esophagus may sit in a wider shallow impression at the base of the lung.[3]

The left lung
The right lung
The left lung (left) and right lung (right). The lobes of the lungs can be seen, and the central root of the lung is also present.

Microanatomy

Cross-sectional detail of the lung
Lung tissue
A respiratory lobule, the functional unit of the lung

The lungs are part of the lower respiratory tract, and accommodate the bronchial airways when they branch from the trachea. The lungs include the bronchial airways that terminate in alveoli, the lung tissue in between, and veins, arteries, nerves and lymphatic vessels.[3][11] The trachea and bronchi have plexuses of lymph capillaries in their mucosa and submucosa. The smaller bronchi have a single layer and they are absent in the alveoli.[12]

All of the lower respiratory tract including the trachea, bronchi, and bronchioles is lined with respiratory epithelium. This is a ciliated epithelium interspersed with goblet cells which produce mucus, and club cells with actions similar to macrophages. Incomplete rings of cartilage in the trachea and smaller plates of cartilage in the bronchi, keep these airways open.[13] Bronchioles are too narrow to support cartilage and their walls are of smooth muscle, and this is largely absent in the narrower respiratory bronchioles which are mainly just of epithelium.[13] The respiratory tract ends in lobules. Each lobule consists of a respiratory bronchiole, which branches into alveolar ducts and alveolar sacs, which in turn divide into alveoli.[3]

The epithelial cells throughout the respiratory tract secrete epithelial lining fluid (ELF), the composition of which is tightly regulated and determines how well mucociliary clearance works.[14][15]:Section 4 pages 7–8 (Page 4–7ff)

Alveoli consist of two types of alveolar cell and an alveolar macrophage. The two types of cell are known as type I and type II alveolar cells[16] (also known as pneumocytes).[3] Types I and II make up the walls and alveolar septa. Type I cells provide 95% of the surface area of each alveoli and are flat ("squamous"), and Type II cells generally cluster in the corners of the alveoli and have a cuboidal shape.[17] Despite this, cells occur in a roughly equal ratio of 1:1 or 6:4.[16][17]

Type I are squamous epithelial cells that make up the alveolar wall structure. They have extremely thin walls that enable an easy gas exchange.[16] These type I cells also make up the alveolar septa which separate each alveolus. The septa consist of an epithelial lining and associated basement membranes.[17] Type I cells are not able to divide, and consequently rely on differentiation from Type II cells.[17]

Type II are larger and they line the alveoli and produce and secrete epithelial lining fluid, and lung surfactant.[16] Type II cells are able to divide and differentiate to Type 1 cells.[17]

The alveolar macrophages have an important immunological role. They remove substances which deposit in the alveoli including loose red blood cells that have been forced out from blood vesels.[17]

The lung is surrounded by a serous membrane of visceral pleura, which has an underlying layer of loose connective tissue attached to the substance of the lung.[18]

Respiratory tract

The lungs as main part of respiratory tract

The lower respiratory tract is part of the respiratory system, and consists of the trachea and the structures below this including the lungs.[16] The trachea receives air from the pharynx and travels down to a place where it splits (the carina) into a right and left bronchus. These supply air to the right and left lungs, splitting progressively into the secondary and tertiary bronchi for the lobes of the lungs, and into smaller and smaller bronchioles until they become the respiratory bronchioles. These in turn supply air through alveolar ducts into the alveoli, where the exchange of gases take place.[16] Oxygen breathed in, diffuses through the walls of the alveoli into the enveloping capillaries and into the circulation,[19] and carbon dioxide diffuses from the blood into the lungs to be breathed out.

Estimates of the total surface area of lungs vary from 50 to 75 square metres (540 to 810 sq ft);[16][17] roughly the same area as one side of a tennis court.[17][20]

The bronchi in the conducting zone are reinforced with hyaline cartilage in order to hold open the airways. The bronchioles have no cartilage and are surrounded instead by smooth muscle.[17] Air is warmed to 37 °C (99 °F), humidified and cleansed by the conducting zone; particles from the air being removed by the cilia on the respiratory epithelium lining the passageways.[21]

Pulmonary stretch receptors in the smooth muscle of the airways initiate a reflex known as the Hering–Breuer reflex that prevents the lungs from over-inflation, during forceful inspiration.

Blood supply

3D rendering of a high resolution computed tomography of the thorax. The anterior thoracic wall, the airways and the pulmonary vessels anterior to the root of the lung have been digitally removed in order to visualize the different levels of the pulmonary circulation.

The lungs have a dual blood supply[16] provided by a bronchial and a pulmonary circulation. The bronchial circulation supplies oxygenated blood to the airways of the lungs, through the bronchial arteries that leave the aorta. There are usually three arteries, two to the left lung and one to the right, and they branch alongside the bronchi and bronchioles.[16] The pulmonary circulation carries deoxygenated blood from the heart to the lungs and returns the oxygenated blood to the heart to supply the rest of the body.[16]

The blood volume of the lungs, is about 450 millilitres on average, about 9 per cent of the total blood volume of the entire circulatory system. This quantity can easily fluctuate from between one-half and twice the normal volume.[22]

Nerve supply

The lungs are supplied by nerves of the autonomic nervous system. Input from the parasympathetic nervous system occurs via the vagus nerve. When stimulated by acetylcholine, this causes constriction of the smooth muscle lining the bronchus and bronchioles, and increases the secretions from glands.[23][page needed] The lungs also have a sympathetic tone from norepinephrine acting on the beta 2 receptors in the respiratory tract, which causes bronchodilation.[23][page needed]

The action of breathing takes place because of nerve signals sent by the respiratory centres in the brainstem, along the phrenic nerve to the diaphragm.[24][page needed]

Other Languages
Acèh: S'ueb
Afrikaans: Long
Alemannisch: Lunge
አማርኛ: ሳምባ
العربية: رئة
aragonés: Polmón
ܐܪܡܝܐ: ܪܐܬܐ
armãneashti: Plimunu
অসমীয়া: হাঁওফাঁও
asturianu: Pulmón
Atikamekw: Opan
Avañe'ẽ: Ñe'ãvevúi
авар: Гьуърул
Aymar aru: Chuyma
azərbaycanca: Ağciyər
تۆرکجه: آغجییر
বাংলা: ফুসফুস
Bân-lâm-gú: Hì (khì-koan)
Basa Banyumasan: Paru-paru
башҡортса: Үпкәләр
беларуская: Лёгкія
беларуская (тарашкевіца)‎: Лёгкія
Bikol Central: Bagâ
български: Бял дроб
bosanski: Pluća
brezhoneg: Skevent
буряад: Уушхан
català: Pulmó
Чӑвашла: Ӳпке
čeština: Plíce
chiShona: Mapapu
Cymraeg: Ysgyfaint
Deutsch: Lunge
ދިވެހިބަސް: ފުއްޕާމޭ
eesti: Kopsud
Ελληνικά: Πνεύμονας
español: Pulmones
Esperanto: Pulmo
euskara: Birika
فارسی: ریه
français: Poumon
Frysk: Long
Gaeilge: Scamhóg
Gàidhlig: Sgamhan
galego: Pulmón
ગુજરાતી: ફેફસાં
客家語/Hak-kâ-ngî: Hi
хальмг: Оошг
한국어: 허파
Հայերեն: Թոքեր
हिन्दी: फेफड़ा
hrvatski: Pluća
Ido: Pulmono
Ilokano: Bara
Bahasa Indonesia: Paru-paru
interlingua: Pulmones
Iñupiak: Puvak
isiXhosa: Imiphunga
íslenska: Lunga
italiano: Polmone
עברית: ריאה
Basa Jawa: Paru-paru
ಕನ್ನಡ: ಶ್ವಾಸಕೋಶ
Kapampangan: Baga
ქართული: ფილტვები
қазақша: Өкпе
Kiswahili: Mapafu
Кыргызча: Өпкө
кырык мары: Шоды
лакку: Гьутру
лезги: Жигер
Latina: Pulmo
latviešu: Plaušas
lietuvių: Plaučiai
Limburgs: Lónge
lingála: Lipúlúlú
la .lojban.: fepri
magyar: Tüdő
македонски: Бели дробови
മലയാളം: ശ്വാസകോശം
Malti: Pulmun
मराठी: फुफ्फुस
მარგალური: ფიჟვი
Bahasa Melayu: Paru-paru
Mìng-dĕ̤ng-ngṳ̄: Hié (ké-guăng)
монгол: Уушги
မြန်မာဘာသာ: အဆုတ်
Nederlands: Long (orgaan)
नेपाली: फोक्सो
नेपाल भाषा: लुङ
日本語:
norsk: Lunge
norsk nynorsk: Lunge
occitan: Palmon
oʻzbekcha/ўзбекча: Oʻpka
ਪੰਜਾਬੀ: ਫੇਫੜਾ
Pangasinan: Bala
پنجابی: پھپھڑے
Papiamentu: Pulmon
پښتو: سږي
Patois: Long
polski: Płuco
português: Pulmão humano
română: Plămân
Runa Simi: Surq'an
русский: Лёгкие
саха тыла: Тыҥа
संस्कृतम्: फुफ्फुसः
Scots: Buffs
shqip: Mushkëria
sicilianu: Purmuna
Simple English: Lung
سنڌي: ڦڦڙ
slovenčina: Pľúca
slovenščina: Pljuča
Soomaaliga: Sambab
српски / srpski: Плућа
srpskohrvatski / српскохрватски: Pluća
Basa Sunda: Bayah
suomi: Keuhkot
svenska: Lunga
татарча/tatarça: Үпкә
ไทย: ปอด
тоҷикӣ: Шуш
Türkçe: Akciğer
українська: Легені
اردو: پھیپھڑے
ئۇيغۇرچە / Uyghurche: ئۆپكە
Vahcuengh: Bwt
vèneto: Polmon
Tiếng Việt: Phổi
Võro: Täü
walon: Peumon
文言:
吴语:
ייִדיש: לונג
粵語:
Zazaki: Ciger
中文:
Kabɩyɛ: Hʋzʋʋ
Lingua Franca Nova: Pulmon