An adult's trachea has an inner diameter of about 1.5 to 2 centimetres (0.6 to 0.8 in) and a length of about 10 to 11 centimetres (4 in.). It begins at the bottom of the larynx, and ends at the carina, the point where the trachea branches into left and right main bronchi. The trachea begins level with the sixth cervical vertebra and the carina is found at the level of the fifth thoracic vertebra (T5), opposite the sternal angle and can be positioned up to two vertebrae lower or higher, depending on breathing.
The trachea is surrounded by rings of hyaline cartilage; these rings are incomplete and C-shaped. The cricoid cartilage is attached to the first tracheal ring at top of the trachea and acts as the bottom of the larynx. There are fifteen to twenty rings in total, separated by narrow intervals. These reinforce the front and sides of the trachea to protect and maintain the airway.
In front of the rings lies connective tissue and skin. Several other structures pass or sit over it; the jugular arch, which joins the two anterior jugular veins, sits in front of the upper part of the trachea. The sternohyoid and sternothyroid muscles stretch along its length, and the thyroid gland sits below this; with the isthmus of the gland overlying the second to fourth rings.
The first tracheal ring is broader than the rest, and often divided at one end; it is connected by the cricotracheal ligament with the lower border of the cricoid cartilage, and is sometimes blended with the next cartilage down. The last cartilage is thick and broad in the middle, due to its lower border being prolonged into a triangular hook-shaped (uncinate) process, which curves downward and backward between the two bronchi. It ends on each side in an imperfect ring, which encloses the commencement of the bronchus. The cartilage above the last is somewhat broader than the others at its center.
Two or more of the cartilages often unite, partially or completely, and they are sometimes bifurcated at their extremities. The rings are generally highly elastic but they may calcify with age.
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, adjoining along the tracheoesophageal stripe. Circular horizontal bands of fibrous 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.
The thyroid gland also lies on top of the trachea, and lies below the cricoid cartilage. The isthmus of the thyroid, which connects both wings, lies directly in front, whereas the wings lie on the front and stretch to the side.
In the fourth week of development of the human embryo as the respiratory bud grows, the trachea separates from the foregut through the formation of tracheoesophageal ridges which fuse to form the tracheoesophageal septum and this separates the future trachea from the oesophagus and divides the foregut tube into the laryngotracheal tube. Before the end of the fifth week, the trachea begins to develop from the laryngotracheal tube which develops from the laryngotracheal groove. The first part of the cephalic region of the tube forms the larynx, and the next part forms the trachea.
The trachea is no more than 4mm diameter during the first year of life, expanding to its adult diameter by late childhood. The trachea is more mobile and of more variable length, deeper, and smaller in children.
10 X Photograph of a histological sample of a human trachea coloured with H&E stain
The trachea is lined with a layer of pseudostratified ciliated columnar epithelium. The epithelium contains goblet cells, which are glandular, modified simple columnar epithelial cells that produce mucins, the main component of mucus. Mucus helps to moisten and protect the airways. 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. This self-clearing mechanism is termed mucociliary clearance.