Inhalation

Short description: Flow of the respiratory current into an organism

Diagram showing inhalation

Inhalation (or inspiration) is the process of drawing air or other gases into the respiratory tract, primarily for the purpose of breathing and oxygen exchange within the body. It is a fundamental physiological function in humans and many other organisms, essential for sustaining life. Inhalation is the first phase of respiration, allowing the exchange of oxygen and carbon dioxide between the body and the environment, vital for the body's metabolic processes. This article delves into the mechanics of inhalation, its significance in various contexts, and its potential impact on health.

## Contents

* 1 Physiology
* 2 Other substances – accidental
* 3 Other substances – deliberate
* 3.1 Recreational use
* 3.2 Medical use
* 3.2.1 Diagnostic
* 3.2.2 Therapeutic
* 4 Mechanism
* 5 Hyperinflation
* 6 Yoga
* 7 See also
* 8 Further reading
* 9 References

## Physiology

The process of inhalation involves a series of coordinated movements and physiological mechanisms. The primary anatomical structures involved in inhalation are the respiratory system, which includes the nose, mouth, pharynx, larynx, trachea, bronchi, and lungs. Here is a brief overview of the inhalation process:

1. Inspiration: Inhalation begins with the contraction of the thoracic diaphragm, a dome-shaped muscle that separates the chest cavity from the abdominal cavity. The diaphragm contracts and moves downward, increasing the volume of the thoracic cavity.
2. Air entry: When a person or animal inhales, the diaphragm, located below the lungs, contracts, and the intercostal muscles between the ribs expand the chest cavity. This expansion creates a lower pressure inside the chest compared to the atmosphere, causing air to flow into the lungs.
3. Air filtration: The nasal passages and the mouth act as entry points for air. These passages are lined with tiny hair-like structures called cilia and mucus-producing cells that help filter and humidify the incoming air, removing particles and debris before it reaches the lungs.
4. Gas exchange: Once the air enters the lungs, it travels through a branching network of tubes known as the bronchial tree, ultimately reaching tiny air sacs called alveoli. In the alveoli, oxygen from the inhaled air diffuses into the bloodstream, while carbon dioxide, a waste product of metabolism, is released from the blood into the alveoli for exhalation.
5. Expiration: Exhalation is a passive process, primarily driven by the relaxation of the diaphragm and the elastic recoil of the lungs. This expels carbon dioxide from the body.[1][2]

## Other substances – accidental

Examples of accidental inhalation includes inhalation of water (e.g. in drowning), smoke, food, vomitus and less common foreign substances[3] (e.g. tooth fragments, coins, batteries, small toy parts, needles).

## Other substances – deliberate

### Recreational use

Legal – helium, nitrous oxide ("laughing gas")

Illegal – various gaseous, vaporised or aerosolized recreational drugs, called inhalants

### Medical use

#### Diagnostic

Various specialized investigations use the inhalation of known substances for diagnostic purposes. Examples include pulmonary function testing (e.g. nitrogen washout test, diffusion capacity testing (carbon monoxide, helium, methane)) and diagnostic radiology (e.g. radioactive xenon isotopes).

#### Therapeutic

Gases and other drugs used in anaesthesia include oxygen, nitrous oxide, helium, xenon, volatile anaesthetic agents. Medication for asthma, croup, cystic fibrosis and some other conditions.

## Mechanism

Inhalation begins with the contraction of the muscles attached to the rib cage; this causes an expansion in the chest cavity. Then takes place the onset of contraction of the thoracic diaphragm, which results in expansion of the intrapleural space and an increase in negative pressure according to Boyle's law. This negative pressure generates airflow because of the pressure difference between the atmosphere and alveolus.

The inflow of air into the lungs occurs via the respiratory airways. In health, these airways begin with the nose.[4][5] It is possible to begin with the mouth, which is the backup breathing system. However, chronic mouth breathing leads to, or is a sign of, illness.[6][7][8] They end in the microscopic dead-end sacs(alveoli) always opened, though the diameters of the various sections can be changed by the sympathetic and parasympathetic nervous systems. The alveolar air pressure is therefore always close to atmospheric air pressure (about 100 kPa at sea level) at rest, with the pressure gradients that cause air to move in and out of the lungs during breathing rarely exceeding 2–3 kPa.[9][10]

Other muscles that can be involved in inhalation include:[11]

* External intercostal muscles
* Scalene muscles
* Sternocleidomastoid muscle
* Trapezius muscle

## Hyperinflation

Hyperinflation or hyperaeration is where the lung volume is abnormally increased, with increased filling of the alveoli. This results in an increased radiolucency on X-ray, a reduction in lung markings and depression of the diaphragm. It may occur in partial obstruction of a large airway, as in e.g. congenital lobar emphysema, bronchial atresia and mucus plugs in asthma.[12]

## Yoga

Yogis such as B. K. S. Iyengar advocate both inhaling and exhaling through the nose in the practice of yoga, rather than inhaling through the nose and exhaling through the mouth.[13][14][15] They tell their students that the "nose is for breathing, the mouth is for eating."[14][16][17][13]

## See also

* Exhalation
* Inhalant – psychoactive drugs consumed through inhalation
* List of terms of lung size and activity
* Mouth breathing
* Obligate nasal breathing
* Respiratory system
* Smoking \- a specific inhalation route
* Breathing
* Work of breathing

## Further reading

* Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. ISBN 978-0735213616.

## References

1. ↑ Guyton, A. C., & Hall, J. E. (2006). Textbook of Medical Physiology. Elsevier Saunders.
2. ↑ West, J. B. (2000). Respiratory Physiology: The Essentials. Lippincott Williams & Wilkins
3. ↑ Passàli, D; Lauriello, M; Bellussi, L; Passali, GC; Passali, FM; Gregori, D (2010). "Foreign body inhalation in children: an update". Acta Otorhinolaryngol Ital 30 (1): 27–32. PMID 20559470.
4. ↑ Turowski, Jason (2016-04-29). "Should You Breathe Through Your Mouth or Your Nose?". Cleveland Clinic. https://health.clevelandclinic.org/breathe-mouth-nose/.
5. ↑ "Your Nose, the Guardian of Your Lungs". Boston Medical Center. https://www.bmc.org/otolaryngology-head-neck-surgery/resources/your-nose-guardian-your-lungs.
6. ↑ Dahl, Melissa (2011-01-11). "'Mouth-breathing' gross, harmful to your health". NBC News. https://www.nbcnews.com/healthmain/mouth-breathing-gross-harmful-your-health-1C6437430.
7. ↑ Valcheva, Zornitsa (January 2018). "THE ROLE OF MOUTH BREATHING ON DENTITION DEVELOPMENT AND FORMATION". Journal of IMAB. https://www.journal-imab-bg.org/issues-2018/issue1/JofIMAB-2018-24-1p1878-1882.pdf.
8. ↑ Gross, Terry (2020-05-27). "How The 'Lost Art' Of Breathing Can Impact Sleep And Resilience". National Public Radio (NPR)/Fresh Air. https://www.npr.org/transcripts/862963172.
9. ↑ Koen, Chrisvan L.; Koeslag, Johan H. (1995). "On the stability of subatmospheric intrapleural and intracranial pressures". News in Physiological Sciences 10 (4): 176–178. doi:10.1152/physiologyonline.1995.10.4.176.
10. ↑ West, J.B. (1985). Respiratory physiology: the essentials.. Baltimore: Williams & Wilkins. pp. 21–30, 84–84, 98–101.
11. ↑ Nosek, Thomas M.. "Section 4/4ch2/s4ch2_10". Essentials of Human Physiology. http://humanphysiology.tuars.com/program/section4/4ch2/s4ch2_10.htm. [|permanent dead link|dead link}}]
12. ↑ "Hyperinflation". Medcyclopaedia. GE. http://www.medcyclopaedia.com/library/topics/volume_vii/h/hyperinflation.aspx.
13. ↑ 13.0 13.1 Yoga Journal Editors (2017-04-12). "Q&A: Is Mouth Breathing OK in Yoga?". Yoga Journal. https://www.yogajournal.com/practice/take-a-breath.
14. ↑ 14.0 14.1 Payne, Larry. "Yogic Breathing: Tips for Breathing through Your Nose (Most of the Time)". Yoga For Dummies, 3rd Edition. https://www.dummies.com/health/exercise/yoga/yogic-breathing-tips-for-breathing-through-your-nose-most-of-the-time/.
15. ↑ Himalayan Institute Core Faculty, Himalayan Institute Core Faculty (2017-07-13). "Yogic Breathing: A Study Guide". Himalayan Institute of Yoga Science and Philosophy. https://www.himalayaninstitute.org/wisdom-library/yogic-breathing-study-guide/.
16. ↑ Krucoff, Carol (2013). Yoga Sparks. New Harbinger Publications. ISBN 9781608827022. https://books.google.com/books?id=QPk_nshsngoC&q="the+nose+is+for+breathing,+the+mouth+is+for+eating"+yoga&pg=RA1-PA11. Retrieved 2020-05-31.
17. ↑ Jurek, Scott (2012). Eat and Run. Houghton Mifflin. ISBN 978-0547569659. https://books.google.com/books?id=fEm6XnTajm0C&q="the+nose+is+for+breathing,+the+mouth+is+for+eating"+yoga&pg=PA108. Retrieved 2020-05-31.

* v
* t
* e

Routes of administration, dosage forms

Oral|

| Digestive
tract (enteral)|

| Solids|

* Pill
* Tablet
* Capsule
* Pastille
* Time release technology
* Osmotic delivery system (OROS)

|
|

Liquids|

* Decoction
* Elixir
* Electuary
* Emulsion
* Extended-release syrup
* Effervescent powder or tablet
* Herbal tea
* Hydrogel
* Molecular encapsulation
* Powder
* Softgel
* Solution
* Suspension
* Syrup
* Syrup Concentrate for dilution and/or addition of carbonated water
* Tincture

Buccal (sublabial),
sublingual|

| Solids|

* Orally disintegrating tablet (ODT)
* Film
* Lollipop
* Sublingual drops
* Lozenges
* Effervescent buccal tablet
* Chewing gum

|

Liquids|

* Mouthwash
* Toothpaste
* Ointment
* Oral spray

Respiratory
tract|

| Solids|

* Smoking device
* Dry-powder inhaler (DPI)

|
|

Liquids|

* Anaesthetic vaporizer
* Vaporizer
* Nebulizer
* Metered-dose inhaler (MDI)

Gas|

* Oxygen mask and Nasal cannula
* Oxygen concentrator
* Anaesthetic machine
* Relative analgesia machine

Ophthalmic,
otologic, nasal]]|

* Nasal spray
* Ear drops
* Eye drops
* Ointment
* Hydrogel
* Nanosphere suspension
* Insufflation
* Mucoadhesive microdisc (microsphere tablet)

Urogenital|

* Ointment
* Pessary (vaginal suppository)
* Vaginal ring
* Vaginal douche
* Intrauterine device (IUD)
* Extra-amniotic infusion
* Intravesical infusion

Rectal (enteral)|

* Ointment
* Suppository
* Enema
* Solution
* Hydrogel
* Murphy drip
* Nutrient enema

Dermal|

* Ointment
* Topical cream
* Topical gel
* Liniment
* Paste
* Film
* DMSO drug solution
* Electrophoretic dermal delivery system
* Hydrogel
* Liposomes
* Transfersome vesicles
* Cream
* Lotion
* Lip balm
* Medicated shampoo
* Dermal patch
* Transdermal patch
* Contact (rubbed into break in the skin)
* Transdermal spray
* Jet injector

Injection,
infusion<br />(into tissue/blood)

| Skin|

* Intradermal
* Subcutaneous
* Transdermal implant

|
|

Organs|

* Intracavernous
* Intravitreal
* Intra-articular injection
* Transscleral

Central nervous system|

* Intracerebral
* Intrathecal
* Epidural

Circulatory,
musculoskeletal|

* Intravenous
* Intracardiac
* Intramuscular
* Intraosseous
* Intraperitoneal
* Nanocell injection
* Patient-controlled analgesia pump
* PIC line

* v
* t
* e

Respiratory physiology

Respiration|

* breath
* inhalation
* exhalation
* respiratory rate
* respirometer
* pulmonary surfactant
* compliance
* elastic recoil
* hysteresivity
* airway resistance
* bronchial
* hyperresponsiveness
* constriction
* dilatation
* mechanical ventilation

Control|

* pons
* pneumotaxic center
* apneustic center
* medulla
* dorsal respiratory group
* ventral respiratory group
* chemoreceptors
* central
* peripheral
* pulmonary stretch receptors
* Hering–Breuer reflex

Lung volumes|

* VC
* FRC
* Vt
* dead space
* CC
* PEF

calculations

respiratory minute volume
FEV1/FVC ratio

Lung function tests

spirometry
body plethysmography
peak flow meter
nitrogen washout

Circulation|

* pulmonary circulation
* hypoxic pulmonary vasoconstriction
* pulmonary shunt

Interactions|

* ventilation (V)
* Perfusion (Q)
* Ventilation/perfusion ratio
* V/Q scan
* zones of the lung
* gas exchange
* pulmonary gas pressures
* alveolar gas equation
* alveolar–arterial gradient
* hemoglobin
* oxygen–haemoglobin dissociation curve (Oxygen saturation
* 2,3-BPG
* Bohr effect
* Haldane effect)
* carbonic anhydrase (chloride shift)
* oxyhemoglobin
* respiratory quotient
* arterial blood gas
* diffusion capacity (DLCO)

Insufficiency|

* high altitude
* oxygen toxicity
* hypoxia

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