If you have been told that you have COPD, you may know by now what the letters C.O.P.D. stand for – chronic obstructive pulmonary disease. But when it comes right down to it, what actually happens in the lungs? In other words, how are they supposed to work, and what went wrong?
Let’s take a look. There’s a lot to cover, but right now we’re going to touch on the key points. You will find more resources at the end of this post.
Your lungs are the only internal organ that has direct contact with the environment outside your body. So, they must take whatever is in the air you breathe and make oxygen (O2) available throughout your body, while at the same time, removing carbon dioxide (CO2). No matter what’s in the air that gets down there, they have to keep on going to keep you breathing and alive.
How do the lungs work?
Air comes into your body through your nose and mouth where it is filtered, humidified, and warmed. If this doesn’t happen, the air that reaches your lungs will be too dirty, too dry, and too cold.
About six inches below your “Adam’s apple” your trachea (windpipe) divides into two main bronchial airways (breathing tubes). If you were to look at them from the outside, they look kind of like the roots of a tree. One leads to your left lung, and the other to your right lung. As your air goes through your bronchial airways, it passes over a thin layer of mucus, picking up moisture and humidifying your air. The mucus also traps dust, bacteria, and debris that made it past the hairs in your nose. Just beneath this thin mucus blanket are millions of cilia, tiny little hair-like sweepers that move the mucus upward, kind of like a conveyor belt, so you can cough it out.
At the end of every branch of airways are clusters of alveoli (air sacs). Each alveolus is just one cell thick – about the same thickness as the wall of a soap bubble! This is where oxygen exchange takes place. Each cluster of alveoli is surrounded by a network of tiny blood vessels. You might picture this as something like a bunch of grapes surrounded by a net. It is here that your oxygen goes through the walls of the alveoli, and into your blood. You might think of your blood as kind of like a railroad train. The oxygen and carbon dioxide hop aboard and get to where they need to go. The oxygen is carried to the heart and pumped through your body to provide oxygen to the cells of your tissues and organs. When oxygen is used by the cells, carbon dioxide, the waste product of this process, is produced. This carbon dioxide is carried back to your lungs where you breathe it out.
This is how healthy lungs work, but what about me? What went wrong with my breathing?
Less elastic stretch
Your lung tissue should be stretchy and elastic, like a balloon. When lungs become damaged the elastic fibers within them start to break down and come apart. When this happens, your lungs are no longer stretchy. Your air tends to stay there unless it is squeezed out more forcefully. If the walls of your alveoli break, some of them may lose contact with the blood vessels.
Another result of loss of the elastic fibers is that the airways lose the strength to stay open. When this happens, they tend to pinch shut or collapse, preventing air from getting out. When you cannot get enough air out of your lungs, there is less room to breathe new air in. This leads to a feeling of shortness of breath.
Less cleaning action
Remember the cilia, the little sweepers in your airways that help keep your lungs clean? Cigarette smoke and other irritants can destroy or paralyze the cilia. This means your lungs are not able to clean themselves as they should. When this happens, your lungs must figure out another way to get rid of excess mucus. This may be why you cough.
Over time, exposure to lung irritants can also cause inflammation (swelling) inside the walls of your airways. When the inside diameter of your airways is smaller than it should be, there is less room for the air to pass through.
Breathing muscles
Your main breathing muscle is your diaphragm. It was meant to do most of the work of breathing, pulling down on the bottoms of your lungs so air can flow in easily. When your lungs become too stretched out, they can cause your diaphragm to flatten, keeping your lungs from moving as well as they should.
But remember, your lungs always find some way to compensate. When the diaphragm doesn’t work so well, the accessory muscles of breathing are called into action. The accessory muscles are around your collarbone, your neck, and between your ribs. But they aren’t able do a very good job of moving your air. Using these muscles to breathe takes a lot of energy and may cause your shoulders and back to become tense, sore, and tired. To learn more, follow this link: Breathing Techniques | COPD Foundation
I know that this can be hard to hear. Your lungs are damaged. It’s normal to feel upset when you first learn this. But if you know what you’re dealing with, you can get the information you need to do your best to breathe better every day. The COPD Foundation is here to help.
Do you have a better idea now of what went wrong with your breathing? Do you have other questions or comments? Let’s talk. I look forward to hearing from you!