Breathing is a basic life function and for most of us it goes on without thinking except when we have a chest infection or are tired after strenuous exercises like running or jogging.
If there is no underlying pathology most of us can breathe normally and it is ideal to have lungs which are functioning optimally to cope with stressful times. This article assumes that there is no underlying pathology and is for individuals who want to improve their breathing without medications. A follow up article, Improving breathing with medications, is already being produced and will be published in about one week.
Normal and Accessory muscles of Respiration.
Air from the exterior enters the lungs when the pressure in the lungs is less than the pressure outside. This happens when the intercostal muscles contract and raise increase the ribs upward. This increases the intrathoracic volume, consequently decreasing the intrathoracic pressure. So air will enter from the exterior to the interior, of the lungs, until the pressures balance out. This process is called inspiration.
Expiration occurs by recoil. When the intercostals muscles relax the recoil of the muscles compresses the thoracic cavity. The internal pressure rises and has to equalize. As long as all the airways are expiration will occur until the pressures balance.
When we have chronic obstructive airway disease our body tries to keep maximum oxygen saturation. Since there is obstruction (usually inflammation) the body has to put in extra effort to get air into the lungs. The body does this by using the accessory muscles of respiration include the neck muscles and the muscles of the nose. Hypertrophy of the neck muscles will make a client’s neck look short. When a patient is using his nose’s muscles, nasal flaring may be seen. Finally, sometimes patients use their lips to help them breathe – this is called pursing. Pursing creates a slightly higher PEEP inside the patient’s lungs. One other accessory breathing muscle is the abdominal muscle / diaphragm. Abdominal breathing is common in the elderly and patients who are acutely ill.
When we are standing up, our abdominal organs fall into the pelvic cavity. Therefore, it is easy for air to enter and exit the lungs. When we lie down, in a horizontal position, our intestines move by gravity to occupy a slightly higher position in the abdominal cavity. This movement actually hinders the movement of air, in and out of the lungs. In a healthy individual this may not mean much. However, in a patient who is barely meeting his oxygen need, this may be sufficient to tilt his health status. For this reason patients who become short of breath when lying down must be nursed sitting up in bed. Sometimes, patients who have problems breathing lying down, are best nursed in a Geriatric Chair. You will need to pay particular attention to their pressure areas. This is a short term solution until the underlying cause of the difficulty in breathing is found and treated.
Patients who have minor difficulties with breathing tend to elevate their arms naturally. This arm movement has the effect of increasing the intrathoracic volume, thus slightly more air than usual will enter the lungs.
Picture 1. Normal Healthy Lungs are better then the Best Lungs money can buy!
In hot weather the demand for oxygen increases because the metabolic rate goes up. Consequently, the individual’s respiratory rate goes up. So, if you are stressed out in hot weather, it may a good idea to cool yourself with a fan or in the cool breeze. You must be wondering, why I am not advocating drinking plenty of water. Read the next paragraph for the answer to this question.
Drinking clean water, is a good thing most of the time. I am cautious against this because if you are on fluid restriction or are in some degree of heart failure, then drinking water may make your situation worse. Excessive water, in patients with heart failure, will fill up the alveoli (small lung tissue bubbles) and make it difficult for gas exchange to take place.
Smoking? The choice is yours. Cigarette smoke contains tar, carbon monoxide, irritants, carcinogens and other poisons. Smoking increases the heart rate and increases the need for oxygen. It also increases the metabolic rate. Additionally, it irritates the epithelium of the lungs and paralyses the cilia (hair like structures which propel waste to the exterior). The not effect of smoking is that it increases the demand for oxygen but obstructs it from getting to the lungs and the tissues where it is needed. So from a breathing perspective, if you want to improve your breathing, you will need to give up smoking. Yes, I know of your grandfather, he smoked all his life, never had a cough or chest infection.
