Trachea

Trachea – the important part of respiratory tracts connecting a throat to bronchial tubes. On this body air together with necessary amount of oxygen comes to lungs.

The trachea looks as tubular hollow body, from 8,5 to 15 centimeters long, depending on organism physiology.

The trachea from a cricoid at the level of the sixth cervical vertebra begins. A third of a tube is at the level of cervical department of a backbone, other part is located in chest department. It comes to an end at the level of the fifth chest vertebra where it is divided into two bronchial tubes. In front of a cervical part of a trachea there is a part of a thyroid gland, and behind the gullet adjoins to a tracheal tube. On each side tracheas there passes the neurovascular bunch including fibers of a vagus nerve, carotid arteries and internal jugular veins.

Trachea structure

If to consider a trachea structure in cross section, it becomes visible that it consists of four layers:

• Mucous membrane. Represents the ciliate multilayer epithelium lying on a basal membrane. As a part of an epithelium there are stem cells and scyphoid which emit slime in small amounts. Also there are incretion cells making noradrenaline and serotonin.
• Submucosal layer. Represents friable, fibrous connecting fabric. In this layer the set of the small vessels and nerve fibrils which are responsible for blood supply and regulation is located.
• Cartilaginous part. This layer of a structure of a trachea consists of the hyaline incomplete cartilages occupying two thirds of a part of all circle of a tracheal tube. Among themselves these cartilages connect by means of ring sheaves. At the person the number of cartilages fluctuates from 16 to 20. Behind there is a webby wall adjoining to a gullet that allows not to interfere with the respiratory process when passing food.
• Extima. It is presented in the form of the thin connecting cover covering an outside part of a tube.

Apparently, a trachea structure quite simple, however it performs the vital functions for an organism.

Functions of a trachea

The main function of a trachea is carrying out air to lungs. Nevertheless, the number of functions on it is not limited.

The mucous membrane of body is covered with the ciliate epithelium moving towards an oral cavity and a throat, and scyphoid cells emit slime. Thus, at hit together with air in a trachea of small foreign bodys, for example, of parts of dust, they are enveloped by slime and by means of cilia force the way in a throat and pass into a throat. From there is a protective function of a trachea.

It is known that warming and clarification of air happens in a nasal cavity, but partially this role is carried out also by a trachea. In addition, it should be noted resonator function of a trachea as it pushes air to phonatory bands.

Trachea pathologies

Conditionally pathologies can be divided into malformations, damages, diseases and cancer of a trachea.

Treat malformations:

• Agenesia – rare defect at which the trachea comes to an end blindly, without being reported with bronchial tubes. Given rise with this defect are almost impractical.
• Stenosis. Can be occlusive (in case of existence of an obstacle in a tube) or compression (as a result of pressure upon a trachea of abnormal vessels or a tumor). In most cases the stenosis successfully is eliminated by means of surgical intervention.
• Fistulas. Meet quite seldom. Can be incomplete (to come to an end blindly), or full (to open on skin of a neck and in a trachea).
• Cysts. Have the favorable forecast of treatment. An operative measure is necessary.
• Diverticulums and the expansions of a trachea caused as a result of inborn weakness of a muscle tone of its wall.

Injuries of a trachea can be open and closed. Gaps owing to injuries of a breast, neck, a trachea intubation belong to the closed damages. Chipped and cut, chipped, gunshot wounds belong to open damages.

From diseases are most widespread:

• Trachea inflammation. Can be in a chronic or acute form. As a rule, the inflammation of a trachea is combined with bronchitis. The chronic inflammation of a trachea often is a symptom of a scleroma, tuberculosis. Mushrooms of Aspergillus, Candida, Actinomyces can cause an inflammation of a trachea.
• The acquired stenoses. Distinguish primary, secondary and compression. Primary stenoses can result from a tracheostomy and a long intubation of a trachea. Also physical (beam damages, a burn) mechanical or chemical injuries can be the cause of stenoses.
• The acquired fistulas. As a rule, they are a consequence traumatized or a consequence of various pathological processes in a trachea and nearby bodies. For example, they can result from break of peritracheal lymph nodes at tuberculosis, openings or suppurations of an inborn cyst of a mediastinum, at disintegration of a tumor of a gullet or trachea.
• Amyloidosis – multiple submucosal deposits of amyloid in the form of tumorous educations or flat plaques. The amyloidosis leads to narrowing of a gleam of a trachea.
• Tumors. Tumors happen primary and secondary. Primary tumors proceed from a trachea wall, and secondary – result of germination of the next bodies malignant tumors. Distinguish more than 20 types of benign and malignant tumors. At children the percent of benign tumors outweighs (papillomas, fibromas, hemangiomas). At adults the frequency of benign and malignant tumors is approximately identical. The most often found malignant tumors are adenoid and cystous cancer of a trachea, planocellular cancer of a trachea, sarcoma, a gemangiperitsitoma. All species of crayfish of a trachea gradually sprout its wall and go beyond its limits.

Trachea intubation

The intubation represents introduction to a trachea of a special tube. This manipulation has a number of technical difficulties which, nevertheless, with surpluses are compensated by its advantages when rendering acute management to the patient who is in critical condition.

The intubation of a trachea provides:

• Easy carrying out the managed or assisted breast;
• Passability of respiratory tracts;
• The best conditions for prevention of a fluid lungs;
• Possibility of aspiration from a trachea and bronchial tubes;

In addition, the intubation excludes probability of asphyxia at a spasm of phonatory bands, retractions of language, aspiration of foreign bodys, a detritis, blood, emetic masses, slime.

The procedure is carried out according to the following indications:

• Terminal state;
• Acute respiratory insufficiency;
• Fluid lungs;
• Obturation of a trachea;
• The serious poisoning which is followed by breath disturbance.

It is forbidden to do an intubation at:

• Any pathological changes of a front part of a skull;
• Inflammatory diseases of a neck;
• Any damages of cervical department of a backbone.