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Breathing and Exchange of Gases

Breathing and Exchange of GasesNEET Zoology · Class 11 · NCERT Chapter 14

Introduction

Every cell in your body burns nutrients to produce ATP. This process, called cellular respiration, uses oxygen (O2) and produces carbon dioxide (CO2) continuously. Breathing, or external respiration, is the physical process that delivers O2 from the atmosphere to your blood and removes CO2 from the blood back into the air. Without breathing, cellular respiration would starve of O2 within minutes.

Expect 1 NEET question from this chapter every year. The most reliable areas to score are: respiratory volumes and capacities with their values, partial pressures of O2 and CO2, the sigmoid dissociation curve with the Bohr effect, and how CO2 is mainly carried as bicarbonate.

Respiratory Organs in Animals

Different animals use different structures for gas exchange, depending on where they live and how large they are.

  • Body surface (cutaneous respiration): in very small or thin animals (like earthworms and planarians), O2 and CO2 simply diffuse through the moist skin. No special organ is needed.
  • Tracheae (tracheal system): insects and many other terrestrial arthropods have a network of air-filled tubes. O2 travels directly to cells through tiny tracheoles. This is very efficient for small, active animals.
  • Gills: aquatic animals like most fish and aquatic arthropods use gills. Blood flows through thin gill lamellae in close contact with water. O2 dissolved in water diffuses in and CO2 diffuses out.
  • Lungs: terrestrial vertebrates use lungs, which are internal sac-like organs with a large moist surface area. Lungs keep the gas-exchange surface protected from drying out.

Human Respiratory System

The human respiratory system has two main parts: the conducting zone (from the nostrils to the terminal bronchioles) and the respiratory zone (alveolar ducts and alveoli where actual gas exchange happens).

DIAPHRAGM
Nasal Chamber
Pharynx
Larynx (Voice Box)
Trachea (Windpipe)
Bronchi
Bronchioles
Alveoli
Lungs
Diaphragm

Trachea (Windpipe)

About 11 to 12 cm long. Kept open by C-shaped cartilaginous rings (the open side faces the oesophagus). Lined with ciliated mucus epithelium that sweeps debris upward. Divides at the carina into two primary bronchi.

NEET fact

Trachea has C-shaped cartilaginous rings. The right primary bronchus is wider, shorter and more vertical, so foreign objects more often lodge there.

The Conducting Pathway

  1. External nostrils: air enters here. The nostrils have hairs (vibrissae) to filter large particles.
  2. Nasal chamber (nasal cavity): lined with ciliated, mucus-secreting epithelium. Warms, humidifies and filters the air. The nasal chamber opens into the pharynx.
  3. Pharynx: a common pathway for food and air. It leads to the larynx (for air) and the oesophagus (for food).
  4. Larynx (voice box): a cartilaginous box at the top of the trachea. Contains the glottis (the opening between the vocal cords) and the epiglottis (a flap that closes over the glottis during swallowing to stop food entering the airway). The vocal cords in the larynx produce sound.
  5. Trachea (windpipe): about 11 to 12 cm long. Kept open by C-shaped cartilaginous rings. Lined with ciliated mucus epithelium that sweeps debris upward. The trachea divides at the carina into the two primary bronchi.
  6. Primary bronchi: one to each lung. The right primary bronchus is wider, shorter and more vertical. It divides into secondary bronchi (one per lobe: 3 on the right, 2 on the left). Secondary bronchi divide into tertiary (segmental) bronchi serving each bronchopulmonary segment. Bronchi have cartilaginous support.
  7. Bronchioles: further branches without cartilage. Walls contain smooth muscle. They end in alveolar ducts and then alveoli.
  8. Alveoli: tiny, thin-walled air sacs (about 300 million in two lungs). Their total surface area is about 70 m2 in adults. The wall is simple squamous epithelium (type I pneumocytes) for fast diffusion. Type II pneumocytes secrete surfactant to reduce surface tension and prevent collapse.

The Lungs and Pleura

The right lung has three lobes (superior, middle, inferior); the left lung has two lobes (superior and inferior, with a cardiac notch to accommodate the heart). Each lung is enclosed in two pleural membranes: the visceral pleura (on the lung surface) and the parietal pleura (on the chest wall). The narrow space between them is the pleural cavity, filled with a small amount of pleural fluid. This fluid lubricates the lungs and creates surface tension that keeps the lungs pressed against the chest wall.

The diaphragm is a dome-shaped muscular sheet separating the thoracic cavity from the abdominal cavity. It is the main muscle of breathing.

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Mechanism of Breathing

Breathing works by changing the volume of the thoracic cavity. Boyle Law states that pressure and volume are inversely related at constant temperature: when volume increases, pressure falls.

Inspiration (Inhalation)
Expiration (Exhalation)
DIAPHRAGMAIR INribsup+outribsup+out

Inspiration (Inhalation)

Both the diaphragm and external intercostal muscles contract simultaneously. The thoracic cavity expands. Because the lungs are attached to the chest wall via the pleura, they expand too. The increased volume lowers the air pressure inside the lungs below atmospheric pressure, so air flows in.

NEET fact

Inspiration is an ACTIVE process: muscles must contract. Quiet expiration is largely PASSIVE (muscles relax).

Feature

Inspiration

Expiration

Diaphragm

Contracts and flattens downward

Relaxes and domes upward

External intercostals

Contract: ribs pulled upward and outward

Relax: ribs fall back

Internal intercostals

Relaxed

Contract in FORCED expiration (e.g. coughing, exercise)

Thoracic cavity volume

Increases (both vertical and lateral dimensions increase)

Decreases

Intra-pulmonary pressure

Falls to about 1 to 3 mm Hg below atmospheric pressure

Rises to about 1 to 3 mm Hg above atmospheric pressure

Air movement

Air rushes IN (from high pressure outside to lower pressure inside)

Air is pushed OUT (from higher pressure inside to atmospheric outside)

  • Inspiration (inhalation): the diaphragm contracts and flattens downward. The external intercostal muscles contract, pulling the ribs upward and outward. Both increase the volume of the thoracic cavity. Lung volume increases; intra-pulmonary pressure falls to about 1 to 3 mm Hg below atmospheric. Air flows in.
  • Expiration (exhalation): in quiet breathing, expiration is largely passive. The diaphragm relaxes and domes upward. The ribs fall back. Thoracic volume decreases; intra-pulmonary pressure rises about 1 to 3 mm Hg above atmospheric. Air flows out. In forced expiration, the internal intercostal muscles and abdominal muscles actively contract to push more air out.

A healthy adult breathes about 12 to 20 times per minute at rest, moving about 500 mL (tidal volume) each breath. This gives a minute ventilation of about 6 to 10 litres per minute.

Respiratory Volumes and Capacities

A spirometer measures respiratory volumes. Here are the key values you need to know for NEET:

  • Tidal Volume (TV): about 500 mL. Air moved in or out in a normal breath at rest.
  • Inspiratory Reserve Volume (IRV): about 2500 to 3000 mL. Extra air that can be inspired forcefully after a normal inspiration.
  • Expiratory Reserve Volume (ERV): about 1000 to 1100 mL. Extra air that can be expired forcefully after a normal expiration.
  • Residual Volume (RV): about 1100 to 1200 mL. Air that always remains in the lungs after maximum expiration. Keeps alveoli from collapsing.

Capacities are sums of two or more volumes:

  • Inspiratory Capacity (IC): TV + IRV = about 3000 to 3500 mL. Total air that can be inspired after a normal expiration.
  • Expiratory Capacity (EC): TV + ERV = about 1500 to 1600 mL. Total air that can be expired after a normal inspiration.
  • Functional Residual Capacity (FRC): ERV + RV = about 2100 to 2300 mL. Air remaining in the lungs after a normal (tidal) expiration.
  • Vital Capacity (VC): TV + IRV + ERV = about 3500 to 4500 mL. The maximum amount of air you can breathe in and out in one breath. Does NOT include RV. VC is reduced in lung diseases.
  • Total Lung Capacity (TLC): VC + RV = about 6000 mL. The total volume the lungs can hold at maximum inspiration.

Exchange of Gases

Gas exchange happens by diffusion: molecules move from an area of high partial pressure to an area of low partial pressure. You do not need to know the actual temperature and pressure calculations, but you do need to know the partial pressure values at each site.

  • pO2 in alveolar air: about 104 mm Hg. pO2 in deoxygenated blood arriving at alveoli: about 40 mm Hg. So O2 diffuses from alveoli into blood.
  • pCO2 in alveolar air: about 40 mm Hg. pCO2 in deoxygenated blood: about 45 mm Hg. So CO2 diffuses from blood into alveoli.
  • At the tissues: pO2 in cells is about 20 to 40 mm Hg (because cells use O2). Oxygenated blood arrives with pO2 about 95 mm Hg. O2 diffuses into cells. pCO2 in cells is about 45 to 50 mm Hg. Blood pCO2 is about 40 mm Hg. CO2 diffuses from cells into blood.

The diffusion membrane at the alveoli has three layers: the alveolar epithelium (squamous), a basement membrane, and the endothelium of the pulmonary capillary. The total thickness is less than 1 micrometre, which allows very rapid diffusion. CO2 diffuses about 20 times faster than O2 through biological membranes because it is far more soluble.

Transport of Gases

Oxygen Transport

About 97% of O2 is transported bound to haemoglobin as oxyhaemoglobin (HbO2). Only about 3% is dissolved in plasma. Each haemoglobin molecule has 4 haem groups; each haem can carry one O2. When all four are occupied, haemoglobin is said to be fully saturated.

pO2 (mm Hg)% Saturation20406080100255075100NormalLung (97%)Tissue (75%)P50=26.5

pCO2: 40 mm Hg

20 (low)

70 (high)

pH: 7.4

7.1 (acid)

7.7 (alk)

Temperature: 37 °C

30 (cold)

43 (fever)

Normal (P50 = 26.5 mm Hg)

Normal physiological conditions (pH 7.4, pCO2 40 mm Hg, 37 C)

Sat at Lung (pO2 100)

97.3%

Sat at Tissue (pO2 40)

75.2%

O2 Delivered

22.1%

NEET key facts

!

The dissociation curve is S-shaped (sigmoid) due to cooperative binding of O2 to haemoglobin.

!

P50 = the pO2 at which haemoglobin is 50% saturated. Normal value ~26.5 mm Hg.

!

Right shift (higher P50): caused by high pCO2, low pH, or high temperature. Haemoglobin releases more O2.

!

Left shift (lower P50): caused by low pCO2, high pH, or low temperature. Haemoglobin picks up O2 more readily.

!

The Bohr effect means active tissues (high CO2, low pH, high temp) automatically receive more O2.

!

97% of O2 is transported as oxyhaemoglobin; only 3% is dissolved in plasma.

The relationship between pO2 and haemoglobin saturation is shown by the oxygen-haemoglobin dissociation curve, which is S-shaped (sigmoid). The S-shape results from cooperative binding: binding of the first O2 makes it easier for the next O2 to bind (and loss of one O2 makes it easier to lose the next). This is a key NEET concept.

The Bohr effect is the shift of this curve caused by CO2, H+ and temperature:

  • Right shift (lower affinity, more O2 released): caused by high pCO2, low pH (more H+), or high temperature. This is what happens in active tissues.
  • Left shift (higher affinity, more O2 picked up): caused by low pCO2, high pH, or low temperature. This is what happens in the lungs.

Carbon Dioxide Transport

CO2 is transported in three forms:

  • Dissolved in plasma: about 7%. CO2 is more soluble than O2 but still most cannot be carried this way alone.
  • As carbamino-haemoglobin: about 23%. CO2 binds to the amino groups (not the haem iron) of haemoglobin. This is called carbamino-haemoglobin (HbCO2). It forms in active tissues and releases CO2 in the lungs.
  • As bicarbonate ions (HCO3-) in plasma: about 70%. In red blood cells, CO2 reacts with water to form carbonic acid (H2CO3), catalysed by carbonic anhydrase. H2CO3 dissociates to H+ and HCO3-. The HCO3- moves into the plasma in exchange for Cl- (the chloride shift or Hamburger phenomenon). The H+ is buffered by haemoglobin. In the lungs, this entire process runs in reverse: HCO3- re-enters the red blood cell, combines with H+ to form H2CO3, and carbonic anhydrase converts it back to CO2 + H2O. CO2 diffuses into the alveoli.

Regulation of Respiration

Breathing is controlled by the nervous system to match ventilation to metabolic demand.

  • Respiratory rhythm centre (medulla oblongata): generates the basic rhythm of breathing. Even without any input, this centre fires regularly to produce inspiration followed by passive expiration.
  • Pneumotaxic centre (pons): moderates the rhythm centre. It sends inhibitory signals to switch off inspiration before the lungs over-inflate. This smooths the respiratory cycle.
  • Chemical regulation: the most important stimulus is CO2. A small rise in blood pCO2 (or fall in pH) stimulates the medullary centre to increase the rate and depth of breathing. This rapidly blows off excess CO2. Low O2 (hypoxia) also stimulates breathing via peripheral chemoreceptors in the carotid and aortic bodies, but CO2 is the dominant driver. Interestingly, very high O2 does not slow breathing significantly.

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Disorders of the Respiratory System

  • Asthma: a condition of inflamed, narrowed airways (mainly bronchioles). Triggered by allergens, cold air, or exercise. Airways become hypersensitive; smooth muscle contracts; mucus production increases. Results in wheezing, chest tightness and shortness of breath. Managed with bronchodilators and anti-inflammatory inhalers.
  • Emphysema: progressive destruction of alveolar walls, usually caused by long-term smoking. Alveoli merge into larger, abnormal air spaces. The surface area for gas exchange is greatly reduced. Patients have chronic breathlessness and a barrel chest. The damage is irreversible.
  • Occupational respiratory disorders: caused by long-term inhalation of industrial dust particles. Examples: silicosis (silica dust), asbestosis (asbestos fibres), and coal workers pneumoconiosis (black lung, from coal dust). Fibrosis of lung tissue reduces elasticity and gas exchange. Symptoms take years to develop.

Worked NEET Problems

1

NEET-style problem · Respiratory Volumes

Question

A person has a tidal volume of 500 mL, an inspiratory reserve volume of 2800 mL, and an expiratory reserve volume of 1100 mL. The residual volume is 1200 mL. Calculate: (a) vital capacity and (b) total lung capacity.

Solution

Vital capacity (VC) = TV + IRV + ERV = 500 + 2800 + 1100 = 4400 mL.

Total lung capacity (TLC) = VC + RV = 4400 + 1200 = 5600 mL.

Note: vital capacity does NOT include residual volume. RV is the air that stays in the lungs even after maximum exhalation and cannot be measured by a simple spirometer.

2

NEET-style problem · Exchange of Gases

Question

State the partial pressures of O2 and CO2 in (a) atmospheric air, (b) alveolar air, (c) blood arriving at the alveoli (deoxygenated), and (d) blood leaving the alveoli (oxygenated). Explain the direction of diffusion at each step.

Solution

(a) Atmospheric air: pO2 about 159 mm Hg; pCO2 about 0.3 mm Hg.

(b) Alveolar air: pO2 about 104 mm Hg (lower because we mix with residual air and water vapour); pCO2 about 40 mm Hg (higher because CO2 comes from blood).

(c) Deoxygenated blood at alveoli: pO2 about 40 mm Hg; pCO2 about 45 mm Hg.

(d) Oxygenated blood leaving alveoli: pO2 rises to about 95 mm Hg; pCO2 drops to about 40 mm Hg.

Direction: O2 moves from alveolus (104) to blood (40) = blood gains O2. CO2 moves from blood (45) to alveolus (40) = blood loses CO2. Both by simple diffusion down the partial pressure gradient.

3

NEET-style problem · Oxygen Transport and Bohr Effect

Question

Explain why exercising muscle receives more oxygen than resting muscle, using the concept of the Bohr effect.

Solution

During exercise, muscle cells respire faster. They produce more CO2, more lactic acid (lowering pH), and generate heat (raising temperature).

All three changes (high pCO2, low pH, high temperature) shift the oxygen-haemoglobin dissociation curve to the RIGHT via the Bohr effect. This means haemoglobin has a lower affinity for O2 at the same pO2.

So at the partial pressure of O2 found in exercising muscle (which is already lower because the muscle is using O2 fast), haemoglobin releases even more O2 than it would at rest. The exercising muscle automatically gets more O2 delivered simply because it produces more CO2 and H+.

4

NEET-style problem · CO2 Transport

Question

Describe the steps by which CO2 produced in a muscle cell is converted to bicarbonate in the blood, and how it is eventually expelled in the lungs.

Solution

In the muscle (tissue):

1. CO2 diffuses from muscle cells (high pCO2) into plasma and then into red blood cells (RBCs).

2. Inside RBCs, carbonic anhydrase catalyses: CO2 + H2O gives H2CO3.

3. H2CO3 dissociates to H+ + HCO3-.

4. HCO3- moves out of the RBC into plasma (chloride shift: Cl- enters RBC in exchange). The H+ is buffered by haemoglobin (which also releases O2, aiding the Bohr effect).

In the lungs:

5. HCO3- re-enters RBCs in exchange for Cl- (reverse chloride shift).

6. Inside RBCs, H+ + HCO3- recombines to form H2CO3, and carbonic anhydrase converts it back to CO2 + H2O.

7. CO2 diffuses from blood (pCO2 about 45 mm Hg) into alveolar air (pCO2 about 40 mm Hg) and is exhaled.

5

NEET-style problem · Regulation of Respiration

Question

After vigorous exercise, a person breathes faster and deeper. Which brain centres control this response, and what chemical signal triggers it?

Solution

The primary centre is the respiratory rhythm centre in the medulla oblongata. It increases both rate and depth of breathing.

The pneumotaxic centre in the pons modulates the medullary rhythm and prevents over-inflation.

Main chemical trigger: the rise in blood pCO2 (and the resulting fall in pH as CO2 forms carbonic acid). Even a small rise in pCO2 powerfully stimulates the medullary centre.

Secondary trigger: lower pO2 in active tissues, detected by peripheral chemoreceptors in the carotid and aortic bodies. These signals also go to the medullary centre.

The increased ventilation blows off excess CO2, restoring pCO2 and pH toward normal.

Summary Cheat Sheet

  • Breathing vs cellular respiration: breathing is physical (moving air); cellular respiration is chemical (breaking down glucose for ATP).
  • Respiratory organs: body surface (earthworm), tracheae (insects), gills (fish, crustaceans), lungs (terrestrial vertebrates).
  • Conducting path: nostrils, nasal chamber, pharynx, larynx (glottis + epiglottis), trachea, primary bronchi, secondary bronchi, tertiary bronchi, bronchioles, alveolar ducts, alveoli.
  • Epiglottis closes over the glottis during swallowing to prevent food entering the airway.
  • Alveoli: about 300 million; surface area about 70 m2; type I pneumocytes for diffusion; type II pneumocytes secrete surfactant.
  • Right lung: 3 lobes. Left lung: 2 lobes (cardiac notch).
  • Inspiration: diaphragm contracts (flattens), external intercostals contract (ribs up and out), thoracic volume increases, pressure falls, air enters.
  • Expiration at rest: passive; diaphragm relaxes (domes up), ribs fall, volume decreases, pressure rises, air exits.
  • Tidal volume (TV): 500 mL. IRV: 2500 to 3000 mL. ERV: 1000 to 1100 mL. RV: 1100 to 1200 mL.
  • Vital capacity: TV + IRV + ERV (about 3500 to 4500 mL). Total lung capacity: VC + RV (about 6000 mL).
  • pO2 alveoli: 104 mm Hg. pO2 deoxygenated blood: 40 mm Hg. O2 diffuses into blood.
  • pCO2 deoxygenated blood: 45 mm Hg. pCO2 alveoli: 40 mm Hg. CO2 diffuses out of blood.
  • CO2 diffuses 20 times faster than O2 through the diffusion membrane.
  • O2 transport: 97% as oxyhaemoglobin (Hb + O2 at haem iron); 3% dissolved.
  • Dissociation curve: S-shaped (sigmoid) due to cooperative binding.
  • Bohr effect: high pCO2, low pH, high temperature = right shift = more O2 released to tissues.
  • CO2 transport: 7% dissolved; 23% as carbamino-haemoglobin (at amino groups); 70% as HCO3- (bicarbonate) in plasma via carbonic anhydrase + chloride shift.
  • Carbonic anhydrase: enzyme in RBCs that converts CO2 + H2O to H2CO3 (and back in lungs).
  • Chloride shift (Hamburger phenomenon): HCO3- leaves RBC into plasma; Cl- enters RBC to balance charge.
  • Respiratory rhythm centre: medulla oblongata (generates rhythm). Pneumotaxic centre: pons (moderates rhythm, stops over-inflation).
  • Main chemical stimulus for breathing: rise in blood pCO2 (fall in pH). Not O2.
  • Asthma: inflamed, narrowed bronchioles. Emphysema: destroyed alveolar walls, reduced surface area. Occupational disorders: dust particles cause fibrosis.

Next: use the interactive learning widgets to explore the respiratory system diagram, compare inspiration and expiration, and try the Bohr effect on the oxygen-haemoglobin dissociation curve, or work through the 14+ NEET PYQs with full solutions. To time yourself, take the free 10-question mock test. You can also explore related chapters: Body Fluids and Circulation for how blood transports gases, Excretory Products and Their Elimination for another major homeostasis chapter, or Neural Control and Coordination for how the brain controls breathing.

Frequently asked questions

How many questions come from Breathing and Exchange of Gases in NEET 2027?

You can expect 1 question from Breathing and Exchange of Gases in NEET 2027. The most reliable scoring areas are: respiratory volumes and capacities (tidal volume, vital capacity, total lung capacity with their values), the partial pressure values of O2 and CO2 in alveoli and blood, oxyhaemoglobin formation and the sigmoid dissociation curve, how CO2 is mainly transported as bicarbonate (about 70%), and the Bohr effect.

What is the difference between breathing and cellular respiration?

Breathing (also called external respiration) is the physical process of moving air in and out of the lungs. It takes place in the respiratory system and is controlled by the nervous system. Cellular respiration is a biochemical process: it is the breakdown of glucose and other organic molecules inside cells to produce ATP, CO2 and water. Breathing delivers the O2 that cellular respiration needs and removes the CO2 it produces. The two processes are related but completely different in nature.

What are the main respiratory volumes and their approximate values for NEET?

Tidal volume (TV): about 500 mL per breath at rest. Inspiratory reserve volume (IRV): about 2500 to 3000 mL extra air that can be inhaled after a normal breath. Expiratory reserve volume (ERV): about 1000 to 1100 mL extra air that can be pushed out after a normal breath. Residual volume (RV): about 1100 to 1200 mL of air that always stays in the lungs, even after maximum exhalation. Vital capacity (VC) = TV + IRV + ERV = about 3500 to 4500 mL. Total lung capacity (TLC) = VC + RV = about 6000 mL.

What is the Bohr effect?

The Bohr effect is the shift of the oxygen-haemoglobin dissociation curve caused by changes in CO2 concentration, H+ (pH) or temperature. When CO2 is high, pH is low (more acidic), or temperature is high (as in active tissues), the curve shifts to the right. This means haemoglobin has a lower affinity for O2, so it releases more O2 to the tissues that need it most. When CO2 is low, pH is high, and temperature is lower (as in the lungs), the curve shifts to the left, meaning haemoglobin picks up O2 more easily in the lungs. This is a vital way the body adjusts O2 delivery to match demand.

How is carbon dioxide transported in the blood?

CO2 is transported in three forms. About 7 percent is dissolved directly in plasma. About 23 percent is carried as carbamino-haemoglobin, which is CO2 bound directly to haemoglobin (at the amino groups, not at the haem iron). About 70 percent is transported as bicarbonate ions (HCO3-) in the plasma. When CO2 enters red blood cells, the enzyme carbonic anhydrase converts it to carbonic acid (H2CO3), which immediately breaks down into H+ and HCO3-. The HCO3- moves into the plasma in exchange for Cl- (the chloride shift). In the lungs, this process runs in reverse.

What is the role of the diaphragm and intercostal muscles in breathing?

Inspiration: the diaphragm contracts and flattens downward. The external intercostal muscles contract and pull the ribs upward and outward. Both actions increase the volume of the thoracic cavity. The lungs expand, intra-pulmonary pressure drops below atmospheric pressure, and air rushes in. Expiration: the diaphragm relaxes and domes upward. The internal intercostal muscles contract (in forced expiration) or the ribs fall back (in relaxed expiration). Thoracic volume decreases, pressure rises above atmospheric, and air is pushed out.

What are the main respiratory disorders covered in NEET?

Asthma: a condition where the bronchioles become inflamed and the smooth muscle contracts, making the airways narrow. Symptoms include wheezing and difficulty breathing. Emphysema: the walls of the alveoli are damaged, reducing the total surface area for gas exchange. Caused mainly by smoking. Occupational respiratory disorders: caused by long-term exposure to dust particles in certain jobs (like coal dust causing pneumoconiosis, or asbestos fibres causing asbestosis). All of these reduce effective gas exchange and cause breathlessness.

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