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Our lungs contain hundreds of millions of mucus-lined sacs called alveoli , which are very similar in size, and about 0.1 mm in diameter. (See [link] .) You can exhale without muscle action by allowing surface tension to contract these sacs. Medical patients whose breathing is aided by a positive pressure respirator have air blown into the lungs, but are generally allowed to exhale on their own. Even if there is paralysis, surface tension in the alveoli will expel air from the lungs. Since pressure increases as the radii of the alveoli decrease, an occasional deep cleansing breath is needed to fully reinflate the alveoli. Respirators are programmed to do this and we find it natural, as do our companion dogs and cats, to take a cleansing breath before settling into a nap.
The tension in the walls of the alveoli results from the membrane tissue and a liquid on the walls of the alveoli containing a long lipoprotein that acts as a surfactant (a surface-tension reducing substance). The need for the surfactant results from the tendency of small alveoli to collapse and the air to fill into the larger alveoli making them even larger (as demonstrated in [link] ). During inhalation, the lipoprotein molecules are pulled apart and the wall tension increases as the radius increases (increased surface tension). During exhalation, the molecules slide back together and the surface tension decreases, helping to prevent a collapse of the alveoli. The surfactant therefore serves to change the wall tension so that small alveoli don’t collapse and large alveoli are prevented from expanding too much. This tension change is a unique property of these surfactants, and is not shared by detergents (which simply lower surface tension). (See [link] .)
If water gets into the lungs, the surface tension is too great and you cannot inhale. This is a severe problem in resuscitating drowning victims. A similar problem occurs in newborn infants who are born without this surfactant—their lungs are very difficult to inflate. This condition is known as hyaline membrane disease and is a leading cause of death for infants, particularly in premature births. Some success has been achieved in treating hyaline membrane disease by spraying a surfactant into the infant’s breathing passages. Emphysema produces the opposite problem with alveoli. Alveolar walls of emphysema victims deteriorate, and the sacs combine to form larger sacs. Because pressure produced by surface tension decreases with increasing radius, these larger sacs produce smaller pressure, reducing the ability of emphysema victims to exhale. A common test for emphysema is to measure the pressure and volume of air that can be exhaled.
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