Breathing Problems

Breathing problems may occur as the result of a disease process affecting one or more of the body's systems. Dysfunction associated with any of the following may lead to difficulty breathing or dyspnea (shortness of breath):

• the musculoskeletal system, including dysfunction of muscles and bones that move in order to facilitate breathing
• the respiratory system, including foreign body obstruction, infection, irritation, lung diseases, and hypoxia (low environmental oxygen)
• the cardiovascular system, including infection, myocardial infarction, congestive heart failure, and congenital valve problems
• the nervous system, including problems of the body's breathing center, and diseases of nerves that innervate respiratory muscles

Some causes of dyspnea are not easily categorized into a body system. For example, emotional factors, such as anxiety, may play a role. The treatment for a person experiencing breathing problems must be tailored to the cause, which is often multifactorial.

Breathing problems involving the musculoskeletal system are familiar to those who engage in sports. The major muscles used during breathing are the diaphragm and the external intercostals. The diaphragm is located below the lungs, within the abdominal cavity, and contracts during inhalation to expand the thoracic cavity and allow for necessary lung expansion. If the diaphragm or external intercostal muscles are damaged, then the accessory breathing muscles (the sternocleidomastoid, the platysma, and the strap muscles of the neck) are utilized. It is not uncommon for these muscles to pull or tear with excessive use or strain such as during sports. Breathing will be difficult and often painful if these muscles are damaged. Similarly, if ribs are fractured from trauma, the expansion of the thoracic cavity will be inhibited during inhalation and cause problems in lung expansion due to pain occurring with inhalation. Rib pain may continue for weeks after the initial trauma because of inflammation.

Body shape plays a role in the amount of work needed to breathe. Some individuals have a skeletal structure that may alter their ability to breathe. For example, a person with severe scoliosis (lateral curvature of the spine) may have difficulty as the curvature of the spine may decrease the volume of the thoracic cavity, and, hence, decrease the potential for lung expansion. Obese patients may also experience breathing problems because of an increased burden on their cardiovascular and respiratory systems, as well as the pressure from excess body weight on the ribs, which move with respiration.

The respiratory system includes the nose, mouth, nasopharynx, oropharynx, pharynx, larynx, trachea, bronchi, and lungs. Dysfunction of any one of these parts may disrupt the system's ability to perform to capacity. For example, a congested or broken nose will limit the amount of air that enters into the system, as will infected and swollen tonsils. Children with strep throat may experience this sort of dyspnea due to congestion. Foreign objects may also block the nose or throat and hinder the flow of air into the lungs. Often, toddlers, if given the opportunity, will put peas, peanuts, candy, marbles, or other small objects into their noses. It is also not uncommon for people of all ages to get a piece of food lodged in their throat, serving as a barrier to air entering the lungs.

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