“Every breath you take triggers a complex process that keeps you alive.

In just a few seconds, your lungs:

• Pull oxygen into your body
• Deliver it to your bloodstream
• Remove carbon dioxide from the blood through the lungs and is exhaled.

Every cell in your body needs oxygen to live. The air we breathe contains oxygen and other gases. The respiratory system’s main job is to move fresh air into your body while removing waste gases.

Once in the lungs, oxygen is moved into the bloodstream and carried through your body. At each cell in your body, oxygen is exchanged for a waste gas called carbon dioxide. Your bloodstream then carries this waste gas back to the lungs where it is removed from the bloodstream and then exhaled. Your lungs and respiratory system automatically perform this vital process, called gas exchange.

Your heart is the engine of your body whereas your lungs are the transmission of the body.  One system can’t live without the other.  Meaning, the heart cannot live without the heart just like the car can’t work with an engine but no transmission.”

The American Lung Association (https://www.lung.org/lung-health-diseases/how-lungs-work)

Your lungs are the pair of spongy, pinkish-gray organs in your chest.  The lungs have openings for oxygen and carbon dioxide to move in and out of the organ tissue openings called alveoli that are elastic to do this function but for smokers or emphysema it damages the alveoli causing them to lose the elasticity=permanently damaged lung tissue.  Ending line, this makes the alveoli not function normally in doing their O2 and CO2 exchange.

When you inhale (breathe in), air enters your lungs, and oxygen from that air moves to your blood. At the same time, carbon dioxide, a waste gas, moves from your blood to the lungs and is exhaled (breathed out). This process, called gas exchange, is essential to life.

The lungs are the centerpiece of your respiratory system. Your respiratory system also includes the trachea (windpipe), muscles of the chest wall and diaphragm, blood vessels, and other tissues. All of these parts make breathing and gas exchange possible. Your brain controls your breathing rate (how fast or slow you breathe), by sensing your body’s need to get oxygen and also get rid of carbon dioxide.

Air first enters your body through your nose or mouth, which moistens and warms the air since cold, dry air can irritate your lungs. The air then travels past your voice box and down your windpipe. Rings of tough tissue, called cartilage, acts as a support to keep the bronchial tubes open.

Inside your lungs, the bronchial tubes branch into thousands of thinner tubes called bronchioles. The bronchioles end in clusters of tiny air sacs called alveoli.

Air fills your lung’s air sacs

Your lungs have about 150 million alveoli. Normally, your alveoli are elastic, meaning that their size and shape can change easily. Alveoli are able to easily expand and contract because their insides are coated with a substance called surfactant. Surfactant reduces the work it takes to breathe by helping the lungs inflate more easily when you breathe in. It also prevents the lungs from collapsing when you breathe out.

Each of these alveoli is made up of a mesh of tiny blood vessels called capillaries. The capillaries connect to a network of arteries and veins that move blood through your body.

Blood low in oxygen flows through the lungs

The pulmonary artery and its branches deliver blood to the capillaries that surround the alveoli. This blood is rich in carbon dioxide and low in oxygen.

Oxygen flows into your blood

Carbon dioxide moves from the blood into the air inside the alveoli. At the same time, oxygen moves from the air into the blood in the capillaries.

Your organ the lungs have parietal and visceral membranes of that organ.

The pleurae are double-layered serous membranes that surround each lung and line the thoracic cavity. They are essential for protecting the lungs and facilitating smooth, efficient breathing.

1. Parietal Pleura

• Location & Structure: The parietal pleura is the outer layer that lines the internal surface of the thoracic cavity. It is thicker than the visceral pleura and is subdivided into:
  • Mediastinal pleura – covers the mediastinum (central thoracic structures).
  • Costal pleura – covers the inner surfaces of the ribs, costal cartilages, and intercostal muscles.
  • Diaphragmatic pleura – covers the superior surface of the diaphragm.
• Function: Anchors the lungs to the thoracic wall, mediastinum, and diaphragm. It produces a small amount of pleural fluid to lubricate the pleural cavity.

2. Visceral Pleura

• Location & Structure: The visceral pleura is the inner layer that directly covers the surface of the lungs, including the bronchi, blood vessels, and nerves. It extends into the interlobar fissures and is continuous with the parietal pleura at the hilum of each lung.
• Function: Adheres tightly to the lung surface, providing support and protection during movement. It also contributes to the production of pleural fluid.

3. Pleural Cavity

• Location: A potential space between the parietal and visceral pleurae.
• Contents: Contains a thin layer of serous fluid that:
  • Lubricates the pleural surfaces, allowing them to slide over each other during breathing.
  • Generates surface tension that keeps the lungs inflated against the chest wall.
• Clinical Note: If air enters the pleural cavity (pneumothorax) or fluid accumulates (pleural effusion), normal function is impaired

Now in understanding the lungs in how they work the next health article we will cover the pleura which is the membrane that lines the thoracic (chest) cavity and covers the lungs.  Including the symptoms of the types of pleural diseases or situations that arise with much more information on thorax problems (Ex. Hemo, Pneumo thorax)

“The earliest known clinical description of sarcoidosis was recorded by Jonathan Hutchinson in 1875, who observed purplish, nodular, sharply circumscribed lesions on a patient’s fingers, forearms, and legs, along with nontender swelling of a finger, marking the first recognition of the disease in medical literature.

In 1877, the Norwegian physician C.W. Boeck described a peculiar skin lesion that would later be recognized as a manifestation of sarcoidosis.

The term “sarcoidosis” was introduced in 1899 by the British dermatologist Robert J. W. Hutchinson, who highlighted the systemic nature of the condition, distinguishing it from other skin diseases and tuberculosis-like conditions. Early on, the disease was primarily considered a dermatological curiosity, but by the early 20th century, its systemic involvement, including the lungs, lymph nodes, and other organs, became evident.

Over the decades, understanding of sarcoidosis expanded significantly, with advances in radiographic imaging, histopathology, and immunology clarifying its multisystem nature. Despite these developments, the exact cause remains unknown, though genetic predisposition and environmental triggers are implicated. Today, sarcoidosis is recognized as a non-infectious granulomatous disease that can affect multiple organs, with skin manifestations being among the earliest observed signs.”

JAMA Dermatology (SARCOIDOSIS | JAMA Dermatology | JAMA Network) and SPRYPT.com (The Historical Context of Sarcoidosis)

How Sarcoidosis can be diagnosed:

• biopsy of the lungs, liver, skin, or other affected organs to check for granulomas
• Blood tests, including complete blood counts, to check hormone levels and to test for other conditions that may cause sarcoidosis
• Bronchoscopy, which may include rinsing an area of the lung to get cells or using a needle to take cells from the lymph nodes in the chest
• Chest X-ray to look for granulomas in the lungs and heart and determine the stage of the disease. Often, sarcoidosis is found because a chest X-ray is performed for another reason.
• Neurological tests, such as electromyography, evoked potentials, spinal taps, or nerve conduction tests, to detect problems with the nervous system caused by sarcoidosis
• Eye exam to look for eye damage, which can occur without symptoms in a person with sarcoidosis
• Gallium scan external link , which uses a radioactive material called gallium to look for inflammation, usually in the eyes or lymph nodes.
• High-resolution computed tomography (CT) scan to look for granulomas
• Magnetic resonance imaging (MRI) to help find granulomas. Learn more in our Chest MRI Health Topic.
• Positron electron tomography (PET) scan, a type of imaging that can help find granulomas
• Pulmonary function tests to check whether you have breathing problems
• Ultrasound to look for granulomas

There is a staging to Sarcoidosis:

“There are many risk factors for sarcoidosis. Some risk factors, such as where you work, can be changed. But your age, family history, and many other risk factors cannot be changed.

Age: You can get sarcoidosis at any age, but the risk goes up as you get older, especially after age 55.

Environment: Living or working near insecticides, mold, or other substances that may cause inflammation raises your risk. You may be around these substances if you are in health care or the automotive industry or are a farmer or firefighter.

Family history and genetics: Having a close relative with sarcoidosis raises your risk.

Medicines: Certain types of HIV medicines and monoclonal antibodies(link is external) used to treat cancer or overactive immune system can raise your risk.

Race or ethnicity: Your risk is higher if you are of African or Scandinavian descent.

Sex: Women are more likely to have sarcoidosis, although men can also have it.

Other medical conditions, such as lymphoma, a type of blood cancer, can also lead to sarcoidosis.”

NIH National Library of Medicine (https://pmc.ncbi.nlm.nih.gov/articles/PMC7755458/)

Lung lesions – 95% Thoracic lymph nodes – 50% Skin lesions – 30%  Eyes – 30%

Inflammatory Disease- Sarcoidosis or Sarcoid is a inflammatory disease that consists of granuloma.

Wide Spread Disease- Disease is wide spread in multiple organs.

• The Sarcoidosis disease tends to come and go all of a sudden.
• Disease may progressively develop as a serious illness.
• Patient may experience several relapse throughout the life.

• Sarcoidosis or Sarcoid is a gradual progressive disease.
• Microscopic lumps called granulomas start to appear in the affected organs.¹
• In most of the cases, these granulomas tend to clear with or without treatments.
• There are few instances where granuloma grows in size and continues to be a part of the organ.
• Granuloma eventually ends up as fibrotic lump but may cause several complications.

Causes

Doctors don’t know the exact cause of sarcoidosis. Some people appear to have a genetic predisposition to develop the disease, which may be triggered by bacteria, viruses, dust or chemicals.

This triggers an overreaction of your immune system and immune cells begin to collect in a pattern of inflammation called granulomas. As granulomas build up in an organ, the function of that organ can be affected.

Risk factors

While anyone can develop sarcoidosis, factors that may increase your risk include:

• Age and sex. Sarcoidosis often occurs between the ages of 20 and 40. Women are slightly more likely to develop the disease.
• Race. African-Americans have a higher incidence of sarcoidosis than do white Americans. Also, sarcoidosis may be more severe and may be more likely to recur and cause lung problems in African-Americans.
• Family history. If someone in your family has had sarcoidosis, you’re more likely to develop the disease.

Complications

For most people, sarcoidosis resolves on its own with no lasting consequences. But sometimes it causes long-term problems.

• Lungs. Untreated pulmonary sarcoidosis can lead to permanent scarring in your lungs, making it difficult to breathe.
• Eyes. Inflammation can affect almost any part of your eye and can eventually cause blindness. Rarely, sarcoidosis also can cause cataracts and glaucoma.
• Kidneys. Sarcoidosis can affect how your body handles calcium, which can lead to kidney failure.
• Heart. Granulomas in your heart can cause abnormal heart rhythms and other heart problems. In rare instances, this may lead to death.
• Nervous system. A small number of people with sarcoidosis develop problems related to the central nervous system when granulomas form in the brain and spinal cord. Inflammation in the facial nerves, for example, can cause facial paralysis.

“Sarcoidosis is an illness that causes tiny islands of inflammatory cells to form throughout the body. These microscopic groups of cells are called granulomas. They are especially common in the lungs, lymph nodes, skin, eyes, and liver. The cause of sarcoidosis is unknown.

Sometimes these granulomas cause very little damage, so a person with sarcoidosis does not have any symptoms of illness and may not even know they have it. In other cases, however, the granulomas produce large areas of inflammation and scarring that can interfere with an organ’s normal functions.”

Harvard Health (Sarcoidosis – Harvard Health)

Sarcoidosis (pronounced SAR-COY-DOE-SIS) is an inflammatory disease characterized by the formation of granulomas, tiny clumps of inflammatory cells, in one or more organs of the body. When the immune system goes into overdrive and too many of these clumps form, they can interfere with an organ’s structure and function. When left unchecked, chronic inflammation can lead to fibrosis, which is permanent thickening or scarring of organ tissue.

This disorder can affect almost any organ in the body, including the heart, skin, liver, kidneys, brain, sinuses, eyes, muscles, bones, and other areas. Sarcoidosis most commonly targets the lungs and the lymph nodes, which are an important part of the immune system. When it affects the lungs, it is called pulmonary sarcoidosis. Ninety percent or more of people diagnosed with the disease have lung involvement.

Doctors believe sarcoidosis results from the body’s immune system responding to an unknown substance, most likely something inhaled from the air.

Symptoms in general to people affected by this disease sarcoidosis:

For many people, sarcoidosis begins with these symptoms in general:

“The Cleveland Clinic states that cataract surgery is one of the most common procedures, with surgeons performing more than 3 million cataract surgeries in the United States, and 20 million globally, improving vision for 97 percent of patients. For those who have had cataract surgery recommended by their eye doctors,”

Prevent Blindness (Cataract Awareness Month 2024: Essential Eye Health Tips)

Medications that can cause Cataracts:

Certain medications are well-known causes of cataracts, and some drugs can also accelerate their development. Steroid medications – whether pills, injections, or eye drops – are most frequently associated with cataract formation. If you are taking steroid medications to manage a long-term condition, it is important to note any visual changes and to have your ocular health managed by a qualified ophthalmologist. The medications that can cause cataracts include:  Corticosteroids, Eye drops containing steroids, Glaucoma medications, Certain antipsychotics and antidepressants, Certain medications for autoimmune conditions, and Medication to control heart arrhythmia

Signs and Symptoms of Cataracts:

You may not have any symptoms at first, when cataracts are mild. But as cataracts grow, they can cause changes in your vision. For example, you may notice that:

• Your vision is cloudy or blurry
• Colors look faded
• You can’t see well at night
• Lamps, sunlight, or headlights seem too bright
• You see a halo around lights
• You see double (this sometimes goes away as the cataract gets bigger)
• You have to change the prescription for your glasses often

These symptoms can be a sign of other eye problems, too. Be sure to talk to your eye doctor if you have any of these problems.

HOW YOU CAN PREVENT CATARACTS:

Maintaining healthy eating habits can help to prevent cataracts in two ways. First, a good diet will control your weight, thus eliminating one of the significant risk factors. Second, increasing your antioxidant intake can also inhibit the oxidation process. In a 2013 Swedish, researchers observed 30,000 women over age 49, and found that those who consumed the highest amounts of antioxidants had a 13 percent lower chance of developing cataracts than those who consumed the least amounts.

To reduce your risk for cataracts, be sure to eat plenty of foods high in antioxidants.

TREATMENTS FOR CATARACTS: