Trachea

Your trachea (pronounced "TRAY-kee-uh") is a tube that connects your upper airways in your throat to your lower airways in your lungs. It’s a part of your respiratory system, which brings oxygen into your lungs and gets rid of carbon dioxide. Another name for your trachea is your windpipe.

While you probably don’t think about your windpipe much, it’s most noticeable when you cough. When dust, food particles, germs or mucus irritate your trachea, its muscles contract to force out whatever’s annoying it.

What does your trachea do?

Functions of your trachea include:

• Providing a path for air: Air travels through your windpipe on its way to and from your lungs.
• Protecting your body: When harmful particles (like dust and germs) enter your body through your nose or mouth, they get trapped in mucus. The cilia — hair-like structures in your airways — push the mucus upward to get rid of germs and irritants. The muscles in your trachea forcefully expel air and mucus when you cough.
• Preventing airway blockages: If food or liquid goes “down the wrong pipe” (aspiration), your cough reflex can force it out of your trachea before it gets lodged in your lower airways.
• Regulating temperature and humidity: Your trachea helps add moisture and warms the air coming into your body to match your body temperature.

Where is your trachea located?

Your trachea sits in your lower neck and upper chest. It connects your larynx (voice box) to your bronchi (large airways that lead into your lungs).

Your trachea can also be described in relation to other parts of your body. It’s:

• In front of your esophagus (the tube that carries food from your mouth to your stomach)
• Behind the notch at your lower throat
• Between the upper lobes of your lungs and the inside edges of your collarbone (clavicle)

Is your trachea for food or air?

Your trachea is part of your airways, the path that air travels through on the way to your lungs. People sometimes confuse it with the esophagus, which is a tube that sits behind the trachea. Food moves through your esophagus on its way to your stomach. The epiglottis, a small cartilage “lid” at the top of your larynx, closes and blocks the path to your lungs (including your trachea) when you eat, so food moves through your esophagus instead.

What’s the structure of your trachea?

In adults, the trachea is a tube that's about 10 to 12 centimeters (about 4 to 4.7 inches) long and 1.5 to 2 centimeters (about 1/2 to 3/4 inch) wide. It looks a bit like an upside-down “Y,” with a straight upper half that connects to your larynx and a lower half that branches off to your left and right bronchi. The place where it splits into your bronchi is called the carina.

What are the layers of your trachea?

Your trachea has four layers. From inside to outside, they are:

• Mucosa: This is the innermost layer. It comes in contact with the air you breathe in, and any particles that come with it. Mucosa lines your respiratory tract with mucus that can trap particles, and cilia that push the mucus and trapped particles out of your body.
• Submucosa: This layer provides the mucosa with blood vessels, nerves, lymphatic vessels and mucus-forming cells.
• Cartilaginous layer: Rings of strong, flexible hyaline cartilage surround your trachea to provide structure and support. They’re shaped like a horseshoe — or a “C” — and wrap around the front of your trachea. Adults have 16 to 20 cartilage rings. At the back, near your esophagus, your trachealis muscle runs from the top to the bottom of your trachea, filling in the gap between the ends of the rings.
• Adventitia: This is the outer layer of your trachea. It’s made up of loose connective tissue that attaches your trachea to your esophagus and other nearby organs.

What conditions affect your trachea?

Health conditions that can affect your trachea include:

• Asthma: Asthma causes inflammation and narrowing of your airways, including your trachea.
• Tracheal obstruction: Foreign objects or tumors can block your trachea.
• Tracheal stenosis: Many conditions can cause narrowing in your windpipe that restricts your breathing.
• Tracheitis: Colds and other respiratory infections can inflame your trachea.
• Tracheoesophageal fistula: A fistula is an irregular connection (hole) in one or more places between your esophagus and your trachea.
• Tracheomalacia or tracheobronchomalacia: These are conditions where your windpipe collapses due to lack of structure.
• Complete tracheal rings: You can be born with an anatomical difference in your tracheal rings, where they make an “O” shape instead of a “C” shape. This means they completely surround your trachea and can narrow it.
• Tracheal cancer: Rarely, cancer can form in your windpipe.

What are common symptoms of conditions that affect your trachea?

Symptoms of conditions that affect your trachea include:

• Noises when you breathe, like wheezing or stridor
• Chronic cough
• Shortness of breath
• Difficulty swallowing
• Choking

What are common tests to check your trachea?

Depending on your symptoms, your provider might diagnose conditions that affect your trachea with:

• Bronchoscopy: This and other procedures can use a scope to look inside your airways.
• Pulmonary function tests: These tests measure how well you’re breathing.
• Imaging: Chest X-rays and CT scans allow your provider to get pictures of your airways to help diagnose and rule out conditions.

What are common treatments for tracheal conditions?

Depending on the type of condition you have, your provider might prescribe medications to:

• Reduce inflammation and open your airways: These include inhaled corticosteroids or bronchodilators.
• Treat infections: These include antivirals, antibiotics and antifungals.
• Block chemicals in your body that cause inflammation: These include antihistamines and leukotriene modifiers.

Other treatments include:

• Pulmonary rehabilitation: This is a combination of physical therapy and education that helps strengthen your breathing muscles.
• Airway clearance: Chest physiotherapy and external percussion vests can help break up and get rid of mucus in your windpipe and airways.
• Positive pressure devices: CPAP or BiPAP® machines help keep your trachea open.

An interventional pulmonologist may give you specialized treatments with bronchoscopy. These include:

• Scar tissue removal, dilations or injections for tracheal stenosis
• Tumor destruction or foreign body removal
• Stent placement to hold your windpipe open or seal a hole in your trachea
• Tracheostomy to create a temporary or permanent opening in your windpipe so you can breathe

Your healthcare provider may refer you to thoracic surgery or otolaryngology if you need surgery for tracheal stenosis, blockage or collapse.

How can I take care of my trachea?

Some tips to keep your trachea and the rest of your respiratory system healthy include:

• Don’t smoke or vape: Smoking damages your airways and can make existing airway conditions worse. Vaping liquids often have many of the same ingredients as cigarettes.
• Avoid toxic substances: These include secondhand smoke, chemicals and radon (a radioactive gas that can cause cancer). Wear a mask if your job or hobbies expose you to fumes, dust or other types of toxic substances.
• Stay hydrated: Drinking plenty of water keeps mucus thin and easier to clear out of your trachea and other airways.
• Prevent infections: Washing your hands often and getting recommended vaccinations can help prevent illnesses that irritate and inflame your trachea.