Airways

What are your airways?

Your airways are a series of passages that air travels through to move into and out of your lungs. They’re part of your respiratory system. You can think of your airways as runways that air rides through to bring oxygen to your lungs. They also remove carbon dioxide (CO2) from your body.

Different sections of your airways are called upper and lower airways. Your upper airways are your nasal cavities, sinuses, pharynx and larynx. Your upper airways are in your face, head and neck, and bring air into your body. Your lower airways are your trachea, bronchi and bronchioles. Your lower airways are in your neck and chest and lead into your lungs.

What do your airways do?

Your airways’ main purpose is structural — as a path from the outside of your body to your lungs. But they also protect your body from harmful particles (like dust and germs), adjust air to your body’s climate, and work with other parts of your body to allow you to smell and talk.

Your airways help you:

• Regulate temperature and humidity. Your airways add moisture and warm the air to match your body temperature.
• Clear mucus. Your airways are lined with hair-like structures called cilia. In your upper airways, they block harmful germs and irritants from getting in. In your lower airways, mucus traps particles and the tiny hairs move in a wave-like motion to push them upward (called the mucociliary escalator). Then, your coughs or sneezes push out the mucus — and the particles with it — from your body.
• Speak and smell. When you speak, it’s because air vibrates your vocal cords. When you breathe in, air molecules pass your olfactory nerve, which sends messages to your brain about the way something smells.

What are the parts of your airways?

Your airways start from your nose and end in small air sacks in your lungs (alveoli). Parts of your airways include:

• Nasal cavity (in your nose).
• Sinuses.
• Pharynx (throat).
• Larynx (voice box).
• Trachea (windpipe).
• Bronchi (large airways).
• Bronchioles (small airways).

What are common conditions that affect airways?

Common conditions that can affect your airways include ongoing (chronic) conditions, inflammation and blockages.

Chronic airway conditions

Genetic conditions, airway damage and anatomical differences can cause chronic airway conditions. These include:

• Asthma.
• Bronchiectasis.
• Chronic obstructive pulmonary disease (COPD).
• Cystic fibrosis.

Airway inflammation

Infections (like the flu or COVID-19) and allergies can cause airway inflammation. Depending on where in your airway you have inflammation, this can lead to:

• Bronchitis
• Bronchiolitis.
• Sinusitis (sinus infections).

Airway blockages

Body tissue, objects and structural changes can block your airway and make it hard to breathe. Airway blockages can be caused by:

• Foreign objects.
• Benign growths.
• Cancerous tumors.
• Narrowing of your airways (stenosis).
• Obstructive sleep apnea (OSA), which blocks your airways while you’re sleeping.

What are some common symptoms of airway conditions?

Symptoms of conditions that affect your airways include:

• Runny or stuffy nose.
• Noises when you breathe like wheezing or stridor.
• Shortness of breath (dyspnea).
• Daytime sleepiness.

What are common tests to look for issues in your airways?

Healthcare providers use many tests and procedures to check the health of your airways. Depending on your symptoms, these might include:

• Tests that use a scope to look inside your airways. These include nasal endoscopy and bronchoscopy.
• Pulmonary function tests. These test how well you’re breathing.
• Pulse oximetry. This test uses a device on your finger to measure your blood oxygen level.
• Chest X-rays and CT scans allow your provider to get pictures of your airways to help diagnose and rule out conditions.
• Sleep studies. Providers use sleep studies to diagnose sleep apnea.

What are common treatments for airway conditions?

Depending on the type of airway 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.

If you have something blocking your airways or if you’re unable to breathe, you might need:

• Surgery to remove a blockage.
• Intubation. A provider may need to use an endotracheal tube to open your airways. Providers usually use mechanical ventilation (a ventilator) to breathe for you when you’re intubated.
• Tracheostomy (tracheotomy). This can be temporary or permanent. A tracheostomy creates an opening in your airways so you can breathe.

If you have OSA, you might need to use positive airway pressure, like a CPAP machine, at night to open your airways.

How can I keep my airways healthy?

Things you can do to keep your airways 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 pollutants. This includes 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 pollutants.
• Stay hydrated. Drinking plenty of water keeps mucus thin and easier to clear out.
• Prevent infections. Washing your hands often and getting vaccinated can help prevent illnesses that irritate and inflame your airways. 
• Perform airway clearance exercises. If you have a chronic condition that makes it hard to clear your airways, there may be techniques you can use to make it easier. Some techniques include huff cough and chest physical therapy.

What are the two types of airways?

If you can’t breathe and a provider needs to open your airways for you, they might use one of two types of airway devices:

• Oropharyngeal airway (oral airway or OPA). This goes through your mouth and into your throat.
• Nasopharyngeal airway (NPA, nasal trumpet). This goes through your nose and into your throat.

Providers use these in emergency situations, before intubation or when they need to open your airways but don’t need to (or can’t) intubate you.