Anatomy and Physiology
The respiratory system of birds is significantly different, both physiologically and anatomically, from that of mammals.
These differences are a result of adaptations to the demands associated with flight resulting in an extremely efficient gas
exchange system allowing them to breathe at high altitudes (low O 2
levels) and maintain their high metabolic rate. The nares are the beginning of the avian respiratory tract and may be
located anywhere along the beak from the tip (kiwis) to the base. Some species have an operculum to filter large particles
from inspired air. Birds have three conchae (rostral, middle, and caudal). The infraorbital sinus is the only paranasal sinus
of birds and has a rostral diverticulum within the beak, the preorbital diverticulum rostral to the eye, the infraorbital
diverticulum ventral to the eye, the postorbital diverticulum caudal to the eye and the mandibular diverticulum that extends
into the caudal mandible. The nasal passages and sinus communicate with the choana, a normal anatomic cleft in the roof of
the mouth. The choana has fine papillae along its margins. During respiration, the glottis abuts the choana allowing birds
to breathe through the nares. The glottis of birds is simple with no epiglottis making them more susceptible to foreign body
aspiration. The glottis is located at the base of the tongue and is usually accessible even in awake birds but is not involved
in sound production.
The trachea is long compared with mammals with complete cartilagenous rings it bifurcates just cranial to the heart as the
syrinx. The syrinx produces sound and is composed of modified tracheal cartilages forming flexible membranes to which muscles
attach. The muscles are used to cause vibration producing sound. The trachea becomes narrower progressing caudally with the
syrinx being the narrowest portion of the trachea which predisposes foreign objects to lodge and granulomas to form there.
Each primary bronchus enters one lung and divides into secondary bronchi which further subdivide into parabronchi. Inspired
air moves from the parabronchi into atria which open along the walls of the parabronchi. Air then flows into air capillaries,
the avian analog of alveoli being the gas exchange site. However, unlike mammalian alveoli, air capillaries communicate with
each other and with other atria so air cannot become entrapped and emphysema does not occur in birds. The lungs of birds are
fixed adhered dorsally to the ribs and vertebrae. They do not expand and collapse during respiration. The lungs are directly
connected to the air sacs of which there are 4-5 sets (cervical, interclavicular, cranial thoracic, caudal thoracic, and abdominal).
The cervicocephalic air sac communicates with the infraorbital sinus and not directly with the lungs.
The respiratory cycle in birds is complicated but the majority of air requires two complete breathes to make it through. Most
of the inspired air bypasses the lungs and goes into the caudal thoracic and abdominal air sacs during the first inspiration.
During the first exhalation, air moves from these caudal air sacs into the lungs where gas exchange occurs. With the second
inspiration, air moves from the lungs into the cranial air sacs and during the second exhalation it leaves through the trachea.
This creates a unidirectional flow of air through the lungs. Blood moves in a direction opposite to that of air flow creating
a counter-current exchange which is very efficient for gas exchange. Air is moved through the respiratory system by movement
of the sternum so if a bird cannot move its sternum it will not be able to move air.
Air Sac Cannulae
A tube inserted into an air sac can obviate, at least temporarily, the need for respiration through the trachea. This can
be a life-saving procedure in birds with upper airway obstruction. An air sac cannula can also provide a means by which oxygen
and anesthetic gases can be supplied to birds while working on the mouth, sinus, trachea, glottis, choana, and the cranial
coelomic cavity. The tube can be placed either in the caudal thoracic or abdominal air sac using one of two insertion sites.
To place an air sac tube into the caudal thoracic, a nick incision is made just cranial to the thigh muscles over the last
intercostal space. The intercostal muscles are penetrated using a mosquito hemostat to create a hole large enough to insert
the tube. If the bird has a respiratory obstruction, as soon as the hole is created, air can be heard passing into and out
of the hole. The tube is only advanced a few millimeters so it does not butt against internal structures. Suture the tube
in place using a finger trap or butterfly tape technique.
The second site commonly used for insertion of an air sac cannula is caudal to the thigh muscles into the abdominal air sac.
I find tubes placed in this location dislodge more easily. The leg is pulled cranially and a nick incision is made where the
caudal thigh muscles cross the last rib. A mosquito hemostat is used to bluntly dissect just caudal to the last rib entering
into the air sac. If the hemostat is too parallel to the body wall it will not penetrate the body wall but will dissect subcutaneously.
Once the tube is inserted the leg is allowed to fall into a normal position and the tube is secured in place. It is probably
best not to leave an air sac cannula in place more than 5 days and birds with air sac tube should be placed on a broad spectrum,