The respiratory system delivers oxygen to tissues and removes carbon dioxide. It includes the upper airways of the nose and pharynx and lower airways of the trachea, bronchi and alveoli. Gas exchange occurs via diffusion across respiratory surfaces. Mammals use lungs filled with alveoli, while other organisms like fish use gills, insects use tracheal systems, and amphibians can use both lungs and skin. Hemoglobin transports oxygen in the bloodstream from the lungs to tissues and transports carbon dioxide in the opposite direction.