Human Body Structure

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Biomedical engineering
Acknowledgement
I would like to thank and dedicate this assignment to Dr Manjula kavisekara our
lecturer who gave her fullest support in doing this assignment and my parents who helped me in
any ways to make this assignment a success. Special thanks go to my friends who gave me ideas
and knowledge in doing the Assignment.
Madusanka de Silva
ICBT Kandy campus
Human body structure and function
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Table of Contents
Acknowledgement...................................................................................................... 1
SECTION A.................................................................................................................. 3
SCENARIO 01........................................................................................................... 3
TASK 01................................................................................................................ 3
a)................................................................................................................................ 3
b)................................................................................................................................ 6
SCENARIO 02......................................................................................................... 14
TASK 02.............................................................................................................. 14
a).............................................................................................................................. 14
b).............................................................................................................................. 19
SCENARIO 03......................................................................................................... 20
TASK 03.............................................................................................................. 20
SECTION B................................................................................................................ 25
SCENARIO 01......................................................................................................... 25
TASK 01.............................................................................................................. 25
SCENARIO 02......................................................................................................... 31
TASK 02.............................................................................................................. 31
a).............................................................................................................................. 31
b).............................................................................................................................. 38
SECTION C................................................................................................................ 41
SCENARIO 01......................................................................................................... 41
TASK 01.............................................................................................................. 41
a).............................................................................................................................. 41
b).............................................................................................................................. 43
SCENARIO 02......................................................................................................... 45
TASK 02.............................................................................................................. 45
a).............................................................................................................................. 45
b).............................................................................................................................. 46
c).............................................................................................................................. 47
d).............................................................................................................................. 50
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SCENARIO 3........................................................................................................... 52
Task 03............................................................................................................... 52
a).............................................................................................................................. 52
b).............................................................................................................................. 52
SECTION D................................................................................................................ 53
SCENARIO 01......................................................................................................... 53
TASK 01.............................................................................................................. 53
a).............................................................................................................................. 53
b).............................................................................................................................. 57
SCENARIO 02......................................................................................................... 62
TASK 02.............................................................................................................. 62
SCENARIO 03......................................................................................................... 66
TASK 03.............................................................................................................. 66
SECTION E................................................................................................................ 69
SCENARIO 01......................................................................................................... 69
TASK 01.............................................................................................................. 69
a).............................................................................................................................. 69
b).............................................................................................................................. 74
SCENARIO 02......................................................................................................... 77
TASK 02.............................................................................................................. 77
a).............................................................................................................................. 77
b).............................................................................................................................. 77
Works Cited.............................................................................................................. 80
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SECTION A
SCENARIO 01
TASK 01
a)
The definition of aging is the progressive loss of physiological functions that increases the
probability of death.
Biologists regard aging as reflecting the sum of multiple and typical biological decrements
occurring after the sexual maturity, nevertheless behavioral scientists view it as reflecting regular
and expected changes occurring in genetically representative organisms advancing through the
life cycle under normal environmental condition.
Several theories have been proposed to explain the nature of aging. Due to the multicasual nature
of this process, it turns out improbable that only one theory could explain all its mechanisms.
The process of aging happens to all the levels, from the molecular level, to the cellular and organ
level.
Every cell possesses a complex system for the reproduction and building of the molecules that
allow it to develop. The information and the machinery to achieve it are codified in the nucleic
acids (DNA and RNA) and in the proteins. In the cells the nucleic acids share an environment
that contains numerous inorganic molecules, water and a great variety of reactive molecular
species that can exist as excited molecules, ions or free radicals, and are later turned into
chemically stable products
Environmental damages that exceed the maintenance system of repair of the DNA can lead to
premature aging. For example, prolonged exhibition to the sun will lead to a premature aging of
the skin due to the high levels of ultraviolet radiation that damages the DNA. Humans live
exposed to a diversity of magnetic fields, some of them generated by the magnetism of the earth,
whereas others are generated by the solar storms and solar changes through time. Electrical
devices also create magnetic fields: engines, television sets, office furniture, computers,
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microwave ovens, electrical wires in the buildings and the power network that provides them.
Even the human body produces subtle magnetic fields that are generated by the chemical
reactions inside the cells and the ionic currents in the nervous system
Free radicals are highly reactive molecules that take part in large amount of pathological
processes. Its role in aging, in the physiopathology of numerous degenerative processes, in the
side effects associated with the above mentioned processes, as well as its utility in the prognosis
of diverse diseases, is something that every day finds a major experimental and clinical support.
Accordingly, to anticipate the production in excess of free radicals must be taken into
consideration as of maximum interest to attain a healthy aging and a better prevention of the
diseases associated with them.
Mainly during the sleep time, when the cellular repair systems are at work, the elimination of
these electromagnetic artificial fields has important health consequences. The aim of this work
was to demonstrate how the reduction of these fields by means of rest in a controlled
environment, reduces significantly the free radicals and balances the endocrine
neuroinmunologic system, resulting in a better health state.
(Mercado-Senz et al., 2010)
Lets consider what are the cell organelles involved with cellular aging,
1) mitochondria
A decline in mitochondrial function plays a key role in the aging process and increases the
incidence of age-related disorders. A deeper understanding of the intricate nature of
mitochondrial dynamics, which is described as the balance between mitochondrial fusion and
fission, has revealed that functional and structural alterations in mitochondrial morphology are
important factors in several key pathologies associated with aging. Indeed, a recent wave of
studies has demonstrated the pleiotropic role of fusion and fission proteins in numerous cellular
processes, including mitochondrial metabolism, redox signaling, the maintenance of
mitochondrial DNA and cell death. Additionally, mitochondrial fusion and fission, together with
autophagy, have been proposed to form a quality-maintenance mechanism that facilitates the
removal of damaged mitochondria from the cell, a process that is particularly important to
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forestall aging. Thus, dysfunctional regulation of mitochondrial dynamics might be one of the
intrinsic causes of mitochondrial dysfunction, which contributes to oxidative stress and cell death
during the aging process. In this Commentary, we discuss recent studies that have converged at a
consensus regarding the involvement of mitochondrial dynamics in key cellular processes, and
introduce a possible link between abnormal mitochondrial dynamics and aging. (Anon., 2010)
2) Peroxisome
The peroxisome is functionally integrated into an exquisitely complex network of
communicating endomembranes which is only beginning to be appreciated. Despite great
advances in identifying essential components and characterizing molecular mechanisms
associated with the organelle's biogenesis and function, there is a large gap in our understanding
of how peroxisomes are incorporated into metabolic pathways and subcellular communication
networks, how they contribute to cellular aging, and where their influence is manifested on the
initiation and progression of degenerative disease. In this review, we summarize recent evidence
pointing to the organelle as an important regulator of cellular redox balance with potentially farreaching effects on cell aging and the genesis of human disease. The roles of the organelle in
lipid homeostasis, anaplerotic reactions, and other critical metabolic and biochemical processes
are addressed elsewhere in this volume.
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b)
There are so many theories about cell aging and cell death. Any cell or organelles aging can be
explained from those theories.
The free radical theory
This theory suggests that the enhancement of the antioxidative defense system to attenuate freeradical-induced damage counteracts the aging process. Among the various theories of the aging
process, the free radical theory, which proposes that deleterious actions of free radicals are
responsible for the functional deterioration associated with aging, has received widespread
attention. Some studies have indicated that the aging process leads to suppression of the
antioxidative defense system and accumulation of lipid peroxidation products, while ginsenoside
Rd attenuates the oxidative damage, which may be responsible for the intervention of
GSH/GSSG redox status.
Mitochondrial Theory
The free radical theory is supported by the directed experimental observations of mitochondrial
aging. They produce cell energy by a process that leads to the formation of potentially damaging
free radicals. Mitochondria are also one of the easiest targets of free-radical injury because they
lack most of the defenses found in other parts of the cell.
Redundant DNA Theory
This theory blames errors accumulating in the genes for age changes. But, as these errors
accumulate, this theory also blames the reserve genetic sequences of identical DNA that take
over until the system is worn out. Dr. Zhores Medvedev proposed that different species life spans
could be a function of the degree of these repeated gene sequences.
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Some of other Cellular aging theories
The "Wear and Tear" Theory

Dr. August Weismann, a German biologist, first introduced this theory in 1882. He believed that
the body and its cells were damaged by overuse and abuse. The organs and skin are worn down
by toxins in the diet and in the environment. Wear and the tear are not confined to the organs; it
also takes place at the cellular level (Warner et al., 1987).
The Neuroendocrine Theory
This theory developed by Dr. Vladimir Dilman elaborates on the wear and tear theory by
focusing on the neuroendocrine system. When young, the hormones work together to regulate
many bodily functions, including the responses to heat and cold, life experiences and sexual
activity. Different organs release various hormones all under the governance of the
hypothalamus. The hypothalamus responds to the body's hormone levels as its guide to
regulating hormonal activity.
When young, hormone levels tend to be high. With the increase in the age, the body produces
lower levels of hormones which can have disastrous effects on the functioning. The growth
hormones, for example, drop dramatically as the age increases so that even if an elderly person
has not gained weight, he or she has undoubtedly increased the ratio of fat-to-muscle.
Hormones are vital for repairing and regulating the bodily functions, and when aging causes a
drop in the hormone production, it causes a decline in body's ability to repair and regulate itself
as well. Thus, hormone replacement therapy, a frequent component of any anti-aging treatment,
helps to reset the body's hormonal clock and so can reverse or delay the effects of aging and thus
keeping young.
The Genetic Control Theory
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This theory states that humans are born with a unique genetic code, a predetermined tendency to
certain types of physical and mental functioning, and that the genetic inheritance has a great deal
to say about how quickly one becomes aged and how long lives. Each person has a biological
clock. When that clock goes off, it signals the bodies first to age and then to die. However, the
timing on this genetic clock is subject to enormous variation, depending on what happens with
the growth and on how one actually lives (quality of life, feeding, sanitation, health care
practices, etc) (Bengtson and Schaie, 1998).
Waste Accumulation Theory
In the course of life span the cells produce more waste than they can properly eliminate. This
waste can include various toxins which when accumulated to a certain level, can interfere with
normal cell function, ultimately killing the cell. Evidence supporting this theory is the presence
of a waste product called lipofuscin leading to age pigment. Lipofuscin is formed by a complex
reaction that binds fat in the cells to proteins. This waste accumulates in the cells as small
granules and increases in size as a person ages (Gavrilov and Gavrilova, 2006).
Limited Number of Cell Divisions Theory
The number of cell divisions is directly affected by the accumulations of the cell's waste
products. The more wastes accumulates over the time, the faster cells degenerate (Bengtson and
Schaie, 1998).
Hayflick Limit Theory
In 1962, two cell biologists, Dr. Hayflick and Dr. Moorehead, made one of the greatest
contributions to the history of cellular biology by demonstrating the senescence of cultured
human cells. Hayflick theorized that the aging process was controlled by a biological clock
contained within each living cell. The 1961 studies concluded that human cells have a limited
life span. The most evident changes took place in the cell organelles, membranes and genetic
material. This improper functioning of cells and loss of cells in organs and tissues may be
responsible for the effects of aging (Hayflick and Moorehead, 1980).
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Death Hormone Theory (DECO)

Unlike other cells, brain cells or neurons do not replicate. The humans are born with roughly 12
billion of them and over a life time, about 10 percent perish. Dr. Denckle speculated that as the
age increased the pituitary released DECO (decreasing oxygen consumption hormone or "death
hormone"). This inhibits the ability of cells to use the thyroxine, the rate at which cells convert
the food to energy. The metabolic rate increases and accelerates the process of aging (Bengtson
and Schaie, 1998).
Thymic-Stimulating Theory
This theory suggests that the disappearance of the thymus contributes to the aging process by
weakening the body's immune system. Thymic hormones may also play a role in stimulating and
controlling the production of neurotransmitters and brain and endocrine system hormones which
means they may be the key regulators responsible for immunity. The size of this gland reduces
from 200 to 250 grams at birth and then shrinks to around three grams by age 60. Thymic factors
are helpful in restoring the immune systems of children born without them as well as
rejuvenating the poorly functioning immune systems of the elderly (Goldberg et al., 2007).
Errors and Repairs Theory
In 1963, Dr. Leslie Orgel suggested that "an error in the machinery for making protein could be
catastrophic." The production of proteins and the reproduction of DNA sometimes are not carried
out with accuracy. The body's DNA is so vital that the natural repair processes kick in when an
error is made. But the system is incapable of making perfect repairs on these molecules every
time, and the accumulation of these flawed molecules can cause diseases and other age changes
to occur (Warner et al., 1987).
Cross-Linkage Theory
Developmental aging and cross-linking were first proposed in 1942 by Johan Bjorksten. He
applied this theory to aging diseases such as sclerosis, a declining immune system and the loss of
elasticity in the skin. Collagen is one of the most common proteins found in the skin, tendons,
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ligaments, bone and cartilage. Collagen protein can be compared to the legs of a ladder with very
few rungs. Each protein is connected to its neighbors by other rungs forming a cross-link
(Warner et al., 1987). In young people, there are few cross-links and the ladders are free to move
up and down. The collagen stays soft and pliable. It is thought that these cross-links begin to
obstruct the passage of nutrients and waste between cells. Cross-linking also appears to occur
when older immune systems are incapable of cleaning out excess glucose molecules in the blood.
These sugar molecules react with proteins causing cross-links and the formation of destructive
free radicals (Warner et al., 1987).
Autoimmune Theory
With age the system's ability to produce necessary antibodies that fight disease declines, as does
its ability to distinguish between the antibodies and proteins. In a sense, the immune system
becomes self-destructive and reacts against itself. Examples of autoimmune disease are lupus,
scleroderma and adult-onset diabetes (Bengtson and Schaie, 1998).
Caloric Restriction Theory
Calorie restriction or energy restriction is a theory proposed by Dr. Roy Walford. He developed a
high nutrient low-calorie diet demonstrating that "under nutrition with malnutrition" could
dramatically retard the functional, if not the chronological aging process. An individual on this
program would lose weight gradually until a point of metabolic efficiency was reached for
maximum health and life span. Walford stressed the importance of not only the high-low diet but
also moderate vitamin and mineral supplements coupled with regular exercise (Turner, 2003).
A major neuroendocrinological effect of calorie restriction is induction of neuropeptide Y in the
arcuate nucleus. Aside from its appetite-stimulating effects, neuropeptide Y is thought to be
involved in the modulation of behavioral processes including anxiety and learning and memory.
Despite established effects of calorie restriction on arcuate nucleus signaling, studies suggest a
mechanistic separation between the two where behavior is concerned (Minor et al., 2008).
The Rate of Living Theory
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German physiologist Dr. Max Rubner who discovered the relationship among the metabolic rate,
body size and longevity first introduced this theory in 1908. It simply states that each one is born
with a limited amount of energy. If this energy is used slowly, then the rate of aging is slowed. If
the energy is consumed quickly, aging is hastened. Other rate-of-living theories focus on limiting
factors such as amount of oxygen inhaled or number of heartbeats spent (Bengtson and Schaie,
1998).
Gene Mutation Theory
In the 1940s, the scientists investigated the role of mutations in aging. Mutations are changes that
occur in the genes which are fundamental to life. Evidence supporting this idea came from the
experiments with radiation. It was observed that radiation not only increased animal's gene
mutation but it also accelerated their aging process as well. However, later studies showed the
radiation-induced changes were only mimicking age changes. This hypothesis further diminished
in validity when the experiments with moderate amounts of radiation actually increased the life
span of rats (Warner et al., 1987).
Accumulated mutations theory
It was first proposed by Medawar in 1952. This theory suggests that influence of natural
selection diminishes with age. When there is a deleterious mutation that manifests itself at a
young age, there will be strong selection pressure to eliminate that mutation because it will
impact the fitness of a large majority of the population. If that same mutation does not manifest
itself until late in life, many of the individuals carrying the mutation will be dead before the
mutation is expressed. If the mutation is rarely expressed, can be passed from one generation to
the next and may accumulate in the genome, because there is little opportunity for natural
selection to clear this mutation from the genome (Sozou and Seymour, 2004).
Antagonistic pleiotropy theory
Antagonistic pleiotropy is the second evolutionary theory of aging. It was formulated by
Williams in 1957 and proposed that genes existed which have beneficial effects early in life but
harmful effects later in life. If these genes confer increased reproductive success early in life,
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they would be selected for despite the fact that they may later cause senescence (Sozou and
Seymour, 2004).
Disposable soma theory
Cell maintenance is costly. Given the fact that extrinsic mortality is extremely high in the wild, it
would make little sense to use precious metabolic resources to maintain the soma beyond the
expected lifetime of the organism. Using extra energy to increase the reproductive capacity will
be more beneficial from an evolutionary standpoint because it will enhance the fitness of that
individual. Therefore, organisms have evolved in such a way that the amount of energy invested
in maintaining the soma is sufficient to keep the animal alive long enough to reproduce but less
than that which would be required to keep it alive indefinitely.
The disposable soma theory helps to explain why different species have different life spans. The
higher the extrinsic mortality rate for a species, the more energy should be directed towards
reproducing as often as is possible (Sozou and Seymour, 2004).
Order to Disorder Theory
From the time of conception to sexual maturation, human bodies undergo a system of
orderliness. Dr. Leonard Hayflick mentioned that humans direct most of the energies to fulfilling
a genetically determined plan for the orderly production and arrangement of an enormous
number and variety of molecules. After the sexual maturation, however, these energies start to
diminish its efficiency. Disorder occurs in the molecules in turn causing other molecules to
produce errors and so on. These chaotic changes in the cells, tissues and organs are the causes of
aging. Disorderliness varies from individual and this may be the reason why the tissues and
organs deteriorate at different rates (Bengtson and Schaie, 1998).
The Telomerase Theory of Aging
This theory was born from the surge of technological breakthroughs in genetics and genetic
engineering. Telomeres are sequences of nucleic acids extending from the ends of chromosomes.
Telomeres act to maintain the integrity of the chromosomes. Every time the cells divide,
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telomeres are shortened, leading to cellular damage and cellular death associated with aging
(Bryan et al., 1998; Goyns and Lavery, 2000).
The key element in rebuilding the disappearing telomeres is the enzyme telomerase, an enzyme
found only in germ cells and cancer cells (Sedivy, 2003). Telomerase appears to repair and
replace the telomeres manipulating the "clocking" mechanism that controls the life span of
dividing cells (Allen, 1996; Bodnar et al., 1998; Shay and Wright, 2000).
Age-related changes do not occur uniformly in the individuals; rather they are controlled jointly
by the genetic and environmental factors which further heighten the difficulty of finding a
universal theory. What is universal is that there exists a global-aging phenomenon. Through the
theoretical gerontology and anti-aging medicine, one may eventually discover that there is no
limit to human life span (Gonzlez Jimnez, 2000)
(Anon., 2009)
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SCENARIO 02
TASK 02
a)
There are two major type of cell, called prokaryotic and eukaryotic. Prokaryotic cells are less
organized and less dynamic than eukaryotic cells. Prokaryotes lack the organelles that are found
in eukaryotic cells. Organelles are small, membraneous bodies, each with a specific structure and
function.
All animal cells are multicellular. They are eukaryotic cells. Animal cells are surrounded by
plasma membrane and it contains the nucleus and organelles that are membrane bound.
Animal cells are of various sizes and have irregular shapes. Most of the cells size range between
1 and 100 micrometers and are visible only with help of microscope. Trillions of cells are found
in the human body. There are many different types of cells, approximately 210 distinct cell types
in adult human body.
In briefly mention about cell organelles and their function below
Cell membrane - forms the outer covering of the cell, and is semi-permeable.
Cytoplasm - is a gel-like matrix where all the other cell organelles are suspended inside the cell.
Nucleus - contains the hereditary material DNA and directs the activities of the cell.
Centrioles - organize the microtubules assembly during cell division.
Endoplasmic Reticulum - are a network of membranes composed of rough and smooth
endoplasmic reticulum.
Golgi complex - is responsible for storing, packaging of cellular products.
Lysosomes - are enzyme sacs that digest cellular wastes.
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Microtubules - are hollow rods, function primarily as support and shape to the cell.
Mitochondria - is the site for cellular respiration and producers of energy.
Ribosomes - are made of RNA and proteins, and are sites for protein synthesis.
Nucleolus - is the structure within the nucleus and helps in synthesis of ribosomes.
Nucleopore - is the tiny hole in the nuclear membrane, allows the movement of nucleic acids and
proteins in/out of the cell.
The Plasma Membrane

It is composed of four different types of molecules,
1.
Phospholipids
2.
Cholesterol
3.
Proteins
4.
Carbohydrates
Functions of the cell membrane,
Isolate the cytoplasm from the external environment
Regulate the exchange of substances
Communicate with other cells
Identification
The Plasma Membrane is also called the Phospholipid bilayer.
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Phospholipids contain a hydrophilic head and a nonpolar hydrophobic tail.

Hydrogen bonds form between the phospholipid "heads" and the watery environment inside and
outside of the cell. Hydrophobic interactions force the "tails" to face inward Phospholipids are
not bonded to each other, which makes the double layer fluid.
The Plasma Membrane has four different types of molecules which are the Structural
components of the cell membrane. Some of those structural components are important to
maintain the transport system. (Phospholipid, protein and cholesterol) The membrane consists of
a phospholipid bilayer, and proteins inserted into it such as receptors or channels. There are other
things in the membrane, like cholesterol but it is a minor component.
Phospholipids
Phospholipids make up the basic structure of a cell membrane. A single phospholipid molecule
has two different ends, a head and a tail. The head end contains a phosphate group and
is hydrophilic. This means that is likes or is attracted to water molecules.
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The tail end is made up of two strings of hydrogen and carbon atoms called fatty acid chains.
These chains are hydrophobic or do not like to mingle with water molecules.
For the most part, the phospholipid membrane functions to keep the cell separate from its outer
environment. This membrane is semi-permeable, allowing for only certain substances to enter or
leave the cell. Much of the phospholipid membranes functioning is owed to the membranes
permeability and its ability to move fluently. The arrangement of water-loving heads
(hydrophilic) and water-hating (hydrophobic) tails of the lipid bilayer prevent such things as
amino acids, carbohydrates, nucleic acids, and proteins from moving across the membrane by
diffusion. Proteins present in the phophoslipid molecule also help to regulate what goes in and
out of the cell. However, the membrane usually allows for the passive diffusion of certain other
molecules. Because the phospholipids form a bilayer, the hydrophilic and hydrophobic layers
line up together facing the same way, making the membrane barrier. The lipid bilayer is usually
held together by no covalent bonds, helping to prevent adjacent molecules from sticking to each
other
Proteins
Some plasma membrane proteins are located in the lipid bilayer and are called integral proteins.
Other proteins, called peripheral proteins, are outside of the lipid bilayer. Peripheral proteins
can be found on either side of the lipid bilayer: inside the cell or outside the cell.
Function of protein
Membrane proteins can function as enzymes to speed up chemical reactions, act as receptors
for specific molecules, or transport materials across the cell membrane. Proteins form
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transporters or channels, allowing substances to pass into and out of the cell. This can be
passively or actively (the Na/K ATPase pump)
Cholesterol
Cholesterol is actually a very important component of cell membranes. Cholesterol molecules

are made up of four rings of hydrogen and carbon atoms. They are hydrophobic and are found
among the hydrophobic tails in the lipid bilayer.
Function of cholesterol
Cholesterol molecules are important for maintaining the consistency of the cell membrane.
They strengthen the membrane by preventing some small molecules from crossing it.
Cholesterol molecules also keep the phospholipid tails from coming into contact and
solidifying. This ensures that the cell membrane stays fluid and flexible.
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b)
Figure 1.1
1. Simple diffusion
2. Increase the diffusion curve
3. D curve
4. No
5. B curve
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SCENARIO 03
TASK 03
The human body made out of four major body tissues, which are associated with the stomach for
its proper function as well as other organs in human body.
The stomach is a muscular organ located on the left side of the upper abdomen. The stomach
receives food from the esophagus. As food reaches the end of the esophagus, it enters the
stomach through a muscular valve called the lower esophageal sphincter.
The stomach secretes acid and enzymes that digest food. Ridges of muscle tissue called rugae
line the stomach. The stomach muscles contract periodically, churning food to enhance digestion.
The pyloric sphincter is a muscular valve that opens to allow food to pass from the stomach to
the small intestine
All organs are built of these four tissues, which have consistent characteristics and arrangements
from organ to organ.
1.
2.
3.
4.
Epithelial Tissue
Connective Tissue
Muscle Tissue
Nervous Tissue
Epithelial Tissue
Epithelial tissue consists of cells attached to one another to form an uninterrupted layer of cells
that separates the underlying tissues from the outside world. The body's epithelium not only
covers its obvious surfaces such as the epidermis of the skin and the linings of respiratory,
urinary, and digestive tracts but also extends into all of the complex invaginations which form
lungs, kidneys, sweat glands, digestive glands, liver.
Functions of Epithelial Tissue
Protection
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Epithelial cells from the skin protect underlying tissue from mechanical injury, harmful
chemicals, invading bacteria and from excessive loss of water.
Sensation
Sensory stimuli penetrate specialized epithelial cells. Specialized epithelial tissue containing
sensory nerve endings is found in the skin, eyes, ears, and nose and on the tongue.
Secretion
In glands, epithelial tissue is specialized to secrete specific chemical substances such as

enzymes, hormones and lubricating fluids.
Absorption
Certain epithelial cells lining the small intestine absorb nutrients from the digestion of food.
Excretion
Epithelial tissues in the kidney excrete waste products from the body and reabsorb needed
materials from the urine. Sweat is also excreted from the body by epithelial cells in the sweat
glands.
Diffusion
Simple epithelium promotes the diffusion of gases, liquids and nutrients. Because they form
such a thin lining, they are ideal for the diffusion of gases such as walls of capillaries and
lungs.
Cleaning
Ciliated epithelium assists in removing dust particles and foreign bodies which have entered
the air passages.
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Reduces Friction
The smooth, tightly-interlocking, epithelial cells that line the entire circulatory system reduce
friction between the blood and the walls of the blood vessels.
Connective Tissue
Connective tissue consists of several cell types and extracellular products which, together,
provide essential functions of mechanical reinforcement, immune surveillance,
transport/diffusion of nutrients and wastes, and energy storage (fat). Embryonically, connective
tissues derive from mesoderm or mesenchyme.
(Anon., n.d.)
Functions of Connective Tissue
The primary functions of epithelial tissues are
To protect the tissues that lie beneath it from radiation, desiccation, toxins, invasion by
pathogens, and physical trauma.
The regulation and exchange of chemicals between the underlying tissues and a body
cavity.
The secretion of hormones into the blood vascular system, and/or the secretion of sweat,
mucus, enzymes, and other products that are delivered by ducts.
To provide sensation.
Nervous Tissue
Nervous tissue is responsible for rapid long-distance signalling, coordination, and thinking.
Nervous tissue consists of highly specialized nerve cells and support cells which are derived
from embryonic neuroectoderm and neural crest.
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Functions of Nerve Tissue
Nervous tissue allows an organism to sense stimuli in both the internal and external
environment.
The stimuli are analyzed and integrated to provide appropriate, co-ordinated responses in
various organs.
The afferent or sensory neurons conduct nerve impulses from the sense organs and
receptors to the central nervous system.
Internuncial or connector neurons supply the connection between the afferent and efferent
neurons as well as different parts of the central nervous system.
Efferent or somatic motor neurons transmit the impulse from the central nervous system
to a muscle (the effector organ) which then reacts to the initial stimulus.
Autonomic motor or efferent neurons transmit impulses to the involuntary muscles and
glands
Muscle Tissue
Muscle is specialized for gross movement by means of cellular contraction. Embryonically,

muscle derives from mesoderm or mesenchyme
Muscles are a fibrous group of tissues that provide contraction, allowing the body to move.
Muscles also function in many vital biological processes including the contraction of the heart,
the movement of food through the digestive system and the flow of blood through the blood
vessels. Three different types of muscle exist: skeletal, smooth and cardiac. Each type requires
cells to perform different function.
(Anon., n.d.)
Functions of muscle tissue
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Movement
Skeletal muscles produce movement, maintain posture and generate body heat. Muscle cells,
called myocytes, contain myofibrils. Myofibril is a bundle of filaments that connects one end of
the cell to the other. In skeletal muscle cells these myofibrils allow the muscle to contract.
Skeletal muscle cells also function to convert glucose, the simple sugar created from the
breakdown of foods, into adenosine triphosphate, or ATP. ATP is the body's main source of
energy. Although skeletal muscle cells can store small amounts of ATP, physical activity often
requires more. To do this, the protein in muscle cells called myoglobin binds oxygen. It then
mixes with glucose to produce carbon dioxide---a waste product expelled by the lungs, water,
heat and ATP
Skeletal muscle cells differ from the smooth or cardiac muscle cells in that they only contract
when stimulated by the nervous system. This allows the skeletal muscles to perform voluntary
movement.
Cardiac Muscle Cells Pump the Heart
The heart contains specialized myocytes known as cardiac muscle cells. Cardiac muscle cells
contract without neural stimulation. A group of specialized cells, known as the sinus node, found
in the upper right chamber of the heart---right atrium---produce electrical impulses. These
impulses stimulate cardiac muscle cell contraction. Although each cardiac myocyte can contract
individually, the formation of intercalated discs---the spaces formed where the cell membranes
connect, allows cardiac cells to contract in unison. The American Heart Association reports that
the average human heart contracts 100,000 times per day. Cardiac muscle cells also function to
exchange ions such as sodium, potassium and calcium, which regulate the strength and duration
of the contractions
(Anon., 2013)
(Anon., n.d.)
26
SECTION B
SCENARIO 01
TASK 01
Mechanism of Skeletal Muscle Contraction

There are so many theories about mechanism of muscle contraction.
The sliding filament theory is the accepted theory for the basic mechanism of muscle
contraction.
A.F. Huxley and Niedergerke (1954), and H.E. Huxley and Hanson (1954) are the founders of
the theory. Their classical experiments are shown in Figures 01 and 02,
Figure 01
figure 02
Fig. 01 shows a living frog muscle fiber under the interference microscope. A bands appear dark,
I bands are light. The length of the sarcomeres, A and I bands were measured on densitometer
tracings. The fiber was stimulated electrically and it was allowed to shorten. On the left side for
each frame two numbers are given. The upper numbers indicate the sarcomere length, which in
successive times during contraction decreased from 3.10 to 2.93 to 2.70 to 2.37m . The lower
27
numbers indicate A band length, 1.43, 1.45, 1.50, and 1.48 m , that means, it was unchanged
during contraction.
Fig. ME2 shows the pictures of glycerol extracted psoas fibrils under phase contrast microscope.
A bands are dark, I bands are light, in the middle of I bands the Z lines are seen. Four sarcomeres
of one fibril are pictured during ATP induced contraction. A bands did not change in length, but
the I bands shortened, in the last frame the I bands disappeared.
(fig 2 = me 2 Changes in sarcomere length and in I band length during contraction of a glycerolextracted fibril contracted by ATP)
Further experimentation revealed that during contraction the length of the actin containing thin
filaments and the length of the myosin containing thick filaments remain constant. Thus, during
contraction the length of the sarcomere and I band decrease, the overlap between thick and thin
filaments increases, the length of the thick and thin filaments remains unchanged. Consequently,
the filaments must slide past each other.
Length-tension relationship: The physiological interpretation of the sliding filament theory was
tested by measuring the tension of a single muscle fiber at different sarcomere length Maximum
tension was obtained at rest length, between 2.0-2.25 m , when all crossbridges were in the
overlap region between thick and thin filaments. When the muscle fiber was stretched so that the
sarcomere length increased from 2.25 to 3.675 m and consequently the number of crossbridges in
the overlap region decreased from maximum to zero, the tension fell from 100% to 0.
The crossbridges are uniformly distributed along the thick filaments with the exception of a short
bare zone in the middle. The crossbridges seem to be identical and are the site of the interaction
between thick and thin filaments. The tension is the algebraic sum of the tension produced at
each individual site. At or above rest length the tension is directly proportional to the number of
crossbridges in the overlap region between thick and thin filaments.
28
Below rest length, when the thin filaments meet in the center of A band or they start to interact
with the oppositely directed crossbridge sites past the bare zone (in the middle of the sarcomere),
tension drops off.
(fig 3 =
me 3 Length-tension relationship of a single frog semitendinosusmuscle fiber. (From Gordon et
al., 1966). The numbers 1 through 6 on the length tension curve correspond to the numbers on
the schematic diagram of thick and thin filament arrangement. In this way the relationship
between thick and thin filaments can be compared to the tension at various sarcomere length.)
Crossbridge cycle and its relation to actomyosin ATPase: A scheme for the coupling of ATP
hydrolysis to the crossbridge cycle is shown in Fig. ME4. The following major steps are
involved:
1. ATP dissociates actomyosin into actin and myosin; i.e. the thick filaments will be
detached from the thin filaments. ATP binds to the myosin head in the thick filaments.
2. ATP is hydrolyzed by myosin; the products ADP and Pi are bound to myosin. The energy
released by the splitting of ATP is stored in the myosin molecule. The
myosin.ADP.Pi complex is a high-energy state; this is the predominant state at rest.
3. Upon muscle stimulation, the inhibition of actin-myosin interaction, imposed by the
regulatory proteins, is lifted and consequently the myosin with bound ADP and
Pi attaches to actin. It is believed that the angle of crossbridge attachment is 90o.
29
4. The actin-myosin interaction triggers the sequential release of Pi and ADP from the
myosin head, resulting in the working stroke. It is thought that the energy stored in the
myosin molecule brings about a conformational change in the crossbridge tilting the
angle from 90oto 45o. This tilting pulls the actin filament about 10 nm toward the center
of the sarcomere, while the energy stored in myosin is utilized.
With a new ATP a new cycle may begin and the cycling may continue till the regulatory
mechanism stops the interaction of actin and myosin. As shown in Fig. ME4, ATP is needed for
step 1 that is for the detachment of myosin from actin. In case of ATP depletion, the cycle is
arrested. When actin and myosin are permanently bound in the absence of ATP, the muscle
becomes rigid. This state is called rigor mortis.
fig 4 Crossbridge cycle

and its relation to actomyosin ATPase.
Summary of Events in Skeletal Muscle Contraction in human body
Excitation
The sarcolemma is depolarized and the action potential propagates
The action potential spreads inside along the T-tubules
The signal is transmitted from T-tubule to terminal sacs of sarcoplasmic reticulum
Calcium is released from sarcoplasmic reticulum into sarcoplasm
30
Contraction
Calcium binds to troponin
Cooperative conformational changes take place in troponin-tropomyosin system
The inhibition of actin and myosin interaction is released
Crossbridges of myosin filaments are attached to actin filaments
Tension is exerted, and/or the muscle shortens by the sliding filament mechanism
Relaxation
Calcium is pumped into sarcoplasmic reticulum
Crossbridges are detached from the thin filaments
Troponin-tropomyosin regulated inhibition of actin and myosin interaction is restored
Active tension disappears and the rest length is restored.
Lactate is the new drug which inhibit the muscle contraction. Lets take it as DRUG X
discusses whether accumulation of DRUG X, is a major cause of skeletal muscle fatigue, decline
of muscle force or power output leading to impaired exercise performance.
There exists a long history of studies on the effects of increased DRUG X concentrations in
muscle or plasma on contractile performance of skeletal muscle.
Evidence suggesting that DRUG X is a culprit has been based on correlation-type studies, which
reveal close temporal relationships between intramuscular DRUG X accumulation and the
decline of force during fatiguing stimulation in human muscle.
31
In addition, an induced acidosis can impair muscle contractility in non-fatigued humans or in

isolated muscle preparations, and several mechanisms to explain such effects have been
provided.
these findings mainly involved diminished negative effects of an induced acidosis in skinned or
intact muscle fibres, at higher more physiological experimental temperatures.
Perhaps more remarkably, there are now several reports of protective effects of lactate exposure
or induced acidosis on potassium-depressed muscle contractions in isolated rodent muscles.
In addition, DRUG X exposure can attenuate severe fatigue in rat muscle stimulated in situ, and
sodium lactate ingestion can increase time to exhaustion during sprinting in humans.
Taken together, these latest findings have led to the idea that DRUG X is ergogenic during
exercise.
32
SCENARIO 02
TASK 02
a)
Homeostatic
Homeostasis is the tendency of an organism or cell to regulate its internal environment and
maintain equilibrium, usually by a system of feedback controls, so as to stabilize health and
functioning.
Generally, the body is in homeostasis when its needs are met and its functioning properly.
Almost all homeostatic control mechanisms are negative feedback mechanisms. These
mechanisms change the variable back to its original state or ideal value.
There are two feedback mechanisms, negative feedback and positive feedback.
Negative feedback mechanisms
Almost all homeostatic control mechanisms are negative feedback mechanisms. These
mechanisms change the variable back to its original state or ideal value.
A good example of a negative feedback mechanism is a home thermostat.

The control of blood sugar by insulin is another good example of a negative feedback
mechanism.
When blood sugar rises, receptors in the body sense a change. In turn, the pancreas secretes
insulin into the blood effectively lowering blood sugar levels. Once blood sugar levels reach
homeostasis, the pancreas stops releasing insulin.
Lets consider how the body controls the blood glucose level with neural and endocrine system.
Positive feedback mechanisms
a positive feedback mechanism is the exact opposite of a negative feedback mechanism. With
negative feedback, the output reduces the original effect of the stimulus. In a positive feedback
system, the output enhances the original stimulus. A good example of a positive feedback system
33
is child birth. During labor, a hormone called oxytocin is released that intensifies and speeds up
contractions. The increase in contractions causes more oxytocin to be released and the cycle goes
on until the baby is born.
Homeostatic control
the endocrine system works alongside of the nervous system to form the control systems of the
body. The nervous system provides a very fast and narrowly targeted system to turn on specific
glands and muscles throughout the body. The endocrine system, on the other hand, is much
slower acting, but has very widespread, long lasting, and powerful effects. Hormones are
distributed by glands through the bloodstream to the entire body, affecting any cell with a
receptor for a particular hormone. Most hormones affect cells in several organs or throughout the
entire body, leading to many diverse and powerful responses.
The levels of hormones in the body can be regulated by several factors. The nervous system can
control hormone levels through the action of the hypothalamus and its releasing and inhibiting
hormones.
(Taylor, n.d.)
.To maintains homeostasis, communication within the body is essential.

1.
Stimulus- produces a change to a variable (the factor being regulated).
2.
Receptor- detects the change. The receptor monitors the environment and responds to
change (stimuli).
3.
Input- information travels along the (afferent) pathway to the control center. The control
center determines the appropriate response and course of action.
4.
Output- information sent from the control center travels down the (efferent) pathway to
the effector.
5.
Response- a response from the effector balances out the original stimulus to maintain
homeostasis.
34
Nervous system
Nervous system that conducts stimuli from sensory receptors to the brain and spinal cord and
that conducts impulses back to other parts of the body, the human nervous system has two main
parts the central nervous system and the peripheral nervous system.
The peripheral nervous system is the part of the nervous system that consists of the nerves
and ganglia outside of the brain and spinal cord
The peripheral nervous system is subdivided into the
sensory-somatic nervous system and the
autonomic nervous system
Autonomic nervous system

35
Autonomic nervous system controls blood pressure, heart and breathing rates, body temperature,
blood glucose, digestion, the balance of water and electrolytes, the production of body fluids,
urination, defecation, sexual response, and other processes.
Many organs are controlled primarily by either the sympathetic or the parasympathetic division.
Sometimes the two divisions have opposite effects on the same organ.
Generally, the sympathetic division prepares the body for stressful or emergency situations
fight or flight.
The parasympathetic division controls body process during ordinary situations. Generally, it
conserves and restores. It slows the heart rate and decreases blood pressure. It stimulates the
digestive tract to process food and eliminate wastes. Energy from the processed food is used to
restore and build tissues.
Both the sympathetic and parasympathetic divisions are involved in sexual activity, as are the
parts of the nervous system that control voluntary actions and transmit sensation from the skin
36
Endocrine regulation of glucose homeostasis

All cells in the body are capable of using glucose as an energy source by the process of
glycolysis. Most cells can also use fatty acids with two important exceptions
1. Neurons (particularly the CNS), although they can adapt to use ketone bodies
2. Blood cells.
If blood glucose levels drop too low, its called hypoglycaemia, then the brain is starved of
energy.
If levels rise too high its called hyperglycaemia then glucose can become toxic. Blood glucose is
tightly controlled within narrow limits to prevent either scenario.
Fasting glucose levels are normally 3.55.5 mmol/L.
37
For glucose levels to be maintained, the body must be able to increase or decrease these levels in
response to changes. There are a number of ways that the body can respond.
The liver is especially important in raising blood glucose.
Glucose homeostasis is maintained by the interplay between insulin and glucagon. These two
hormones act as antagonists of each other because they are secreted under opposing conditions
1. insulin
Insulin lowers blood glucose by stimulating uptake, metabolism and anabolism. It also inhibits
the actions of glucagon.
2. glucagon
Glucagon raises blood glucose by stimulating gluconeogenesis and glycogenolysis. It also
inhibits the actions of insulin but stimulates insulin secretion.
Insulin is the only hormone that lowers blood glucose levels but a number of hormones,
including glucagon and adrenaline (epinephrine), can raise them.
Other hormones are involving controlled to blood glucose level,
Three non-pancreatic hormones also significantly increase blood glucose
1. Adrenaline released in response to stress; it inhibits insulin.
2. Cortisol released in response to stress; it reduces sensitivity to insulin, which explains

the diabetes seen in Cushings patients.
38
3. Growth hormone released at night; it reduces sensitivity to insulin.

All three hormones can stimulate glycogenolysis and gluconeogenesis to raise blood glucose
levels directly. Neural signals and other hormones can cause less significant rises in blood
glucose.
Hyperglycaemia
Hyperglycaemia is an excess of glucose in the blood, it is defined as a fasting concentrations>7.8
mmol/L.
This can occur in
Diabetes mellitus a common disease caused by insulin deficiency or insulin resistance
Glucagonoma a very rare tumour of cells that secrete glucagon.

Hypoglycaemia
Hypoglycaemia is a deficiency of blood glucose defined as a concentration <2.5 mmol/L.

This can occur in
Taking oral hypoglycaemics or too much insulin
Alcohol (binge or heavy drinking). This is very important to remember when assessing
someone who you think is drunk, as hypoglycaemia can mimic drunkenness as well as be
caused by it
Certain medications, (quinine, salicylates or propranolol)
Inappropriate levels of exercise or food intake. Type 1 diabetics control their blood
glucose by balancing insulin dosage, food intake and energy expended through exercise
39
Rare cases include liver, kidney, pancreas or thyroid disease. Another cause is advanced
insulin-secreting tumours elsewhere in the body.
Neural regulation of glucose homeostasis

The regulation of blood glucose is generally stated to be under the control of the endocrine
system.
But the endocrine secretion is itself regulated by the central nervous system, especially the
hypothalamus.
The brain can sense the energy status of the body by using neural afferent signals and metabolic
cues such as glucose.
A variety of experimental evidences have been put forth to support the postulate that there are
glucoreceptors, sensitive to blood glucose and glucose utilization, in the hypothalamus.
Gastrointestinal afferents, which carry information about the energy intake, reach the
hypothalamic regions and interact with the glucose sensitive mechanisms.
Available evidence suggests that obesity and decreased body weight, resulting from lesions of
the hypothalamic 'satiety' and 'feeding' centres respectively, are not only due to altered food
intake, but also to derangement in glucose homeostasis.
The medial preoptic area does the fine tuning of energy balance (regulation of food intake) in
response to alterations in the temperature, locomotor activity and sleep wakefulness.
Thus the hypothalamus regulates energy balance through its control of energy intake on the one
hand, and its expenditure and storage on the other.
Neuroendocrine system and autonomic nervous system deal with storage and expenditure of
energy.
40
41
b)
Endocrine system includes all of the glands of the body and the hormones produced by those
glands. The glands are controlled directly by stimulation from the nervous system as well as by
chemical receptors in the blood and hormones produced by other glands. By regulating the
functions of organs in the body, these glands help to maintain the bodys homeostasis. Cellular
metabolism, reproduction, sexual development, sugar and mineral homeostasis, heart rate, and
digestion are among the the many processes regulated by the actions of hormones
Complications can arise if positive and negative feedback loops are affected or altered in any
way, leading to homeostatic imbalance.
Many diseases are a result of homeostatic imbalance or an inability of the body to restore a
functional and stable internal environment.
Aging is a source of homeostatic imbalance as the control mechanisms of the feedback loops lose
their efficiency.
Diseases that result from a homeostatic imbalance include diabetes, dehydration, hypoglycemia,
hyperglycemia, gout, and any disease resulting from bloodstream toxins.
42
Diabetes occurs when the control mechanism for insulin becomes imbalanced either because
insulin is deficient or the cells have become resistant to insulin. Insulin is produced by endocrine
system.
Homeostasis is the property of a system that regulates its internal environment, maintaining a
stable, relatively constant set of properties such as temperature or pH, in which the body's internal
environment is kept stable and functional.
List of endocrine diseases
Adrenal disorders
Glucose homeostasis disorders
Thyroid disorders
Calcium homeostasis disorders and Metabolic bone disease
Pituitary gland disorders
The hypothalamus is a gland in the brain which is responsible for regulating certain metabolic
processes or maintaining the body's status quo. Without the hypothalamus there would be no link
between the nervous system and the endocrine system as the hypothalamus "tells" other organs,
such as the pituitary gland, what to secrete and when to do it.
The pituitary gland is a small gland in the brain that is about the size of a pea. For such a small
gland, it is responsible for producing most of the important hormones that the body
manufactures. The hormones that are secreted from the pituitary gland are a vital part of normal
body function and include controlling functions such as emotions, sexual functions, controlling
body temperature, hunger and thirst.
43
Diabetes
With diabetes, one of the first symptoms people will have is excessive thirst. This indicates that
the pituitary gland is working overtime to keep up with the demand of Blood glucose. The
thyroid gland is a gland located in the lower part of the neck and it produces a hormone called
thyroxin. Thyroxin regulates the metabolism and is important to healthy bone growth and aids in
the development of the brain and nervous system.
Endocrine system keeps the body's hormone and secretion levels in balance. Since there is a
whole series of organs and glands that must work in tandem to maintain healthy hormone and
secretion levels, when one of them doesn't function the way it's supposed to function, it puts a
heavy strain on the rest of the body.
This is what happens when the Pancreas stops producing Insulin and a person gets Type 1
diabetes. Type 1 diabetes is an autoimmune disorder where some other part of the body's immune
system attacks pancreatic cells, preventing them from producing insulin. Any one of these
delicate systems can be the culprit in pushing the body's system out of balance.
Taking insulin as a treatment for Type 1 diabetes is just part of the solution to this disorder. If one
of the glands or organs is still stressed due to overworking or not getting what it needs, daily
insulin levels will fluctuate, making it harder to control Type 1 diabetes.
The goal for the person with Type 1 diabetes is to take control of their disorder and maintaining
healthy glucose levels. But to understand the delicate balance of the endocrine system and how
the diabetic can achieve this goal, it helps to explore the function of each organ and gland.
Glands included in the endocrine system include the hypothalamus, pituitary gland, thyroid,
parathyroid, adrenal glands, pineal body and reproductive glands which include the ovaries and
the testes. Each one of these systems has a function to help the body stay in balance.
44
45
SECTION C
SCENARIO 01
TASK 01
a)
Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In
some infants, it can be life-threatening.
HDN may develop when a mother and her unborn baby have different blood types called
incompatibility. The mother produces substances called antibodies that attack the developing
baby's red blood cells.
The most common form of HDN is ABO incompatibility, which is usually not very severe.
Other, less common types may cause more severe problems.
Rh incompatibility is a condition that develops when a pregnant woman has Rh-negative blood
and the baby in her womb has Rh-positive blood.
Rh-negative and Rh-positive refer to whether the blood has Rh factor. Rh factor is a protein on
red blood cells. If you have Rh factor, you're Rh-positive. If you don't have it, you're Rhnegative. Rh factor is inherited. Most people are Rh-positive.
Whether you have Rh factor doesn't affect your general health. However, it can cause problems
during pregnancy.
When mother is pregnant, blood from baby can cross into mothers bloodstream, especially
during delivery. If mother is Rh-negative and baby is Rh-positive, mothers body will react to the
baby's blood as a foreign substance.
Mothers body will create antibodies (proteins) against the baby's Rh-positive blood. These
antibodies usually don't cause problems during a first pregnancy. This is because the baby often
is born before many of the antibodies develop.
46
However, the antibodies stay in mothers body once they have formed. Thus, Rh incompatibility
is more likely to cause problems in second pregnancies (if the baby is Rh-positive).
The Rh antibodies can cross the placenta and attack the 2nd baby's red blood cells. This can lead
to hemolytic anemia in the 2nd baby.
Hemolytic anemia is a condition in which red blood cells are destroyed faster than the body can
replace them. Red blood cells carry oxygen to all parts of the body.
Without enough red blood cells, 2nd baby won't get enough oxygen. This can lead to serious
problems. Severe hemolytic anemia may even be fatal to the child.
47
b)
Function of red blood cells
Red blood cells (RBCs) have several important roles to play in our bodies.
1. The primary function of red blood cells is to carry oxygen from the lungs to the tissues
around the body.
2. As a secondary function, they are also a key player in getting waste carbon dioxide from
tissues to lungs, where it can be breathed out. When red blood cells stop functioning
properly,
In order to properly understand the function of a red blood cell, have to understand something
about the structure.
A typical RBC is about 6-8 micrometers in diameter, about the same as the width of a spider web
strand. An RBC is biconcave in shape.
This small shape and physical structure allows the RBC to squish in to the small capillaries
where the blood vessels are the smallest. Without this ability to flex, they would easily get stuck
and cause obstructions in the circulation.
1. Carry oxygen from the lungs to the tissues around the body.
The oxygen carried in red blood cells is stored in a special protein known as hemoglobin.
There are several different types of hemoglobin and the exact structure of this important protein
is quite complicated, so this explanation will be something of a gross oversimplification.
A single hemoglobin molecule is made of four identical sub-units. Each sub-unit has a heme
component, aglobin chain and an iron atom bound to the heme section.
Oxygen is able to bind to each of the iron atoms, meaning that a single hemoglobin molecule is
able to carry up to four oxygen molecules at its maximum capacity.
The ability of oxygen to bind to hemoglobin is effected by many factors.
The acidity of the blood (pH) is a primary factor, as is the temperature.

Fetal blood has a different ability to bind oxygen (it holds on to the oxygen more tightly).
48
Other chemicals such as hydrogen sulfide, carbon monoxide, hydrogen sulfide and
2,3bisphosphoglycerate also effect the ability of hemoglobin to carry oxygen.
Factors in binding such as pH and temperature are vital to hemoglobin function. red blood cells
need to grab on to oxygen in the lungs and let go of it in the tissues. Subtle changes in the pH
and temperature of blood allow the hemoglobin molecules to catch and release oxygen at the
proper times.
A huge amount of space in a red blood cell is taken up by hemoglobin. Well over 90% of the
content of an RBC that is not water, is hemoglobin.
2. getting waste carbon dioxide from tissues to lungs
The second important function, just as important as carrying oxygen although less commonly
known, is the ability of red blood cells to carry carbon dioxide.
CO2 is a waste product of metabolism in every cell in your body. cells need some way of getting
rid of it all the time, or cells will die rather quickly.
Red blood cells serve as the vehicle to rid body of this waste.
The process by which red blood cells transport carbon dioxide is different than oxygen transport.
RBCs contain an enzyme called carbonic anhydrase. As the CO2 enters the RBC, this enzyme,
with the help of some water, converts it into another chemical called bicarbonate.
Bicarbonate is used to control the pH in blood and it later excreted either via lungs or kidneys.
Some CO2 is dissolved in blood directly and a small amount is actually carried on the
hemoglobin molecules, but the vast majority is converted to bicarbonate.
Because red blood cells are so important to body, when they don't work properly, it often leads to
disease. Although there are literally dozens of diseases related to your blood.
49
SCENARIO 02
TASK 02
a)
Figure 1.1
A = ventricular filling phase
B = closes of the mitral valve
C = isometric contraction
D = opening of the aortic valve
E = Aortic and ventricular systolic pressure
F = closure of the aortic valve
G = isometric relaxation
H = opening of the mitral valve
I = arterial contraction
b)
50
Figure 1.2
1 = opening of the mitral valve
2 = ventricular filling phase
3 = arterial contraction
4 = closes of the mitral valve
5 = isometric contraction
6 = opening of the aortic valve
7 = aortic and ventricular systolic pressure
8 = closure of the aortic valve
9 = isometric relaxation
51
c)
Heart is a muscular organ about the size of a fist,
Heart is located just behind and slightly left of the breastbone. The heart pumps blood through
the network of arteries and veins called the cardiovascular system.
The heart has four chambers

The right atrium receives blood from the veins and pumps it to the right ventricle.
The right ventricle receives blood from the right atrium and pumps it to the lungs, where it is
loaded with oxygen.
The left atrium receives oxygenated blood from the lungs and pumps it to the left ventricle.
The left ventricle (the strongest chamber) pumps oxygen-rich blood to the rest of the body. The
left ventricles vigorous contractions create our blood pressure.
52
Circulation of blood over the human body
The human circulatory system functions to transport blood and oxygen from the lungs to the
various tissues of the body.
The heart pumps the blood throughout the body.
The components of the human circulatory system include the heart, blood, red and white blood
cells, platelets, and the lymphatic system.
53
It contains four chambers, two atria and two ventricles.

Oxygen-poor blood enters the right atrium through a major vein called the vena cava.
The blood passes through the tricuspid valve into the right ventricle.
Next, the blood is pumped through the pulmonary artery to the lungs for gas exchange.
Oxygen-rich blood returns to the left atrium via the pulmonary vein.
The oxygen-rich blood flows through the bicuspid (mitral) valve into the left ventricle, from
which it is pumped through a major artery, the aorta.
Two valves called semilunar valves are found in the pulmonary artery and aorta.
The ventricles contract about 70 times per minute, which represents a person's pulse rate.
Blood pressure, in contrast, is the pressure exerted against the walls of the arteries.
A normal blood pressure is a height of 120 millimeters of mercury during heart contraction
( systole), and a height of 80 millimeters of mercury during heart relaxation ( diastole).
Normal blood pressure is usually expressed as 120 over 80.
Coronary arteries supply the heart muscle with blood.
The heart is controlled by nerves that originate on the right side in the upper region of the atrium
at the sinoatrial node.
Blood is the medium of transport in the body. The fluid portion of the blood, the plasma, is a
straw-colored liquid composed primarily of water. All the important nutrients, the hormones, and
the clotting proteins as well as the waste products are transported in the plasma.
Red blood cells and white blood cells are also suspended in the plasma. Plasma from which the
clotting proteins have been removed is serum.
54
d)
Function of heart
The pump action performed by the heart is achieved by a sequence of alternating contraction and
relaxation of the heart muscle. In systole refers to the contraction part of the sequence and the
diastole to the relaxation part of the sequence. Hence, the "systolic" and "diastolic" pressures
may be measured and recorded separately when monitoring blood pressure.
This process is directed by the nervous system, nerve impluses initiating each sequence.
The whole series of actions that cause alternating contractions and relaxations may be
summarized in five steps below,
1. The vagus nerve stimulates the Sino atrial node (SAN), the pacemaker of the heart.
The Sino atrial node (SAN) is a tiny area of specialized cardiac muscle in the upper wall
of the right atrium, near the vena cava. The fibres of the SAN contract rhythmically
approx. 70 times each minute. After each of these contractions, the impluse is dispersed
across the atrial cardiac muscle.
2. Simultaneous contraction of both the right and left atria. This movement of the cardiac
muscle pushes blood from the atria into the ventricles (via the tricuspid and bicuspid
valves).
55
3. The contractions of the atria send impulses down the Purkinje fibers, which in turn
stimulate the atrioventricular node (AVN). The atrioventricular node is a mass of
modified cardiac muscle located in the lower/central part of the right atrium of the heart.
Purkynje Fibres, and as the Bundle. These are a bundle of modified cardiac muscle fibers
that transmit impulses from the atria, via the AVN, to the ventricles.
4. The action potential from the impulse transmitted down the Purkinje fibers reaches the
right and left branches of the Purkinje fibres.
5. The ventricles to contract, which pushes blood upwards into the arteries that take
the blood away from the heart and the pulmonary artery taking blood to the lungs, and the
aorta taking blood to the body
56
SCENARIO 3
Task 03
a)
1. Systemic vasodilatation = yes
2. Venous occlusion = no
b)
Vasodilatation is to the widening of blood vessels. It results from relaxation of smooth
muscle cells within the vessel walls, in particular in the large veins, large arteries, and
smaller arterioles. In essence, the process is the opposite of vasoconstriction, which is the
narrowing of blood vessels.
When blood vessels dilate, the flow of blood is increased due to a decrease in vascular resistance.
Therefore, dilation of arterial blood vessels decreases blood pressure. The response may be
intrinsic or extrinsic. In addition, the response may be localized to a specific organ, or it may be
systemic.
Venous occlusion describes a condition in which the vein coming from the arm into the chest
becomes narrowed, blocked or pinched.
It is usually seen in people who use their arms in repetitive tasks, such as swimming or house
painting.
The overuse of the muscles results in thickening that can pinch the vein where it enters the body
from the arm, just above the first rib.
Reduced flow of blood from the arm is usually acute, causing pain, swelling, or discoloration of
the arm. It requires immediate medical attention to restore proper blood flow.
Cardiac output is calculated in this equation:
Cardiac output = Heart rate x Stroke Volume
57
Heart rate is the number of beats your heart cycles in one minute.
Stroke Volume is the amount of blood pumped with each contraction.
Blood pressure is a measure of the force exerted on arterial walls, and total peripheral resistance
is the friction blood experiences when traveling through blood vessels.
If heart rate or stroke volume were to increase, or decrease, the cardiac output would also
increase or decrease.
Moving on to BP. If cardiac output increased, there is a resultant increase in the amount of blood
being ejected from the heart which would cause an increase in BP.
If cardiac output falls, so does the BP. Total peripheral resistance can be affected by
vasoconstriction, vasodilation, and plaque build up in the blood vessels.
When vasoconstriction occurs, BP increases due to increased friction and force exerted on the
arterial walls. When vasodilation occurs, the arteries widen, and the BP decreases.
58
SECTION D
SCENARIO 01
TASK 01
a)
The respiratory system is the system in the human body that enables to breathe.
The respiratory system is divided into two parts,
Upper respiratory tract,
Upper respiratory tract includes the nose, mouth, and the beginning of the trachea.
This section that takes air in and lets it out.
Lower respiratory tract,
Lower respiratory tract includes the trachea, the bronchi, bronchiole and the lungs
The act of breathing takes place in this part of the system.
The organs of the lower respiratory tract are located in the chest cavity. They are delineated and
protected by the ribcage, the chest bone (sternum), and the muscles between the ribs and the
diaphragm.
59
The act of breathing has two stages, inhaling and exhaling air in the body; the absorption of
oxygen from the air in order to produce energy; the discharge of carbon dioxide, which is the
byproduct of the process.
Inhalation the intake of air into the lungs through expansion of chest volume.
Exhalation the expulsion of air from the lungs through contraction of chest volume.
There are two major structural components of the respiratory system in maintaining effective
lung compliance
1.
Rib muscles = the muscles between the ribs in the chest.
2.
Diaphragm muscle
Muscle movement the diaphragm and rib muscles are constantly contracting and relaxing
(approximately 16 times per minute), thus causing the chest cavity to increase and decrease.
During inhalation
Contraction of the diaphragm muscle causes the diaphragm to flatten, thus enlarging the chest
cavity.
Contraction of the rib muscles causes the ribs to rise, thus increasing the chest volume
The chest cavity expands, thus reducing air pressure and causing air to be passively drawn into
the lungs. Air passes from the high pressure outside the lungs to the low pressure inside the
lungs.
60
During exhalation the muscles relax

The muscles are no longer contracting, they are relaxed.
The diaphragm curves and rises, the ribs descend and chest volume decreases.
The chest cavity contracts thus increasing air pressure and causing the air in the lungs to be
expelled through the upper respiratory tract. Exhalation, too, is passive. Air passes from the high
pressure in the lungs to the low pressure in the upper respiratory tract.
Inhalation and exhalation are involuntary and therefore their control requires an effort.
The other organs of the respiratory systems respectively given below.
The trachea the tube connecting the throat to the bronchi.
The bronchi the trachea divides into two bronchi (tubes). One leads to the left lung, the other to
the right lung. Inside the lungs each of the bronchi divides into smaller bronchi.
The broncheoli - the bronchi branches off into smaller tubes called broncheoli which end in the
pulmonary alveolus.
Pulmonary alveoli tiny sacs (air sacs) delineated by a single-layer membrane with blood
capillaries at the other end.
61
The exchange of gases takes place through the membrane of the pulmonary alveolus, which
always contains air oxygen is absorbed from the air into the blood capillaries and the action of
the heart circulates it through all the tissues in the body. At the same time, carbon dioxide is
transmitted from the blood capillaries into the alveoli and then expelled through the bronchi and
the upper respiratory tract.
The inner surface of the lungs where the exchange of gases takes place is very large, due to the
structure of the air sacs of the alveoli.
The lungs a pair of organs found in all vertebrates.
The structure of the lungs includes the bronchial tree air tubes branching off from the bronchi
into smaller and smaller air tubes, each one ending in a pulmonary
62
b)
Lung compliance is a measurement of the distensibility of the lung.
It is expressed as a change in volume divided by a change in pressure.
The standard units of Liters/cm H20.
The normal lung + thorax compliance of an adult is around 0.1 L/cm H20.
When the compliance is low, more pressure will be need to deliver a given volume of gas to a
patient.
Disease states resulting in low compliance include the Adult Respiratory Distress Syndrome
(ARDS), pulmonary edema, pneumonectomy, pleural effusion, pulmonary fibrosis, and
pneumonia among others. Emphysema is a typical cause of increased lung compliance.
Airway Resistance
Resistance is the amount of pressure required to deliver a given flow of gas and is expressed in
terms of a change in pressure divided by flow.
The standard units of resistance are cm H20/L/second and the normal value for an adult is around
0.5 - 1.5 cm H20/L/sec while in states of disease this value may be 100.0 cm H20/L/sec or higher.
There really aren't any diseases characterized by decreased airway resistance since normal values
are so low but there are many disease states that result in increased airway resistance including
use of artificial airways, asthma, emphysema with airway collapse, mucus plugging, vocal cord
paralysis, and end obronchial obstruction either from tumors or foreign bodies.
Time Constant
the Time Constant of the lung (TC) is a concept borrowed from electrical engineering which
describes the phenomenon whereby a given percentage of a passively exhaled breath of air will
require a constant amount of time to be exhaled regardless of the starting volume given constant
lung mechanics.
63
That's quite a mouth-full of a definition but consider what determines how long it takes to exhale
a tidal breath passively. At the start of exhalation, the initial flow of gas out of the lung depends
upon the driving pressure (i.e. alveolar pressure - mouth pressure) and it depends on the airway
resistance. For any given volume of gas, the alveolar pressure at the start of exhalation is only
dependent upon the lung compliance. Mathematically, the time constant is defined as compliance
multiplied by the airway resistance and the resulting value has units of seconds of time..
Airway Pressure & Alveolar Pressure
Airway pressure is the pressure measured at the patient's airway during mechanical ventilation.
Airway pressure is determined by the sum of the alveolar pressure and the pressure required to
deliver flow across the airways which is determined by the airway resistance. Alveolar pressure
is the pressure in the distensible parts of the respiratory tract and is determined by the tidal
volume and the lung/chest compliance.
Airway pressure is equal to alveolar pressure when there is no flow occurring. At the end of a
mechanical inspiration, flow to the distal parts of the lung continues even after inspiratory flow
from the ventilator stops as time is required for gas to reach the periphery of the lung.
To measure alveolar pressure, one must measure the airway pressure at a time when both
pressures are equal, i.e. when there is no flow. Measuring Compliance To measure lung
compliance one must know the delivered tidal volume and must also know the change in alveolar
pressure that results from the addition of that known tidal volume. We normally assume that
alveolar and airway pressure start out at atmospheric (our zero reference) before an inspiration
starts. To equalize airway and alveolar pressures we only have to prevent exhalation after
inspiration has ceased by utilizing an inspiratory hold maneuver. The actual calculation is to
divide the delivered tidal volume by the plateau pressure where the plateau pressure is the
steady-state pressure measured during an inspiratory hold maneuver. If precise measurement is
necessary then the pressure should be the plateau pressure minus any end expiratory pressure (or
the pleural pressure or Auto-PEEP if it is available) and the volume should be either measured at
the airway itself or should be corrected for compressible volume loss. In most cases, approximate
values are adequate for clinical use so the plateau pressure minus the end expiratory pressure is
divided into the exhaled tidal volume as measured by the ventilator. This compliance
64
measurement is sometimes called the static compliance since it is measured after an inspiratory
hold such that there is no gas flow during its measurement.
Measuring Resistance
Airway resistance can be estimated by dividing the difference between peak and plateau airway
pressures by the mean inspiratory flow rate. Some ventilators have an inspiratory flow rate
setting such that you can read the control for an estimate of delivered flow rate while others give
an inspiratory time setting where you have to divide the tidal volume by the inspiratory time to
determine the inspiratory flow rate. An alternative way of following airway resistance is to
calculate a nonsense parameter known as the dynamic compliance . The dynamic compliance is
the result of dividing the delivered tidal volume by the peak airway pressure. Since peak airway
pressure is determined by a combination of the lung compliance, the airway resistance,
inspiratory flow rate, and the tidal volume, this value does not really give a quantitative estimate
of airway resistance itself but can be used to detect changes in the airway resistance if all other
factors are held constant. This makes the value useful for comparing measurements on a single
patient over a short period of time but it is too much to ask to expect that all of the other
variables affecting peak airway pressure will stay the same from day to day or certainly from
patient to patient. Because of the limitations of dynamic compliance measurements, it makes
more sense to just follow the peak pressure to plateau pressure gradient since it requires less
math and is just as useful (or useless) as the dynamic compliance calculation. A third way to
estimate airway resistance can be used if the patient is exhaling passively. This method works
based on the time constant. The practitioner times how long it takes for the patient to exhale
completely and then divides this result by 3 to estimate the time constant. The lung compliance is
then measured and divided into the time constant to result in the airway resistance thus: Raw =
Time Constant / Clung
Auto PEEP
Auto PEEP is the popular name used to describe increased alveolar pressure caused by gas
trapping during mechanical ventilation. Gas trapping occurs when there is inadequate time to
exhale the mechanical tidal volume. Recall that the time constant determines the length of time
needed for a passive exhalation and that the time constant is the product of airway resistance and
65
lung compliance. The lower the compliance, the higher the driving pressure pushing gas out of
the lungs during exhalation; the lower the resistance, the higher the expiratory flow rate can be
when driven by the alveolar pressure. If the time constant is known (or can be estimated) then the
maximum mechanical respiratory rate that can be used before Auto PEEP results can be
estimated. Consider that at least 3 time constants are required to exhale passively any volume of
gas. The combination of inspiratory and expiratory time leads to a give respiratory rate such
that:
Total Breath Time = Insp time + Exp time
Respiratory Rate = 60 / Total Breath Time
Maximum Rate = 60 / (Insp time + 3 x TC)
A patient with a compliance of 0.05 L/cm H20 and an airway resistance of 30 cm H20/L/sec.
This would give a time constant of 1.5 seconds. A complete exhalation would take around 4.5
seconds. If inspiratory time is 1 second then total breath time is 5.5 seconds and the maximum
respiratory rate without gas trapping would be 11 breaths per minute. When gas trapping occurs,
the functional residual capacity (FRC) is increased. As the FRC increases, the alveolar pressure
increases by an amount of pressure determined by the patient's lung compliance. As the FRC
rises in relation to the total lung capacity (TLC), the lung compliance will decrease. This
decrease in lung compliance shortens the time constant for the next breath and thus shortens the
time required to exhale the next breath and lessens the amount of trapping that will occur with
each subsequent breath until the time constant shortens enough that gas trapping no longer
occurs. When this steady state is reached, the FRC is at its maximum and the auto-PEEP is also
at its maximum. This fact gives us a way to measure how much auto-PEEP exists since we can
serially measure exhaled tidal volumes and then interrupt ventilation (by turning the respiratory
rate to zero for several seconds) and measuring how much gas the patient exhales as the patient
exhales back to the FRC level that existed prior to ventilation. If we take the difference between
the exhaled volume during ventilation and the exhaled volume after interrupting ventilation then
we have the amount of gas that was trapped. If we divide this volume by the lung compliance we
66
will have calculated the amount of auto-PEEP applied to the alveoli during ventilation. Normally
we are more interested in avoiding auto-PEEP than in measuring it though there are many
patients in whom it cannot be avoided so it is useful to be able to quantitate it. Another way to
detect auto-PEEP is to watch a patient's chest movement and/or breath sounds during exhalation
to see if exhalation stops prior to initiation of inspiration by the ventilator. If exhalation doesn't
finish then auto-PEEP is occurring. When exhaled tidal volumes cannot be measured (which is
seldom with modern ventilators) the level of auto-PEEP can be very roughly estimated by
interrupting exhalation just prior to initiation of inspiration and watching to see if there is a
pressure increase at the airway as exhalation continues into the circuit between the patient and
the point of your interruption. This is not an accurate measurement since the interruption
necessarily cuts exhalation shorter than it would normally be and because the circuit volume
dampens the pressure measurement but this technique can be useful if you are unable to use the
more reliable methods outlined
67
SCENARIO 02
TASK 02
The kidneys filter about one-quarter (750-1000 pints) of the blood that is output by the heart
daily.
This blood is sent to the body's filter treatment plant, where it is purified by the kidneys and
circulated on to the rest of the body.
Some of the blood flow becomes fluid waste (1/1000th to 2/1000th) and is sent into the bladder
for storage until it can be conveniently expelled. This toxic waste is called urine.
The paired kidneys in the upper part of the abdomen toward the back balance the fluid levels of
the body.
They balance the body's acid/alkaline nature and the concentrations of salts, minerals and other
materials.
The blood is filtered, purified, cleansed and adjusted twenty-four hours every day. Hundreds of
pints of blood flow through these organs daily, about one-fourth of the heart's output or
approximately the body's entire volume.
The blood circulates through the kidneys twenty times each hour for purification. About two and
one-half pints of this flow becomes urine, although the amount largely depends on our
consumption of food and drink, our physical activity and other factors,
68
The purpose of this diet is to maintain a balance of electrolytes, minerals, and fluid in patients
who are on dialysis. The special diet is important because dialysis alone does not effectively
remove ALL waste products.
Most dialysis patients urinate very little or not at all, and therefore fluid restriction between
treatments is very important. Without urination, fluid will build up in the body and cause excess
fluid in the heart, lungs, and ankles.
Patients on dialysis need to get enough protein and adequate nutrition because they can
become malnourished.
This diet will help dialysis patients feel as good as possible.
The dialysis diet controls the intake of fluid, protein, sodium, potassium, and phosphorus. The
amounts of these nutrients in the diet are based on blood levels of sodium, potassium,
phosphorus, calcium, albumin, and urea.
Weight loss is a problem that causes particular concern in kidney failure. This is usually because
patients are not eating enough protein and energy-providing food. Malnourished people lose
weight and muscle mass. Malnutrition can develop with patients on either hemodialysis or
peritoneal dialysis. Dietitians monitor renal patients for any signs of malnutrition. Obesity can
69
cause practical problems for people on dialysis. Overweight people with fat arms can have
particular problems with access for hemodialysis. Their veins can be difficult to reach, or weak,
and therefore difficult to make a fistula from. Peritoneal dialysis is less likely to work for patients
who have a fat or distended tummy.Overweight patients should refer to a dietitian for advice.
Reversing obesity will not cure kidney failure, but it will bring significant health benefits.
Phosphate and calcium
Phosphate and calcium affect the health of the bones. When a person has kidney failure, the
calcium level in their body tends to be too low and the phosphate level too high.
Treatment for kidney patients aims to raise blood calcium levels and lower blood phosphate
levels. This can be achieved by moderating the phosphate content of your diet, by adequate
dialysis, and by the use of a phosphate binder taken with meals.
However, it is difficult to cut down on phosphate intake without also lowering protein intake.
Iron
Many people with kidney failure suffer from anemia. One of the causes of anemia is a low level
of iron in the body. If they have low iron levels they may need to take medication.
Potassium
If potassium levels in the blood are too high, the heart can stop beating. Low potassium levels
may cause arrhythmias.
The dietitian will try to find out if a patient is eating anything that might lead to a high level of
potassium. Hemodialysis patients might have to avoid such high-potassium foods as chocolate,
and moderate their intake of other potassium contianing foods.
Peritoneal dialysis patients rarely need to restrict their potassium intake.
Protein
Protein is an essential nutrient that enables the body to build muscles and repair itself. It also
helps the body to fight infection. The main sources of protein in our diet are meat, fish, dairy
products, eggs, and vegetables such as peas, beans, and lentils. Low levels of protein can lead to
70
malnutrition, fluid retention and a reduction in the body's ability to fight infections. When protein
is used by the body waste products are formed and enter the blood. One of these wastes is called
urea. Normal healthy kidneys are good at getting rid of urea. Failing kidneys are not good at this,
but kidney patients should still eat protein.
When the time for dialysis draws closer, some patients do not feel as hungry as they used to, and
some food, particularly meat products, may taste 'funny'. Special dietary supplements may help
such patients maintain adequate protein intake.
It is very important to follow your dietitian's advice regarding protein intake.
Sodium
Hemodialysis patients often have greater restrictions on fluid intake than peritoneal dialysis
patients, and therefore need to be very careful about salt. This is because a salty diet can make a
patient thirsty and may increase blood pressure.
71
SCENARIO 03
TASK 03
The principal organs involved in maintaining a normal blood pH are the lungs and the kidneys.
Consequently, this combo is oftreferred to as the Renal-Respiratory System.
Maintenance of a blood pH is crucial to normal physiological function. If the blood pH deviates
too much from 7.4, many of the body's proteins undergo conformational changes, reducing their
efficiency.
The actions of the Renal-Respiratory System are important in blood pH homeostasis.
The Renal-Respiratory System does much of this job by manipulating the concentration
of bicarbonate in the blood.
The respiratory system, by altering the rate of breathing, can control how quickly CO2 is blown
off.
Slower breathing = more CO2 retained in the body
Rapid breathing = more CO2 blown off, out of the body
That means that you can lower your pH by breathing more slowly, or raise your pH by breathing
more rapidly.
The renal system, by controlling how much bicarbonate gets into urine, can affect the pH of
blood.
The HCO3- is the conjugate base of carbonic acid. If look at the reaction that allows the
conversion of CO2 into HCO3-, and will note that by changing the concentration of HCO3-, by
mass action you consequently change the concentration of H+.
If the blood pH drops, the kidneys can increase the acidity of the urine, returning
more bicarbonate to the blood.
If the blood pH gets too high, the kidneys can dump more bicarbonate into the urine.
72
The Lungs change blood pH by maniuplating how much CO2 exhale, while the kidneys change
blood pH by manipulating how much HCO3- pee out.
Acidosis refers to an increased concentration of H+ in the blood.
Respiratory acidosis is acidosis that results from an increase in PCO2, as might be caused by a
decreased breathing rate or an increase in the PCO2 of the surrounding atmosphere.
on the Renal-Respiratory System and on bicarbonate for more information on how changes in
blood CO2 result in changes in blood pH.
Respiratory acidosis is a disease state. It represents a deviation of blood pH away from the
normal value of 7.4.
Because it is a disease state, the body takes actions to restore things back to normal.
Because the lungs are somehow involved in the cause of the disease state, a typical response is
compensation by the kidneys.The kidneys compensate by conserving HCO3-.
The renal response is not usually enough to fully return blood pH to 7.4. The extent of renal
compensation can be determined from base excess.
Alkalosis refers to a decreased concentration of H+ in the blood.
Respiratory alkalosis is alkalosis that results from a decrease in PCO2, as might be caused
by hyperventilation. Refer to the web notes on the Renal-Respiratory System and on bicarbonate
for more information on how changes in blood CO2 result in changes in blood pH.
Respiratory alkalosis is a disease state. It represents a deviation of blood pH above the normal
value of 7.4.
Because it is a disease state, the body takes actions to restore things back to normal.
This is an example of homeostasis.
Because the lungs are somehow involved in the cause of the disease state, a typical response is
compensation by the kidneys.
The kidneys compensate by increasing the excretion rate of HCO3-.
73
The renal response is not usually enough to fully return blood pH to 7.4. The extent of renal
compensation can be determined from base deficit.
74
SECTION E
SCENARIO 01
TASK 01
a)
The structure,
Salivary
glands
Food
intake
Large
intestine
Mouth
Oesophagus
Small
intestine
Pancreas
Anus
Stomach
75
The alimentary canal is a long tube which runs from the mouth to the anus. It is part of
the digestive system. The digestive system also includes the liver and the pancreas.
Main regions of the alimentary canal are respectively given below,
1. Mouth, salivary glands

2. Oesophagus
3. Stomach
4. Pancreas, liver, gall bladder
5. Small intestine (duodenum + ileum)
6. Large intestine (colon +rectum)
7. Anus
The alimentary canal is a hollow tube of varying diameter, consisting of the esophagus, stomach,
small intestine, and large intestine (comprising mecum, colon, rectum and anal canal). It has the
76
same basic structural organization throughout its length, in that it always consists of the
following four layers,
(1) The mucosa,

(2) The sub mucosa,
(3) The muscularis externa
(4) The adventitia or serosa.
Although these four layers are always present, they can be strikingly different in appearance in
different parts of the alimentary canal. The mucosa, in particular, shows great variability.
General Structure of the Alimentary Canal
Cross section of the alimentary canal

The Mucosa
The first layer, the mucosa always has three parts:
(1) An epithelium (and of course the associated basement membrane),
(2) A layer of loose connective tissue called the lamina propria, and
77
(3) A band of smooth muscle, the muscularis mucosa, denoting the limit of the mucosa.
The epithelium acts as a barrier separating the organisms body from the environment, which is
continuous with the lumen of the alimentary canal. In different areas, the epithelium may simply
be a route, may have a secretory function (stomach, goblet cells in intestines) or may have an
absortive function. The type of epithelium present reflects the function of the particular segment
of the alimentary canal.
The muscularis mucosa allows for movement of the mucosa independent of the wall of
the digestive tract, thereby increasing its contact with food. In most of the alimentary canal, the
muscularis mucosa consists of an inner circular and outer longitudinal layer of smooth muscle.
The Submucosa
The submucosa consists of moderately dense irregular connective tissue. It contains blood and
lymph vessels and nerve plexi. The plexi contain sensory fibres, as well as fibres of the
sympathetic and parasympathetic nervous systems and of the motor neurons of the enteric
division of theautonomic nervous system. Ganglion cells that can sometimes be seen are the cell
bodies of postganglionic parasympathetic neurons and enteric neurons.
The Muscularis Externa
Most of the digestive tract, the muscularis externa consists of an inner circular and outer
longitudinal layer of smooth muscle. The inner circular layer is arranged in a tight spiral, and its
contraction results in the mixing of food by constricting the lumen of the tube. The outer
longitudinal layer is arranged in a loose spiral. Contraction of this layer shortens the tube and
propels the contents. This layer, controlled by the enteric nervous system, undergoes slow,
rhythmic contractions that propel the contents of the lumen along the digestive tract. The waves
of contraction are called peristalsis. Between the two muscle layers is a thin layer of connective
tissue in which can be seen blood and lymph vessels, as well as the ganglion cells and fibres of
Auerbachs plexus.
The Serosa or Adventitia
78
The outermost layer consists of a small amount of connective tissue in which may be found the
major blood vessels and nerves. Sometimes this connective tissue just blends in with that of the
surrounding structures.
(Anon., n.d.) (Anon., 2010) (Anon., n.d.)
b)
The function,
Salivary gland,
Secrete salivary amylases
in to the mouth.
Mouth
Food
intake
Oesophagus
Starch
Small intestine,
Pancreas,
Secrete pancreatic
enzyme into small
intestine
Disaccharide breaks into

monosaccharide,
Stomach,
Maltose breaks into glucose

by maltase enzyme,
Stop the activity of

salivary amylase by
HCL secrete,
Sucrose breaks into glucose

+ fructose by sucrose
enzyme,
Lactose breaks into glucose
+ galactose by lactase.
Large intestine,
Anal
79
Carbohydrate digestion begins in the mouth.

The main function of carbohydrates is to provide the body with energy to support muscular
work, brain activity, breathing and other important activities.
Carbohydrates are made up of sugars known as saccharides.
Most carbohydrate foods contain many saccharides linked together, which are known as
polysaccharides.
Carbohydrate digestion begins in the mouth and is complete when the polysaccharides are
broken down into single sugars, or monosaccharaides, which can be absorbed by the body.
In mouth
Carbohydrate digestion begins in the mouth.
The salivary glands in the mouth secrete saliva, which helps to moisten the food.
The food is then chewed while the salivary glands also release the enzyme salivary amylase,
which begins the process of breaking down the polysaccharides in the carbohydrate food.
Pancreas and Small Intestine
After being in the stomach, the chyme enters the beginning portion of the small intestine, or the
duodenum.
In response to chyme being in the duodenum, the pancreas releases the enzyme pancreatic
amylase, which breaks the polysaccharide down into a disaccharide, a chain of only two sugars
linked together.
The small intestine then produces enzymes called lactase, sucrase and maltase, which break
down the disaccharides into monosaccharide.
The monosaccharaides are single sugars that are then absorbed in the small intestine.
80
Large Intestine
Carbohydrates that were not digested and absorbed by the small intestine reach the colon where
they are partly broken down by intestinal bacteria. Fiber, which cannot be digested like other
carbohydrates, is excreted with feces or partly digested by the intestinal bacteria.
81
SCENARIO 02
TASK 02
a)
Other systems of the body which are associated with control of the bile secretion are,
Endocrine system.
Nervous system.
b)
Bile is produced in the liver by hepatocytes.
Bile contains phospholipids and bile salts, emulsifying agents that are necessary for fat
absorption and digestion.
Importantly, the bile is also a route for excretion of cholesterol and bile pigments.
Bile pigments are metabolic breakdown products of hemoglobin and cytochromes that give bile
its yellow-green color.
Bile pigments are further metabolized by bacteria in the colon, causing feces to have a
characteristic brown color.
Additionally, bile contains water and bicarbonate ions that are secreted by duct cells that line the
bile ducts within the liver.
Regulation of Pancreatic Function
The pancreas is controlled by both the autonomic nervous system (ANS) and the endocrine
system.
The ANS has 2 divisions: the sympathetic and the parasympathetic.
Nerves of the sympathetic division become active during stressful situations, emergencies, and
exercise.
Sympathetic neurons stimulate the alpha cells of the pancreas to release the hormone glucagon
into the bloodstream.
82
Glucagon stimulates the liver to begin the breakdown of the energy storage molecule glycogen
into smaller glucose molecules.
Glucose is then released into the bloodstream for the organs, especially the heart and skeletal
muscles, to use as energy.
The sympathetic nerves also inhibit the function of beta cells and acini to reduce or prevent the
secretion of insulin and pancreatic juice.
The inhibition of these functions provides more energy for other parts of the body that are active
in dealing with the stressful situation.
Nerves of the parasympathetic division of the ANS become active during restful times and
during the digestion of a meal.
Parasympathetic nerves stimulate the release of insulin and pancreatic juice by the pancreas.
Pancreatic juice helps with the digestion of food while insulin stores the glucose released from
the digested food in the bodys cells.
The endocrine system uses 2 hormones to regulate the digestive function of the
pancreas: secretin and cholecystokinin (CCK).
Cells in the lining of the duodenum produce secretin in response to acidic chyme emerging from
the stomach.
Secretin stimulates the pancreas to produce and secrete pancreatic juice containing a high
concentration of bicarbonate ions.
Bicarbonate reacts with and neutralizes hydrochloric acid present in chyme to return the chyme
to a neutral pH of around 7.
CCK is a hormone produced by cells in the lining of the duodenum in response to the presence of
proteins and fats in chyme.
CCK travels through the bloodstream and binds to receptor cells in the acini of the pancreas.
CCK stimulates these cells to produce and secrete pancreatic juice that has a high concentration
of digestive enzymes.
The high levels of enzymes in pancreatic juice help to digest large protein and lipid molecules
that are more difficult to break down.
83
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Human Body Structure

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Human body structure and function

Human body structure and function

Human body structure and function

Human body structure and function

Human body structure and function

Human body structure and function

Human body structure and function

Some of other Cellular aging theories

The "Wear and Tear" Theory

Human body structure and function

Human body structure and function

Death Hormone Theory (DECO)

Human body structure and function

Human body structure and function

Human body structure and function

Human body structure and function

Human body structure and function

The Plasma Membrane

Functions of the cell membrane,

Isolate the cytoplasm from the external environment

Regulate the exchange of substances

Communicate with other cells

The Plasma Membrane is also called the Phospholipid bilayer.

Human body structure and function

Phospholipids contain a hydrophilic head and a nonpolar hydrophobic tail.

Human body structure and function

Human body structure and function

Cholesterol is actually a very important component of cell membranes. Cholesterol molecules

Human body structure and function

Human body structure and function

Human body structure and function

In glands, epithelial tissue is specialized to secrete specific chemical substances such as

Human body structure and function

Human body structure and function

Functions of Nerve Tissue

Muscle is specialized for gross movement by means of cellular contraction. Embryonically,

Human body structure and function

Cardiac Muscle Cells Pump the Heart

Human body structure and function

Mechanism of Skeletal Muscle Contraction

Human body structure and function

Human body structure and function

Human body structure and function

fig 4 Crossbridge cycle

Human body structure and function

In addition, an induced acidosis can impair muscle contractility in non-fatigued humans or in

Human body structure and function

A good example of a negative feedback mechanism is a home thermostat.

Human body structure and function

.To maintains homeostasis, communication within the body is essential.

Stimulus- produces a change to a variable (the factor being regulated).

Human body structure and function

sensory-somatic nervous system and the

autonomic nervous system

Autonomic nervous system

Human body structure and function

Endocrine regulation of glucose homeostasis

1. Adrenaline released in response to stress; it inhibits insulin.

2. Cortisol released in response to stress; it reduces sensitivity to insulin, which explains

Human body structure and function

3. Growth hormone released at night; it reduces sensitivity to insulin.

Diabetes mellitus a common disease caused by insulin deficiency or insulin resistance

Glucagonoma a very rare tumour of cells that secrete glucagon.