HL - Option D: Human Physiology

(NOTES)

Topic D.1 – Human nutrition

Topic D.2 – Digestion

Topic D.3 – Functions of the liver

Topic D.4 – The heart

Topic D.5 – Hormones and metabolism

Topic D.6 – Transport of respiratory gases

 Topic D.1 – Human nutrition

Nutrition & nutrient

Nutrients are chemical substances in foods that are used
in the human body.
A balanced diet gives us all the essential nutrients that we
need in just the right quantities.
We need a number of nutrients to build our bodies and to
stay healthy.
In the case of humans, essential nutrients are those that
cannot be synthesized in the body and must therefore be
included in the diet.
The essential nutrients are divided into various chemical
groups such as:

1. Vitamins – These are chemically diverse carbon compounds (organic compounds) needed by
the body in small amounts (e.g. ascorbic acid).

2. Minerals – These are usually derived from inorganic ions (e.g. calcium, iron).

3. Amino acids – There are 20 amino acids which are required for the synthesis of proteins.

4. Fatty acids – These include the likes of omega-3-fatty acids.

Malnutrition
Malnutrition can be caused by an imbalance, deficiency or excess of specific nutrients in the
diet.
Malnutrition occurs when a person does not eat a balanced diet.
There are many forms of malnutrition depending on which nutrient is in excess or insufficient
quantities in the body.
A person may eat a lot of food, yet may be malnourished.

Starvation
Starvation is different from malnutrition and is a prolonged shortage of food.
It occurs when an individual does not have enough food to eat.
Starvation can lead to the breakdown of body tissues.
Firstly, stored carbohydrate (glycogen) followed by fat reserves are used up, and then protein
from body structures as a source of energy for respiration.

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Anorexia
It is an eating disorder in which individuals do not eat enough food to sustain themselves even
though there is food available.
Thus, they become severely underweight because they have an obsessive fear of gaining body
mass.
Some of the effects include damage to the kidneys and liver, loss in hair and muscle mass.
As in the case of starvation, body tissues are broken down, with the heart muscles also being
broken down in extreme cases.
The condition has psychological causes, and people affected with the disorder perceive
themselves as overweight despite being normal or underweight.
The condition largely affects young females (about 90 %) with few men being affected.

Obesity
Obesity is the excessive storage of fat in adipose tissue.
Eating an excess of fatty foods is the likely cause of this.
There is also a risk of heart disease, and other cardiovascular problems associated with excess of
saturated and trans-fatty acids in the diet.
Similarly, the od s apa it to store gl oge is li ited, so eating an excess of carbohydrates
over a long period of time can lead to weight gain.
Obese or overweight individuals suffer from health issues like Type II diabetes and hypertension
(excessively high blood pressure).

Type II diabetes
Type II diabetes is the most common form of diabetes.
It is also known as late-onset diabetes.
People who possess the condition develop insulin resistance in their bodies, which means that
the receptor cells that respond to insulin fail to be stimulated by it.
This occurs even though the beta cells in the pancreas produce insulin.
Some of the factors that lead to Type II diabetes are as follows:

High fatty food diet

Diet low in fibre
Lack of exercise
Genetic make-up

The symptoms of a diabetic person include the following:

high glucose levels in the blood

glucose in the urine
tiredness and fatigue

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Hypertension & CHD
Eating a diet that is high in saturated fatty acids has been shown to have a positive correlation
with hypertension (high blood pressure).
This is because saturated fatty acids can be deposited inside the arteries.
If these deposits combine with cholesterol they may reduce the diameter of the lumen and
leads to hypertension.
Reliable evidence suggests that when the typical diet is high in saturated fatty acids, high-fat
foods, animal products and processed foods, there is likely to be a high incidence of CHD.

Cholesterol
A i di ator of the risk of CHD is the le el of holesterol i a i di idual s lood.
Cholesterol is a steroid that is synthesized in the liver and found mainly in foods of animal origin.
It is part of the cell membrane, and it helps to reduce the fluidity of the cell membrane.
Cholesterol is carried in the blood to the liver, where it can either be broken down or excreted in
the bile.
Cholesterol is transported around the body in the form of two types of lipoprotein:

1. Low-density lipoproteins (LDLs): These are also referred to as ad holesterol as the do

not travel easily in the bloodstream. It can clog up arteries, causing blockages, CHD or
stroke. Raised levels of LDL in the blood occur in people who have high levels of saturated or
trans-fatty acids in their diet.

2. High-density lipoproteins (HDLs): It is also kno as good holesterol . HDLs a e arried

easily in the blood and do not contribute to blockages in the arteries. HDL can help to
remove LDLs from arteries and reduce blockages.

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 Appetite control
The appetite control centre is found in the hypothalamus of the brain.
It signals the body when sufficient food has been eaten.
Also in most people, leptin is produced by the adipose tissue which causes a reduction in
appetite of the individual.

Energy content
Energy content of any food material can be found out by using combustion.
The following formula is useful in calculating the value of energy content in Jg-1.

Q: Calculate the energy content of a macadamia nut weighing 2.7 g, when it was combusted in an
apparatus containing 150 ml of water. The temperature of water rose from 27 oC to 36 oC.

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Vitamin D
Vitamin D also known as calciferol is essential to ensure that sufficient calcium is absorbed in
the digestive system to build and maintain healthy bones.
Vitamin D is obtained from foods such as oily fish like salmon and tuna, egg yolks, liver and dairy
products including milk, cheese and butter.
Vitamin D supplements are also available, and sometimes milk is fortified with vitamin D.
Vitamin D is one of the few vitamins that can be made in the body.
It is synthesized in the skin when it is exposed to ultraviolet (UV) rays from the sun.
In some countries at extreme latitudes, there is not much sunlight (low intensity of UV) in winter
months for vitamin D to be made.
However, the liver can store vitamin D that is produced during the summer to avoid a deficiency
in winter.
Vitamin D deficiency shows same symptoms as calcium deficiency and can lead to softening or
malformation of the bones, a condition known as osteomalacia or rickets.
This condition is a problem in growing children and breastfeeding mothers whose vitamin D
intake is low.
Osteomalacia causes bones to become softened because of inadequate bone mineralization.
Rickets is the condition when it occurs in children, and can be particularly severe because the
bones are still growing.

Vitamin C
It is also known as ascorbic acid.
Ascorbic acid cannot be synthesized in the human body
and must be obtained by foods.
Vitamin C is generally found in citrus fruits such as
oranges, lemons, tangerines, which are rich sources of
ascorbic acid.
Vitamin C is also found in fresh vegetables.
Vitamin C helps to protect the body from infection.

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It is also important in keeping bones, teeth and gums healthy and for synthesis of the protein
collagen needed for skin and walls of blood vessels.
Scurvy is the shortage of the vitamin
leading to its deficiency.
Techniques have been used to find out
the vitamin C requirement of a person
each day.
These involves the use of animal and
human test subjects, with animals
receiving insufficient vitamin C showing
signs of deficiency, such as poor collagen
in bones and increased infection.

Phenylketonuria
We can synthesize some amino acids in our cells by converting certain nutrients into amino
acids, but there are some of them that cannot be synthesized and must be obtained through the
diet. These are known as essential amino acids.
Phenylalanine is one such essential amino acid.
Phenylketonuria (PKU) is a rare genetic disorder in which the level of the amino acid
phenylalanine in the blood becomes too high.
It s a ge eti disease, ith the trait ei g re essi e.

It is caused by a mutation to a gene that codes for an enzyme known as phenylalanine

hydroxylase.
They are thus unable to make this enzyme which converts phenylalanine into another non-
essential amino acid called tyrosine.
Phenylalanine is essential for normal growth of an individual.
However, excess build up in the blood can result in brain damage and mental retardation.
Treatment for PKU involves intake of a special diet that is low in protein and especially low in
the amino acid phenylalanine.
High protein foods such as milk and dairy products, nuts, fish and meat must be avoided.
The condition is treatable if it is diagnosed soon after birth followed by immediate treatment.
PKU only affects children until puberty.

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 Topic D.2 – Digestion

Digestive juices
The digestive juices can be categorized into 3 main types:

Digestive juice Production site Contents

Saliva Salivary glands in the mouth Salivary amylase, mucus, water

Gastric juice Glands in the stomach wall Pepsin, mucus, water, hydrochloric acid

Pancreatic juice Exocrine glands in the pancreas Pancreatic amylase, lipase, trypsin, water, etc.

The two enzymes pepsin and trypsin are protease enzymes which can digest proteins and are
therefore harmful to the cells that produce them and structures that they are in contact with.
Thus, both these enzymes are secreted as inactive precursors: pepsinogen and trypsinogen.
These are then converted to their active form after secretion at the site of need.
Pepsinogen is converted to pepsin in the stomach, when in the presence of hydrochloric acid,
which is secreted by the cells of the stomach lining.
Trypsinogen is activated by an enzyme secreted by the walls of the small intestine when food
enters from the stomach, which converts trypsinogen to active trypsin.

Exocrine glands
Exocrine are those that secrete their contents by means of ducts.
Digestive juices are produced in exocrine glands in the mouth (salivary glands), in the stomach
wall (gastric glands) and in the walls of the pancreas.
All exocrine glands secrete their products via ducts to where they are needed.
The cells of an exocrine gland that makes digestive juices are arranged in a single layer around
small ducts.
Exocrine gland cells of the digestive system produce enzymes.
These are actually proteins, so the cells contain extensive amounts of rough endoplasmic
reticulum, which is useful for protein synthesis.
Apart from this, there are numerous ribosomes and Golgi apparatus for packaging and
processing the enzymes
Large numbers of vesicles, needed for storing enzymes before they are secreted by exocytosis
into the ducts of the gland are also seen.

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Gastric juice
Gastric juice is secreted by cells in the epithelium that lines the stomach.
The components of gastric juice are: hydrochloric acid, pepsin, mucus and water.
The acid helps control pathogens in the ingested food as well as serves to activate pepsin.
Pepsin is essential for the breakdown of proteins in the foods.
Mucus protects the walls of the stomach from being damaged by the acid.

Stomach acid
Hydrochloric acid released into the stomach maintains the contents at around pH 1-2, which is
the optimum pH for the breakdown of protein molecules by protease enzymes.
The highly acidic conditions of the stomach denature proteins and the peptide bonds in protein
molecules are exposed to protease enzymes.
The hydrochloric acid also kills bacteria that may be present in ingested food.
Gastric acid (hydrogen ions) is secreted by the parietal cells, which line the stomach epithelium.
In the plasma membranes of the parietal cells, there are hydrogen-potassium pumps with
ATPase enzymes, which pump H+ ions from the cell into the stomach lumen.
They can generate an extremely H+ gradient which makes the stomach contents very acidic and
highly corrosive.
A mucus barrier protects the stomach lining to prevent damage.
There are other cells in the stomach that release hydrogen carbonate ions, which prevent the
contents becoming too acidic.

In some people, the mucus barrier breaks down, so the stomach lining gets damaged and
bleeding occurs.
Excess acid in the stomach can cause acid indigestion, which can be treated with antacids.

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However, if a person suffers from excess acid secretion for long periods of time, the amount of
acid in the stomach increases and can lead to ulcers.
Sometimes, problems arise with the circular muscle at the top of the stomach which can lead to
acid reflux or heartburn (acid contents enter into the esophagus).
Such conditions can be treated using proton pump inhibitors (PPIs), a group of drugs that are
very effective inhibitors of acid secretion, and are used to treat indigestion, acid reflux and
stomach ulcers.
PPIs work by blocking to the hydrogen–potassium pumps and binding to the ATPase enzymes in
the plasma membranes of the parietal cells.

Control of gastric juice secretion

The production of digestive juices requires energy, and large numbers of mitochondria can be
seen in the exocrine cells.
The body controls the secretion of digestive juices so that they are released at the correct time
when food is present and so that enzymes are not wasted.
The secretion of digestive juices are controlled by both the nervous and hormonal systems.
The sight or smell of food stimulates the production of saliva and stimulates the brain to send
nerve impulses to the parietal cells, which respond by secreting acid.
These responses are known as reflex actions.

When food enters the stomach, more gastric juice is released as receptors in the walls of the
stomach send impulses to the brain.
Sodium ions are also secreted, causing water to move by osmosis into the stomach forming the
gastric juice.
The chemoreceptors in the stomach lining also send impulses to the brain, which controls the
continued stimulation of the gastric glands.
Nerve impulses via the vagus nerve pass to endocrine glands in the stomach wall stimulating the
production of a hormone known as gastrin.
Gastrin stimulates the parietal cells of the gastric glands to produce more hydrochloric acid.

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There are 2 other hormones, secretin and somatostatin which inhibit the secretion of gastrin, if
the pH in the stomach falls too low.

Stomach ulcers
Stomach ulcers are open sores in the stomach walls, which are caused by the partial digestion of
the stomach lining by the enzyme pepsin coupled with hydrochloric acid.
Excessive acid secretion and emotional stress were regarded as the prime reasons for stomach
ulcers, however, it has been discovered that 80% of the cases are due to the bacterium
Helicobacter pylori.
Helicobacter pylori is a spiral-shaped bacterium that is able to grow in the human stomach.
Unlike other types of bacteria, it can tolerate and adapt to acidic conditions, and survives in the
pH range of the stomach.
Barry Marshall & Robin Warren isolated the bacterium from the stomach linings of patients who
were suffering from stomach ulcers and gastritis problems.
Marshall and Warren proposed that H. pylori caused these symptoms in the patients.
They also cured the ulcers using antibiotics to kill the H. pylori.
Short-term treatment of symptoms includes consumptions of antacids to neutralize the acid.
For long term relief and to cure ulcers, anti-microbial drugs need to be taken.

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Cholera
Cholera is the disease caused by the infection of the gut with the bacterium Vibrio cholera.
Cholera toxin is produced by the cholera bacterium Vibrio cholera.
This can infect the intestine if ingested by means of contaminated water or food.
The toxin binds to surface receptors on the intestinal cells.
The toxin is then taken into the cells by endocytosis.
Once inside the cell, the toxin modifies a channel protein in the cell membrane so that Cl- and
HCO3- ions are released out of the cell.
This is followed by the secretion of water, sodium ions, and potassium ions into the intestine.
The lost water and ions is drawn from the blood in a continuous process, so that the overall
effect of the toxin will result in a large amount of fluid loss from the intestine.
A person with cholera can quickly become severely dehydrated.
It can also result in death if the patient does not receive rehydration.

Absorption of food
Absorption of digested food particles occurs in the ileum part of the small intestine.
The inner lining of the small intestine is the intestinal mucosa and this layer is responsible for
absorbing food.
The longitudinal and circular muscles in the intestine wall contract to move food along.
The surface area provided for absorbing food is increased greatly by folding of its inner lining
into structures known as villi
The villus contains capillaries and a lacteal to transport absorbed molecules.

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Villus
The villus is the structure responsible for the absorption of food particles from the intestine.
The villus contains capillaries and a lacteal to transport absorbed molecules.
They have many tiny projections known as microvilli.
These structures give rise to a very large surface area for the absorption of digested materials.
The digested food material must pass through the microvilli of the epithelial cells in order to
reach the lacteal vessel or capillary bed.
These epithelial cells possess certain structures vital to the processes of absorption.
They contain large number of mitochondria which are useful for taking in substances by means
of active transport and it requires energy in the form of ATP.
Some materials are taken in by pinocytosis, which is indicative by the presence of many vesicles.
The epithelial cells are linked together by tight junctions, which seals adjacent cells and prevent
leakage of any matter across the membranes.

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Fibre & undigested matter
Some material in the food are not digested or absorbed by the body, and hence pass through
the small and large intestines and out of the body via egestion.
These indigestible materials are known as fibres.
Dietary fibre is found in cereals, fruits and vegetables.
Fibre is either made up of the indigestible parts or compounds of plants, which pass unchanged
through the stomach and intestines.
Fibres are of 2 types: soluble and insoluble.
Soluble fibers are mainly in fruits, vegetables, oat bran, beans and lentils and help slow down
the rate of digestion and helps the contraction of intestinal muscles.
It is also useful i lo eri g LDL ad holesterol le els i the loodstrea .
Insoluble fibres are found in bran, fruit skins, vegetables and wholegrain foods (e.g. cellulose).
It mainly adds bulk to the feces which pass through the colon more easily, preventing
constipation and related problems.
Insoluble fibres also help reduce the chances of colon cancers.

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 Topic D.3 – Functions of the liver

Liver
The liver is the largest internal organ in the human body.
It has many important roles including detoxification of bodily toxins, recycling the constituents
of worn out red blood cells, production of bile and storage of certain nutrients.

Blood flow through the liver

The liver is supplied with blood by 2 vessels: the hepatic artery and the hepatic portal vein.
The hepatic artery is a branch of the aorta, which carries oxygenated blood to the liver.
The hepatic portal vein carries blood from the intestine to the liver.
Blood in the hepatic portal vein is highly rich in nutrients, as it comes from the small intestine
which has taken in the absorbed food by means of capillaries.
20% of the total volume of blood in the body, flows through the liver at any instant.
The liver is divided into lobules, which consists of rows of hepatocytes (liver cells) arranged in a
circular pattern around a central vein.
Inside the liver, the hepatic portal vein divides into smaller vessels known as sinusoids.
These are similar to capillaries in the aspect that they have a single layer of very thin cells,
however they are much wider than regular capillaries.
There are a number of gaps in between these cells so that the blood flowing along the sinusoids
comes in close contact with the surrounding hepatocytes.

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 The oxygen needed by the hepatocytes for aerobic cell respiration is provided by the hepatic
artery which branches into finer capillaries that join the sinusoids at various points along their
length.
Blood from the sinusoids flows into the central veins, which unite to form the hepatic vein.
The blood from hepatic vein leaves the liver and enters the vena cava.
Kupffer cells are phagocytes which are attached to the walls of the sinusoids.
These help to remove and break down bacteria and damaged erythrocytes.

Functions of the liver

The liver performs are wide number of functions as follows:

1. Detoxification:
The liver has an important role in removing toxins from the blood and detoxifying it.
Hepatocytes absorb toxic substances from the blood and convert them into less toxic or
non-toxic products.
Common blood toxins ingested substances such as alcohol, food additives and pesticides.

2. Breakdown of erythrocytes:
Erythrocytes (red blood cells) survive in the blood for about 120 days before they die.
These must be replaced with new cells from the bone marrow.
At the end of their lifespan, erythrocytes breakdown into fragments as their membranes
become weakened releasing free hemoglobin into the bloodstream.
Kupffer cells in the walls of the sinusoids in the liver are specialized cells that absorb the
damaged red blood cells by means of phagocytosis.
The component parts of hemoglobin are broken down for recycling or excretion.

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 The hemoglobin is split into heme group and globins.
The globins are proteins which are hydrolyzed into amino acids, and released into the blood.
Iron is removed from the heme group, leaving a yellow coloured fluid called bile pigment (or
bilirubin).
The iron is carried to the bone marrow and is used to make hemoglobin for incorporation
into new red blood cells.
The bile pigment is used to make bile in the liver.

3. Production of plasma proteins:

Plasma proteins which are found in the blood play an important role in blood homeostasis.
They help to regulating the osmotic balance of bodily fluids and regulate the movement of
water between plasma and tissue fluid.
The rough endoplasmic reticulum of hepatocytes synthesize 90% of blood plasma proteins.
These are processed in the Golgi apparatus of hepatocytes before being released into the
bloodstream.

4. Synthesis and cholesterol and bile salts:

Hepatocytes also synthesize cholesterol, which a plays a vital role in membrane structure
and it is also the precursor for several steroidal hormones.
The liver cells convert cholesterol into bile salts which is a component of bile in the liver.
The bile salts helps to emulsify fats in the small intestine speeding up the digestion process
by the enzyme lipase.

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5. Storage of nutrients and regulation:
Liver can store lipids, iron (obtained by the breakdown of hemoglobin) and the fat-soluble
vitamins A and D.
The hepatic portal vein carries absorbed nutrients directly from the intestine to the liver.
The blood that leaves the liver contains regulated amounts of nutrients.
For instance, after a meal, when blood glucose levels suddenly rises, the hormone insulin
stimulates the hepatocytes to absorb the excess glucose from the blood and convert it into
glycogen for storage.
This glycogen is stored in the liver and muscle cells.
When the blood glucose levels fall, the hormone glucagon stimulates the hepatocytes to
break down the stored glycogen and release glucose into the bloodstream.
Thus, bodily nutrients are regulated by the liver.

Alcohol & the liver

When alcohol is absorbed from the small intestine, it passes straight to the liver in the hepatic
portal vein and is absorbed by the hepatocytes.
As alcohol is a body toxin, the hepatocytes detoxify the alcohol.
However, if it is present in large amounts, blood needs to flow through the liver many times
before the entire alcohol in the blood can be absorbed.
This creates a strain on the liver cells and make them very susceptible to damage by alcohol.
Also, fatty deposits begin to build up in the liver, reducing liver function.
The liver may become permanently damaged as scar tissue develops in place of damaged blood
vessels and hepatocytes, and this condition is known as cirrhosis of the liver.

Jaundice
Jaundice is the condition in which the eyes and skin turn yellow due to an accumulation of
bilirubin or bile pigment in the blood and tissues of the body.
Jaundice can occur as a result of any condition that disrupts the movement of bilirubin from the
blood to the liver and then out of the body.
The li er s i a ilit to eta olize a d e rete the iliru i a result i uildi g up of the ile
pigment in the blood.
Adults with jaundice experience itching as one of the symptoms.
However, if the bilirubin levels remain high for a long period of time, it can lead to brain
damage, deafness and cerebralpalsy.

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 Topic D.4 – The heart

Cardiac muscle
The cardiac muscles operate throughout our lives and never rests.
It requires constant supplies of oxygen and nutrients, which the blood carries to it.
Coronary arteries branch from the aorta and supply heart muscles with oxygen-rich blood.
Heart muscle is made up of short, striped muscles fibres, which branch out.
These are joined together at their ends by connective structures known as intercalated discs.
These types of linkages between cells allows action potentials to spread rapidly and enables the
heart muscle fibres to act together.
Blood vessels, found in the spaces between the fibres, are branches of coronary arteries, which
arise from the aorta.
This allows the heart to be provided with a good amount of blood supply carrying oxygen and
nutrients for its activity.

Control of cardiac cycle

The cardiac muscles are unique in that they can contract without being stimulated – it is said to
be myogenic.
A perso s heart rate ha ges ith the le el of their a ti it , e otio s or stress.
However, heart rate can be controlled by nervous or hormonal stimulation.

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Cardiac muscle cells have the special property of being able to stimulate each other to contract.
The intercalated discs between adjacent cardiac muscles allow impulses to spread through the
wall of the heart, initiating contraction.
The sinoatrial node (SA node) which is present in the right atrium initiates each impulse and acts
as the pacemaker of the heart.
Cells in the SA node generate action potentials that spread through the muscle cells in the walls
of the atria causing atrial systole.
The impulses are prevented from passing directly to the ventricles by a layer of fibrous tissue.
Instead, they stimulate a group of cells known as the atrioventricular node (AV node).
The AV node is located in the lower part of the atrium, close to the ventricles.
The AV node sends out impulses down conducting fibres known as bundle of His that run down
the centre of the heart, between the two ventricles.
Narrower conducting fibres (Purkinje fibres) branch out from these bundles and carry the
impulses to all parts of the ventricle walls.
As impulses arrive, coordinated contraction occurs across the muscles of the ventricle walls.
This sequence of events is termed as the cardiac cycle.
Two nerves from the medulla of the brain regulate the increase or decrease of heart rate.
Also, increasing levels of the hormone epinephrine (adrenalin), are produced at times of stress
or fear which stimulates the SAN to increase the heart rate.

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Artificial pacemakers
These are medical devices that are surgically fitted into patients having a malfunctioning heart.
This can mean that the heart beats too slowly or too fast.
They are also used for patients who have suffered some sort of heart failure.
An artificial pacemaker regulates heart rate and ensures it follows a steady rhythm.
Pacemakers are fitted under the skin below the collar bone and have wires that connect to the
heart through vein.
Pacemakers are battery powered and generate electrical pulses that stimulate the heart at an
appropriate, adequate rate.

Defibrillators
If a perso s heart stops eati g properly they it may lead to a cardiac arrest.
A defibrillator is a device that can be used to deliver an electric shock to the heart, which will be
stimulated into re-establishing its regular normal rhythm.
A defi rillator o sists of a pair of ele trodes, hi h are o ta ted ith the patie t s hest, a d
a battery that delivers an electrical impulse between them.
Defibrillators are used when uncoordinated contraction of the ventricular muscle makes the
ventricles twitch rather than contract fully.
Defibrillation can also treat tachycardia, a fast heart rhythm that originates in one of the two
ventricles.

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The cardiac cycle
The cardiac cycle can be divided into following distinct phases:

1. The muscles of the atrium wall contract, the atrioventricular valves open and pumps blood
into the ventricles. Both the atria contract at the same time. This is known as atrial systole.

2. Blood pumped into the ventricles causes the blood pressure inside them to increase, so the
atrioventricular valves shut to prevent backflow of blood. When the ventricles are full,
ventricle muscles contract, generating the pressure that opens the semilunar valves and also
drives blood into the aorta and the pulmonary artery. This is ventricular systole.

3. Ventricles and atria then relax, and the pressure inside them is low. The semilunar valves are
closed by the back pressure of blood in the arteries. This phase of the cycle is called diastole.

4. Blood flows into both the atria of the heart from the veins. Deoxygenated blood from the
body enters the right atrium via the vena cava, and oxygenated blood from the lungs enters
the left atrium via the pulmonary artery.

5. The whole cycle is repeated when the atria contract again.

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Coronary heart disease
Coronary heart disease (CHD) is often caused by damage to the coronary arteries, which are the
arteries that supply oxygen and nutrients to the cardiac muscles of the heart.
Atherosclerosis is a slow degeneration of arteries caused by a build-up of plaque within them.
Plaque becomes attached to the smooth lining of the artery and can accumulate over the years.
Calcium deposition causes the artery to lose elasticity, become hard and inflexible.
Over the course of time, the diameter of the artery becomes so narrow that blood cannot flow
efficiently leading to hypertension (high-blood pressure).
Blood may clot in the artery, further restricting the movement of blood along it.
Clots can break free and travel to block another artery elsewhere in the body, and this is called a
thrombosis.
A blockage in a coronary artery or its branches is termed as coronary thrombosis.
Similarly, if an artery is blocked in the brain, the clot may result in a stroke.

Risk factors associated with CHD

Lack of exercise
Genetic factors
Smoking
Obesity
Gender
Diet
Age

Electrocardiogram
Electrical signals from the heart can be detected using an electrocardiogram (ECG).
The pattern as seen from the image on
the right is obtained.
The P-wave is caused by the atrial
systole.
The QRS-wave is obtained due to
ventricular systole.
The size of the peaks and lengths of
intervals as seen from the ECG can help
doctors detect heart problems.

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 Topic D.5 – Hormones and metabolism

Hormones
Hormones are chemical substances that are secreted directly into the bloodstream by endocrine
glands found throughout the body.
A wide range of chemical substances work as hormones in humans.
Since hormones circulate in the bloodstream, they are carried to target cells in the body.
These target cells have receptors on the plasma membrane that recognize and bind to the
respective hormone.
Hormones can be categorized into the 2 following types:

Type Examples
Steroids testosterone, estrogen, progesterone
Peptides Insulin, ADH, FSH, LH

Steroid hormones
Steroid hormones enter into the target cells.
This is because they can easily pass through the plasma membrane.
They bind to a specific receptor in the cytoplasm of target cells forming a hormone–receptor
complex.
The hormone regulates the process of transcription of one or more specific genes.
Transcription of some genes is stimulated and other genes are inhibited.
This in turn helps to control the protein being synthesized, and development of target cells.

Peptide hormones
These bind to a surface receptor, usually a glycoprotein, but do not enter the cells.
The binding process triggers the release of a second messenger inside the cell, where this
messenger controls the activity of the cell causing a cascade of reactions.
This involves regulating the activity of a specific enzymes in the cell, either activating it or
inhibiting it.

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Hypothalamus & pituitary gland
The hypothalamus is a small part of the brain that monitors hormone levels and is involved
indirectly in functions such as controlling body temperature, hunger and sleep.
It links the endocrine and nervous systems.
It controls release of hormones by the pituitary gland, which are very essential in controlling
growth, development, reproduction and homeostasis.
The pituitary gland, situated just below the hypothalamus is divided into two different parts: the
anterior and posterior lobes.
The posterior lobe develops from the brain and has neurons connecting it directly to the brain.
The anterior lobe develops separately and has no direct connection to the brain.
The hypothalamus contains the cell bodies of many neurosecretory cells, which have their
terminal ends in the posterior lobe of the pituitary.
Surrounding the terminal ends of the neurosecretory cells is a capillary network so that when
the cells receive the signals, they can release the hormone directly into the blood. Examples of
posterior lobe hormones released in this way are ADH and oxytocin.
Regulation of the anterior lobe of the pituitary is by another set of neurosecretory cells in the
hypothalamus. These cells terminate in a different capillary bed and blood from these capillaries
flows into a portal vein, which passes into capillaries within the anterior lobe of the pituitary.
FSH is released in this way.

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Control of milk secretion
The secretion of milk by the body is regulated by pituitary hormones.
During pregnancy, the placenta produces progesterone and estrogen, which suppress the
menstrual cycle and promote the growth of breast tissue for lactation (milk production).
After birth, the hormone prolactin is secreted from the anterior pituitary gland, and this
hormone stimulates milk production by the mammary glands.
During pregnancy, high levels of estrogen increase the levels of prolactin production in the body,
but inhibit its effects.
After childbirth, a sudden decline in the levels of estrogen stops this inhibition, and milk
production begins.
As a baby suckles, prolactin secretion is maintained and oxytocin is also released from the
posterior pituitary gland.
The physical stimulation of suckling by a baby stimulates oxytocin secretion by the posterior
pituitary gland.
Oxytocin is necessary for the milk-ejection reflex and it causes contraction of the smooth muscle
cells that squeeze milk into the duct system of the breasts.
Both these hormones continue to be released in proportion to the amount of milk the baby
consumes as it suckles.

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Growth hormone in athletics
Growth hormone is secreted by the pituitary gland.
It stimulates the breakdown of fat, increase in muscle mass, synthesis of proteins, bone
mineralization and overall body growth.
Human growth hormones have been exploited by athletes in power sports such as weight lifting,
bodybuilding and swimming with the intent of improving performance.
This hormone has been listed on the banned substances list by the anti-doping agencies across
all competitive sports, as there is significant evidence that it enhances performances in events.

Iodine deficiency
Iodine is the element which forms an important component in the hormone thyroxin.
Thyroxin is the hormone secreted by the thyroid gland and is necessary for homeostasis.
A deficiency of iodine is seen as a swelling of the thyroid gland in the neck.
Pregnant women who are iodine deficient, can result in children with permanent brain damage.
To counter this problem of iodine deficiency worldwide, the International Council for the
Control of Iodine Deficiency Disorders (ICCIDD) has been set-up.

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 Topic D.6 – Transport of respiratory gases

Oxygen dissociation curves

In the human body, oxygen is transported from the lungs to respiring tissues by blood when
bound to hemoglobin molecules.
Each hemoglobin molecule can bind four oxygen molecules.
When hemoglobin comes into contact with air containing oxygen, it binds readily and reversibly
with oxygen molecules and becomes almost 100% saturated.
The oxygen saturation is 100% when all the hemoglobin in blood carry 4 oxygen molecules.
Thus, in area of the body where there is a high partial pressure of oxygen, such as the lungs,
hemoglobin molecules will be carrying maximum amount of oxygen and will be fully saturated.
But, in case of areas where the oxygen level is low, fewer hemoglobin molecules carry their
maximum capacity of oxygen and the hemoglobin may be only partially saturated.
As blood travels from the lungs to actively respiring tissues, the amount of oxygen bound to
hemoglobin falls as the partial pressure of oxygen decreases.
Hemoglobin readily gives away oxygen where the partial pressure is lower.
An oxygen dissociation curve shows the percentage saturation of hemoglobin at different
oxygen concentrations.
The sigmoid S-shape of the dissociation curve is because the affinity of hemoglobin changes at
different partial pressures of oxygen.
At a partial pressure of about 10 kPa, which exists in the lungs, hemoglobin is 95% saturated.
At a partial pressure of 4 kPa, seen in the tissues, hemoglobin releases the oxygen, so saturation
decreases to only about 50%. Large amounts of the oxygen collected by hemoglobin in the lungs
is released at this low partial pressure to supply the needs of actively respiring cells.

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Myoglobin is also an oxygen-binding protein, but it is found in muscle cells.
Each myoglobin molecule consists of only one heme group, and thus can it bind to just one
oxygen molecule.
Its purpose is to store oxygen, which is released when oxygen supply in the muscles falls and the
muscles begin to respire anaerobically.
The dissociation curve for myoglobin is to the left of the curve for hemoglobin.
Myoglobin remains saturated at almost all partial pressures of oxygen.
It is still fully saturated with oxygen at partial pressures below those causing hemoglobin to
release oxygen, and myoglobin can hold onto oxygen until the partial pressure falls very low.
It provides a reserve of oxygen during rigorous physical activities.
This is because oxygen is only released when the partial pressure falls to around 1 kPa, and this
reserve means that muscles can continue to carry out aerobic respiration for longer.

The Bohr shift

The release of oxygen by
hemoglobin is influenced by
an effect known as Bohr
shift.
As the partial pressure of
carbon dioxide increase,
he oglo i s affi it for
oxygen is reduced.
Hence, the oxygen
dissociation curve shifts to
the right, as compared to
normal blood CO2
concentrations.
Respiring tissues have high
partial pressures of carbon
dioxide in them, so oxygen
tends to dissociate easily,
whereas in the case of lungs,
there is a higher partial
pressure of oxygen and this
allows the oxygen to bind to
hemoglobin.

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Fetal hemoglobin
The molecular structure of fetal hemoglobin is different from that of an adult hemoglobin.
Fetal hemoglobin has a higher affinity for oxygen than adult hemoglobin, irrespective of the
concentration of oxygen.
The dissociation curve for fetal hemoglobin lies to the left of the adult curve for all partial
pressures of oxygen.
In the placenta, the partial pressure of oxygen is low.
Here the other s adult he oglo i releases o ge , and this oxygen is easily picked up and
bound to fetal hemoglobin.
As seen from the graph, at a partial pressure of 4 kPa, the adult hemoglobin is only 50%
saturated, but fetal hemoglobin is around 70% saturated.
The fetal hemoglobin carries the oxygen to the hild s body and releases it into the respiring
tissues of the fetus.

High altitudes & gas exchange

The composition of oxygen in the air is the same at high altitude, as it is at sea level.
However, the partial pressure of oxygen is lower.
At these low partial pressures, hemoglobin does not become fully saturated with oxygen.
When a person moves from low to high altitude they may experience mountain sickness.
Some of the symptoms include headache, nausea, dizziness, rapid pulse and breathlessness.
This can be avoided by travelling to high altitudes gradually over a period of days so that the
body has the chance to acclimatize to the conditions.
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During acclimatization, the body copes with the lower oxygen availability.
Ventilation rate increases temporarily and adjustments to the circulatory system ensure that the
rate of oxygen delivery to the tissues increases.
Over a period of time, the number of red blood cells rises and causes an increase in the
concentration of hemoglobin.
The muscles produce more myoglobin and the density of capillaries in the lungs rises.
After prolonged stay at high altitudes, the size of the lungs and the tidal volume increases.
People who live permanently at high altitude, thus have a larger lung capacity and surface area
for gas exchange, as well as a greater concentration of myoglobin in their muscles.

Emphysema
Emphysema is a chronic pulmonary disease which slowly destroys the alveolar tissue in the
lungs, causing them to eventually burst.
They then turn into large, irregular sacs, which trap air in the lungs.
The area available for gas exchange is significantly reduced, so that insufficient oxygen reaches
the blood.
The causes of emphysema are: smoking, long-term exposure to air pollution, industrial
pollutants and coal, silica dust, etc.
Treatment includes quitting smoking, bronchial dilators delivered via an inhaler, oxygen therapy
in which oxygen is inhaled from a cylinder either continuously or during periods of exercise.
Sometimes surgery may be required either to remove damaged lung tissue or even for carrying
out lung transplants.

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Methods of carbon dioxide transport
Carbon dioxide is carried by the blood to the lungs in 3 different ways.
A tiny amount is carried dissolved in the blood plasma.
Some of them are bound to hemoglobin reversibly.
However, the largest amount of carbon dioxide is converted to HCO3- ions in red blood cells.
The process occurs in the following manner:

Carbon dioxide gas diffuses into the red blood cells.

It then reacts with water to form carbonic acid, which dissociates to form hydrogen
carbonate (HCO3-) ions and hydrogen (H+) ions.
This reaction is catalyzed by an enzyme known as carbonic anhydrase.
The HCO3- ions that are formed move out of the red blood cells via channel proteins by
means of facilitated diffusion.
HCO3- ions are exchanged for chloride ions, so the balance of charges on either side of the
membrane is not altered. This phenomenon is termed as the chloride shift.
The H+ ions remaining in the red blood cells bind reversibly to hemoglobin to prevent the fall
of pH by a process known as pH buffering.

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Control of ventilation rate
During exercise, the ventilation rate and tidal volume increases.
The bodily muscles need oxygen for aerobic cell respiration.
Thus, as the rate of exercise increases, the rate of oxygen consumption also rises.
Blood reaching the lungs has a higher amount of carbon dioxide resulting from increased cell
activity.
An increase in ventilation rate and tidal volume draws in more fresh air to maintain the
concentration gradient between across the alveolar walls.
Thus, oxygen can be taken in at a faster rate, and can get rid of the additional carbon dioxide
produced.
These ha ges i e tilatio are adjusted to at h the od s eta oli eeds.
Ventilation rate is controlled by the breathing centre of the medulla oblongata in the brain
stem, which receives nerve impulses from sensory cells in different parts of the body.
The breathing centre responds to match ventilation rate to activity levels.
Chemoreceptors in the inner wall of the aorta and carotid arteries respond to an increase in
levels of carbon dioxide in the blood.
This excess carbon dioxide forms carbonic acid that cannot be buffered, and so the pH of the
blood falls.
Impulses are passed to the medulla, which increases the ventilation rate by sending motor
impulses to the intercostal muscles and diaphragm to increase their rate of contraction.
The breathing centre contains similar chemoreceptors, which also respond to deviations of
blood pH from the normal level.
An increase in ventilation rate causes carbon dioxide to be removed from the body at a faster
rate and blood pH returns to its normal level.
After completion of exercise, as the level of carbon dioxide in the blood drops, the pH rises and
the ventilation rate decreases.

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