Module-3 21BE45 Notes

RV Institute of Technology & Management®
Rashtreeya Sikshana Samithi Trust's
Rashtreeya Vidyalaya Institute of Technology and

Management (RVITM), Bengaluru
BIOLOGY FOR ENGINEERS

SEMESTER-4
HUMAN ORGAN SYSTEMS AND BIO-DESIGNS - 2 (QUALITATIVE)

Module-3
Prepared by
Mr.Manjunath K N
Assistant Professor,
Dept. of CSE,
RVITM, Bengaluru
DEPARTMENT OF COMPUTER SCIENCE AND ENGINEERING
IV-Semester, Biology for Engineers (21BE45) Page1 | 42

Module 3 HUMAN ORGAN SYSTEMS AND BIO-DESIGNS - 2 (QUALITATIVE) RBT Levels
 Lungs as purification system (architecture, gas exchange mechanisms,

spirometry, abnormal lung physiology - COPD, Ventilators, Heart-lung
machine). L1, L2
 Kidney as a filtration system (architecture, mechanism of filtration, CKD,
dialysis systems).
 Muscular and Skeletal Systems as scaffolds (architecture, mechanisms,
bioengineering solutions for muscular dystrophy and osteoporosis).

LUNGS AS PURIFICATION SYSTEM

1.1 The Structure of Respiratory System
The respiratory system is divided into a respiratory zone which is the site of gas exchange
between air and blood, and a conducting zone. The exchange of gases between air and blood
occurs across the walls of respiratory alveoli, which permit rapid rates of gas diffusion.
The term respiration includes three separate but related functions: (1) ventilation
(breathing); (2) gas exchange, which occurs between the air and blood in the lungs and
between the blood and other tissues of the body; and (3) oxygen utilization by the tissues in
the energy-liberating reactions of cell respiration.
Ventilation and the exchange of gases (oxygen and carbon dioxide) between the air and blood
are collectively called external respiration. Gas exchange between the blood and other tissues
and oxygen utilization by the tissues are collectively known as internal respiration.
Ventilation is the mechanical process that moves air into and out of the lungs. Because the
oxygen concentration of air is higher in the lungs than in the blood, oxygen diffuses from air
to blood. Carbon dioxide, conversely, moves from the blood to the air within the lungs by
diffusing down its concentrationgradient. As a result of this gas exchange, the inspired air
contains more oxygen and less carbon dioxide than the expired air. More importantly, blood
leaving the lungs (in the pulmonary veins) has a higher oxygen and a lower carbon dioxide
concentration than the blood delivered to the lungs in the pulmonary arteries. This is because
the lungs function to bring the blood into gaseous equilibrium with the air.
Gas exchange between the air and blood occurs entirely by diffusion through lung tissue.
This diffusion occurs very rapidly because of the large surface area within the lungs and the
very small diffusion distance between blood and air.
1.2 Gas exchange mechanisms
Gas exchange in the lungs occurs across an estimated 300million tiny (about 100 mm in
diameter) air sacs known as alveoli. Their enormous number provides a large surface area
(60 to 80 square meters, or about 760 square feet) for diffusion of gases. The diffusion rate
between the alveolar air and capillary blood also depends on the distance separating them.

The thickness of the average alveolar cell and capillary endothelial cells is about 0.15 mm
each, forming an extremely thin air-blood distance of only about 0.3 mm.
There are two types of alveolar cells, designated type I alveolar cells and type II alveolar
cells (fig. 16.1).
Fig. 1.1 The relationship between lung alveoli and pulmonary capillaries.
The type Ialveolar cells comprise 95% to 97% of the total surface areaof the lung; gas
exchange with the blood thus occurs primarilythrough type I alveolar cells. These cells are
accordingly verythin: where the basement membranes of the type I alveolarcells and capillary
endothelial cells fuse, the diffusion distancebetween blood and air can be as little as 0.3
mm,which is about 1/100th the width of a human hair. The type II alveolar cells are the cells
that secrete pulmonary surfactantand that reabsorb Na1 and H2O, thereby preventingfluid
build-up within the alveoli.
In order to maximize the rate of gas diffusion between the air and blood, the air-blood barrier
provided by the alveoli is extremely thin and has a very large surface area. Despite these
characteristics, the alveolar wall isn’t fragile but is strong enough to withstand high stress
during heavy exercise and high lung inflation. The great tensile strength of the alveolar wall
is provided by the fused basement membranes (composed of type IV collagen proteins;
chapter 1, section 1.3) of the blood capillaries and the alveolar walls.

Alveoli are polyhedral in shape and are usually clustered, like the units of a honeycomb. Air
within one member of a cluster can enter other members through tiny pores. These clusters of
alveoli usually occur at the ends of respiratory bronchioles,the very thin air tubes that end
blindly in alveolar sacs. Individual alveoli also occur as separate outpouchings along the
length of respiratory bronchioles. Although the distance between each respiratory bronchiole
and its terminal alveoli is only about 0.5 mm, these units together constitute most of the mass
of the lungs.
The air passages of the respiratory system are divided into two functional zones. The
respiratory zone is the region where gas exchange occurs, and it therefore includes the
respiratory bronchioles (because they contain separate outpouchings of bronchiole and its
terminal alveoli is only about 0.5 mm, these units together constitute most of the mass of the
lungs. The conducting zoneincludes all of the anatomical structures through which air passes
before reaching the respiratory zone (fig. 16.2).
Fig. 1.2 The conducting and respiratory zones of the respiratory system.
Air enters the respiratory bronchioles from terminal bronchioles, which are the narrowest of
the airways that do not have alveoliand do not contribute to gas exchange. The terminal
bronchioles receive air from larger airways, which are formed from successive branchings of
the right and left primary bronchi. These two large air passages, in turn, are continuous with
the trachea, or windpipe, which is located in the neck in front of the oesophagus (a muscular

tube that carries food to the stomach). The trachea is a sturdy tube supported by rings of
cartilage (fig. 16.3).
Fig. 1.3 The conducting zone of the respiratory system. (a) An anterior view extending
from the larynx to the terminal bronchi and (b) the airway from the trachea to the
terminal bronchioles.
Air enters the trachea from the pharynx, which is the cavity behind the palate that receives
the contents of both the oral and nasal passages. In order for air to enter or leave the trachea
and lungs, however, it must pass through a valve like opening called the glottis between the
vocal folds. The ventricular andvocal folds are part of the larynx, or voice box, which guards
the entrance to the trachea. The projection at the front of the throat, commonly called the
“Adam’s apple,” is formed by the largest cartilage of the larynx.
The conducting zone of the respiratory system, in summary, consists of the mouth, nose,
pharynx, larynx, trachea, primary bronchi, and all successive branchings of the bronchioles
up to and including the terminal bronchioles. In addition to conducting air into the respiratory
zone, these structures serve additional functions: warming and humidification of the inspired
air, and filtration and cleaning.

Regardless of the temperature and humidity of the ambientair, when the inspired air reaches
the respiratory zone it isat a temperature of 37 degree C (body temperature), and it is
saturatedwith water vapour as it flows over the warm, wet mucousmembranes that line the
respiratory airways. This ensures thata constant internal body temperature will be maintained
andthat the lung tissue will be protected from desiccation.
1.3 Spirometry
Spirometry is a simple test used to help diagnose and monitor certain lung conditions by
measuring how much air you can breathe out in one forced breath.
It's carried out using a device called a spirometer, which is a small machine attached by a
cable to a mouthpiece.
Spirometry can be used to help diagnose a lung condition if you have symptoms, or if your
doctor feels you're at an increased risk of developing a particular lung condition. For
example, spirometry may be recommended if you have a persistent cough or breathlessness,
or if you're over 35 and smoke.
Conditions that can be picked up and monitored using spirometry include:
 asthma – a long-term condition where the airways become periodically inflamed

(swollen) and narrowed
 chronic obstructive pulmonary disease (COPD) – a group of lung conditions where
the airways become narrowed
 cystic fibrosis – a genetic condition where the lungs and digestive system become
clogged with thick, sticky mucus
 pulmonary fibrosis – scarring of the lungs
If you've already been diagnosed with 1 of these conditions, spirometry may be carried out to
check the severity of the condition or see how you're responding to treatment.
Spirometry is also a standard test for people being considered for surgery, or to check the
general health of people who have other conditions, such as rheumatoid arthritis.
1.3.1 What happens during a spirometry test?

When you're ready for the test, you'll be asked to:

 inhale fully, so your lungs are completely filled with air

 close your lips tightly around the mouthpiece
 exhale as quickly and forcefully as you can, making sure you empty your lungs fully
This will normally need to be repeated at least 3 times to ensure a reliable result.
Sometimes, the test may need to be repeated around 15 minutes after taking some inhaled
bronchodilator medicine.
1.3.2 Risks and side effects

Spirometry is a straightforward test and is generally considered very safe. Some people may
feel dizzy, faint, shaky, sick or tired for a short period afterwards.
Most people are able to have a spirometry test safely. But the test increases the pressure
inside your head, chest, stomach and eyes as you breathe out, so it may need to be delayed or
avoided if you have a condition that could be made worse by this.
For example, spirometry may not be safe if you have, or have recently had, unstable angina, a
heart attack, uncontrolled high blood pressure, or an operation to your head, chest, stomach or
eyes.
1.4 Abnormal lung physiology – COPD
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough,
mucus (sputum) production and wheezing. It's typically caused by long-term exposure to
irritating gases or particulate matter, most often from cigarette smoke. People with COPD are
at increased risk of developing heart disease, lung cancer and a variety of other conditions.
Emphysema and chronic bronchitis are the two most common conditions that contribute
to COPD. These two conditions usually occur together and can vary in severity among
individuals with COPD.
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and
from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum)

production.Emphysema is a condition in which the alveoli at the end of the smallest air
passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to
cigarette smoke and other irritating gases and particulate matter.Although COPD is a
progressive disease that gets worse over time, COPD is treatable. With proper management,
most people with COPD can achieve good symptom control and quality of life, as well as
reduced risk of other associated conditions.
1.4.1 Symptoms
COPD symptoms often don't appear until significant lung damage has occurred, and they
usually worsen over time, particularly if smoking exposure continues.Signs and symptoms
of COPD may include:
 Shortness of breath, especially during physical activities
 Wheezing
 Chest tightness
 A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or
greenish
 Frequent respiratory infections
 Lack of energy
 Unintended weight loss (in later stages)
 Swelling in ankles, feet or legs
1.5 Ventilator
A ventilator is a piece of medical technology that provides mechanical ventilation by moving
breathable air into and out of the lungs, to deliver breaths to a patient who is physically
unable to breathe, or breathing insufficiently. Ventilators are computerized microprocessor-
controlled machines, but patients can also be ventilated with a simple, hand-operated bag
valve mask. Ventilators are chiefly used in intensive-care medicine, home care,

and emergency medicine (as standalone units) and in anaesthesiology (as a component of
an anaesthesia machine).
Ventilators are sometimes called "respirators", a term commonly used for them in the 1950s
(particularly the "Bird respirator"). However, contemporary medical terminology uses the
word "respirator" to refer instead to a face-mask that protects wearers against hazardous
airborne substances.
In its simplest form, a modern positive pressure ventilator (fig 1.4), consists of a
compressible air reservoir or turbine, air and oxygen supplies, a set of valves and tubes, and a
disposable or reusable "patient circuit". The air reservoir is pneumatically compressed several
times a minute to deliver room-air, or in most cases, an air/oxygen mixture to the patient. If a
turbine is used, the turbine pushes air through the ventilator, with a flow valve adjusting
pressure to meet patient-specific parameters. When over pressure is released, the patient will
exhale passively due to the lungs' elasticity, the exhaled air being released usually through
a one-way valve within the patient circuit called the patient manifold.
Ventilators may also be equipped with monitoring and alarm systems for patient-related
parameters (e.g., pressure, volume, and flow) and ventilator function (e.g., air leakage, power
failure, and mechanical failure), backup batteries, oxygen tanks, and remote control. The
pneumatic system is nowadays often replaced by a computer-controlled turbo pump.

Fig. 1.4 The Ventilator support system
Modern ventilators are electronically controlled by a small embedded system to allow exact
adaptation of pressure and flow characteristics to an individual patient's needs. Fine-tuned
ventilator settings also serve to make ventilation more tolerable and comfortable for the
patient.
The patient circuit usually consists of a set of three durable, yet lightweight plastic tubes,
separated by function (e.g. inhaled air, patient pressure, exhaled air). Determined by the type
of ventilation needed, the patient-end of the circuit may be either non-invasive or invasive.
Non-invasive methods, such as continuous positive airway pressure (CPAP) and non-invasive
ventilation, which are adequate for patients who require a ventilator only while sleeping and
resting, mainly employ a nasal mask. Invasive methods require intubation, which for long-
term ventilator dependence will normally be a tracheotomy cannula, as this is much more
comfortable and practical for long-term care than is larynx or nasal intubation.
1.6 Heart-Lung Machine

A heart-lung machine is a piece of equipment that temporarily takes over the work of the
heart and/or lungs, providing blood and oxygen to the body. Also called a cardiopulmonary
bypass machine (CBM) or a heart-lung bypass machine, it is most often used during serious

procedures that require the heart to be stopped.
Fig. 1.5 Cardiopulmonary bypass machine
Patients are kept on a heart-lung machine for only as long as it takes to stop the heart
frombeating, complete open-heart surgery or a procedure on the lungs, and restart the heart.
A heart-lung machine may also be used on a person who needs heart or respiratory support
for non-surgical reasons. For example, the machine can be used for someone with heart
failure who is waiting for a heart transplant.
1.6.1 What Does a Heart-Lung Machine Do?
To stop the heart without harming the patient, oxygenated blood must continue to circulate
through the body during surgery without stopping. The cardiopulmonary bypass pump does
the work of the heart, pumping blood through the body and making sure that the tissues of the
body get the oxygen they need.
The machine also adds oxygen to the blood while taking over the pumping action of the
heart, replacing the function of the lungs.

1.6.2 When a Heart-Lung Machine Is Used
There are two primary reasons why a heart-lung machine is used. The most common use is so
the heart can be stopped for surgery, but the machine can also be used to support people with
heart failure.
1.6.3 Heart Surgery
Some cardiac surgeries would be impossible to perform with the heart beating, as surgery
would be performed on a “moving target” or there would be significant blood loss.A great
example of this is a heart transplant procedure: The patient's heart must be removed from the
body so the donated heart can be put in.Without a pump to replace the action of the heart, the
heart transplant would be impossible.
1.6.4 Lung Surgery
The same is true of some lung surgeries; there must be a way to oxygenate the blood when
the lungs cannot.A lung transplant procedure requires an alternative way to oxygenate blood
when the lungs cannot, but the heart may continue to beat during the procedure.
1.6.5 Heart Failure
For other patients, the pump is used not for surgery, but to help keep a patient alive when
they are experiencing heart failure that would be life-ending. In some rare cases, a heart
failure patient may be placed on the pump to support the patient until a
heart transplant becomes available.
1.6.6 How Does a Heart-Lung Bypass Machine Work?
The surgeon attaches special tubing to a large blood vessel (like starting a very large IV) that
allows oxygen-depleted blood to leave the body and travel to the bypass machine. There, the
machine oxygenates the blood and returns it to the body through the second set of tubing,
also attached to the body. The constant pumping of the machine pushes the oxygenated blood
through the body, much like the heart does.

The placement of the tubes is determined by the preference of the surgeon. The tubes must be
placed away from the surgical site so they do not interfere with the surgeon’s work, but
placed in a blood vessel large enough to accommodate the tubing and the pressure of the
pump. The two tubes ensure that blood leaves the body before reaching the heart and returns
to the body after the heart, giving the surgeon a still and mostly bloodless area to work.
A third tube is also inserted very near or directly into the heart, but not connected to the
CPM. It is used to flush the heart with cardioplegia, a potassium solution which stops the
heart.Once the cardioplegia takes effect, the CBM is initiated and takes over the heart and
lung function.
1.6.7 Risks of Cardiopulmonary Bypass
The risks of being on heart and lung bypass include blood clots, bleeding after surgery,
surgical injury to the phrenic nerve, acute kidney injury, and decreased lung and/or heart
function. These risks are decreased with shorter times on the pump and increased with longer
pump times.
KIDNEY AS A FILTRATION SYSTEM

2.1 Structure and function of the kidneys
Each kidney contains many tiny tubules that empty into acavity drained by the ureter. Each of
the tubules receives a blood filtrate from a capillary bed called the glomerulus. The filtrate is
modified as it passes through different regions of the tubule and is thereby changed into
urine.
The primary function of the kidneys is regulation of the extracellularfluid (plasma and
interstitial fluid) environment in the body. This is accomplished through the formation of
urine, which is a modified filtrate of plasma. In the process of urine formation, the kidneys
regulate
1. The volume of blood plasma (and thus contribute significantly to the regulation of blood
pressure).
2. The concentration of waste products in the plasma.
3. The concentration of electrolytes (Na1, K1, HCO3- and other ions) in the plasma; and

4. The pH of plasma.
2.1.1 Gross Structure of the Urinary System
The paired kidneys lie on either side of the vertebral column below the diaphragm and liver.
Each adult kidney weighs about 160 g and is about 11 cm (4 in.) long and 5 to 7 cm (2 to 3
in.) wide—about the size of a fist. Urine produced in the kidneys is drained into a cavity
known as the renal pelvis (5 basin) and then is channelled from each kidney via long ducts—
the ureters —to the urinary bladder (fig. 2.1).
Fig. 2.1 Structure of the Urinary System

A coronal section of the kidney shows two distinct regions (fig. 2.1). The outer cortex is
reddish brown and granular in appearance because of its many capillaries. The deeper region
or medulla, is striped in appearance due to the presence of microscopic tubules and blood
vessels.
The medulla is composed of 8 to 15 conical renal pyramids separated by renal columns.
The cavity of the kidney is divided into several portions. Each pyramid projects into a small
depression called a minorcalyx (the plural form is calyces). Several minor calyces unite to
form a major calyx. The major calyces then join to form the funnel-shaped renal pelvis.

Fig. 2.2The Structure of the kidney
The renal pelvis collects urine from the calyces and transports it to the ureters and urinary
bladder. The ureter undergoes peristalsis, wavelike contractionssimilar to those that occur in
the digestive tract. (This resultsin intense pain when a person passes a kidney stone.)
Interestingly,the pacemaker of these peristaltic waves is located in the renal calyces and
pelvis (see fig. 2.2), which contain smooth muscle. The calyces and pelvis also undergo
rhythmic contractions, which may aid the emptying of urine from the kidney.
Some scientists have suggested that these peristaltic contractions may affect the transport
properties of the renal tubules, and thus influence the concentration of the urine. the urinary
bladder is a storage sac for urine, and its shape is determined by the amount of urine it
contains. An empty urinary bladder is pyramidal; as it fills, it becomes ovoid and bulges
upward into the abdominal cavity. The urinary bladder is drained inferiorly by the tubular
urethra. In females, the urethra is 4 cm (1.5 in.) long and opens into the space between the
labia minora (chapter 20; see fig. 20.24). In males, the urethra is about 20 cm (8 in.) long and
opens at the tip of the penis, from which it can discharge either urine or semen.

Fig. 2.2 A pseudocolor radiograph of the urinary system.
2.1.2Microscopic Structure of the Kidney
The nephron (see fig. 2.3) is the functional unit of the kidneyresponsible for the formation of
urine. Each kidney contains more than a million nephrons. A nephron consists of small tubes,
or tubules, and associated small blood vessels. Fluid formed by capillary filtration enters the
tubules and is subsequently modified by transport processes; the resulting fluid that leaves the
tubules is urine.
Fig. 2.3A single nephron tubule

a) Renal Blood Vessels

Arterial blood enters the kidney through the renal artery, which divides into interlobar
arteries that pass between the pyramids through the renal columns. Arcuate arteries branch
from the interlobar arteries at the boundary of the cortex and medulla.
A number of interlobular arteries radiate from the arcuate arteries into the cortex and
subdivide into numerous afferent arterioles (fig.), which are microscopic. The afferent
arterioles deliver blood into glomeruli —capillary networks that produce a bloodfiltrate that
enters the urinary tubules. The blood remaining in a glomerulus leaves through an efferent
arteriole, which delivers the blood into another capillary network—the
peritubularcapillaries surrounding the renal tubules.
This arrangement of blood vessels is unique. It is the only one in the body in which a
capillary bed (the glomerulus) is drained by an arteriole rather than by a venule and delivered
to a second capillary bed located downstream (the peritubular capillaries).
Blood from the peritubular capillaries is drained into veins that parallel the course of the
arteries in the kidney. These veins are called the interlobular veins, arcuate veins, and
interlobarveins. The interlobar veins descend between the pyramids, converge, and leave the
kidney as a single renal vein, which empties into the inferior vena cava.
b) Nephron Tubules
The tubular portion of a nephron consists of a glomerular capsule,a proximal convoluted
tubule, a descending limb of the loop of Henle, an ascending limb of the loop of Henle, and
adistal convoluted tubule.
The glomerular (Bowman’s) capsule surrounds the glomerulus. The glomerular capsule and
its associated glomerulus are located in the cortex of the kidney and together constitute the
renal corpuscle. The glomerular capsule contains an inner visceral layer of epithelium around
the glomerular capillaries and an outer parietal layer. The space between these two layers is
continuous with the lumen of the tubule and receives the glomerular filtrate, as will be
described in the next section.
Filtrate that enters the glomerular capsule passes into the lumen of the proximal convoluted
tubule. The wall of the proximal convoluted tubule consists of a single layer of cuboidal cells
containing millions of microvilli; these microvilli increase the surface area for reabsorption.

In the process of reabsorption, salt, water, and other molecules needed by the body are
transported from the lumen, through the tubular cells and into the surrounding peritubular
capillaries.
The glomerulus, glomerular capsule, and convoluted tubule are located in the renal cortex.
Fluid passes from the proximal convoluted tubule to the nephron loop, or loop of Henle.
This fluid is carried into the medulla in the descending limb of the loop and returns to the
cortex in the ascending limb of the loop. Back in the cortex, the tubule again becomes coiled
and is called the distal convoluted tubule. The distal convoluted tubule is shorter than the
proximal tubule and has relatively few microvilli. The distal convoluted tubule terminates as
it empties into a collecting duct.
The two principal types of nephrons are classified according to their position in the kidney
and the lengths of their loops of Henle. Nephrons that originate in the inner one-third of the
cortex—called juxtamedullary nephrons because they are next to the medulla—have longer
nephron loops than the more numerous cortical nephrons, which originate in the outer two
thirds of the cortex. The juxtamedullary nephrons play an important role in the ability of the
kidney to produce aconcentrated urine.
2.2 Mechanism of filtration

There are four basic processes in the formation of urine starting with plasma.
1) Filtration
Filtration is the mass movement of water and solutes from plasma to the renal tubule that
occurs in the renal corpuscle. About 20% of the plasma volume passing through the
glomerulus at any given time is filtered. This means that about 180 liters of fluid are filtered
by the kidneys every day. Thus, the entire plasma volume (about 3 liters) is filtered 60 times
a day! Filtration is primarily driven by hydraulic pressure (blood pressure) in the capillaries
of the glomerulus. The kidneys filter much more fluid than the amount of urine that is
actually excreted (about 1.5 liters per day). This is essential for the kidneys to rapidly remove
waste and toxins from the plasma efficiently.
2) Reabsorption

Reabsorption is the movement of water and solutes from the tubule back into the plasma.
Reabsorption of water and specific solutes occurs to varying degrees over the entire length of
the renal tubule.
Bulk reabsorption, which is not under hormonal control, occurs largely in the proximal
tubule. Over 70% the filtrate is reabsorbed here. In addition, many important solutes
(glucose, amino acids, bicarbonate) are actively transported out of the proximal tubule such
that their concentrations are normally extremely low in the remaining fluid. Further bulk
reabsorption of sodium occurs in the loop of Henle.Regulated reabsorption, in which
hormones control the rate of transport of sodium and water depending on systemic
conditions, takes place in the distal tubule and collecting duct.
3) Secretion
Even after filtration has occurred, the tubules continue to secrete additional substances into
the tubular fluid. This enhances the kidney's ability to eliminate certain wastes and toxins. It
is also essential to regulation of plasma potassium concentrations and pH. (See Fluid and
electrolyte balance).
4) Excretion
Excretion is what goes into the urine, the end result of the above three processes. Although
the original concentration of a substance in the tubule fluid may initially be close to that of
plasma, subsequent reabsorption and/or secretion can dramatically alter the final
concentration in the urine.The amount of a particular substance that is excreted is determined
by the formula:amount excreted = amount filtered - amount reabsorbed + amount secreted
2.2.1 Urine-creation
The kidneys filter unwanted substances from the blood and produce urine to excrete them.
There are three main steps of urine formation: glomerular filtration, reabsorption, and
secretion. These processes ensure that only waste and excess water are removed from the
body.

1. The Glomerulus Filters Water and Other Substances from the Bloodstream
Each kidney contains over 1 million tiny structures called nephrons. Each nephron has
a glomerulus, the site of blood filtration. The glomerulus is a network of capillaries
surrounded by a cuplike structure, the glomerular capsule (or Bowman’s capsule). As blood
flows through the glomerulus, blood pressure pushes water and solutes from the capillaries
into the capsule through a filtration membrane. This glomerular filtration begins the urine
formation process.
2. The Filtration Membrane Keeps Blood Cells and Large Proteins in the Bloodstream
Inside the glomerulus, blood pressure pushes fluid from capillaries into the glomerular
capsule through a specialized layer of cells. This layer, the filtration membrane, allows
water and small solutes to pass but blocks blood cells and large proteins. Those components
remain in the bloodstream. The filtrate (the fluid that has passed through the membrane)
flows from the glomerular capsule further into the nephron.
3. Reabsorption Moves Nutrients and Water Back into the Bloodstream

The glomerulus filters water and small solutes out of the bloodstream. The resulting filtrate
contains waste, but also other substances the body needs: essential ions, glucose, amino acids,
and smaller proteins. When the filtrate exits the glomerulus, it flows into a duct in the
nephron called the renal tubule. As it moves, the needed substances and some water are
reabsorbed through the tube wall into adjacent capillaries. This reabsorption of vital nutrients
from the filtrate is the second step in urine creation.
4. Waste Ions and Hydrogen Ions Secreted from the Blood Complete the Formation of
Urine
The filtrate absorbed in the glomerulus flows through the renal tubule, where nutrients and
water are reabsorbed into capillaries. At the same time, waste ions and hydrogen ions pass
from the capillaries into the renal tubule. This process is called secretion. The secreted ions
combine with the remaining filtrate and become urine. The urine flows out of the nephron
tubule into a collecting duct. It passes out of the kidney through the renal pelvis, into the
ureter, and down to the bladder.

5. Urine Is 95% Water

The nephrons of the kidneys process blood and create urine through a process of filtration,
reabsorption, and secretion. Urine is about 95% water and 5% waste products. Nitrogenous
wastes excreted in urine include urea, creatinine, ammonia, and uric acid. Ions such as
sodium, potassium, hydrogen, and calcium are also excreted.
2.3 Chronic kidney disease

Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney
function. Your kidneys filter wastes and excess fluids from your blood, which are then
removed in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid,
electrolytes and wastes to build up in your body. In the early stages of chronic kidney disease,
you might have few signs or symptoms. You might not realize that you have kidney disease
until the condition is advanced.
Treatment for chronic kidney disease focuses on slowing the progression of kidney damage,
usually by controlling the cause. But, even controlling the cause might not keep kidney
damage from progressing. Chronic kidney disease can progress to end-stage kidney failure,
which is fatal without artificial filtering (dialysis) or a kidney transplant.
2.3.1 Symptoms
Signs and symptoms of chronic kidney disease develop over time if kidney damage
progresses slowly. Loss of kidney function can cause a build-up of fluid or body waste or
electrolyte problems. Depending on how severe it is, loss of kidney function can cause:
 Nausea
 Vomiting
 Loss of appetite
 Fatigue and weakness
 Sleep problems

 Urinating more or less
 Decreased mental sharpness
 Muscle cramps
 Swelling of feet and ankles
 Dry, itchy skin
 High blood pressure (hypertension) that's difficult to control
 Shortness of breath, if fluid builds up in the lungs
 Chest pain, if fluid builds up around the lining of the heart

Signs and symptoms of kidney disease are often nonspecific. This means they can also be
caused by other illnesses. Because your kidneys are able to make up for lost function, you
might not develop signs and symptoms until irreversible damage has occurred.
2.3.2 Causes
Chronic kidney disease occurs when a disease or condition impairs kidney function, causing
kidney damage to worsen over several months or years. Diseases and conditions that cause
chronic kidney disease include:
 Type 1 or type 2 diabetes
 High blood pressure

 Glomerulonephritis, an inflammation of the kidney's filtering units (glomeruli)
 Interstitial nephritis, an inflammation of the kidney's tubules and surrounding structures
 Polycystic kidney disease or other inherited kidney diseases
 Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate,
kidney stones and some cancers
 Vesicoureteral reflux, a condition that causes urine to back up into your kidneys
 Recurrent kidney infection, also called pyelonephritis
2.3.4 Risk factors

Factors that can increase your risk of chronic kidney disease include:
 Diabetes
 High blood pressure
 Heart (cardiovascular) disease
 Smoking
 Obesity
 Being Black, Native American or Asian American
 Family history of kidney disease
 Abnormal kidney structure
 Older age
 Frequent use of medications that can damage the kidney

2.3.5 Complication
Chronic kidney disease can affect almost every part of your body. Potential complications
include:
 Fluid retention, which could lead to swelling in your arms and legs, high blood
pressure, or fluid in your lungs (pulmonary edema)
 A sudden rise in potassium levels in your blood (hyperkalaemia), which could impair
your heart's function and can be life-threatening
 Anaemia
 Heart disease
 Weak bones and an increased risk of bone fractures
 Decreased sex drive, erectile dysfunction or reduced fertility
 Damage to your central nervous system, which can cause difficulty concentrating,
personality changes or seizures
 Decreased immune response, which makes you more vulnerable to infection

 Pericarditis, an inflammation of the saclike membrane that envelops your heart

(pericardium)
 Pregnancy complications that carry risks for the mother and the developing foetus
 Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring

either dialysis or a kidney transplant for survival
2.3.6 Prevention
To reduce your risk of developing kidney disease:
 Follow instructions on over-the-counter medications. When using non-prescription

pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen
(Tylenol, others), follow the instructions on the package. Taking too many pain
relievers for a long time could lead to kidney damage.
 Maintain a healthy weight. If you're at a healthy weight, maintain it by being

physically active most days of the week. If you need to lose weight, talk with your
doctor about strategies for healthy weight loss.
 Don't smoke. Cigarette smoking can damage your kidneys and make existing kidney
damage worse. If you're a smoker, talk to your doctor about strategies for quitting.
Support groups, counselling and medications can all help you to stop.
 Manage your medical conditions with your doctor's help. If you have diseases or
conditions that increase your risk of kidney disease, work with your doctor to control
them. Ask your doctor about tests to look for signs of kidney damage.
2.4 Dialysis Systems

Dialysis is a procedure to remove waste products and excess fluid from the blood when the
kidneys stop working properly. It often involves diverting blood to a machine to be
cleaned.Dialysis is a procedure to remove waste products and excess fluid from the
blood when the kidneys stop working properly. It often involves diverting blood to a machine
to be cleaned.
Normally, the kidneys filter the blood, removing harmful waste products and excess fluid and
turning these into urine to be passed out of the body.
2.4.1 Why do I need dialysis?
If your kidneys are not working properly – for example, because you have advanced chronic
kidney disease (kidney failure) – the kidneys may not be able to clean the blood
properly.Waste products and fluid can build up to dangerous levels in your body. Left
untreated, this can cause a number of unpleasant symptoms and eventually be fatal.Dialysis
filters out unwanted substances and fluids from the blood before this happens.
2.4.2 How long will I need dialysis for?
It depends. In some cases, kidney failure may be a temporary problem and dialysis can be
stopped when your kidneys recover.But often, someone with kidney failure will need
a kidney transplant. It's not always possible to carry out a kidney transplant straight away, so
dialysis may be needed until a suitable donor kidney becomes available.If a kidney transplant
is not suitable for you – for example, because you're not well enough to have a major
operation – dialysis may be needed for the rest of your life.
There are 2 main types of dialysis: haemodialysis and peritoneal dialysis.
1) Haemodialysis
Haemodialysis is the most common type of dialysis and the one most people are aware of,
during the procedure a tube is attached to a needle in your arm. Blood passes along the tube
and into an external machine that filters it, before it's passed back into the arm along another

tube.At dialysis centres, this is usually carried out 3 days a week, with each session lasting
around 4 hours.It can also be done at home. Some examples of a home dialysis schedule
include:
 4 times a week for 4 hours

 5 times a week for 3 hours
 6 days a week for 8 hours overnight
2) Peritoneal dialysis
Peritoneal dialysis uses the inside lining of your abdomen (the peritoneum) as the filter,
rather than a machine.Like the kidneys, the peritoneum contains thousands of tiny blood
vessels, making it a useful filtering device.Before treatment starts, a cut (incision) is made
near your belly button and a thin tube called a catheter is inserted through the incision and
into the space inside your abdomen (the peritoneal cavity). This is left in place permanently.
Fluid is pumped into the peritoneal cavity through the catheter. As blood passes through the
blood vessels lining the peritoneal cavity, waste products and excess fluid are drawn out of
the blood and into the dialysis fluid.The used fluid is drained into a bag a few hours later and
replaced with fresh fluid.Changing the fluid usually takes about 30 to 40 minutes and
normally needs to be repeated around 4 times a day.If you prefer, this can be done by a
machine overnight while you sleep.
2.4.3 Side effects of dialysis
Haemodialysis can cause itchy skin and muscle cramps. Peritoneal dialysis can put you at
risk of developing peritonitis, an infection of the thin membrane that surrounds your
abdomen.
Both types of dialysis can make you feel exhausted.

MUSCULAR AND SKELETAL SYSTEMS AS

SCAFFOLDS

3.1 Musculoskeletal system

The musculoskeletal system (locomotor system) is a human body system that provides our
body with movement, stability, shape, and support. It is subdivided into two broad systems.
 Muscular system, which includes all types of muscles in the body. Skeletal muscles, in
particular, are the ones that act on the body joints to produce movements. Besides muscles, the
muscular system contains the tendons which attach the muscles to the bones.
 Skeletal system, whose main component is the bone. Bones articulate with each other and form
the joints, providing our bodies with a hard-core, yet mobile, skeleton. The integrity and
function of the bones and joints is supported by the accessory structures of the skeletal
system; articular cartilage, ligaments, and bursae.
Besides its main function to provide the body with stability and mobility, the musculoskeletal
system has many other functions; the skeletal part plays an important role in other homeostatic
functions such as storage of minerals (e.g., calcium) and haematopoiesis, while the muscular
system stores the majority of the body's carbohydrates in the form of glycogen.
3.1.1 Muscular system
The muscular system is an organ system composed of specialized contractile tissue called
the muscle tissue. There are three types of muscle tissue, based on which all the muscles are
classified into three groups:
 Cardiac muscle, which forms the muscular layer of the heart (myocardium)
 Smooth muscle, which comprises the walls of blood vessels and hollow organs
 Skeletal muscle, which attaches to the bones and provides voluntary movement.
Based on their histological appearance, these types are classified into striated and non-striated
muscles; with the skeletal and cardiac muscles being grouped as striated, while the smooth
muscle is non-striated. The skeletal muscles are the only ones that we can control by the
power of our will, as they are innervated by the somatic part of the nervous system. In
contrast to this, the cardiac and smooth muscles are innervated by the autonomic nervous
system, thus being controlled involuntarily by the autonomic centers in our brain.

3.1.2 Skeletal muscles
The skeletal muscles are the main functional units of the muscular system. There are more
than 600 muscles in the human body. They vary greatly in shape in size, with the smallest
one being the stapedius muscle in the inner ear, and the largest one being the quadriceps
femoris muscle in the thigh. The skeletal muscles of the human body are organized into four
groups for every region of the body.
 Muscles of the head and neck, which include the muscles of the facial expression, muscles of
mastication, muscles of the orbit, muscles of the tongue, muscles of the pharynx, muscles of the
larynx, and muscles of the neck
 Muscles of the trunk, which include the muscles of the back, anterior and lateral abdominal
muscles, and muscles of the pelvic floor
 Muscles of the upper limbs, which include muscles of the shoulder, muscles of the
arm, muscles of the forearm and muscles of the hand
 Muscles of the lower limbs, which include hip and thigh muscles, leg muscles and foot muscles
Structurally, the skeletal muscles are composed of the skeletal muscle cells which are called
the myocytes (muscle fibres, or myofibrils). Muscle fibers are specialized cells whose main
feature is the ability to contract. They are elongated, cylindrical, multinucleated cells
bounded by a cell membrane called sarcolemma. The cytoplasm of skeletal muscle fibers
(sarcoplasm), contains contractile proteins called actin and myosin. These proteins are
arranged into patterns, forming the units of contractile micro-apparatus called sarcomeres.

Fig. 3.1 The structure of a skeletal muscle.
Each muscle fiber is enclosed with a loose connective tissue sheath called endomysium.
Multiple muscle fibers are grouped into muscle fascicles or muscle bundles, which are
encompassed by their own connective tissue sheath called the perimysium. Ultimately, a
group of muscle fascicles comprises a whole muscle belly which is externally enclosed by
another connective tissue layer called the epimysium. This layer is continuous with yet
another layerof connective tissue called the deep fascia of skeletal muscle, which separates
the muscles from other tissues and organs. This structure gives the skeletal muscle tissue four
main physiological properties.
 Excitability - the ability to detect the neural stimuli (action potential);
 Contractibility - the ability to contract in response to a neural stimulus;
 Extensibility - the ability of a muscle to be stretched without tearing;

 Elasticity - the ability to return to its normal shape after being extended.
3.1.3 Muscle contraction
The most important property of skeletal muscles is its ability to contract. Muscle contraction
occurs as a result of the interaction of myofibrils inside the muscle cells. This process either
shortens the muscle or increases its tension, generating a force that either facilitates or slows
down a movement.
There are two types of muscle contraction; isometric and isotonic. A muscle contraction is
deemed as isometric if the length of the muscle does not change during the contraction,
and isotonic if the tension remains unchanged while the length of the muscle changes. There
are two types of isotonic contractions.
 Concentric contraction, in which the muscle shortens due to generating enough force to
overcome the imposed resistance. This type of contraction serves to facilitate any noticeable
movement (e.g. lifting a barbell or walking on an incline).
 Eccentric contraction, in which the muscle stretches due to the resistance being greater than
the force the muscle generates. During an eccentric contraction, the muscle maintains high
tension. This type of contraction usually serves to slow down a movement (e.g. lowering a
barbell or walking downhill).
Fig. 3.2 Eccentric and concentric muscle contractions

The sequence of events that results in the contraction of a muscle cell begins as the nervous
system generates a signal called the action potential. This signal travels through motor
neurons to reach the neuromuscular junction, the site of contact between the motor nerve and
the muscle. A group of muscle cells innervated by the branches of a single motor nerve is
called the motor unit.
The incoming action potential from the motor nerve initiates the release of acetylcholine
(ACh) from the nerve into the synaptic cleft, which is the space between the nerve ending and
the sarcolemma. The ACh binds to the receptors on the sarcolemma and triggers a chemical
reaction in the muscle cell. This involves the release of calcium ions from the sarcoplasmic
reticulum, which in turn causes a rearrangement of contractile proteins within the muscle cell.
The main proteins involved are actin and myosin, which in the presence of ATP, slide over
each other and pull on the ends of each muscle cell together, causing a contraction. As the
nerve signal diminishes, the chemical process reverses and the muscle relaxes.
Fig. 3.2 The motor unit

3.1.4 Tendons
A tendon is a tough, flexible band of dense connective tissue that serves to attach skeletal
muscles to bones. Tendons are found at the distal and proximal ends of muscles, binding
them to the periosteum of bones at their proximal (origin) and distal attachment (insertion) on
the bone. As muscles contract, the tendons transmit the mechanical force to the bones, pulling
them and causing movement.

Being made of dense regular connective tissue, the tendons have an abundance of parallel
collagen fibers, which provide them with high tensile strength (resistance to longitudinal
force). The collagen fibers within a tendon are organized into fascicles, and individual
fascicles are ensheathed by a thin layer of dense connective tissue called endotenon. In turn,
groups of fascicles are ensheathed by a layer of dense irregular connective tissue
called epitenon. Finally, the epitenon is encircled with a synovial sheath and attached to it by
a delicate connective tissue band called mesotenon.
3.2 Functions of the muscular system

The main function of the muscular system is to produce movement of the body. Depending
on the axis and plane, there are several different types of movements that can be performed
by the musculoskeletal system. Some of the most important ones include:
 Flexion and extension: movement of decreasing or increasing the angle between the bones
involved in the movement, respectively. This motion takes place in the sagittal plane around a
frontal axis. An example of flexion is bending the leg at the knee joint, whereas extension
would be straightening knee from a flexed position.
 Adduction and abduction: movements of bringing the parts of the body towards or away from
the midline, respectively. These movements are carried out in the frontal plane around a
sagittal axis. For example, abduction of the arm at the shoulder joint involves moving the arm
away from the side of the body, while adduction involves bringing it back towards the body.
 Rotation is the movement in which a part of the body rotates around its vertical (longitudinal)
axis in the transverse plane. This movement is defined relative to the midline, where internal
rotation involves rotating the segment towards to the midline, while external rotation involves
moving it away from the midline. Examples include lateral or medial rotation of the thigh.
 Supination and pronation are special types of rotatory movements usually used to describe
the movements of the forearm. Supination is essentially a lateral rotation of the forearm
which turns the palms anteriorly (if the arm is anatomical position) or superiorly, when the
elbow is flexed. These movements are also sometimes used to describe movements in
the ankle and foot, in which supination means rolling the foot outwards, while pronation
means rolling the foot inwards.

Both during movement and stationary positions, muscles contribute to the overall support
and stability of joints. Many muscles and their tendons pass over joints and thereby stabilize
the articulating bones and hold them in position. In addition, the muscles also play an
important role in maintaining posture. While the movements occur mainly due to muscles
intermittently contracting and relaxing, the posture is maintained by a sustained tonic
contraction of postural muscles. These muscles act against gravity and stabilize the body
during standing or walking. The postural muscles include the muscles of the back and
abdominal muscles.
Another important function of muscles is heat production. Muscle tissue is one of the most
metabolically active tissues in the body, in which approximately 85 percent of the heat
produced in the body is the result of muscle contraction. This makes the muscles essential for
maintaining normal body temperature.
3.3 Muscular dystrophy

Muscular dystrophy is a group of diseases that cause progressive weakness and loss of
muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the
production of proteins needed to form healthy muscle.There are many kinds of muscular
dystrophy. Symptoms of the most common variety begin in childhood, mostly in boys. Other
types don't surface until adulthood. There's no cure for muscular dystrophy. But medications
and therapy can help manage symptoms and slow the course of the disease.
3.3.1 Symptoms
The main sign of muscular dystrophy is progressive muscle weakness. Specific signs and
symptoms begin at different ages and in different muscle groups, depending on the type of
muscular dystrophy.
3.3.2 Duchenne type muscular dystrophy

This is the most common form. Although girls can be carriers and mildly affected, it's much
more common in boys. Signs and symptoms, which typically appear in early childhood,
might include

 Frequent falls
 Difficulty rising from a lying or sitting position
 Trouble running and jumping
 Waddling gait
 Walking on the toes
 Large calf muscles
 Muscle pain and stiffness
 Learning disabilities
 Delayed growth
3.3.3 Becker muscular dystrophy

Signs and symptoms are similar to those of Duchenne muscular dystrophy, but tend to be
milder and progress more slowly. Symptoms generally begin in the teens but might not occur
until the mid-20s or later.
Other types of muscular dystrophy

Some types of muscular dystrophy are defined by a specific feature or by where in the body
symptoms begin. Examples include:
 Myotonic. This is characterized by an inability to relax muscles following contractions.

Facial and neck muscles are usually the first to be affected. People with this form
typically have long, thin faces; drooping eyelids; and swanlike necks.
 Facioscapulohumeral (FSHD). Muscle weakness typically begins in the face, hip and
shoulders. The shoulder blades might stick out like wings when arms are raised. Onset
usually occurs in the teenage years but can begin in childhood or as late as age 50.

 Congenital. This type affects boys and girls and is apparent at birth or before age 2.
Some forms progress slowly and cause only mild disability, while others progress
rapidly and cause severe impairment.
 Limb-girdle. Hip and shoulder muscles are usually affected first. People with this type
of muscular dystrophy might have difficulty lifting the front part of the foot and so
might trip frequently. Onset usually begins in childhood or the teenage years.
3.4 Osteoporosis
Osteoporosis weakens bones, making them more susceptible to sudden and unexpected
fractures. The disease often progresses without any symptoms or pain, and is not found until
bones fracture.
3.4.1 What is osteoporosis?
The word ‘osteoporosis’ means ‘porous bone.’ It is a disease that weakens bones, and if you
have it, you are at a greater risk for sudden and unexpected bone fractures. Osteoporosis
means that you have less bone mass and strength. The disease often develops without any
symptoms or pain, and it is usually not discovered until the weakened bones cause painful
fractures. Most of these are fractures of the hip, wrist and spine.
About 200 million people are estimated to have osteoporosis throughout the world. In the
U.S., the figure is about 54 million people. Although osteoporosis occurs in both men and
women, women are four times more likely to develop the disease than men. There are
currently about two million men in the U.S. who have osteoporosis and some 12 million more
who are at risk of developing the condition.
After age 50, one in two women and one in four men will have an osteoporosis-related
fracture in their lifetimes. Another 30% have low bone density that puts them at risk of
developing osteoporosis. This condition is called osteopenia.

Osteoporosis is responsible for more than two million fractures each year, and this number
continues to grow. There are steps you can take to prevent osteoporosis from ever occurring.
Treatments can also slow the rate of bone loss if you do have osteoporosis.
3.4.2 What causes osteoporosis?
Researchers understand how osteoporosis develops even without knowing the exact cause of
why it develops. Your bones are made of living, growing tissue. The inside of healthy bone
looks like a sponge. This area is called trabecular bone. An outer shell of dense bone wraps
around the spongy bone. This hard shell is called cortical bone.
When osteoporosis occurs, the "holes" in the "sponge" grow larger and more numerous,
which weakens the inside of the bone. Bones support the body and protect vital organs.
Bones also store calcium and other minerals. When the body needs calcium, it breaks down
and rebuilds bone. This process, called bone remodelling, supplies the body with needed
calcium while keeping the bones strong.
Up until about age 30, you normally build more bone than you lose. After age 35, bone
breakdown occurs faster than bone build-up, which causes a gradual loss of bone mass. If you
have osteoporosis, you lose bone mass at a greater rate. After menopause, the rate of bone
breakdown occurs even more quickly.
3.4.3 Symptoms and Causes
Usually, there are no symptoms of osteoporosis. That is why it is sometimes called a silent
disease. However, you should watch out for the following things:
 Loss of height (getting shorter by an inch or more).

 Change in posture (stooping or bending forward).
 Shortness of breath (smaller lung capacity due to compressed disks).
 Bone fractures.
 Pain in the lower back.

There are many risk factors that increase your chance of developing osteoporosis, with two of
the most significant being gender and age.
1) Everyone’s risk for osteoporosis fractures increases with age. However, women
over the age of 50 or postmenopausal women have the greatest risk of developing
osteoporosis. Women undergo rapid bone loss in the first 10 years after entering
menopause, because menopause slows the production of estrogen, a hormone that
protects against excessive bone loss.Age and osteoporosis affect men also. You might
be surprised to know that men over the age of 50 are more likely to have an
osteoporosis-induced bone break than to get prostate cancer. About 80,000 men per
year are expected to break a hip, and men are more likely than women to die in the
year after a hip fracture.
2) Your risk of developing osteoporosis is also linked to ethnicity. Caucasian and
Asian women are more likely to develop osteoporosis. However, African-American
and Hispanic women are still at risk. In fact, African-American women are more
likely than white women to die after a hip fracture.
3) Another factor is bone structure and body weight. Petite and thin people have a
greater risk of developing osteoporosis because they have less bone to lose than
people with more body weight and larger frames.
4) Family history also plays a part in osteoporosis risk. If your parents or
grandparents have had any signs of osteoporosis, such as a fractured hip after a minor
fall, you may have a greater risk of developing the disease.
5) Finally, some medical conditions and medications increase your risk. If you have
or had any of the following conditions, some of which are related to irregular
hormone levels, you and your healthcare provider might consider earlier screening for
osteoporosis.
 Overactive thyroid, parathyroid, or adrenal glands.

 History of bariatric (weight loss) surgery or organ transplant.
 Hormone treatment for breast or prostate cancer or a history of missed periods.
 Celiac disease, or inflammatory bowel disease.
 Blood diseases such as multiple myeloma.

Some medications cause side effects that may damage bone and lead to osteoporosis. These
include steroids, treatments for breast cancer, and medications for treating seizures. You
should speak with your healthcare provider or pharmacist about the effect of your
medications on bones.
It may seem as though every risk factor is related to something that is out of your control, but
that’s not true. You do have control over some of the risk factors for osteoporosis. You can
discuss medication issues with your healthcare provider. And—you are in charge of your
 Eating habits: You are more likely to develop osteoporosis if your body doesn’t have
enough calcium and vitamin D. Although eating disorders like bulimia or anorexia are
risk factors, they can be treated.
 Lifestyle: People who lead sedentary (inactive) lifestyles have a higher risk of
osteoporosis.
 Tobacco use: Smoking increases the risk of fractures.
 Alcohol use: Having two drinks a day (or more) increases the risk of osteoporosis.
3.4.4 Diagnosis and Tests
Your healthcare provider can order a test to give you information about your bone health
before problems begin. Bone mineral density (BMD) tests are also known as dual-energy X-
ray absorptiometry (DEXA or DXA) scans. These X-rays use very small amounts of radiation
to determine how solid the bones of the spine, hip or wrist are. Regular X-rays will only show
osteoporosis when the disease is very far along.
All women over the age of 65 should have a bone density test. The DEXA scan may be done
earlier for women who have risk factors for osteoporosis. Men over age 70, or younger men
with risk factors, should also consider getting a bone density test.
Treatments for established osteoporosis may include exercise, vitamin and mineral
supplements, and medications. Exercise and supplementation are often suggested to help you
prevent osteoporosis. Weight-bearing, resistance and balance exercises are all important.

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RV Institute of Technology & Management®

Rashtreeya Sikshana Samithi Trust's

Rashtreeya Vidyalaya Institute of Technology and

BIOLOGY FOR ENGINEERS

HUMAN ORGAN SYSTEMS AND BIO-DESIGNS - 2 (QUALITATIVE)

DEPARTMENT OF COMPUTER SCIENCE AND ENGINEERING

IV-Semester, Biology for Engineers (21BE45) Page1 | 42

Module 3 HUMAN ORGAN SYSTEMS AND BIO-DESIGNS - 2 (QUALITATIVE) RBT Levels

 Lungs as purification system (architecture, gas exchange mechanisms,

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LUNGS AS PURIFICATION SYSTEM

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1.1 The Structure of Respiratory System

1.2 Gas exchange mechanisms

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IV-Semester, Biology for Engineers (21BE45) Page5 | 42

IV-Semester, Biology for Engineers (21BE45) Page6 | 42

IV-Semester, Biology for Engineers (21BE45) Page7 | 42

Conditions that can be picked up and monitored using spirometry include:

 asthma – a long-term condition where the airways become periodically inflamed

1.3.1 What happens during a spirometry test?

IV-Semester, Biology for Engineers (21BE45) Page8 | 42

 inhale fully, so your lungs are completely filled with air

1.3.2 Risks and side effects

1.4 Abnormal lung physiology – COPD

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 Shortness of breath, especially during physical activities

 Frequent respiratory infections

 Unintended weight loss (in later stages)

 Swelling in ankles, feet or legs

IV-Semester, Biology for Engineers (21BE45) Page10 | 42

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Fig. 1.4 The Ventilator support system

1.6 Heart-Lung Machine

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procedures that require the heart to be stopped.

Fig. 1.5 Cardiopulmonary bypass machine

1.6.1 What Does a Heart-Lung Machine Do?

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1.6.2 When a Heart-Lung Machine Is Used

1.6.3 Heart Surgery

1.6.4 Lung Surgery

1.6.5 Heart Failure

1.6.6 How Does a Heart-Lung Bypass Machine Work?

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1.6.7 Risks of Cardiopulmonary Bypass

KIDNEY AS A FILTRATION SYSTEM

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2.1 Structure and function of the kidneys

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2.1.1 Gross Structure of the Urinary System

Fig. 2.1 Structure of the Urinary System

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Fig. 2.2The Structure of the kidney

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Fig. 2.2 A pseudocolor radiograph of the urinary system.

2.1.2Microscopic Structure of the Kidney

Fig. 2.3A single nephron tubule

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