38.1. Transport in Invertebrates

    A. Transport Mechanisms

        1. Unicellular protozoa make exchanges directly with environment across the plasma membrane.
        2. Some multicellular animals lack internal transport system; they can live without it.
        3. Larger invertebrates usually have circulatory systems-either an open system or a closed system.

    B. Invertebrates With a Cavity (Without a Circulatory System)

        1. Sea anemones and planaria are organisms with a sac body plan; a circulatory system is unnecessary.
        2. Sea anemone cells are part of external layer or gastrovascular cavity; diffusion supplies all nutrients.
        3. Planaria have a tri-lobed gastrovascular cavity and small, flat body where diffusion meets these needs.

    C. With an Open or a Closed System

        1. In a circulatory system, a pumping heart moves one of two circulatory fluids into blood vessels.
            a. Blood is a circulatory fluid contained within blood vessels
            b. Hemolymph is a circulatory fluid which flows into the hemocoel of certain arthropods and mollusks;
                it is a mixture of blood and interstitial fluid.
        2. Certain arthropods and mollusks have an open circulatory system.
            a. Hemolymph is pumped by heart into body cavity or sinuses.
            b. Hemolymph bathes internal organs and then drains back to heart.
            c. In grasshoppers, dorsal heart pumps hemolymph into an aorta, which empties into hemocoel.
            d. Hemolymph is colorless (it lacks hemoglobin or other respiratory pigments); tracheae provide oxygen.
        3. Some invertebrates, including earthworms and cephalopods, have a closed circulatory systemin which
           blood never leaves the heart or vessels.
            a. Valves prevent backward flow of blood as it moves through vessels.
            b. Earthworms have five pairs of anterior lateral vessels that pump blood to every segment.
            c. Blood moves in capillaries where exchange with tissue fluid take place before returning in veins.
            d. Earthworms' red respiratory pigment hemoglobin is dissolved in blood, not inside blood cells.
            e. With no special cavity for gas exchange, gas must diffuse across body wall.

38.2. Transport in Vertebrates

    A. Closed Circulatory System

        1. Vertebrates have a closed circulatory system in a cardiovascular system.
        2. Muscular heart keeps blood circulating through the animal body.
            a. Atrium is chamber of the heart that receives blood.
            b. Ventricles pump blood into arteries.
        3. There are three kinds of blood vessels: arteries carry blood away from heart, capillaries are where
            exchange with tissue fluid takes place, and veins return blood to heart.
            a. Arteries:
                1) have thick walls and are resilient.
                2) expand to accommodate sudden increase in blood volume that results after heart contraction.
                3) divide into small arterioles.
            b. Arterioles constriction and dilation are regulated by nervous system to regulate blood pressure.
            c. Capillaries are microscopic blood vessels with a wall formed of one layer of simple squamous cells.
                1) Capillary beds are so prevalent that, in humans, all cells are within 60-80 µm of a capillary.
                2) Only 5% are open at one time; if animal eats, capillary beds of digestive system open.
                3) Capillaries are so narrow that red blood cells must pass through in single file.
                4) Gas, nutrient, and waste exchange occurs across thin walls.
            d. Venules are vessels that take blood from capillaries, and join to form a vein.
            e. Veins transport blood toward the heart.
                1) Wall of a vein is much thinner than that of arteries; there is low blood pressure.
                2) One-way valves open in direction of heart; close to prevent backflow. (Fig. 41.3d)

    B. Comparison of Circulatory Pathways

        1. In vertebrates, there are three different types of circulatory pathways.
        2. Fishes have a one-circuit (single-loop circulatory) pathway.
            a. Heart has a single atrium and ventricle and pumps blood under pressure to gills.
            b. Blood in gills is oxygenated.
            c. After passing through gills, blood is under reduced pressure and flow.
        3. Other vertebrates have a two-circuit (double-loop circulatory) pathway to breathe air on land.
            a. Systemic circulation transports blood to tissues.
            b. Pulmonary circulation pumps blood to lungs.
        4. In amphibians and most reptiles, the heart has two atria but a single ventricle.
        5. Hearts of some reptiles and all birds and mammals are divided into two halves.
            a. With two atria and two ventricles, oxygenated blood is always separate from deoxygenated blood.
            b. Right ventricle pumps blood to lungs; Left ventricle pumps blood to rest of body.
            c. This arrangement provides adequate blood pressure for both pulmonary and systemic circulations.

38.3. Transport in Humans

    A. Heart Pumps Blood

        1. Pumping of heart keeps blood moving in arteries.
        2. Skeletal muscle contraction is responsible for blood movement in veins.
        3. Heart is a cone-shaped, muscular organ about size of a fist.
        4. It is located between lungs directly behind the sternum and is tilted so that apex is directed to left.
        5. Myocardium is major portion of the heart consisting mostly of cardiac muscle; muscle fibers are branched
            and tightly joined together.
        6. Heart lies within a pericardium sac that contains pericardial fluid which provides cushioning.
        7. Endocardium lines inner surface of the heart; it consists of connective tissue and endothelial tissue.
        8. Internal wall called the septum separates heart into right and left halves.
        9. Heart has two upper, thin-walled atria and two lower, thick-walled ventricles.
            a. Atria receive blood from venous portion of cardiovascular system.
            b. Atria are much smaller and weaker than muscular ventricles but hold the same volume of blood.
            c. Ventricles pump blood into arterial portion of cardiovascular system.
        10. Heart valves direct flow of blood and prevent backward movement.
            a. Valves are supported by strong fibrous tendons (chordae tendineae) attached to muscular projections
                of ventricular walls; they prevent valves from inverting.
            b. Atrioventricular valves between atria and ventricles prevent back flow from ventricle to atrium.
            c. Right atrioventricular (tricuspid) valve on right side of heart consists of three cusps or flaps.
            d. Left atrioventricular (bicuspid or mitral) valve on left side consists of two cusps or flaps.
            e. Semilunar valves resembling half-moons are located between a ventricle and an artery that prevents
                back flow from artery to ventricle.
                1) The pulmonary semilunar valve lies between the right ventricle and the pulmonary trunk.
                2) The aortic semilunar valve lies between the left ventricle and the aorta.

    C. Path of Blood Through the Heart  

        1. Route of blood through heart is as follows.
            a. Deoxygenated blood enters right atrium from both superior vena cava and inferior vena cava.
            b. Right atrium sends blood through right atrioventricular (tricuspid) valve to right ventricle.
            c. Right ventricle sends blood through pulmonary semilunar valve into pulmonary trunk and arteries to lungs.
            d. Oxygenated blood returns from lungs through pulmonary veins and is delivered to left atrium.
            e. Left atrium sends blood through left atrioventricular (bicuspid or mitral) valve to left ventricle.
            f. Left ventricle sends blood through aortic semilunar valve into aorta and to body proper.
        2. Heart is therefore a double pump serving the lungs and body circulations simultaneously.
        3. Since the left side has the harder job of pumping blood throughout the body, its walls are thicker.

    D. The Heartbeat

        1. Heart contracts (beats) about 70 times a minute; each heartbeat lasts about 0.85 seconds.
        2. Heartbeat or cardiac cycle consists of phases: systole refers to contraction of heart chambers
            and diastole is relaxation of heart chambers.
        3. Atria contract first while ventricles relax (0.15 sec.), then ventricles contract while atria relax (0.30 sec.),
            then all chambers rest (0.40 sec.).
        4. Heart is in diastole about 50% of the time.
        5. Short systole of the atria is needed only to send blood into ventricles.
        6. When the term "systole" is used alone, it refers to left ventricle systole.
        7. When the heart beats, familiar lub-dub sound is heard as valves of heart close.
            a. Lub is caused by vibrations of the heart when atrioventricular valves close.
            b. Dub is heard when vibrations occur due to closing of semilunar valves.
        8. Pulse is a wave effect that passes down walls of arterial blood vessels when aorta expands and then
            almost immediately recoils following ventricle systole.
        9. Since there is one arterial pulse per ventricular systole, arterial pulse rate can be used to determine heart rate.
        10. Rhythmic contraction of heart is due to cardiac conduction system.
            a. Sinoatrial (SA) node is "pacemaker" found in upper dorsal wall of right atrium; it initiates heartbeat
                by sending out an excitatory impulse every 0.85 seconds to cause atria to contract.
            b. Atrioventricular (AV) node is found in base of right atrium very near septum; when stimulated by impulses
                from SA node, it sends out impulses through septum to cause ventricles to contract.
        11. Electrocardiogram (ECG or EKG) is a graphical recording of ionic changes that occur in the heart
            during a cardiac cycle; it is used as a diagnostic tool to identify abnormal cardiac function.
        12. Normal Cardiac Cycle
            a. P wave represents excitation and occurs just before atrial contraction.
            b. QRS complex signals that ventricles are about to contract.
        13. Ventricular fibrillation is uncoordinated contraction of the ventricles; with application of a strong
            electric current, the SA node may reestablish a coordinated beat.

    E. Vascular Pathways

        1. Human cardiovascular system has two major circular pathways.             2. The Pulmonary Circuit
            a. Pulmonary circuit circulates blood to lungs where blood is oxygenated.
            b. Deoxygenated blood from body collects in right ventricle, which pumps it to pulmonary trunk.
            c. Pulmonary trunk divides into right and left pulmonary arteries to carry blood to each lung.
            d. In lungs, carbon dioxide (CO2) is unloaded and O2 is picked up by blood.
            e. Oxygenated blood from lungs is returned through pulmonary veins to left atrium.
        3. The Systemic Circuit
            a. Aorta and vena cavae are main pathways for blood in systemic circuit.
            b. Transport of oxygenated blood moves from left ventricle through aorta out to all tissues.
            c. Deoxygenated blood returns from all tissues via vena cava.
            d. In a systemic circuit, arteries contain bright red oxygenated blood; veins contain dull red deoxygenated blood.
        4. Coronary arteries serve heart muscle itself.
            a. Coronary arteries originate from base of aorta just above aortic semilunar valve.
            b. Coronary arteries lie on external surface of heart; they branch into arterioles and capillaries.
            c. Capillary beds enter venules that join to form cardiac veins.
            d. Coronary veins collect deoxygenated blood from capillaries and empty into right atrium.
        5. Portal system is a pathway of blood flow that begins and ends in capillaries.
            a. Hepatic portal vein transports blood from capillaries in small intestinal villi to capillaries in liver.
            b. Hepatic vein leaves liver and enters inferior vena cava.

    F. Blood Pressure

        1. Systolic pressure results from blood being forced into arteries during ventricular systole.
        2. Diastolic pressure is pressure in arteries during ventricular diastole.
        3. Human blood pressure is measured as force pushing against wall of brachial artery of upper arm.
            a. Blood pressure is measured by a sphygmomanometer which has a pressure cuff.
            b. Clinical blood pressure measures pressures produced by contraction and relaxation of right ventricle.
            c. It is stated in millimeters of mercury (e.g., 120/80 mm Hg for systolic/diastolic).
        4. As blood flows from aorta into arteries and arterioles, blood pressure falls.
        5. Difference in pressure between systolic and diastolic pressures gradually diminishes.
        6. Capillaries have slow, even blood flow due to high total cross-sectional area. (Fig. 41.9)
            a. Total length of human capillaries is estimated at 60,000 miles.
            b. Most of this distance is due to quantity of capillaries.
        7. Blood pressure in veins is low and cannot move blood back to heart, especially from limbs.
        8. Skeletal muscle contraction on walls of veins with valves preventing backflow of blood is responsible
            for flow of blood in veins.
        9. Varicose veins are abnormal dilations that develop when valves become weak and ineffective.

38.4. Cardiovascular Disorders

    A. Cardiovascular Disease

        1. Cardiovascular disease (CVD) is the leading cause of untimely deaths in the United States.
        2. Risk of CVD can be reduced by following guidelines for a heart-healthy life-style.

    B. Hypertension

        1. An estimated 20% of Americans suffer from hypertension or high blood pressure.
        2. Women have this condition if their blood pressure is significantly higher than 160/95; men under age
            45 if over 130/90, and beyond age 45 if above 140/95.
        3. Diastolic pressure is emphasized when medical treatment is considered.
        4. Hypertension may not be detected until a stroke or heart attack occurs.
        5. Two genes are involved in hypertension for some individuals.
            a. One gene codes for angiotensinogen, plasma protein converted to a vasoconstrictor by product of second gene.
            b. Persons with this form of hypertension may one day be cured by gene therapy.

    C. Atherosclerosis

        1. Hypertension is seen in individuals with atherosclerosis, formerly called arteriosclerosis.
        2. Soft plague masses of fatty materials accumulate beneath inner linings of arteries.
        3. As plaque accumulates, it protrudes into a vessel, interfering with blood flow.
        4. Atherosclerosis develops in early adulthood but symptoms may not appear until age 50 or older.
        5. Plaque can cause a blood clot to form on irregular arterial walls.
        6. As long as a clot remains stationary, it is a thrombus.
        7. If a clot dislodges, it is an embolus, a blood clot that moves in the blood.
        8. In some families, atherosclerosis is inherited as familial hypercholesterolemia.

    D. Stroke and Heart Attack

        1. Stroke, heart attack, and aneurysm are associated with hypertension and atherosclerosis.
        2. Strokes can result in paralysis or death; a small arteriole bursts or is blocked by an embolus.
            a. Stroke is also called a cardiovascular accident (CVA).
            b. Paralysis or death depends on extent a portion of the brain lacks O2.
            c. Warning symptoms include: numbness in hands or face, difficulty speaking, blindness in one eye.
        3. A myocardial infarction (MI) is also called heart attack.
            a. It occurs when a portion of heart muscle dies due to a lack of O2.
            b. A partially blocked coronary artery causes angina pectoris causing chest pains or radiating pain in left arm.
            c. Nitroglycerin and related drugs dilate blood vessels and relieve pain.
            d. One cause of heart attacks is blockage of coronary arteries due to a thromboembolism.

38.5. Blood, a Transport Medium

A.              Blood has two components, plasma and formed elements (cells and platelets).

        1. Plasma contains water and many types of molecules, including nutrients, wastes, salts, and proteins.
        2. Salts and proteins buffer blood.
            a. They effectively keep blood pH near 7.4.
            b. They maintain blood osmotic pressure so water has a tendency to enter blood capillaries.
        3. Some plasma proteins are involved in blood clotting.
        4. Some plasma proteins assist in transporting large organic molecules in blood.
            a. Lipoproteins that transport cholesterol are globulins.
            b. Albumin, a common plasma protein, transports bilirubin, a breakdown product of hemoglobin.

    B. Formed Elements

        1. Blood cells are in three types: red blood cells (RBCs), white blood cells (WBCs), and platelets.
        2. Red Blood Cells
            a. Red blood cells (erythrocytes) are small bi-concave disks.
            b. RBCs lack a nucleus and contain hemoglobin.
            c. There are 6 million RBCs per mm3 of whole blood.
            d. Each RBC contains 250 million hemoglobin molecules.
                1) Hemoglobin contains four globin protein chains; each with an iron-containing heme group.
                2) Iron atom of a heme group loosely binds with an O2 molecule; thus, blood carries oxygen.
                3) Anemia is insufficient hemoglobin; an individual suffers from a tired, run-down feeling.
            e. RBCs are manufactured in red bone marrow of skull, ribs, vertebrae, and ends of long bones.
            f. Growth factor erythropoietin is produced when an enzyme from kidneys acts on a precursor made by
                liver and stimulates production of red blood cells; as a drug it helps people with anemia.
            g. Before being released from bone marrow, RBCs lose their nucleus and synthesize hemoglobin.
            h. Red blood cells have a life span of about 120 days; they are destroyed chiefly in liver and spleen.
            i. Iron is recovered and returned to bone marrow where it is re-used.
            j. Heme portions undergo chemical degradation; excreted by liver as bile pigments, it colors feces.
        3. White Blood Cells
            a. White blood cells (leukocytes) differ from RBCs in being larger and in having a nucleus.
            b. WBCs lack hemoglobin and appear translucent without staining.
            c. Granular leukocytes contain conspicuous granules in their cytoplasm; have a lobed nucleus.
                1) Neutrophils have granules that stain slightly pink; they are amoeboid, spherical cells that readily
                    squeeze through capillary walls and phagocytize foreign material.
                2) Eosinophils have granules that take up red dye eosin.
                3) Basophils have granules that take up a basic dye, staining them deep blue.
            d. Newly discovered stem cell growth factor increases production of all WBCs.
            e. Agranular leukocytes lack granules in cytoplasm and have a circular or indented nucleus.
                1) Monocytes are amoeboid and able to enter tissues where they transform into macrophages.
                2) Macrophages release white blood cell growth factors that increase number of leukocytes.
                3) Pus is a thick, yellowish fluid that contains a large proportion of dead WBCs that have fought infection.
                4) Lymphocytes play a key roles in fighting infection and include two types.
                    a) T cells are lymphocytes that directly attack virus-infected cells.
                    b) B cells can be stimulated to produce one type of antibody specific for one type of antigen.
                5) Antigen is any substance stimulating production of antibodies; antigen is foreign to the body.
                6) Antibodies combine with antigens to promote their being phagocytized by a macrophage.
                7) A person is actively immune when many B cells produce specific antibody for an infection.
        4. Platelets
            a. Platelets (thrombocytes) form from fragmented giant cells (megakaryocytes) in bone marrow.
            b. 200 billion platelets are produced a day; blood contains 150,000-300,000 per mm3.
            c. Platelets are involved in blood clotting or coagulation.
            d. At least 12 clotting factors in blood participate in clotting.
            e. Hemophilia is an inherited disorder where liver is unable to produce one of the clotting factors.
            f. Minor bumps can cause internal bleeding; bleeding into brain causes death in hemophilia.
            g. Vitamin K is necessary to produce prothrombin; deficiency causes hemorrhagic disorders.
        5. Blood Clotting
            a. When a blood vessel is damaged, platelets clump at site of hemorrhage and partially seal leak.
            b. Platelets and damaged tissue cells release a clotting factor called prothrombin activator.
            c. With calcium ions, prothrombin activator catalyzes reaction converting prothrombin to thrombin.
            d. Thrombin acts as an enzyme to sever two amino acid chains from each fibrinogen molecule.
            e. These activated fragments join end-to-end forming long threads of fibrin.
            f. Fibrin threads wind around platelet plug and provide a framework for a clot. (Fig. 41.12b)
            g. RBCs are trapped within fibrin threads, making clot appear red.
            h. When blood vessel repair is initiated, plasmin destroys fibrin network and restores plasma fluidity.
            i. When clotting occurs in test tube, fluid serum collects above a clot; it has same composition as
                plasma except fibrinogen.

    C. Capillary Exchange

        1. Two forces control movement of fluid through capillary walls.
            a. Osmotic pressure tends to cause water to move from tissue fluid to blood.
            b. Blood pressure tends to cause water to move from blood to tissue fluid.
            c. At arterial end of a capillary, blood pressure is higher than osmotic pressure: water exits and moves into tissues.
            d. Between ends of a capillary, O2 and nutrients diffuse out into tissue fluid, while CO2 and other metabolic
                wastes diffuse into capillaries from tissue fluid.
        2. Midway along a capillary, there is no net movement of water.
        3. Tissue fluid is intercellular fluid that surrounds cells; circulatory system exchanges materials with this fluid.
        4. Exchange between blood and tissue fluid occurs by diffusion through one-cell-thick capillary walls.
            a. At venule end, osmotic pressure is higher than blood pressure and water moves back into blood.
            b. Almost same amount of fluid that left capillary returns to it; there is always some excess tissue fluid
                collected by lymphatic capillaries.
        5. Tissue fluid within lymphatic vessels is lymph.
        6. Lymph returns to systemic venous blood when lymphatic vessels enter subclavian veins in shoulder.
        7. Not all capillary beds open at same time; pre-capillary sphincters shunt blood in various pathways.
        8. Blood also distributes heat to body parts and conserves heat when cold.

38.6. How Animals Exchange Gases  

    A. Respiration results in gas exchange between the environment and the body's cells.

        1. Breathing includes inspiration (bringing air in) and expiration (moving air out).
        2. External respiration involves gas exchange with external environment at a respiratory surface.
        3. Internal respiration in more complex animals involves gas exchange between blood and tissue fluid.

    B. Diffusion Accompanies Gas Exchange

        1. An effective gas exchange region must be moist, thin, and large in relation to size of the body.
        2. Some animals are small and shaped to allow the surface to be a gas-exchange surface.
        3. Complex animals have a specialized gas-exchange surface.
        4. Diffusion improves with vascularization; delivery is promoted if blood contains hemoglobin.

    C. Water Environments

        1. It is more difficult to obtain O2 from water than from air.
            a. Water fully saturated with air contains only a fraction of O2 as air.
            b. Water is more dense than air; aquatic animals use more energy to breathe.
            c. Fish use up to 25% of energy to breathe; land mammals use 1-2% of energy output to breathe.
        2. Hydras and planaria have a large surface area in comparison to their size. (Fig. 44.1)
            a. Gas exchange occurs directly across their body surface.
            b. Hydra's outer cell layer contacts environment; inner layer exchanges gases with gastrovascular cavity.
            c. Flat body of planaria permits ready exchange of gases with the external environment.
        3. A tubular shape and parapodia extensions (polychaete worms) provide surface areas for diffusion.
        4. Often aquatic animals pass water over gills.
            a. Gills are finely divided and vascularized outgrowths of either an outer or inner body surface.
            b. Among clams, water drawn into mantle cavity passes over gills.
            c. Decapod gills are located in brachial chambers under exoskeleton; water circulates by special mouthparts.
            d. Fish gills are outward extensions of the pharynx organized into arches.
            e. Ventilation is result of combined action of mouth and gill covers.
            f. When mouth is open, opercula are closed and water is drawn in; the mouth then closes and opercula
                open, drawing water from pharynx through gill slits located between gill arches.
            g. Outside of gill arches are gill filaments folded into platelike lamellae, each of which contains
                capillaries; result is atremendous surface area for gas exchange.
                1) Blood in capillaries of gill lamellae flows in a direction opposite to that of water.
                2) Countercurrent flow of water and blood increases amount of O2 and CO2 exchanged.
                3) Countercurrent mechanism extracts about 80-90% of initial dissolved O2 in water.

    D. Land Environments

        1. Air is a richer source of O2 than water but dries respiratory surfaces; humans lose 350 ml of water
            per day at 50% relative humidity.
        2. Earthworm is an invertebrate that uses its body surface for respiration.
            a. Earthworms expend energy to secrete mucus and release fluids from excretory pores.
            b. Earthworm is behaviorally adapted to stay in moist soil during the day when air is driest.
        3. Terrestrial insects utilize tracheal systems.
            a. Oxygen enters tracheal system at spiracles, valve-like openings at side of body.
            b. Tracheae branch and rebranch to end in tiny tracheoles in direct contact with body cells.
            c. Larger insects have air sacs located near major muscles to keep air moving in and out of trachea.
            d. Tracheae effectively deliver oxygen to cells; circulatory system has no role in gas transport.
        4. Terrestrial vertebrates use lungs for gas exchange.
            a. Lungs are vascularized outgrowths of lower pharyngeal region.
            b. Amphibian lungs are simple, saclike structures, that connect to external environment by way of
                two bronchi, which connect to a short trachea. (Fig. 44.4a)
                1) Amphibian gas exchange occurs through skin kept moist by mucus produced by glands.
                2) In winter, amphibians burrow in mud; gas exchange occurs across skin.
                3) Frogs use positive pressure to force air in; nostrils shut and floor of mouth forces air into lungs.
            c. Reptiles, birds, and mammals use negative pressure to move air into lungs.
                1) Jointed ribs can be raised and a muscular diaphragm is flattened to expand lungs.
                2) As thoracic cavity expands, lung volume increases; air flows in due to difference in air pressure.
                3) By lowering ribs, pressure is exerted on the lungs, which forces air out.
            d. Lungs of reptiles, amphibians and mammals are not completely emptied each breathing cycle.
                1) With incomplete ventilation, entering air mixes with used air in lungs.
                2) This conserves moisture but decreases gas-exchange efficiency.
            e. High oxygen requirements of flying birds requires a complete ventilation system. (Fig. 44.5)
                1) Incoming air is carried past lungs by a bronchus that takes it to set of posterior air sacs.
                2) Air then passes forward through lungs into a set of anterior air sacs and is finally expelled.
                3) One-way flow means oxygen-rich air does not mix with used air; this maximizes gas exchange.

38.7. Human Respiratory System

    A. Structure

        1. Human respiratory system includes everything that conducts air to and from lungs; lungs lie deep
            within thoracic cavity for protection from drying out.
        2. Air moves into nose, then flows past pharynx to trachea, bronchi and lungs.
            a. This process filters debris, warms air and adds moisture.
            b. When air reaches lungs, it is at body temperature and saturated with water.
            c. Trachea and bronchi are lined with cilia that beat upward carrying mucus, dust and particles.
            d. Hard and soft palates separate nasal cavities from mouth.
            e. Air and food passages cross in pharynx; danger of choking is offset by providing an alternative path
                for breathing during congestion, and increasing air intake during exercise.
            f. Air flows past pharynx through glottis into larynx, which is protected by epiglottis.
            g. At edges of glottis are vocal cords; as air passes across them, tissues vibrate creating sounds.
            h. From the larynx, air flows down trachea to bronchi.
                1) Larynx is held open by cartilage that forms Adam's apple.
                2) Trachea walls are reinforced with C-shaped rings of cartilage.
                3) As food is swallowed, larynx rises and glottis is closed by a flap of tissue called epiglottis.
                4) Backward movement of soft palate covers entrance to nasal passages; food is directed down.
            i. Trachea divides into two bronchi; C-shaped rings of cartilage diminish as bronchi branch.
            j. Within lungs, each bronchus branches into numerous bronchioles that conduct air to alveoli.
            k. Alveoli are microscopic air sacs.

    B. Breathing

        1. Humans breathe using negative pressure just as all other mammals.
        2. During inhalation, lowering diaphragm and raising ribs forms negative pressure by increasing volume
            of thoracic cavity; air under greater outside pressure flows into lung.
        3. Increases in CO2 and H+ concentrations in blood are the primary stimuli increasing breathing rate.
            a. Chemical content of blood is monitored by chemoreceptors sensitive to increases in CO2 and H+
                concentrations of blood, but minimally sensitive to decreases in O2 concentration.
                1) Aortic bodies are chemoreceptors located in wall of aortic arch.
                2) Carotid bodies are chemoreceptors located in wall of carotid arteries.
        4. Information from these goes to respiratory center in medulla oblongata increasing breathing rate when
            CO2 or H+ concentrations increase; this respiratory center is sensitive to blood reaching brain.

    C. Gas Exchange and Transport

        1. Gas exchange in lungs and tissues is primarily by diffusion.
        2. Atmospheric air contains little CO2, but blood flowing in pulmonary capillaries has a higher concentration of CO2.
        3. CO2 diffuses from higher concentration in blood across walls of alveolar capillaries to lower concentration
            in air in alveoli.
        4. Blood coming into pulmonary capillaries is oxygen poor and alveolar air is oxygen rich.
        5. Oxygen diffuses from higher concentration in alveoli across walls of alveolar capillaries to lower
            concentration in blood.

    D. Transport of O2 and CO2

        1. Most O2 entering blood combines with hemoglobin (Hb) to form oxyhemoglobin (HbO2).

Hb               +               O2                        HbO2
deoxyhemoglobin               oxygen               oxyhemoglobin

        2. Hemoglobin molecule has four polypeptide chains; each chain is folds over an iron-containing heme.
            a. Iron atom of a heme group loosely binds with an O2 molecule.
            b. Each RBC has 250 million hemoglobin molecules; each RBC can carry a billion molecules
                of O2 oxyhemoglobin.
        3. Oxygen-binding ability of hemoglobin can be graphed.
            a. Percentage of oxygen-binding sites of hemoglobin carrying O2 varies with partial pressure of O2
                (PO2) in immediate environment.
            b. Partial pressure is amount of pressure exerted by a particular gas among all gases present.
            c. At normal partial pressures of O2 in lungs, hemoglobin becomes practically saturated with O2.
            d. But at the O2 partial pressures in tissues, oxyhemoglobin quickly unloads much of its O2.

HbO2     Hb + O2

            e. Acid pH and warmer temperature of tissues promote this dissociation.
        4. In tissues, some hemoglobin combines with CO2 to form carbaminohemoglobin.

Hb + CO2    HbCO2
                            carbaminohemoglobin

        5. However, most CO2 is transported in form of bicarbonate ion (HCO3-).
            a. First CO2 combines with water, forming carbonic acid (H2CO3).
            b. Then this dissociates to a H+ and a HCO3 -

CO2 + H2O       H2CO3        H+ + HCO3-
                           carbonic acid        bicarbonate ion

            c. Carbonic anhydrase an enzyme in red blood cells speeds this reaction.
            d. Released H+ ions could drastically lower blood pH; however, hydrogen ions are absorbed by
                globin portions of hemoglobin and HCO3- diffuses out of RBCs into plasma.
            e. Hemoglobin combines with a H+ ions as reduced hemoglobin (HHb); HHb plays a vital role in blood pH.
            f. As blood enters pulmonary capillaries, most CO2 is in plasma as HCO3-.
            g. The little free CO2 remaining diffuses out of blood across walls of pulmonary capillaries into alveoli.
            h. Decrease in plasma CO2 concentration causes the following reaction also catalyzed by carbonic anhydrase:

H+   +   HCO3   H2CO3    CO2 + H2O

            i. At same time, hemoglobin unloads H+ and HHb becomes Hb.

38.8. Respiration and Health

    A. Upper Respiratory Tract Infections (URI)

        1. Entire respiratory tract has a warm, wet, mucous membrane lining exposed to environmental air.
        2. Upper respiratory tract consists of nose, pharynx and larynx.
        3. Strept throat is a severe infection caused by the bacteria Streptococcus pyogenes resulting in high
            fever and difficult swallowing and it may lead to a systemic infection.
        4. Sinusitis is infection of the sinuses; 1-3% of upper respiratory infections are accompanied by it.
        5. Tonsillitis occurs when tonsils and adenoids of pharynx are inflamed as first line of defense.
        6. Laryngitis is infection of the larynx causing hoarseness and inability to talk.
        7. Persistent hoarseness without an upper respiratory infection is one of the warning signs of cancer.

    B. Lower Respiratory Tract Infections

        1. Acute bronchitis is an infection of primary and secondary bronchi usually preceded by a viral URI.
        2. Pneumonia
            a. Pneumonia is usually caused by bacterial or viral lung infection.
            b. Bronchi and alveoli fill with fluid.
            c. Pneumonia can be localized in specific lobules.
            d. AIDS patients are subject to a rare form caused by the protozoan Pneumocystis carinii.
        3. Pulmonary Tuberculosis
            a. Tuberculosis is caused by the tubercle bacillus, a type of bacterium.
            b. A TB skin test is a highly diluted extract of the bacilli injected into the patient's skin; if a person
                has been exposed, the immune response causes an area of inflammation.
            c. Bacilli that invade lung tissue are isolated by lung tissue in tiny capsules called tubercles.
            d. If the person is resistant, the imprisoned bacteria die.
            e. If the person is not resistant, the bacteria can eventually be liberated.
            f. A chest X ray detects active tubercles.
            g. Appropriate drug therapy can ensure localization and eventual destruction of live bacteria
            h. Resurgence has accompanied increases in AIDS, homeless, and poor; new strains are resistant.

    C. Pulmonary Disorders  

        1. Pulmonary Fibrosis
            a. Inhaling particles of silica, coal dust, fiberglass and asbestos can lead to pulmonary fibrosis.
            b. These agents result in build up of fibrous connective tissue; lungs cannot inflate properly.
            c. Asbestos was use widely for fireproofing and widespread exposure occurred; a possible 2 million
                deaths could be caused by asbestos between 1990 and 2020.
        2. Chronic Bronchitis
            a. Airways are inflamed and filled with mucus; a cough brings mucus up.
            b. Bronchi degenerate, losing cilia and normal cleansing action and making infection likely.
            c. Smoking cigarettes and cigars is most common cause but air pollution is also involved.
        3. Emphysema
            a. Emphysema involves distended damaged alveoli and ballooning of lungs due to trapped air.
            b. It is often preceded by chronic bronchitis.
            c. Elastic recoil of lungs is reduced, airways are narrowed, making expiration difficult.
            d. Since surface area for gas exchange is reduced, insufficient O2 reaches the heart and the brain.
            e. This triggers heart to work furiously to force more blood through lungs; this can lead to a heart condition.
            f. Lack of oxygen to brain makes patient feel depressed, sluggish, and irritable.
        4. Asthma
            a. Asthma is disease of bronchi and bronchioles causing wheezing, breathlessness and cough.
            b. Airways are sensitive to specific allergens (e.g. pollen, dust, cold air, etc.)
            c. Exposure to the irritant causes smooth muscle in bronchi to spasm .
            d. Bronchial inflammation reduces diameter of airways.
            e. Inhalers can control inflammation; other inhalers can stop muscle spasms.
        5. Lung Cancer
            a. Formerly more common in men, lung cancer now surpasses breast cancer as cause of death in
                women due to smoking.
            b. Lung cancer develops in lung tissue in steps:
                1) First, a thickening and callusing of cells lining the bronchi appears.
                2) Cilia are lost so it is impossible to prevent dust and dirt from settling in lungs.
                3) Next, cells with atypical nuclei appear in callused lining.
                4) A tumor consisting of disordered cells with atypical nuclei develops as cancer in situ.
                5) When some tumor cells break free and penetrate other tissue (metastasis), cancer spreads.
                6) Tumor may grow until bronchus is blocked, cutting off air supply to lungs.
                7) Entire lung collapses; trapped secretions become infected causing pneumonia or lung abscess.
            c. The only treatment is surgery (pneumonectomy) where a lobe or whole lung is removed.

 

 

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