Module-3

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

Lungs as purification system (architecture, gas exchange

mechanisms, spirometry, abnormal lung physiology , Ventilators,
Heart-lung machine).Kidney as a filtration system (architecture,
mechanism of filtration, dialysis systems). Muscular and Skeletal
Systems as scaffolds (architecture, mechanisms, bio-engineering
solutions for muscular dystrophy and osteoporosis).
LUNGS AS A PURIFICATION SYSTEM:
Every cell in your body needs oxygen to live. The air we breathe contains oxygen and
other gases. The respiratory system's main job is to move fresh air into your body while
removing waste gases. Once in the lungs, oxygen is moved into the blood stream and
carried through your body. At each cell in your body, oxygen is exchanged for a waste
gas called carbon dioxide. Your blood stream then carries this waste gas back to the
lungs where it is removed from the blood stream and then exhaled. Your lungs and the
respiratory system automatically perform this vital process, called gas exchange.
In addition to gas exchange, your respiratory system performs other roles important
to breathing. These include:
1.Bringing air to the proper body temperature and moisturizing it to the right humidity
level.
2.Protecting your body from harmful substances. This is done by coughing,
sneezing,
filtering, or swallowing them.
3.Supporting your sense of smell.
Lungs help in the purification of blood. Arteries carry pure oxygenated blood from the
heart to other parts of the body. Veins carry impure venous blood back from other parts
of the body to the right side of the heart.
Architecture:
The lung parenchyma is mainly comprised of numerous air-containing
passages and intervening fine structures, corresponding to alveolar
ductal lumens and alveoli, as well as alveolar septa and small pulmonary
vessels occupying 10% of total parenchymal volume.
The primary function of the lungs is gas exchange. However, the lungs
perform several important
non-respiratory functions that are vital for normal physiology.
The lung acts as a filter against endogenous and exogenous emboli,
preventing them from accessing systemic circulation.
● Pulmonary epithelium forms the first line of defense against inhaled
particles.
● Pulmonary endothelial cells are responsible for the uptake
● metabolism, and biotransformation of several exogenous and
endogenous
substances.
● Pulmonary metabolic capacity is easily saturated, but pulmonary
endothelial binding of some drugs alters their pharmacokinetics.
GAS EXCHANGE MECHANISMS:
Air enters the body through the mouth or nose and quickly moves to the
pharynx or throat. From there, it passes through the larynx, or voice box,
and enters the trachea.

The trachea is a strong tube that contains rings of cartilage that prevent
it from collapsing. Within the lungs, the trachea branches into a left and
right bronchus. These further divide into smaller and smaller branches
called bronchioles. The smallest bronchioles end in tiny air sacs. These
are called alveoli.
They inflate when a person inhales and deflate when a person exhales.
During gas exchange oxygen moves from the lungs to the blood stream.
At the same time, carbon dioxide passes from the blood to the lungs.
This happens in the lungs between the alveoli and a network of tiny
blood vessels called capillaries, which are located in the walls of the
alveoli.
The walls of the alveoli share a membrane with the capillaries. That's how
close they are. This lets oxygen and carbon dioxide diffuse, or move
freely, between the respiratory system and the blood stream.
Oxygen molecules attach to red blood cells, which travel back to the
heart. At the same time, the carbon dioxide molecules in the alveoli are
blown out of the body the next time a person exhales. The gas exchange
allows the body to replenish the oxygen and eliminate carbon dioxide.
Doing both is necessary for survival.
SPIROMETRY:

Spirometry (spy-ROM-uh-tree) is a common office test used to assess

how well your lungs work by measuring how much air you inhale, how
much you exhale, and how quickly you exhale. Spirometry is used to
diagnose asthma, chronic obstructive pulmonary disease (COPD), and
other conditions that affect breathing.
175 years have elapsed since John Hutchinson introduced the world to
his version of an apparatus that had been in development for nearly two
Requirements of an acceptable spirometer are:
● Spirometers must be able to accumulate volume for ≥15 s.
● The measuring volume should be ≥8 L (body temperature and pressure, saturated).
● The accuracy of reading should be at least ±3% (or ±0.05 L) with flows from 0–14 L per s.
● The total resistance to air flow at 14 L per s should be <1.5 cmH2O per L per s (<0.15 kPa per L per s).
HOW TO CALCULATE THE NORMAL RATE OF RESPIRATION IN A SPIROMETER:

The forced expiratory volume and forced vital capacity i.e. FEV1/FVC
Ratio (FEV1%) parameter is calculated by dividing the measured FEV1
value by the measured FVC value. The Measured column shows the
absolute (numerical) ratio, and the Predicted column shows the ratio
expressed as a percentage. In healthy adults of the same gender, height,
and age, the normal Predicted percentage should be between 70% and
85%.
ABNORMAL LUNG PHYSIOLOGY:
Percentages lower than 70% are considered abnormal. This is an important
measurement because obstructive diseases such as chronic obstructive
pulmonary disease (COPD) chronic bronchitis, and emphysema cause
increased airway resistance to expiratory airflow, and may result in
percentages of 45% to 60%. Restrictive diseases such as pulmonary fibrosis
tend to reduce both FEV1 and FVC values, so the percentage can remain
within the normal range, or even increase.
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.

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
● Swelling in ankles, feet, or legs
Tests may include:
● Lung (pulmonary) function tests.
● Chest X-ray.
● CT scan.
● Arterial blood gas analysis.
● Laboratory tests.
Medications:
● Oral steroids
● Phosphodiesterase-4 inhibitors
● Theophylline
● Antibiotics
VENTILATOR:
Mechanical ventilators are machines that act as bellows to move air in and out of your
lungs. Your respiratory therapist and doctor set the ventilator to control how often it
pushes air into your lungs and how much air you get. You may be fitted with a mask to
get air from the ventilator into your lungs or you may need a breathing tube if your
breathing problem is more serious. When you’re ready to be taken off the ventilator, your
healthcare team will “wean” you or decrease the ventilator support until you can start
breathing on your own.
HEART LUNG MACHINE:
A heart-lung machine is an apparatus that does the work both of the heart (i.e.,
pumps blood) and the lungs (i.e., oxygenates the blood) during, for example, open-
heart surgery The basic function of the machine is to oxygenate the body's venous
supply of blood and then to pump it back into the arterial system.
Blood returning to the heart is diverted through the machine before returning to the
arterial circulation. Some of the more important components of these machines
include pumps, oxygenators, temperature regulators, and filters. The heart-lung
machine also provides intracardiac suction, filtration, and temperature control.
Blood drains by gravity or with the use of gentle suction into the oxygenator
venous reservoir labeled (B). (A) represents the arterial pump that pumps
the blood from the venous reservoir (B) and delivers blood to the membrane
oxygenator which is attached to the lower part of the venous reservoir. Once
oxygen, carbon dioxide, and heat exchange have occurred the blood is
directed thru an arterial blood filter (C). A purge line to the uppermost part of
the filter serves for the removal of any micro emboli that may have been
introduced into the blood during its passage through the circuit. The
oxygenated blood is introduced back into the patient’s circulatory system
through cannulae (a large tube connected to the circuit) placed in the
ascending aorta. The line attached to intravenous bags labeled (D) provides
a method for priming the CPB circuit with electrolyte fluid or a port for
adding blood during bypass. Four roller pumps labeled (E) in the diagram are
auxiliary. The one on the far left is used to pump a cardioplegia solution with
a mixture of blood and additives, labeled (H), and used to arrest the heart.
This solution is cooled with a separate heat exchanger labeled (F).
KIDNEY AS FILTRATION SYSTEM:

Kidneys remove wastes and extra fluid from the body. Kidneys also
remove
a acid that is produced by the cells of the body and maintain
healthy
balance of water, salts, and minerals-such as sodium, calcium,
phosphorus, and potassium-in the blood. Without this balance,
nerves,
muscles,
●Kidneys also make hormones that help
●Control blood pressure.
●Make red blood cells NIH external link.
Keeps bones strong and healthy.
Architecture:
The kidneys are two bean-shaped organs, each about the size of a fist. They are located
just below
the rib cage, one on each side of the spine. Healthy kidneys filter about a half cup of
blood every minute, removing wastes and extra water to make urine. The urine flows
from the kidneys to the bladder through two thin tubes of muscle called ureters, one on
each side of the bladder. Your bladder stores urine. Kidneys, ureters, and bladder are
part of your urinary tract
MECHANISM OF FILTRATION:
Each kidney is made up of about a million filtering units called nephrons.
Each nephron includes a filter, called the glomerulus, and a tubule. The
nephrons work through a two-step process: the glomerulus filters blood, and
the tubule returns needed substances to your blood and removes wastes.
Each nephron has a glomerulus to filter your blood and a tubule that
returns needed substances to your blood and pulls out additional
wastes. Wastes and extra water become urine.
The glomerulus filters your blood. As blood flows into each nephron, it
enters a cluster of tiny blood vessels—the glomerulus. The thin walls of
the glomerulus allow smaller molecules, wastes, and fluid—mostly water
—to pass into the tubule. Larger molecules, such as proteins and blood
cells, stay in the blood vessel. The tubule returns needed substances to
your blood and removes wastes.
 A blood vessel runs alongside the tubule. As the filtered fluid moves along the
tubule, the blood vessel reabsorbs almost all of the water, along with minerals and
nutrients your body needs. The tubule helps remove excess acid from the blood.
The remaining fluid and wastes in the tubule become urine.
How does blood flow through my kidneys?

Blood flows into the kidney through the renal artery. This large blood vessel
branches into smaller and smaller blood vessels until the blood reaches the
nephrons. In the nephron, blood is filtered by the tiny blood vessels of the glomeruli
and then flows out of the kidney through the renal vein.

Blood circulates through your kidneys many times a day. In a single day, kidneys filter
about 150 quarts of blood. Most of the water and other substances that filter
through your glomeruli are returned to the blood by the tubules. Only 1 to 2 quarts
become urine.

When the kidney doesn't function properly, chronic kidney disease occurs when a
disease or condition impairs kidney function, causing kidney damage to worsen over
several months or years
Chronic kidney disease (CKD):
Chronic kidney disease includes conditions that damage your kidneys and decrease
their ability to keep you healthy by filtering wastes from your blood. If kidney disease
worsens, wastes can build to high levels in your blood and make you feel sick. You
may develop complications like

● high blood pressure

● anemia (low blood count)
● weak bones
● poor nutritional health
● nerve damage
Symptoms:
People with CKD may not feel ill or notice any symptoms. The only way to find out for
sure if
you have CKD is through specific blood and urine tests. These tests include the
measurement
of both the creatinine level in the blood and the protein in the urine.
Treatment:
● Depending on the cause, some types of kidney disease can be treated. Often,
though, chronic kidney disease has no cure. Treatment usually consists of
measures to help control signs and symptoms, reduce complications, and slow
DIALYSIS:

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.
There are 2 main types of dialysis:

● Hemodialysis involves diverting blood into an external machine, where

it’s
filtered before being returned to the body

● Peritoneal dialysis involves pumping dialysis fluid into the space inside
your abdomen (tummy) to draw out waste products from the blood
passing through vessels lining the inside of the abdomen
MUSCULAR AND SKELETAL SYSTEM AS SCAFFOLDS

Skeletal muscle architecture is one of the most important properties that determine a
muscle’s force and excursion capability. In the current review, basic architectural terms
first are reviewed, and then specific examples relevant to upper extremity anatomy are
presented. Specific examples of anatomic considerations required for surgical
reconstruction after radial nerve palsy also are detailed. Together, these data show not
only the wide variety of architectural designs in human muscles but the importance of
considering architectural design when making surgical decisions. The relationship
between structure and function in skeletal muscle has been described and probed for
more than a century. A classic study has elucidated the microscopic and ultrastructural
properties of skeletal muscle fibers, yielding great insights into their function. However,
less attention has been given to excellent and insightful studies of the macroscopic
properties of skeletal muscle tissues dating back to the 1600s. This macroscopic
arrangement of muscle fibers is known as a muscle’s architecture.
Architecture:
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
Some of the most common causes of musculoskeletal pain and movement
problems are:

Aging
Arthritis
Back problems
Cancer
Congenital abnormalities
Injuries
BIO-ENGINEERING SOLUTIONS FOR MUSCULAR DYSTROPHY AND OSTEOPOROSIS :

The traditional method of fabricating 3D muscle constructs first developed more

than 25 years ago involves casting myogenic cells within a cylindrically shaped
collagen-I gel that is anchored at the ends to porous felts. In this system, cell-
mediated gel compaction and remodeling result in the generation of uniaxial
passive stress within the gel, which, in turn, promotes the fusion of myoblasts into
myotubes and also myotube alignment. Alternatively, myoblasts, or mixtures of
myogenic precursors and fibroblasts, can be cultured on laminin- or hydrogel-coated
dishes until spontaneous contractions of formed myotubes detach the entire cell
layer, allowing it to self- assemble into a cylindrical tissue construct attached at the
ends to premade suture anchors.

Rapid-prototyping techniques for hydrogel molding can be further used to vary local
myofiber alignment and to design complex muscle structures, and advanced
biomaterials can deliver angiogenic, myogenic, and pro-survival factors to cells in a
spatiotemporally controlled fashion. In addition to using biomaterial scaffolds,
scaffold-free muscle tissue constructs have been