BIOLOGY FOR ENGINEERS

MODULE 3

HUMAN ORGAN SYSTEMS AND

BIODESIGNS
LUNG as Purification System
2

 Every cell in the 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 bloodstream and carried through
your body.
 At each cell in your body, oxygen is exchanged for a waste gas called carbon
dioxide.
 The bloodstream then carries this waste gas back to the lungs where it is removed
from the bloodstream and then exhaled.
 The lungs and the respiratory system automatically perform this vital process,
called gas exchange.
 Bringing air to the proper body temperature and moisturizing it to the right
humidity level.
 Protecting your body from harmful substances.
 This is done by coughing, sneezing, filtering, or swallowing them.
 Supporting your sense of smell.
  The lung purifies air by removing harmful substances and adding oxygen to the
bloodstream. The process of purifying air in the lungs can be described as follows:
3
 Filtration: The nose and mouth serve as a first line of defense against
harmful substances in the air, such as dust, dirt, and bacteria. The tiny
hairs in the nose, called cilia, and the mucus produced by the respiratory
system trap these substances and prevent them from entering the lungs.
 Moisturization: The air is also humidified as it passes over the moist lining
of the respiratory tract, which helps to keep the airways moist and prevent
them from drying out.
 Gas Exchange: Once the air reaches the alveoli, the gas exchange process
occurs, where oxygen diffuses across the thin alveolar and capillary walls
into the bloodstream, and carbon dioxide diffuses in the opposite direction,
from the bloodstream into the alveoli to be exhaled. This process ensures
that the bloodstream is supplied with fresh, oxygen-rich air, while waste
carbon dioxide is removed from the body.
 Overall, the lung serves as a vital purification system, filtering out harmful
substances, adding oxygen to the bloodstream, and removing waste carbon
dioxide. It plays a critical role in maintaining the body's homeostasis and
supporting life.
4
Architecture of Lungs
5

 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, with its unique ability to distend and recruit
pulmonary vasculature, acts as a reservoir of blood, fine-
tuning preload to the left heart to optimize cardiac output.
 6 Architecture of Lungs as Purification System
 The architecture of the lung is designed to maximize surface area for efficient gas
exchange. The lung is divided into several parts, including the trachea, bronchi,
bronchioles, and alveoli.
 Trachea: The trachea is the main airway that leads from the larynx
(voice box) to the lungs. It is lined with cilia and mucus-secreting glands
that help to filter out harmful substances and trap them in the mucus.
 Bronchi: The trachea branches into two main bronchi, one for each
lung. The bronchi are larger airways that continue to branch into
smaller airways called bronchioles.
 Bronchioles: The bronchioles are smaller airways that eventually lead to
the alveoli. They are surrounded by tiny air sacs called alveoli, which
are the sites of gas exchange.
 Alveoli: The alveoli are tiny air sacs that are lined with a network of
capillaries. This close proximity of the alveoli and capillaries allows for
efficient diffusion of oxygen and carbon dioxide between the air in the
alveoli and the bloodstream.
 Overall, the architecture of the lung is designed to provide a large surface area for
gas exchange, while filtering out harmful substances and humidifying the air. The
close proximity of the alveoli and capillaries, along with the moist lining of the
respiratory tract, ensures that the air is properly purified and the bloodstream is
supplied with fresh, oxygen-rich air.
Functions
7

 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 mechanism
8
 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 bloodstream.
 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.
9
 The gas exchange mechanism in the lung involves the transfer of oxygen
from the air in the alveoli to the bloodstream, and the transfer of carbon
dioxide from the bloodstream to the air in the alveoli. This process is known
as diffusion and occurs due to differences in partial pressures of oxygen
and carbon dioxide.
 Oxygen Diffusion: The partial pressure of oxygen in the air in the
alveoli is higher than the partial pressure of oxygen in the
bloodstream. This difference creates a gradient that causes
oxygen to diffuse from the alveoli into the bloodstream, where it
binds to hemoglobin in red blood cells to form oxyhemoglobin.
 Carbon Dioxide Diffusion: The partial pressure of carbon dioxide
in the bloodstream is higher than the partial pressure of carbon
dioxide in the air in the alveoli. This difference creates a gradient
that causes carbon dioxide to diffuse from the bloodstream into
the alveoli, where it is exhaled.
Gas Exchange Mechanism
10
 The walls of the alveoli share a membrane with the
capillaries.
 This lets oxygen and carbon dioxide diffuse, or move
freely, between the respiratory system and the bloodstream.
 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
 Abnormalities of pulmonary gas
exchange
11 leads to

 Obstructive lung disease in the

form of asthma, chronic bronchitis
or emphysema.

 Conditions such as pulmonary

edema, atelectasis, pulmonary
fibrosis.

 Patients who has received general

anesthesia as well as post cardiac
arrest patients often require
ventilatory support until they have
recovered from the effects of the
anesthesia or the insult of an arrest.
SPIROMETRY
12

 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
centuries, the spirometer
 Principle: The principle behind spirometry is to
measure the volume of air that can be exhaled from the
13lungs in a given time period. By measuring the volume
of air exhaled, spirometry can provide information about
the functioning of the lungs and the ability of the lungs
to move air in and out.
 Working: Spirometry is performed using a spirometer,
a device that consists of a mouthpiece, a flow sensor,
and a volume sensor. The patient is asked to exhale as
much air as possible into the spirometer, and the
spirometer measures the volume and flow rate of the
exhaled air. The volume of air exhaled is displayed on a
graph called a flow-volume loop, which provides
information about the lung function.
 Interpretation of Results The results of spirometry
can be used to determine if the lungs are functioning
normally and to diagnose lung conditions. For example,
a decrease in the volume of air exhaled or a decrease in
the flow rate of the exhaled air can indicate a restriction
in the airways, which can be a sign of a lung condition
such as asthma or COPD.
 Types of
14
Spirometers
 Spirometers can be divided into two basic groups:
• Volume-measurement devices (e.g. wet and
dry spirometers).
• Flow-measurement devices (e.g.
pneumotachograph systems, mass flow meters).
 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 airflow at 14 L per s should
be <1.5 cmH2O per L per s (<0.15 kPa per L per s)
15
HOW TO CALCULATE THE NORMAL RATE OF
RESPIRATION IN A SPIROMETER

 The 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%
16

 Percentages lower than 70% are considered

abnormal. This is an important
measurement because obstructive diseases
such as COPD, chronic bronchitis, and
emphysema cause increased airway
resistance to expiratory airflow, 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
 ABNORMAL LUNG PHYSIOLOGY:

17
Abnormal lung physiology refers to any deviation from the normal functioning of
the respiratory system. This can be caused by a variety of factors, including
diseases, injuries, or genetic conditions. Some common examples of abnormal
lung physiology include:
 Asthma: A chronic inflammatory disease that causes the airways
to narrow, making it difficult to breathe.
 Chronic obstructive pulmonary disease (COPD): A progressive lung
disease that makes it hard to breathe and can include conditions
such as emphysema and chronic bronchitis.
 Pulmonary fibrosis: A disease in which scar tissue builds up in the
lungs, making it difficult to breathe and reducing lung function.
 Pneumonia: An infection in the lungs that can cause inflammation
and fluid buildup in the air sacs.
 Pulmonary embolism: A blockage in one of the pulmonary arteries,
usually by a blood clot, which can cause lung damage and reduce
oxygen flow to the body.
 Lung cancer: A type of cancer that originates in the lung and can
impair lung function by interfering with normal air flow and oxygen
exchange.
 Treatment for abnormal lung physiology depends on the underlying cause and
may include medications, lifestyle changes, or surgery.
 It's important to seek prompt medical attention if you experience symptoms
such as shortness of breath, wheezing, or chest pain, as these can be indicative
of a serious lung problem.
 COPD

18
Chronic obstructive pulmonary disease (COPD) is a chronic
inflammatory lung disease that causes obstructed airflow from the
lungs. I
 In COPD, the airways and small air sacs (alveoli) in the lungs become
damaged or blocked, leading to difficulty in exhaling air. This results
in a decrease in lung function, leading to shortness of breath,
wheezing, and coughing. Over time, these symptoms can get worse
and limit a person's ability to perform everyday activities.
 The primary cause of COPD is long-term exposure to irritants such as
tobacco smoke, air pollution, and dust. Other risk factors include a
history of frequent lung infections, a family history of lung disease,
and exposure to second-hand smoke.
 Symptoms include breathing difficulty, cough, mucus (sputum)
production, and wheezing.
 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.
 There is no cure for COPD, but treatment can help manage the
symptoms and slow the progression of the disease. Treatment options
include medication, such as bronchodilators and steroids, oxygen
therapy, and lung rehabilitation. In severe cases, surgery may also be
an option. In addition, quitting smoking and avoiding exposure to
 19 Symptoms: Diagnosis
 Lung (pulmonary) function tests.
COPD symptoms often don't appear until significant lung  Chest X-ray.
damage has occurred, and they usually  CT scan.
worsen over time, particularly if smoking exposure  Arterial blood gas analysis.
continues.  Laboratory tests
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
 20 Treatment
 Several kinds of medications are used to treat the symptoms and complications of COPD.
 You may take some medications regularly and others as needed.
 Bronchodilators
 Inhaled steroids
 Combination inhalers
 Oral steroids
 Phosphodiesterase-4 inhibitors
 Theophylline
 Antibiotics
 Mechanical ventilation either invasive or non-invasive has an important role in the management of acute
exacerbation of COPD (AECOPD).
 VENTILATOR
21
 Ventilators are medical devices used to assist or control breathing in individuals who are
unable to breathe adequately on their own. They are commonly used in the treatment of
acute respiratory failure, which can occur as a result of a variety of conditions such as
pneumonia, severe asthma, and chronic obstructive pulmonary disease (COPD).
 There are several different types of ventilators, including volume-controlled ventilators,
pressure-controlled ventilators, and bilevel positive airway pressure (BiPAP) devices. The type
of ventilator used depends on the patient's individual needs and the type of respiratory failure
being treated.
 Ventilators work by delivering pressurized air or oxygen into the lungs through a breathing
tube or mask. The pressure can be adjusted to match the patient's needs and to help maintain
adequate oxygen levels in the blood.
 While ventilators can be lifesaving for individuals with acute respiratory failure, they also
come with potential risks and complications. For example, prolonged use of a ventilator can
increase the risk of ventilator-associated pneumonia, and patients may experience discomfort
or pain from the breathing tube.
 The use of ventilators is carefully monitored and managed by healthcare professionals to
ensure that the patient receives the appropriate level of support while minimizing potential
risks and complications.
22
 Mechanical ventilators are machines that
act as bellows to move air in and out of
the lungs.
 The 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.
23 NEED FOR VENTILATION
 Mechanical Ventilation is ventilation of the lungs by artificial means usually by a ventilator.
 A ventilator delivers gas to the lungs with either negative or positive pressure.
 To maintain or improve ventilation, & tissue oxygenation.
 To decrease the work of breathing & improve patient’s comfort.

 TYPES OF VENTILATORS
 Negative-pressure ventilators
 Positive-pressure ventilators.
24 Negative-Pressure Ventilators
 Early negative-pressure ventilators were known as “Iron lungs.”
 The patient’s body was encased in an iron cylinder and negative
pressure was generated .
 The iron lung are still occasionally used today.
 Intermittent short-term negative-pressure ventilation is
sometimes used in patients with chronic diseases.
 The use of negative-pressure ventilators is restricted in clinical
practice, however, because they limit positioning and movement
and they lack adaptability to large or small body torsos (chests).
 Our focus will be on the positive-pressure ventilators.
25 Positive-pressure ventilators
Positive-pressure ventilators deliver gas to the patient under positive-pressure, during the
inspiratory phase.

Types of Positive-Pressure Ventilators

1- Volume Ventilators.
2- Pressure Ventilators
3- High-Frequency Ventilators
 Volume Ventilators
26
 The volume ventilator is commonly used in critical care settings.
 The basic principle of this ventilator is that a designated volume of air is delivered
with each breath.
 The amount of pressure required to deliver the set volume depends on
- Patient’s lung compliance
- Patient–ventilator resistance factors.
 Therefore, peak inspiratory pressure (PIP ) must be monitored in volume modes
because it varies from breath to breath.
 With this mode of ventilation, a respiratory rate, inspiratory time, and tidal volume
are selected for the mechanical breaths.
27 Pressure Ventilators
 The use of pressure ventilators is increasing in critical care units.
 A typical pressure mode delivers a selected gas pressure to the patient early in
inspiration, and sustains the pressure throughout the inspiratory phase.
 By meeting the patient’s inspiratory flow demand throughout inspiration, patient
effort is reduced and comfort increased.
 Although pressure is consistent with these modes, volume is not.
 Volume will change with changes in resistance or compliance,
 Therefore, exhaled tidal volume is the variable to monitor closely.
 With pressure modes, the pressure level to be delivered is selected, and with some
mode options rate and inspiratory time are preset as well.
28 High-Frequency Ventilators
 High-frequency ventilators use small tidal volumes (1 to 3
mL/kg) at frequencies greater than 100 breaths/minute.
 The high-frequency ventilator accomplishes oxygenation by
the diffusion of oxygen and carbon dioxide from high to low
gradients of concentration.
 This diffusion movement is increased if the kinetic energy of
the gas molecules is increased.
 A high-frequency ventilator would be used to achieve lower
peak ventilator pressures, thereby lowering the risk of
barotrauma.
 29 Heart Lung Machine
 A heart-lung machine, also known as a
cardiopulmonary bypass machine, is a device used in
cardiovascular surgery to temporarily take over the
functions of the heart and lungs. The heart-lung
machine is used during open-heart surgery, such as
coronary artery bypass graft (CABG) surgery and
valve replacement surgery, to support the patient's
circulatory and respiratory functions while the heart
is stopped
 The heart-lung machine works by circulating blood
outside of the body through a series of tubes and
pumps. Blood is taken from the body, oxygenated,
and then returned to the body. This allows the heart
to be stopped during the surgery without causing any
harm to the patient.
30

•The use of a heart-lung machine

during surgery carries some risks,
including the potential for blood
clots, bleeding, and infections.
•Additionally, there may be some
long-term effects on the body, such
as cognitive decline, that are not yet
fully understood.
•However, the use of a heart-lung
machine has revolutionized the field
of cardiovascular surgery, allowing
for more complex procedures to be
performed and greatly improving
patient outcomes.
 Artificial Lungs


31 Artificial lungs are devices designed to mimic the function of
the natural respiratory system. They are used to support
patients with acute respiratory distress syndrome (ARDS) or
acute lung injury (ALI) and to help the patient's own lungs
recover and heal.
 Types
 There are two main types of artificial lungs: membrane
oxygenators and extracorporeal lung assist devices.
 Membrane Oxygenators: These are devices that use a
semipermeable membrane to transfer oxygen and carbon
dioxide between the blood and the air. The blood is pumped
through the membrane, where it comes into contact with air,
allowing for the exchange of gases.
 Extracorporeal Lung Assist Devices: These devices work by
removing carbon dioxide from the blood and adding oxygen,
allowing the patient's natural lungs to rest and heal. One
example of an extracorporeal lung assist device is the
extracorporeal membrane oxygenation (ECMO) machine,
which is used to treat patients with severe respiratory failure.
ECMO works by removing carbon dioxide from the blood and
adding oxygen, and it can be used as a bridge to recovery or
as a bridge to lung transplantation.
 KIDNEY AS FILTRATION SYSTEM:
32

 The kidney is a complex organ that acts as a filtration system for the body. It
removes waste and excess fluid from the bloodstream and maintains a
delicate balance of electrolytes, hormones, and other substances that are
critical for the body's normal functioning.
 The kidney also plays an important role in regulating blood pressure by
secreting the hormone renin, which helps control the balance of fluid and
electrolytes in the body. It also regulates red blood cell production and the
levels of various minerals in the blood, such as calcium and phosphorus.
 Without the kidney, waste and excess fluid would accumulate in the body,
leading to serious health problems.
 33
 Kidneys remove wastes and extra fluid from the body.
 Kidneys also remove acid that is produced by the cells
of the body
 Kidney maintain a healthy balance of water, salts, and
minerals—such as sodium, calcium, phosphorus, and
potassium—in the blood.
 Without this balance, nerves, muscles, and other
tissues in the body may not work normally.
 Kidneys also make hormones that help
 Control blood pressure.
 Make red blood cells NIH external link.
 Keeps bones strong and healthy
 Architecture of Kidney

34

 The kidney is composed of functional units called

nephrons, which are the basic structural and
functional units of the kidney. Each kidney contains
approximately one million nephrons, and each
nephron performs the functions of filtration,
reabsorption, and secretion.
 The nephron is comprised of several key structures:
 Bowman's capsule: This is a cup-shaped
structure that surrounds the glomerulus
and filters waste and excess fluid from
the bloodstream into the renal tubule.
 Glomerulus: A network of tiny blood
vessels within the Bowman's capsule
that filters waste and excess fluid from
the bloodstream.
 Proximal convoluted tubule: A segment
of the renal tubule that reabsorbs
important substances, such as glucose,
amino acids, and electrolytes, back into
the bloodstream.
  Loop of Henle: A U-shaped segment of the
35
renal tubule that is critical for the
reabsorption of ions and water.
 Distal convoluted tubule: A segment of the
renal tubule that regulates the levels of
electrolytes and other important substances
in the bloodstream.
 Collecting duct: A series of ducts that collect
the filtrate from the renal tubules and
transport it to the renal pelvis, where it
drains into the ureter and eventually into
the bladder.
 The nephrons are surrounded by a network of blood
vessels, including the afferent arteriole and the efferent
arteriole, which bring blood into and out of the
glomerulus, respectively. The filtrate produced by the
nephron passes through the renal tubules, where it is
modified by reabsorption and secretion, before being
eliminated from the body as urine.
36 Mechanism of Filtration – Urine
Formation
 The mechanism of filtration in the kidneys is
a complex process that involves multiple
steps to remove waste and excess fluids
from the bloodstream. The following is a
summary of the steps involved in the
filtration process:
 Blood enters the kidney through the renal
arteries and flows into tiny filtering units
called glomeruli.
 At the glomerulus, the pressure in the blood
vessels causes a portion of the plasma and
dissolved substances to filter out and enter
a structure called Bowman's capsule.
37  In Bowman's capsule, the filtrate is then transferred into the renal tubules, which
are the main filtering units of the kidneys.
 In the renal tubules, the filtrate passes through a series of specialized cells, such
as proximal tubular cells and distal tubular cells, which reabsorb important
substances such as glucose, amino acids, and electrolytes back into the
bloodstream.
 At the same time, the renal tubules secrete waste products, such as urea and
creatinine, back into the filtrate.
 Finally, the filtered fluid, now known as urine, is transported through the renal
pelvis and ureters to the bladder, where it is eventually eliminated from the
body.
 This process of filtration, reabsorption, and secretion helps to maintain the
proper balance of fluids and electrolytes in the body, as well as to remove waste
and excess substances
 38 FLOW OF BLOOD THROUGH KIDNEY
 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
39 CHRONIC KIDNEY DISEASE
 CKD stands for Chronic Kidney Disease. It is a long-term condition in which
the kidneys gradually become less able to function properly. It can be
caused by a variety of factors, including diabetes, high blood pressure,
and other health problems that damage the kidneys.
 Symptoms of CKD include fatigue, swelling in the legs and feet, trouble
sleeping, and difficulty concentrating. As the disease progresses, it can
lead to more serious complications, such as anemia, nerve damage, and
an increased risk of heart disease and stroke.
 Treatment for CKD may include lifestyle changes, such as eating a healthy
diet and exercising regularly, as well as medications to manage symptoms
and underlying health conditions. In severe cases, kidney transplant or
dialysis may be necessary.
 It is important for individuals with risk factors for CKD to get regular check-
ups and to talk to their doctor about how to best manage their condition.
 40

Chronic kidney disease includes conditions that damage

your kidneys and decrease their ability to keep healthy by
filtering wastes from blood.
If kidney disease worsens, wastes can build to high levels in
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
 41 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:

 Haemodialysis
 Peritoneal dialysis
 Both hemodialysis and peritoneal dialysis can
effectively treat the symptoms of kidney failure,
but each has its own advantages and
disadvantages. The choice of dialysis system
depends on various factors such as the
individual's overall health, lifestyle, and personal
preferences.
42

Hemodialysis is a procedure
that uses a machine to clean
the blood. During
hemodialysis, blood is removed
from the body, passed through
a dialysis machine that filters
out waste and excess fluids,
and then returned to the body.
Hemodialysis typically takes
place in a hospital or dialysis
center, and is typically
performed three times a week
for three to four hours at a
time.
43
 Peritoneal dialysis is a type of
dialysis that uses the lining of the
abdomen, called the peritoneum,
to filter waste and excess fluids
from the blood. A sterile solution
is introduced into the abdomen,
where it absorbs waste and
excess fluids, and is then drained
and replaced with fresh solution.
Peritoneal dialysis can be
performed at home and allows for
more flexibility in scheduling.
 Artificial Kidney
 While much progress has been made in developing an artificial
44 kidney, it is still in the experimental stage and is not yet widely
available. Further research and development is needed to improve
the efficiency and safety of artificial kidney devices, and to ensure
that they can be widely adopted as a treatment for chronic kidney
disease.
 An artificial kidney is a device that is being developed to mimic the
functions of the human kidney. The goal of an artificial kidney is to
provide a more effective and efficient means of treating patients with
chronic kidney disease, who currently rely on dialysis or kidney
transplantation.
 There are currently two main approaches to developing an artificial
kidney: a biological approach and a technological approach.
 The biological approach involves using living cells, such as kidney
cells or stem cells, to create a functional, implantable artificial kidney.
 The technological approach involves using synthetic materials, such
as silicon or polymer, to create a dialysis device that can filter the
blood and remove waste and excess fluids.
 It's important to note that while the development of an artificial
kidney holds great promise, it is not a cure for chronic kidney disease
and patients with kidney failure will still need dialysis or kidney
transplantation in the meantime.
45 Muscular Systems as Scaffolds
 The use of muscular systems as scaffolds in regenerative medicine is an area of active
research and development. Muscles have the potential to be used as scaffolds for the
regeneration of tissues due to their inherent mechanical properties and ability to support cell
growth and tissue formation.
 One example of using muscular systems as scaffolds is in the treatment of damaged or
diseased heart tissue. Researchers have developed methods for using muscle cells to
create a functional, three-dimensional scaffold that can support the growth of new heart
tissue. In this approach, muscle cells are harvested from the patient and then seeded onto a
scaffold, such as a hydrogel or artificial matrix. The scaffold provides a framework for the
cells to grow and differentiate into new heart tissue, which can help to repair the damaged
or diseased tissue.
 Another example is in the treatment of skeletal muscle injuries, such as those caused
by trauma or disease. In this case, muscle cells can be harvested and seeded onto a
scaffold, which can then be implanted into the damaged muscle to promote the growth of
new, functional tissue.
 While the use of muscular systems as scaffolds is still in the experimental stage, it holds
great promise for the treatment of a variety of conditions and represents an area of active
research and development in the field of regenerative medicine
 Architecture
46
 Inside each skeletal muscle, muscle fibers are
organized into bundles, called fascicles,
surrounded by a middle layer of connective tissue
called the perimysium. This fascicular organization
is common in muscles of the limbs; it allows the
nervous system to trigger a specific movement of a
muscle by activating a subset of muscle fibers
within a fascicle of the muscle. Inside each fascicle,
each muscle fiber is encased in a thin connective
tissue layer of collagen and reticular fibers called
the endomysium. The endomysium surrounds the
extracellular matrix of the cells and plays a role in
transferring force produced by the muscle fibers to
the tendons.
 Inside the muscle fibers, there are tiny structures
called myofibrils. Myofibrils are made up of smaller
units called sarcomeres, which are responsible for
muscle contraction.
47
 Sarcomeres contain thin (Actin) and thick filaments
(Myosin) that work together to make the muscle fibers
contract. Each muscle fiber is surrounded by a
protective layer called endomysium. Multiple muscle
fibers are grouped together into bundles called
fascicles. Fascicles are surrounded by another layer of
connective tissue called perimysium.
 All the fascicles together make up the entire muscle,
which is surrounded by a layer called epimysium. The
muscle also has a special membrane called the
sarcolemma, which protects the muscle fiber. Inside
the muscle fiber, there are small tunnels called T-
tubules that help transmit signals for muscle
contraction. Muscles work through the coordination of
motor units, which consist of a motor neuron and the
muscle fibers it controls. This architecture allows
muscles to generate force, move our bodies, and
perform various activities.
 MECHANISM
48 
The nervous system (your body’s command center) controls your voluntary
muscle movements. Voluntary muscles are ones you control intentionally.
Some involve large muscle groups to do activities like jumping. Others use
smaller movements, like pushing a button.
 Movements happen when nervous system (brain and nerves) sends a message
to activate your skeletal (voluntary) muscles.Our muscle fibers contract (tense
up) in response to the message.
 When the muscle activates or bunches up, it pulls on the tendon. Tendons
attach muscles to bones. The tendon pulls the bone, making it move.
 To relax the muscle, your nervous system sends another message, It triggers
the muscles to relax or deactivate.
 The relaxed muscle releases tension, moving the bone to a resting position.
 Hundreds of conditions can cause problems with the musculoskeletal system.
 They can affect the way you move, speak and interact with the world.
  The mechanism of how the muscular system can be used as a scaffold in regenerative
49
medicine involves the use of muscle cells and a scaffold to support the growth and
regeneration of new tissue.
 The method of growing muscle tissue using hydrogel or artificial scaffold is explained
below:
 The basic steps in this process are as follows:
 Harvesting of muscle cells: Muscle cells are typically obtained from the patient and
then isolated and expanded in culture.
 Seeding onto scaffold: The muscle cells are then seeded onto a scaffold, such as a
hydrogel or artificial matrix. The scaffold provides a framework for the cells to grow
and differentiate into new tissue.
 Cell differentiation and tissue formation: Once the cells are seeded onto the scaffold,
they undergo differentiation, in which they change into specific cell types, such as
muscle cells or heart cells. The cells also begin to organize and form new tissue, such
as heart tissue or skeletal muscle tissue.
 Implantation into patient: The scaffold and cells are then implanted into the patient to
promote the growth of new, functional tissue.
50

Figure Representing the formation of polymer based

Figure: Representing the muscle tissue growth using hydrogel or artificial scaffold scaffold and cell culture
 Muscle Cells as Scaffold

 Muscle cells can be used as a scaffold for tissue generation by removing the living cells from the muscle
51
tissue, leaving behind the structure known as the extracellular matrix (ECM). This decellularized muscle
scaffold provides a framework that can guide and support the growth of new tissues.
 The Process
 Harvesting muscle tissue: A small sample of muscle tissue is taken, typically from a donor or an
animal model.
 Cell removal: The living cells within the muscle tissue are removed using a process called
decellularization. This involves treating the tissue with specific chemical solutions or enzymes
that break down and wash away the cellular components, while preserving the ECM.
 ECM scaffold: The remaining ECM, which forms the structure of the muscle, is now a scaffold. It
consists of proteins, such as collagen and elastin, and other molecules that provide support and
signals for tissue growth.
 Seeding cells: The decellularized muscle scaffold is then seeded with desired cells. These can be
stem cells or specialized cells relevant to the type of tissue being regenerated. The cells are
introduced onto the scaffold, allowing them to attach and populate the structure.
 Tissue growth: Over time, the seeded cells proliferate and differentiate, meaning they multiply
and transform into specific cell types required for the desired tissue. The ECM scaffold guides the
cells' growth, providing physical support, and biochemical cues to influence their behavior.
 Tissue integration: As the cells continue to grow, they populate the scaffold and form new tissue.
The new tissue integrates with the surrounding native tissue, gradually replacing the
decellularized scaffold with functional, regenerated tissue.
 By utilizing the decellularized muscle scaffold, the process of tissue generation takes advantage of the
existing three-dimensional architecture and mechanical properties of the muscle. This approach has the
potential to address challenges in tissue engineering, such as creating a suitable environment for cell growth,
promoting vascularization, and facilitating functional integration of regenerated tissues.
 Muscular Dystrophy
 Muscular dystrophy is a group of genetic disorders that result in progressive
52
weakness and degeneration of the skeletal muscles, which are responsible
for movement.
 The disorders are caused by mutations in genes that encode proteins needed for
muscle function.
 The most common type of muscular dystrophy is Duchenne muscular dystrophy,
which typically affects young boys and leads to severe disability by early adulthood.
 Other forms of the disease include Becker muscular dystrophy, limb-girdle
muscular dystrophy, and facioscapulohumeral dystrophy, among others.
 There is currently no cure for muscular dystrophy, but various treatments can help
manage symptoms and slow the progression of the disease. These may include
physical therapy, assistive devices, orthopedic surgery, and medication to
manage muscle spasms and pain. In some cases, genetic therapy and stem
cell transplantation are also being explored as potential treatment options.
 It's important for individuals with muscular dystrophy to work closely with a
healthcare team that includes specialists in neurology, rehabilitation medicine, and
orthopedics, to develop a comprehensive care plan that meets their specific needs.
53  Duchenne muscular dystrophy (DMD) usually appears early in
childhood between the ages of 2 and 3. DMD primarily affects boys but
can affect girls in rare cases. The primary symptom of DMD is muscle
weakness that begins in the muscles close to the body and later affects
muscles in the outer limbs.
 Becker muscular dystrophy typically becomes apparent between the
ages of 5 and 15. It is similar to Duchenne MD, except that it progresses
slower and symptoms begin to appear later. Boys are primarily affected
by Becker MD. Becker MD causes muscle loss that begins in the hips and
pelvic area, thighs, and shoulders.
 The age of onset of limb-girdle muscular dystrophy is highly varied,
ranging from early childhood to later adulthood. The disease is
characterized by muscle weakness and atrophy of the muscles of the
hip and shoulder areas (the limb girdles).
 Facioscapulohumeral dystrophy (FSHD) typically appears before the
age of 20, but can appear later in adulthood or even in childhood in both
males and females. FSHD affects the muscles of the face, around the
shoulder blades, and in the upper arms.
 Bioengineering solutions for muscular dystrophy
54
 Bioengineering solutions for muscular dystrophy aim to improve the lives of
individuals affected by the disease by addressing the underlying genetic mutations
and muscle weakness. Some of the approaches being explored include:
 Gene therapy: This involves delivering a functional copy of the missing or mutated
gene to the affected muscle cells. The goal is to restore the production of the missing
protein and improve muscle function.
 Stem cell therapy: This involves using stem cells to replace the damaged muscle
cells and promote repair and regeneration of the muscle tissue. Stem cells can be
taken from the patient's own body (autologous stem cells) or from a donor (allogenic
stem cells).
 Exoskeleton technology: This involves using wearable devices, such as robotic
exoskeletons, to support and enhance the movement of individuals with muscular
dystrophy. The devices use motors and sensors to mimic the movements of the
wearer and help improve mobility.
 Tissue engineering: This involves using a combination of materials, such as
scaffolds and growth factors, to promote the growth and repair of muscle tissue. The
goal is to create functional muscle tissue that can replace the damaged tissue in
individuals with muscular dystrophy.
 These approaches are still in the early stages of development, but hold promise for
the future treatment of muscular dystrophy. Clinical trials and further research are
 Artificial Muscles
55
Artificial muscle refers to a type of technology that aims to mimic the properties and
functions of natural muscle. Artificial muscles can be made from various materials,
including shape memory alloys, electroactive polymers, and carbon nanotubes.

Shape Memory Alloys (SMAs)

 SMAs are materials with the ability to remember and recover their original shape
after being deformed.
 SMAs, like nickel-titanium (NiTi) alloys, are commonly used in artificial muscle
applications.
 When exposed to heat or an electric current, SMAs undergo a phase transformation,
enabling them to contract and generate force.
 This property makes them suitable for mimicking muscle-like movements in devices such
as prosthetics, robotics, and actuators.
 The unique combination of shape memory and superelasticity in SMAs provides excellent
mechanical properties and durability for artificial muscle applications.
 Electroactive Polymers (EAPs)
 EAPs are a class of materials that exhibit significant changes in shape or size when subjected to an
56 electric field.
 These polymers, such as polypyrrole and polyacrylonitrile, have the ability to undergo large deformation
and respond quickly to electrical stimulation.
 EAPs are particularly advantageous for artificial muscle applications due to their lightweight nature,
flexibility, and biocompatibility.
 They can be designed to contract or expand in response to electrical signals, enabling precise control
and mimicry of muscle-like movements.
 EAPs have promising potential in areas such as soft robotics, haptic devices, and biomedical
applications.

Carbon Nanotubes (CNTs)

 CNTs are cylindrical structures composed of carbon atoms, exhibiting exceptional mechanical, electrical,
and thermal properties.
 CNTs possess high tensile strength and are highly conductive, making them suitable for artificial muscle
development.
 By utilizing the electromechanical properties of CNTs, they can act as actuators that contract or expand
when stimulated by an electric current.
 CNT-based artificial muscles offer advantages such as high power-to-weight ratio, fast response times,
and potential scalability.
 Research is underway to optimize CNT-based artificial muscles for applications in robotics, aerospace,
and microelectromechanical systems (MEMS).
57  Artificial muscles have a number of potential applications, including:
 Robotics: Artificial muscles can be used to create more advanced and flexible
robots that can move and perform tasks more like humans.
 Prosthetics: Artificial muscles can be used to create more advanced prosthetic
limbs that are more responsive and capable of performing a wider range of
movements.
 Biomedical devices: Artificial muscles can be used in various biomedical
devices, such as heart assist pumps and artificial hearts, to improve their
performance and reliability.
 Textile and clothing applications: Artificial muscles can be integrated into
textiles and clothing to create smart garments that can change shape and adjust
to the wearer's movements.
 Artificial muscles have several advantages over traditional motors, including
higher power-to-weight ratios, faster response times, and greater flexibility.
However, the technology is still in the early stages of development and further
research is needed to fully realize its potential and overcome its limitations
58 Skeletal Systems
 The skeletal system of human beings refers to the framework of
bones, joints, and connective tissues that provide structure,
support, and protection to the body.
 The key components and functions of the skeletal system are:
 Bones: The human body consists of 206 bones that vary in size
and shape. Bones are composed of hard and dense connective
tissue that provides strength and support. They serve as the
anchor points for muscles, protect internal organs, and store
minerals like calcium and phosphorus.
 Cartilage: Cartilage is a flexible connective tissue found in
certain joints and structures such as the ears and nose. It acts as
a cushion between bones, reducing friction and absorbing shock.
 Ligaments: Ligaments are tough bands of fibrous tissue that
connect bones to other bones in joints, providing stability and
preventing excessive movement
 Tendons: Tendons are strong fibrous tissues that connect
muscles to bones, enabling movement by transmitting the force
generated by muscles.
59

 Axial Skeleton: The axial skeleton forms the central

axis of the body and includes the skull, vertebral
column, and ribcage. The skull protects the brain,
and the vertebral column (spine) supports the body's
weight and houses the spinal cord. The ribcage
encloses and protects the heart, lungs, and other
thoracic organs.
 Appendicular Skeleton: The appendicular skeleton
comprises the bones of the limbs and the
shoulder and pelvic girdles. The upper limbs
(arms) consist of the humerus (upper arm bone),
radius and ulna (forearm bones), and the hand
bones. The lower limbs (legs) include the femur
(thigh bone), tibia and fibula (lower leg bones), and
the foot bones. The shoulder and pelvic girdles attach
the limbs to the axial skeleton.
 60
 Joints: Joints are the points where
bones meet and allow for movement.
There are different types of joints,
including hinge joints (e.g., elbow
and knee) that enable bending and
straightening, ball-and-socket joints
(e.g., hip and shoulder) that allow for a
wide range of motion, and pivot
joints (e.g., between the atlas and
axis vertebrae) that allow rotational
movement.
 The skeletal system works in
conjunction with muscles, tendons,
and ligaments to allow for movement,
protect internal organs, support the
body's weight, and provide a structural
framework for the body Figure: Representing various skeletal joints A) Ball and socket, B)
Hinge, C) Pivot, D) Ellipsoidal, E) Saddle, and F) Glider or planar
 Skeletal System as Scaffold
61
 The skeletal system can be used as a scaffold for tissue growth in
certain applications.
 Scaffold-based tissue engineering is a field that aims to create artificial
scaffolds to support the growth and regeneration of tissues and organs.
 In some cases, the natural structure of the skeletal system can serve as
a scaffold or template for tissue engineering purposes.
 For example, bone tissue engineering often involves the use of scaffolds
to facilitate the repair and regeneration of bone defects or injuries.
Synthetic or natural biomaterial scaffolds, designed to mimic the
properties of bone, can be used to fill the void left by a bone defect. The
scaffold provides a three-dimensional structure that supports the
attachment, proliferation, and differentiation of cells involved in bone
regeneration. Over time, the scaffold can be replaced by newly formed
bone tissue, resulting in the restoration of bone structure and function.
62
 In addition to bone tissue engineering, the skeletal system has also been
explored as a scaffold for other tissues. For instance, researchers have
investigated using decellularized bone or cartilage scaffolds as templates
for the regeneration of other tissues like muscle, blood vessels, or nerves.
The existing extracellular matrix and structure of the skeletal system can
provide a framework for cells to populate and guide tissue growth.
 However, it's important to note that using the skeletal system as a
scaffold for tissue growth requires careful consideration and modification
to match the specific requirements of the target tissue. Additional steps,
such as surface modifications, incorporation of bioactive molecules, or
cell seeding, may be necessary to optimize the scaffold's effectiveness
for promoting tissue regeneration.
 Though the skeletal system has potential as a scaffold for tissue growth,
successful application requires further research, customization, and
integration with tissue engineering strategies specific to the desired
tissue type.
 Osteoporosis
63
 Osteoporosis is a condition that weakens the bones and makes them more
likely to break (fracture), especially the bones in the hip, spine, and wrist. It occurs
when the body loses bone mass and density more quickly than it can be replaced,
leading to fragile bones that are prone to fracture.
 Treatment for osteoporosis aims to slow down bone loss, prevent fractures, and treat
fractures if they occur. Some of the treatments include:
 Medications: Bisphosphonates, denosumab, and teriparatide are some of the
medications that can slow down bone loss and reduce the risk of fractures.
 Calcium and Vitamin D supplementation: Calcium and Vitamin D are essential
for healthy bones, and taking supplements can help maintain bone mass.
 Exercise: Weight-bearing and resistance exercises can help improve bone density
and reduce the risk of fractures.
 Lifestyle changes: Quitting smoking, reducing alcohol consumption, and eating a
healthy diet that includes enough calcium and Vitamin D can help maintain healthy
bones.
 It's important to work closely with a healthcare provider to develop a comprehensive
treatment plan for osteoporosis, as the right approach may vary depending on the
individual's specific needs and medical history.
  Osteoporosis is a common condition, especially among older women, and it
64 can increase the risk of falls and fractures, which can result in significant
pain and disability. Risk factors for osteoporosis include being , older age,
having a family history of the condition, smoking, drinking excessive
amounts of alcohol, being thin or having a small body frame, and
having a low calcium intake.
65 Bioengineering solutions for osteoporosis
 Bioengineering solutions for osteoporosis aim to improve bone health and prevent fractures.
Some of the approaches being explored include:
 Tissue engineering: This involves using scaffolds and growth factors to stimulate the growth
of new bone tissue and promote the repair of damaged bones. The goal is to create functional
bone tissue that can replace the lost bone mass and density in individuals with osteoporosis.
 Stem cell therapy: This involves using stem cells to replace the damaged bone cells and
promote the repair and regeneration of bone tissue. Stem cells can be taken from the patient's
own body (autologous stem cells) or from a donor (allogenic stem cells).
 Biomaterials: This involves using synthetic or natural materials to replace or augment
damaged bone tissue. Biomaterials can be designed to mimic the properties of natural bone and
promote the growth of new bone tissue.
 Gene therapy: This involves delivering a functional copy of a gene involved in bone growth
and repair to the affected bone cells. The goal is to restore the production of the missing protein
and improve bone health.
 These approaches are still in the early stages of development, but hold promise for the future
treatment of osteoporosis. Clinical trials and further research are needed to determine the
safety and efficacy of these therapies.
 In addition, traditional treatments for osteoporosis, such as medication, exercise, and lifestyle
changes, will likely continue to play an important role in preventing fractures and maintaining
healthy bones in individuals with osteoporosis.
66
Artificial Bones
 Artificial bones, also known as bioceramic implants, are medical devices used to replace
damaged or missing bones. They are made from biocompatible materials, such as ceramics
or polymers, that mimic the properties of natural bone.
Ceramics:
 Ceramics commonly used in artificial bone applications are biocompatible materials that
resemble the mineral component of natural bone. Some examples include:
 Hydroxyapatite (HA): HA is a calcium phosphate ceramic that closely resembles the mineral
phase of natural bone. It provides excellent biocompatibility, osteoconductivity (ability to
support bone ingrowth), and chemical similarity to bone mineral. HA-based ceramics are
widely used in bone grafts, coatings for orthopedic implants, and scaffolds for bone tissue
engineering.
 Tricalcium Phosphate (TCP): TCP is another calcium phosphate ceramic that is similar in
composition to natural bone. It has good biocompatibility and biodegradability, allowing it to
gradually resorb as new bone tissue forms. TCP ceramics are commonly used in bone graft
substitutes and as fillers for bone defects.
 Bioactive Glass: Bioactive glasses, such as silicate-based glasses, possess the ability to bond
with bone tissue through the formation of a biologically active interface. These glasses
promote bone regeneration and are used in bone grafts, coatings for implants, and scaffolds.
67

Polymers:
 Polymers used in artificial bone applications offer flexibility, versatility, and the
ability to customize their properties. Some examples include:
 Polycaprolactone (PCL): PCL is a biodegradable polymer with good mechanical
properties. It is often used in bone tissue engineering scaffolds due to its slow
degradation rate, allowing it to provide support during the regeneration process.
 Poly(lactic-co-glycolic acid) (PLGA): PLGA is a biocompatible and biodegradable
polymer composed of lactic acid and glycolic acid units. It has been extensively
used in various medical applications, including bone tissue engineering. PLGA
scaffolds can be tailored to degrade at a desired rate, enabling synchronized new
tissue formation.
 Polyethylene Glycol (PEG): PEG is a hydrophilic polymer that can be modified to
create scaffolds with specific properties. It can be combined with other materials,
such as ceramics, to enhance their mechanical strength and bioactivity. PEG-
based hydrogels and composites have shown promise for bone tissue
engineering.
68
Advantages
 Artificial bones can be used to treat a variety of conditions, including osteoporosis, bone fractures,
and congenital conditions that result in missing or malformed bones. Some of the advantages of
artificial bones include:
 Durability: Artificial bones can be made from materials that are more durable than natural bone,
making them more resistant to fractures and other forms of damage.
 Customization: Artificial bones can be designed and manufactured to fit a specific patient's
needs, taking into account factors such as size, shape, and bone quality.
 Reduced risk of rejection: Unlike natural bone, which can be rejected by the body, artificial
bones are made from biocompatible materials that are less likely to cause an immune response.
 Faster recovery: Artificial bones can often be implanted more quickly than natural bone grafts,
which can lead to faster healing and rehabilitation.
 However, there are also some potential drawbacks to artificial bones, such as the risk of implant
failure, long-term stability issues, and the need for additional surgeries in the case of implant wear
or damage. Overall, artificial bones are a promising technology that can provide a range of
benefits to patients with damaged or missing bones. However, further research is needed to fully
understand their safety and efficacy, and to develop new and improved artificial bone implants
69