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HUMAN PHYSIOLOGY Physiology is the study of how organisms work or function whereas anatomy is the study of the structure of living organisms. The functioning of an organism involves various changes, which maintain the stability of the internal environment (homeostasis) and keep the organism alive. Homeostasis is the maintenance of constant internal conditions (such as blood chemistry, temperature, and blood pressure) by the body’s control systems. A homeostatic system is constantly reacting to external forces so as to maintain limits set by the body’s need. Physiology is concerned with the changes that take place, where in the organism these changes occur and how they are regulated. Therefore, there is a need to understand physiology for one to understand nutrition better. Levels of human biological organization Human beings are as simple as a collection of atoms and as complex as a single organism. Beginning as tiny units, atoms combine millions of times to form living organisms. First molecules form, then many molecules combine to form cells. Cells combine and become tissue, which connects to form organs. The interaction of organs forms a coordinated system, called an organism. The human body is just such a coordinated unit of many organ systems. Atoms system molecules cells tissues organs body organism Human cell Details of structure of a typical animal cell. 1 Structure and function of cellular components COMPONENT STRUCTURE Cell/plasma membrane Membrane composed of phospholipid and protein molecules. Cytoplasm Fluid, jellylike substance in which organelles are suspended. Endoplasmic System of interconnected reticulum membrane-forming canals and tubules. Ribosomes Golgi apparatus Mitochondria Granular particles composed of protein and RNA Cluster of flattened membrane sacs Lysosomes Membranous sacs with folded inner partitions Membranous sacs Peroxisomes Spherical membranous vesicles Centrosome Nonmembranous mass of two rodlike centrioles. Membranous sacs Vacuoles Fibrils and microtubules Cilia and flagella Nuclear membrane Nucleolus Nucleus Chromatin Thin, hollow tubes Minute cytoplasmic extensions from cell Membrane surrounding nucleus, composed of protein and lipid molecules Dense, nonmembranous mass composed of protein and RNA molecules. A spherical stracture surrounded by its own membrane Fibrous strands composed of protein and DNA molecules. FUNCTION Gives form to cell and controls passage of materials in and out of cell. Serves as matrix substance in which chemical reactions occur. Smooth endoplasmic reticulum metabolizes nonpolar compounds and stores Ca++ in striated muscle cells; rough endoplasmic reticulum assists in protein synthesis. Synthesize proteins Synthesizes carbohydrates and packages molecules for secretion; secretes lipids and glycoproteins. Release energy from food molecules and transform energy into usable ATP. Digest foreign molecules and worn and damaged cells. Contain enzymes that produce hydrogen peroxide and use this for oxidation reactions. Helps organize spindle fibers and distribute chromosomes during mitosis. Store and excrete various substances within the cytoplasm. Support cytoplasm and transport materials within the cytoplasm. Move particles along surface of cell or move cell. Supports nucleus and controls passage of materials between nucleus and cytoplasm. Forms ribosomes Carries the genetic information needed to determine the exact nature of the protein that will be synthesized. Controls cellular activity for carrying on life processes. 2 METABOLISM Metabolism is the sum total of all the chemical reactions that go on in living cell; energy metabolism includes all the reactions by which the body obtains and spends the energy from food. Metabolism involves two types of reaction (catabolism and anabolism). Catabolism refers to reactions in which large molecules are broken down to smaller ones. Catabolic reactions usually release energy. . kata = down Anabolism refers to reactions in which small molecules are put together to build larger ones. Anabolic reactions require energy. . ana = up However, there are other pathways (progression of chemical reaction from the starting to the ending process) that connect anabolism and catabolism, described as amphibolic pathways. These include pathways that serve both catabolic and anabolic purposes, such as the citric acid cycle and oxidative phosphorylation. In any one cell of the body catabolic and anabolic processes are carried out simultaneously. Each chemical reaction requires a catalyst. Enzymes are protein substances, produced in cells, which act as biological catalysts (speed up chemical reactions without taking part). Enzymes are found throughout the body but are present in particularly large amounts in the digestive system. NB. There is a difference between an enzyme and a hormone. A hormone is a chemical substance produced in an endocrine gland and transported by the blood to other tissues where it influences function and metabolic activity. OR, hormones are chemical messengers. These are secreted by a variety of glands in response to altered conditions in the body. Each hormone travels to one or more specific target tissues or organs, where it elicits a specific response to maintain homeostasis. In general, a gastrointestinal hormone is called an enterogastrone. Enzymes vs. hormones All enzymes and some hormones are proteins, but an enzyme is not a hormone. Enzymes facilitate the making and breaking of bonds in chemical reactions; hormones act as chemical messengers, sometimes regulating enzyme action. In metabolism there are two of the most important metabolic processes, which take place in cells. These are energy production and protein synthesis. Energy production (respiration) Carbohydrates, fats and proteins contain chemical energy “locked up” in the molecules. Respiration is the breakdown of these substances and the subsequent release of energy. In order to remain alive, both animals and plants must respire. Respiration normally involves the uptake of oxygen and the release of carbon dioxide and it has become synonymous with breathing. For clarity, therefore, the external signs of respiration (breathing) are termed external respiration and the breakdown processes within the cells internal respiration. 3 Energy from carbohydrates Glucose and glycogen (storage form of glucose in the liver and muscles) are broken down in the cells of the body into carbon dioxide and water. The breakdown is a complex process, which takes place as a series of reactions involving many intermediate products. One of the main intermediate products is pyruvic acid. The following equation represents the breakdown of glucose into pyruvic acid. C6H12O6 Glucose 2 CH3COCOOH + 4 [H] energy pyruvic acid hydrogen This part of the respiratory process is anaerobic. The hydrogen atoms are not released as free hydrogen but are transferred to co-enzymes that act as hydrogen acceptors. (Coenzyme are small organic molecules that work with enzymes to facilitate the enzymes’ activity. Many co-enzymes have vitamin Bs as part of their structures – they form an integral part of co-enzymes. Co = with). Eventually the hydrogen atoms combine with oxygen to form water. The breakdown of pyruvic acid is aerobic. energy 2CH3COCOOH + 5O2 pyruvic acid oxygen 6CO2 + 4H2O carbon water dioxide This stage releases more energy than the first stage above. During periods of strenuous exercise there is insufficient oxygen reaching muscle cells and as a result pyruvic acid is broken down in the anaerobic conditions into lactic acid. A build-up of lactic acid causes muscle fatigue. The energy produced by the oxidation of glucose and other nutrients is not released immediately. Certain organic phosphate compounds are able to store energy until it is required. Two of these compounds of particular importance are: adenosine diphosphate (ADP), a compound with two phosphate groups; and adenosine triphosphate (ATP), a compound with three phosphate groups. The addition of one more phosphate group to ADP, to convert it into ATP, requires a relatively large amount of energy. Conversely, the removal of a phosphate group from ATP releases a large amount of energy. The energy released during the oxidation of nutrients is used to produce ATP from ADP. When the cell needs energy, ATP is converted into ADP. Energy from fats Fat is first of all transferred from the adipose tissue to the liver. In the liver it is hydrolyzed to glycerol and fatty acids. The glycerol is converted into pyruvic acid and oxidized by the method already described above. The fatty acids are broken down into acetic (ethanoic) acid (CH3COOH), which joins in with the series of reactions involving the oxidation of pyruvic acid. 4 Energy from proteins Proteins in the diet also yield energy, although their main function is growth and maintenance of cells. Amino acids not required for protein synthesis are deaminated in the liver. (Deamination is the reaction that removes the nitrogen-containing amino group from an amino acid). The deaminated molecules are converted into pyruvic acid and other intermediate products, which are oxidized, and energy is released. The summary of energy production is illustrated as follows: Proteins Amino acids Carbohydrates glucose Fats glycerol fatty acids ADP ATP Urea pyruvic acid acetic acid ADP ATP CO2 + H2O B vitamins roles in metabolism B vitamins busily work in metabolic pathways all over the body. Metabolism is the body’s work, and the B vitamin coenzymes are indispensable to every step. These coenzymes depend on the following vitamins: -NAD and NADP: niacin -TPP: thiamin -CoA: pantothenic acid -B12: vitamin B12 -FMN and FAD: riboflavin -THF: folate -PLP: vitamin B6 -Biotin Thiamin Pyrophosphate (TPP) is a coenzyme that includes the thiamin molecule as part of its structure. Flavin Mononucleotide (FMN) is a coenzyme that includes the riboflavin molecule as part of its structure. 5 Flavin Adenine Dinucleotide (FAD) is a coenzyme that includes the riboflavin molecule as part of its structure. Nicotinamide Adenine Dinucleotide (NAD+) and Nicotinamide Adenine Dinucleotide Phosphate (NADP+). NADP has the same structure as NAD but with a phosphate group attached to the O instead of the H. Reduced NAD+ (NADH). When NAD+ is reduced by the addition of H+ and two electrons, it becomes the coenzyme NADH. Pyridoxal phosphate (PLP) and pyridoxamine phosphate. These coenzymes are necessary for transamination (the transfer of an amino group from one amino acid to a keto acid, producing a new nonessential amino acid and a new keto acid) and other important processes. Tetrahydrofolic acid, the active coenzyme form of folate. This active form has four added hydrogens. An intermediate form, dihydrofolate, has two added hydrogens. Coenzyme A (CoA). This molecule is made up in part of pantothenic acid. To break down glucose to pyruvate, the cells must have certain enzymes. For the enzymes to work, they must have the niacin coenzyme NAD. To make NAD, the cells must be supplied with niacin (or enough of the amino acid tryptophan to make niacin). They can make the rest of the coenzyme without dietary help. The next step in glucose catabolism is the breakdown of pyruvate to acetyl CoA. The enzymes involved in this step require NAD plus the thiamin coenzyme TPP. The cells can manufacture the TPP they need from thiamin, if thiamin is in the diet. Another coenzyme needed for this step is CoA. Predictably, the cells can make CoA except for an essential part that must be obtained in the diet – pantothenic acid. Another coenzyme requiring biotin serves the enzyme complex involved in converting pyruvate to a compound that can combine with acetyl CoA in the TCA cycle. These and other coenzymes are involved throughout all the metabolic pathways. When the diet provides riboflavin, the body synthesizes FAD – a needed coenzyme in the TCA cycle. Vitamin B6 is an indispensable part of PLP – a coenzyme required for many amino acid conversions, for a crucial step in the making of the iron-containing portion of hemoglobin for red blood cells, and for many other reactions. Folate becomes THF – the coenzyme required for the synthesis of new genetic material and therefore new cells. The vitamin B12 coenzyme, in turn, regenerates THF to its active form; thus vitamin B12 is also necessary for the formation of new cells. Therefore each of the B vitamin coenzymes is involved, directly or indirectly, in energy metabolism. 6 Some are facilitators of the energy-releasing reactions themselves; others help build new cells to deliver the oxygen and nutrients that permit the energy pathways to run. Metabolic functions of the liver The following are just some of the many jobs performed by the liver. Carbohydrates: Converts fructose and galactose to glucose Makes and stores glycogen Breaks down glycogen and releases glucose Breaks down glucose for energy when needed Makes glucose from some amino acids and glycerol when needed. Lipids: Builds and breaks down triglycerides, phospholipids, and cholesterol as needed Breaks down fatty acids for energy when needed Packages extra lipids in lipoproteins for transport to other body organs Manufactures bile to send to the gallbladder for use in fat digestion Makes ketone bodies when necessary Proteins: Manufactures nonessential amino acids that are in short supply Removes from circulation amino acids that are present in excess of need and deaminates them or converts them to other amino acids Removes ammonia from the blood and converts it to urea to be sent to the kidneys for excretion. Makes other nitrogen-containing compounds the body needs (such as bases used in DNA and RNA). Makes plasma proteins such as clotting factors. Other: Detoxifies alcohol, other drugs, and poisons; prepares waste products for excretion Helps dismantle old red blood cells and captures the iron for recycling Stores most vitamins and many minerals Forms lymph. 7 TISSUES Although some single cells are self-sufficient organisms, multicellular organisms such as the human body contain specialized cells, each of which has a particular function. Some, for example, are capable of contraction, others can secrete substances from the blood and so on. Groups of identical cells, which together perform a certain function, are called tissues. There are several types of tissues which vary according to the structure (size and shape) of their cells, their position and their function. In the body, there are five basic tissues namely: epithelial, connective, muscle, nervous, and fluid. 1. Epithelial tissue This consists of flat sheets of closely packed cells. It is found in the skin, lining membranes and outer membranes of many organs. Because of the porosity of this tissue, small molecules can pass through it; this occurs in the alveoli of the lungs and in the small intestine. Some epithelial tissue possesses hair-like projections, called cilia, which propel substances past the cells; this occurs in the trachea when mucus is brushed upwards towards the mouth. Many epithelial cells produce secretions such as mucus, which keep surfaces and linings moist. 8 2. Connective tissue This joins defferent kinds of tissue together, encloses groups of cells and holds organs in place. It consists of specialized cells surrounded by non-cellular material called a matrix. Much connective tissue contains collagen, a strong fibrous protein. There are three main types of fibrous protein: a) White collagen fibres – the most common, made of the protein collagen; b) Reticular fibres – made of a protein called reticulin; c) Yellow elastic fibres – composed of the protein elastin. These fibres will stretch but recoil to resome thir original length. The relative proportions of these fibres vary in the different types of connective tissue. 1) Areolar tissue. This type of connective tissue is found under the skin and surrounding internal organs, keeping them in place. It contains many loosely packed collagen fibres. 2) Adipose tissue. This is the fatty tissue of the body. It is similar to areolar tissue but the cells are swollen with droplets of fat. This fat represents the main energy reserve of the body. Adipose tissue is also found under the skin and around certain organs. It helps to reduce heat loss from the surface of the body and protects organs such as the kidneys. 9 3) Fibrous tissue. This is a form of connective tissue in which collagen fibres are closely packed in bundles or sheets. It is tough and inelastic and forms ligaments and tendons. Ligaments hold bones together at the joints and tendons attach muscles to bones. Fibrous tissue also surrounds muscle fibres and bundles of muscles fibres. 4) Cartilage. Is a strong connective tissue often found at the ends of bones where it prevents friction. Cartilage contains a tough, rubbery organic matrix. Some types contain white collagen fibres and some yellow fibres. Outgrowths of cartilage form a large part of the nose and ear and it is found in pads or discs between the vertebrae of the back bone. It is also found in the wall of the trachea-windpipe. 5) Bone. Is another form of connective tissue, which gives the body shape and firmness. It consists of a hard matrix containing large deposits of calcium phosphate. Interspersed here and there are cells which are connected to one another and are fed by blood vessels which pass into the bone tissue. 10 6) Elastic tissue. Is found in the walls of arteries, the stomach, and bladder and forms a large part of the lung tissue. 3.Muscle tissue Muscle is necessary for all movement in the body. The muscle cell is specialized for contraction, which it does when stimulated to do so by nervous impulses. Nearly all bodily processes depend on movement. The blood circulation and transport of nutrients depend on the contraction of the heart. Intake of oxygen depends on contraction of the respiratory muscles. Food is propelled along the digestive tract by peristaltic contraction. Even our entrance into the world is brought about by the powerful contractions of the uterus. 1) Skeletal (or voluntary) muscle is made up of bundles of fiblres running parallel to one another, which are bound together with connective tissue. The fibres are elongated multinucleated cells, which are covered with visible cross-markings or striations, which give the muscle an alternative name, striated muscle. These striations consist of thick and thin filaments containing two proteins called actin and myocin respectively. Contraction occurs in response to stimuli from branches of neurons. Each fibre shortens as the filaments slide over one another; this may continue for a few seconds or relaxation may follow. As the fibre becomes fatigued quickly, the muscle cannot be held in a state of contraction for long. Energy for contraction comes from the ATP in the cells. When large amounts of energy are required, for example for a quick sprint, the glycogen stored in the muscle is converted into lactic acid, releasing energy. Only one quarter of the energy thus supplied is in the form of mechanical energy and the remaining three-quarters is given off as heat, a normal product of the muscular activity. Skeletal muscle contracts much fast than other types of muscle, but as it tires easily, it works best in short bursts. Skeletal muscle makes up the fleshy part of the body and is found on the limbs and trunk. As it is under the control of the will (the cerebral cortex) it is also called voluntary muscle. 11 2) Smooth (or involuntary) muscle. This consists of sheets of spindleshaped cells (wide at the middle and narrow at each end). Each cell contains a single nucleus. Smooth muscle has no striations and is very elastic. It is not under voluntary control but is controlled by neurons of the sympathetic and parasympathetic nervous system. Smooth muscle is found on the walls of hollow organs and blood vessels. It causes contractions of the arteries, alimentary canal, uterus and bladder; the contractions brought about are long and slow, unlike the stronger quick contractions of the voluntary muscles. 3) Cardiac muscle consists of short, irregularly striated fibres. Each is a true cell, which interlocks with the next, forming parallel lines. Its structure is similar to that of skeletal muscle except for some branching of fibres. Cardiac muscle is capable of initiating its own contractions. The sinoartial nodes, which are specialized groups of muscle cells, stimulate the contractions of the heart. Although some sympathetic nerves pass into the heart, they serve only to speed up or slow down the heart beat. With each beat of the heart, all of the available energy in the heart muscle is utilized. As there is no energy reserve, loss of oxygen, even for a few seconds could have fatal consequences. 12 4. Nervous tissue Nervous tissue consists of nerve cells or neurones which have the ability to respond to stimuli (change in the environment) and to transmit impulses to other tissues, e.g. to muscles. A neurone has a cell body with many thread-like projections or processes. There is usually a large number of branched processes called dendrites which conduct impulses to the cell body and a single, long process, the axon, which conducts the impulse away. The axon may be a metre or more in length. 13 5. Fluid tissue Blood and lymph may be classified as fluid tissue. They consist of cells which move in a liquid intercellular matrix. 14 OVERVIEW OF ORGANS An organ is a structure composed of at least two, and usually all types of primary tissues. For example, organs of the skeletal system (head, trunk, girdles, limbs) contain connective tissue (bone, cartilage, areolar); fluid tissue; voluntary muscle and nerve. The organs of the digestive system (mouth – [including teeth, tongue and salivary glands]; oesophagus; stomach; liver; pancreas; small intestine; large intestine) contain epithelial (glandular); connective (areolar); fluid (blood); involuntary muscle; and nerve (autonomic). The organs of respiratory system (nose, larynx, trachea, bronchi, lungs) contain epithelial; connective (bone, cartilage); fluid (blood); voluntary muscle; nerve. The organs of the circulatory system (heart, arteries, veins, capillaries) contain epithelial; connective (areolar); fluid (blood); heart/cardiac muscle (involuntary); nerve. The organs of the urogenital (often regarded as two systems) – kidneys, bladder, gonads (testis or ovary), other sex glands, uterus, external organs (penis or vulva) contain epithelial (glandular); connective (areolar); fluid (blood); involuntary muscle; and the nerve. The largest organ in the body, in terms of its surface area, is the skin. Functions of the skin 1. To protect the inner tissues 2. To excrete waste substances 3. As a temperature regulator 4. As a sensory organ 5. To manufacture vitamin D 6. To act as an insulator by storing fat These functions therefore, will serve in this section to illustrate how primary tissues cooperate in the service of organ physiology. The cornified epidermis protects the skin against water loss and against invasion by disease-causing organisms. Invaginations of the epithelium into the underlying connective tissue dermis create the exocrine glands of the skin. These include hair follicles (which produce the hair), sweat glands, and sebaceous glands. The secretion of sweat glands cools the body by evaporation and produces odors that, at least in lower animals, serve as sexual attractants. Sebaceous glands secrete oily sebum into hair follicles, where it is transported to the surface of the skin. Sebum lubricates the cornified surface of the skin, helping to prevent it from drying and cracking. The skin is nourished by blood vessels within the dermis. In addition to blood vessels, the dermis contains wandering white blood cells and other types of cells that protect against invading disease-causing organisms, as well as nerve fibers and fat cells. Most of the fat cells, however, are grouped together to form the hypodermis (a layer beneath the dermis). Although fat cells are a type of connective tissue, masses of fat deposits throughout the body – such as subcutaneous fat – are referred to as adipose tissue. 15 Sensory nerve endings within the dermis mediate the cutaneous sensations of touch, pressure, heat, cold, and pain. Some of these sensory stimuli directly affect the sensory nerve endings. Others act via sensory structures derived from non neural primary tissues. The pacinian corpuscles in the dermis of the skin, for example, monitors sensations of pressure. Motor nerve fibers in the skin stimulate effector organs, resulting in, for example, the secretions of exocrine glands and contractions of the arrector pili muscles, which attach to hair follicles and surrounding connective tissue (producing goose bumps). The degree of constrictions or dilations of cutaneous blood vessels – and therefore the rate of blood flow – is also regulated by motor nerve fibers. The epidermis itself is a dynamic structure that can respond to environmental stimuli. The rate of its cell division – and consequently the thickness of the cornified layer - increases under the stimulus of constant abrasion. This produces calluses (areas of thick hardened skin). The skin also protects itself against the dangers of ultraviolet light by increasing its production of melanin pigment, which absorbs ultraviolet light while producing a tan. In addition, the skin is an endocrine gland that produces and secretes vitamin D (derived from cholesterol under the influence of ultraviolet light), which functions as a hormone. The architecture of most organs is similar to that of the skin. Most are covered by an epithelium immediately over a connective tissue layer. The connective tissue contains blood vessels, nerve endings, scattered cells for fighting infection, and possibly glandular tissue as well. If the organ is hollow – as in the digestive tract or in blood vessels- the lumen is also lined with an epithelium immediately over a connective tissue layer. The presence, type, and distribution of muscular and nervous tissue vary in different organs. 16 THE RESPIRATORY SYSTEM The function of the respiratory system is to supply the body with oxygen and to get rid of carbon dioxide. The respiratory system is divided into a respiratory zone, where gas exchange between air and blood occurs, and a conducting zone, which conducts the air to the respiratory zone. The exchange of gases between air and blood occurs across the walls of tiny air sacs called alveoli, which are only one cell across in thickness to permit very rapid rates of gas diffusion. The term respiration includes three separate but related functions: 1) Ventilation (breathing); 2) Gas exchange Which occurs between the air and blood in the lungs and Between the blood and other tissues of the body; 3) Oxygen utilization by the tissues in the energy-liberating reactions of cell respiration. Ventilation and the exchange of gases (oxygen and carbon dioxide) between the air and blood are together called external respiration. Gas exchange between the blood and other tissues and oxygen utilization by the tissues are together known as internal respiration. Ventilation is the mechanical process that moves air into and out of the lungs. Since air in the lungs has a higher oxygen concentration than in the blood, oxygen diffuses from air to blood. Carbon dioxide, conversely, moves from the blood to the air within the lungs by diffusing down its concentration gradient. As a result of this gas exchange, the inspired air contains more oxygen and less carbon dioxide than the expired air. More importantly, blood leaving the lungs (in the pulmonary vein) contains a higher oxygen and a lower carbon dioxide concentration than the blood delivered to the lungs in the pulmonary arteries. This results from the fact that the lungs function to bring the blood into gaseous equilibrium with the air. Gas exchange between the air and blood occurs entirely by diffusion through lung tissue. This diffusion occurs very rapidly because there is a high surface area within the lungs and a very short diffusion distance between blood and air. The pathway of air Air flowing in and out of lungs passes through the respiratory tract. The conducting zone of the respiratory system, in summary, consists of the mouth, nose, pharynx, larynx, trachea/windpipe, primary bronchi, and all successive branching of the bronchioles up to and including the terminal bronchioles. In addition to conducting air into the respiratory zone, these structures serve additional functions: Warming and humidification of the inspired air and Filtration and cleaning When the inspired air reaches the respiratory zone it is at a temperature of 37 0C (body temperature), and it is saturated with water vapor. Therefore, the warming function is 17 needed to maintain a constant internal body temperature, and humidification is needed to protect delicate lung tissue from desiccation (drying up). Mucus secreted by cells of the conducting zone which is moved along at a rate of 1-2 centimeters per minute by cilia projecting from the tops of epithelial cells that line the conducting zone, serves to trap small particles in the inspired air and thereby performs a filtration function. As a result of this filtration, particles larger than about 6 m do not normally enter the respiratory zone of the lungs. The disease called black lung, which occurs in miners who inhale too much carbon dust and therefore develop pulmonary fibrosis, evidences the importance of this function. As these functions are concerned, breathing through the mouth is not as satisfactory because the air is neither filtered nor conditioned and lung infection may ensue through bacterial action or inflammation caused by dryness. The alveoli themselves are normally kept clean by the action of macrophages (literally, “big eaters”) that reside within them. The cleansing action of cilia and macrophages in the lungs has been shown to be diminished by cigarette smoke. Surfactant and the Respiratory Distress Syndrome Alveolar fluid contains a phospholipid known as dipalmitoyl lecithin, probably attached to a protein, which functions to lower surface tension (surface tension is created by the fact that water molecules at the surface are attracted more to other water molecules than to air. As a result, attractive forces from underneath pull the surface water molecules tightly together. The surface tension of an alveolus produces a force that is directed inward and, as a result, creates pressure within the alveolus). This compound is called lung surfactant, which is a contraction of the term surface active agent. Because of the presence of surfactant, the surface tension in the alveoli is lower than would be predicted if surfactant were absent. Further, the ability of surfactant to lower surface tension improves, as the alveoli get smaller during expiration. This may be because the surfactant molecules become more concentrated as the alveoli get smaller. Surfactant thus prevents the alveoli from collapsing during expiration. Even after a forceful expiration, the alveoli remain open and a residual volume of air remains in the lungs. Since the alveoli do not collapse, less surface tension has to be overcome to inflate (fill with air) them at the next inspiration. Type II alveolar cells in late fetal life produce surfactant. Since surfactant does not start to be produced until about the eight month, premature babies are sometimes born with lungs that lack sufficient surfactant, and their alveoli are collapsed as a result. This condition is called respiratory distress syndrome. It is also called hyaline membrane disease, because the high surface tension causes plasma fluid to leak into the alveoli, producing a glistening “membrane” appearance (and pulmonary edema). This condition does not occur in all premature babies; the rate of lung development depends on hormonal conditions (thyroxine and hydrocortisone primarily) and on genetic factors. 18 EXCRETORY SYSTEM The waste substances produced during the metabolic processes must be removed regularly to enable the body to function properly. Such wastes are removed by the excretory organs: the lungs, the skin, the kidneys, and the liver (the liver acts as an excretory organ by altering and storing some waste substances). The large intestine is an organ of elimination rather than excretion. The CO2 produced by cellular respiration leaves the cells and is carried to the lungs by red blood cells. At the lungs, red blood cells release their load of CO2, which is then exhaled into the environment. These red blood cells then pick up oxygen for delivery to the cells for use in cellular respiration. In addition to CO2, the lungs excrete a significant amount of H2O through evaporation. Another site for the excretion of wastes is the skin. Here perspiration or sweat causes the loss of H2O, urea, and some minerals. The kidney is the primary site for excretion of waste products from protein metabolism, such as urea. The kidney works in two phases. In the first phase, water and dissolved substances are filtered out of the blood into the tubules of the kidney. In the second phase, some H2O and dissolved substances that are useful to the body, such as glucose, are reabsorbed from the filtrate. Dissolved wastes, along with some H2O and other substances that are not reabsorbed, are excreted in the urine. Urea synthesis When amino nitrogen is stripped from amino acids, ammonia is produced. The liver detoxifies ammonia before releasing it into the bloodstream by combining it with another waste product, carbon dioxide, to produce urea. H ׀ H–N– H ammonia O N ║ ׀ + C + H– N – H ║ ammonia O H–O-H water H O H ׀ ║ ׀ H–N–C–N -H urea 19 Urea excretion The liver and kidneys both play a role in disposing of excess nitrogen. This is the reason why the person with liver disease has high blood ammonia, while the person with kidney disease has high blood urea. The reabsorption of H2O must be regulated to prevent dehydration. The amount of H2O excreted in the urine and the amount reabsorbed are under hormonal control, so homeostasis is maintained. Osmoregulation Water lost by urine, feces, sweat and lungs must be balanced by the intake of H2O in food and drink. The brain controls this delicate balancing of the H2O level of the body. Sensory receptors in the hypothalamus stimulate the pituitary gland just below to produce the antidiuretic hormone (ADH) (it is a hormone released by the pituitary gland in response to highly concentrated blood. The kidneys respond by reabsorbing water, thus preventing water loss. It is also called vasopressin because it elevates blood pressure). Anti=against; dia=through; ure=urine; vaso=vessel and press= pressure. This on reaching the kidneys, stimulates the tubules to return more water to the blood, thereby increasing the concentration of urine. This would occur after considerable water loss occurred, e.g. after sweating or diarrhea. Likewise when the blood becomes too dilute 20 (when large quantities of liquid have been drunk), the amount of ADH is suppressed and the tubules return less water, increasing the quantity of urine excreted. Inability to secrete this hormone causes diabetes insipidus, the symptoms of which are thirst and frequent heavy urine. Blood volume and blood pressure Water balance maintains the blood volume, which in turn influences blood pressure. If the body loses too much water, blood volume and blood pressure fall. ADH and water retention: whenever the blood becomes too concentrated, or whenever blood volume or blood pressure falls too low, the hypothalamus signals the pituitary gland to release the antidiuretic hormone (ADH). ADH stimulates the kidneys to reabsorb water, rather than excrete it. Consequently, the more water you need, the less your kidneys excrete. Angiotensin and blood vessel constriction: Cells in the kidneys respond to low blood pressure by releasing an enzyme called renin. Through a complex series of events, renin causes the kidneys to reabsorb sodium. Sodium reabsorption, in turn, is always accompanied by water retention, which helps to restore blood volume and blood pressure. Renin also activates the blood protein angiotensinogen to angiotensin. Angiotensin is a powerful vasoconstrictor: it narrows the diameters of blood vessels, thereby raising the blood pressure. Aldosterone and Sodium retention: angiotensin also mediates the release of the hormone aldosterone from the adrenal glands. Aldosterone causes the kidneys to retain more sodium (and thus more water). Again, the effect is that when more water is needed, less is excreted. In summary, in response to low blood volume or highly concentrated blood, these three actions combine to effectively restore homeostasis as shown in the following diagram: ADH causes water retention Angiotensin constricts blood vessels Aldosterone causes sodium retention. Renin is an enzyme from the kidneys that activates angiotensin. N.B.: Renin and Rennin are two different enzymes. The latter is an enzyme that coagulates milk, found in the gastric juice of cows, but not human beings except for infants. Angiotensin is a hormone involved in blood pressure regulation. Its precursor protein is called angiotensinogen. Vasoconstrictor is a substance that constricts or narrows the blood vessels. Aldosterone is a hormone secreted by the adrenal glands that stimulates the reabsorption of sodium by the kidneys; aldosterone also regulates chloride and potassium concentrations. 21 How the body regulates water excretion The kidneys respond to reduced blood flow by releasing the enzyme renin. The hypothalamus responds to high salt concentrations in the blood by stimulating the pituitary gland. Renin Renin initiates the activation of the protein angiotensinogen to angiotensin. The pituitary gland releases antidiuretic hormone (ADH) Angiotensin Adrenal glands secrete aldosterone. ADH Blood vessels constrict, raising pressure Aldosterone Kidneys retain sodium and water, thus increasing blood volume. 22 NERVOUS SYSTEM In order to control the various body processes and enable the body to work as a unit, there must be a system, which coordinates all the others. In fact there are two systems – the nervous system and the endocrine system. The nervous system is composed of neurons, which produce and conduct electrochemical impulses, and neuroglial cells, which support the functions of neurons. The function of the nervous system is to control and coordinate the activities of the body by enabling the body to perceive changes in the environment (stimuli) and to respond accordingly. The nervous system is divided into the central nervous system (CNS), which includes the brain and spinal cord, which contain nuclei and tracts (collections of nerve fibers that interconnect regions of CNS) and the peripheral nervous system (PNS), which includes the cranial nerves arising from the brain and the spinal nerves arising from the spinal cord, and ganglia (collections of neuron cell bodies located outside CNS). Functions of the spinal cord are as follows: 1. It carries impulses to and from the brain 2. It is the center for simple reflex actions (e.g. lifting one’s fingers from a very hot object). Neurons Although neurons vary considerably in size and shape, they generally have three principal regions: 1. a cell body 2. dendrites 3. an axon Dendrites and axon can be referred to generically as processes, or extensions from the cell body. The cell body, or perikaryon (peri = around; karyon = nucleus), is the enlarged portion of the neuron, which contains the nucleus and serves as the “nutritional center” of the neuron where macromolecules are produced. The perikaryon also contains granular, densely staining material known as Nissl bodies, which are not found in the dendrites or axon. The Nissl bodies are composed of granular (rough) endoplasmic reticulum, an organelle involved in protein synthesis. The cell bodies within the CNS are frequently clustered into groups called nuclei (not to be confused with the nucleus of the cell). Cell bodies in the PNS usually occur in clusters called ganglia. Dendrites (dendron = tree branch) are thin-branched processes that extend from the cytoplasm of the cell body. Dendrites serve as a receptive area that transmits electrical impulses to the cell body. The axon, or nerve fiber, is a longer process that conducts impulses away from the cell body. Axons vary in length from only a millimeter to a meter or more (for axons that extend from the CNS to the foot). The origin of the axon near the cell body is called 23 the axon hillock, and side branches that may extend from the axon are called axon collaterals. Proteins and other molecules are transported through the axon at faster rates than could be achieved by simple diffusion. This rapid movement is produced by two different mechanisms: axoplasmic flow and axonal transport. Axoplasmic flow, the slower of the two, results from rhythmic waves of contraction that push the cytoplasm from the axon hillock to the nerve endings. Axonal transport, which is more rapid and more selective, may occur in a reverse (retrograde) as well as a forward (orthograde) direction. Indeed, retrograde transport may be responsible for the movement of herpes virus, rabies virus, and tetanus toxin from the nerve terminals into cell bodies. Comparison of axoplasmic flow with axonal transport Axoplasmic flow Axonal transport -Transport rate comparatively slow (1-2 mm/day) -Molecules transported only from cell body -Transport rate comparatively fast (200-400mm/day) - Molecules transported from cell body to axon endings and in reverse direction. -Transport of specific proteins, mainly of membrane proteins and acetylcholinesterase. -transport dependent on cagelike microtubule structure within axon and on actin and Ca++ -Bulk movement of proteins in axoplasm, including micro filaments and tubules -Transport accompanied by peristaltic waves of axon membrane Classification of Neurons and nerves Neurons may be classified according to their structure or function. The functional classification is based on the direction that they conduct impulses. When a nerve fiber is stimulated, usually at one end, a reaction causes a change in the next part of the fiber. This, in turn, causes another section to react and in this way the impulse travels along the length of the fiber (it could be compared to a lighting fuse). The speed of the reaction is roughly 120 meters per second. A supply of oxygen is necessary for the transmission of impulses. The functional classification is as follows: 1. Sensory, or afferent neurons conduct impulses from sensory receptors into the CNS. 2. Motor, or efferent neurons conduct impulses out of the CNS to effector organs (muscles and glands) 3. Association neurons, or interneurons, are located entirely within the CNS and serve the associative, or integrative, functions of the nervous system. 24 There are two types of motor neurons: somatic and autonomic. a) Somatic motor neurons provide both reflex and voluntary control of skeletal muscles. b) Autonomic motor neurons innervate (distribute the nerves to) the involuntary effectors-smooth muscle, cardiac muscle, and glands. The cell bodies of the autonomic neurons that innervate these organs are located outside the CNS in autonomic ganglia. There are two subdivisions of autonomic motor neurons: sympathetic and parasympathetic. Autonomic motor neurons, together with their central control centers, comprise the autonomic nervous system. i) The sympathetic nervous system makes sudden action possible by increasing blood supply to the heart and lungs and reducing the supply to the organs of digestion and excretion. It speeds up conversion of glycogen to glucose. ii) The parasympathetic nervous system reverses the effects of the sympathetic system, restoring the body to normal. It decreases heart beat and blood supply to lungs and restarts digestive and excretory organs. It also exercises control on the degree of the contractions, which occur. The structural classification of neurons is based on the number of processes that extend from the cell body of the neuron. 1. Bipolar neurons have two processes, one at either end; this type is found in the retina of the eye. 2. Multipolar neurons have several dendrites and one axon extending from the cell body; this is the most common type of neuron (motor neurons are good examples of this type). 3. A pseudounipolar neuron has a single short process that divides like a T to form a longer process. Sensory neurons are pdeudounipolar – one end of the process formed by the T receives sensory stimuli and produces nerve impulses; the other end of the T delivers these impulses to synapses within the brain or spinal cord. The long process that extends from the sensory receptor to the stalk of the T (toward the cell body) is a dendrite, while the process that extends from the stalk to the CNS is the axon. The cell bodies of these sensory neurons are located outside the CNS in the dorsal root ganglia of spinal and cranial nerves. Three different types of neurons according to their structures 25 A nerve is a bundle of axons outside the CNS. Most nerves are composed of both motor and sensory fibers and are thus called mixed nerves. Some of the cranial nerves, however, contain only sensory processes. These are the nerves that serve the special senses of sight, hearing, taste, and smell. The senses of sight, taste and smell play an important role in the appreciation of food and in stimulating the secretion of digestive juices. The retina has two types of nerve endings: rods and cones. These are both sensitive to light and impulses are conveyed from them, along the optic nerve, to the brain. The rods contain the pigment rhodopsin (visual purple) and are concerned with black and white vision in dim light. A deficiency of vitamin A depletes the supply of rhodopsin and night blindness results. The cones contain other pigments and are concerned with color vision in daylight. The receptors of taste are the taste buds, which are situated on the tongue and soft palate, the back part of the roof of the mouth. Each taste bud is a round cluster of spindle-shaped cells from which nerve fibres lead to the brain. The sensation of taste depends on water, either from food or from saliva, to carry the stimulating substances to the taste buds. The taste buds are capable of recognizing four basic or fundamental tastes, namely, sweet, sour, salt and bitter. These different tastes are transmitted along the nerves by different patterns of impulse. Some parts of the tongue are more sensitive than others to particular tastes. The four basic tastes Basic taste Sweet Sour Salt Bitter Substances responsible Sugars, saccharin, aspartame… Acids, e.g., citric, malic, tartaric… Chlorides, especially sodium chloride (common salt) Alkaloids, e. g., quinine (tonic water); caffeine (coffee) Area of tongue where detected Tip and Top front Sides Tip and Sides Back The olfactory organs, the organs responsible for the sense of smell, are found in the upper part of the nose and are somewhat similar in structure to the taste buds. 26 ENDOCRINE SYSTEM As mentioned earlier, there are two systems concerned with the control and coordination of the activities of the body. These are the nervous system and the endocrine system. The latter is made up of various glands, which release secretions, known as hormones, into the blood stream. The word hormone comes from the Greek hormaein meaning “I activate”. Endocrine glands are ductless and are distinct from exocrine glands, which release their secretions (e.g. sweat, digestive juices) into a duct to be used locally. Although hormones are slow to cause change, their effects last longer than the effects of nervous impulses. They regulate such long-term processes as growth, sexual maturity and ageing. The amount of hormone secreted is extremely important as an imbalance leads to various disorders. Normally, the amount of hormone is adjusted to suit the body’s current requirements. Many hormones are neutralized in the liver and eventually excreted by the kidneys. Pituitary Gland This “master” gland influences the activity of many endocrine glands. It is a peasized structure at the base of the brain, which is divided into two parts, the anterior pituitary and the posterior pituitary. The pituitary gland is closely associated with the hypothalamus, which lies just above it. The hypothalamus is very sensitive to changes in the body and can respond by stimulating the pituitary into the production of hormones. Anterior pituitary. The anterior pituitary secretes at least seven hormones: 1. Human growth hormone (HGH) influences the growth of cells. Excess causes gigantism, while its deficiency results in dwarfism. 2. Lactogenic hormone (LTH) stimulates milk production in females after birth. 3. Thyroid stimulating hormone (TSH) or Thyrotropic hormone stimulates the thyroid gland to secrete its hormone thyroxine. 4. Adrenocorticotropic hormone (ACTH) stimulates the adrenal cortex to release its hormones. 5. Follicle stimulating hormone (FSH) acts on the gonads (sex organs). In the female it stimulates egg ripening and oestrogen production; in males it stimulates the development of the seminiferous tubules and sperm production. 6. Luteinising hormone (LH) stimulates production of sex hormones – progesterone in females and androgens in males. 7. Melanocyte stimulating hormone (MSH) affects the pigmentation of the skin. 27 Posterior lobe. 1. Oxytocin stimulates the contraction of the uterus thus beginning labour in childbirth. When birth is artificially induced it is injected into the bloodstream. 2. Antidiuretic hormone (ADH) stimulates reabsorption of water from kidney tubules. It also affects blood pressure by constricting the walls of small arterioles. Thyroid Gland This is the largest endocrine gland. It is a double structure situated in the neck in front of the trachea and is richly supplied with blood. Thyroxine, its hormone, controls the rate of growth in the young: deficiency of this in children can cause dwarfism and mental retardation (known as cretinism). If the condition is diagnosed quickly, administering thyroxine can cure it. In adults thyroxine affects the rate of metabolism: excess amounts raise the metabolic rate, causing thinness and hyperactivity, while a deficiency lowers the basal metabolic rate causing obesity, lethargy and mental confusion. Any disturbance in the activity of the gland causes it to enlarge, resulting in goiter. The hormone thyroxine contains iodine, and if there is a deficiency of iodine in the diet, goiter will result. Parathyroid Glands Imbedded in the tissues at the back of the thyroid are four small glands known as parathyroids. They release a hormone parathormone (PTH), which controls the level of calcium in the blood. Excess PTH causes brittle, badly formed bones and may cause kidney stones, while deficiency can be fatal unless calcium is administered. Adrenal Glands These are two small structures, which lie one on each kidney. Adrenal cortex. This is the outer layer of the glands. It produces at least three types of hormones: 1. The glucocorticoids – steroids including cortisone, which is involved with metabolism of carbohydrates, stimulate the laying down of glycogen in the liver. They are also involved with general body metabolism. The glucocorticoids reduce inflammation; this is why cortisone is important in the treatment of many diseases. They also take over from adrenaline after its initial stimulation has worn off, helping the body to adapt to stress. 2. Aldosterone, which regulates salt/water balance in the blood 3. Sex hormones, particularly male androgens (the steroid sex hormones that exert masculinizing effects, and they promote protein anabolism and growth). Excess of these hormones causes male characteristics in women. A general deficiency of the hormones of the adrenal cortex causes Addison’s Disease, which results in 28 muscular weakness, apathy and eventually death. Administration of cortical hormones is usually successful, however. Adrenal medulla. This is the interior of the adrenal gland. It secretes two hormones, adrenaline and noradrenaline. The former is secreted in large quantities when the body suffers stress, anger, fright or injury; it causes the heartbeat to quicken, diverts blood from less important organs to those concerned with “fright or flight”, speeds up the rate of breathing, raises the blood pressure and blood sugar and increases the rate of metabolism. All of these changes prepare the body for violent physical action. The latter hormone, noradrenaline, is secreted soon after adrenaline in order to sustain these reactions by causing a further increase in blood pressure. Pancreas Apart from its function in the digestion of food, the pancreas contains groups of endocrine cells called Islets of Longerhans. These secrete insulin, a hormone which controls carbohydrate metabolism and hence the level of sugar in the blood. A rise in blood sugar releases insulin into the blood. This passes through the portal vein to the liver where it hastens the conversion of glucose to fat and glycogen, quickly returning the blood sugar level to normal. Insufficient insulin causes diabetes mellitus. As the body is unable to convert extra glucose to glycogen, large amounts circulate in the blood and pass into the urine. Protein and fat are converted into glucose and through osmosis, large amounts of water remain in the tubules to be excreted as urine. A low carbohydrate diet is often effective in coping with mild cases of diabetes, and injections of animal insulin control the disease in more serious cases so that diabetics can lead a normal life. Excessive insulin can reduce the level of glucose in the blood to such an extent that the brain cells are deprived of food, and shock and even coma may result. Gonads These are the male and female reproductive organs. As well as producing the sperms and ova, they are endocrine glands, which secrete important hormones controlling reproduction and sex drive. Testes These produce the male sex hormone testosterone, which influences the development of secondary male characteristics such as the deepening of the voice and growth of hair on the face and body. The LH from the pituitary gland stimulates it. Ovaries These secrete two hormones in response to stimulation by the pituitary gland: Oestrogen, which causes various changes to take place at puberty, e.g. breast development. This hormone also initiates and controls menstruation. 29 Progesterone controls the changes, which occur during pregnancy and lactation. Deficiency causes miscarriage. Other organs with endocrine functions The stomach secretes a hormone gastrin into the blood stream when we eat and when this returns to the stomach it stimulates the production of gastric juices. The duodenum produces secretin which, when it reaches the pancreas in the bloodstream, activates the production of pancreatic enzymes. The kidneys produce a hormone concerned with blood pressure. Feedback Many hormones operate a self-regulating feedback system whereby the release of one hormone into the bloodstream triggers off a response in another hormone, causing it to suppress production. This ensures that excessive amounts of any one hormone are not released. For example, presence of thyroxine inhibits TSH production; TSH stimulates the formation of thyroxine. 30 REPRODUCTIVE SYSTEM Reproduction is the means whereby a species is perpetuated. Human life begins as a single-celled embryo formed by the fusion of a sperm from the testes of a male and an ovum (egg) from the ovaries of a female. In humans the reproduction also satisfies emotional needs and drives such as love, protection and security. Male reproductive organs The reproductive organs of the male lie outside the body because the cooler temperature is more conducive to the production of sperm. They consist of the testes, two oval organs which lie in a loose covering of skin called the scrotum. Each testis contains a large mass of seminiferous tubules, the walls of which contain cells that manufacture sperm. The mature sperm pass into a duct, which leads from inside the testes to another coiled tube, this time outside each testis (the epididymis). From this a larger tube, called the vas deferens or sperm duct, passes out of the scrotum. Near the bladder it braches into two, one branch leading to the coiled seminal vesicle, the other opening into the urethra at the base of the bladder. Near this point are two glands, the prostate gland and Cowpers gland. Together with the seminal vesicles, these produce the seminal fluid in which the spermatozoa (sperm) are suspended. The urethra travels downward into the penis, which is composed of connective tissue and in which there are large numbers of spaces resembling the holes in a sponge. These fill with blood during intercourse. At puberty the pituitary hormone LH stimulates production of testosterone which brings about secondary male characteristics (e.g. hair growth, deepening of the voice, etc.) and also initiates sperm production. The seminal vesicles and prostate are androgen-dependent accessory sexual organs – they atrophy if androgen is withdrawn by castration. The seminal vesicles secrete fluid containing fructose (which serves as an energy source for the spermatozoa), citric acid, coagulation proteins, and prostaglandins. The prostate secretes a liquefying agent and the enzyme acid phosphatase, which is often measured clinically to assess prostate function. Erection, emission, and ejaculation Erection, accompanied by increases in the length and width of the penis, is achieved as a result of blood flow into the “erectile tissue” of the penis. These erectile tissues include two paired structures – the corpora cavernosa- located on the dorsal side of the penis, and one unpaired corpus spongiosum on the ventral side. The urethra runs through the center of the corpus spongiosum. The erectile tissue forms columns extending the length of the penis, although the corpora cavernosa do not extend all the way to the tip. Erection is achieved as a result of parasympathetic nerve – induced vasodilation of arterioles that allows blood to flow into the penis. As the erectile tissues become engorged with blood and the penis becomes turgid, venous outflow of blood is partially occluded, thus aiding erection. The emission refers to the movement of semen into the 31 urethra, and ejaculation refers to the forcible expulsion of semen from the urethra out of the penis. Emission and ejaculation are stimulated by sympathetic nerves, which cause peristaltic contractions of the tubular system, contractions of the seminal vesicles and prostate, and contractions of muscles at the base of the penis. Sexual function in the male thus requires the synergistic action (rather than antagonistic action) of the parasympathetic and sympathetic systems. Two portions of the central nervous system- the hypothalamus in the brain and the sacral portion of the spinal cord control erection. Conscious sexual thoughts originating in the cerebral cortex act via the hypothalamus to control the sacral region, which in turn increases parasympathetic nerve activity to promote vasodilation and erection in the penis. Conscious thought is not required for erection, however, because sensory stimulation of the penis can more directly activate the sacral region of the spinal cord and cause an erection. Female reproductive organs The two ovaries lie within the pelvis, towards the back and underneath the kidneys. They are small, oval organs, each about the size of a bean, composed of connective tissue and containing many thousands of immature ova or eggs. The oviduct or Fallopian tube with its funnel-shaped opening commences beside each ovary and passes into the uterus or womb, a pear-shaped muscular organ. The uterus is about 8 cm long and opens at the base where there is a strong band of muscle called the cervix. From this a narrow muscular tube, the vagina, passes outwards and opens between the labia into the groin. The bladder, which lies to the front of the uterus, releases its urine through the urethra, which opens close to the vagina. Ovulation Thousands of potential ova (egg cells) are present in the ovaries of a girl even before birth. These lie dormant until puberty when, upon stimulation of the ovaries by the pituitary hormone FSH, the ova begin to mature one at a time about once a month. One by one, each ovum grows larger and a sheath of cells containing fluid rich in nutrients develops around it. This Graafian or ovarian follicle, as it is called, grows larger as it ripens and pushes the wall of the ovary outwards until it eventually bursts, discharging the ovum into the funnel-shaped entrance to the Fallopian tube. The process just described is ovulation. It occurs in the 2nd week after a period and is the time during which fertilization is most likely to occur. As the ovum travels along the Fallopian tube to the uterus, the follicle in the ovary continues to grow, eventually forming the corpus luteum. This secretes the hormone progesterone, which begins to prepare the body for pregnancy by thickening the uterine lining and enlarging the breasts. If fertilization does not occur the corpus luteum shrivels up and the progesterone level falls rapidly. If the ovum is fertilized the corpus luteum enlarges, secreting even greater amounts of progesterone. This increases the blood supply to the uterus, stimulates further thickening of the uterine wall and halts the development of follicles in the ovaries. 32 Menstruation The menstrual cycle is directly related to the hormonal influence on the uterine lining. This lining is thin following menstruation. As the follicle ripens it releases oestrogen, which causes thickening of the lining and an increase in the blood flow to the uterus. After ovulation, the corpus luteum secretes progesterone, which causes further thickening of the lining. When fertilization does not take place, production of progesterone slows down and stops, the corpus luteum shrinks, the uterine lining disintegrates and as a result of contractions of the uterus, its contents are expelled through the vagina. Menstruation – or a period as it is usually called – occurs about fourteen days after ovulation. The cramps often experienced on the first or second day of a period are due to uterine contraction; some people also experience pre-menstrual tension, which is thought to be related to the withdrawal of progesterone. Menstruation begins at puberty, usually between the ages of eleven and fifteen, and continues every month (except during pregnancy) until menopause, when it becomes more erratic and finally ceases altogether. During the menopause, which generally occurs between the mid-forties and mid-fifties, some women experience unpleasant symptoms (e.g. depression, hot flushes) because of the withdrawal of the female hormones. In some cases these symptoms can be alleviated by the use of hormone replacement therapy (HRT). Fertilization During sexual intercourse the blood vessels in the penis dilate and an extra supply of blood fills the spaces, causing the penis to become erect. This facilitates its entry into the vagina and upon further sexual stimulations the urethra contracts, causing ejaculation of the semen. In the female the walls of the vagina relax during intercourse and secrete lubricating mucus. Each sperm consists of a “head” containing a nucleus and a long “tail”. The strong, lashing movements of the tail enable the hundreds of millions of sperm released to swim upward through the cervix into the Fallopian tubes. Many millions die before they reach the tubes, but others survive and if an ovum is present it is likely that fertilization will take place. Several sperm surround the ovum but only one penetrates its protective covering. Soon afterwards the nucleus of the sperm enters the ovum and unites with the nucleus of the ovum. This is the moment of fertilization. Pregnancy The fertilized ovum, now called a zygote, divides in two. Each cell then divides again and thus the growth of the embryo begins. The cells multiply rapidly as the embryo moves along the Fallopian tube until within a week it reaches the uterus. Here it sinks into the thick uterine lining (endometrium) and sends small projections (villi) into the lining to hold it in position and facilitate absorption of nutrients from its walls. The area around the villi develops into the placenta, which is attached to the abdomen of the foetus by the umbilical cord. 33 The placenta This is concerned with providing the embryo with nutrients and oxygen from its mother’s blood. It also receives waste products such as carbon dioxide and urea from the blood of the embryo. Although the capillaries in the placenta closely connect the blood of mother and embryo, they do not mix; rather the placenta acts as a filter through which certain substances are allowed to pass and by which many harmful products are held back. It does not prevent the passage of all dangerous substances, however: some drugs and viruses such as German measles can pass through and may have unfortunate consequences for the foetus. For this reason it is inadvisable to take any form of drugs, even aspirin, or to smoke during pregnancy. The placenta stimulates increased production of oestrogen and progesterone and eventually begins to produce its own progesterone. These hormones are responsible for the many changes which occur during pregnancy, preparing the body for birth and lactation: 1. Enlargement and thickening of the uterus 2. Accumulation of fat and fluid 3. Inhibition of contraction of the uterus 4. Enlargement of the mammary glands. The uterus grows larger to accommodate the growing embryo and the cells in the embryo begin to form tissues. Within eight weeks the embryo, now called a foetus, has a recognizable form with a head, trunk and limbs. The foetus is surrounded by a water sac or amnion (containing amniotic fluid), which protects it from injury. It continues to develop and by about six months all the organs are fully formed, but it remains in the uterus until it is strong enough to survive independently. The whole period of pregnancy, known as the gestation period, is about forty weeks. Birth By the time the baby is ready to be born it lies with its head down, facing the cervix. Secretion of progesterone diminishes and, stimulated by the hormone oxytocin, labor begins. The uterus begins to contract rhythmically and the contractions gradually increase in strength and frequency. After some time the cervix dilates, the membrane of the amniotic sac ruptures and the amniotic fluid flows out. In the final stages of labor, vigorous contractions of the uterus and abdomen expel the baby out through the cervix and vagina. The baby now begins to breathe on its own. The umbilical cord is tied and severed and soon afterwards, as a result of further contractions of the uterus, the placenta, now called the afterbirth, is expelled. Within a couple of days the mammary glands, stimulated by the lactogenic hormone from the pituitary gland, begin to secrete milk with which to suckle the baby. 34