Human Physiology

Human Physiology
Tissue: Group of cells that usually have a common embryonic origin and function together to
carry out specialized activities.

Histology is the science that deals with study of tissue.

 Body tissues can be classified into four basic types according to structure and function:

•Covers external •Detects changes in •Movement •Most abundant

surface variety of conditions (Contraction and •Transportation
• internal cavities inside and outside relaxation) •Structural
•tubes and organs the body. •Maintenance of framework
•Functions: •Receive information posture •Storage of energy
Protection, from stimuli and •Joint stabilization •Protection
absorption and communicate with •Heat generation •Defending body
secretion. spinal cord and brain from invading
via electrical nerve micro organisms.
impulses.
 Epithelial Tissue
It is a sheet of cells that covers the body surface or lines the body cavity. It occurs in the body
as: i) Covering and lining epithelium
ii) Glandular epithelium

Characteristics of epithelial tissue:

Epithelial tissue has many characteristics that distinguish them from other tissue types:
i) Cellularity: It is almost composed entirely of closed packed cells. Only a tiny amount of
extracellular material lies in the narrow spaces between them.
ii) Specialized contacts: Epithelial cells fit close together to form continuous sheets.
Adjacent cells are bound together at many points by lateral contacts(including tight
junctions and desmosomes)
 Epithelial Tissue
iii) Polarity: All epithelia have an apical surface, an upper free surface exposed to the body
exterior or the cavity of an internal organ and a lower attached basal surface. Hence, all
epithelia exhibit polarity, meaning the cell regions near the apical surface differ from
those near the basal surface in both structure and function.
iv)Supported by connective tissue: All epithelial sheets rest upon and are supported by
connective tissue. Connective tissue helps it to resist stretching and tearing forces and
defines the epithelial boundary
v) Avascular but innervated: Although epithelium is innervated (supplied by nerve fibers) , it
is avascular (contains no blood vessels). These cells are nourished by substances diffusing
from blood vessels in the underlying connective tissue.
vi) Regeneration: Epithelium has a high regeneration capacity. Some epithelia are exposed to
friction and their surface cells rub-off. Others are damaged by hostile substances in the
external environment(bacteria, acids, smoke). As long as epithelial cells receive adequate
nutrition, they can replace lost cells rapidly by cell division.
 Structures derived from the primary germ layers:

Ectoderm: Hair, nail follicles, sweat glands, pituitary glands, nervous system.

Mesoderm: Dermis bone and cartilage, skeletal, cardiac and most smooth muscles, kidneys,
adrenal cortex, bone marrow and blood.

Endoderm: Mucosa of oesophagus, stomach & intestine, epithelium of respiratory tract,

including the liver and mucosa of gall bladder.
Simple Epithelium: These are most concerned with absorption, secretion and filtration.
Because they consists of single cell layer and are usually very thin.

i) Simple squamous:
• These are flattened laterally and their cytoplasm is sparse.
• Thin and often permeable. This epithelium is found where filtration or the exchange of
substance takes place by rapid diffusion.
• In kidneys these cells form part of the filtration membrane, in lungs they form the wall of
air sacs across which gas exchange occurs.

ii) Simple cuboidal epithelium:

• These are single layer of cells as tall as they are wide.
• A spherical nuclei stain darkly, causing the cell to look like a string of beads when viewed
microscopically.
• They form walls of the smallest ducts of glands and many of kidney tubules

iii) Simple columnar epithelium:

• These are single layer of tall, closely packed cells, aligned like soldiers in a row.
• Lines the digestive tract from the stomach through the rectum.
• They display cilia on their free surfaces, which help to move substances or cells through
an internal passageway.
Stratified epithelium:
• They contain 2 or more cell layers.

• They regenerate from below, i.e; the basal cells divide and push apically to replace the older
surface cells.

• Considerably more durable than the simple epithelia, major role of stratified epithelium is
protection.

i) Stratified squamous:
• It is most spread of the stratified.

• It is composed of several layers, it is thick and well suited for its protective role in body.

• It’s free surface cells are squamous cells of the deeper layers are cuboidal or columnar.

• This epithelium is found in areas subjected to wear and tear and its surface cells are
constantly being rubbed away and replaced by division of its basal cells.
Example: Palm of the hand, sole of the foot
Stratified epithelium:

ii) Transitional epithelium:

• It forms the lining of hollow urinary organs, which stretch as they fill with urine cells of
its basal layer are cuboidal or columnar.
• The apical cells vary in appearance depending on the degree of distention of the organ.
• When the organ is distended standard with urine the transitional epithelium thins from
about 6 cell layers to 3 and it’s dome like apical cells flatten to becomes squamous like.
• The ability of transitional cells to change their shape allows a greater volume of urine to
flow through a tube like organ. In the bladder, it allows more urine to be stored.
Pseudostratified columnar epithelium:

•These cells vary in height.

•All of its cells rest on the basement membrane, but only the tallest reach the free
surface of the epithelium.

•Because the cell nuclei lie at the different levels above the basement membrane, it
gives the false pseudo impression that several cell layers are present, hence
“pseudostratified”.

•The short cells are relatively unspecialized and give rise to the taller cells.

•These cells like simple columnar variety, secretes or absorbs substances.

•A ciliated version containing goblet cells, lines most of the respiratory tract. Here the
motile cilia propel sheets of the dust trapping mucus superiorly away from the lungs.
 Endocrine glands

Glandular epithelium

Exocrine glands

Endocrine glands:
Description: Secretory products diffuse into blood after passing interstitial fluid without
ducts.

Location: Examples include pituitary gland at the base of the brain, pineal gland in brain,
thyroid and parathyroid glands near larynx (voice box), adrenal glands superior to kidneys,
pancreas near stomach.

Function: Produce hormones that regulate various body activities

Exocrine glands:
Description: Secretory products released into ducts.

Location: Sweat, oil, earwax glands of the skin, digestive glands such as salivary glands.

Function: Produce substances such as sweat, oil, earwax, saliva or digestive enzymes.

Merocrine
M secretion Apocrine secretion

Holocrine secretion
 Connective tissue

One of the most abundant and widely distributed tissues in the body.

Function:
•Supports and connects tissues.
•Separates different tissues from each other.

Characteristics of connective tissues:

•cells
•Ground substance Extracellular
•Fibers Matrix

This extracellular matrix is usually secreted by connective tissue cells and determine
the tissues’s quality. For instance, in cartilage, the extracellular matrix is firm but
pliable. Whereas in bone by contrast is hard and inflexible.
 Classification of connective tissue

Embryonic connective tissue Mature connective tissue

Mesenchyme Mucous connective tissue

Loose connective Dense connective Cartilage Bone tissue Liquid connective

tissue tissue tissue

Dense Hyaline cartilage Blood tissue

Areolar
regular
Fibrocartilage
Adipose Dense
irregular Lymph

Elastic cartilage
Reticular Elastic
Types of connective tissue:

1. Fibroblasts: Large flat cells with branching processes. They migrate through the
connective tissue, secreting the fibers and certain components of ground
substances.

2. Adipocytes: Also called as fat cells that store triglycerides(fat cells), found deep in
the skin and around organs such as heart and kidney cells.

3. Mast cells: Abundant alongside the blood vessels that supply the connective tissue.
They produce histamine, a chemical that dilates small blood vessels as part of
inflammatory response.

4. White Blood Cells: They are not found in significant number in normal connective
tissues. However, in response to certain conditions they migrate from blood into
connective tissues. Example, neutrophils gather at sites of infection, and
eosinophils migrate to sites of parasitic invasions and allergic responses.
5. Macrophages: They develop from monocytes, a type of WBC, capable of engulfing
bacteria and cellular debris by phagocytosis.

6. Plasma Cells: They are small cells that develop from type of WBC called as B
lymphocyte. They secrets antibodies, proteins that attack or neutralize foreign
substances. Most of them reside in gastrointestinal and respiratory tracts.

Connective tissue extracellular matrix:

Each type of connective tissue has unique properties, based on the specific extracellular
materials between the cells.

Ground substance: Component of connective tissue between the cells and fibers. It
may be fluid, semi fluid, gelatinous or calcified.
 Collagen
•Fibrous protein main function is to maintain the shape and rigid structure deformation of
tissue.

•They are very strong and resist pulling forces, but they are not stiff, which allows tissue
flexibility.

•Madeup of 3 α helical polypeptide chains(mostly made-up of proline and glycine) called

tropocollagen

•Has unique helical structure, where glycine is present at every third position in the
polypeptide chain

•The most abundant amino acid present in collagen is glycine.

•Most abundant protein in the body 25% o f the total prorein.

•The pyrolidine ring structure of imino acid have a stereo chemical properties that limit
flexibility
•The hydroxylation of proline residues on collagen enhance the stability of the triple helix
and influence on collagen fibril formation.

•Collagen fibers are found in most types of connective tissues, especially bone, cartilage,
tendons and ligaments.

•Examples:
1. In bones and tendons arrangement of collagen fibers are parallel, while in case of lungs
the arrangement of collagen fibers is less ordered.
2. In cornea the arrangement of collagen fiber is orthogonally arranged, in case of
cartilage tissue it is network like.
General properties of collagen:
•Most assymetric fibrous protein in living organisms.
•Upon exposure to boiling water, collagen is converted to gelatin.
Collagen fiber molecular structure
 Elastin
•Key structural fibrous protein found in the extracellular matrix of connective
tissues.

•Maintains elasticity or reversal of skin condition.

•Madeup of hydropobic amino acids ( G, A ,V and P)

•Rich in proline and charged amino acid like lysine, also contains little hydroxyproline.

•In stress conditions it is not falling apart due to lysine linkage.

•As we age linkage of lysine go down gradually due to which elastin cannot go back
to relaxed state properly.

•Predominantly found in the walls of arteries, lungs, intestines and skin etc.

•Unlike the collagen it is not converted to gelatin upon boiling.

Structure of elastin
 Collagen Elastin
Function Provides structural Provides structural
support, strength and support and elasticity
rigidity
Location Connective tissue Elastic connective
tissue

Prevalence Most abundant protein in Less abundant

the body
Appearance White Yellow
Life cycle Produced until the aging Produced primarily
period begins during fetal
development
 Composition of bone

Schematic representation showing composition of bone between compact (cortical) and

spongy (cancellous). Cortical bone is evaluated further and broken into its constituents
70%minerals, 22% organic protein and 8% water.

The matrix of bone is made up of calcium salts and collagen and is strong, hard and not
flexible.
 Composition of bone
•Bone consists of cells embedded in mineralized organic matrix.

•The primary component of bone is hydroxyapatite (mineral form of calcium apatite) the
dominant bone mineral.

•The organic components of the matrix consist mainly of type 1 collagen.

•The collagen fibers give bone its tensile strength, and the interspersed crystals of
hydroxyapatite give bone its compressive strength. These effects are synergistic.

•Type 1 collagen composes of 90-95% of the organic matrix, while the remaining part of
the matrix being a homogenous liquid called ground substance (proteoglycans like
hyaluronic acid ,chondritin sulfate and non collagenous protein).

•Collagen consists of strands of repeating units, which give bone its tensile strength, and
are arranged in an overlapping fashion that prevent shear stress
Types of Bone cells
. Bone
•Two types of bone can be identified microscopically according to arrangement of
collagen: Woven and lamellar

Woven bone (fibrous bone): Haphazard organization of collagen fibers and

mechanically weak.

Lamellar bone: Has a regular parallel alignment of collagen into sheets ("lamellae")
and mechanically strong.

•In adults woven bone is created after fractures or in Paget's disease. Woven bone
has smaller number of randomly oriented collagen fibers, it is for this appearance
of the fibrous matrix that the bone is termed woven.

•Lamellar bone, which makes its first appearance in humans in the fetus filled with
many collagen fibers parallel to other fibers in the same layer.

•Compared to woven bone, lamellar bone formation takes place more slowly. 
•The extracellular matrix(ECM) of bone is laid down by osteoblasts, which secrete both
collagen and ground substance.

•These ECM synthesize collagen within the cell and then secrete collagen fibrils. The
collagen fibers rapidly polymerise to form collagen strands.
 Bone growth and remodeling
•The size and shape of the bones not only changes during growth, but for rest of ones life
it is continuously being remodeled in response to the stress put on it.

•Approximately 10% of bone mass is removed and replaced each year.

•Bone remodelling requires coordinated activity of two types of cells:

a) Osteoclasts (resorption of bone)
b) Osteoblasts (deposition of bone)

c) Osteoclasts:

• They are multinucleated cells derived from pluripotent hematopoeitic stem cells.
• They posses epical membrane of ruffled border into the resorption area.
• Proton translocating ATP expels protons across the ruffled border into the resorption
area which lowers the pH to 4 or even less; thus increasing the solubility of
hydroxyapatite and allowing demineralization.
• Lysosomal acid protease digest the matrix proteins.
b) Osteoblasts:

• They are mononuclear cells derived from pluripotent mesenchymal precursors

synthesize most of the proteins found in bone as well as growth factors and
cytokines.
• They control mineralization by regulating the passage of calcium and phosphate ions
across surface membrane.
• Alkaline phosphate contribute to mineralization.
• Excess activity of osteoclasts (common for menopause in women) produces
osteoporosis. Reduced activity of osteoclasts produces osteopetrosis.
• Inhibition of function of osteoclasts causes too much bone to form leading to extra-
dense bone which actually is more brittle than normal bone thus leading to fractures.
 Factors affecting Bone Growth

•Bone remodelling is controlled by parathyroid hormone(PTH) in addition with growth

hormone and sex hormones (estrogen and progesteron).

•PTH promotes the number and activity of osteoblasts.

•The parathyroid glands are 4 tiny structures embedded in the rear surface of the thyroid
gland which secretes parathyroid hormone (PTH) a polypeptide of 84 amino acids.

•Clacitriol, Vit D3, thyroid stimulating hormone inhibit the activity of osteoclasts

•Leptin increases the number of osteoclasts.

PTH increases the concentration of Ca in the blood in three ways:

1. It promotes the release of Ca from the huge reservoir in the bones (99%
of Ca in our body is incorporated in the bones)

2. It helps in reabsorption of Ca from the fluid in the kidney tubules.

3. It helps in absorption of Ca from the contents in intestine (this activity is

mediated by calcitriol, the active form of Vit D)

Tumors in parathyroids elevate the levels of PTH which leads to increase

in the level of Ca in the blood which maybe withdrawn from the bone
leading to brittle and weak bones.
 Factors affecting Bone Growth

•Calcitriol acts on:

a) The cells of the intestine to promote absorption of Ca from food.
b) Bone to mobilize calcium from the bone to the blood.

•Deficiency of thyroid stimulating hormone (TSH) causes osteoporosis. TSH deficiency

leads to increased number of bone-reabsorbing osteoclasts.

•Calcitonin hormone synthesized by thyroid is a polypeptide of 32 amino acids. They have

receptors that bind calcium ions circulating in the blood which monitor the the level of
circulating Ca.

•A rise in the Ca level stimulates the cells to release calcitonin.

•Since calcitonin promotes the transfer of Ca to bones, it has been examines as a possible
treatment for osteoporosis.
 Blood and body fluids
Homeostasis and body fluids

An important aspect of homeostasis is maintaining the volume and composition of body

fluids.
Fluid

Intracellular (ICF) Extracellular(ECF) Interstitial

(inside the cells) (outside the cells) (in between the cells)

ECF differs depending upon where it occurs in the body.

ECF is termed as :
1. Blood plasma within blood vessels
2. Lymph within lymphatic vessels
3. Cerebrospinal fluid around brain and spinal cord
4. Synovial fluid in joints
5. Aqueous humor and vitreous body in eye
 Body fluids
The proper functioning of body cells depends on precise regulation of the composition of
interstitial fluid surrounding them. Hence, interstitial fluid is often called as body’s internal
environment.

The composition of interstitial fluid changes as substances move back and forth between it and
blood plasma.

This movement in both the directions across capillary walls provides needed materials such as
glucose, oxygen, ions and so on to cells.

It also removes wastes such as carbon di-oxide from interstitial fluid.

 Composition of blood
•Blood is made-up of two components
1. Blood plasma (55%): watery liquid extracellular matrix that contains dissolved
substances. 55% of blood plasma is made-up of 7% proteins, 91.5% water and
1.5% other solutes

2. Formed elements (45%): which are cells and cell fragments which includes Red
blood cells, White blood cells and Platelets

Functions of blood
•Transports oxygen, carbon di-oxide, nutrients, hormones, heat and wastes.

•Regulates pH, body temperature, and water content of cells.

•Protects against blood loss through clotting, and against diseases through phagocytic
white blood cells and antibodies.
 Erythropoiesis
Tightly regulated and complex process involved in production of RBC’S.

Starts in the red bone marrow with a precursor cell called as proerythroblast

These proerythroblast divides several times, that begin to synthesize hemoglobin.

Ultimately, a cell near the end of development sequence ejects its nucleus and becomes a
reticulocyte.

Loss of the nucleus causes the centre of the cell to indent, producing the RBC’s distinctive
biconcave shape.

Reticulocytes retain some mitochondria, ribosomes and endoplasmic reticulum.

Reticulocytes develop into mature red blood cells within 1 to 2 days after their release
from red bone marrow.
 Blood Coagulation

•Normally blood remains in its liquid form as long as it stays with in vessels. If it is drawn
from the body, however it thickens and forms as gel. The process of gel formation is called
clotting or coagulation.

•Blood Coagulation/clotting : It is a complex cascade of enzymatic reactions in which each

clotting factor activates many molecules of next one in a fixed sequence. Finally a large
quantity of product ( the insoluble fibrin protein) is formed.

•Clotting involves several substances known as clotting (coagulation factors). These include
Ca ions and several inactive enzymes synthesized by hepatocytes (liver cells).

•It an be divided into three stages:

1. Two pathways the extrinsic and intrinsic pathway, leads to the formation of
prothrombinase.
2. Prothrombinase converts prothrombin into the enzyme thrombin
3. Thrombin forms soluble fibrinogen into insoluble fibrin. Fibrin forms the threads of the
clot.
Figure: Blood clotting cascade
Figure: Blood clot formation
 Outline of Extrinsic and Intrinsic pathway
Extrinsic pathway
It has fewer steps than intrinsic pathway
and occurs rapidly with in a matter of
seconds if trauma is severe.
It is so named because a tissue protein
names tissue factor (TF), also known as
thromboplastin, leaks into the blood from
cells outside (extrinsic) blood vessels and
initiates the formation of prothrombinase.
Intrinsic pathway
It is more complex than extrinsic pathway
and it occurs more slowly usually requiring
several minutes.
It is so named because its activators are
either in direct contact with blood or
contained within (intrinsic) the blood.
 Extrinsic pathway
TF factor is a complex mixture of lipoproteins and phospholipids released from the
surface of damaged cells.

In the presence of Ca, TF begins as sequence of reactions that ultimately activates clotting
factor X.

Once factor X is activated, it combines with factor V in the presence of Ca to form the
active enzyme prothrombinase, completing the extrinsic pathway
 Intrinsic pathway
If endothelial cells becomes roughened or damaged, blood can come in contact with
collagen fibers in the connective tissue.

In addition, trauma to endothelial cells causes damage to paltelets, resulting release

of phospholipids by platelets.

Contact with collagen fibers (or with glass sides of blood collection tube) activates
clotting factor XII which begins a sequence of reactions that eventually activates
clotting factor X.

Once factor X is activated, it combines with factor V in the presence of Ca to form the
active enzyme prothrombinase, completing the intrinsic pathway
 Composition and functions of CSF(Cerebrospinal fluid)
•Cerebrospinal fluid (CSF) is a clear, colorless liquid that protects the brain and spinal cord from
physical and chemical injuries.

•It also carries oxygen, glucose and other needed chemicals from the blood to neurons.

•The total volume of CSF is 80 to 150 ml in an adult.

•CSF contains glucose, proteins, lactic acid, urea, cations (K, Na, Mg, Ca) and anions (Cl, HCO3) ,
it also contains some WBC’s.

•The CSF contributes to homeostasis in three main ways:

1. Mechanical protection: Serves as shock absorbing medium that protects the delicate tissues
of the brain and spinal cord from the jolts that would otherwise cause them to hit the bony
walls of the carnival cavity and vertebral canal.

2. Chemical protection: CSF provides optimal chemical environment for accurate neurnal
signaling.

3. Circulation: Allows exchange of nutrients and waste products between the blood and
nervous tissue
 Composition and Functions of Lymph
•Lymph is a extracellular fluid that flows in lymphatic vessels and helps body defend against
disease causing agents.

•It is a connective tissue that consists of several types of cells in a clear liquid extracellular
matrix that is similar to blood plasma but with much less protein.

•Composition of lymph varies from one part of the body to another. For example, lymph
leaving lymph nodes includes many lymphocytes a type of white blood cells, in contrast to
lymph from small intestine, which has a high content of newly absorbed dietary lipids.

•Lymph nodes are small solid structures found at varying points along the lymphatic system,
example: groin, arm pits and mesentery.

•They range in size from 2 to 10 mm, are spherical in shape and are encapsulated.

•The primary role of lymph node is to filter the lymph and then produce immune response
against trapped microbes/antigens.
 Functions of the lymphatic system

The lymphatic system has three primary functions:

Drains excess interstitial fluid: Lymphatic vessels drain access interstitial fluid from tissue
spaces and return it to the blood.
Transport dietary lipids: Lymphatic vessels transport dietary and lipid soluble vitamins
(A,D,E and K) absorbed by the gastrointestinal tract.
Carries out immune responses: Lymphatic tissue initiates highly specific responses
directed against particular microbes or abnormal cells.
Composition of Lymph
 Respiratory system

Upper
respiratory
tract

Lower
respiratory
tract

Anatomy of Respiratory Tract

Functions of the respiratory system:
Provides for gas exchange - Intake of oxygen for delivery to body cells and elimination of
carbon dioxide produced by body cells.
Helps regulate blood pH.
Contains receptors for the sense of smell, filters inspired air, produces vocal sounds
(phonation) and excretes small amounts of water and heat.
Mechanism of respiration:
The air which we breathe in and out of the lungs varies in the pressure. So basically when
there is a fall in air pressure the alveolar spaces falls and air enters the lungs (Inspiration)
and as the pressure of the alveoli within exceeds the atmospheric pressure, the air is
drawn from the lungs (expiration). The flow rate of the air isn’t proportion to the
magnitude of the pressure difference. The breathing mechanism involves 2 processes.
1. Inspiration.
2. Expiration.
Mechanism of inspiration:
• The process of intake of atmospheric air is known as inspiration. It is an active process.
• When the volume of the thoracic cavity increases and the air pressure decreases.
Inspiration takes place.
• Contraction of external intercostal muscles increases the volume of the thoracic cavity.
• Contraction of the diaphragm further increases the size of the thoracic cavity.
Simultaneously, the lungs expand.
• With the expansion of the lungs, the air pressure inside the lungs decreases.
• The pressure equalizes and atmospheric air rushes inside the lungs.
Mechanism of expiration:
The process of exhaling carbon dioxide is called expiration. It is a passive process.
It occurs when the size of the thoracic cavity decreases and the air pressure outside
increases.
Now the external intercostal muscles relax and the internal intercostal muscles contract.
As a result, the ribs are pulled inwards and the size of the thoracic cavity is reduced.
The diaphragm is relaxed and the lungs get compressed.
Consequently, the pressure increases and the air is forced outside.
Mechanism of respiration
(a) Inspiration
(b) Expiration
 Transport of gases

•Blood is a medium of transport for oxygen and carbon-di-oxide.

•About 97% of oxygen is transported by RBC in the blood.

•Remaining 3% of oxygen is carried in a dissolved state through the plasma.

•Nearly 20-25% of carbon-di-oxide is transported by RBC whereas 70% of t is carried by

bicarbonate.

•About 7% of carbon-di-oxide is carried in a dissolved state through plasma.

 Transport of gases

Inhaling and exhaling may seem like simple actions, but they are just part of the complex
process of respiration, which includes these four steps:

1.Ventilation: Refers to the flow of air into and out of the alveoli. Individual alveoli have variable
degrees of ventilation.

2.Pulmonary gas exchange: Pulmonary gas exchange takes place in the lungs between the alveoli
and the blood

3.Gas transport:  Inhaled oxygen moves from the alveoli to the blood in the capillaries, and
carbon dioxide moves from the blood in the capillaries to the air in the alveoli.

4.Peripheral gas exchange: At this point the final stage of respiration occurs as the much needed
O2 is absorbed by the tissues and the waste CO2 that the tissues have created is diffuses back
into the blood and is transported back to the lungs to be exhaled
 Artificial respiration
Breathing induced by some of the manipulative techniques, when the natural respiration has
been stopped and the heart is running or flattering, artificial respiration is applied quickly and
properly to prevent people from dying due to drowning, choking, strangulation, suffocation,
carbon monoxide poisoning, or electric shock.

Machines of artificial respiration are also known as artificial lung ventilation machines. 
 
It mainly consists of two actions,

1. Maintain and establish an open-air passage from the upper respiratory tract to the lungs,
2. Exchange of air and carbon dioxide in the terminal air sac of the lungs, while the heart is
still functioning. 
 Different Methods of Artificial Respiration
Schaffer’s Method
In this method, the victim is made to lay on his belly, with one
arm extended directly overhead and the other arm bent at the
elbow. The face is turned outward and resting on the forearm. In
this position, the nose and mouth are free for breathing. Now,
the doctor kneels to the patient’s waist and puts his palm on the
patient’s loin. The first step will be to apply the pressure by
bending forward, then the doctor pushes the abdominal viscera
to bring about the expiration. Pressing forward expiration takes
place and the bending backwards inspiration takes place.
According to some rough calculations, expiration lasts for 3
seconds and the inspiration lasts for 2 seconds. Some of the
advantages of this method are its prone position, so that water
from the abdomen and lungs can be easily drained,; it is a very
simple method, non-tiring, and it can be continued for a long
time. 
 
This method can be applied, if there are injuries to the thorax or back. The main
disadvantage of this method are that inspiration is passive and the expiration is active,
which is not physiological. This method is not applied to patients with injuries in the
abdomen.
 Different Methods of Artificial Respiration

Sylvester’s Method 
In this method the pillow is given below the shoulder and the
neck is fully extended. During this method, the doctor will
kneel near the patient’s head, facing towards the patient. The
doctor will catch the patient's wrist and by bending the doctor
will pull the patient’s arms up, this will result in inspiration.
Then bending forward the doctor will put deep pressure on the
chest with the patient’s hand, this will cause expiration. In this
method, inspiration should last for 3 seconds and expire for 2
seconds. 
The main advantages of this method are that both inspiration
and expiration are active, so good ventilation is obtained. And
the disadvantage of this method is that there is no drainage of
water from the lungs, due to the supine position of the patient,
so this method should not be used in cases of drowning. This
method is quite tiring, so assistance is required for this and if
there is rib fracture or thorax this method cannot be applied.
Mouth to Mouth Respiration :
In this method, the doctor kneels near the patient’s neck facing toward him. And a pillow
is placed below the patient’s shoulder so that the neck is extended fully. With the left-
hand doctor closes the patient’s nostril and places the handkerchief on the patient’s
mouth, and then the doctor will blow the expired air in the patient’s mouth, this will
cause inspiration. When the mouth is taken away, expiration occurs passively. 
 
The main advantage of this method is giving expired air containing carbon dioxide, which
stimulates the patient’s respiratory centre, and in this good ventilation is obtained. 
 Artificial Respiration Machine 

An artificial respiration machine is also known as a breathing machine or artificial

ventilation machine. Some of the patients require help to breathe,; in such situations, this
kind of machine is used to assist the function of the lungs.

The main purpose of the ventilator is to blow the air into the lungs, helping to maintain the
level of oxygen in the blood. To use the mechanical ventilator, the medical team needs
some form of access to the patient’s lungs. Like a tube is inserted into the mouth or nose to
reach the lungs, this process is called intubation. Or, even a tube can be inserted into the
opening of the windpipe, medically known as the trachea and this process is called a
tracheostomy.  
Different types of artificial respiration devices are used to treat different respiratory
diseases according to the symptoms and condition of the patient. Some of the
artificial breathing devices are mentioned below
•Chest compression system 
•CPAP
•CPR devices 
•CPR pocket mask 
•Demand valves and aspirators 
•Humidifiers 
•Nebulizers 
•Oxygen delivery devices 
•Oxygen regulator
•Oxygen fittings
•Oxygen flowmeters and selector valves 
 Cardiopulminory Resuscitation
In cases in which the heart suddenly stop beating, cardiopulminory resuscitation(CPR) properly
applied cardiac compressions, performed with artificial ventilation of the lungs via mouth-to-
mouth respiration saves life.
CPR keeps oxygenated blood circulating until the heart can be restarted.
 Acid base balance by lungs and kidneys

The human body is built to naturally maintain a healthy balance of acidity and alkalinity.
The lungs and kidneys play a key role in this process. A normal blood pH level is 7.35 to
7.45.
Small change in pH can produce major disturbances in the body like:
Most enzymes work with only normal pH range.
Acid-base balance can also affect electrolytes (Na, K, Cl)
Can also affect hormones
The body produces more acids than bases through food ingested, metabolism etc.
 Acid base balance by lungs and kidneys

•Acids are produced in the course of metabolism.

•Metabolism generates carbon dioxide within cells.
•Carbon dioxide dissolves in water, forming carbonic acid, which in turn dissociates releasing
hydrogen ion.
•The acids derived from sources other than CO2 are known as nonvolatile; by definition, they
cannot be removed through the lungs, and must be excreted via the kidney.
•Lactic acid is produced during anaerobic glycolysis and its concentration in plasma is the
hallmark of hypoxia.
•The metabolism of sulfur-containing amino acids and phosphorus-containing compounds also
generates inorganic acids.
•In spite of the amount of hydrogen ion produced, its blood concentration is remarkably
constant: it remains between 35 and 45 nmol/L (pH 7.35–7.45).
•Maintenance of stable pH is essential because it affects the ionization of proteins and,
consequently, the activity of many enzymes and other biologically active molecules such as ion
channels.
•Changes in pH together with the partial pressure of carbon dioxide (pCO2) affect the shape of
the hemoglobin saturation curve, and thus tissue oxygenation.
•Also, a decrease in pH increases sympathetic tone and may lead to cardiac dysrhythmias.
 Acid base balance by lungs and kidneys
•Maintaining the acid–base balance involves lungs, erythrocytes and kidneys.
•The lungs control the exchange of carbon dioxide and oxygen between the blood and the
atmosphere, Carbon dioxide generated in tissues is transported in plasma as bicarbonate
•Erythrocytes transport gases between lungs and tissues, erythrocyte hemoglobin
contributes to CO2 transport. Hemoglobin also buffers the hydrogen ion derived from
carbonic acid.
•Kidneys control plasma bicarbonate synthesis and the excretion of the hydrogen ion.
 kidneys reabsorb filtered bicarbonate in the proximal tubules and generate new
bicarbonate in the distal tubules, where there is a net secretion of hydrogen ion.

Main buffers in the human body

 Bohr’s effect

•The Bohr effect is a describes hemoglobin's oxygen

binding affinity is inversely related both to acidity and
to the concentration of carbon dioxide.

• That is, the Bohr effect refers to the shift in the

oxygen dissociation curve caused by changes in the
concentration of carbon dioxide or the pH of the
environment.

•Since carbon dioxide reacts with water to

form carbonic acid, an increase in CO2 results in a
Christian Bohr decrease in blood pH, resulting in hemoglobin
Danish physiologist proteins releasing their load of oxygen.
First described Bohr effect in 1904
•Conversely, a decrease in carbon dioxide provokes an
increase in pH, which results in hemoglobin picking
up more oxygen.
(c) As temperature
 Factors affecting the affinity of hemoglobin for oxygen

1. Acidity: As the acidity increases (pH decreases) the affinity of hemoglobin for oxygen
decreases, and oxygen dissociates more readily from hemoglobin. When pH decreases the
entire oxygen-hemoglobin dissociation curve shifts to the right at any given Po 2. The Bohr
effect works both the ways, an increase in H+ in blood causes oxygen to unload from
hemoglobin, and the binding of oxygen to hemoglobin causes unloading of H+ from
hemoglobin.
2. Partial pressure
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