Sambhram institute of Technology – Biology for Engineers (CSE)

Biology for Engineers (CSE)

Course code: BBOC407 IV Semester

Module 3

Adaptation of anatomical principles for bioengineering design

Brain as a CPU system

Eye as a Camera system
Heart as a pump system
Lungs as purification system
Kidney as a filtration system

Brain as a CPU system:

Introduction:
The analogy of the brain functioning as a CPU (central processing unit) is a useful way to
understand the complexity and efficiency of brain processes through the lens of computer science.
Both the brain and a CPU are central to their respective systems, handling information processing
and decision-making.

The Brain: An Overview

Structure: Composed of billions of neurons (nerve cells) interconnected through synapses.
Function: Manages cognitive processes, motor functions, sensory processing, and homeostatic
functions.
Neurons: Basic processing units that transmit information via electrical and chemical signals.
Synapses: Junctions through which neurons communicate, allowing complex processing and
learning.

CPU: An Overview

Structure: Consists of transistors, logic gates, registers, and memory units.

Function: Executes instructions from programs, performing arithmetic, logic, control, and
input/output (I/O) operations.
Cores: Modern CPUs have multiple cores to handle parallel processing.
Clock Speed: Determines how many instructions a CPU can process per second.

 Both CPU and brain use electrical signals to send messages.

 The brain uses chemicals to transmit information; the computer uses electricity.
 Even though electrical signals travel at high speeds in the nervous system, they travel even
faster through the wires in a computer. Both transmit information.

The nervous system has two main parts:

The central nervous system (CNS) is made up of the brain and spinal cord.
The peripheral nervous system is made up of nerves that branch off from the spinal cord and
extend to all parts of the body.
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1) Central nervous system:

CNS includes the brain and spinal cord. The brain is the body’s ―control centre.‖ The CNS has
various centres located within it that carry out the sensory, motor and integration of data. These
centres can be subdivided to Lower Centres (including the spinal cord and brain stem) and higher
centres communicating with the brain via effectors.

2) Peripheral nervous system:

PNS is a vast network of spinal and cranial nerves that are linked to the brain and the spinal cord.
It contains sensory receptors which help in processing changes in the internal and external
environment. This information is sent to the CNS via afferent sensory nerves. The PNS is then
subdivided into the autonomic nervous system and the somatic nervous system. The autonomic
has involuntary control of internal organs, blood vessels, smooth and cardiac muscles. The
somatic has voluntary control of skin, bones, joints, and skeletal muscle. The two systems
function together, by way of nerves from the PNS entering and becoming part of the CNS, and
vice versa.

Source: Marc Seymour

Signal transmission:
 A neuron sending a signal (i.e., a presynaptic neuron) releases a chemical called a
neurotransmitter, which binds to a receptor on the surface of the receiving (i.e.,
postsynaptic) neuron.
 Neurotransmitters are released from presynaptic terminals, which may branch to
communicate with several postsynaptic neurons.
 Axon terminals are where neurotransmission begins. Hence, it is at axon terminals where
the neuron sends its OUTPUT to other neurons.
 At electrical synapses, the OUTPUT will be the electrical signal itself. At chemical
synapses, the OUTPUT will be neurotransmitter.
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 The correct outline for the sequence of transmission of an electrical impulse through a
neuron is dendrites, cell body, axon, axon terminal.

Fig: A neuron with its dendrites and long axon.

Brain-Computer Interfaces (BCI):

 A BCI system is a computer-based system that takes brain signals, analyses them and translates
them into commands that are relayed to a device to trigger a desired action.
 BCI enables direct communication between the brain and external devices, aiding in medical
prosthetics and communication for individuals with disabilities.
 BCI is a potential for enhancing cognitive functions through integration with computer
systems.
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 Brain computer interfaces have contributed to various areas of research, like medicine, neuro-
technology and smart environment, neuro-marketing and advertising, education and self-
regulation, games and entertainment, as well as security and identification.

Electro Encephalo Gram (EEG):

An electroencephalogram (EEG) is a test that measures electrical activity in the brain using small,
metal discs (electrodes) attached to the scalp. Brain cells communicate via electrical impulses and
are active all the time, even during sleep. This activity shows up as wavy lines on an EEG
recording.

An EEG is one of the main diagnostic tests for epilepsy. An EEG can also play a role in
diagnosing other brain disorders.
An EEG can find changes in brain activity that might be useful in diagnosing brain disorders,
especially epilepsy or another seizure disorder. An EEG might also be helpful for diagnosing or
treating:

 Brain tumours
 Brain damage from head injury
 Brain dysfunction that can have a variety of causes (encephalopathy)
 Sleep disorders
 Inflammation of the brain (herpes encephalitis)
 Stroke

 An EEG might also be used to confirm brain death in someone in a persistent coma.
A continuous EEG is used to help find the right level of anaesthesia for someone in a medically
induced coma.
 Voltage fluctuations measured by the EEG bio-amplifier and electrodes allow the evaluation of
normal brain activity including the posterior dominant rhythm (PDR), first described by Hans
Berger.
 EEG can detect abnormal electrical discharges such as sharp waves, spikes or spike-and-wave
complexes that are seen in people with epilepsy, thus it is often used to inform the medical
diagnosis.
 It is also used to help diagnose sleep disorders, depth of anaesthesia, coma, encephalopathy,
cerebral hypoxia after cardiac arrest, and brain death.
 EEG used to be a first-line method of diagnosis for tumours, stroke and other focal brain
disorders, but this use has decreased with the advent of high-resolution anatomical imaging
techniques such as magnetic resonance imaging (MRI) and computed tomography (CT).
 It is one of the few mobile techniques available and offers millisecond-range temporal
resolution which is not possible with CT, PET or MRI.
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Eye as a Camera system:

The human eye is a wonderful instrument which can be compared to a camera in many ways, with
various components of the eye performing similar functions to those of a camera. Here's a detailed
look at each part and its corresponding camera component:

Source: NCI VISUALS ONLINE

1. Cornea and Lens - Camera Lens

Function: The cornea and lens work together to focus light onto the retina, much like a camera
lens focuses light onto the camera's sensor or film.

Cornea: The cornea is the eye's outermost layer. It functions as a powerful refracting surface,
providing approximately 70% of the eye's focusing power.

Lens: The lens fine-tunes the focus of light, allowing us to see objects clearly at various distances.
It changes shape to adjust the focal length (accommodation), similar to a camera lens' ability to
zoom in and out.

2. Pupil and Iris - Aperture

Function: The pupil and iris control the amount of light entering the eye, similar to how a
camera's aperture works.
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Pupil: The pupil is the opening through which light enters the eye. Its size adjusts based on the
intensity of light in the environment.

Iris: The iris is the coloured part of the eye surrounding the pupil. It controls the size of the pupil,
regulating the amount of light that enters the eye.

3. Retina - Image sensor (Film or Digital sensor)

Function: The retina captures light and converts it into electrical signals, akin to how a camera's
sensor captures light to create an image.

Retina: The retina is a layer of light-sensitive cells (rods and cones) at the back of the eye. It
translates light into neural signals that are sent to the brain.

The Photoreceptors – Rods & Cones: These photoreceptors are localized around an area near
the centre of the retina called the macula, which is the functional centre of the retina. The macula
is responsible for high-resolution, night vision and colour vision, provided by different types of
photoreceptors. Photoreceptors in the retina are classified into two groups, named after their
physical morphologies.

Rods: These cells are sensitive to low light and are crucial for night vision.
Cones: These cells are responsible for colour vision and function best in bright light.

Source: EASY BIOLOGY CLASS

4. Optic Nerve - Data Transfer Cable

Function: The optic nerve transmits the electrical signals from the retina to the brain, similar to
how a data cable transfers image data from a camera sensor to a storage device.

Optic Nerve: This nerve carries visual information from the retina to the brain, where the signals
are processed to form images.
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5. Sclera and Choroid - Camera Body

Function: The sclera and choroid provide structure and support, much like the camera body.
Sclera: The white, outer layer of the eye that provides protection and form.
Choroid: A layer containing blood vessels that nourish the eye, lying between the retina and
sclera.

6. Aqueous and Vitreous Humor - Lens Elements

Function: These fluids maintain eye shape and optical properties, similar to the lens elements
within a camera.
Aqueous Humor: A clear fluid between the cornea and lens that helps maintain pressure and
nourishes the cornea and lens.
Vitreous Humor: A gel-like substance filling the space between the lens and retina, maintaining
the eye's shape and optical stability.

Comparison summary:
Component Eye function Camera equivalent Camera function
Focuses light onto the Focuses light onto the
Cornea & Lens Lens
retina sensor/film
Controls amount of light Controls amount of
Pupil & Iris Aperture
entering light entering
Captures light, converts to Image Sensor Captures light to create
Retina
signals (Film/Digital) an image
Transmits signals to the
Optic Nerve Data Transfer Cable Transfers image data
brain
Provides structure and Provides structure and
Sclera & Choroid Camera Body
nourishment housing
Aqueous & Vitreous Maintains shape and Maintains focus and
Lens Elements
Humor optical properties image clarity

Detailed process of vision (Analogous to taking a photograph):

1. Light Entry: Light enters the eye through the cornea and pupil, similar to light entering a
camera through the lens and aperture.
2. Focusing: The cornea and lens focus the light onto the retina, much like a camera lens
focuses light onto the sensor.
3. Light Detection: The retina detects the focused light, converting it into electrical signals
(similar to a sensor capturing the image).
4. Signal Transmission: The optic nerve carries these signals to the brain (analogous to
transferring the image from the camera to a memory card or computer).
5. Image Processing: The brain processes these signals to form a coherent image, just as
image processing software would enhance and render a photo.

Understanding the eye as a camera system provides a fascinating insight into how our vision
works and highlights the complexity and efficiency of the human eye in capturing and processing
visual information.
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Optical corrections:
Optical corrections involve the use of lenses or surgical procedures to correct refractive errors in
the eye. Refractive errors occur when the eye cannot focus light correctly onto the retina, resulting
in blurred vision. The main types of refractive errors are myopia (near sightedness) and hyperopia
(far sightedness).

1. Myopia (Near sightedness):

Myopia occurs when the eyeball is too long, or the cornea is too curved, causing light to focus in
front of the retina. This makes distant objects appear blurry while close objects are seen clearly.

Correction methods:
Concave (Diverging) lenses: These lenses are thinner at the centre and thicker at the edges. They
spread out light rays before they enter the eye, moving the focal point back onto the retina.

Contact lenses: Soft or rigid lenses placed directly on the cornea to correct the focal point.
Refractive surgery: Procedures like LASIK (Laser-Assisted In Situ Keratomileusis) reshape the
cornea to correct the refractive error.

2. Hyperopia (Far sightedness):

Hyperopia occurs when the eyeball is too short, or the cornea is too flat, causing light to focus
behind the retina. This makes close objects appear blurry while distant objects are seen clearly.

Correction methods:
Convex (Converging) lenses: These lenses are thicker at the centre and thinner at the edges.
They converge light rays before they enter the eye, moving the focal point forward onto the retina.

Contact lenses: Soft or rigid lenses that correct the focal point by converging light rays.

Refractive surgery: Procedures like LASIK or conductive keratoplasty reshape the cornea to
adjust the focal point.

Cataract:
A cataract is a clouding of the normally clear lens of the eye. At first, the cloudiness in vision
caused by a cataract may affect only a small part of the eye's lens. As the cataract grows larger, it
clouds more of the lens and distorts the light passing through the lens. This may lead to more-
noticeable symptoms.

As you age, the lenses in your eyes become less flexible, less transparent and thicker. Age-related
and other medical conditions cause proteins and fibres within the lenses to break down and clump
together, clouding the lenses.

As the cataract continues to develop, the clouding becomes denser. A cataract scatters and blocks
the light as it passes through the lens, preventing a sharply defined image from reaching your
retina. As a result, your vision becomes blurred. Cataracts generally develop in both eyes, but not
always at the same rate. The cataract in one eye may be more advanced than the other, causing a
difference in vision between eyes.
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Source: THE EYE HEALTH CENTRE

Heart as a pump system:

Heart is sort of like a pump or two pumps in one. The main function of heart is to circulate blood
throughout the body to supply oxygen and nutrients and remove waste products. The human heart
is a four-chambered muscular organ, shaped and sized roughly like a man's closed fist with two-
thirds of the mass to the left of midline.

The cardiac muscle (myocardium) of the heart wall is a working muscle that needs a continuous
supply of oxygen and nutrients to function efficiently. For this reason, cardiac muscle has an
extensive network of blood vessels to bring oxygen to the contracting cells and to remove waste
products.
The human heart is very strong and is capable of pumping blood up to 30 feet distance. An
average heart beats maximum of 70-80 beats per minute and is considered healthy. The heart is
called a double pump because each side pumps blood to a different circulation. The right side of
heart receives blood from the body and pumps it to the lungs. The left side of the heart does the
exact opposite: It receives blood from the lungs and pumps it out to the body.

Anatomy:
 Four chambers: Two atria (upper) and two ventricles (lower).
 Major blood vessels: Aorta, Vena Cava, Pulmonary Arteries, and Pulmonary Veins.
 Valves: Tricuspid, Pulmonary, Mitral (Bicuspid), and Aortic.
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Source: Cleveland Clinic

Pumping mechanism:

Cardiac cycle:
 Systole: Contraction phase where blood is ejected from the heart.
 Ventricular Systole: Blood is pumped into the aorta and pulmonary artery.

 Diastole: Relaxation phase where the heart fills with blood.

 Ventricular Diastole: Ventricles fill with blood from the atria.

Heart rate and Stroke volume:

 Heart Rate (HR): Number of beats per minute.
 Stroke Volume (SV): Volume of blood pumped per beat.
 Cardiac Output (CO): Total volume of blood pumped per minute (CO = HR x SV).

Electrical system of the Heart:

Electrical conduction system:

 Sinoatrial (SA) Node: Natural pacemaker initiates the heartbeat.

 Atrioventricular (AV) Node: Relays electrical impulses from atria to ventricles.
 Bundle of His and Purkinje fibers: Conduct impulses to all parts of the ventricles.

Electrical signalling:
The sinus node generates an electrical stimulus regularly, 60 to 100 times per minute under
normal conditions. The atria are then activated. The electrical stimulus travels down through the
conduction pathways and causes the heart's ventricles to contract and pump out blood.
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Electrocardiogram
Source: Cleveland clinic

Here is what happens as blood flows through the heart and lungs:
 The blood first enters the right atrium.
 The blood then flows through the tricuspid valve into the right ventricle.
 When the heart beats, the ventricle pushes blood through the pulmonic valve into the
pulmonary artery.
 The pulmonary artery carries blood to the lungs where it ―picks up‖ oxygen. It then leaves the
lungs to return to the heart through the pulmonary vein.
 The blood enters the left atrium. It drops through the mitral (bicuspid) valve into the left
ventricle.
 The left ventricle then pumps blood through the aortic valve and into the aorta.
 The aorta is the artery that feeds the rest of the body through a system of blood vessels.
 Blood returns to the heart from the body via two large blood vessels called the superior vena
cava and the inferior vena cava.
 This blood carries little oxygen, as it is returning from the body where oxygen was used.
 The vena cava pump blood into the right atrium and the cycle begins all over again.
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Electrocardiography:
Electrocardiography (ECG) is a quick and easily accessible method for diagnosis and screening of
cardiovascular diseases including heart failure (HF). Artificial intelligence (AI) can be used for
semi-automated ECG analysis. The aim of this evaluation is to provide an overview of AI use in
HF detection from ECG signals and to perform a meta-analysis of available studies.

Evaluation of symptoms suggestive of HF currently demands physicians to valuate various

parameters including imaging and laboratory data and the electrocardiogram (ECG). Besides a
standard examination that includes an ECG, imaging information, such as echocardiography or
magnetic resonance imaging, is seen as gold standard in diagnosis of HF.

The ECG is a well-established, quick, and easily accessible method for diagnosis and screening of
various cardiovascular diseases. It provides specific features that indicate presence of HF or
prognosis in HF patients especially to rule out HF in case of a normal ECG. However, use of an
ECG as primary diagnostic instrument often only yields insufficient diagnostic specificity.

Coronary artery disease:

Coronary artery disease is a common heart condition. The major blood vessels that supply the
heart (coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart muscle.
Cholesterol deposits (plaques) in the heart arteries and inflammation are usually the cause of
coronary artery disease.
Signs and symptoms of coronary artery disease occur when the heart doesn't get enough oxygen-
rich blood. This reduced blood flow to the heart can cause chest pain (angina) and shortness of
breath. A complete blockage of blood flow can cause a heart attack.

Reasons for blockages of blood vessels:

Coronary artery disease starts when fats, cholesterols and other substances collect on the inner
walls of the heart arteries. This condition is called atherosclerosis. The build-up is called plaque.
Plaque can cause the arteries to narrow, blocking blood flow. The plaque can also burst, leading to
a blood clot. Besides high cholesterol, damage to the coronary arteries may be caused by:
Diabetes or insulin resistance, high blood pressure, not getting enough exercise (sedentary
lifestyle), smoking or tobacco use.

Plaque formation in arteries Source: Mayo Foundation

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Treatment:
A stent is a tiny tube that can play a big role in treating your heart disease. It helps keep your
arteries open. Most stents are made out of wire mesh and are permanent. Some are made out of
fabric. These are called stent grafts and are often used for larger arteries. Others are made of a
material that dissolves and that your body absorbs over time. They're coated in medicine that
slowly releases into your artery to prevent it from being blocked again.

Doctor usually inserts a stent using a minimally invasive procedure. They will make a small
incision and use a catheter to guide specialized tools through your blood vessels to reach the area
that needs a stent. This incision is usually in the groin or arm. One of those tools may have a
camera on the end to help your doctor guide the stent. During the procedure, doctor may also use
an imaging technique called an angiogram to help guide the stent through the vessel.
Using the necessary tools, doctor will locate the broken or blocked vessel and install the stent.
Then they will remove the instruments from your body and close the incision.

Stent in Coronary artery

Source: Mayo Foundation

Pacemaker:
A pacemaker is a small device that's placed (implanted) in the chest to help control the heartbeat.
It's used to prevent the heart from beating too slowly. Implanting a pacemaker in the chest
requires a surgical procedure.
A pacemaker is implanted to help control your heartbeat. Your doctor may recommend a
temporary pacemaker when you have a slow heartbeat (bradycardia) after a heart attack, surgery
or medication overdose but your heartbeat is otherwise expected to recover. A pacemaker may be
implanted permanently to correct a chronic slow or irregular heartbeat or to help treat heart
failure.
Pacemakers work only when needed. If your heartbeat is too slow (bradycardia), the pacemaker
sends electrical signals to your heart to correct the beat.
Some newer pacemakers also have sensors that detect body motion or breathing rate and signal
the devices to increase heart rate during exercise, as needed.
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Lungs as a purification system:

Introduction:
The respiratory system's main job is to move fresh air into our body while removing waste gases.
The human lungs are a critical part of the respiratory system, responsible for gas exchange—
primarily oxygen intake and carbon dioxide expulsion. They can be viewed as a biological
purification system, filtering the air we breathe and maintaining the body's homeostasis.

Lungs help in the purification of blood. Arteries carry pure oxygenated blood from the heart to
other parts of the body. Veins carry impure venous blood back from other parts of the body to the
right side of the heart. This impure blood goes to the lungs for purification. Our lungs and the
respiratory system automatically perform this vital process, called gas exchange. When the breath
is inhaled, oxygen from the air comes in contact with the impure blood and the blood takes up
oxygen. The waste matter in the blood releases carbonic acid and the blood is purified. The
purified blood is carried to the heart by the pulmonary veins.

The primary function of the lungs is gas exchange. However, the lungs perform several important
non-respiratory functions that are vital for normal physiology, these include:

 Bringing air to the proper body temperature and moisturizing it to the right humidity level.
 Protecting our body from harmful substances. This is done by coughing, sneezing,
filtering, or swallowing them.
 Supporting our sense of smell.

Architecture/Anatomy of the lungs:

Structure: The lungs are divided into lobes; the right lung has three lobes, and the left lung has
two lobes.
Bronchial tree: Air enters through the trachea, which splits into the bronchi, bronchioles, and
finally into the alveoli where gas exchange occurs.
Alveoli: Tiny sacs surrounded by capillaries where oxygen and carbon dioxide exchange takes
place.

Source: Physiopedia
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Function of the lungs:

Gas exchange:
Air enters the body through the nose or mouth and quickly moves to the pharynx or throat. From
there, it passes through the larynx, or voice box, and enters the trachea. The trachea is a strong
tube that contains rings of cartilage that prevent it from collapsing. Within the lungs, the trachea
branches into a left and right bronchus. These further divide into smaller and smaller branches
called bronchioles. The smallest bronchioles end in tiny air sacs. These are called alveoli. They
inflate when a person inhales and deflate when a person exhales.

During the gas exchange, oxygen from inhaled air diffuses through the alveolar walls into the
blood. At the same time, carbon dioxide from the blood diffuses into the alveoli. This happens in
the lungs between the alveoli and a network of tiny blood vessels called capillaries, which are
located in the walls of the alveoli. The walls of the alveoli share a membrane with the capillaries.
That's how close they are. This lets oxygen and carbon dioxide diffuse, or move freely, between
the respiratory system and the bloodstream.

Oxygen molecules attach to red blood cells, which travel back to the heart. At the same time, the
carbon dioxide molecules in the alveoli are blown out of the body the next time a person exhales.
The gas exchange allows the body to replenish the oxygen and eliminate carbon dioxide. Doing
both is necessary for survival.
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Filtration of air:
Nasal cavity filters large particles via hairs and mucous. Mucous traps smaller particles; cilia
move the mucous upwards to the throat for expulsion. Alveolar macrophages engulf and digest
pathogens and particles that reach the alveoli.

Mechanisms of purification:
1. Mechanical filtration: Physical barriers (nasal hairs, mucous) trap dust, pollen and other
particulates. The trachea and bronchi have a lining of mucous to trap smaller particles.
2. Biological filtration: Macrophages in the alveoli engulf bacteria, dust, and other small
particles. The immune system responds to and destroys pathogens.
3. Chemical processes: Enzymes in the respiratory tract neutralize harmful chemicals. Cells
lining the respiratory tract can metabolize some inhaled substances.

Comparison with artificial systems:

1. Filters in HVAC (heating, ventilation and air conditioning) systems: Similar to nasal hairs
and mucous, HVAC systems use filters to remove particulates from the air.

2. Air purifiers: Utilize HEPA (high efficiency particulate air) filters, UV light, and activated
carbon to remove particulates, microbes, and chemicals, analogous to the combined mechanical,
biological, and chemical filtration of the lungs.

Engineering perspectives:
1. Efficiency of gas exchange
 Surface area of alveoli (~70 square meters) maximizes gas exchange efficiency.
 Engineers design systems (e.g., catalytic converters, industrial scrubbers) to maximize
surface area for reactions.
2. Redundancy and robustness
 Lungs have multiple pathways (bronchioles) ensuring functionality even if some are
blocked.
 Engineering systems often incorporate redundancy to enhance reliability (e.g., multiple
filters in parallel).
3. Self-cleaning mechanisms
 The mucociliary escalator and macrophages are similar to self-cleaning mechanisms in
machines (e.g., self-cleaning filters).
 Engineers can design systems with automatic cleaning or maintenance schedules.
4. Adaptation to environment
 Lungs can adapt to different environmental conditions (e.g., high altitude) by adjusting the
efficiency of gas exchange.
 Adaptive control systems in engineering adjust operating parameters based on
environmental inputs.

Spirometry:
Spirometry (spy-ROM-uh-tree) is a common office test used to assess how well our lungs work by
measuring how much air inhaled, how much is exhaled, and how quickly it is exhaled.
Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD), and other
conditions that affect breathing.
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COPD:
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus
(sputum) production, and wheezing.

It's typically caused by long-term exposure to irritating gases or particulate matter, most often
from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung
cancer, and a variety of other conditions.
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Symptoms:
COPD symptoms often don't appear until significant lung damage has occurred, and they usually
worsen over time, particularly if smoking exposure continues.

Signs and symptoms of COPD may include:

 Shortness of breath, especially during physical activities
 Wheezing
 Chest tightness
 A chronic cough that may produce mucus (sputum) that may be clear, white, yellow, or
greenish
 Frequent respiratory infections
 Lack of energy
 Unintended weight loss (in later stages)
 Swelling in ankles, feet, or legs

Tests may include:

 Lung (pulmonary) function tests.
 Chest X-ray.
 CT scan.
 Arterial blood gas analysis.
 Laboratory tests.

Medications:
Several kinds of medications are used to treat the symptoms and complications of COPD. You
may take some medications regularly and others as needed.
 Bronchodilators
 Inhaled steroids
 Combination inhalers
 Oral steroids
 Phosphodiesterase-4 inhibitors
 Theophylline
 Antibiotics

Mechanical ventilation is a lifesaving therapy in patients who have acute respiratory failure due to
chronic obstructive pulmonary disease (COPD). Mechanical ventilation either invasive or non-
invasive has an important role in the management of acute exacerbation of COPD (AECOPD).

Ventilator:
Mechanical ventilators are machines that act as bellows to move air in and out of lungs.
Respiratory therapist and doctor set the ventilator to control how often it pushes air into lungs and
how much air to get. Patient may be fitted with a mask to get air from the ventilator into lungs or
may need a breathing tube if breathing problem is more serious. When patient is ready to be taken
off the ventilator, healthcare team will ―wean‖ or decrease the ventilator support until patient can
start breathing on his/her own.
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Kidney as a filtration system:

Introduction:
The kidneys are vital organs in the human body responsible for homeostasis, filtering blood,
removing waste products, balancing fluids, electrolytes and pH levels. Each kidney contains
around one million nephrons, which are the functional units of the kidney responsible for actual
filtration and purification of blood.

Kidneys also make hormones that help

 Control blood pressure.
 Make red blood cells.
 Keeps bones strong and healthy.

The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below
the rib cage, one on each side of the spine. Healthy kidneys filter about a half cup of blood every
minute, removing wastes and extra water to make urine. The urine flows from the kidneys to the
bladder through two thin tubes of muscle called ureters, one on each side of the bladder. Kidneys,
ureters, and bladder are part of our urinary tract.

Source: Hans Bachofen

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Architecture/Anatomy of the Kidney:

1. Cortex: The outer part of the kidney where most filtration occurs.
2. Medulla: The inner region containing the renal pyramids, which are involved in the
concentration of urine.
3. Renal Pelvis: A funnel-shaped structure that collects urine and channels it to the ureter.

Kidney structure Source: Byju’s

The Nephron - Functional unit of the Kidney:

Each nephron consists of:

 Glomerulus: A network of capillaries where blood filtration begins.

 Bowman's capsule: Surrounds the glomerulus and collects the filtrate.
 Proximal convoluted tubule (PCT): Reabsorbs nutrients, ions, and water from the
filtrate.
 Loop of Henle: Creates a concentration gradient in the medulla, aiding in water
reabsorption.
 Distal convoluted tubule (DCT): Further adjusts the composition of the filtrate.
 Collecting Duct: Final adjustment of urine concentration and channelling urine to the
renal pelvis.
 Sambhram institute of Technology – Biology for Engineers (CSE)

The Nephron

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Mechanism of filtration:
 Each kidney is made up of about a million filtering units called nephrons.
 Each nephron includes a filter, called the glomerulus (secured in a cup-like structure called
Bowman’s capsule), and a tubule.
 The nephrons work through a two-step process: the glomerulus filters blood, and the tubule
returns needed substances to blood and removes wastes and extra water as urine.
 As blood flows into each nephron, it enters a cluster of tiny blood vessels, the glomerulus.
 The thin walls of the glomerulus allow water, ions, glucose, amino acids and waste products to
pass into the tubule (this is called filtrate).
 Larger molecules, such as proteins and blood cells, stay in the blood vessel.
 A blood vessel runs alongside the tubule. As the filtrate passes through the tubule (Proximal
convoluted tubule – PCT), the blood vessel reabsorbs almost all of the water, along with
essential substances like glucose, amino acids, minerals and nutrients need by the body.
 The remaining fluid and wastes in the tubule become urine.

How does blood flow through our kidneys?

 Blood flows into the kidney through the renal artery.
 This large blood vessel branches into smaller and smaller blood vessels until the blood reaches
the nephrons.
 Sambhram institute of Technology – Biology for Engineers (CSE)

 In the nephron, blood is filtered by the tiny blood vessels of the glomeruli and then flows out of
the kidney through the renal vein.
 Blood circulates through our kidneys many times a day.
 In a single day, kidneys filter about 150 quarts of blood (~140 litres).
 Most of the water and other substances that filter through glomeruli are returned to the blood
by the tubules.
 Only 1 to 2 quarts become urine.

Waste products excreted by the kidney:

 Urea: A by-product of protein metabolism.
 Creatinine: From muscle metabolism.
 Uric Acid: From nucleic acid metabolism.
 Ions: Excess potassium, sodium, and chloride.

Importance of kidney filtration

 Removal of Waste: Prevents toxic accumulation in the body.
 Fluid and electrolyte balance: Maintains homeostasis.
 Acid-base balance: Regulates pH of blood.
 Blood pressure regulation: Via RAAS (Renin-Angiotensin-Aldosterone System) and
other mechanisms.

Chronic kidney disease occurs when a disease or condition impairs kidney function, causing
kidney damage to worsen over several months or years.

Chronic Kidney Diseases:

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to
keep you healthy by filtering wastes from your blood. If kidney disease worsens, wastes can build
to high levels in your blood and make you feel sick. You may develop complications like

 High blood pressure

 Diabetes
 Anaemia (low blood count)
 Weak bones
 Poor nutritional health
 Nerve damage

Symptoms:
People with CKD may not feel ill or notice any symptoms initially. The only way to find out for
sure if you have CKD is through specific blood and urine tests. These tests include the
measurement of both the serum Creatinine level in the blood and the protein in the urine.

Treatment:
Depending on the cause, some types of kidney disease can be treated. Often, though, chronic
kidney disease has no cure. Treatment usually consists of measures to help control signs and
symptoms, reduce complications, and slow the progression of the disease. If your kidneys become
severely damaged, you might need treatment for end-stage kidney disease.

Dialysis:
Dialysis is a procedure to remove waste products and excess fluid from the blood when the
kidneys stop working properly. It often involves diverting blood to a machine to be cleaned.
 Sambhram institute of Technology – Biology for Engineers (CSE)

There are 2 main types of dialysis:

 Haemodialysis involves diverting blood into an external machine, where it's filtered before
being returned to the body
 Peritoneal dialysis involves pumping dialysis fluid into the space inside your abdomen
(tummy) to draw out waste products from the blood passing through vessels lining the inside of
the abdomen.