Created by CK-12 Foundation/Adapted by Christine Miller

Did you ever hear of a person looking at something or someone with a “jaundiced eye”? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.

Accessory organs of digestion are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the liver, the major accessory organs of digestion are the gallbladder and pancreas. These organs secrete or store substances that are needed for digestion in the first part of the small intestine — the duodenum — where most chemical digestion takes place. You can see the three organs and their locations in Figure 15.6.2.

Liver

The liver is a vital organ located in the upper right part of the abdomen. It lies just below the diaphragm, to the right of the stomach. The liver plays an important role in digestion by secreting bile, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.

Structure of the Liver

The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.

As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.

Functions of the Liver

The main digestive function of the liver is the production of bile. Bile is a yellowish alkaline liquid that consists of water, electrolytes, bile salts, and cholesterol, among other substances, many of which are waste products. Some of the components of bile are synthesized by hepatocytes. The rest are extracted from the blood.

As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.

Besides its roles in digestion, the liver has many other vital functions:

• The liver synthesizes glycogen from glucose and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.
• The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the minerals iron and copper.
• The liver synthesizes numerous proteins and many of the amino acids needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.
• The liver synthesizes many important lipids, including cholesterol, triglycerides, and lipoproteins.
• The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the kidneys, which excrete them in urine.

The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic location and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.

The gallbladder is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.

Pancreas

The pancreas is a glandular organ that is part of both the digestive system and the endocrine system. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.

As an endocrine gland, the pancreas secretes several hormones, including insulin and glucagon, which circulate in the blood. The endocrine hormones are secreted by clusters of cells called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive enzymes and also bicarbonate, which helps neutralize acidic chyme after it enters the duodenum. The pancreas is stimulated to secrete its digestive substances when food in the stomach and duodenum triggers the release of endocrine hormones into the blood that reach the pancreas via the bloodstream. The pancreatic digestive enzymes are secreted by clusters of cells called acini, and they travel through the pancreatic ducts to the duodenum. In the duodenum, they help to chemically break down carbohydrates, proteins, lipids, and nucleic acids in chyme. The pancreatic digestive enzymes include:

• Amylase, which helps digest starch and other carbohydrates.
• Trypsin and chymotrypsin, which help digest proteins.
• Lipase, which helps digest lipids.
• Deoxyribonucleases and ribonucleases, which help digest nucleic acids.

 

Attributions

Figure 15.6.1

Scleral_Icterus by Sheila J. Toro on Wikimedia Commons is used under a  CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 15.6.2

Blausen_0428_Gallbladder-Liver-Pancreas_Location by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 15.6.3

Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg by Cancer Research UK on Wikimedia Commons is used under a CC BY-SA 4.0  (https://creativecommons.org/licenses/by-sa/4.0) license.

Figure 15.6.4

Gallbladder by NIH Image Gallery on Flickr is used CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Figure 15.6.5

Gallbladder_(organ) (1) by BruceBlaus on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0) license. (See a full animation of this medical topic at blausen.com.)

Figure 15.6.6

Blausen_0698_PancreasAnatomy by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

References

Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https://www.youtube.com/watch?v=a0d1yvGcfzQ&feature=youtu.be

TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=wbh3SjzydnQ&feature=youtu.be

TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=8dgoeYPoE-0&feature=youtu.be

The central nervous system organ inside the skull that is the control center of the nervous system.

Created by CK-12 Foundation

You probably recognize the colourful object in this photo (Figure 7.6.1) as a human brain. The brain is arguably the most important organ in the human body. Fortunately for us, the brain has its own special “container,” called the cranial cavity. The cranial cavity enclosing the brain is just one of several cavities in the human body that form “containers” for vital organs.

The human body, like that of many other multicellular organisms, is divided into a number of body cavities. A body cavity is a fluid-filled space inside the body that holds and protects internal organs. Human body cavities are separated by membranes and other structures. The two largest human body cavities are the ventral cavity and dorsal cavity. These two body cavities are subdivided into smaller body cavities. Both the dorsal and ventral cavities and their subdivisions are shown in the Figure 7.6.2 diagram.

The ventral cavity is at the anterior (or front) of the trunk. Organs contained within this body cavity include the lungs, heart, stomach, intestines, and reproductive organs. The ventral cavity allows for considerable changes in the size and shape of the organs inside as they perform their functions. Organs such as the lungs, stomach, or uterus, for example, can expand or contract without distorting other tissues or disrupting the activities of nearby organs.

The ventral cavity is subdivided into the thoracic and abdominopelvic cavities.

• The thoracic cavity fills the chest and is subdivided into two pleural cavities and the pericardial cavity. The pleural cavities hold the lungs, and the pericardial cavity holds the heart.
• The abdominopelvic cavity fills the lower half of the trunk and is subdivided into the abdominal cavity and the pelvic cavity. The abdominal cavity holds digestive organs and the kidneys, and the pelvic cavity holds reproductive organs and organs of excretion.

The dorsal cavity is at the posterior (or back) of the body, including both the head and the back of the trunk. The dorsal cavity is subdivided into the cranial and spinal cavities.

• The cranial cavity fills most of the upper part of the skull and contains the brain.
• The spinal cavity is a very long, narrow cavity inside the vertebral column. It runs the length of the trunk and contains the spinal cord.

The brain and spinal cord are protected by the bones of the skull and the vertebrae of the spine. They are further protected by the meninges, a three-layer membrane that encloses the brain and spinal cord. A thin layer of cerebrospinal fluid is maintained between two of the meningeal layers. This clear fluid is produced by the brain, and it provides extra protection and cushioning for the brain and spinal cord.

The meninges membranes that protect the brain and spinal cord inside their cavities may become inflamed, generally due to a bacterial or viral infection. This condition is called meningitis, and it can lead to serious long-term consequences such as deafness, epilepsy, or cognitive deficits, especially if not treated quickly. Meningitis can also rapidly become life-threatening, so it is classified as a medical emergency.

Learning the symptoms of meningitis may help you or a loved one get prompt medical attention if you ever develop the disease. Common symptoms include fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit less specific symptoms, such as irritability, drowsiness, or poor feeding.

Meningitis is diagnosed with a lumbar puncture (commonly known as a "spinal tap"), in which a needle is inserted into the spinal canal to collect a sample of cerebrospinal fluid. The fluid is analyzed in a medical lab for the presence of pathogens. If meningitis is diagnosed, treatment consists of antibiotics and sometimes antiviral drugs. Corticosteroids may also be administered to reduce inflammation and the risk of complications (such as brain damage). Supportive measures such as IV fluids may also be provided.

Some types of meningitis can be prevented with a vaccine. Ask your health care professional whether you have had the vaccine or should get it. Giving antibiotics to people who have had significant exposure to certain types of meningitis may reduce their risk of developing the disease. If someone you know is diagnosed with meningitis and you are concerned about contracting the disease yourself, see your doctor for advice.

Attributions

Figure 7.6.1

Brain Lobes by John A Beal, Department of Cellular Biology & Anatomy, Louisiana State University Health Sciences Center Shreveport on Wikimedia Commons is used under a CC BY 2.5 (https://creativecommons.org/licenses/by/2.5/deed.en) license.

Figure 7.6.2

body_cavities-en.svg by Mysid (SVG) on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain). (Original by US National Cancer Institute [NCI].)

References

Mayo Clinic Staff. (n.d.). Meningitis. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508

TED-Ed. (2018, November 19). Why is meningitis so dangerous? - Melvin Sanicas. YouTube. https://www.youtube.com/watch?v=IaQdv_dBDqM&feature=youtu.be

 

Created by CK-12/Adapted by Christine Miller

As you read in the beginning of this chapter, new parents Samantha and Aki left their pediatrician’s office still unsure whether or not to vaccinate baby James. Dr. Rodriguez gave them a list of reputable sources where they could look up information about the safety of vaccines, including the Centers for Disease Control and Prevention (CDC). Samantha and Aki read that the consensus within the scientific community is that there is no link between vaccines and autism. They find a long list of studies published in peer-reviewed scientific journals that disprove any link. Additionally, some of the studies are “meta-analyses” that analyzed the findings from many individual studies. The new parents are reassured by the fact that many different researchers, using a large number of subjects in numerous well-controlled and well-reviewed studies, all came to the same conclusion.

Samantha also went back to the web page that originally scared her about the safety of vaccines. She found that the author was not a medical doctor or scientific researcher, but rather a self-proclaimed “child wellness expert.” He sold books and advertising on his site, some of which were related to claims of vaccine injury. She realized that he was both an unqualified and potentially biased source of information.

Samantha also realized that some of his arguments were based on correlations between autism and vaccines, but, as the saying goes, “correlation does not imply causation.” For instance, the recent rise in autism rates may have occurred during the same time period as an increase in the number of vaccines given in childhood, but Samantha could think of many other environmental and social factors that have also changed during this time period. There are just too many variables to come to the conclusion that vaccines, or anything else, are the cause of the rise in autism rates based on that type of argument alone. Also, she learned that the age of onset of autism symptoms happens to typically be around the time that the MMR vaccine is first given, so the apparent association in the timing may just be a coincidence.

Finally, Samantha came across news about  a measles outbreak in Vancouver, British Columbia in the winter of 2019. Measles wasn’t just a disease of the past! She learned that measles and whooping cough, which had previously been rare thanks to widespread vaccinations, are now on the rise, and that people choosing not to vaccinate their children seems to be one of the contributing factors. She realized that it is important to vaccinate her baby against these diseases, not only to protect him from their potentially deadly effects, but also to protect others in the population.

In their reading, Samantha and Aki learn that scientists do not yet know the causes of autism, but they feels reassured by the abundance of data that disproves any link with vaccines. Both parents think that the potential benefits of protecting their baby’s health against deadly diseases outweighs any unsubstantiated claims about vaccines. They will be making an appointment to get baby James his shots soon.

Attribution

Figure 1.8.1

[Photo of person sitting in front of personal computer] by Avel Chuklanov on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Image shows a diagram of the negative feedback loops that maintain homeostasis of body temperature. When body temperature falls, blood vessels constrict so that heat is conserved, sweat glands do not secrete fluid, and shivering generates body heat, which warms the body. When body temperature rises, blood vessels dilate, resulting in heat loss to the environment, sweat glands release fluid and as the fluid evaporates, heat is lost from the body.

Groups of connected cells form tissues. The cells in a tissue may all be the same type, or they may be of multiple types. In either case, the cells in the tissue work together to carry out a specific function, and they are always specialized to be able to carry out that function better than any other type of tissue.  There are four main types of human tissues: connective, epithelial, muscle, and nervous tissues. We use tissues to build organs and organ systems.  The 200 types of cells that the body can produce based on our single set of DNA can create all the types of tissue in the body.

Epithelial Tissue

Epithelial tissue is made up of cells that line inner and outer body surfaces, such as the skin and the inner surface of the digestive tract. Epithelial tissue that lines inner body surfaces and body openings is called mucous membrane. This type of epithelial tissue produces mucus, a slimy substance that coats mucous membranes and traps pathogens, particles, and debris. Epithelial tissue protects the body and its internal organs, secretes substances (such as hormones) in addition to mucus, and absorbs substances (such as nutrients).

The key identifying feature of epithelial tissue is that it contains a free surface and a basement membrane.  The free surface is not attached to any other cells and is either open to the outside of the body, or is open to the inside of a hollow organ or body tube.  The basement membrane anchors the epithelial tissue to underlying cells.

Epithelial tissue is identified and named by shape and layering.  Epithelial cells exist in three main shapes: squamous, cuboidal, and columnar.  These specifically shaped cells can, depending on function, be layered several different ways: simple, stratified, pseudostratified, and transitional.

Epithelial tissue forms coverings and linings and is responsible for a range of functions including diffusion, absorption, secretion and protection.  The shape of an epithelial cell can maximize its ability to perform a certain function.  The thinner an epithelial cell is, the easier it is for substances to move through it to carry out diffusion and/or absorption.  The larger an epithelial cell is, the more room it has in its cytoplasm to be able to make products for secretion, and the more protection it can provide for underlying tissues. Their are three main shapes of epithelial cells: squamous (which is shaped like a pancake- flat and oval), cuboidal (cube shaped), and columnar (tall and rectangular).

Figure 7.4.2 The shape of epithelial tissues is important.  

Epithelial tissue will also organize into different layerings depending on their function.  For example, multiple layers of cells provide excellent protection, but would no longer be efficient for diffusion, whereas a single layer would work very well for diffusion, but no longer be as protective; a special type of layering called transitional is needed for organs that stretch, like your bladder.  Your tissues exhibit the layering that makes them most efficient for the function they are supposed to perform. There are four main layerings found in epithelial tissue: simple (one layer of cells), stratified (many layers of cells), pseudostratified (appears stratified, but upon closer inspection is actually simple), and transitional (can stretch, going from many layers to fewer layers).

Figure 7.4.3 The layerings found in epithelial tissues is important.  

See Table 7.4.1 for a summary of the different layering types and shapes epithelial cells can form and their related functions and locations.

Table 7.4.1

Summary of Epithelial Tissue Cells

So far, we have identified epithelial tissue based on shape and layering.  The representative diagrams we have seen so far are helpful for visualizing the tissue structures, but it is important to look at real examples of these cells.  Since cells are too tiny to see with the naked eye, we rely on microscopes to help us study them.  Histology is the study of the microscopic anatomy and cells and tissues.  See Table 7.4.2 to see some examples of slides of epithelial tissues prepared for the purpose of histology.

Table 7.4.2

Epithelial Tissues and Histological Samples

 

Epithelial Tissue Type	Tissue Diagram	Histological Sample
Stratified squamous (from skin)
Simple cuboidal (from kidney tubules)
Pseudostratified ciliated columnar (from trachea)

Connective Tissue

Bone and blood are examples of connective tissue. Connective tissue is very diverse. In general, it forms a framework and support structure for body tissues and organs. It's made up of living cells separated by non-living material, called extracellular matrix, which can be solid or liquid. The extracellular matrix of bone, for example, is a rigid mineral framework. The extracellular matrix of blood is liquid plasma.

The key identifying feature of connective tissue is that is is composed of a scattering of cells in a non-cellular matrix. There are three main categories of connective tissue, based on the nature of the matrix. They  look very different from one another, which is a reflection of their different functions:

1. Fibrous connective tissue: is characterized by a matrix which is flexible and is made of protein fibres including collagen, elastin and possibly reticular fibres.  These tissues are found making up tendons, ligaments, and body membranes.
2. Supportive connective tissue: is characterized by a solid matrix and is what is used to make bone and cartilage.  These tissues are used for support and protection.
3. Fluid connective tissue: is characterized by a fluid matrix and includes both blood and lymph.

Fibrous Connective Tissue

Fibrous connective tissue contains cells called fibroblasts.  These cells produce fibres of collagen, elastin, or reticular fibre which makes up the matrix of this type of connective tissue.  Based on how tightly packed these fibres are and how they are oriented changes the properties, and therefore the function of the fibrous connective tissue.

 

• Loose fibrous connective tissue:  composed of a loose and disorganized weave of collagen and elastin fibres, creating a tissue that is thin and flexible, yet still tough.  This tissue, which is also sometimes referred to as "areolar tissue", is found in membranes and surrounding blood vessels and most body organs.  As you can see from the diagram in Figure 7.4.4, loose fibrous connective tissue fulfills the definition of connectives tissue since it is a scattering of cells (fibroblasts) in a non-cellular matrix (a mesh of collagen and elastin fibres).  There are two types of specialized loose fibrous connective tissue: reticular and adipose.  Adipose tissue stores fat and reticular tissue forms the spleen and lymph nodes.
  
• Dense Fibrous Connective Tissue: composed of a dense mat of parallel collagen fibres and a scattering of fibroblasts, creating a tissue that is very strong.  Dense fibrous connective tissue forms tendons and ligaments, which connect bones to muscles and/or bones to neighbouring bones.
  

Supportive Connective Tissue

Supportive connective tissue exhibits the defining feature of connective tissue in that it is a scattering of cells in a non-cellular matrix; what sets it apart from other connective tissues is its solid matrix.  In this tissue group, the matrix is solid- either bone or cartilage.  While fibrous connective tissue contained cells called fibroblasts which produced fibres, supportive connective tissue contains cells that either create bone (osteocytes) or cells that create cartilage (chondrocytes).

Cartilage

Chondrocytes produce the cartilage matrix in which they reside.  Cartilage is made up of protein fibres and chondrocytes in lacunae.  This is tissue is strong yet flexible and is used many places in the body for protection and support.  Cartilage is one of the few tissues that is not vascular (doesn't have a direct blood supply) meaning it relies on diffusion to obtain nutrients and gases; this is the cause of slow healing rates in injuries involving cartilage.  There are three main types of cartilage:

• Hyaline cartilage: a smooth, strong and flexible tissue.  Found at the ends of ribs and long bones, in the nose, and comprising the entire fetal skeleton.
• Fibrocartilage: a very strong tissue containing thick bundles of collagen.  Found in joints that need cushioning from high impact (knees, jaw).
• Elastic cartilage: contains elastic fibres in addition to collagen,  giving support with the benefit of elasticity.  Found in earlobes and the epiglottis.
  

  

Bone

Osteocytes produce the bone matrix in which they reside.  Since bone is very solid, these cells reside in small spaces called lacunae.  This bone tissue is composed of collagen fibres embedded in calcium phosphate giving it strength without brittleness.  There are two types of bone: compact and spongy.

• Compact bone: has a dense matrix organized into cylindrical units called osteons.  Each osteon contains a central canal (sometimes called a Harversian Canal) which allows for space for blood vessels and nerves, as well as concentric rings of bone matrix and osteocytes in lacunae, as per the diagram here.  Compact bone is found in long bones and forms a shell around spongy bone.

• Spongy bone: a very porous type of bone which most often contains bone marrow.  It is found at the end of long bones, and makes up the majority of the ribs, shoulder blades and flat bones of the cranium.

Fluid Connective Tissue

Fluid connective tissue has a matrix that is fluid; unlike the other two categories of connective tissue, the cells that reside in the matrix do not actually produce the matrix. Fibroblasts make the fibrous matrix, chondrocytes make the cartilaginous matrix, osteocytes make the bony matrix, yet blood cells do not make the fluid matrix of either lymph or plasma.  This tissue still fits the definition of connective tissue in that it is still a scattering of cells in a non-cellular matrix.

There are two types of fluid connective tissue:

• Blood: blood contains three types of cells suspended in plasma, and is contained in the cardiovascular system.
  • Eryththrocytes, more commonly called red blood cells, are present in high numbers (roughly 5 million cells per mL) and are responsible for delivering oxygen from to the lungs to all the other areas of the body. These cells are relatively small in size with a diameter of around 7 micrometres and live no longer than 120 days.
  • Leukocytes, often referred to as white blood cells, are present in lower numbers (approximately 5 thousand cells per mL) are responsible for various immune functions.  They are typically larger than erythrocytes, but can live much longer, particularly white blood cells responsible for long term immunity.  The number of leukocytes in your blood can go up or down based on whether or not you are fighting an infection.
  • Thrombocytes, also known as platelets, are very small cells responsible for blood clotting.  Thrombocytes are not actually true cells, they are fragments of a much larger cell called a megakaryocyte.
• Lymph: contains a liquid matrix and white blood cells and is contained in the lymphatic system, which ultimately drains into the cardiovascular system.

Figure 7.4.11 A stained lymphocyte surrounded by red blood cells viewed using a light microscope. 

Muscular Tissue

Muscular tissue is made up of cells  that have the unique ability to contract- which is the defining feature of muscular tissue.  There are three major types of muscle tissue, as pictured in Figure 7.4.12 skeletal, smooth, and cardiac muscle tissues.

Skeletal Muscle

Skeletal muscles are voluntary muscles, meaning that you exercise conscious control over them.  Skeletal muscles are attached to bones by tendons, a type of connective tissue. When these muscles shorten to pull on the bones to which they are attached, they enable the body to move. When you are exercising, reading a book, or making dinner, you are using skeletal muscles to move your body to carry out these tasks.

Under the microscope, skeletal muscles are striated (or striped) in appearance, because of their internal structure which contains alternating protein fibres of actin and myosin.  Skeletal muscle is described as multinucleated, meaning one "cell" has many nuclei.  This is because in utero, individual cells destined to become skeletal muscle fused, forming muscle fibres in a process known as myogenesis.  You will learn more about skeletal muscle and how it contracts in the Muscular System.

Smooth Muscle

Smooth muscles are nonstriated muscles- they still contain the muscle fibres actin and myosin, but not in the same alternating arrangement seen in skeletal muscle.   Smooth muscle is found in the tubes of the body - in the walls of blood vessels and in the reproductive, gastrointestinal, and respiratory tracts. Smooth muscles are not under voluntary control meaning that they operate unconsciously, via the autonomic nervous system.  Smooth muscles move substances through a wave of contraction which cascades down the length of a tube, a process termed peristalsis. 

Watch the YouTube video "What is Peristalsis" by Mister Science to see peristalsis in action.

https://www.youtube.com/watch?v=kVjeNZA5pi4

What is Peristalsis, Mister Science, 2018.

 

 

Cardiac Muscle

Cardiac muscles work involuntarily, meaning they are regulated by the autonomic nervous system.  This is probably a good thing, since you wouldn't want to have to consciously concentrate on keeping your heart beating all the time! Cardiac muscle, which is found only in the heart, is mononucleated and striated (due to alternating bands of myosin and actin). Their contractions cause the heart to pump blood. In order to make sure entire sections of the heart contract in unison, cardiac muscle tissue contains special cell junctions called intercalated discs, which conduct the electrical signals used to "tell" the chambers of the heart when to contract.

Nervous Tissue

Nervous tissue is made up of neurons and a group of cells called neuroglia (also known as glial cells).  Nervous tissue makes up the central nervous system (mainly the brain and spinal cord) and peripheral nervous system (the network of nerves that runs throughout the rest of the body).  The defining feature of nervous tissue is that it is specialized to be able to generate and conduct nerve impulses.  This function is carried out by neurons, and the purpose of neuroglia is to support neurons.

A neuron has several parts to its structure:

• Dendrites which collect incoming nerve impulses
• A cell body, or soma, which contains the majority of the neuron's organelles, including the nucleus
• An axon, which carries nerve impulses away from the soma, to the next neuron in the chain
• A myelin sheath, which encases the axon and increases that rate at which nerve impulses can be conducted
• Axon terminals, which maintain physical contact with the dendrites of neighbouring neurons

 

Attributions

Figure 7.4.1

• Construction man kneeling in front of wall by Charles Deluvio on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Beige wooden frame by Charles Deluvio on Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Tambour on green by Pierre Châtel-Innocention Unsplash is used under the Unsplash License (https://unsplash.com/license).
• Tags: Construction Studs Plumbing Wiring by JWahl on Pixabay is used under the Pixabay License (https://pixabay.com/es/service/license/).

Figure 7.4.2 and Figure 7.4.3

• Simple columnar epithelium tissue by Kamil Danak on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license. 
• Simple cuboidal epithelium by Kamil Danak on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.
• Simple squamous epithelium by Kamil Danak on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license. 

Figure 7.4.4

Loose fibrous connective tissue by CNX OpenStax. Biology. on Wikimedial Commons is used under a CC BY 4.0. (https://creativecommons.org/licenses/by/4.0) license.

Figure 7.4.5

Connective Tissue: Loose Aerolar by Berkshire Community College Bioscience Image Library on Flickr is used under a CC0 1.0 Universal public domain dedication (https://creativecommons.org/publicdomain/zero/1.0/) license.

Figure 7.4.6

Dense Fibrous Connective Tissue by by CNX OpenStax. Biology. on Wikimedial Commons is used under a CC BY 4.0. (https://creativecommons.org/licenses/by/4.0) license.

Figure 7.4.7

Dense_connective_tissue-400x by J Jana on Wikimedia Commons is used under a  CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en) license.

Figure 7.4.8

Types_of_Cartilage-new by OpenStax College on Wikipedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license. 

Figure 7.4.9

Compact_bone_histology_2014 by Athikhun.suw on Wikimedia Commons is used under a  CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en) license.

Figure 7.4.10

Bone_normal_and_degraded_micro_structure by Gtirouflet on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.

Figure 7.4.11

Lymphocyte2 by NicolasGrandjean on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.  [No machine-readable author provided. NicolasGrandjean is assumed, based on copyright claims.]

Figure 7.4.12

Skeletal_muscle_横纹肌1 by 乌拉跨氪 on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en) license.

Figure 7.4.13

Smooth_Muscle_new by OpenStax on Wikimedia Commons is used under a CC BY 4.0  (https://creativecommons.org/licenses/by/4.0/deed.en) license.

Figure 7.4.14

Peristalsis by OpenStax on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0/deed.en) license.

Figure 7.4.15

400x Cardiac Muscle by Jessy731 on Flickr is used and adapted by Christine Miller under a CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Figure 7.4.16

Neuron.svg by User:Dhp1080 on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license.

Figure 7.4.17

400x Nervous Tissue  by Jessy731 on Flickr is used under a CC BY-NC 2.0 (https://creativecommons.org/licenses/by-nc/2.0/) license.

Table 7.4.1

Summary of Epithelial Tissue Cells, by OpenStax College on Wikipedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license. 

Table 7.4.2

• Epithelial_Tissues_Stratified_Squamous_Epithelium_(40230842160) by
  Berkshire Community College Bioscience Image Library on Wikimedia Commons is used under a  CC0 1.0 Universal Public Domain Dedication (https://creativecommons.org/publicdomain/zero/1.0/) license.
• Simple cuboidal epithelial tissue histology by Berkshire Community College on Flickr is used under a  CC0 1.0 Universal Public Domain Dedication (https://creativecommons.org/publicdomain/zero/1.0/) license.
• Pseudostratified_Epithelium by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 4.8 Summary of epithelial tissue cells [digital image].  In Anatomy and Physiology (Section 4.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/4-2-epithelial-tissue

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 4.16 Types of cartilage [digital image].  In Anatomy and Physiology (Section 4.3). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/4-3-connective-tissue-supports-and-protects

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 10.23 Smooth muscle [digital micrograph].  In Anatomy and Physiology (Section 10.8). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-8-smooth-muscle (Micrograph provided by the Regents of University of Michigan Medical School © 2012)

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 22.5 Pseudostratified ciliated columnar epithelium [digital micrograph].  In Anatomy and Physiology (Section 22.1). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/22-1-organs-and-structures-of-the-respiratory-system

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). Figure 23.5 Peristalsis [diagram]. In Anatomy and Physiology (Section 23.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/23-2-digestive-system-processes-and-regulation

Mister Science. (2018). What is peristalsis? YouTube. https://www.youtube.com/watch?v=kVjeNZA5pi4

MoomooMath and Science. (2017, May 18). Types of human body tissue. YouTube. https://www.youtube.com/watch?v=O0ZvbPak4ck&feature=youtu.be

Open Stax. (2016, May 27). Figure 6 Loose connective tissue [digital image]. In OpenStax Biology (Section 33.2). OpenStax CNX. https://cnx.org/contents/GFy_h8cu@10.53:-LfhWRES@4/Animal-Primary-Tissues

Open Stax. (2016, May 27). Figure 7 Fibrous connective tissue from the tendon [digital image]. In OpenStax Biology (Section 33.2). OpenStax CNX. https://cnx.org/contents/GFy_h8cu@10.53:-LfhWRES@4/Animal-Primary-Tissues

TED-Ed. (2019, October 17). How to 3D print human tissue - Taneka Jones. YouTube. https://www.youtube.com/watch?v=uHbn7wLN_3k&feature=youtu.be

TED-Ed. (2020, January 27). How bones make blood - Melody Smith. YouTube. https://www.youtube.com/watch?v=1Qfmkd6C8u8&feature=youtu.be

 

 

Created by CK-12 Foundation/Adapted by Christine Miller

Why can you “see your breath” on a cold day? The air you exhale through your nose and mouth is warm like the inside of your body. Exhaled air also contains a lot of water vapor, because it passes over moist surfaces from the lungs to the nose or mouth. The water vapor in your breath cools suddenly when it reaches the much colder outside air. This causes the water vapor to condense into a fog of tiny droplets of liquid water. You release water vapor and other gases from your body through the process of respiration.

Respiration is the life-sustaining process in which gases are exchanged between the body and the outside atmosphere. Specifically, oxygen moves from the outside air into the body; and water vapor, carbon dioxide, and other waste gases move from inside the body to the outside air. Respiration is carried out mainly by the respiratory system. It is important to note that respiration by the respiratory system is not the same process as cellular respiration —which occurs inside cells — although the two processes are closely connected. Cellular respiration is the metabolic process in which cells obtain energy, usually by “burning” glucose in the presence of oxygen. When cellular respiration is aerobic, it uses oxygen and releases carbon dioxide as a waste product. Respiration by the respiratory system supplies the oxygen needed by cells for aerobic cellular respiration, and removes the carbon dioxide produced by cells during cellular respiration.

Respiration by the respiratory system actually involves two subsidiary processes. One process is ventilation, or breathing. Ventilation is the physical process of conducting air to and from the lungs. The other process is gas exchange. This is the biochemical process in which oxygen diffuses out of the air and into the blood, while carbon dioxide and other waste gases diffuse out of the blood and into the air. All of the organs of the respiratory system are involved in breathing, but only the lungs are involved in gas exchange.

The organs of the respiratory system form a continuous system of passages, called the respiratory tract, through which air flows into and out of the body. The respiratory tract has two major divisions: the upper respiratory tract and the lower respiratory tract. The organs in each division are shown in Figure 13.2.2. In addition to these organs, certain muscles of the thorax (body cavity that fills the chest) are also involved in respiration by enabling breathing. Most important is a large muscle called the diaphragm, which lies below the lungs and separates the thorax from the abdomen. Smaller muscles between the ribs also play a role in breathing.

Upper Respiratory Tract

All of the organs and other structures of the upper respiratory tract are involved in conduction, or the movement of air into and out of the body. Upper respiratory tract organs provide a route for air to move between the outside atmosphere and the lungs. They also clean, humidify, and warm the incoming air. No gas exchange occurs in these organs.

Nasal Cavity

The nasal cavity is a large, air-filled space in the skull above and behind the nose in the middle of the face. It is a continuation of the two nostrils. As inhaled air flows through the nasal cavity, it is warmed and humidified by blood vessels very close to the surface of this epithelial tissue . Hairs in the nose and mucous produced by mucous membranes help trap larger foreign particles in the air before they go deeper into the respiratory tract. In addition to its respiratory functions, the nasal cavity also contains chemoreceptors  needed for sense of smellno post, and contribution to the sense of taste.

Pharynx

The pharynx is a tube-like structure that connects the nasal cavity and the back of the mouth to other structures lower in the throat, including the larynx. The pharynx has dual functions — both air and food (or other swallowed substances) pass through it, so it is part of both the respiratory and the digestive systems. Air passes from the nasal cavity through the pharynx to the larynx (as well as in the opposite direction). Food passes from the mouth through the pharynx to the esophagus.

Larynx

The larynx connects the pharynx and trachea, and helps to conduct air through the respiratory tract. The larynx is also called the voice box, because it contains the vocal cords, which vibrate when air flows over them, thereby producing sound. You can see the vocal cords in the larynx in Figures 13.2.3 and 13.2.4. Certain muscles in the larynx move the vocal cords apart to allow breathing. Other muscles in the larynx move the vocal cords together to allow the production of vocal sounds. The latter muscles also control the pitch of sounds and help control their volume.

Figure 13.2.4 The larynx as viewed from the top.

A very important function of the larynx is protecting the trachea from aspirated food. When swallowing occurs, the backward motion of the tongue forces a flap called the epiglottis to close over the entrance to the larynx. (You can see the epiglottis in both Figure 13.2.3 and 13.2.4.) This prevents swallowed material from entering the larynx and moving deeper into the respiratory tract. If swallowed material does start to enter the larynx, it irritates the larynx and stimulates a strong cough reflex. This generally expels the material out of the larynx, and into the throat.

 

https://www.youtube.com/watch?v=BsyB88mq5rQ

Larynx Model - Respiratory System, Dr. Lotz, 2018.

Lower Respiratory Tract

The trachea and other passages of the lower respiratory tract conduct air between the upper respiratory tract and the lungs. These passages form an inverted tree-like shape (Figure 13.2.5), with repeated branching as they move deeper into the lungs. All told, there are an astonishing 2,414 kilometres (1,500 miles) of airways conducting air through the human respiratory tract! It is only in the lungs, however, that gas exchange occurs between the air and the bloodstream.

Trachea

The trachea, or windpipe, is the widest passageway in the respiratory tract. It is about 2.5 cm wide and 10-15 cm long (approximately 1 inch wide and 4–6 inches long). It is formed by rings of cartilage, which make it relatively strong and resilient. The trachea connects the larynx to the lungs for the passage of air through the respiratory tract. The trachea branches at the bottom to form two bronchial tubes.

Bronchi and Bronchioles

There are two main bronchial tubes, or bronchi (singular, bronchus), called the right and left bronchi. The bronchi carry air between the trachea and lungs. Each bronchus branches into smaller, secondary bronchi; and secondary bronchi branch into still smaller tertiary bronchi. The smallest bronchi branch into very small tubules called bronchioles. The tiniest bronchioles end in alveolar ducts, which terminate in clusters of minuscule air sacs, called alveoli (singular, alveolus), in the lungs.

Lungs

The lungs are the largest organs of the respiratory tract. They are suspended within the pleural cavity of the thorax. The lungs are surrounded by two thin membranes called pleura, which secrete fluid that allows the lungs to move freely within the pleural cavity. This is necessary so the lungs can expand and contract during breathing. In Figure 13.2.6, you can see that each of the two lungs is divided into sections. These are called lobes, and they are separated from each other by connective tissues. The right lung is larger and contains three lobes. The left lung is smaller and contains only two lobes. The smaller left lung allows room for the heart, which is just left of the center of the chest.

Lung tissue consists mainly of alveoli (see Figures 13.2.7 and 13.2.8). These tiny air sacs are the functional units of the lungs where gas exchange takes place. The two lungs may contain as many as 700 million alveoli, providing a huge total surface area for gas exchange to take place. In fact, alveoli in the two lungs provide as much surface area as half a tennis court! Each time you breathe in, the alveoli fill with air, making the lungs expand. Oxygen in the air inside the alveoli is absorbed by the blood via diffusion in the mesh-like network of tiny capillaries that surrounds each alveolus. The blood in these capillaries also releases carbon dioxide (also by diffusion) into the air inside the alveoli. Each time you breathe out, air leaves the alveoli and rushes into the outside atmosphere, carrying waste gases with it.

The lungs receive blood from two major sources. They receive deoxygenated blood from the right side of the heart. This blood absorbs oxygen in the lungs and carries it back to the left side heart to be pumped to cells throughout the body. The lungs also receive oxygenated blood from the heart that provides oxygen to the cells of the lungs for cellular respiration.

You may be able to survive for weeks without food and for days without water, but you can survive without oxygen for only a matter of minutes — except under exceptional circumstances — so protecting the respiratory system is vital. Ensuring that a patient has an open airway is the first step in treating many medical emergencies. Fortunately, the respiratory system is well protected by the ribcage of the skeletal system. The extensive surface area of the respiratory system, however, is directly exposed to the outside world and all its potential dangers in inhaled air. It should come as no surprise that the respiratory system has a variety of ways to protect itself from harmful substances, such as dust and pathogens in the air.

The main way the respiratory system protects itself is called the mucociliary escalator. From the nose through the bronchi, the respiratory tract is covered in epithelium that contains mucus-secreting goblet cells. The mucus traps particles and pathogens in the incoming air. The epithelium of the respiratory tract is also covered with tiny cell projections called cilia (singular, cilium), as shown in the animation. The cilia constantly move in a sweeping motion upward toward the throat, moving the mucus and trapped particles and pathogens away from the lungs and toward the outside of the body. The upward sweeping motion of cilia lining the respiratory tract helps keep it free from dust, pathogens, and other harmful substances.

Watch "Mucociliary clearance" by I-Hsun Wu to learn more:

https://www.youtube.com/watch?v=HMB6flEaZwI

Mucociliary clearance, I-Hsun Wu, 2015.

Sneezing is a similar involuntary response that occurs when nerves lining the nasal passage are irritated. It results in forceful expulsion of air from the mouth, which sprays millions of tiny droplets of mucus and other debris out of the mouth and into the air, as shown in Figure 13.2.9. This explains why it is so important to sneeze into a tissue (rather than the air) if we are to prevent the transmission of respiratory pathogens.

 

 

How the Respiratory System Works with Other Organ Systems

The amount of oxygen and carbon dioxide in the blood must be maintained within a limited range for survival of the organism. Cells cannot survive for long without oxygen, and if there is too much carbon dioxide in the blood, the blood becomes dangerously acidic (pH is too low). Conversely, if there is too little carbon dioxide in the blood, the blood becomes too basic (pH is too high). The respiratory system works hand-in-hand with the nervous and cardiovascular systems to maintain homeostasis in blood gases and pH.

It is the level of carbon dioxide — rather than the level of oxygen — that is most closely monitored to maintain blood gas and pH homeostasis. The level of carbon dioxide in the blood is detected by cells in the brain, which speed up or slow down the rate of breathing through the autonomic nervous system as needed to bring the carbon dioxide level within the normal range. Faster breathing lowers the carbon dioxide level (and raises the oxygen level and pH), while slower breathing has the opposite effects. In this way, the levels of carbon dioxide, oxygen, and pH are maintained within normal limits.

The respiratory system also works closely with the cardiovascular system to maintain homeostasis. The respiratory system exchanges gases with the outside air, but it needs the cardiovascular system to carry them to and from body cells. Oxygen is absorbed by the blood in the lungs and then transported through a vast network of blood vessels to cells throughout the body, where it is needed for aerobic cellular respiration. The same system absorbs carbon dioxide from cells and carries it to the respiratory system for removal from the body.

Choking due to a foreign object becoming lodged in the airway results in nearly 5 thousand deaths in Canada each year. In addition, choking accounts for almost 40% of unintentional injuries in infants under the age of one.  For the sake of your own human body, as well as those of loved ones, you should be aware of choking risks, signs, and treatments.

Choking is the mechanical obstruction of the flow of air from the atmosphere into the lungs. It prevents breathing, and may be partial or complete. Partial choking allows some — though inadequate — air flow into the lungs. Prolonged or complete choking results in asphyxia, or suffocation, which is potentially fatal.

Obstruction of the airway typically occurs in the pharynx or trachea. Young children are more prone to choking than are older people, in part because they often put small objects in their mouth and do not understand the risk of choking that they pose. Young children may choke on small toys or parts of toys, or on household objects, in addition to food. Foods that are round (hotdogs, carrots, grapes) or can adapt their shape to that of the pharynx (bananas, marshmallows), are especially dangerous, and may cause choking in adults, as well as children.

How can you tell if a loved one is choking? The person cannot speak or cry out, or has great difficulty doing so. Breathing, if possible, is laboured, producing gasping or wheezing. The person may desperately clutch at his or her throat or mouth. If breathing is not soon restored, the person’s face will start to turn blue from lack of oxygen. This will be followed by unconsciousness, brain damage, and possibly death if oxygen deprivation continues beyond a few minutes.

If an infant is choking, turning the baby upside down and slapping him on the back may dislodge the obstructing object. To help an older person who is choking, first encourage the person to cough. Give them a few hard back slaps to help force the lodged object out of the airway. If these steps fail, perform the Heimlich maneuver on the person. See the series of  videos below, from ProCPR, which demonstrate several ways to help someone who is choking based on age and consciousness.

 

Attributions

Figure 13.2.1

Exhale by pavel-lozovikov-HYovA7yPPvI [photo] by Pavel Lozovikov on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 13.2.2

Illu_conducting_passages.svg by Lord Akryl, Jmarchn from SEER Training Modules/ National Cancer Institute on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain).

Figure 13.2.3

Larynx by www.medicalgraphics.de  is used under a CC BY-ND 4.0 (https://creativecommons.org/licenses/by-nd/4.0/) license.

Figure 13.2.4

Larynx top view by Alan Hoofring (Illustrator) for National Cancer Institute is in the public domain (https://en.wikipedia.org/wiki/Public_domain).

Figure 13.2.5

2000px-Lungs_diagram_detailed.svg by Patrick J. Lynch, medical illustrator on Wikimedia Commons is used under a CC BY 2.5 (https://creativecommons.org/licenses/by/2.5) license. (Derivative work of Fruchtwasserembolie.png.)

Figure 13.2.6

Gross_Anatomy_of_the_Lungs by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 13.2.7

Alveoli Structure by CNX OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 13.2.8

annotated_diagram_of_an_alveolus.svg by Katherinebutler1331 on Wikimedia Commons is used under a CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0) license.

Figure 13.2.9

Sneeze by James Gathany at CDC Public Health Imagery Library (PHIL) #11162 on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain).

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 22.2 Major respiratory structures [digital image].  In Anatomy and Physiology (Section 22.1). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/22-1-organs-and-structures-of-the-respiratory-system [CC BY 4.0 (https://creativecommons.org/licenses/by/4.0)].

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 22.13 Gross anatomy of the lungs [digital image].  In Anatomy and Physiology (Section 22.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/22-2-the-lungs

BrainStuff - HowStuffWorks. (2015, December 1). Why do men have deeper voices?  YouTube. https://www.youtube.com/watch?v=6iFPs6JlSzY&feature=youtu.be

Dr. Lotz. (2018, January 25). Larynx model - Respiratory system. YouTube. https://www.youtube.com/watch?v=BsyB88mq5rQ&feature=youtu.be

I-Hsun Wu. (2015, March 31). Mucociliary clearance. YouTube. https://www.youtube.com/watch?v=HMB6flEaZwI&feature=youtu.be

OpenStax. (2016, May 27). Figure 9 Terminal bronchioles are connected by respiratory bronchioles to alveolar ducts and alveolar sacs [digital image]. In OpenStax, Biology (Section 39.1). OpenStax CNX.  https://cnx.org/contents/GFy_h8cu@10.53:35-R0biq@11/Systems-of-Gas-Exchange

ProCPR. (2009, November 24). Conscious child choking. YouTube. https://www.youtube.com/watch?v=ZjmbD7aIaf0&feature=youtu.be

ProCPR. (2009, November 24).Unconscious child choking. YouTube. https://www.youtube.com/watch?v=Sba0T2XGIn4&feature=youtu.be

ProCPR. (2011, February 1). Conscious infant choking. YouTube. https://www.youtube.com/watch?v=axqIju9CLKA&feature=youtu.be

ProCPR. (2011, February 1). Unconscious adult choking. YouTube. https://www.youtube.com/watch?v=5kmsKNvKAvU&feature=youtu.be

ProCPR. (2011, February 1). Unconscious infant choking. YouTube. https://www.youtube.com/watch?v=_K7Dwy6b2wQ&feature=youtu.be

ProCPR. (2016, April 8). Conscious adult choking. YouTube. https://www.youtube.com/watch?v=XOTbjDGZ7wg&feature=youtu.be

TED-Ed. (2014, November 24). How do lungs work? - Emma Bryce. YouTube. https://www.youtube.com/watch?v=8NUxvJS-_0k&feature=youtu.be

TED-Ed. (2018, August 2). Why does your voice change as you get older? - Shaylin A. Schundler. YouTube. https://www.youtube.com/watch?v=rjibeBSnpJ0&feature=youtu.be

A diagram showing the steps the nervous system takes to initiate a flight or fight response, and then the changes to each body system based on commands from the nervous system. When a threat or harmful event is perceived, the brain processes the signals, beginning in the amygdala and then the hypothalamus. From here, the pituitary gland secretes adrenocorticotropic hormone, which causes the release of cortisol and adrenaline. The physical effects of cortisol and adrenaline are increased heart rate, bladder relaxation, tunnel vision, shaking, dilated pupils, flushed face, dry mouth, slowed digestion, and hearing loss.

division of the peripheral nervous system that controls involuntary activities

Created by CK-12 Foundation/Adapted by Christine Miller

Does the organism in Figure 17.2.1 look like a space alien? A scary creature from a nightmare? In fact, it’s a 1-cm long worm in the genus Schistosoma. It may invade and take up residence in the human body, causing a very serious illness known as schistosomiasis. The worm gains access to the human body while it is in a microscopic life stage. It enters through a hair follicle when the skin comes into contact with contaminated water. The worm then grows and matures inside the human organism, causing disease.

The Schistosoma worm has a parasitic relationship with humans. In this type of relationship, one organism, called the parasite, lives on or in another organism, called the host. The parasite always benefits from the relationship, and the host is always harmed. The human host of the Schistosoma worm is clearly harmed by the parasite when it invades the host’s tissues. The urinary tract or intestines may be infected, and signs and symptoms may include abdominal pain, diarrhea, bloody stool, or blood in the urine. Those who have been infected for a long time may experience liver damage, kidney failure, infertility, or bladder cancer. In children, Schistosoma infection may cause poor growth and difficulty learning.

Like the Schistosoma worm, many other organisms can make us sick if they manage to enter our body. Any such agent that can cause disease is called a pathogen. Most pathogens are microorganisms, although some — such as the Schistosoma worm — are much larger. In addition to worms, common types of pathogens of human hosts include bacteria, viruses, fungi, and single-celled organisms called protists. You can see examples of each of these types of pathogens in Table 17.1.1. Fortunately for us, our immune system is able to keep most potential pathogens out of the body, or quickly destroy them if they do manage to get in. When you read this chapter, you’ll learn how your immune system usually keeps you safe from harm — including from scary creatures like the Schistosoma worm!

Table 17.1.1: Types of Disease-Causing Pathogens

Type of Pathogen		Description	Disease Caused
Bacteria: Example shown: Escherichia coli		Single celled organisms without a nucleus	Strep throat, staph infections, tuberculosis, food poisoning, tetanus, pneumonia, syphillis
Viruses: Example shown: Herpes simplex		Non-living particles that reproduce by taking over living cells	Common cold, flu, genital herpes, cold sores, measles, AIDS, genital warts, chicken pox, small pox
Fungi: Example shown: Death cap mushroom		Simple organisms, including mushrooms and yeast, that grow as single cells or thread-like filaments	Ringworm, athletes foot, tineas, candidias, histoplasmomis, mushroom poisoning
Protozoa: Example shown: Giardia lamblia		Single celled organisms with a nucleus	Malaria, "traveller's diarrhea", giardiasis, typano somiasis ("sleeping sickness")

What is the Immune System?

The immune systemno post is a host defense system. It comprises many biological structures —ranging from individual leukocytes to entire organs — as well as many complex biological processes. The function of the immune system is to protect the host from pathogens and other causes of disease, such as tumor (cancer) cells. To function properly, the immune system must be able to detect a wide variety of pathogens. It also must be able to distinguish the cells of pathogens from the host’s own cells, and also to distinguish cancerous or damaged host cells from healthy cells. In humans and most other vertebrates, the immune system consists of layered defenses that have increasing specificity for particular pathogens or tumor cells. The layered defenses of the human immune system are usually classified into two subsystems, called the innate immune system and the adaptive immune system.

Innate Immune System

The innate immune system (sometimes referred to as "non-specific defense") provides very quick, but non-specific responses to pathogens. It responds the same way regardless of the type of pathogen that is attacking the host. It includes barriers — such as the skin and mucous membranes — that normally keep pathogens out of the body. It also includes general responses to pathogens that manage to breach these barriers, including chemicals and cells that attack the pathogens inside the human host. Certain leukocytes (white blood cells), for example, engulf and destroy pathogens they encounter in the process called phagocytosis, which is illustrated in Figure 17.2.2. Exposure to pathogens leads to an immediate maximal response from the innate immune system.

Adaptive Immune System

The adaptive immune system is activated if pathogens successfully enter the body and manage to evade the general defenses of the innate immune system. An adaptive response is specific to the particular type of pathogen that has invaded the body, or to cancerous cells. It takes longer to launch a specific attack, but once it is underway, its specificity makes it very effective. An adaptive response also usually leads to immunity. This is a state of resistance to a specific pathogen, due to the adaptive immune system's ability to “remember” the pathogen and immediately mount a strong attack tailored to that particular pathogen if it invades again in the future.

Both innate and adaptive immune responses depend on the immune system's ability to distinguish between self- and non-self molecules. Self molecules are those components of an organism’s body that can be distinguished from foreign substances by the immune system. Virtually all body cells have surface proteins that are part of a complex called major histocompatibility complex (MHC). These proteins are one way the immune system recognizes body cells as self. Non-self proteins, in contrast, are recognized as foreign, because they are different from self proteins.

Antigens and Antibodies

Many non-self molecules comprise a class of compounds called antigens. Antigens, which are usually proteins, bind to specific receptors on immune system cells and elicit an adaptive immune response. Some adaptive immune system cells (B cells) respond to foreign antigens by producing antibodies. An antibody is a molecule that precisely matches and binds to a specific antigen. This may target the antigen (and the pathogen displaying it) for destruction by other immune cells.

Antigens on the surface of pathogens are how the adaptive immune system recognizes specific pathogens. Antigen specificity allows for the generation of responses tailored to the specific pathogen. It is also how the adaptive immune system ”remembers” the same pathogen in the future.

Immune Surveillance

Another important role of the immune system is to identify and eliminate tumor cells. This is called immune surveillance. The transformed cells of tumors express antigens that are not found on normal body cells. The main response of the immune system to tumor cells is to destroy them. This is carried out primarily by aptly-named killer T cells of the adaptive immune system.

The lymphatic system is a human organ system that is a vital part of the adaptive immune system. It is also part of the cardiovascular system and plays a major role in the digestive system (see section 17.3 Lymphatic System). The major structures of the lymphatic system are shown in Figure 17.2.3 .

The lymphatic system consists of several lymphatic organs and a body-wide network of lymphatic vessels that transport the fluid called lymph. Lymph is essentially blood plasma that has leaked from capillaries into tissue spaces. It includes many leukocytes, especially lymphocytes, which are the major cells of the lymphatic system. Like other leukocytes, lymphocytes defend the body. There are several different types of lymphocytes that fight pathogens or cancer cells as part of the adaptive immune system.

Major lymphatic organs include the thymus and bone marrow. Their function is to form and/or mature lymphocytes. Other lymphatic organs include the spleen, tonsils, and lymph nodes, which are small clumps of lymphoid tissue clustered along lymphatic vessels. These other lymphatic organs harbor mature lymphocytes and filter lymph. They are sites where pathogens collect, and adaptive immune responses generally begin.

The brain and spinal cord are normally protected from pathogens in the blood by the selectively permeable blood-brain and blood-spinal cord barriers. These barriers are part of the neuroimmune system. The neuroimmune system has traditionally been considered distinct from the rest of the immune system, which is called the peripheral immune system — although that view may be changing. Unlike the peripheral system, in which leukocytes are the main cells, the main cells of the neuroimmune system are thought to be nervous system cells called neuroglia. These cells can recognize and respond to pathogens, debris, and other potential dangers. Types of neuroglia involved in neuroimmune responses include microglial cells and astrocytes.

• Microglial cells are among the most prominent types of neuroglia in the brain. One of their main functions is to phagocytize cellular debris that remains when neurons die. Microglial cells also “prune” obsolete synapses between neurons.
• Astrocytes are neuroglia that have a different immune function. They allow certain immune cells from the peripheral immune system to cross into the brain via the blood-brain barrier to target both pathogens and damaged nervous tissue.

“They’ll have to rewrite the textbooks!”

That sort of response to a scientific discovery is sure to attract media attention, and it did. It’s what Kevin Lee, a neuroscientist at the University of Virginia, said in 2016 when his colleagues told him they had discovered human anatomical structures that had never before been detected. The structures were tiny lymphatic vessels in the meningeal layers surrounding the brain.

How these lymphatic vessels could have gone unnoticed when all human body systems have been studied so completely is amazing in its own right. The suggested implications of the discovery are equally amazing:

• The presence of these lymphatic vessels means that the brain is directly connected to the peripheral immune system, presumably allowing a close association between the human brain and human pathogens. This suggests an entirely new avenue by which humans and their pathogens may have influenced each other’s evolution. The researchers speculate that our pathogens even may have influenced the evolution of our social behaviors.
• The researchers think there will also be many medical applications of their discovery. For example, the newly discovered lymphatic vessels may play a major role in neurological diseases that have an immune component, such as multiple sclerosis. The discovery might also affect how conditions such as autism spectrum disorders and schizophrenia are treated.

Attributions

Figure 17.1.1

Schistosome Parasite by Bruce Wetzel and Harry Schaefer (Photographers) from the National Cancer Institute, Visuals online is in the public domain (https://en.wikipedia.org/wiki/Public_domain).

Figure 17.1.2

Phagocytosis by Rlawson at en.wikibooks on Wikimedia Commons is used under a CC BY ­SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/deed.en) license. (Transferred from en.wikibooks to Commons by User:Adrignola.)

Figure 17.1.3

2201_Anatomy_of_the_Lymphatic_System by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

 

Table 17.1.1 

• EscherichiaColi NIAID [photo] by Rocky Mountain Laboratories,  NIH National Institute of Allergy and Infectious Diseases (NIAID) on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain).
• Herpes simplex virus TEM B82-0474 lores by Dr. Erskine Palmer/ CDC Public Health Image Library (PHIL) on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain).
• Red death cap mushroom by Rosendahl on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain). (Transferred from Pixnio by Fæ.)
• Scanning electron micrograph (SEM) of Giardia lamblia by Janice Haney Carr/ CDC, Public Health Image Library (PHIL) Photo ID# 8698 is in the public domain (https://en.wikipedia.org/wiki/Public_domain).

References

Barney, J. (2016, March 21). They’ll have to rewrite the textbooks [online article]. Illimitable - Discovery. UVA Today/ University of Virginia. https://news.virginia.edu/illimitable/discovery/theyll-have-rewrite-textbooks

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 21.2 Anatomy of the lymphatic system [digital image].  In Anatomy and Physiology (Section 21.1). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/21-1-anatomy-of-the-lymphatic-and-immune-systems

Handwritten Tutorials. (2011, October 25). Overview of the immune system. YouTube. https://www.youtube.com/watch?v=Nw27_jMWw10&feature=youtu.be

ImmiflexImmuneSystem. (2013). Neutrophil phagocytosis - White blood cell eats staphylococcus aureus bacteria. YouTube. https://www.youtube.com/watch?v=Z_mXDvZQ6dU

Kurzgesagt – In a Nutshell. (2016, March 16). The antibiotic apocalypse explained. YouTube. https://www.youtube.com/watch?v=xZbcwi7SfZE&feature=youtu.be

Louveau, A., Smirnov, I., Keyes, T. J., Eccles, J. D., Rouhani, S. J., Peske, J. D., Derecki, N. C., Castle, D., Mandell, J. W., Lee, K. S., Harris, T. H., & Kipnis, J. (2015). Structural and functional features of central nervous system lymphatic vessels. Nature, 523(7560), 337–341. https://doi.org/10.1038/nature14432

Mayo Clinic Staff. (n.d.). Autism spectrum disorder [online article]. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928

Mayo Clinic Staff. (n.d.). Multiple sclerosis [online article]. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

Mayo Clinic Staff. (n.d.). Schizophrenia [online article]. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443

TED-Ed. (2016, April 19). The surprising reason you feel awful when you're sick - Marco A. Sotomayor. YouTube. https://www.youtube.com/watch?v=gVdY9KXF_Sg&feature=youtu.be

 

As described in the caption.

 

You probably recognize the colourful object in this photo (Figure 7.6.1) as a human brain. The brain is arguably the most important organ in the human body. Fortunately for us, the brain has its own special “container,” called the cranial cavity. The cranial cavity enclosing the brain is just one of several cavities in the human body that form “containers” for vital organs.

The human body, like that of many other multicellular organisms, is divided into a number of body cavities. A body cavity is a fluid-filled space inside the body that holds and protects internal organs. Human body cavities are separated by membranes and other structures. The two largest human body cavities are the ventral cavity and dorsal cavity. These two body cavities are subdivided into smaller body cavities. Both the dorsal and ventral cavities and their subdivisions are shown in the Figure 7.6.2 diagram.

The ventral cavity is at the anterior (or front) of the trunk. Organs contained within this body cavity include the lungs, heart, stomach, intestines, and reproductive organs. The ventral cavity allows for considerable changes in the size and shape of the organs inside as they perform their functions. Organs such as the lungs, stomach, or uterus, for example, can expand or contract without distorting other tissues or disrupting the activities of nearby organs.

The ventral cavity is subdivided into the thoracic and abdominopelvic cavities.

• The thoracic cavity fills the chest and is subdivided into two pleural cavities and the pericardial cavity. The pleural cavities hold the lungs, and the pericardial cavity holds the heart.
• The abdominopelvic cavity fills the lower half of the trunk and is subdivided into the abdominal cavity and the pelvic cavity. The abdominal cavity holds digestive organs and the kidneys, and the pelvic cavity holds reproductive organs and organs of excretion.

The dorsal cavity is at the posterior (or back) of the body, including both the head and the back of the trunk. The dorsal cavity is subdivided into the cranial and spinal cavities.

• The cranial cavity fills most of the upper part of the skull and contains the brain.
• The spinal cavity is a very long, narrow cavity inside the vertebral column. It runs the length of the trunk and contains the spinal cord.

The brain and spinal cord are protected by the bones of the skull and the vertebrae of the spine. They are further protected by the meninges, a three-layer membrane that encloses the brain and spinal cord. A thin layer of cerebrospinal fluid is maintained between two of the meningeal layers. This clear fluid is produced by the brain, and it provides extra protection and cushioning for the brain and spinal cord.

The meninges membranes that protect the brain and spinal cord inside their cavities may become inflamed, generally due to a bacterial or viral infection. This condition is called meningitis, and it can lead to serious long-term consequences such as deafness, epilepsy, or cognitive deficits, especially if not treated quickly. Meningitis can also rapidly become life-threatening, so it is classified as a medical emergency.

Learning the symptoms of meningitis may help you or a loved one get prompt medical attention if you ever develop the disease. Common symptoms include fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit less specific symptoms, such as irritability, drowsiness, or poor feeding.

Meningitis is diagnosed with a lumbar puncture (commonly known as a "spinal tap"), in which a needle is inserted into the spinal canal to collect a sample of cerebrospinal fluid. The fluid is analyzed in a medical lab for the presence of pathogens. If meningitis is diagnosed, treatment consists of antibiotics and sometimes antiviral drugs. Corticosteroids may also be administered to reduce inflammation and the risk of complications (such as brain damage). Supportive measures such as IV fluids may also be provided.

Some types of meningitis can be prevented with a vaccine. Ask your health care professional whether you have had the vaccine or should get it. Giving antibiotics to people who have had significant exposure to certain types of meningitis may reduce their risk of developing the disease. If someone you know is diagnosed with meningitis and you are concerned about contracting the disease yourself, see your doctor for advice.

Attributions

Figure 7.6.1

Brain Lobes by John A Beal, Department of Cellular Biology & Anatomy, Louisiana State University Health Sciences Center Shreveport on Wikimedia Commons is used under a CC BY 2.5 (https://creativecommons.org/licenses/by/2.5/deed.en) license.

Figure 7.6.2

body_cavities-en.svg by Mysid (SVG) on Wikimedia Commons is in the public domain (https://en.wikipedia.org/wiki/Public_domain). (Original by US National Cancer Institute [NCI].)

References

Mayo Clinic Staff. (n.d.). Meningitis. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508

TED-Ed. (2018, November 19). Why is meningitis so dangerous? - Melvin Sanicas. YouTube. https://www.youtube.com/watch?v=IaQdv_dBDqM&feature=youtu.be

 

Created by CK-12 Foundation/Adapted by Christine Miller

Imagine the man in Figure 12.3.1 turns his eyes in your direction. This is a very small movement, considering the conspicuously large and strong external eye muscles that control eyeball movements. These muscles have been called the strongest muscles in the human body relative to the work they do. However, the external eye muscles actually do a surprising amount of work. Eye movements occur almost constantly during waking hours, especially when we are scanning faces or reading. Eye muscles are also exercised nightly during the phase of sleep called rapid eye movement sleep. External eye muscles can move the eyes because they are made mainly of muscle tissue.

Muscle tissue is a soft tissue that makes up most of the tissues in the muscles of the human muscular system. Other tissues in muscles are connective tissues, such as tendons that attach skeletal muscles to bones and sheaths of connective tissues that cover or line muscle tissues. Only muscle tissue per se, has cells with the ability to contract.

There are three major types of muscle tissues in the human body: skeletal, smooth, and cardiac muscle tissues. Figure 12.3.2 shows how the three types of muscle tissues appear under magnification. When you read about each type below, you will learn why the three types appear as they do.

Skeletal muscle is muscle tissue that is attached to bones by tendons, which are bundles of collagen fibres. Whether you are moving your eyes or running a marathon, you are using skeletal muscles. Contractions of skeletal muscles are voluntary, or under conscious control of the central nervous system via the somatic nervous system. Skeletal muscle tissue is the most common type of muscle tissue in the human body. By weight, an average adult male is about 42% skeletal muscles, and the average adult female is about 36% skeletal muscles. Some of the major skeletal muscles in the human body are labeled in Figure 12.3.3 below.

Skeletal Muscle Pairs

To move bones in opposite directions, skeletal muscles often consist of muscle pairs that work in opposition to one another, also called antagonistic muscle pairs.  For example, when the biceps muscle (on the front of the upper arm) contracts, it can cause the elbow joint to flex or bend the arm, as shown in Figure 12.3.4. When the triceps muscle (on the back of the upper arm) contracts, it can cause the elbow to extend or straighten the arm. The biceps and triceps muscles, also shown in Figure 12.3.4, are an example of a muscle pair where the muscles work in opposition to each other.

Skeletal Muscle Structure

Each skeletal muscle consists of hundreds — or even thousands — of skeletal muscle fibres, which are long, string-like cells. As shown in Figure 12.3.5 below, skeletal muscle fibres are individually wrapped in connective tissue called endomysium. The skeletal muscle fibres are bundled together in units called muscle fascicles, which are surrounded by sheaths of connective tissue called perimysium. Each fascicle contains between ten and 100 (or even more!) skeletal muscle fibres. Fascicles, in turn, are bundled together to form individual skeletal muscles, which are wrapped in connective tissue called epimysium. The connective tissues in skeletal muscles have a variety of functions. They support and protect muscle fibres, allowing them to withstand the forces of contraction by distributing the forces applied to the muscle. They also provide pathways for nerves and blood vessels to reach the muscles. In addition, the epimysium anchors the muscles to tendons.

The same bundles-within-bundles structure is replicated within each muscle fibre. As shown in Figure 12.3.6, a muscle fibre consists of a bundle of myofibrils, which are themselves bundles of protein filaments. These protein filaments consist of thin filaments of the protein actin, which are anchored to structures called Z discs, and thick filaments of the protein myosin. The filaments are arranged together within a myofibril in repeating units called sarcomeres, which run from one Z disc to the next. The sarcomere is the basic functional unit of skeletal and cardiac muscles. It contracts as actin and myosin filaments slide over one another. Skeletal muscle tissue is said to be striated, because it appears striped. It has this appearance because of the regular, alternating A (dark) and I (light) bands of filaments arranged in sarcomeres inside the muscle fibres. Other components of a skeletal muscle fibre include multiple nuclei and mitochondria.

Slow- and Fast-Twitch Skeletal Muscle Fibres

Skeletal muscle fibres can be divided into two types, called slow-twitch (or type I) muscle fibres and fast-twitch (or type II) muscle fibres.

• Slow-twitch muscle fibres are dense with capillaries and rich in mitochondria and myoglobin, which is a protein that stores oxygen until needed for muscle activity. Relative to fast-twitch fibres, slow-twitch fibres can carry more oxygen and sustain aerobic (oxygen-using) activity. Slow-twitch fibres can contract for long periods of time, but not with very much force. They are relied upon primarily in endurance events, such as distance running or cycling.
• Fast-twitch muscle fibres contain fewer capillaries and mitochondria and less myoglobin. This type of muscle fibre can contract rapidly and powerfully, but it fatigues very quickly. Fast-twitch fibres can sustain only short, anaerobic (non-oxygen-using) bursts of activity. Relative to slow-twitch fibres, fast-twitch fibres contribute more to muscle strength and have a greater potential for increasing in mass. They are relied upon primarily in short, strenuous events, such as sprinting or weightlifting.

Proportions of fibre types vary considerably from muscle to muscle and from person to person. Individuals may be genetically predisposed to have a larger percentage of one type of muscle fibre than the other. Generally, an individual who has more slow-twitch fibres is better suited for activities requiring endurance, whereas an individual who has more fast-twitch fibres is better suited for activities requiring short bursts of power.

Smooth muscle is muscle tissue in the walls of internal organs and other internal structures such as blood vessels. When smooth muscles contract, they help the organs and vessels carry out their functions. When smooth muscles in the stomach wall contract, for example, they squeeze the food inside the stomach, helping to mix and churn the food and break it into smaller pieces. This is an important part of digestion. Contractions of smooth muscles are involuntary, so they are not under conscious control. Instead, they are controlled by the autonomic nervous system, hormones, neurotransmitters, and other physiological factors.

Structure of Smooth Muscle

The cells that make up smooth muscle are generally called myocytes. Unlike the muscle fibres of striated muscle tissue, the myocytes of smooth muscle tissue do not have their filaments arranged in sarcomeres. Therefore, smooth tissue is not striated. However, the myocytes of smooth muscle do contain myofibrils, which in turn contain bundles of myosin and actin filaments. The filaments cause contractions when they slide over each other, as shown in Figure 12.3.7.

Unlike striated muscle, smooth muscle can sustain very long-term contractions. Smooth muscle can also stretch and still maintain its contractile function, which striated muscle cannot. The elasticity of smooth muscle is enhanced by an extracellular matrix secreted by myocytes. The matrix consists of elastin, collagen, and other stretchy fibres. The ability to stretch and still contract is an important attribute of smooth muscle in organs such as the stomach and uterus (see Figures 12.3.8 and 12.3.9), both of which must stretch considerably as they perform their normal functions.

The following list indicates where many smooth muscles are found, along with some of their specific functions.

• Walls of organs of the gastrointestinal tract (such as the esophagus, stomach, and intestines), moving food through the tract by peristalsis
• Walls of air passages of the respiratory tract (such as the bronchi), controlling the diameter of the passages and the volume of air that can pass through them
• Walls of organs of the male and female reproductive tracts; in the uterus, for example, pushing a baby out of the uterus and into the birth canal
• Walls of structures of the urinary system, including the urinary bladder, allowing the bladder to expand so it can hold more urine, and then contract as urine is released
• Walls of blood vessels, controlling the diameter of the vessels and thereby affecting blood flow and blood pressure
• Walls of lymphatic vessels, squeezing the fluid called lymph through the vessels
• Iris of the eyes, controlling the size of the pupils and thereby the amount of light entering the eyes
• Arrector pili in the skin, raising hairs in hair follicles in the dermis

Cardiac muscle is found only in the wall of the heart. It is also called myocardium. As shown in Figure 12.3.10, myocardium is enclosed within connective tissues, including the endocardium on the inside of the heart and pericardium on the outside of the heart. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac muscle cells in an area of the heart muscle called the sinoatrial node.

Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in sarcomeres inside the muscle fibres. However, in cardiac muscle, the myofibrils are branched at irregular angles rather than arranged in parallel rows (as they are in skeletal muscle). This explains why cardiac and skeletal muscle tissues look different from one another.

The cells of cardiac muscle tissue are arranged in interconnected networks. This arrangement allows rapid transmission of electrical impulses, which stimulate virtually simultaneous contractions of the cells. This enables the cells to coordinate contractions of the heart muscle.

The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Although the power output of the heart is much less than the maximum power output of some other muscles in the human body, the heart does its work continuously over an entire lifetime without rest. Cardiac muscle contains a great many mitochondria, which produce ATP for energy and help the heart resist fatigue.

Cardiomyopathy is a disease in which the muscles of the heart are no longer able to effectively pump blood to the body — extreme forms of this disease can lead to heart failure.  There are four main types of cardiomyopathy (also illustrated in Figure 12.3.11):

• Dilated (congestive) cardiomyopathy: the left ventricle (the chamber itself) of the heart becomes enlarged and can't pump blood our to the body.  This is normally related to coronary artery disease and/or heart attack
• Hypertrophic cardiomyopathy: abnormal thickening of the muscular walls of the left ventricle make the chamber less able to work properly.  This condition is more common in patients with a family history of the disease.
• Restrictive cardiomyopathy: the myocardium becomes abnormally rigid and inelastic and is unable to expand in between heartbeats to refill with blood.  Restrictive cardiomyopathy typically affects older people.
• Arrhythmogenic right ventricular cardiomyopathy: the right ventricular muscle is replaced by adipose or scar tissue, reducing elasticity and interfering with normal heartbeat and rhythm.  This disease is often caused by genetic mutations.

Cardiomyopathy is typically diagnosed with a physical exam supplemented by medical and family history, an angiogram, blood tests, chest x-rays and electrocardiograms.  In some cases your doctor would also requisition a CT scan and/or genetic testing.

When treating cardiomyopathy, the goal is to reduce symptoms that affect everyday life.  Certain medications can help regularize and slow heart rate, decrease chances of blood clots and cause vasodilation in the coronary arteries.  If medication is not sufficient to manage symptoms, a pacemaker or even a heart transplant may be the best option.  Lifestyle can also help manage the symptoms of cardiomyopathy — people living with this disease are encouraged to avoid drug and alcohol use, control high blood pressure, eat a healthy diet, get ample rest and exercise, as well as reduce stress levels.

 

Attributions

Figure 12.3.1

Look by ali-yahya-155huuQwGvA [photo] by Ali Yahya on Unsplash is used under the Unsplash License (https://unsplash.com/license).

Figure 12.3.2

Skeletal_Smooth_Cardiac by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.3

Anterior_and_Posterior_Views_of_Muscles by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.4

Antagonistic Muscle Pair by Laura Guerin at CK-12 Foundation on Wikimedia Commons is used under a CC BY-NC 3.0 (https://creativecommons.org/licenses/by-nc/3.0/) license. 

Figure 12.3.5

Muscle_Fibes_(large) by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.6

Muscle_Fibers_(small) by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.7

Smooth_Muscle_Contraction by OpenStax on Wikimedia Commons is used under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) license.

Figure 12.3.8

Blausen_0747_Pregnancy by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.9

Size_of_Uterus_Throughout_Pregnancy-02 by OpenStax College on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.10

1024px-Blausen_0470_HeartWall by BruceBlaus on Wikimedia Commons is used under a CC BY 3.0 (https://creativecommons.org/licenses/by/3.0) license.

Figure 12.3.11

Tipet_e_kardiomiopative by Npatchett at English Wikipedia on Wikimedia Commons is used under a CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) license. (Work derived from Blausen 0165 Cardiomyopathy Dilated by BruceBlaus)

References

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 4.18 Muscle tissue [digital image].  In Anatomy and Physiology (Section 4.4). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/4-4-muscle-tissue-and-motion

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 28.18 Size of uterus throughout pregnancy [digital image].  In Anatomy and Physiology (Section 28.4). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/28-4-maternal-changes-during-pregnancy-labor-and-birth

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 10.3 The three connective tissue layers [digital image].  In Anatomy and Physiology (Section 10.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-2-skeletal-muscle

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 10.4 Muscle fiber [digital image].  In Anatomy and Physiology (Section 10.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-2-skeletal-muscle

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 10.24 Muscle contraction [digital image].  In Anatomy and Physiology (Section 10.8). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/10-8-smooth-muscle

Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 11.5 Overview of the muscular system [digital image].  In Anatomy and Physiology (Section 11.2). OpenStax. https://openstax.org/books/anatomy-and-physiology/pages/11-2-naming-skeletal-muscles

Blausen.com staff. (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

Brainard, J/ CK-12 Foundation. (2012). Figure 5 Triceps and biceps muscles in the upper arm are opposing muscles. [digital image]. In CK-12 Biology (Section 21.3) [online Flexbook]. CK12.org. https://www.ck12.org/book/ck-12-biology/section/21.3/ (Last modified August 11, 2017.)

khanacademymedicine. (2012, October 19). Three types of muscle | Circulatory system physiology | NCLEX-RN | Khan Academy. YouTube.

TED-Ed. (2017, February 14).  What happens during a heart attack? - Krishna Sudhir. YouTube. https://www.youtube.com/watch?v=3_PYnWVoUzM&feature=youtu.be

 

Like the little girl shown in Figure 6.1.1, seven-year-old Mateo is battling leukemia, a type of cancer that affects blood cells. Leukemia usually starts in the bone marrow where blood cells are produced. It causes the production of abnormal blood cells, most commonly white blood cells. Depending on the type of leukemia, it can also affect other types of blood cells. The abnormal blood cells replace the patient’s normal blood cells over time, which can lead to symptoms of fatigue, frequent infections, and easy bruising or bleeding. Leukemia can be fatal, but fortunately, there are some treatment options available that can prolong life — and may even cure the disease.

Mateo has undergone chemotherapy to kill the cancerous cells, but his doctors have told his parents that it is not enough. Mateo needs a bone marrow transplant in order to replace his abnormal bone marrow with healthy bone marrow. His family members are eager to donate bone marrow to him, but first they must be tested to see if they are a compatible match.

For blood transfusions, it is relatively easy to find a compatible blood donor, but bone marrow transplants require much more specific matching between donor and recipient. They must share several of the same type of proteins — called human leukocyte antigens (HLAs) — on the surface of their cells. One type of HLA protein is illustrated in Figure 6.1.3. Different people have different types of HLA proteins (or markers) depending on their specific genes. Typically, eight to ten HLA markers are tested and compared in the potential bone marrow donor and recipient. At least six or seven of these HLA markers must be identical between them in order for a match to be made.

If the match is not good, the patient’s body could reject the bone marrow transplant. Conversely, the transplanted bone marrow could produce immune cells that attack the patient’s body. A good match between donor and recipient is critical for bone marrow donation to be safe and effective.

A full sibling frequently provides the best match for bone marrow donation because they share many of the same genes from their parents. Mateo’s sister is tested, but unfortunately, she is not a match for him. This is not all that surprising since there is only about a 25 per cent chance that a sibling will be an identical HLA match. His parents and other family members are also tested, but none of them are a match, either. Mateo must join the 70 per cent of patients that need to look outside of their families for a bone marrow donor.

How do you find a bone marrow match outside of your family? Fortunately, people from all over the world have signed up to be potential bone marrow donors, usually by providing a simple swab of the inside of their cheek. DNA from the cells collected on the swab is then tested for HLA type. The potential donor’s HLA information is put into a donor registry, and doctors can then search national and international registries for compatible matches for their patients.

Patients are much more likely to be a match with a bone marrow donor of their same race or ethnic background. People with similar ancestry are more likely to share similar HLA genes. In Mateo’s case, his mother is African American, and his father is Japanese and Caucasian. His relatively rare combination of ethnic backgrounds may make it harder for him to find a match in the donor registries, as is the case for many multiethnic patients.

Read the rest of this chapter to learn more about the genetic and phenotypic variations that exist in humans, and how some of these differences came about due to differing natural selection pressures in different areas of the world. At the end of the chapter, learn more about Mateo’s quest for a bone marrow donor, the need for bone marrow donors from diverse ethnic backgrounds, and how you may be able to save someone’s life based on your genetic makeup!