This week's reading is section 44.1 – 44.5 (all sections of chapter 44) of the course textbook, which is accessible through the Syllabus or through the course's "Textbooks" page. Grading: Answers shou

Biology

SENIOR CONTRIBUTING A UTHORS

C ONNIE R YE , EAST M ISSISSIPPI C OMMUNITY C OLLEGE

R OBERT W ISE , U NIVERSITY OF W ISCONSIN , O SHKOSH

V LADIMIR JURUKOVSKI , SUFFOLK C OUNTY C OMMUNITY C OLLEGE

JEAN D ESAIX , U NIVERSITY OF N ORTH C AROLINA AT C HAPEL H ILL

JUNG C HOI , G EORGIA INSTITUTE OF TECHNOLOGY

YAEL A VISSAR , R HODE ISLAND C OLLEGE

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39 | THE RESPIRATORY

SYSTEM

Figure 39.1 Lungs, which appear as nearly transparent tissue surrounding the heart in this X-ray of a dog (left), are

the central organs of the respiratory system. The left lung is smaller than the right lung to accommodate space for the

heart. A dog’s nose (right) has a slit on the side of each nostril. When tracking a scent, the slits open, blocking the

front of the nostrils. This allows the dog to exhale though the now-open area on the side of the nostrils without losing

the scent that is being followed. (credit a: modification of work by Geoff Stearns; credit b: modification of work by Cory

Zanker)

Chapter Outline

39.1: Systems of Gas Exchange

39.2: Gas Exchange across Respiratory Surfaces

39.3: Breathing

39.4: Transport of Gases in Human Bodily Fluids

Introduction

Breathing is an involuntary event. How often a breath is taken and how much air is inhaled or exhaled are tightly regulated

by the respiratory center in the brain. Humans, when they aren’t exerting themselves, breathe approximately 15 times per

minute on average. Canines, like the dog in Figure 39.1 , have a respiratory rate of about 15–30 breaths per minute. With

every inhalation, air fills the lungs, and with every exhalation, air rushes back out. That air is doing more than just inflating

and deflating the lungs in the chest cavity. The air contains oxygen that crosses the lung tissue, enters the bloodstream,

and travels to organs and tissues. Oxygen (O 2) enters the cells where it is used for metabolic reactions that produce ATP, a

high-energy compound. At the same time, these reactions release carbon dioxide (CO 2) as a by-product. CO 2is toxic and

must be eliminated. Carbon dioxide exits the cells, enters the bloodstream, travels back to the lungs, and is expired out of

the body during exhalation.

Chapter 39 | The Respiratory System 1135 39.1 | Systems of Gas Exchange

By the end of this section, you will be able to:

• Describe the passage of air from the outside environment to the lungs

• Explain how the lungs are protected from particulate matter

The primary function of the respiratory system is to deliver oxygen to the cells of the body’s tissues and remove carbon

dioxide, a cell waste product. The main structures of the human respiratory system are the nasal cavity, the trachea, and

lungs.

All aerobic organisms require oxygen to carry out their metabolic functions. Along the evolutionary tree, different

organisms have devised different means of obtaining oxygen from the surrounding atmosphere. The environment in which

the animal lives greatly determines how an animal respires. The complexity of the respiratory system is correlated with the

size of the organism. As animal size increases, diffusion distances increase and the ratio of surface area to volume drops.

In unicellular organisms, diffusion across the cell membrane is sufficient for supplying oxygen to the cell ( Figure 39.2 ).

Diffusion is a slow, passive transport process. In order for diffusion to be a feasible means of providing oxygen to the cell,

the rate of oxygen uptake must match the rate of diffusion across the membrane. In other words, if the cell were very large

or thick, diffusion would not be able to provide oxygen quickly enough to the inside of the cell. Therefore, dependence

on diffusion as a means of obtaining oxygen and removing carbon dioxide remains feasible only for small organisms or

those with highly-flattened bodies, such as many flatworms (Platyhelminthes). Larger organisms had to evolve specialized

respiratory tissues, such as gills, lungs, and respiratory passages accompanied by complex circulatory systems, to transport

oxygen throughout their entire body.

Figure 39.2 The cell of the unicellular algae Ventricaria ventricosa is one of the largest known, reaching one to five

centimeters in diameter. Like all single-celled organisms, V. ventricosa exchanges gases across the cell membrane.

Direct Diffusion

For small multicellular organisms, diffusion across the outer membrane is sufficient to meet their oxygen needs. Gas

exchange by direct diffusion across surface membranes is efficient for organisms less than 1 mm in diameter. In simple

organisms, such as cnidarians and flatworms, every cell in the body is close to the external environment. Their cells

are kept moist and gases diffuse quickly via direct diffusion. Flatworms are small, literally flat worms, which ‘breathe’

through diffusion across the outer membrane ( Figure 39.3 ). The flat shape of these organisms increases the surface area for

diffusion, ensuring that each cell within the body is close to the outer membrane surface and has access to oxygen. If the

flatworm had a cylindrical body, then the cells in the center would not be able to get oxygen.

1136 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 39.3 This flatworm’s process of respiration works by diffusion across the outer membrane. (credit: Stephen

Childs)

Skin and Gills

Earthworms and amphibians use their skin (integument) as a respiratory organ. A dense network of capillaries lies just

below the skin and facilitates gas exchange between the external environment and the circulatory system. The respiratory

surface must be kept moist in order for the gases to dissolve and diffuse across cell membranes.

Organisms that live in water need to obtain oxygen from the water. Oxygen dissolves in water but at a lower concentration

than in the atmosphere. The atmosphere has roughly 21 percent oxygen. In water, the oxygen concentration is much smaller

than that. Fish and many other aquatic organisms have evolved gills to take up the dissolved oxygen from water ( Figure

39.4 ). Gills are thin tissue filaments that are highly branched and folded. When water passes over the gills, the dissolved

oxygen in water rapidly diffuses across the gills into the bloodstream. The circulatory system can then carry the oxygenated

blood to the other parts of the body. In animals that contain coelomic fluid instead of blood, oxygen diffuses across the gill

surfaces into the coelomic fluid. Gills are found in mollusks, annelids, and crustaceans.

Figure 39.4 This common carp, like many other aquatic organisms, has gills that allow it to obtain oxygen from water.

(credit: "Guitardude012"/Wikimedia Commons)

The folded surfaces of the gills provide a large surface area to ensure that the fish gets sufficient oxygen. Diffusion is a

process in which material travels from regions of high concentration to low concentration until equilibrium is reached. In

this case, blood with a low concentration of oxygen molecules circulates through the gills. The concentration of oxygen

molecules in water is higher than the concentration of oxygen molecules in gills. As a result, oxygen molecules diffuse from

water (high concentration) to blood (low concentration), as shown in Figure 39.5 . Similarly, carbon dioxide molecules in

the blood diffuse from the blood (high concentration) to water (low concentration).

Chapter 39 | The Respiratory System 1137 Figure 39.5 As water flows over the gills, oxygen is transferred to blood via the veins. (credit "fish": modification of

work by Duane Raver, NOAA)

Tracheal Systems

Insect respiration is independent of its circulatory system; therefore, the blood does not play a direct role in oxygen

transport. Insects have a highly specialized type of respiratory system called the tracheal system, which consists of a

network of small tubes that carries oxygen to the entire body. The tracheal system is the most direct and efficient respiratory

system in active animals. The tubes in the tracheal system are made of a polymeric material called chitin.

Insect bodies have openings, called spiracles, along the thorax and abdomen. These openings connect to the tubular network,

allowing oxygen to pass into the body ( Figure 39.6 ) and regulating the diffusion of CO 2and water vapor. Air enters and

leaves the tracheal system through the spiracles. Some insects can ventilate the tracheal system with body movements.

Figure 39.6 Insects perform respiration via a tracheal system.

Mammalian Systems

In mammals, pulmonary ventilation occurs via inhalation (breathing). During inhalation, air enters the body through the

nasal cavity located just inside the nose ( Figure 39.7 ). As air passes through the nasal cavity, the air is warmed to body

temperature and humidified. The respiratory tract is coated with mucus to seal the tissues from direct contact with air. Mucus

is high in water. As air crosses these surfaces of the mucous membranes, it picks up water. These processes help equilibrate

the air to the body conditions, reducing any damage that cold, dry air can cause. Particulate matter that is floating in the air

is removed in the nasal passages via mucus and cilia. The processes of warming, humidifying, and removing particles are

important protective mechanisms that prevent damage to the trachea and lungs. Thus, inhalation serves several purposes in

addition to bringing oxygen into the respiratory system.

1138 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 39.7 Air enters the respiratory system through the nasal cavity and pharynx, and then passes through the

trachea and into the bronchi, which bring air into the lungs. (credit: modification of work by NCI)

Which of the following statements about the mammalian respiratory system is false?

a. When we breathe in, air travels from the pharynx to the trachea.

b. The bronchioles branch into bronchi.

c. Alveolar ducts connect to alveolar sacs.

d. Gas exchange between the lung and blood takes place in the alveolus.

From the nasal cavity, air passes through the pharynx (throat) and the larynx (voice box), as it makes its way to the trachea

(Figure 39.7 ). The main function of the trachea is to funnel the inhaled air to the lungs and the exhaled air back out of

the body. The human trachea is a cylinder about 10 to 12 cm long and 2 cm in diameter that sits in front of the esophagus

and extends from the larynx into the chest cavity where it divides into the two primary bronchi at the midthorax. It is

made of incomplete rings of hyaline cartilage and smooth muscle ( Figure 39.8 ). The trachea is lined with mucus-producing

goblet cells and ciliated epithelia. The cilia propel foreign particles trapped in the mucus toward the pharynx. The cartilage

provides strength and support to the trachea to keep the passage open. The smooth muscle can contract, decreasing the

trachea’s diameter, which causes expired air to rush upwards from the lungs at a great force. The forced exhalation helps

expel mucus when we cough. Smooth muscle can contract or relax, depending on stimuli from the external environment or

the body’s nervous system.

Chapter 39 | The Respiratory System 1139 Figure 39.8 The trachea and bronchi are made of incomplete rings of cartilage. (credit: modification of work by Gray's

Anatomy)

Lungs: Bronchi and Alveoli

The end of the trachea bifurcates (divides) to the right and left lungs. The lungs are not identical. The right lung is larger

and contains three lobes, whereas the smaller left lung contains two lobes ( Figure 39.9 ). The muscular diaphragm , which

facilitates breathing, is inferior to (below) the lungs and marks the end of the thoracic cavity.

Figure 39.9 The trachea bifurcates into the right and left bronchi in the lungs. The right lung is made of three lobes

and is larger. To accommodate the heart, the left lung is smaller and has only two lobes.

In the lungs, air is diverted into smaller and smaller passages, or bronchi . Air enters the lungs through the two primary

(main) bronchi (singular: bronchus). Each bronchus divides into secondary bronchi, then into tertiary bronchi, which

in turn divide, creating smaller and smaller diameter bronchioles as they split and spread through the lung. Like the

trachea, the bronchi are made of cartilage and smooth muscle. At the bronchioles, the cartilage is replaced with elastic

fibers. Bronchi are innervated by nerves of both the parasympathetic and sympathetic nervous systems that control

muscle contraction (parasympathetic) or relaxation (sympathetic) in the bronchi and bronchioles, depending on the nervous

system’s cues. In humans, bronchioles with a diameter smaller than 0.5 mm are the respiratory bronchioles . They lack

cartilage and therefore rely on inhaled air to support their shape. As the passageways decrease in diameter, the relative

amount of smooth muscle increases.

The terminal bronchioles subdivide into microscopic branches called respiratory bronchioles. The respiratory bronchioles

subdivide into several alveolar ducts. Numerous alveoli and alveolar sacs surround the alveolar ducts. The alveolar sacs

resemble bunches of grapes tethered to the end of the bronchioles ( Figure 39.10 ). In the acinar region, the alveolar ducts

1140 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 are attached to the end of each bronchiole. At the end of each duct are approximately 100 alveolar sacs , each containing 20

to 30 alveoli that are 200 to 300 microns in diameter. Gas exchange occurs only in alveoli. Alveoli are made of thin-walled

parenchymal cells, typically one-cell thick, that look like tiny bubbles within the sacs. Alveoli are in direct contact with

capillaries (one-cell thick) of the circulatory system. Such intimate contact ensures that oxygen will diffuse from alveoli

into the blood and be distributed to the cells of the body. In addition, the carbon dioxide that was produced by cells as a

waste product will diffuse from the blood into alveoli to be exhaled. The anatomical arrangement of capillaries and alveoli

emphasizes the structural and functional relationship of the respiratory and circulatory systems. Because there are so many

alveoli (~300 million per lung) within each alveolar sac and so many sacs at the end of each alveolar duct, the lungs have a

sponge-like consistency. This organization produces a very large surface area that is available for gas exchange. The surface

area of alveoli in the lungs is approximately 75 m 2. This large surface area, combined with the thin-walled nature of the

alveolar parenchymal cells, allows gases to easily diffuse across the cells.

Figure 39.10 Terminal bronchioles are connected by respiratory bronchioles to alveolar ducts and alveolar sacs. Each

alveolar sac contains 20 to 30 spherical alveoli and has the appearance of a bunch of grapes. Air flows into the atrium

of the alveolar sac, then circulates into alveoli where gas exchange occurs with the capillaries. Mucous glands secrete

mucous into the airways, keeping them moist and flexible. (credit: modification of work by Mariana Ruiz Villareal)

Watch the following video (http://openstaxcollege.org/l/lungs_pulmonary) to review the respiratory system.

Protective Mechanisms

The air that organisms breathe contains particulate matter such as dust, dirt, viral particles, and bacteria that can damage

the lungs or trigger allergic immune responses. The respiratory system contains several protective mechanisms to avoid

problems or tissue damage. In the nasal cavity, hairs and mucus trap small particles, viruses, bacteria, dust, and dirt to

prevent their entry.

Chapter 39 | The Respiratory System 1141 If particulates do make it beyond the nose, or enter through the mouth, the bronchi and bronchioles of the lungs also contain

several protective devices. The lungs produce mucus —a sticky substance made of mucin , a complex glycoprotein, as well

as salts and water—that traps particulates. The bronchi and bronchioles contain cilia, small hair-like projections that line

the walls of the bronchi and bronchioles ( Figure 39.11 ). These cilia beat in unison and move mucus and particles out of the

bronchi and bronchioles back up to the throat where it is swallowed and eliminated via the esophagus.

In humans, for example, tar and other substances in cigarette smoke destroy or paralyze the cilia, making the removal of

particles more difficult. In addition, smoking causes the lungs to produce more mucus, which the damaged cilia are not able

to move. This causes a persistent cough, as the lungs try to rid themselves of particulate matter, and makes smokers more

susceptible to respiratory ailments.

Figure 39.11 The bronchi and bronchioles contain cilia that help move mucus and other particles out of the lungs.

(credit: Louisa Howard, modification of work by Dartmouth Electron Microscope Facility)

39.2 | Gas Exchange across Respiratory Surfaces

By the end of this section, you will be able to:

• Name and describe lung volumes and capacities

• Understand how gas pressure influences how gases move into and out of the body

The structure of the lung maximizes its surface area to increase gas diffusion. Because of the enormous number of alveoli

(approximately 300 million in each human lung), the surface area of the lung is very large (75 m 2). Having such a large

surface area increases the amount of gas that can diffuse into and out of the lungs.

Basic Principles of Gas Exchange

Gas exchange during respiration occurs primarily through diffusion. Diffusion is a process in which transport is driven by

a concentration gradient. Gas molecules move from a region of high concentration to a region of low concentration. Blood

that is low in oxygen concentration and high in carbon dioxide concentration undergoes gas exchange with air in the lungs.

The air in the lungs has a higher concentration of oxygen than that of oxygen-depleted blood and a lower concentration of

carbon dioxide. This concentration gradient allows for gas exchange during respiration.

Partial pressure is a measure of the concentration of the individual components in a mixture of gases. The total pressure

exerted by the mixture is the sum of the partial pressures of the components in the mixture. The rate of diffusion of a gas is

proportional to its partial pressure within the total gas mixture. This concept is discussed further in detail below.

Lung Volumes and Capacities

Different animals have different lung capacities based on their activities. Cheetahs have evolved a much higher lung

capacity than humans; it helps provide oxygen to all the muscles in the body and allows them to run very fast. Elephants

1142 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 also have a high lung capacity. In this case, it is not because they run fast but because they have a large body and must be

able to take up oxygen in accordance with their body size.

Human lung size is determined by genetics, gender, and height. At maximal capacity, an average lung can hold almost six

liters of air, but lungs do not usually operate at maximal capacity. Air in the lungs is measured in terms of lung volumes

and lung capacities (Figure 39.12 and Table 39.1 ). Volume measures the amount of air for one function (such as inhalation

or exhalation). Capacity is any two or more volumes (for example, how much can be inhaled from the end of a maximal

exhalation).

Figure 39.12 Human lung volumes and capacities are shown. The total lung capacity of the adult male is six liters.

Tidal volume is the volume of air inhaled in a single, normal breath. Inspiratory capacity is the amount of air taken in

during a deep breath, and residual volume is the amount of air left in the lungs after forceful respiration.

Lung Volumes and Capacities (Avg Adult Male)

Volume/

Capacity Definition Volume

(liters) Equations

Tidal volume (TV) Amount of air inhaled during a normal breath 0.5 -

Expiratory reserve

volume (ERV)

Amount of air that can be exhaled after a normal

exhalation 1.2 -

Inspiratory reserve

volume (IRV)

Amount of air that can be further inhaled after a normal

inhalation 3.1 -

Residual volume

(RV) Air left in the lungs after a forced exhalation 1.2 -

Vital capacity (VC) Maximum amount of air that can be moved in or out of

the lungs in a single respiratory cycle 4.8 ERV+TV+IRV

Inspiratory capacity

(IC)

Volume of air that can be inhaled in addition to a

normal exhalation 3.6 TV+IRV

Functional residual

capacity (FRC) Volume of air remaining after a normal exhalation 2.4 ERV+RV

Total lung capacity

(TLC)

Total volume of air in the lungs after a maximal

inspiration 6.0 RV+ERV+TV+IRV

Forced expiratory

volume (FEV1)

How much air can be forced out of the lungs over a

specific time period, usually one second ~4.1 to 5.5 -

Table 39.1

Chapter 39 | The Respiratory System 1143 The volume in the lung can be divided into four units: tidal volume, expiratory reserve volume, inspiratory reserve volume,

and residual volume. Tidal volume (TV) measures the amount of air that is inspired and expired during a normal breath.

On average, this volume is around one-half liter, which is a little less than the capacity of a 20-ounce drink bottle. The

expiratory reserve volume (ERV) is the additional amount of air that can be exhaled after a normal exhalation. It is the

reserve amount that can be exhaled beyond what is normal. Conversely, the inspiratory reserve volume (IRV) is the

additional amount of air that can be inhaled after a normal inhalation. The residual volume (RV) is the amount of air that is

left after expiratory reserve volume is exhaled. The lungs are never completely empty: There is always some air left in the

lungs after a maximal exhalation. If this residual volume did not exist and the lungs emptied completely, the lung tissues

would stick together and the energy necessary to re-inflate the lung could be too great to overcome. Therefore, there is

always some air remaining in the lungs. Residual volume is also important for preventing large fluctuations in respiratory

gases (O 2and CO 2). The residual volume is the only lung volume that cannot be measured directly because it is impossible

to completely empty the lung of air. This volume can only be calculated rather than measured.

Capacities are measurements of two or more volumes. The vital capacity (VC) measures the maximum amount of air that

can be inhaled or exhaled during a respiratory cycle. It is the sum of the expiratory reserve volume, tidal volume, and

inspiratory reserve volume. The inspiratory capacity (IC) is the amount of air that can be inhaled after the end of a normal

expiration. It is, therefore, the sum of the tidal volume and inspiratory reserve volume. The functional residual capacity

(FRC) includes the expiratory reserve volume and the residual volume. The FRC measures the amount of additional air that

can be exhaled after a normal exhalation. Lastly, the total lung capacity (TLC) is a measurement of the total amount of air

that the lung can hold. It is the sum of the residual volume, expiratory reserve volume, tidal volume, and inspiratory reserve

volume.

Lung volumes are measured by a technique called spirometry . An important measurement taken during spirometry is the

forced expiratory volume (FEV) , which measures how much air can be forced out of the lung over a specific period,

usually one second (FEV1). In addition, the forced vital capacity (FVC), which is the total amount of air that can be forcibly

exhaled, is measured. The ratio of these values ( FEV1/FVC ratio ) is used to diagnose lung diseases including asthma,

emphysema, and fibrosis. If the FEV1/FVC ratio is high, the lungs are not compliant (meaning they are stiff and unable

to bend properly), and the patient most likely has lung fibrosis. Patients exhale most of the lung volume very quickly.

Conversely, when the FEV1/FVC ratio is low, there is resistance in the lung that is characteristic of asthma. In this instance,

it is hard for the patient to get the air out of his or her lungs, and it takes a long time to reach the maximal exhalation volume.

In either case, breathing is difficult and complications arise.

Respiratory Therapist

Respiratory therapists or respiratory practitioners evaluate and treat patients with lung and cardiovascular

diseases. They work as part of a medical team to develop treatment plans for patients. Respiratory

therapists may treat premature babies with underdeveloped lungs, patients with chronic conditions such

as asthma, or older patients suffering from lung disease such as emphysema and chronic obstructive

pulmonary disease (COPD). They may operate advanced equipment such as compressed gas delivery

systems, ventilators, blood gas analyzers, and resuscitators. Specialized programs to become a respiratory

therapist generally lead to a bachelor’s degree with a respiratory therapist specialty. Because of a growing

aging population, career opportunities as a respiratory therapist are expected to remain strong.

Gas Pressure and Respiration

The respiratory process can be better understood by examining the properties of gases. Gases move freely, but gas particles

are constantly hitting the walls of their vessel, thereby producing gas pressure.

Air is a mixture of gases, primarily nitrogen (N 2; 78.6 percent), oxygen (O 2; 20.9 percent), water vapor (H 2O; 0.5 percent),

and carbon dioxide (CO 2; 0.04 percent). Each gas component of that mixture exerts a pressure. The pressure for an

individual gas in the mixture is the partial pressure of that gas. Approximately 21 percent of atmospheric gas is oxygen.

Carbon dioxide, however, is found in relatively small amounts, 0.04 percent. The partial pressure for oxygen is much greater

than that of carbon dioxide. The partial pressure of any gas can be calculated by:

P = (P atm ) × (percent content in mixture).

Patm , the atmospheric pressure, is the sum of all of the partial pressures of the atmospheric gases added together,

1144 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Patm = P N2 + P O2 + P H2O + P CO 2= 760 mm Hg

× (percent content in mixture).

The pressure of the atmosphere at sea level is 760 mm Hg. Therefore, the partial pressure of oxygen is:

PO2= (760 mm Hg) (0.21) = 160 mm Hg

and for carbon dioxide:

PCO 2= (760 mm Hg) (0.0004) = 0.3 mm Hg.

At high altitudes, P atm decreases but concentration does not change; the partial pressure decrease is due to the reduction in

Patm .

When the air mixture reaches the lung, it has been humidified. The pressure of the water vapor in the lung does not change

the pressure of the air, but it must be included in the partial pressure equation. For this calculation, the water pressure (47

mm Hg) is subtracted from the atmospheric pressure:

760 mm Hg − 47 mm Hg = 713 mm Hg

and the partial pressure of oxygen is:

(760 mm Hg − 47 mm Hg) × 0.21 = 150 mm Hg.

These pressures determine the gas exchange, or the flow of gas, in the system. Oxygen and carbon dioxide will flow

according to their pressure gradient from high to low. Therefore, understanding the partial pressure of each gas will aid in

understanding how gases move in the respiratory system.

Gas Exchange across the Alveoli

In the body, oxygen is used by cells of the body’s tissues and carbon dioxide is produced as a waste product. The ratio of

carbon dioxide production to oxygen consumption is the respiratory quotient (RQ) . RQ varies between 0.7 and 1.0. If just

glucose were used to fuel the body, the RQ would equal one. One mole of carbon dioxide would be produced for every mole

of oxygen consumed. Glucose, however, is not the only fuel for the body. Protein and fat are also used as fuels for the body.

Because of this, less carbon dioxide is produced than oxygen is consumed and the RQ is, on average, about 0.7 for fat and

about 0.8 for protein.

The RQ is used to calculate the partial pressure of oxygen in the alveolar spaces within the lung, the alveolar PO2Above,

the partial pressure of oxygen in the lungs was calculated to be 150 mm Hg. However, lungs never fully deflate with an

exhalation; therefore, the inspired air mixes with this residual air and lowers the partial pressure of oxygen within the

alveoli. This means that there is a lower concentration of oxygen in the lungs than is found in the air outside the body.

Knowing the RQ, the partial pressure of oxygen in the alveoli can be calculated:

alveolar P O2= inspired P O2− ( alveolar P O2 RQ )

With an RQ of 0.8 and a PCO 2in the alveoli of 40 mm Hg, the alveolar PO2is equal to:

alveolar P O2 = 150 mm Hg − ( 40 mm Hg

0.8 ) = mm Hg.

Notice that this pressure is less than the external air. Therefore, the oxygen will flow from the inspired air in the lung ( PO2

= 150 mm Hg) into the bloodstream ( PO2= 100 mm Hg) ( Figure 39.13 ).

In the lungs, oxygen diffuses out of the alveoli and into the capillaries surrounding the alveoli. Oxygen (about 98 percent)

binds reversibly to the respiratory pigment hemoglobin found in red blood cells (RBCs). RBCs carry oxygen to the tissues

where oxygen dissociates from the hemoglobin and diffuses into the cells of the tissues. More specifically, alveolar PO2

is higher in the alveoli ( PALVO 2= 100 mm Hg) than blood PO2(40 mm Hg) in the capillaries. Because this pressure

gradient exists, oxygen diffuses down its pressure gradient, moving out of the alveoli and entering the blood of the

Chapter 39 | The Respiratory System 1145 capillaries where O 2binds to hemoglobin. At the same time, alveolar PCO 2is lower PALVO 2= 40 mm Hg than blood

PCO 2= (45 mm Hg). CO 2diffuses down its pressure gradient, moving out of the capillaries and entering the alveoli.

Oxygen and carbon dioxide move independently of each other; they diffuse down their own pressure gradients. As blood

leaves the lungs through the pulmonary veins, the venous PO2= 100 mm Hg, whereas the venous PCO 2= 40 mm Hg. As

blood enters the systemic capillaries, the blood will lose oxygen and gain carbon dioxide because of the pressure difference

of the tissues and blood. In systemic capillaries, PO2= 100 mm Hg, but in the tissue cells, PO2= 40 mm Hg. This pressure

gradient drives the diffusion of oxygen out of the capillaries and into the tissue cells. At the same time, blood PCO 2= 40

mm Hg and systemic tissue PCO 2= 45 mm Hg. The pressure gradient drives CO 2out of tissue cells and into the capillaries.

The blood returning to the lungs through the pulmonary arteries has a venous PO2= 40 mm Hg and a PCO 2= 45 mm Hg.

The blood enters the lung capillaries where the process of exchanging gases between the capillaries and alveoli begins again

(Figure 39.13 ).

Figure 39.13 The partial pressures of oxygen and carbon dioxide change as blood moves through the body.

Which of the following statements is false?

a. In the tissues, PO2drops as blood passes from the arteries to the veins, while PCO 2increases.

b. Blood travels from the lungs to the heart to body tissues, then back to the heart, then the lungs.

c. Blood travels from the lungs to the heart to body tissues, then back to the lungs, then the heart.

d. PO2is higher in air than in the lungs.

In short, the change in partial pressure from the alveoli to the capillaries drives the oxygen into the tissues and the carbon

dioxide into the blood from the tissues. The blood is then transported to the lungs where differences in pressure in the alveoli

result in the movement of carbon dioxide out of the blood into the lungs, and oxygen into the blood.

1146 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Watch this video (http://openstaxcollege.org/l/spirometry) to learn how to carry out spirometry.

39.3 | Breathing

By the end of this section, you will be able to:

• Describe how the structures of the lungs and thoracic cavity control the mechanics of breathing

• Explain the importance of compliance and resistance in the lungs

• Discuss problems that may arise due to a V/Q mismatch

Mammalian lungs are located in the thoracic cavity where they are surrounded and protected by the rib cage, intercostal

muscles, and bound by the chest wall. The bottom of the lungs is contained by the diaphragm, a skeletal muscle that

facilitates breathing. Breathing requires the coordination of the lungs, the chest wall, and most importantly, the diaphragm.

Types of Breathing

Amphibians have evolved multiple ways of breathing. Young amphibians, like tadpoles, use gills to breathe, and they don’t

leave the water. Some amphibians retain gills for life. As the tadpole grows, the gills disappear and lungs grow. These

lungs are primitive and not as evolved as mammalian lungs. Adult amphibians are lacking or have a reduced diaphragm, so

breathing via lungs is forced. The other means of breathing for amphibians is diffusion across the skin. To aid this diffusion,

amphibian skin must remain moist.

Birds face a unique challenge with respect to breathing: They fly. Flying consumes a great amount of energy; therefore, birds

require a lot of oxygen to aid their metabolic processes. Birds have evolved a respiratory system that supplies them with

the oxygen needed to enable flying. Similar to mammals, birds have lungs, which are organs specialized for gas exchange.

Oxygenated air, taken in during inhalation, diffuses across the surface of the lungs into the bloodstream, and carbon dioxide

diffuses from the blood into the lungs and expelled during exhalation. The details of breathing between birds and mammals

differ substantially.

In addition to lungs, birds have air sacs inside their body. Air flows in one direction from the posterior air sacs to the lungs

and out of the anterior air sacs. The flow of air is in the opposite direction from blood flow, and gas exchange takes place

much more efficiently. This type of breathing enables birds to obtain the requisite oxygen, even at higher altitudes where

the oxygen concentration is low. This directionality of airflow requires two cycles of air intake and exhalation to completely

get the air out of the lungs.

Chapter 39 | The Respiratory System 1147 Avian Respiration

Birds have evolved a respiratory system that enables them to fly. Flying is a high-energy process and

requires a lot of oxygen. Furthermore, many birds fly in high altitudes where the concentration of oxygen in

low. How did birds evolve a respiratory system that is so unique?

Decades of research by paleontologists have shown that birds evolved from therapods, meat-eating

dinosaurs ( Figure 39.14 ). In fact, fossil evidence shows that meat-eating dinosaurs that lived more than 100

million years ago had a similar flow-through respiratory system with lungs and air sacs. Archaeopteryx and

Xiaotingia , for example, were flying dinosaurs and are believed to be early precursors of birds.

Figure 39.14 (a) Birds have a flow-through respiratory system in which air flows unidirectionally from the posterior

sacs into the lungs, then into the anterior air sacs. The air sacs connect to openings in hollow bones. (b)

Dinosaurs, from which birds descended, have similar hollow bones and are believed to have had a similar

respiratory system. (credit b: modification of work by Zina Deretsky, National Science Foundation)

Most of us consider that dinosaurs are extinct. However, modern birds are descendants of avian dinosaurs.

The respiratory system of modern birds has been evolving for hundreds of millions of years.

1148 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 All mammals have lungs that are the main organs for breathing. Lung capacity has evolved to support the animal’s activities.

During inhalation, the lungs expand with air, and oxygen diffuses across the lung’s surface and enters the bloodstream.

During exhalation, the lungs expel air and lung volume decreases. In the next few sections, the process of human breathing

will be explained.

The Mechanics of Human Breathing

Boyle’s Law is the gas law that states that in a closed space, pressure and volume are inversely related. As volume decreases,

pressure increases and vice versa ( Figure 39.15 ). The relationship between gas pressure and volume helps to explain the

mechanics of breathing.

Figure 39.15 This graph shows data from Boyle’s original 1662 experiment, which shows that pressure and volume

are inversely related. No units are given as Boyle used arbitrary units in his experiments.

There is always a slightly negative pressure within the thoracic cavity, which aids in keeping the airways of the lungs

open. During inhalation, volume increases as a result of contraction of the diaphragm, and pressure decreases (according

to Boyle’s Law). This decrease of pressure in the thoracic cavity relative to the environment makes the cavity less than

the atmosphere ( Figure 39.16 a). Because of this drop in pressure, air rushes into the respiratory passages. To increase the

volume of the lungs, the chest wall expands. This results from the contraction of the intercostal muscles , the muscles that

are connected to the rib cage. Lung volume expands because the diaphragm contracts and the intercostals muscles contract,

thus expanding the thoracic cavity. This increase in the volume of the thoracic cavity lowers pressure compared to the

atmosphere, so air rushes into the lungs, thus increasing its volume. The resulting increase in volume is largely attributed to

an increase in alveolar space, because the bronchioles and bronchi are stiff structures that do not change in size.

Figure 39.16 The lungs, chest wall, and diaphragm are all involved in respiration, both (a) inhalation and (b) expiration.

(credit: modification of work by Mariana Ruiz Villareal)

The chest wall expands out and away from the lungs. The lungs are elastic; therefore, when air fills the lungs, the elastic

recoil within the tissues of the lung exerts pressure back toward the interior of the lungs. These outward and inward forces

Chapter 39 | The Respiratory System 1149 compete to inflate and deflate the lung with every breath. Upon exhalation, the lungs recoil to force the air out of the lungs,

and the intercostal muscles relax, returning the chest wall back to its original position ( Figure 39.16 b). The diaphragm

also relaxes and moves higher into the thoracic cavity. This increases the pressure within the thoracic cavity relative to

the environment, and air rushes out of the lungs. The movement of air out of the lungs is a passive event. No muscles are

contracting to expel the air.

Each lung is surrounded by an invaginated sac. The layer of tissue that covers the lung and dips into spaces is called the

visceral pleura . A second layer of parietal pleura lines the interior of the thorax ( Figure 39.17 ). The space between these

layers, the intrapleural space , contains a small amount of fluid that protects the tissue and reduces the friction generated

from rubbing the tissue layers together as the lungs contract and relax. Pleurisy results when these layers of tissue become

inflamed; it is painful because the inflammation increases the pressure within the thoracic cavity and reduces the volume of

the lung.

Figure 39.17 A tissue layer called pleura surrounds the lung and interior of the thoracic cavity. (credit: modification of

work by NCI)

View (http://openstaxcollege.org/l/boyle_breathing) how Boyle’s Law is related to breathing and watch this video

(http://openstaxcollege.org/l/boyles_law) on Boyle’s Law.

The Work of Breathing

The number of breaths per minute is the respiratory rate . On average, under non-exertion conditions, the human respiratory

rate is 12–15 breaths/minute. The respiratory rate contributes to the alveolar ventilation , or how much air moves into

and out of the alveoli. Alveolar ventilation prevents carbon dioxide buildup in the alveoli. There are two ways to keep

the alveolar ventilation constant: increase the respiratory rate while decreasing the tidal volume of air per breath (shallow

breathing), or decrease the respiratory rate while increasing the tidal volume per breath. In either case, the ventilation

1150 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 remains the same, but the work done and type of work needed are quite different. Both tidal volume and respiratory rate are

closely regulated when oxygen demand increases.

There are two types of work conducted during respiration, flow-resistive and elastic work. Flow-resistive refers to the work

of the alveoli and tissues in the lung, whereas elastic work refers to the work of the intercostal muscles, chest wall, and

diaphragm. Increasing the respiration rate increases the flow-resistive work of the airways and decreases the elastic work of

the muscles. Decreasing the respiratory rate reverses the type of work required.

Surfactant

The air-tissue/water interface of the alveoli has a high surface tension. This surface tension is similar to the surface tension

of water at the liquid-air interface of a water droplet that results in the bonding of the water molecules together. Surfactant

is a complex mixture of phospholipids and lipoproteins that works to reduce the surface tension that exists between the

alveoli tissue and the air found within the alveoli. By lowering the surface tension of the alveolar fluid, it reduces the

tendency of alveoli to collapse.

Surfactant works like a detergent to reduce the surface tension and allows for easier inflation of the airways. When a balloon

is first inflated, it takes a large amount of effort to stretch the plastic and start to inflate the balloon. If a little bit of detergent

was applied to the interior of the balloon, then the amount of effort or work needed to begin to inflate the balloon would

decrease, and it would become much easier to start blowing up the balloon. This same principle applies to the airways. A

small amount of surfactant to the airway tissues reduces the effort or work needed to inflate those airways. Babies born

prematurely sometimes do not produce enough surfactant. As a result, they suffer from respiratory distress syndrome ,

because it requires more effort to inflate their lungs. Surfactant is also important for preventing collapse of small alveoli

relative to large alveoli.

Lung Resistance and Compliance

Pulmonary diseases reduce the rate of gas exchange into and out of the lungs. Two main causes of decreased gas exchange

are compliance (how elastic the lung is) and resistance (how much obstruction exists in the airways). A change in either

can dramatically alter breathing and the ability to take in oxygen and release carbon dioxide.

Examples of restrictive diseases are respiratory distress syndrome and pulmonary fibrosis. In both diseases, the airways are

less compliant and they are stiff or fibrotic. There is a decrease in compliance because the lung tissue cannot bend and move.

In these types of restrictive diseases, the intrapleural pressure is more positive and the airways collapse upon exhalation,

which traps air in the lungs. Forced or functional vital capacity (FVC) , which is the amount of air that can be forcibly

exhaled after taking the deepest breath possible, is much lower than in normal patients, and the time it takes to exhale most

of the air is greatly prolonged ( Figure 39.18 ). A patient suffering from these diseases cannot exhale the normal amount of

air.

Obstructive diseases and conditions include emphysema, asthma, and pulmonary edema. In emphysema, which mostly

arises from smoking tobacco, the walls of the alveoli are destroyed, decreasing the surface area for gas exchange. The

overall compliance of the lungs is increased, because as the alveolar walls are damaged, lung elastic recoil decreases due to a

loss of elastic fibers, and more air is trapped in the lungs at the end of exhalation. Asthma is a disease in which inflammation

is triggered by environmental factors. Inflammation obstructs the airways. The obstruction may be due to edema (fluid

accumulation), smooth muscle spasms in the walls of the bronchioles, increased mucus secretion, damage to the epithelia of

the airways, or a combination of these events. Those with asthma or edema experience increased occlusion from increased

inflammation of the airways. This tends to block the airways, preventing the proper movement of gases ( Figure 39.18 ).

Those with obstructive diseases have large volumes of air trapped after exhalation and breathe at a very high lung volume

to compensate for the lack of airway recruitment.

Chapter 39 | The Respiratory System 1151 Figure 39.18 The ratio of FEV1 (the amount of air that can be forcibly exhaled in one second after taking a deep

breath) to FVC (the total amount of air that can be forcibly exhaled) can be used to diagnose whether a person has

restrictive or obstructive lung disease. In restrictive lung disease, FVC is reduced but airways are not obstructed, so

the person is able to expel air reasonably fast. In obstructive lung disease, airway obstruction results in slow exhalation

as well as reduced FVC. Thus, the FEV1/FVC ratio is lower in persons with obstructive lung disease (less than 69

percent) than in persons with restrictive disease (88 to 90 percent).

Dead Space: V/Q Mismatch

Pulmonary circulation pressure is very low compared to that of the systemic circulation. It is also independent of cardiac

output. This is because of a phenomenon called recruitment , which is the process of opening airways that normally remain

closed when cardiac output increases. As cardiac output increases, the number of capillaries and arteries that are perfused

(filled with blood) increases. These capillaries and arteries are not always in use but are ready if needed. At times, however,

there is a mismatch between the amount of air (ventilation, V) and the amount of blood (perfusion, Q) in the lungs. This is

referred to as ventilation/perfusion (V/Q) mismatch .

There are two types of V/Q mismatch. Both produce dead space , regions of broken down or blocked lung tissue. Dead

spaces can severely impact breathing, because they reduce the surface area available for gas diffusion. As a result, the

amount of oxygen in the blood decreases, whereas the carbon dioxide level increases. Dead space is created when no

ventilation and/or perfusion takes place. Anatomical dead space or anatomical shunt, arises from an anatomical failure,

while physiological dead space or physiological shunt, arises from a functional impairment of the lung or arteries.

An example of an anatomical shunt is the effect of gravity on the lungs. The lung is particularly susceptible to changes in the

magnitude and direction of gravitational forces. When someone is standing or sitting upright, the pleural pressure gradient

leads to increased ventilation further down in the lung. As a result, the intrapleural pressure is more negative at the base

of the lung than at the top, and more air fills the bottom of the lung than the top. Likewise, it takes less energy to pump

blood to the bottom of the lung than to the top when in a prone position. Perfusion of the lung is not uniform while standing

or sitting. This is a result of hydrostatic forces combined with the effect of airway pressure. An anatomical shunt develops

because the ventilation of the airways does not match the perfusion of the arteries surrounding those airways. As a result,

the rate of gas exchange is reduced. Note that this does not occur when lying down, because in this position, gravity does

not preferentially pull the bottom of the lung down.

A physiological shunt can develop if there is infection or edema in the lung that obstructs an area. This will decrease

ventilation but not affect perfusion; therefore, the V/Q ratio changes and gas exchange is affected.

The lung can compensate for these mismatches in ventilation and perfusion. If ventilation is greater than perfusion, the

arterioles dilate and the bronchioles constrict. This increases perfusion and reduces ventilation. Likewise, if ventilation is

less than perfusion, the arterioles constrict and the bronchioles dilate to correct the imbalance.

1152 Chapter 39 | The Respiratory System

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39.4 | Transport of Gases in Human Bodily Fluids

By the end of this section, you will be able to:

• Describe how oxygen is bound to hemoglobin and transported to body tissues

• Explain how carbon dioxide is transported from body tissues to the lungs

Once the oxygen diffuses across the alveoli, it enters the bloodstream and is transported to the tissues where it is unloaded,

and carbon dioxide diffuses out of the blood and into the alveoli to be expelled from the body. Although gas exchange is a

continuous process, the oxygen and carbon dioxide are transported by different mechanisms.

Transport of Oxygen in the Blood

Although oxygen dissolves in blood, only a small amount of oxygen is transported this way. Only 1.5 percent of oxygen in

the blood is dissolved directly into the blood itself. Most oxygen—98.5 percent—is bound to a protein called hemoglobin

and carried to the tissues.

Hemoglobin

Hemoglobin , or Hb, is a protein molecule found in red blood cells (erythrocytes) made of four subunits: two alpha subunits

and two beta subunits ( Figure 39.19 ). Each subunit surrounds a central heme group that contains iron and binds one oxygen

molecule, allowing each hemoglobin molecule to bind four oxygen molecules. Molecules with more oxygen bound to the

heme groups are brighter red. As a result, oxygenated arterial blood where the Hb is carrying four oxygen molecules is

bright red, while venous blood that is deoxygenated is darker red.

Figure 39.19 The protein inside (a) red blood cells that carries oxygen to cells and carbon dioxide to the lungs is (b)

hemoglobin. Hemoglobin is made up of four symmetrical subunits and four heme groups. Iron associated with the

heme binds oxygen. It is the iron in hemoglobin that gives blood its red color.

It is easier to bind a second and third oxygen molecule to Hb than the first molecule. This is because the hemoglobin

molecule changes its shape, or conformation, as oxygen binds. The fourth oxygen is then more difficult to bind. The binding

of oxygen to hemoglobin can be plotted as a function of the partial pressure of oxygen in the blood (x-axis) versus the

Chapter 39 | The Respiratory System 1153 relative Hb-oxygen saturation (y-axis). The resulting graph—an oxygen dissociation curve —is sigmoidal, or S-shaped

(Figure 39.20 ). As the partial pressure of oxygen increases, the hemoglobin becomes increasingly saturated with oxygen.

Figure 39.20 The oxygen dissociation curve demonstrates that, as the partial pressure of oxygen increases,

more oxygen binds hemoglobin. However, the affinity of hemoglobin for oxygen may shift to the left or the right

depending on environmental conditions.

The kidneys are responsible for removing excess H+ ions from the blood. If the kidneys fail, what would

happen to blood pH and to hemoglobin affinity for oxygen?

Factors That Affect Oxygen Binding

The oxygen-carrying capacity of hemoglobin determines how much oxygen is carried in the blood. In addition to PO2,

other environmental factors and diseases can affect oxygen carrying capacity and delivery.

Carbon dioxide levels, blood pH, and body temperature affect oxygen-carrying capacity ( Figure 39.20 ). When carbon

dioxide is in the blood, it reacts with water to form bicarbonate (HCO 3− )and hydrogen ions (H +). As the level of carbon

dioxide in the blood increases, more H +is produced and the pH decreases. This increase in carbon dioxide and subsequent

decrease in pH reduce the affinity of hemoglobin for oxygen. The oxygen dissociates from the Hb molecule, shifting the

oxygen dissociation curve to the right. Therefore, more oxygen is needed to reach the same hemoglobin saturation level

as when the pH was higher. A similar shift in the curve also results from an increase in body temperature. Increased

temperature, such as from increased activity of skeletal muscle, causes the affinity of hemoglobin for oxygen to be reduced.

Diseases like sickle cell anemia and thalassemia decrease the blood’s ability to deliver oxygen to tissues and its oxygen-

carrying capacity. In sickle cell anemia , the shape of the red blood cell is crescent-shaped, elongated, and stiffened,

reducing its ability to deliver oxygen ( Figure 39.21 ). In this form, red blood cells cannot pass through the capillaries. This

is painful when it occurs. Thalassemia is a rare genetic disease caused by a defect in either the alpha or the beta subunit

of Hb. Patients with thalassemia produce a high number of red blood cells, but these cells have lower-than-normal levels of

hemoglobin. Therefore, the oxygen-carrying capacity is diminished.

1154 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 39.21 Individuals with sickle cell anemia have crescent-shaped red blood cells. (credit: modification of work by

Ed Uthman; scale-bar data from Matt Russell)

Transport of Carbon Dioxide in the Blood

Carbon dioxide molecules are transported in the blood from body tissues to the lungs by one of three methods: dissolution

directly into the blood, binding to hemoglobin, or carried as a bicarbonate ion. Several properties of carbon dioxide in the

blood affect its transport. First, carbon dioxide is more soluble in blood than oxygen. About 5 to 7 percent of all carbon

dioxide is dissolved in the plasma. Second, carbon dioxide can bind to plasma proteins or can enter red blood cells and bind

to hemoglobin. This form transports about 10 percent of the carbon dioxide. When carbon dioxide binds to hemoglobin, a

molecule called carbaminohemoglobin is formed. Binding of carbon dioxide to hemoglobin is reversible. Therefore, when

it reaches the lungs, the carbon dioxide can freely dissociate from the hemoglobin and be expelled from the body.

Third, the majority of carbon dioxide molecules (85 percent) are carried as part of the bicarbonate buffer system .

In this system, carbon dioxide diffuses into the red blood cells. Carbonic anhydrase (CA) within the red blood cells

quickly converts the carbon dioxide into carbonic acid (H 2CO 3). Carbonic acid is an unstable intermediate molecule

that immediately dissociates into bicarbonate ions (HCO 3− )and hydrogen (H +) ions. Since carbon dioxide is quickly

converted into bicarbonate ions, this reaction allows for the continued uptake of carbon dioxide into the blood down its

concentration gradient. It also results in the production of H +ions. If too much H +is produced, it can alter blood pH.

However, hemoglobin binds to the free H +ions and thus limits shifts in pH. The newly synthesized bicarbonate ion is

transported out of the red blood cell into the liquid component of the blood in exchange for a chloride ion (Cl -); this is

called the chloride shift . When the blood reaches the lungs, the bicarbonate ion is transported back into the red blood cell in

exchange for the chloride ion. The H +ion dissociates from the hemoglobin and binds to the bicarbonate ion. This produces

the carbonic acid intermediate, which is converted back into carbon dioxide through the enzymatic action of CA. The carbon

dioxide produced is expelled through the lungs during exhalation.

CO 2 + H 2O↔ H2CO 3

(carbonic acid) ↔ HCO 3 + H +

(bicarbonate)

The benefit of the bicarbonate buffer system is that carbon dioxide is “soaked up” into the blood with little change to the pH

of the system. This is important because it takes only a small change in the overall pH of the body for severe injury or death

to result. The presence of this bicarbonate buffer system also allows for people to travel and live at high altitudes: When

the partial pressure of oxygen and carbon dioxide change at high altitudes, the bicarbonate buffer system adjusts to regulate

carbon dioxide while maintaining the correct pH in the body.

Carbon Monoxide Poisoning

While carbon dioxide can readily associate and dissociate from hemoglobin, other molecules such as carbon monoxide (CO)

cannot. Carbon monoxide has a greater affinity for hemoglobin than oxygen. Therefore, when carbon monoxide is present,

it binds to hemoglobin preferentially over oxygen. As a result, oxygen cannot bind to hemoglobin, so very little oxygen

is transported through the body ( Figure 39.22 ). Carbon monoxide is a colorless, odorless gas and is therefore difficult to

detect. It is produced by gas-powered vehicles and tools. Carbon monoxide can cause headaches, confusion, and nausea;

long-term exposure can cause brain damage or death. Administering 100 percent (pure) oxygen is the usual treatment for

carbon monoxide poisoning. Administration of pure oxygen speeds up the separation of carbon monoxide from hemoglobin.

Chapter 39 | The Respiratory System 1155 Figure 39.22 As percent CO increases, the oxygen saturation of hemoglobin decreases.

1156 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 alveolar PO2

alveolar duct

alveolar sac

alveolar ventilation

alveolus

anatomical dead space

bicarbonate (HCO 3− )ion

bicarbonate buffer system

bronchiole

bronchus

carbaminohemoglobin

carbonic anhydrase (CA)

chloride shift

compliance

dead space

diaphragm

elastic recoil

elastic work

expiratory reserve volume (ERV)

FEV1/FVC ratio

flow-resistive

forced expiratory volume (FEV)

functional residual capacity (FRC)

functional vital capacity (FVC)

heme group

hemoglobin

inspiratory capacity (IC)

inspiratory reserve volume (IRV)

KEY TERMS

partial pressure of oxygen in the alveoli (usually around 100 mmHg)

duct that extends from the terminal bronchiole to the alveolar sac

structure consisting of two or more alveoli that share a common opening

how much air is in the alveoli

(plural: alveoli) (also, air sac) terminal region of the lung where gas exchange occurs

(also, anatomical shunt) region of the lung that lacks proper ventilation/perfusion due to an

anatomical block

ion created when carbonic acid dissociates into H +and (HCO 3− )

system in the blood that absorbs carbon dioxide and regulates pH levels

airway that extends from the main tertiary bronchi to the alveolar sac

(plural: bronchi) smaller branch of cartilaginous tissue that stems off of the trachea; air is funneled through the

bronchi to the region where gas exchange occurs in alveoli

molecule that forms when carbon dioxide binds to hemoglobin

enzyme that catalyzes carbon dioxide and water into carbonic acid

chloride shift exchange of chloride for bicarbonate into or out of the red blood cell

measurement of the elasticity of the lung

area in the lung that lacks proper ventilation or perfusion

domed-shaped skeletal muscle located under lungs that separates the thoracic cavity from the abdominal

cavity

property of the lung that drives the lung tissue inward

work conducted by the intercostal muscles, chest wall, and diaphragm

amount of additional air that can be exhaled after a normal exhalation

ratio of how much air can be forced out of the lung in one second to the total amount that is forced out of

the lung; a measurement of lung function that can be used to detect disease states

work of breathing performed by the alveoli and tissues in the lung

(also, forced vital capacity) measure of how much air can be forced out of the lung

from maximal inspiration over a specific amount of time

expiratory reserve volume plus residual volume

amount of air that can be forcibly exhaled after taking the deepest breath possible

centralized iron-containing group that is surrounded by the alpha and beta subunits of hemoglobin

molecule in red blood cells that can bind oxygen, carbon dioxide, and carbon monoxide

tidal volume plus inspiratory reserve volume

amount of additional air that can be inspired after a normal inhalation

Chapter 39 | The Respiratory System 1157 intercostal muscle

intrapleural space

larynx

lung capacity

lung volume

mucin

mucus

nasal cavity

obstructive disease

oxygen dissociation curve

oxygen-carrying capacity

partial pressure

particulate matter

pharynx

physiological dead space

pleura

pleurisy

primary bronchus

recruitment

residual volume (RV)

resistance

respiratory bronchiole

respiratory distress syndrome

respiratory quotient (RQ)

respiratory rate

restrictive disease

sickle cell anemia

spirometry

muscle connected to the rib cage that contracts upon inspiration

space between the layers of pleura

voice box, a short passageway connecting the pharynx and the trachea

measurement of two or more lung volumes (how much air can be inhaled from the end of an expiration to

maximal capacity)

measurement of air for one lung function (normal inhalation or exhalation)

complex glycoprotein found in mucus

sticky protein-containing fluid secretion in the lung that traps particulate matter to be expelled from the body

opening of the respiratory system to the outside environment

disease (such as emphysema and asthma) that arises from obstruction of the airways; compliance

increases in these diseases

curve depicting the affinity of oxygen for hemoglobin

amount of oxygen that can be transported in the blood

amount of pressure exerted by one gas within a mixture of gases

small particle such as dust, dirt, viral particles, and bacteria that are in the air

throat; a tube that starts in the internal nares and runs partway down the neck, where it opens into the esophagus

and the larynx

(also, physiological shunt) region of the lung that lacks proper ventilation/perfusion due to a

physiological change in the lung (like inflammation or edema)

tissue layer that surrounds the lungs and lines the interior of the thoracic cavity

painful inflammation of the pleural tissue layers

(also, main bronchus) region of the airway within the lung that attaches to the trachea and bifurcates

to each lung where it branches into secondary bronchi

process of opening airways that normally remain closed when the cardiac output increases

amount of air remaining in the lung after a maximal expiration

measurement of lung obstruction

terminal portion of the bronchiole tree that is attached to the terminal bronchioles and alveoli

ducts, alveolar sacs, and alveoli

disease that arises from a deficient amount of surfactant

ratio of carbon dioxide production to each oxygen molecule consumed

number of breaths per minute

disease that results from a restriction and decreased compliance of the alveoli; respiratory distress

syndrome and pulmonary fibrosis are examples

genetic disorder that affects the shape of red blood cells, and their ability to transport oxygen and

move through capillaries

method to measure lung volumes and to diagnose lung diseases

1158 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 surfactant

terminal bronchiole

thalassemia

tidal volume (TV)

total lung capacity (TLC)

trachea

venous PCO 2

venous PO2

ventilation/perfusion (V/Q) mismatch

vital capacity (VC)

detergent-like liquid in the airways that lowers the surface tension of the alveoli to allow for expansion

region of bronchiole that attaches to the respiratory bronchioles

rare genetic disorder that results in mutation of the alpha or beta subunits of hemoglobin, creating smaller

red blood cells with less hemoglobin

amount of air that is inspired and expired during normal breathing

sum of the residual volume, expiratory reserve volume, tidal volume, and inspiratory reserve

volume

cartilaginous tube that transports air from the larynx to the primary bronchi

partial pressure of carbon dioxide in the veins (40 mm Hg in the pulmonary veins)

partial pressure of oxygen in the veins (100 mm Hg in the pulmonary veins)

region of the lung that lacks proper alveolar ventilation (V) and/or arterial

perfusion (Q)

sum of the expiratory reserve volume, tidal volume, and inspiratory reserve volume

CHAPTER SUMMARY

39.1 Systems of Gas Exchange

Animal respiratory systems are designed to facilitate gas exchange. In mammals, air is warmed and humidified in the nasal

cavity. Air then travels down the pharynx, through the trachea, and into the lungs. In the lungs, air passes through the

branching bronchi, reaching the respiratory bronchioles, which house the first site of gas exchange. The respiratory

bronchioles open into the alveolar ducts, alveolar sacs, and alveoli. Because there are so many alveoli and alveolar sacs in

the lung, the surface area for gas exchange is very large. Several protective mechanisms are in place to prevent damage or

infection. These include the hair and mucus in the nasal cavity that trap dust, dirt, and other particulate matter before they

can enter the system. In the lungs, particles are trapped in a mucus layer and transported via cilia up to the esophageal

opening at the top of the trachea to be swallowed.

39.2 Gas Exchange across Respiratory Surfaces

The lungs can hold a large volume of air, but they are not usually filled to maximal capacity. Lung volume measurements

include tidal volume, expiratory reserve volume, inspiratory reserve volume, and residual volume. The sum of these equals

the total lung capacity. Gas movement into or out of the lungs is dependent on the pressure of the gas. Air is a mixture of

gases; therefore, the partial pressure of each gas can be calculated to determine how the gas will flow in the lung. The

difference between the partial pressure of the gas in the air drives oxygen into the tissues and carbon dioxide out of the

body.

39.3 Breathing

The structure of the lungs and thoracic cavity control the mechanics of breathing. Upon inspiration, the diaphragm

contracts and lowers. The intercostal muscles contract and expand the chest wall outward. The intrapleural pressure drops,

the lungs expand, and air is drawn into the airways. When exhaling, the intercostal muscles and diaphragm relax, returning

the intrapleural pressure back to the resting state. The lungs recoil and airways close. The air passively exits the lung.

There is high surface tension at the air-airway interface in the lung. Surfactant, a mixture of phospholipids and

lipoproteins, acts like a detergent in the airways to reduce surface tension and allow for opening of the alveoli.

Breathing and gas exchange are both altered by changes in the compliance and resistance of the lung. If the compliance of

the lung decreases, as occurs in restrictive diseases like fibrosis, the airways stiffen and collapse upon exhalation. Air

becomes trapped in the lungs, making breathing more difficult. If resistance increases, as happens with asthma or

emphysema, the airways become obstructed, trapping air in the lungs and causing breathing to become difficult.

Alterations in the ventilation of the airways or perfusion of the arteries can affect gas exchange. These changes in

ventilation and perfusion, called V/Q mismatch, can arise from anatomical or physiological changes.

Chapter 39 | The Respiratory System 1159 39.4 Transport of Gases in Human Bodily Fluids

Hemoglobin is a protein found in red blood cells that is comprised of two alpha and two beta subunits that surround an

iron-containing heme group. Oxygen readily binds this heme group. The ability of oxygen to bind increases as more

oxygen molecules are bound to heme. Disease states and altered conditions in the body can affect the binding ability of

oxygen, and increase or decrease its ability to dissociate from hemoglobin.

Carbon dioxide can be transported through the blood via three methods. It is dissolved directly in the blood, bound to

plasma proteins or hemoglobin, or converted into bicarbonate. The majority of carbon dioxide is transported as part of the

bicarbonate system. Carbon dioxide diffuses into red blood cells. Inside, carbonic anhydrase converts carbon dioxide into

carbonic acid (H 2CO 3), which is subsequently hydrolyzed into bicarbonate (HCO 3− )and H +. The H +ion binds to

hemoglobin in red blood cells, and bicarbonate is transported out of the red blood cells in exchange for a chloride ion. This

is called the chloride shift. Bicarbonate leaves the red blood cells and enters the blood plasma. In the lungs, bicarbonate is

transported back into the red blood cells in exchange for chloride. The H +dissociates from hemoglobin and combines with

bicarbonate to form carbonic acid with the help of carbonic anhydrase, which further catalyzes the reaction to convert

carbonic acid back into carbon dioxide and water. The carbon dioxide is then expelled from the lungs.

ART CONNECTION QUESTIONS

1. Figure 39.7 Which of the following statements about

the mammalian respiratory system is false?

a. When we breathe in, air travels from the

pharynx to the trachea.

b. The bronchioles branch into bronchi.

c. Alveolar ducts connect to alveolar sacs.

d. Gas exchange between the lung and blood takes

place in the alveolus.

2. Figure 39.13 Which of the following statements is

false?

a. In the tissues, PO2drops as blood passes from

the arteries to the veins, while PCO 2increases.

b. Blood travels from the lungs to the heart to body

tissues, then back to the heart, then the lungs.

c. Blood travels from the lungs to the heart to body

tissues, then back to the lungs, then the heart.

d. PO2is higher in air than in the lungs.

3. Figure 39.20 The kidneys are responsible for removing

excess H+ ions from the blood. If the kidneys fail, what

would happen to blood pH and to hemoglobin affinity for

oxygen?

REVIEW QUESTIONS

4. The respiratory system ________.

a. provides body tissues with oxygen

b. provides body tissues with oxygen and carbon

dioxide

c. establishes how many breaths are taken per

minute

d. provides the body with carbon dioxide

5. Air is warmed and humidified in the nasal passages.

This helps to ________.

a. ward off infection

b. decrease sensitivity during breathing

c. prevent damage to the lungs

d. all of the above

6. Which is the order of airflow during inhalation?

a. nasal cavity, trachea, larynx, bronchi,

bronchioles, alveoli

b. nasal cavity, larynx, trachea, bronchi,

bronchioles, alveoli

c. nasal cavity, larynx, trachea, bronchioles,

bronchi, alveoli

d. nasal cavity, trachea, larynx, bronchi,

bronchioles, alveoli

7. The inspiratory reserve volume measures the ________.

a. amount of air remaining in the lung after a

maximal exhalation

b. amount of air that the lung holds

c. amount of air the can be further exhaled after a

normal breath

d. amount of air that can be further inhaled after a

normal breath

8. Of the following, which does not explain why the

partial pressure of oxygen is lower in the lung than in the

external air?

a. Air in the lung is humidified; therefore, water

vapor pressure alters the pressure.

b. Carbon dioxide mixes with oxygen.

c. Oxygen is moved into the blood and is headed to

the tissues.

d. Lungs exert a pressure on the air to reduce the

oxygen pressure.

1160 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 9. The total lung capacity is calculated using which of the

following formulas?

a. residual volume + tidal volume + inspiratory

reserve volume

b. residual volume + expiratory reserve volume +

inspiratory reserve volume

c. expiratory reserve volume + tidal volume +

inspiratory reserve volume

d. residual volume + expiratory reserve volume +

tidal volume + inspiratory reserve volume

10. How would paralysis of the diaphragm alter

inspiration?

a. It would prevent contraction of the intercostal

muscles.

b. It would prevent inhalation because the

intrapleural pressure would not change.

c. It would decrease the intrapleural pressure and

allow more air to enter the lungs.

d. It would slow expiration because the lung would

not relax.

11. Restrictive airway diseases ________.

a. increase the compliance of the lung

b. decrease the compliance of the lung

c. increase the lung volume

d. decrease the work of breathing

12. Alveolar ventilation remains constant when ________.

a. the respiratory rate is increased while the

volume of air per breath is decreased

b. the respiratory rate and the volume of air per

breath are increased

c. the respiratory rate is decreased while increasing

the volume per breath

d. both a and c

13. Which of the following will NOT facilitate the transfer

of oxygen to tissues?

a. decreased body temperature

b. decreased pH of the blood

c. increased carbon dioxide

d. increased exercise

14. The majority of carbon dioxide in the blood is

transported by ________.

a. binding to hemoglobin

b. dissolution in the blood

c. conversion to bicarbonate

d. binding to plasma proteins

15. The majority of oxygen in the blood is transported by

________.

a. dissolution in the blood

b. being carried as bicarbonate ions

c. binding to blood plasma

d. binding to hemoglobin

CRITICAL THINKING QUESTIONS

16. Describe the function of these terms and describe

where they are located: main bronchus, trachea, alveoli,

and acinus.

17. How does the structure of alveoli maximize gas

exchange?

18. What does FEV1/FVC measure? What factors may

affect FEV1/FVC?

19. What is the reason for having residual volume in the

lung?

20. How can a decrease in the percent of oxygen in the air

affect the movement of oxygen in the body?

21. If a patient has increased resistance in his or her lungs,

how can this detected by a doctor? What does this mean?

22. How would increased airway resistance affect

intrapleural pressure during inhalation?

23. Explain how a puncture to the thoracic cavity (from a

knife wound, for instance) could alter the ability to inhale.

24. When someone is standing, gravity stretches the

bottom of the lung down toward the floor to a greater

extent than the top of the lung. What implication could this

have on the flow of air in the lungs? Where does gas

exchange occur in the lungs?

25. What would happen if no carbonic anhydrase were

present in red blood cells?

26. How does the administration of 100 percent oxygen

save a patient from carbon monoxide poisoning? Why

wouldn’t giving carbon dioxide work?

Chapter 39 | The Respiratory System 1161 1162 Chapter 39 | The Respiratory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 40 | THE CIRCULATORY

SYSTEM

Figure 40.1 Just as highway systems transport people and goods through a complex network, the circulatory system

transports nutrients, gases, and wastes throughout the animal body. (credit: modification of work by Andrey Belenko)

Chapter Outline

40.1: Overview of the Circulatory System

40.2: Components of the Blood

40.3: Mammalian Heart and Blood Vessels

40.4: Blood Flow and Blood Pressure Regulation

Introduction

Most animals are complex multicellular organisms that require a mechanism for transporting nutrients throughout their

bodies and removing waste products. The circulatory system has evolved over time from simple diffusion through cells in

the early evolution of animals to a complex network of blood vessels that reach all parts of the human body. This extensive

network supplies the cells, tissues, and organs with oxygen and nutrients, and removes carbon dioxide and waste, which are

byproducts of respiration.

At the core of the human circulatory system is the heart. The size of a clenched fist, the human heart is protected beneath

the rib cage. Made of specialized and unique cardiac muscle, it pumps blood throughout the body and to the heart itself.

Heart contractions are driven by intrinsic electrical impulses that the brain and endocrine hormones help to regulate.

Understanding the heart’s basic anatomy and function is important to understanding the body’s circulatory and respiratory

systems.

Gas exchange is one essential function of the circulatory system. A circulatory system is not needed in organisms with

no specialized respiratory organs because oxygen and carbon dioxide diffuse directly between their body tissues and

the external environment. However, in organisms that possess lungs and gills, oxygen must be transported from these

specialized respiratory organs to the body tissues via a circulatory system. Therefore, circulatory systems have had to evolve

to accommodate the great diversity of body sizes and body types present among animals.

Chapter 40 | The Circulatory System 1163 40.1 | Overview of the Circulatory System

By the end of this section, you will be able to:

• Describe an open and closed circulatory system

• Describe interstitial fluid and hemolymph

• Compare and contrast the organization and evolution of the vertebrate circulatory system.

In all animals, except a few simple types, the circulatory system is used to transport nutrients and gases through the body.

Simple diffusion allows some water, nutrient, waste, and gas exchange into primitive animals that are only a few cell layers

thick; however, bulk flow is the only method by which the entire body of larger more complex organisms is accessed.

Circulatory System Architecture

The circulatory system is effectively a network of cylindrical vessels: the arteries, veins, and capillaries that emanate from a

pump, the heart. In all vertebrate organisms, as well as some invertebrates, this is a closed-loop system, in which the blood is

not free in a cavity. In a closed circulatory system , blood is contained inside blood vessels and circulates unidirectionally

from the heart around the systemic circulatory route, then returns to the heart again, as illustrated in Figure 40.2 a. As

opposed to a closed system, arthropods—including insects, crustaceans, and most mollusks—have an open circulatory

system, as illustrated in Figure 40.2 b. In an open circulatory system , the blood is not enclosed in the blood vessels but is

pumped into a cavity called a hemocoel and is called hemolymph because the blood mixes with the interstitial fluid . As

the heart beats and the animal moves, the hemolymph circulates around the organs within the body cavity and then reenters

the hearts through openings called ostia . This movement allows for gas and nutrient exchange. An open circulatory system

does not use as much energy as a closed system to operate or to maintain; however, there is a trade-off with the amount of

blood that can be moved to metabolically active organs and tissues that require high levels of oxygen. In fact, one reason

that insects with wing spans of up to two feet wide (70 cm) are not around today is probably because they were outcompeted

by the arrival of birds 150 million years ago. Birds, having a closed circulatory system, are thought to have moved more

agilely, allowing them to get food faster and possibly to prey on the insects.

Figure 40.2 In (a) closed circulatory systems, the heart pumps blood through vessels that are separate from the

interstitial fluid of the body. Most vertebrates and some invertebrates, like this annelid earthworm, have a closed

circulatory system. In (b) open circulatory systems, a fluid called hemolymph is pumped through a blood vessel that

empties into the body cavity. Hemolymph returns to the blood vessel through openings called ostia. Arthropods like

this bee and most mollusks have open circulatory systems.

Circulatory System Variation in Animals

The circulatory system varies from simple systems in invertebrates to more complex systems in vertebrates. The simplest

animals, such as the sponges (Porifera) and rotifers (Rotifera), do not need a circulatory system because diffusion allows

adequate exchange of water, nutrients, and waste, as well as dissolved gases, as shown in Figure 40.3 a. Organisms that

are more complex but still only have two layers of cells in their body plan, such as jellies (Cnidaria) and comb jellies

(Ctenophora) also use diffusion through their epidermis and internally through the gastrovascular compartment. Both their

internal and external tissues are bathed in an aqueous environment and exchange fluids by diffusion on both sides, as

illustrated in Figure 40.3 b. Exchange of fluids is assisted by the pulsing of the jellyfish body.

1164 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 40.3 Simple animals consisting of a single cell layer such as the (a) sponge or only a few cell layers such as

the (b) jellyfish do not have a circulatory system. Instead, gases, nutrients, and wastes are exchanged by diffusion.

For more complex organisms, diffusion is not efficient for cycling gases, nutrients, and waste effectively through the

body; therefore, more complex circulatory systems evolved. Most arthropods and many mollusks have open circulatory

systems. In an open system, an elongated beating heart pushes the hemolymph through the body and muscle contractions

help to move fluids. The larger more complex crustaceans, including lobsters, have developed arterial-like vessels to push

blood through their bodies, and the most active mollusks, such as squids, have evolved a closed circulatory system and

are able to move rapidly to catch prey. Closed circulatory systems are a characteristic of vertebrates; however, there are

significant differences in the structure of the heart and the circulation of blood between the different vertebrate groups due

to adaptation during evolution and associated differences in anatomy. Figure 40.4 illustrates the basic circulatory systems

of some vertebrates: fish, amphibians, reptiles, and mammals.

Chapter 40 | The Circulatory System 1165 Figure 40.4 (a) Fish have the simplest circulatory systems of the vertebrates: blood flows unidirectionally from the two-

chambered heart through the gills and then the rest of the body. (b) Amphibians have two circulatory routes: one for

oxygenation of the blood through the lungs and skin, and the other to take oxygen to the rest of the body. The blood

is pumped from a three-chambered heart with two atria and a single ventricle. (c) Reptiles also have two circulatory

routes; however, blood is only oxygenated through the lungs. The heart is three chambered, but the ventricles are

partially separated so some mixing of oxygenated and deoxygenated blood occurs except in crocodilians and birds.

(d) Mammals and birds have the most efficient heart with four chambers that completely separate the oxygenated and

deoxygenated blood; it pumps only oxygenated blood through the body and deoxygenated blood to the lungs.

As illustrated in Figure 40.4 aFish have a single circuit for blood flow and a two-chambered heart that has only a single

atrium and a single ventricle. The atrium collects blood that has returned from the body and the ventricle pumps the blood to

the gills where gas exchange occurs and the blood is re-oxygenated; this is called gill circulation . The blood then continues

through the rest of the body before arriving back at the atrium; this is called systemic circulation . This unidirectional flow

of blood produces a gradient of oxygenated to deoxygenated blood around the fish’s systemic circuit. The result is a limit in

the amount of oxygen that can reach some of the organs and tissues of the body, reducing the overall metabolic capacity of

fish.

1166 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 In amphibians, reptiles, birds, and mammals, blood flow is directed in two circuits: one through the lungs and back to the

heart, which is called pulmonary circulation , and the other throughout the rest of the body and its organs including the

brain (systemic circulation). In amphibians, gas exchange also occurs through the skin during pulmonary circulation and is

referred to as pulmocutaneous circulation .

As shown in Figure 40.4 b, amphibians have a three-chambered heart that has two atria and one ventricle rather than the

two-chambered heart of fish. The two atria (superior heart chambers) receive blood from the two different circuits (the

lungs and the systems), and then there is some mixing of the blood in the heart’s ventricle (inferior heart chamber), which

reduces the efficiency of oxygenation. The advantage to this arrangement is that high pressure in the vessels pushes blood

to the lungs and body. The mixing is mitigated by a ridge within the ventricle that diverts oxygen-rich blood through the

systemic circulatory system and deoxygenated blood to the pulmocutaneous circuit. For this reason, amphibians are often

described as having double circulation .

Most reptiles also have a three-chambered heart similar to the amphibian heart that directs blood to the pulmonary and

systemic circuits, as shown in Figure 40.4 c. The ventricle is divided more effectively by a partial septum, which results in

less mixing of oxygenated and deoxygenated blood. Some reptiles (alligators and crocodiles) are the most primitive animals

to exhibit a four-chambered heart. Crocodilians have a unique circulatory mechanism where the heart shunts blood from

the lungs toward the stomach and other organs during long periods of submergence, for instance, while the animal waits for

prey or stays underwater waiting for prey to rot. One adaptation includes two main arteries that leave the same part of the

heart: one takes blood to the lungs and the other provides an alternate route to the stomach and other parts of the body. Two

other adaptations include a hole in the heart between the two ventricles, called the foramen of Panizza, which allows blood

to move from one side of the heart to the other, and specialized connective tissue that slows the blood flow to the lungs.

Together these adaptations have made crocodiles and alligators one of the most evolutionarily successful animal groups on

earth.

In mammals and birds, the heart is also divided into four chambers: two atria and two ventricles, as illustrated in Figure

40.4 d. The oxygenated blood is separated from the deoxygenated blood, which improves the efficiency of double circulation

and is probably required for the warm-blooded lifestyle of mammals and birds. The four-chambered heart of birds and

mammals evolved independently from a three-chambered heart. The independent evolution of the same or a similar

biological trait is referred to as convergent evolution.

40.2 | Components of the Blood

By the end of this section, you will be able to:

• List the basic components of the blood

• Compare red and white blood cells

• Describe blood plasma and serum

Hemoglobin is responsible for distributing oxygen, and to a lesser extent, carbon dioxide, throughout the circulatory systems

of humans, vertebrates, and many invertebrates. The blood is more than the proteins, though. Blood is actually a term

used to describe the liquid that moves through the vessels and includes plasma (the liquid portion, which contains water,

proteins, salts, lipids, and glucose) and the cells (red and white cells) and cell fragments called platelets . Blood plasma

is actually the dominant component of blood and contains the water, proteins, electrolytes, lipids, and glucose. The cells

are responsible for carrying the gases (red cells) and immune the response (white). The platelets are responsible for blood

clotting. Interstitial fluid that surrounds cells is separate from the blood, but in hemolymph, they are combined. In humans,

cellular components make up approximately 45 percent of the blood and the liquid plasma 55 percent. Blood is 20 percent

of a person’s extracellular fluid and eight percent of weight.

The Role of Blood in the Body

Blood, like the human blood illustrated in Figure 40.5 is important for regulation of the body’s systems and homeostasis.

Blood helps maintain homeostasis by stabilizing pH, temperature, osmotic pressure, and by eliminating excess heat.

Blood supports growth by distributing nutrients and hormones, and by removing waste. Blood plays a protective role by

transporting clotting factors and platelets to prevent blood loss and transporting the disease-fighting agents or white blood

cells to sites of infection.

Chapter 40 | The Circulatory System 1167 Figure 40.5 The cells and cellular components of human blood are shown. Red blood cells deliver oxygen to the

cells and remove carbon dioxide. White blood cells—including neutrophils, monocytes, lymphocytes, eosinophils, and

basophils—are involved in the immune response. Platelets form clots that prevent blood loss after injury.

Red Blood Cells

Red blood cells , or erythrocytes (erythro- = “red”; -cyte = “cell”), are specialized cells that circulate through the body

delivering oxygen to cells; they are formed from stem cells in the bone marrow. In mammals, red blood cells are small

biconcave cells that at maturity do not contain a nucleus or mitochondria and are only 7–8 µm in size. In birds and non-

avian reptiles, a nucleus is still maintained in red blood cells.

The red coloring of blood comes from the iron-containing protein hemoglobin, illustrated in Figure 40.6 a. The principal job

of this protein is to carry oxygen, but it also transports carbon dioxide as well. Hemoglobin is packed into red blood cells at

a rate of about 250 million molecules of hemoglobin per cell. Each hemoglobin molecule binds four oxygen molecules so

that each red blood cell carries one billion molecules of oxygen. There are approximately 25 trillion red blood cells in the

five liters of blood in the human body, which could carry up to 25 sextillion (25 × 10 21) molecules of oxygen in the body at

any time. In mammals, the lack of organelles in erythrocytes leaves more room for the hemoglobin molecules, and the lack

of mitochondria also prevents use of the oxygen for metabolic respiration. Only mammals have anucleated red blood cells,

and some mammals (camels, for instance) even have nucleated red blood cells. The advantage of nucleated red blood cells

is that these cells can undergo mitosis. Anucleated red blood cells metabolize anaerobically (without oxygen), making use

of a primitive metabolic pathway to produce ATP and increase the efficiency of oxygen transport.

Not all organisms use hemoglobin as the method of oxygen transport. Invertebrates that utilize hemolymph rather than

blood use different pigments to bind to the oxygen. These pigments use copper or iron to the oxygen. Invertebrates have

a variety of other respiratory pigments. Hemocyanin, a blue-green, copper-containing protein, illustrated in Figure 40.6 b

is found in mollusks, crustaceans, and some of the arthropods. Chlorocruorin, a green-colored, iron-containing pigment is

found in four families of polychaete tubeworms. Hemerythrin, a red, iron-containing protein is found in some polychaete

worms and annelids and is illustrated in Figure 40.6 c. Despite the name, hemerythrin does not contain a heme group and

its oxygen-carrying capacity is poor compared to hemoglobin.

1168 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 40.6 In most vertebrates, (a) hemoglobin delivers oxygen to the body and removes some carbon dioxide.

Hemoglobin is composed of four protein subunits, two alpha chains and two beta chains, and a heme group that has

iron associated with it. The iron reversibly associates with oxygen, and in so doing is oxidized from Fe 2+ to Fe 3+.In

most mollusks and some arthropods, (b) hemocyanin delivers oxygen. Unlike hemoglobin, hemolymph is not carried in

blood cells, but floats free in the hemolymph. Copper instead of iron binds the oxygen, giving the hemolymph a blue-

green color. In annelids, such as the earthworm, and some other invertebrates, (c) hemerythrin carries oxygen. Like

hemoglobin, hemerythrin is carried in blood cells and has iron associated with it, but despite its name, hemerythrin

does not contain heme.

The small size and large surface area of red blood cells allows for rapid diffusion of oxygen and carbon dioxide across the

plasma membrane. In the lungs, carbon dioxide is released and oxygen is taken in by the blood. In the tissues, oxygen is

released from the blood and carbon dioxide is bound for transport back to the lungs. Studies have found that hemoglobin

also binds nitrous oxide (NO). NO is a vasodilator that relaxes the blood vessels and capillaries and may help with gas

exchange and the passage of red blood cells through narrow vessels. Nitroglycerin, a heart medication for angina and heart

attacks, is converted to NO to help relax the blood vessels and increase oxygen flow through the body.

A characteristic of red blood cells is their glycolipid and glycoprotein coating; these are lipids and proteins that have

carbohydrate molecules attached. In humans, the surface glycoproteins and glycolipids on red blood cells vary between

individuals, producing the different blood types, such as A, B, and O. Red blood cells have an average life span of 120 days,

at which time they are broken down and recycled in the liver and spleen by phagocytic macrophages, a type of white blood

cell.

White Blood Cells

White blood cells, also called leukocytes (leuko = white), make up approximately one percent by volume of the cells in

blood. The role of white blood cells is very different than that of red blood cells: they are primarily involved in the immune

response to identify and target pathogens, such as invading bacteria, viruses, and other foreign organisms. White blood cells

are formed continually; some only live for hours or days, but some live for years.

The morphology of white blood cells differs significantly from red blood cells. They have nuclei and do not contain

hemoglobin. The different types of white blood cells are identified by their microscopic appearance after histologic staining,

and each has a different specialized function. The two main groups, both illustrated in Figure 40.7 are the granulocytes,

which include the neutrophils, eosinophils, and basophils, and the agranulocytes, which include the monocytes and

lymphocytes.

Chapter 40 | The Circulatory System 1169 Figure 40.7 (a) Granulocytes—including neutrophils, eosinophils and basophils—are characterized by a lobed nucleus

and granular inclusions in the cytoplasm. Granulocytes are typically first-responders during injury or infection. (b)

Agranulocytes include lymphocytes and monocytes. Lymphocytes, including B and T cells, are responsible for adaptive

immune response. Monocytes differentiate into macrophages and dendritic cells, which in turn respond to infection or

injury.

Granulocytes contain granules in their cytoplasm; the agranulocytes are so named because of the lack of granules in their

cytoplasm. Some leukocytes become macrophages that either stay at the same site or move through the blood stream and

gather at sites of infection or inflammation where they are attracted by chemical signals from foreign particles and damaged

cells. Lymphocytes are the primary cells of the immune system and include B cells, T cells, and natural killer cells. B

cells destroy bacteria and inactivate their toxins. They also produce antibodies. T cells attack viruses, fungi, some bacteria,

transplanted cells, and cancer cells. T cells attack viruses by releasing toxins that kill the viruses. Natural killer cells attack

a variety of infectious microbes and certain tumor cells.

One reason that HIV poses significant management challenges is because the virus directly targets T cells by gaining entry

through a receptor. Once inside the cell, HIV then multiplies using the T cell’s own genetic machinery. After the HIV virus

replicates, it is transmitted directly from the infected T cell to macrophages. The presence of HIV can remain unrecognized

for an extensive period of time before full disease symptoms develop.

Platelets and Coagulation Factors

Blood must clot to heal wounds and prevent excess blood loss. Small cell fragments called platelets (thrombocytes) are

attracted to the wound site where they adhere by extending many projections and releasing their contents. These contents

activate other platelets and also interact with other coagulation factors, which convert fibrinogen, a water-soluble protein

present in blood serum into fibrin (a non-water soluble protein), causing the blood to clot. Many of the clotting factors

require vitamin K to work, and vitamin K deficiency can lead to problems with blood clotting. Many platelets converge and

stick together at the wound site forming a platelet plug (also called a fibrin clot), as illustrated in Figure 40.8 b. The plug or

clot lasts for a number of days and stops the loss of blood. Platelets are formed from the disintegration of larger cells called

megakaryocytes, like that shown in Figure 40.8 a. For each megakaryocyte, 2000–3000 platelets are formed with 150,000

to 400,000 platelets present in each cubic millimeter of blood. Each platelet is disc shaped and 2–4 μm in diameter. They

contain many small vesicles but do not contain a nucleus.

1170 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 40.8 (a) Platelets are formed from large cells called megakaryocytes. The megakaryocyte breaks up into

thousands of fragments that become platelets. (b) Platelets are required for clotting of the blood. The platelets collect

at a wound site in conjunction with other clotting factors, such as fibrinogen, to form a fibrin clot that prevents blood

loss and allows the wound to heal.

Plasma and Serum

The liquid component of blood is called plasma, and it is separated by spinning or centrifuging the blood at high rotations

(3000 rpm or higher). The blood cells and platelets are separated by centrifugal forces to the bottom of a specimen tube.

The upper liquid layer, the plasma, consists of 90 percent water along with various substances required for maintaining the

body’s pH, osmotic load, and for protecting the body. The plasma also contains the coagulation factors and antibodies.

The plasma component of blood without the coagulation factors is called the serum . Serum is similar to interstitial fluid in

which the correct composition of key ions acting as electrolytes is essential for normal functioning of muscles and nerves.

Other components in the serum include proteins that assist with maintaining pH and osmotic balance while giving viscosity

to the blood. The serum also contains antibodies, specialized proteins that are important for defense against viruses and

bacteria. Lipids, including cholesterol, are also transported in the serum, along with various other substances including

nutrients, hormones, metabolic waste, plus external substances, such as, drugs, viruses, and bacteria.

Human serum albumin is the most abundant protein in human blood plasma and is synthesized in the liver. Albumin, which

constitutes about half of the blood serum protein, transports hormones and fatty acids, buffers pH, and maintains osmotic

pressures. Immunoglobin is a protein antibody produced in the mucosal lining and plays an important role in antibody

mediated immunity.

Chapter 40 | The Circulatory System 1171 Blood Types Related to Proteins on the Surface of the Red Blood

Cells

Red blood cells are coated in antigens made of glycolipids and glycoproteins. The composition of these

molecules is determined by genetics, which have evolved over time. In humans, the different surface

antigens are grouped into 24 different blood groups with more than 100 different antigens on each red

blood cell. The two most well known blood groups are the ABO, shown in Figure 40.9 , and Rh systems.

The surface antigens in the ABO blood group are glycolipids, called antigen A and antigen B. People with

blood type A have antigen A, those with blood type B have antigen B, those with blood type AB have both

antigens, and people with blood type O have neither antigen. Antibodies called agglutinougens are found in

the blood plasma and react with the A or B antigens, if the two are mixed. When type A and type B blood are

combined, agglutination (clumping) of the blood occurs because of antibodies in the plasma that bind with

the opposing antigen; this causes clots that coagulate in the kidney causing kidney failure. Type O blood

has neither A or B antigens, and therefore, type O blood can be given to all blood types. Type O negative

blood is the universal donor. Type AB positive blood is the universal acceptor because it has both A and B

antigen. The ABO blood groups were discovered in 1900 and 1901 by Karl Landsteiner at the University of

Vienna.

The Rh blood group was first discovered in Rhesus monkeys. Most people have the Rh antigen (Rh+) and

do not have anti-Rh antibodies in their blood. The few people who do not have the Rh antigen and are

Rh– can develop anti-Rh antibodies if exposed to Rh+ blood. This can happen after a blood transfusion

or after an Rh– woman has an Rh+ baby. The first exposure does not usually cause a reaction; however,

at the second exposure, enough antibodies have built up in the blood to produce a reaction that causes

agglutination and breakdown of red blood cells. An injection can prevent this reaction.

Figure 40.9 Human red blood cells may have either type A or B glycoproteins on their surface, both glycoproteins

combined (AB), or neither (O). The glycoproteins serve as antigens and can elicit an immune response in a person

who receives a transfusion containing unfamiliar antigens. Type O blood, which has no A or B antigens, does not

elicit an immune response when injected into a person of any blood type. Thus, O is considered the universal

donor. Persons with type AB blood can accept blood from any blood type, and type AB is considered the universal

acceptor.

Play a blood typing game on the Nobel Prize website (http://openstaxcollege.org/l/blood_typing) to solidify your

understanding of blood types.

1172 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 40.3 | Mammalian Heart and Blood Vessels

By the end of this section, you will be able to:

• Describe the structure of the heart and explain how cardiac muscle is different from other muscles

• Describe the cardiac cycle

• Explain the structure of arteries, veins, and capillaries, and how blood flows through the body

The heart is a complex muscle that pumps blood through the three divisions of the circulatory system: the coronary (vessels

that serve the heart), pulmonary (heart and lungs), and systemic (systems of the body), as shown in Figure 40.10 . Coronary

circulation intrinsic to the heart takes blood directly from the main artery (aorta) coming from the heart. For pulmonary and

systemic circulation, the heart has to pump blood to the lungs or the rest of the body, respectively. In vertebrates, the lungs

are relatively close to the heart in the thoracic cavity. The shorter distance to pump means that the muscle wall on the right

side of the heart is not as thick as the left side which must have enough pressure to pump blood all the way to your big toe.

Figure 40.10 The mammalian circulatory system is divided into three circuits: the systemic circuit, the pulmonary

circuit, and the coronary circuit. Blood is pumped from veins of the systemic circuit into the right atrium of the

heart, then into the right ventricle. Blood then enters the pulmonary circuit, and is oxygenated by the lungs. From

the pulmonary circuit, blood re-enters the heart through the left atrium. From the left ventricle, blood re-enters the

systemic circuit through the aorta and is distributed to the rest of the body. The coronary circuit, which provides

blood to the heart, is not shown.

Which of the following statements about the circulatory system is false?

a. Blood in the pulmonary vein is deoxygenated.

b. Blood in the inferior vena cava is deoxygenated.

c. Blood in the pulmonary artery is deoxygenated.

d. Blood in the aorta is oxygenated.

Chapter 40 | The Circulatory System 1173 Structure of the Heart

The heart muscle is asymmetrical as a result of the distance blood must travel in the pulmonary and systemic circuits. Since

the right side of the heart sends blood to the pulmonary circuit it is smaller than the left side which must send blood out to

the whole body in the systemic circuit, as shown in Figure 40.11 . In humans, the heart is about the size of a clenched fist; it

is divided into four chambers: two atria and two ventricles. There is one atrium and one ventricle on the right side and one

atrium and one ventricle on the left side. The atria are the chambers that receive blood, and the ventricles are the chambers

that pump blood. The right atrium receives deoxygenated blood from the superior vena cava , which drains blood from the

jugular vein that comes from the brain and from the veins that come from the arms, as well as from the inferior vena cava

which drains blood from the veins that come from the lower organs and the legs. In addition, the right atrium receives blood

from the coronary sinus which drains deoxygenated blood from the heart itself. This deoxygenated blood then passes to the

right ventricle through the atrioventricular valve or the tricuspid valve , a flap of connective tissue that opens in only one

direction to prevent the backflow of blood. The valve separating the chambers on the left side of the heart valve is called the

biscuspid or mitral valve. After it is filled, the right ventricle pumps the blood through the pulmonary arteries, by-passing

the semilunar valve (or pulmonic valve) to the lungs for re-oxygenation. After blood passes through the pulmonary arteries,

the right semilunar valves close preventing the blood from flowing backwards into the right ventricle. The left atrium then

receives the oxygen-rich blood from the lungs via the pulmonary veins. This blood passes through the bicuspid valve or

mitral valve (the atrioventricular valve on the left side of the heart) to the left ventricle where the blood is pumped out

through aorta , the major artery of the body, taking oxygenated blood to the organs and muscles of the body. Once blood

is pumped out of the left ventricle and into the aorta, the aortic semilunar valve (or aortic valve) closes preventing blood

from flowing backward into the left ventricle. This pattern of pumping is referred to as double circulation and is found in

all mammals.

1174 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 40.11 (a) The heart is primarily made of a thick muscle layer, called the myocardium, surrounded by

membranes. One-way valves separate the four chambers. (b) Blood vessels of the coronary system, including the

coronary arteries and veins, keep the heart musculature oxygenated.

Which of the following statements about the heart is false?

a. The mitral valve separates the left ventricle from the left atrium.

b. Blood travels through the bicuspid valve to the left atrium.

c. Both the aortic and the pulmonary valves are semilunar valves.

d. The mitral valve is an atrioventricular valve.

The heart is composed of three layers; the epicardium, the myocardium, and the endocardium, illustrated in Figure 40.11 .

The inner wall of the heart has a lining called the endocardium . The myocardium consists of the heart muscle cells that

Chapter 40 | The Circulatory System 1175 make up the middle layer and the bulk of the heart wall. The outer layer of cells is called the epicardium , of which the

second layer is a membranous layered structure called the pericardium that surrounds and protects the heart; it allows

enough room for vigorous pumping but also keeps the heart in place to reduce friction between the heart and other

structures.

The heart has its own blood vessels that supply the heart muscle with blood. The coronary arteries branch from the aorta

and surround the outer surface of the heart like a crown. They diverge into capillaries where the heart muscle is supplied

with oxygen before converging again into the coronary veins to take the deoxygenated blood back to the right atrium

where the blood will be re-oxygenated through the pulmonary circuit. The heart muscle will die without a steady supply

of blood. Atherosclerosis is the blockage of an artery by the buildup of fatty plaques. Because of the size (narrow) of the

coronary arteries and their function in serving the heart itself, atherosclerosis can be deadly in these arteries. The slowdown

of blood flow and subsequent oxygen deprivation that results from atherosclerosis causes severe pain, known as angina , and

complete blockage of the arteries will cause myocardial infarction : the death of cardiac muscle tissue, commonly known

as a heart attack.

The Cardiac Cycle

The main purpose of the heart is to pump blood through the body; it does so in a repeating sequence called the cardiac

cycle. The cardiac cycle is the coordination of the filling and emptying of the heart of blood by electrical signals that

cause the heart muscles to contract and relax. The human heart beats over 100,000 times per day. In each cardiac cycle, the

heart contracts ( systole ), pushing out the blood and pumping it through the body; this is followed by a relaxation phase (

diastole ), where the heart fills with blood, as illustrated in Figure 40.12 . The atria contract at the same time, forcing blood

through the atrioventricular valves into the ventricles. Closing of the atrioventricular valves produces a monosyllabic “lup”

sound. Following a brief delay, the ventricles contract at the same time forcing blood through the semilunar valves into the

aorta and the artery transporting blood to the lungs (via the pulmonary artery). Closing of the semilunar valves produces a

monosyllabic “dup” sound.

Figure 40.12 During (a) cardiac diastole, the heart muscle is relaxed and blood flows into the heart. During (b) atrial

systole, the atria contract, pushing blood into the ventricles. During (c) atrial diastole, the ventricles contract, forcing

blood out of the heart.

The pumping of the heart is a function of the cardiac muscle cells, or cardiomyocytes, that make up the heart muscle.

Cardiomyocytes , shown in Figure 40.13 , are distinctive muscle cells that are striated like skeletal muscle but pump

rhythmically and involuntarily like smooth muscle; they are connected by intercalated disks exclusive to cardiac muscle.

They are self-stimulated for a period of time and isolated cardiomyocytes will beat if given the correct balance of nutrients

and electrolytes.

1176 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 40.13 Cardiomyocytes are striated muscle cells found in cardiac tissue. (credit: modification of work by Dr. S.

Girod, Anton Becker; scale-bar data from Matt Russell)

The autonomous beating of cardiac muscle cells is regulated by the heart’s internal pacemaker that uses electrical signals

to time the beating of the heart. The electrical signals and mechanical actions, illustrated in Figure 40.14 , are intimately

intertwined. The internal pacemaker starts at the sinoatrial (SA) node , which is located near the wall of the right atrium.

Electrical charges spontaneously pulse from the SA node causing the two atria to contract in unison. The pulse reaches

a second node, called the atrioventricular (AV) node, between the right atrium and right ventricle where it pauses for

approximately 0.1 second before spreading to the walls of the ventricles. From the AV node, the electrical impulse enters

the bundle of His, then to the left and right bundle branches extending through the interventricular septum. Finally, the

Purkinje fibers conduct the impulse from the apex of the heart up the ventricular myocardium, and then the ventricles

contract. This pause allows the atria to empty completely into the ventricles before the ventricles pump out the blood. The

electrical impulses in the heart produce electrical currents that flow through the body and can be measured on the skin using

electrodes. This information can be observed as an electrocardiogram (ECG) —a recording of the electrical impulses of

the cardiac muscle.

Figure 40.14 The beating of the heart is regulated by an electrical impulse that causes the characteristic reading of an

ECG. The signal is initiated at the sinoatrial valve. The signal then (a) spreads to the atria, causing them to contract.

The signal is (b) delayed at the atrioventricular node before it is passed on to the (c) heart apex. The delay allows the

atria to relax before the (d) ventricles contract. The final part of the ECG cycle prepares the heart for the next beat.

Chapter 40 | The Circulatory System 1177 Visit this site (http://openstaxcollege.org/l/electric_heart) to see the heart’s “pacemaker” in action.

Arteries, Veins, and Capillaries

The blood from the heart is carried through the body by a complex network of blood vessels ( Figure 40.15 ).Arteries take

blood away from the heart. The main artery is the aorta that branches into major arteries that take blood to different limbs

and organs. These major arteries include the carotid artery that takes blood to the brain, the brachial arteries that take blood

to the arms, and the thoracic artery that takes blood to the thorax and then into the hepatic, renal, and gastric arteries for

the liver, kidney, and stomach, respectively. The iliac artery takes blood to the lower limbs. The major arteries diverge into

minor arteries, and then smaller vessels called arterioles , to reach more deeply into the muscles and organs of the body.

Figure 40.15 The major human arteries and veins are shown. (credit: modification of work by Mariana Ruiz Villareal)

Arterioles diverge into capillary beds. Capillary beds contain a large number (10 to 100) of capillaries that branch among

the cells and tissues of the body. Capillaries are narrow-diameter tubes that can fit red blood cells through in single file and

are the sites for the exchange of nutrients, waste, and oxygen with tissues at the cellular level. Fluid also crosses into the

interstitial space from the capillaries. The capillaries converge again into venules that connect to minor veins that finally

connect to major veins that take blood high in carbon dioxide back to the heart. Veins are blood vessels that bring blood

back to the heart. The major veins drain blood from the same organs and limbs that the major arteries supply. Fluid is also

brought back to the heart via the lymphatic system.

1178 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 The structure of the different types of blood vessels reflects their function or layers. There are three distinct layers, or tunics,

that form the walls of blood vessels ( Figure 40.16 ). The first tunic is a smooth, inner lining of endothelial cells that are

in contact with the red blood cells. The endothelial tunic is continuous with the endocardium of the heart. In capillaries,

this single layer of cells is the location of diffusion of oxygen and carbon dioxide between the endothelial cells and red

blood cells, as well as the exchange site via endocytosis and exocytosis. The movement of materials at the site of capillaries

is regulated by vasoconstriction , narrowing of the blood vessels, and vasodilation , widening of the blood vessels; this is

important in the overall regulation of blood pressure.

Veins and arteries both have two further tunics that surround the endothelium: the middle tunic is composed of smooth

muscle and the outermost layer is connective tissue (collagen and elastic fibers). The elastic connective tissue stretches

and supports the blood vessels, and the smooth muscle layer helps regulate blood flow by altering vascular resistance

through vasoconstriction and vasodilation. The arteries have thicker smooth muscle and connective tissue than the veins to

accommodate the higher pressure and speed of freshly pumped blood. The veins are thinner walled as the pressure and rate

of flow are much lower. In addition, veins are structurally different than arteries in that veins have valves to prevent the

backflow of blood. Because veins have to work against gravity to get blood back to the heart, contraction of skeletal muscle

assists with the flow of blood back to the heart.

Figure 40.16 Arteries and veins consist of three layers: an outer tunica externa, a middle tunica media, and an inner

tunica intima. Capillaries consist of a single layer of epithelial cells, the tunica intima. (credit: modification of work by

NCI, NIH)

40.4 | Blood Flow and Blood Pressure Regulation

By the end of this section, you will be able to:

• Describe the system of blood flow through the body

• Describe how blood pressure is regulated

Blood pressure (BP) is the pressure exerted by blood on the walls of a blood vessel that helps to push blood through

the body. Systolic blood pressure measures the amount of pressure that blood exerts on vessels while the heart is beating.

The optimal systolic blood pressure is 120 mmHg. Diastolic blood pressure measures the pressure in the vessels between

heartbeats. The optimal diastolic blood pressure is 80 mmHg. Many factors can affect blood pressure, such as hormones,

stress, exercise, eating, sitting, and standing. Blood flow through the body is regulated by the size of blood vessels, by the

action of smooth muscle, by one-way valves, and by the fluid pressure of the blood itself.

How Blood Flows Through the Body

Blood is pushed through the body by the action of the pumping heart. With each rhythmic pump, blood is pushed under

high pressure and velocity away from the heart, initially along the main artery, the aorta. In the aorta, the blood travels at

Chapter 40 | The Circulatory System 1179 30 cm/sec. As blood moves into the arteries, arterioles, and ultimately to the capillary beds, the rate of movement slows

dramatically to about 0.026 cm/sec, one-thousand times slower than the rate of movement in the aorta. While the diameter of

each individual arteriole and capillary is far narrower than the diameter of the aorta, and according to the law of continuity,

fluid should travel faster through a narrower diameter tube, the rate is actually slower due to the overall diameter of all the

combined capillaries being far greater than the diameter of the individual aorta.

The slow rate of travel through the capillary beds, which reach almost every cell in the body, assists with gas and nutrient

exchange and also promotes the diffusion of fluid into the interstitial space. After the blood has passed through the capillary

beds to the venules, veins, and finally to the main venae cavae, the rate of flow increases again but is still much slower than

the initial rate in the aorta. Blood primarily moves in the veins by the rhythmic movement of smooth muscle in the vessel

wall and by the action of the skeletal muscle as the body moves. Because most veins must move blood against the pull of

gravity, blood is prevented from flowing backward in the veins by one-way valves. Because skeletal muscle contraction

aids in venous blood flow, it is important to get up and move frequently after long periods of sitting so that blood will not

pool in the extremities.

Blood flow through the capillary beds is regulated depending on the body’s needs and is directed by nerve and hormone

signals. For example, after a large meal, most of the blood is diverted to the stomach by vasodilation of vessels of the

digestive system and vasoconstriction of other vessels. During exercise, blood is diverted to the skeletal muscles through

vasodilation while blood to the digestive system would be lessened through vasoconstriction. The blood entering some

capillary beds is controlled by small muscles, called precapillary sphincters, illustrated in Figure 40.17 . If the sphincters

are open, the blood will flow into the associated branches of the capillary blood. If all of the sphincters are closed, then the

blood will flow directly from the arteriole to the venule through the thoroughfare channel (see Figure 40.17 ). These muscles

allow the body to precisely control when capillary beds receive blood flow. At any given moment only about 5-10% of our

capillary beds actually have blood flowing through them.

Figure 40.17 (a) Precapillary sphincters are rings of smooth muscle that regulate the flow of blood through

capillaries; they help control the location of blood flow to where it is needed. (b) Valves in the veins prevent blood

from moving backward. (credit a: modification of work by NCI)

Varicose veins are veins that become enlarged because the valves no longer close properly, allowing blood

to flow backward. Varicose veins are often most prominent on the legs. Why do you think this is the case?

Visit this site (http://openstaxcollege.org/l/circulation) to see the circulatory system’s blood flow.

Proteins and other large solutes cannot leave the capillaries. The loss of the watery plasma creates a hyperosmotic solution

within the capillaries, especially near the venules. This causes about 85% of the plasma that leaves the capillaries to

1180 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 eventually diffuses back into the capillaries near the venules. The remaining 15% of blood plasma drains out from the

interstitial fluid into nearby lymphatic vessels ( Figure 40.18 ). The fluid in the lymph is similar in composition to the

interstitial fluid. The lymph fluid passes through lymph nodes before it returns to the heart via the vena cava. Lymph nodes

are specialized organs that filter the lymph by percolation through a maze of connective tissue filled with white blood cells.

The white blood cells remove infectious agents, such as bacteria and viruses, to clean the lymph before it returns to the

bloodstream. After it is cleaned, the lymph returns to the heart by the action of smooth muscle pumping, skeletal muscle

action, and one-way valves joining the returning blood near the junction of the venae cavae entering the right atrium of the

heart.

Figure 40.18 Fluid from the capillaries moves into the interstitial space and lymph capillaries by diffusion down a

pressure gradient and also by osmosis. Out of 7,200 liters of fluid pumped by the average heart in a day, over 1,500

liters is filtered. (credit: modification of work by NCI, NIH)

Vertebrate Diversity in Blood Circulation

Blood circulation has evolved differently in vertebrates and may show variation in different animals for the

required amount of pressure, organ and vessel location, and organ size. Animals with longs necks and those

that live in cold environments have distinct blood pressure adaptations.

Long necked animals, such as giraffes, need to pump blood upward from the heart against gravity. The

blood pressure required from the pumping of the left ventricle would be equivalent to 250 mm Hg (mm Hg

= millimeters of mercury, a unit of pressure) to reach the height of a giraffe’s head, which is 2.5 meters

higher than the heart. However, if checks and balances were not in place, this blood pressure would damage

the giraffe’s brain, particularly if it was bending down to drink. These checks and balances include valves

and feedback mechanisms that reduce the rate of cardiac output. Long-necked dinosaurs such as the

sauropods had to pump blood even higher, up to ten meters above the heart. This would have required

a blood pressure of more than 600 mm Hg, which could only have been achieved by an enormous heart.

Evidence for such an enormous heart does not exist and mechanisms to reduce the blood pressure required

include the slowing of metabolism as these animals grew larger. It is likely that they did not routinely feed

on tree tops but grazed on the ground.

Living in cold water, whales need to maintain the temperature in their blood. This is achieved by the

veins and arteries being close together so that heat exchange can occur. This mechanism is called a

countercurrent heat exchanger. The blood vessels and the whole body are also protected by thick layers

of blubber to prevent heat loss. In land animals that live in cold environments, thick fur and hibernation are

used to retain heat and slow metabolism.

Chapter 40 | The Circulatory System 1181 Blood Pressure

The pressure of the blood flow in the body is produced by the hydrostatic pressure of the fluid (blood) against the walls of

the blood vessels. Fluid will move from areas of high to low hydrostatic pressures. In the arteries, the hydrostatic pressure

near the heart is very high and blood flows to the arterioles where the rate of flow is slowed by the narrow openings of the

arterioles. During systole, when new blood is entering the arteries, the artery walls stretch to accommodate the increase of

pressure of the extra blood; during diastole, the walls return to normal because of their elastic properties. The blood pressure

of the systole phase and the diastole phase, graphed in Figure 40.19 , gives the two pressure readings for blood pressure.

For example, 120/80 indicates a reading of 120 mm Hg during the systole and 80 mm Hg during diastole. Throughout the

cardiac cycle, the blood continues to empty into the arterioles at a relatively even rate. This resistance to blood flow is called

peripheral resistance .

Figure 40.19 Blood pressure is related to the blood velocity in the arteries and arterioles. In the capillaries and veins,

the blood pressure continues to decease but velocity increases.

Blood Pressure Regulation

Cardiac output is the volume of blood pumped by the heart in one minute. It is calculated by multiplying the number of

heart contractions that occur per minute (heart rate) times the stroke volume (the volume of blood pumped into the aorta

per contraction of the left ventricle). Therefore, cardiac output can be increased by increasing heart rate, as when exercising.

However, cardiac output can also be increased by increasing stroke volume, such as if the heart contracts with greater

strength. Stroke volume can also be increased by speeding blood circulation through the body so that more blood enters the

heart between contractions. During heavy exertion, the blood vessels relax and increase in diameter, offsetting the increased

heart rate and ensuring adequate oxygenated blood gets to the muscles. Stress triggers a decrease in the diameter of the

blood vessels, consequently increasing blood pressure. These changes can also be caused by nerve signals or hormones, and

even standing up or lying down can have a great effect on blood pressure.

1182 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 angina

aorta

arteriole

artery

atherosclerosis

atrioventricular valve

atrium

bicuspid valve

blood pressure (BP)

capillary

capillary bed

cardiac cycle

cardiac output

cardiomyocyte

closed circulatory system

coronary artery

coronary vein

diastole

double circulation

electrocardiogram (ECG)

endocardium

epicardium

gill circulation

hemocoel

hemolymph

inferior vena cava

KEY TERMS

pain caused by partial blockage of the coronary arteries by the buildup of plaque and lack of oxygen to the heart

muscle

major artery of the body that takes blood away from the heart

small vessel that connects an artery to a capillary bed

blood vessel that takes blood away from the heart

buildup of fatty plaques in the coronary arteries in the heart

one-way membranous flap of connective tissue between the atrium and the ventricle in the right

side of the heart; also known as tricuspid valve

(plural: atria) chamber of the heart that receives blood from the veins and sends blood to the ventricles

(also, mitral valve; left atrioventricular valve) one-way membranous flap between the atrium and the

ventricle in the left side of the heart

pressure of blood in the arteries that helps to push blood through the body

smallest blood vessel that allows the passage of individual blood cells and the site of diffusion of oxygen and

nutrient exchange

large number of capillaries that converge to take blood to a particular organ or tissue

filling and emptying the heart of blood by electrical signals that cause the heart muscles to contract and

relax

the volume of blood pumped by the heart in one minute as a product of heart rate multiplied by stroke

volume

specialized heart muscle cell that is striated but contracts involuntarily like smooth muscle

system in which the blood is separated from the bodily interstitial fluid and contained in

blood vessels

vessel that supplies the heart tissue with blood

vessel that takes blood away from the heart tissue back to the chambers in the heart

relaxation phase of the cardiac cycle when the heart is relaxed and the ventricles are filling with blood

flow of blood in two circuits: the pulmonary circuit through the lungs and the systemic circuit

through the organs and body

recording of the electrical impulses of the cardiac muscle

innermost layer of tissue in the heart

outermost tissue layer of the heart

circulatory system that is specific to animals with gills for gas exchange; the blood flows through the gills

for oxygenation

cavity into which blood is pumped in an open circulatory system

mixture of blood and interstitial fluid that is found in insects and other arthropods as well as most mollusks

drains blood from the veins that come from the lower organs and the legs

Chapter 40 | The Circulatory System 1183 interstitial fluid

lymph node

myocardial infarction

myocardium

open circulatory system

ostium

pericardium

peripheral resistance

plasma

platelet

precapillary sphincter

pulmocutaneous circulation

pulmonary circulation

red blood cell

semilunar valve

serum

sinoatrial (SA) node

stroke volume>

superior vena cava

systemic circulation

systole

tricuspid valve

unidirectional circulation

vasoconstriction

vasodilation

fluid between cells

specialized organ that contains a large number of macrophages that clean the lymph before the fluid is

returned to the heart

(also, heart attack) complete blockage of the coronary arteries and death of the cardiac muscle

tissue

heart muscle cells that make up the middle layer and the bulk of the heart wall

system in which the blood is mixed with interstitial fluid and directly covers the organs

(plural: ostia) holes between blood vessels that allow the movement of hemolymph through the body of insects,

arthropods, and mollusks with open circulatory systems

membrane layer protecting the heart; also part of the epicardium

resistance of the artery and blood vessel walls to the pressure placed on them by the force of the

heart pumping

liquid component of blood that is left after the cells are removed

(also, thrombocyte) small cellular fragment that collects at wounds, cross-reacts with clotting factors, and forms a

plug to prevent blood loss

small muscle that controls blood circulation in the capillary beds

circulatory system in amphibians; the flow of blood to the lungs and the moist skin for

gas exchange

flow of blood away from the heart through the lungs where oxygenation occurs and then returns

to the heart again

small (7–8 μm) biconcave cell without mitochondria (and in mammals without nuclei) that is packed with

hemoglobin, giving the cell its red color; transports oxygen through the body

membranous flap of connective tissue between the aorta and a ventricle of the heart (the aortic or

pulmonary semilunar valves)

plasma without the coagulation factors

the heart’s internal pacemaker; located near the wall of the right atrium

- the volume of blood pumped into the aorta per contraction of the left ventricle

drains blood from the jugular vein that comes from the brain and from the veins that come from the

arms

flow of blood away from the heart to the brain, liver, kidneys, stomach, and other organs, the limbs,

and the muscles of the body, and then the return of this blood to the heart

contraction phase of cardiac cycle when the ventricles are pumping blood into the arteries

one-way membranous flap of connective tissue between the atrium and the ventricle in the right side of

the heart; also known as atrioventricular valve

flow of blood in a single circuit; occurs in fish where the blood flows through the gills, then

past the organs and the rest of the body, before returning to the heart

narrowing of a blood vessel

widening of a blood vessel

1184 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 vein

vena cava

ventricle

venule

white blood cell

blood vessel that brings blood back to the heart

major vein of the body returning blood from the upper and lower parts of the body; see the superior vena cava

and inferior vena cava

(heart) large inferior chamber of the heart that pumps blood into arteries

blood vessel that connects a capillary bed to a vein

large (30 μm) cell with nuclei of which there are many types with different roles including the protection

of the body from viruses and bacteria, and cleaning up dead cells and other waste

CHAPTER SUMMARY

40.1 Overview of the Circulatory System

In most animals, the circulatory system is used to transport blood through the body. Some primitive animals use diffusion

for the exchange of water, nutrients, and gases. However, complex organisms use the circulatory system to carry gases,

nutrients, and waste through the body. Circulatory systems may be open (mixed with the interstitial fluid) or closed

(separated from the interstitial fluid). Closed circulatory systems are a characteristic of vertebrates; however, there are

significant differences in the structure of the heart and the circulation of blood between the different vertebrate groups due

to adaptions during evolution and associated differences in anatomy. Fish have a two-chambered heart with unidirectional

circulation. Amphibians have a three-chambered heart, which has some mixing of the blood, and they have double

circulation. Most non-avian reptiles have a three-chambered heart, but have little mixing of the blood; they have double

circulation. Mammals and birds have a four-chambered heart with no mixing of the blood and double circulation.

40.2 Components of the Blood

Specific components of the blood include red blood cells, white blood cells, platelets, and the plasma, which contains

coagulation factors and serum. Blood is important for regulation of the body’s pH, temperature, osmotic pressure, the

circulation of nutrients and removal of waste, the distribution of hormones from endocrine glands, and the elimination of

excess heat; it also contains components for blood clotting. Red blood cells are specialized cells that contain hemoglobin

and circulate through the body delivering oxygen to cells. White blood cells are involved in the immune response to

identify and target invading bacteria, viruses, and other foreign organisms; they also recycle waste components, such as

old red blood cells. Platelets and blood clotting factors cause the change of the soluble protein fibrinogen to the insoluble

protein fibrin at a wound site forming a plug. Plasma consists of 90 percent water along with various substances, such as

coagulation factors and antibodies. The serum is the plasma component of the blood without the coagulation factors.

40.3 Mammalian Heart and Blood Vessels

The heart muscle pumps blood through three divisions of the circulatory system: coronary, pulmonary, and systemic.

There is one atrium and one ventricle on the right side and one atrium and one ventricle on the left side. The pumping of

the heart is a function of cardiomyocytes, distinctive muscle cells that are striated like skeletal muscle but pump

rhythmically and involuntarily like smooth muscle. The internal pacemaker starts at the sinoatrial node, which is located

near the wall of the right atrium. Electrical charges pulse from the SA node causing the two atria to contract in unison;

then the pulse reaches the atrioventricular node between the right atrium and right ventricle. A pause in the electric signal

allows the atria to empty completely into the ventricles before the ventricles pump out the blood. The blood from the heart

is carried through the body by a complex network of blood vessels; arteries take blood away from the heart, and veins

bring blood back to the heart.

40.4 Blood Flow and Blood Pressure Regulation

Blood primarily moves through the body by the rhythmic movement of smooth muscle in the vessel wall and by the action

of the skeletal muscle as the body moves. Blood is prevented from flowing backward in the veins by one-way valves.

Blood flow through the capillary beds is controlled by precapillary sphincters to increase and decrease flow depending on

the body’s needs and is directed by nerve and hormone signals. Lymph vessels take fluid that has leaked out of the blood

to the lymph nodes where it is cleaned before returning to the heart. During systole, blood enters the arteries, and the artery

walls stretch to accommodate the extra blood. During diastole, the artery walls return to normal. The blood pressure of the

systole phase and the diastole phase gives the two pressure readings for blood pressure.

Chapter 40 | The Circulatory System 1185 ART CONNECTION QUESTIONS

1. Figure 40.10 Which of the following statements about

the circulatory system is false?

a. Blood in the pulmonary vein is deoxygenated.

b. Blood in the inferior vena cava is deoxygenated.

c. Blood in the pulmonary artery is deoxygenated.

d. Blood in the aorta is oxygenated.

2. Figure 40.11 Which of the following statements about

the heart is false?

a. The mitral valve separates the left ventricle from

the left atrium.

b. Blood travels through the bicuspid valve to the

left atrium.

c. Both the aortic and the pulmonary valves are

semilunar valves.

d. The mitral valve is an atrioventricular valve.

3. Figure 40.17 Varicose veins are veins that become

enlarged because the valves no longer close properly,

allowing blood to flow backward. Varicose veins are often

most prominent on the legs. Why do you think this is the

case?

REVIEW QUESTIONS

4. Why are open circulatory systems advantageous to

some animals?

a. They use less metabolic energy.

b. They help the animal move faster.

c. They do not need a heart.

d. They help large insects develop.

5. Some animals use diffusion instead of a circulatory

system. Examples include:

a. birds and jellyfish

b. flatworms and arthropods

c. mollusks and jellyfish

d. None of the above

6. Blood flow that is directed through the lungs and back

to the heart is called ________.

a. unidirectional circulation

b. gill circulation

c. pulmonary circulation

d. pulmocutaneous circulation

7. White blood cells:

a. can be classified as granulocytes or

agranulocytes

b. defend the body against bacteria and viruses

c. are also called leucocytes

d. All of the above

8. Platelet plug formation occurs at which point?

a. when large megakaryocytes break up into

thousands of smaller fragments

b. when platelets are dispersed through the blood

stream

c. when platelets are attracted to a site of blood

vessel damage

d. none of the above

9. In humans, the plasma comprises what percentage of

the blood?

a. 45 percent

b. 55 percent

c. 25 percent

d. 90 percent

10. The red blood cells of birds differ from mammalian

red blood cells because:

a. they are white and have nuclei

b. they do not have nuclei

c. they have nuclei

d. they fight disease

11. The heart’s internal pacemaker beats by:

a. an internal implant that sends an electrical

impulse through the heart

b. the excitation of cardiac muscle cells at the

sinoatrial node followed by the atrioventricular

node

c. the excitation of cardiac muscle cells at the

atrioventricular node followed by the sinoatrial

node

d. the action of the sinus

12. During the systolic phase of the cardiac cycle, the

heart is ________.

a. contracting

b. relaxing

c. contracting and relaxing

d. filling with blood

13. Cardiomyocytes are similar to skeletal muscle

because:

a. they beat involuntarily

b. they are used for weight lifting

c. they pulse rhythmically

d. they are striated

14. How do arteries differ from veins?

a. Arteries have thicker smooth muscle layers to

accommodate the changes in pressure from the

heart.

b. Arteries carry blood.

c. Arteries have thinner smooth muscle layers and

valves and move blood by the action of skeletal

muscle.

d. Arteries are thin walled and are used for gas

exchange.

15. High blood pressure would be a result of ________.

1186 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 a. a high cardiac output and high peripheral

resistance

b. a high cardiac output and low peripheral

resistance

c. a low cardiac output and high peripheral

resistance

d. a low cardiac output and low peripheral

resistance

CRITICAL THINKING QUESTIONS

16. Describe a closed circulatory system.

17. Describe systemic circulation.

18. Describe the cause of different blood type groups.

19. List some of the functions of blood in the body.

20. How does the lymphatic system work with blood

flow?

21. Describe the cardiac cycle.

22. What happens in capillaries?

23. How does blood pressure change during heavy

exercise?

Chapter 40 | The Circulatory System 1187 1188 Chapter 40 | The Circulatory System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 41 | OSMOTIC

REGULATION AND

EXCRETION

Figure 41.1 Just as humans recycle what we can and dump the remains into landfills, our bodies use and recycle what

they can and excrete the remaining waste products. Our bodies’ complex systems have developed ways to treat waste

and maintain a balanced internal environment. (credit: modification of work by Redwin Law)

Chapter Outline

41.1: Osmoregulation and Osmotic Balance

41.2: The Kidneys and Osmoregulatory Organs

41.3: Excretion Systems

41.4: Nitrogenous Wastes

41.5: Hormonal Control of Osmoregulatory Functions

Introduction

The daily intake recommendation for human water consumption is eight to ten glasses of water. In order to achieve a

healthy balance, the human body should excrete the eight to ten glasses of water every day. This occurs via the processes

of urination, defecation, sweating and, to a small extent, respiration. The organs and tissues of the human body are soaked

in fluids that are maintained at constant temperature, pH, and solute concentration, all crucial elements of homeostasis. The

solutes in body fluids are mainly mineral salts and sugars, and osmotic regulation is the process by which the mineral salts

and water are kept in balance. Osmotic homeostasis is maintained despite the influence of external factors like temperature,

diet, and weather conditions.

Chapter 41 | Osmotic Regulation and Excretion 1189 41.1 | Osmoregulation and Osmotic Balance

By the end of this section, you will be able to:

• Define osmosis and explain its role within molecules

• Explain why osmoregulation and osmotic balance are important body functions

• Describe active transport mechanisms

• Explain osmolarity and the way in which it is measured

• Describe osmoregulators or osmoconformers and how these tools allow animals to adapt to different environments

Osmosis is the diffusion of water across a membrane in response to osmotic pressure caused by an imbalance of molecules

on either side of the membrane. Osmoregulation is the process of maintenance of salt and water balance ( osmotic balance )

across membranes within the body’s fluids, which are composed of water, plus electrolytes and non-electrolytes. An

electrolyte is a solute that dissociates into ions when dissolved in water. A non-electrolyte , in contrast, doesn’t dissociate

into ions during water dissolution. Both electrolytes and non-electrolytes contribute to the osmotic balance. The body’s

fluids include blood plasma, the cytosol within cells, and interstitial fluid, the fluid that exists in the spaces between cells

and tissues of the body. The membranes of the body (such as the pleural, serous, and cell membranes) are semi-permeable

membranes . Semi-permeable membranes are permeable (or permissive) to certain types of solutes and water. Solutions

on two sides of a semi-permeable membrane tend to equalize in solute concentration by movement of solutes and/or water

across the membrane. As seen in Figure 41.2 , a cell placed in water tends to swell due to gain of water from the hypotonic

or “low salt” environment. A cell placed in a solution with higher salt concentration, on the other hand, tends to make

the membrane shrivel up due to loss of water into the hypertonic or “high salt” environment. Isotonic cells have an equal

concentration of solutes inside and outside the cell; this equalizes the osmotic pressure on either side of the cell membrane

which is a semi-permeable membrane.

Figure 41.2 Cells placed in a hypertonic environment tend to shrink due to loss of water. In a hypotonic environment,

cells tend to swell due to intake of water. The blood maintains an isotonic environment so that cells neither shrink nor

swell. (credit: Mariana Ruiz Villareal)

The body does not exist in isolation. There is a constant input of water and electrolytes into the system. While

osmoregulation is achieved across membranes within the body, excess electrolytes and wastes are transported to the kidneys

and excreted, helping to maintain osmotic balance.

Need for Osmoregulation

Biological systems constantly interact and exchange water and nutrients with the environment by way of consumption of

food and water and through excretion in the form of sweat, urine, and feces. Without a mechanism to regulate osmotic

pressure, or when a disease damages this mechanism, there is a tendency to accumulate toxic waste and water, which can

have dire consequences.

Mammalian systems have evolved to regulate not only the overall osmotic pressure across membranes, but also specific

concentrations of important electrolytes in the three major fluid compartments: blood plasma, extracellular fluid, and

1190 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 intracellular fluid. Since osmotic pressure is regulated by the movement of water across membranes, the volume of the fluid

compartments can also change temporarily. Because blood plasma is one of the fluid components, osmotic pressures have a

direct bearing on blood pressure.

Transport of Electrolytes across Cell Membranes

Electrolytes, such as sodium chloride, ionize in water, meaning that they dissociate into their component ions. In water,

sodium chloride (NaCl), dissociates into the sodium ion (Na +) and the chloride ion (Cl –). The most important ions,

whose concentrations are very closely regulated in body fluids, are the cations sodium (Na +), potassium (K +), calcium

(Ca +2), magnesium (Mg +2), and the anions chloride (Cl -), carbonate (CO 3-2), bicarbonate (HCO 3-), and phosphate(PO 3-).

Electrolytes are lost from the body during urination and perspiration. For this reason, athletes are encouraged to replace

electrolytes and fluids during periods of increased activity and perspiration.

Osmotic pressure is influenced by the concentration of solutes in a solution. It is directly proportional to the number of

solute atoms or molecules and not dependent on the size of the solute molecules. Because electrolytes dissociate into their

component ions, they, in essence, add more solute particles into the solution and have a greater effect on osmotic pressure,

per mass than compounds that do not dissociate in water, such as glucose.

Water can pass through membranes by passive diffusion. If electrolyte ions could passively diffuse across membranes, it

would be impossible to maintain specific concentrations of ions in each fluid compartment therefore they require special

mechanisms to cross the semi-permeable membranes in the body. This movement can be accomplished by facilitated

diffusion and active transport. Facilitated diffusion requires protein-based channels for moving the solute. Active transport

requires energy in the form of ATP conversion, carrier proteins, or pumps in order to move ions against the concentration

gradient.

Concept of Osmolality and Milliequivalent

In order to calculate osmotic pressure, it is necessary to understand how solute concentrations are measured. The unit for

measuring solutes is the mole . One mole is defined as the gram molecular weight of the solute. For example, the molecular

weight of sodium chloride is 58.44. Thus, one mole of sodium chloride weighs 58.44 grams. The molarity of a solution is

the number of moles of solute per liter of solution. The molality of a solution is the number of moles of solute per kilogram

of solvent. If the solvent is water, one kilogram of water is equal to one liter of water. While molarity and molality are used

to express the concentration of solutions, electrolyte concentrations are usually expressed in terms of milliequivalents per

liter (mEq/L): the mEq/L is equal to the ion concentration (in millimoles) multiplied by the number of electrical charges on

the ion. The unit of milliequivalent takes into consideration the ions present in the solution (since electrolytes form ions in

aqueous solutions) and the charge on the ions.

Thus, for ions that have a charge of one, one milliequivalent is equal to one millimole. For ions that have a charge of two

(like calcium), one milliequivalent is equal to 0.5 millimoles. Another unit for the expression of electrolyte concentration is

the milliosmole (mOsm), which is the number of milliequivalents of solute per kilogram of solvent. Body fluids are usually

maintained within the range of 280 to 300 mOsm.

Osmoregulators and Osmoconformers

Persons lost at sea without any fresh water to drink are at risk of severe dehydration because the human body cannot adapt

to drinking seawater, which is hypertonic in comparison to body fluids. Organisms such as goldfish that can tolerate only

a relatively narrow range of salinity are referred to as stenohaline. About 90 percent of all bony fish are restricted to either

freshwater or seawater. They are incapable of osmotic regulation in the opposite environment. It is possible, however, for

a few fishes like salmon to spend part of their life in fresh water and part in sea water. Organisms like the salmon and

molly that can tolerate a relatively wide range of salinity are referred to as euryhaline organisms. This is possible because

some fish have evolved osmoregulatory mechanisms to survive in all kinds of aquatic environments. When they live in

fresh water, their bodies tend to take up water because the environment is relatively hypotonic, as illustrated in Figure

41.3 a. In such hypotonic environments, these fish do not drink much water. Instead, they pass a lot of very dilute urine,

and they achieve electrolyte balance by active transport of salts through the gills. When they move to a hypertonic marine

environment, these fish start drinking sea water; they excrete the excess salts through their gills and their urine, as illustrated

in Figure 41.3 b. Most marine invertebrates, on the other hand, may be isotonic with sea water ( osmoconformers ). Their

body fluid concentrations conform to changes in seawater concentration. Cartilaginous fishes’ salt composition of the blood

is similar to bony fishes; however, the blood of sharks contains the organic compounds urea and trimethylamine oxide

(TMAO). This does not mean that their electrolyte composition is similar to that of sea water. They achieve isotonicity

with the sea by storing large concentrations of urea. These animals that secrete urea are called ureotelic animals. TMAO

stabilizes proteins in the presence of high urea levels, preventing the disruption of peptide bonds that would occur in other

Chapter 41 | Osmotic Regulation and Excretion 1191 animals exposed to similar levels of urea. Sharks are cartilaginous fish with a rectal gland to secrete salt and assist in

osmoregulation.

Figure 41.3 Fish are osmoregulators, but must use different mechanisms to survive in (a) freshwater or (b) saltwater

environments. (credit: modification of work by Duane Raver, NOAA)

Dialysis Technician

Dialysis is a medical process of removing wastes and excess water from the blood by diffusion and

ultrafiltration. When kidney function fails, dialysis must be done to artificially rid the body of wastes. This is

a vital process to keep patients alive. In some cases, the patients undergo artificial dialysis until they are

eligible for a kidney transplant. In others who are not candidates for kidney transplants, dialysis is a life-long

necessity.

Dialysis technicians typically work in hospitals and clinics. While some roles in this field include equipment

development and maintenance, most dialysis technicians work in direct patient care. Their on-the-job

duties, which typically occur under the direct supervision of a registered nurse, focus on providing dialysis

treatments. This can include reviewing patient history and current condition, assessing and responding to

patient needs before and during treatment, and monitoring the dialysis process. Treatment may include

taking and reporting a patient’s vital signs and preparing solutions and equipment to ensure accurate and

sterile procedures.

1192 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 41.2 | The Kidneys and Osmoregulatory Organs

By the end of this section, you will be able to:

• Explain how the kidneys serve as the main osmoregulatory organs in mammalian systems

• Describe the structure of the kidneys and the functions of the parts of the kidney

• Describe how the nephron is the functional unit of the kidney and explain how it actively filters blood and generates

urine

• Detail the three steps in the formation of urine: glomerular filtration, tubular reabsorption, and tubular secretion

Although the kidneys are the major osmoregulatory organ, the skin and lungs also play a role in the process. Water and

electrolytes are lost through sweat glands in the skin, which helps moisturize and cool the skin surface, while the lungs

expel a small amount of water in the form of mucous secretions and via evaporation of water vapor.

Kidneys: The Main Osmoregulatory Organ

The kidneys , illustrated in Figure 41.4 , are a pair of bean-shaped structures that are located just below and posterior to the

liver in the peritoneal cavity. The adrenal glands sit on top of each kidney and are also called the suprarenal glands. Kidneys

filter blood and purify it. All the blood in the human body is filtered many times a day by the kidneys; these organs use

up almost 25 percent of the oxygen absorbed through the lungs to perform this function. Oxygen allows the kidney cells

to efficiently manufacture chemical energy in the form of ATP through aerobic respiration. The filtrate coming out of the

kidneys is called urine .

Figure 41.4 Kidneys filter the blood, producing urine that is stored in the bladder prior to elimination through the

urethra. (credit: modification of work by NCI)

Kidney Structure

Externally, the kidneys are surrounded by three layers, illustrated in Figure 41.5 . The outermost layer is a tough connective

tissue layer called the renal fascia . The second layer is called the perirenal fat capsule , which helps anchor the kidneys

in place. The third and innermost layer is the renal capsule . Internally, the kidney has three regions—an outer cortex ,a

medulla in the middle, and the renal pelvis in the region called the hilum of the kidney. The hilum is the concave part of

the bean-shape where blood vessels and nerves enter and exit the kidney; it is also the point of exit for the ureters. The renal

cortex is granular due to the presence of nephrons —the functional unit of the kidney. The medulla consists of multiple

pyramidal tissue masses, called the renal pyramids . In between the pyramids are spaces called renal columns through

Chapter 41 | Osmotic Regulation and Excretion 1193 which the blood vessels pass. The tips of the pyramids, called renal papillae, point toward the renal pelvis. There are, on

average, eight renal pyramids in each kidney. The renal pyramids along with the adjoining cortical region are called the

lobes of the kidney . The renal pelvis leads to the ureter on the outside of the kidney. On the inside of the kidney, the renal

pelvis branches out into two or three extensions called the major calyces , which further branch into the minor calyces. The

ureters are urine-bearing tubes that exit the kidney and empty into the urinary bladder .

Figure 41.5 The internal structure of the kidney is shown. (credit: modification of work by NCI)

Which of the following statements about the kidney is false?

a. The renal pelvis drains into the ureter.

b. The renal pyramids are in the medulla.

c. The cortex covers the capsule.

d. Nephrons are in the renal cortex.

Because the kidney filters blood, its network of blood vessels is an important component of its structure and function.

The arteries, veins, and nerves that supply the kidney enter and exit at the renal hilum. Renal blood supply starts with the

branching of the aorta into the renal arteries (which are each named based on the region of the kidney they pass through)

and ends with the exiting of the renal veins to join the inferior vena cava . The renal arteries split into several segmental

arteries upon entering the kidneys. Each segmental artery splits further into several interlobar arteries and enters the renal

columns, which supply the renal lobes. The interlobar arteries split at the junction of the renal cortex and medulla to form the

arcuate arteries . The arcuate “bow shaped” arteries form arcs along the base of the medullary pyramids. Cortical radiate

arteries , as the name suggests, radiate out from the arcuate arteries. The cortical radiate arteries branch into numerous

afferent arterioles, and then enter the capillaries supplying the nephrons. Veins trace the path of the arteries and have similar

names, except there are no segmental veins.

As mentioned previously, the functional unit of the kidney is the nephron, illustrated in Figure 41.6 . Each kidney is made up

of over one million nephrons that dot the renal cortex, giving it a granular appearance when sectioned sagittally. There are

two types of nephrons— cortical nephrons (85 percent), which are deep in the renal cortex, and juxtamedullary nephrons

(15 percent), which lie in the renal cortex close to the renal medulla. A nephron consists of three parts—a renal corpuscle ,

arenal tubule , and the associated capillary network, which originates from the cortical radiate arteries.

1194 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 41.6 The nephron is the functional unit of the kidney. The glomerulus and convoluted tubules are located

in the kidney cortex, while collecting ducts are located in the pyramids of the medulla. (credit: modification of work

by NIDDK)

Which of the following statements about the nephron is false?

a. The collecting duct empties into the distal convoluted tubule.

b. The Bowman’s capsule surrounds the glomerulus.

c. The loop of Henle is between the proximal and distal convoluted tubules.

d. The loop of Henle empties into the distal convoluted tubule.

Renal Corpuscle

The renal corpuscle, located in the renal cortex, is made up of a network of capillaries known as the glomerulus and the

capsule, a cup-shaped chamber that surrounds it, called the glomerular or Bowman's capsule .

Renal Tubule

The renal tubule is a long and convoluted structure that emerges from the glomerulus and can be divided into three parts

based on function. The first part is called the proximal convoluted tubule (PCT) due to its proximity to the glomerulus;

it stays in the renal cortex. The second part is called the loop of Henle , or nephritic loop, because it forms a loop (with

descending and ascending limbs ) that goes through the renal medulla. The third part of the renal tubule is called the distal

convoluted tubule (DCT) and this part is also restricted to the renal cortex. The DCT, which is the last part of the nephron,

connects and empties its contents into collecting ducts that line the medullary pyramids. The collecting ducts amass contents

from multiple nephrons and fuse together as they enter the papillae of the renal medulla.

Capillary Network within the Nephron

The capillary network that originates from the renal arteries supplies the nephron with blood that needs to be filtered. The

branch that enters the glomerulus is called the afferent arteriole . The branch that exits the glomerulus is called the efferent

arteriole . Within the glomerulus, the network of capillaries is called the glomerular capillary bed. Once the efferent arteriole

exits the glomerulus, it forms the peritubular capillary network , which surrounds and interacts with parts of the renal

tubule. In cortical nephrons, the peritubular capillary network surrounds the PCT and DCT. In juxtamedullary nephrons, the

peritubular capillary network forms a network around the loop of Henle and is called the vasa recta .

Chapter 41 | Osmotic Regulation and Excretion 1195 Go to this website (http://openstaxcollege.org/l/kidney_section) to see another coronal section of the kidney and to

explore an animation of the workings of nephrons.

Kidney Function and Physiology

Kidneys filter blood in a three-step process. First, the nephrons filter blood that runs through the capillary network in the

glomerulus. Almost all solutes, except for proteins, are filtered out into the glomerulus by a process called glomerular

filtration . Second, the filtrate is collected in the renal tubules. Most of the solutes get reabsorbed in the PCT by a process

called tubular reabsorption . In the loop of Henle, the filtrate continues to exchange solutes and water with the renal

medulla and the peritubular capillary network. Water is also reabsorbed during this step. Then, additional solutes and

wastes are secreted into the kidney tubules during tubular secretion , which is, in essence, the opposite process to tubular

reabsorption. The collecting ducts collect filtrate coming from the nephrons and fuse in the medullary papillae. From here,

the papillae deliver the filtrate, now called urine, into the minor calyces that eventually connect to the ureters through the

renal pelvis. This entire process is illustrated in Figure 41.7 .

1196 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 41.7 Each part of the nephron performs a different function in filtering waste and maintaining homeostatic

balance. (1) The glomerulus forces small solutes out of the blood by pressure. (2) The proximal convoluted tubule

reabsorbs ions, water, and nutrients from the filtrate into the interstitial fluid, and actively transports toxins and drugs

from the interstitial fluid into the filtrate. The proximal convoluted tubule also adjusts blood pH by selectively secreting

ammonia (NH 3) into the filtrate, where it reacts with H +to form NH 4+. The more acidic the filtrate, the more ammonia

is secreted. (3) The descending loop of Henle is lined with cells containing aquaporins that allow water to pass from

the filtrate into the interstitial fluid. (4) In the thin part of the ascending loop of Henle, Na +and Cl -ions diffuse into the

interstitial fluid. In the thick part, these same ions are actively transported into the interstitial fluid. Because salt but not

water is lost, the filtrate becomes more dilute as it travels up the limb. (5) In the distal convoluted tubule, K +and H +ions

are selectively secreted into the filtrate, while Na +, Cl -, and HCO 3-ions are reabsorbed to maintain pH and electrolyte

balance in the blood. (6) The collecting duct reabsorbs solutes and water from the filtrate, forming dilute urine. (credit:

modification of work by NIDDK)

Glomerular Filtration

Glomerular filtration filters out most of the solutes due to high blood pressure and specialized membranes in the afferent

arteriole. The blood pressure in the glomerulus is maintained independent of factors that affect systemic blood pressure.

The “leaky” connections between the endothelial cells of the glomerular capillary network allow solutes to pass through

easily. All solutes in the glomerular capillaries, except for macromolecules like proteins, pass through by passive diffusion.

There is no energy requirement at this stage of the filtration process. Glomerular filtration rate (GFR) is the volume

of glomerular filtrate formed per minute by the kidneys. GFR is regulated by multiple mechanisms and is an important

indicator of kidney function.

To learn more about the vascular system of kidneys, click through this review (http://openstaxcollege.org/l/kidneys)

and the steps of blood flow.

Chapter 41 | Osmotic Regulation and Excretion 1197 Tubular Reabsorption and Secretion

Tubular reabsorption occurs in the PCT part of the renal tubule. Almost all nutrients are reabsorbed, and this occurs either

by passive or active transport. Reabsorption of water and some key electrolytes are regulated and can be influenced by

hormones. Sodium (Na +) is the most abundant ion and most of it is reabsorbed by active transport and then transported to

the peritubular capillaries. Because Na +is actively transported out of the tubule, water follows it to even out the osmotic

pressure. Water is also independently reabsorbed into the peritubular capillaries due to the presence of aquaporins, or water

channels, in the PCT. This occurs due to the low blood pressure and high osmotic pressure in the peritubular capillaries.

However, every solute has a transport maximum and the excess is not reabsorbed.

In the loop of Henle, the permeability of the membrane changes. The descending limb is permeable to water, not solutes;

the opposite is true for the ascending limb. Additionally, the loop of Henle invades the renal medulla, which is naturally

high in salt concentration and tends to absorb water from the renal tubule and concentrate the filtrate. The osmotic gradient

increases as it moves deeper into the medulla. Because two sides of the loop of Henle perform opposing functions, as

illustrated in Figure 41.8 ,itactsasa countercurrent multiplier . The vasa recta around it acts as the countercurrent

exchanger .

Figure 41.8 The loop of Henle acts as a countercurrent multiplier that uses energy to create concentration

gradients. The descending limb is water permeable. Water flows from the filtrate to the interstitial fluid, so

osmolality inside the limb increases as it descends into the renal medulla. At the bottom, the osmolality is higher

inside the loop than in the interstitial fluid. Thus, as filtrate enters the ascending limb, Na +and Cl -ions exit through

ion channels present in the cell membrane. Further up, Na +is actively transported out of the filtrate and Cl -follows.

Osmolarity is given in units of milliosmoles per liter (mOsm/L).

Loop diuretics are drugs sometimes used to treat hypertension. These drugs inhibit the reabsorption of Na +

and Cl -ions by the ascending limb of the loop of Henle. A side effect is that they increase urination. Why do

you think this is the case?

By the time the filtrate reaches the DCT, most of the urine and solutes have been reabsorbed. If the body requires additional

water, all of it can be reabsorbed at this point. Further reabsorption is controlled by hormones, which will be discussed in a

later section. Excretion of wastes occurs due to lack of reabsorption combined with tubular secretion. Undesirable products

like metabolic wastes, urea, uric acid, and certain drugs, are excreted by tubular secretion. Most of the tubular secretion

happens in the DCT, but some occurs in the early part of the collecting duct. Kidneys also maintain an acid-base balance by

secreting excess H +ions.

1198 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Although parts of the renal tubules are named proximal and distal, in a cross-section of the kidney, the tubules are placed

close together and in contact with each other and the glomerulus. This allows for exchange of chemical messengers between

the different cell types. For example, the DCT ascending limb of the loop of Henle has masses of cells called macula densa ,

which are in contact with cells of the afferent arterioles called juxtaglomerular cells . Together, the macula densa and

juxtaglomerular cells form the juxtaglomerular complex (JGC). The JGC is an endocrine structure that secretes the enzyme

renin and the hormone erythropoietin. When hormones trigger the macula densa cells in the DCT due to variations in blood

volume, blood pressure, or electrolyte balance, these cells can immediately communicate the problem to the capillaries in

the afferent and efferent arterioles, which can constrict or relax to change the glomerular filtration rate of the kidneys.

Nephrologist

A nephrologist studies and deals with diseases of the kidneys—both those that cause kidney failure (such as

diabetes) and the conditions that are produced by kidney disease (such as hypertension). Blood pressure,

blood volume, and changes in electrolyte balance come under the purview of a nephrologist.

Nephrologists usually work with other physicians who refer patients to them or consult with them about

specific diagnoses and treatment plans. Patients are usually referred to a nephrologist for symptoms such

as blood or protein in the urine, very high blood pressure, kidney stones, or renal failure.

Nephrology is a subspecialty of internal medicine. To become a nephrologist, medical school is followed

by additional training to become certified in internal medicine. An additional two or more years is spent

specifically studying kidney disorders and their accompanying effects on the body.

41.3 | Excretion Systems

By the end of this section, you will be able to:

• Explain how vacuoles, present in microorganisms, work to excrete waste

• Describe the way in which flame cells and nephridia in worms perform excretory functions and maintain osmotic

balance

• Explain how insects use Malpighian tubules to excrete wastes and maintain osmotic balance

Microorganisms and invertebrate animals use more primitive and simple mechanisms to get rid of their metabolic wastes

than the mammalian system of kidney and urinary function. Three excretory systems evolved in organisms before complex

kidneys: vacuoles, flame cells, and Malpighian tubules.

Contractile Vacuoles in Microorganisms

The most fundamental feature of life is the presence of a cell. In other words, a cell is the simplest functional unit of a

life. Bacteria are unicellular, prokaryotic organisms that have some of the least complex life processes in place; however,

prokaryotes such as bacteria do not contain membrane-bound vacuoles. The cells of microorganisms like bacteria, protozoa,

and fungi are bound by cell membranes and use them to interact with the environment. Some cells, including some

leucocytes in humans, are able to engulf food by endocytosis—the formation of vesicles by involution of the cell membrane

within the cells. The same vesicles are able to interact and exchange metabolites with the intracellular environment. In

some unicellular eukaryotic organisms such as the amoeba, shown in Figure 41.9 , cellular wastes and excess water are

excreted by exocytosis, when the contractile vacuoles merge with the cell membrane and expel wastes into the environment.

Contractile vacuoles (CV) should not be confused with vacuoles, which store food or water.

Chapter 41 | Osmotic Regulation and Excretion 1199 Figure 41.9 Some unicellular organisms, such as the amoeba, ingest food by endocytosis. The food vesicle fuses with

a lysosome, which digests the food. Waste is excreted by exocytosis.

Flame Cells of Planaria and Nephridia of Worms

As multi-cellular systems evolved to have organ systems that divided the metabolic needs of the body, individual organs

evolved to perform the excretory function. Planaria are flatworms that live in fresh water. Their excretory system consists of

two tubules connected to a highly branched duct system. The cells in the tubules are called flame cells (or protonephridia )

because they have a cluster of cilia that looks like a flickering flame when viewed under the microscope, as illustrated

in Figure 41.10 a. The cilia propel waste matter down the tubules and out of the body through excretory pores that open

on the body surface; cilia also draw water from the interstitial fluid, allowing for filtration. Any valuable metabolites are

recovered by reabsorption. Flame cells are found in flatworms, including parasitic tapeworms and free-living planaria. They

also maintain the organism’s osmotic balance.

Figure 41.10 In the excretory system of the (a) planaria, cilia of flame cells propel waste through a tubule formed

by a tube cell. Tubules are connected into branched structures that lead to pores located all along the sides of the

body. The filtrate is secreted through these pores. In (b) annelids such as earthworms, nephridia filter fluid from the

coelom, or body cavity. Beating cilia at the opening of the nephridium draw water from the coelom into a tubule. As

the filtrate passes down the tubules, nutrients and other solutes are reabsorbed by capillaries. Filtered fluid containing

nitrogenous and other wastes is stored in a bladder and then secreted through a pore in the side of the body.

Earthworms (annelids) have slightly more evolved excretory structures called nephridia , illustrated in Figure 41.10 b.A

pair of nephridia is present on each segment of the earthworm. They are similar to flame cells in that they have a tubule

with cilia. Excretion occurs through a pore called the nephridiopore . They are more evolved than the flame cells in that

they have a system for tubular reabsorption by a capillary network before excretion.

Malpighian Tubules of Insects

Malpighian tubules are found lining the gut of some species of arthropods, such as the bee illustrated in Figure 41.11 . They

are usually found in pairs and the number of tubules varies with the species of insect. Malpighian tubules are convoluted,

which increases their surface area, and they are lined with microvilli for reabsorption and maintenance of osmotic balance.

Malpighian tubules work cooperatively with specialized glands in the wall of the rectum. Body fluids are not filtered as

in the case of nephridia; urine is produced by tubular secretion mechanisms by the cells lining the Malpighian tubules that

are bathed in hemolymph (a mixture of blood and interstitial fluid that is found in insects and other arthropods as well as

most mollusks). Metabolic wastes like uric acid freely diffuse into the tubules. There are exchange pumps lining the tubules,

which actively transport H +ions into the cell and K +or Na +ions out; water passively follows to form urine. The secretion

1200 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 of ions alters the osmotic pressure which draws water, electrolytes, and nitrogenous waste (uric acid) into the tubules. Water

and electrolytes are reabsorbed when these organisms are faced with low-water environments, and uric acid is excreted as a

thick paste or powder. Not dissolving wastes in water helps these organisms to conserve water; this is especially important

for life in dry environments.

Figure 41.11 Malpighian tubules of insects and other terrestrial arthropods remove nitrogenous wastes and other

solutes from the hemolymph. Na +and/or K +ions are actively transported into the lumen of the tubules. Water then

enters the tubules via osmosis, forming urine. The urine passes through the intestine, and into the rectum. There,

nutrients diffuse back into the hemolymph. Na +and/or K +ions are pumped into the hemolymph, and water follows.

The concentrated waste is then excreted.

Visit this site (http://openstaxcollege.org/l/malpighian) to see a dissected cockroach, including a close-up look at its

Malpighian tubules.

41.4 | Nitrogenous Wastes

By the end of this section, you will be able to:

• Compare and contrast the way in which aquatic animals and terrestrial animals can eliminate toxic ammonia from

their systems

• Compare the major byproduct of ammonia metabolism in vertebrate animals to that of birds, insects, and reptiles

Of the four major macromolecules in biological systems, both proteins and nucleic acids contain nitrogen. During the

catabolism, or breakdown, of nitrogen-containing macromolecules, carbon, hydrogen, and oxygen are extracted and stored

in the form of carbohydrates and fats. Excess nitrogen is excreted from the body. Nitrogenous wastes tend to form toxic

ammonia , which raises the pH of body fluids. The formation of ammonia itself requires energy in the form of ATP and

large quantities of water to dilute it out of a biological system. Animals that live in aquatic environments tend to release

ammonia into the water. Animals that excrete ammonia are said to be ammonotelic . Terrestrial organisms have evolved

other mechanisms to excrete nitrogenous wastes. The animals must detoxify ammonia by converting it into a relatively

nontoxic form such as urea or uric acid. Mammals, including humans, produce urea, whereas reptiles and many terrestrial

Chapter 41 | Osmotic Regulation and Excretion 1201 invertebrates produce uric acid. Animals that secrete urea as the primary nitrogenous waste material are called ureotelic

animals.

Nitrogenous Waste in Terrestrial Animals: The Urea Cycle

The urea cycle is the primary mechanism by which mammals convert ammonia to urea. Urea is made in the liver and

excreted in urine. The overall chemical reaction by which ammonia is converted to urea is 2 NH 3(ammonia) + CO 2+3

ATP + H 2O → H 2N-CO-NH 2(urea) + 2 ADP + 4 P i+ AMP.

The urea cycle utilizes five intermediate steps, catalyzed by five different enzymes, to convert ammonia to urea, as shown

inFigure 41.12 . The amino acid L-ornithine gets converted into different intermediates before being regenerated at the end

of the urea cycle. Hence, the urea cycle is also referred to as the ornithine cycle. The enzyme ornithine transcarbamylase

catalyzes a key step in the urea cycle and its deficiency can lead to accumulation of toxic levels of ammonia in the body.

The first two reactions occur in the mitochondria and the last three reactions occur in the cytosol. Urea concentration in the

blood, called blood urea nitrogen or BUN, is used as an indicator of kidney function.

Figure 41.12 The urea cycle converts ammonia to urea.

1202 Chapter 41 | Osmotic Regulation and Excretion

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The theory of evolution proposes that life started in an aquatic environment. It is not surprising to see

that biochemical pathways like the urea cycle evolved to adapt to a changing environment when terrestrial

life forms evolved. Arid conditions probably led to the evolution of the uric acid pathway as a means of

conserving water.

Nitrogenous Waste in Birds and Reptiles: Uric Acid

Birds, reptiles, and most terrestrial arthropods convert toxic ammonia to uric acid or the closely related compound guanine

(guano) instead of urea. Mammals also form some uric acid during breakdown of nucleic acids. Uric acid is a compound

similar to purines found in nucleic acids. It is water insoluble and tends to form a white paste or powder; it is excreted

by birds, insects, and reptiles. Conversion of ammonia to uric acid requires more energy and is much more complex than

conversion of ammonia to urea Figure 41.13 .

Figure 41.13 Nitrogenous waste is excreted in different forms by different species. These include (a) ammonia, (b)

urea, and (c) uric acid. (credit a: modification of work by Eric Engbretson, USFWS; credit b: modification of work by B.

"Moose" Peterson, USFWS; credit c: modification of work by Dave Menke, USFWS)

Chapter 41 | Osmotic Regulation and Excretion 1203 Gout

Mammals use uric acid crystals as an antioxidant in their cells. However, too much uric acid tends to form

kidney stones and may also cause a painful condition called gout, where uric acid crystals accumulate in the

joints, as illustrated in Figure 41.14 . Food choices that reduce the amount of nitrogenous bases in the diet

help reduce the risk of gout. For example, tea, coffee, and chocolate have purine-like compounds, called

xanthines, and should be avoided by people with gout and kidney stones.

Figure 41.14 Gout causes the inflammation visible in this person’s left big toe joint. (credit: "Gonzosft"/Wikimedia

Commons)

41.5 | Hormonal Control of Osmoregulatory Functions

By the end of this section, you will be able to:

• Explain how hormonal cues help the kidneys synchronize the osmotic needs of the body

• Describe how hormones like epinephrine, norepinephrine, renin-angiotensin, aldosterone, anti-diuretic hormone,

and atrial natriuretic peptide help regulate waste elimination, maintain correct osmolarity, and perform other

osmoregulatory functions

While the kidneys operate to maintain osmotic balance and blood pressure in the body, they also act in concert with

hormones. Hormones are small molecules that act as messengers within the body. Hormones are typically secreted from

one cell and travel in the bloodstream to affect a target cell in another portion of the body. Different regions of the nephron

bear specialized cells that have receptors to respond to chemical messengers and hormones. Table 41.1 summarizes the

hormones that control the osmoregulatory functions.

Hormones That Affect Osmoregulation

Hormone Where produced Function

Epinephrine and

Norepinephrine Adrenal medulla Can decrease kidney function temporarily by vasoconstriction

Renin Kidney nephrons Increases blood pressure by acting on angiotensinogen

Table 41.1

1204 Chapter 41 | Osmotic Regulation and Excretion

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Hormone Where produced Function

Angiotensin Liver Angiotensin II affects multiple processes and increases blood

pressure

Aldosterone Adrenal cortex Prevents loss of sodium and water

Anti-diuretic

hormone

(vasopressin)

Hypothalamus (stored

in the posterior

pituitary)

Prevents water loss

Atrial natriuretic

peptide Heart atrium

Decreases blood pressure by acting as a vasodilator and

increasing glomerular filtration rate; decreases sodium

reabsorption in kidneys

Table 41.1

Epinephrine and Norepinephrine

Epinephrine and norepinephrine are released by the adrenal medulla and nervous system respectively. They are the flight/

fight hormones that are released when the body is under extreme stress. During stress, much of the body’s energy is used

to combat imminent danger. Kidney function is halted temporarily by epinephrine and norepinephrine. These hormones

function by acting directly on the smooth muscles of blood vessels to constrict them. Once the afferent arterioles are

constricted, blood flow into the nephrons stops. These hormones go one step further and trigger the renin-angiotensin-

aldosterone system.

Renin-Angiotensin-Aldosterone

The renin-angiotensin-aldosterone system, illustrated in Figure 41.15 proceeds through several steps to produce

angiotensin II , which acts to stabilize blood pressure and volume. Renin (secreted by a part of the juxtaglomerular

complex) is produced by the granular cells of the afferent and efferent arterioles. Thus, the kidneys control blood

pressure and volume directly. Renin acts on angiotensinogen, which is made in the liver and converts it to angiotensin I .

Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II. Angiotensin II raises blood pressure by

constricting blood vessels. It also triggers the release of the mineralocorticoid aldosterone from the adrenal cortex, which in

turn stimulates the renal tubules to reabsorb more sodium. Angiotensin II also triggers the release of anti-diuretic hormone

(ADH) from the hypothalamus, leading to water retention in the kidneys. It acts directly on the nephrons and decreases

glomerular filtration rate. Medically, blood pressure can be controlled by drugs that inhibit ACE (called ACE inhibitors).

Chapter 41 | Osmotic Regulation and Excretion 1205 Figure 41.15 The renin-angiotensin-aldosterone system increases blood pressure and volume. The hormone ANP has

antagonistic effects. (credit: modification of work by Mikael Häggström)

Mineralocorticoids

Mineralocorticoids are hormones synthesized by the adrenal cortex that affect osmotic balance. Aldosterone is a

mineralocorticoid that regulates sodium levels in the blood. Almost all of the sodium in the blood is reclaimed by the renal

tubules under the influence of aldosterone. Because sodium is always reabsorbed by active transport and water follows

sodium to maintain osmotic balance, aldosterone manages not only sodium levels but also the water levels in body fluids.

In contrast, the aldosterone also stimulates potassium secretion concurrently with sodium reabsorption. In contrast, absence

of aldosterone means that no sodium gets reabsorbed in the renal tubules and all of it gets excreted in the urine. In addition,

the daily dietary potassium load is not secreted and the retention of K +can cause a dangerous increase in plasma K +

concentration. Patients who have Addison's disease have a failing adrenal cortex and cannot produce aldosterone. They lose

sodium in their urine constantly, and if the supply is not replenished, the consequences can be fatal.

Antidiurectic Hormone

As previously discussed, antidiuretic hormone or ADH (also called vasopressin ), as the name suggests, helps the body

conserve water when body fluid volume, especially that of blood, is low. It is formed by the hypothalamus and is stored

and released from the posterior pituitary. It acts by inserting aquaporins in the collecting ducts and promotes reabsorption

of water. ADH also acts as a vasoconstrictor and increases blood pressure during hemorrhaging.

Atrial Natriuretic Peptide Hormone

The atrial natriuretic peptide (ANP) lowers blood pressure by acting as a vasodilator . It is released by cells in the atrium

of the heart in response to high blood pressure and in patients with sleep apnea. ANP affects salt release, and because water

passively follows salt to maintain osmotic balance, it also has a diuretic effect. ANP also prevents sodium reabsorption by

the renal tubules, decreasing water reabsorption (thus acting as a diuretic) and lowering blood pressure. Its actions suppress

the actions of aldosterone, ADH, and renin.

1206 Chapter 41 | Osmotic Regulation and Excretion

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ammonia

ammonotelic

angiotensin converting enzyme (ACE)

angiotensin I

angiotensin II

anti-diuretic hormone (ADH)

antioxidant

arcuate artery

ascending limb

blood urea nitrogen (BUN)

Bowman's capsule

calyx

cortex (animal)

cortical nephron

cortical radiate artery

countercurrent exchanger

countercurrent multiplier

descending limb

distal convoluted tubule (DCT)

efferent arteriole

electrolyte

flame cell

glomerular filtration

glomerular filtration rate (GFR)

glomerulus (renal)

hilum

inferior vena cava

interlobar artery

juxtaglomerular cell

juxtamedullary nephron

KEY TERMS

arteriole that branches from the cortical radiate artery and enters the glomerulus

compound made of one nitrogen atom and three hydrogen atoms

describes an animal that excretes ammonia as the primary waste material

enzyme that converts angiotensin I to angiotensin II

product in the renin-angiotensin-aldosterone pathway

molecule that affects different organs to increase blood pressure

hormone that prevents the loss of water

agent that prevents cell destruction by reactive oxygen species

artery that branches from the interlobar artery and arches over the base of the renal pyramids

part of the loop of Henle that ascends from the renal medulla to the renal cortex

estimate of urea in the blood and an indicator of kidney function

structure that encloses the glomerulus

structure that connects the renal pelvis to the renal medulla

outer layer of an organ like the kidney or adrenal gland

nephron that lies in the renal cortex

artery that radiates from the arcuate arteries into the renal cortex

peritubular capillary network that allows exchange of solutes and water from the renal

tubules

osmotic gradient in the renal medulla that is responsible for concentration of urine

part of the loop of Henle that descends from the renal cortex into the renal medulla

part of the renal tubule that is the most distant from the glomerulus

arteriole that exits from the glomerulus

solute that breaks down into ions when dissolved in water

(also, protonephridia) excretory cell found in flatworms

filtration of blood in the glomerular capillary network into the glomerulus

amount of filtrate formed by the glomerulus per minute

part of the renal corpuscle that contains the capillary network

region in the renal pelvis where blood vessels, nerves, and ureters bunch before entering or exiting the kidney

one of the main veins in the human body

artery that branches from the segmental artery and travels in between the renal lobes

cell in the afferent and efferent arterioles that responds to stimuli from the macula densa

nephron that lies in the cortex but close to the renal medulla

Chapter 41 | Osmotic Regulation and Excretion 1207 kidney

lobes of the kidney

loop of Henle

macula densa

Malpighian tubule

medulla

microvilli

molality

molarity

mole

nephridia

nephridiopore

nephron

non-electrolyte

osmoconformer

osmoregulation

osmoregulator

osmotic balance

osmotic pressure

perirenal fat capsule

peritubular capillary network

proximal convoluted tubule (PCT)

renal artery

renal capsule

renal column

renal corpuscle

renal fascia

renal pelvis

renal pyramid

renal tubule

organ that performs excretory and osmoregulatory functions

renal pyramid along with the adjoining cortical region

part of the renal tubule that loops into the renal medulla

group of cells that senses changes in sodium ion concentration; present in parts of the renal tubule and

collecting ducts

excretory tubules found in arthropods

middle layer of an organ like the kidney or adrenal gland

cellular processes that increase the surface area of cells

number of moles of solute per kilogram of solvent

number of moles of solute per liter of solution

gram equivalent of the molecular weight of a substance

excretory structures found in annelids

pore found at the end of nephridia

functional unit of the kidney

solute that does not break down into ions when dissolved in water

organism that changes its tonicity based on its environment

mechanism by which water and solute concentrations are maintained at desired levels

organism that maintains its tonicity irrespective of its environment

balance of the amount of water and salt input and output to and from a biological system without

disturbing the desired osmotic pressure and solute concentration in every compartment

pressure exerted on a membrane to equalize solute concentration on either side

fat layer that suspends the kidneys

capillary network that surrounds the renal tubule after the efferent artery exits the

glomerulus

part of the renal tubule that lies close to the glomerulus

branch of the artery that enters the kidney

layer that encapsulates the kidneys

area of the kidney through which the interlobar arteries travel in the process of supplying blood to the renal

lobes

glomerulus and the Bowman's capsule together

connective tissue that supports the kidneys

region in the kidney where the calyces join the ureters

conical structure in the renal medulla

tubule of the nephron that arises from the glomerulus

1208 Chapter 41 | Osmotic Regulation and Excretion

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renin-angiotensin-aldosterone

segmental artery

semi-permeable membrane

transport maximum

tubular reabsorption

tubular secretion

urea cycle

ureotelic

ureter

uric acid

urinary bladder

urine

vasa recta

vasodilator

vasopressin

branch of a vein that exits the kidney and joins the inferior vena cava

biochemical pathway that activates angiotensin II, which increases blood pressure

artery that branches from the renal artery

membrane that allows only certain solutes to pass through

maximum amount of solute that can be transported out of the renal tubules during reabsorption

reclamation of water and solutes that got filtered out in the glomerulus

process of secretion of wastes that do not get reabsorbed

pathway by which ammonia is converted to urea

describes animals that secrete urea as the primary nitrogenous waste material

urine-bearing tube coming out of the kidney; carries urine to the bladder

byproduct of ammonia metabolism in birds, insects, and reptiles

structure that the ureters empty the urine into; stores urine

filtrate produced by kidneys that gets excreted out of the body

peritubular network that surrounds the loop of Henle of the juxtamedullary nephrons

compound that increases the diameter of blood vessels

another name for anti-diuretic hormone

CHAPTER SUMMARY

41.1 Osmoregulation and Osmotic Balance

Solute concentrations across a semi-permeable membranes influence the movement of water and solutes across the

membrane. It is the number of solute molecules and not the molecular size that is important in osmosis. Osmoregulation

and osmotic balance are important bodily functions, resulting in water and salt balance. Not all solutes can pass through a

semi-permeable membrane. Osmosis is the movement of water across the membrane. Osmosis occurs to equalize the

number of solute molecules across a semi-permeable membrane by the movement of water to the side of higher solute

concentration. Facilitated diffusion utilizes protein channels to move solute molecules from areas of higher to lower

concentration while active transport mechanisms are required to move solutes against concentration gradients. Osmolarity

is measured in units of milliequivalents or milliosmoles, both of which take into consideration the number of solute

particles and the charge on them. Fish that live in fresh water or saltwater adapt by being osmoregulators or

osmoconformers.

41.2 The Kidneys and Osmoregulatory Organs

The kidneys are the main osmoregulatory organs in mammalian systems; they function to filter blood and maintain the

osmolarity of body fluids at 300 mOsm. They are surrounded by three layers and are made up internally of three distinct

regions—the cortex, medulla, and pelvis.

The blood vessels that transport blood into and out of the kidneys arise from and merge with the aorta and inferior vena

cava, respectively. The renal arteries branch out from the aorta and enter the kidney where they further divide into

segmental, interlobar, arcuate, and cortical radiate arteries.

The nephron is the functional unit of the kidney, which actively filters blood and generates urine. The nephron is made up

of the renal corpuscle and renal tubule. Cortical nephrons are found in the renal cortex, while juxtamedullary nephrons are

found in the renal cortex close to the renal medulla. The nephron filters and exchanges water and solutes with two sets of

blood vessels and the tissue fluid in the kidneys.

There are three steps in the formation of urine: glomerular filtration, which occurs in the glomerulus; tubular reabsorption,

which occurs in the renal tubules; and tubular secretion, which also occurs in the renal tubules.

Chapter 41 | Osmotic Regulation and Excretion 1209 41.3 Excretion Systems

Many systems have evolved for excreting wastes that are simpler than the kidney and urinary systems of vertebrate

animals. The simplest system is that of contractile vacuoles present in microorganisms. Flame cells and nephridia in

worms perform excretory functions and maintain osmotic balance. Some insects have evolved Malpighian tubules to

excrete wastes and maintain osmotic balance.

41.4 Nitrogenous Wastes

Ammonia is the waste produced by metabolism of nitrogen-containing compounds like proteins and nucleic acids. While

aquatic animals can easily excrete ammonia into their watery surroundings, terrestrial animals have evolved special

mechanisms to eliminate the toxic ammonia from their systems. Urea is the major byproduct of ammonia metabolism in

vertebrate animals. Uric acid is the major byproduct of ammonia metabolism in birds, terrestrial arthropods, and reptiles.

41.5 Hormonal Control of Osmoregulatory Functions

Hormonal cues help the kidneys synchronize the osmotic needs of the body. Hormones like epinephrine, norepinephrine,

renin-angiotensin, aldosterone, anti-diuretic hormone, and atrial natriuretic peptide help regulate the needs of the body as

well as the communication between the different organ systems.

ART CONNECTION QUESTIONS

1. Figure 41.5 Which of the following statements about

the kidney is false?

a. The renal pelvis drains into the ureter.

b. The renal pyramids are in the medulla.

c. The cortex covers the capsule.

d. Nephrons are in the renal cortex.

2. Figure 41.6 Which of the following statements about

the nephron is false?

a. The collecting duct empties into the distal

convoluted tubule.

b. The Bowman’s capsule surrounds the

glomerulus.

c. The loop of Henle is between the proximal and

distal convoluted tubules.

d. The loop of Henle empties into the distal

convoluted tubule.

3. Figure 41.8 Loop diuretics are drugs sometimes used to

treat hypertension. These drugs inhibit the reabsorption of

Na +and Cl -ions by the ascending limb of the loop of

Henle. A side effect is that they increase urination. Why

do you think this is the case?

REVIEW QUESTIONS

4. When a dehydrated human patient needs to be given

fluids intravenously, he or she is given:

a. water, which is hypotonic with respect to body

fluids

b. saline at a concentration that is isotonic with

respect to body fluids

c. glucose because it is a non-electrolyte

d. blood

5. The sodium ion is at the highest concentration in:

a. intracellular fluid

b. extracellular fluid

c. blood plasma

d. none of the above

6. Cells in a hypertonic solution tend to:

a. shrink due to water loss

b. swell due to water gain

c. stay the same size due to water moving into and

out of the cell at the same rate

d. none of the above

7. The macula densa is/are:

a. present in the renal medulla.

b. dense tissue present in the outer layer of the

kidney.

c. cells present in the DCT and collecting tubules.

d. present in blood capillaries.

8. The osmolarity of body fluids is maintained at

________.

a. 100 mOsm

b. 300 mOsm

c. 1000 mOsm

d. it is not constantly maintained

9. The gland located at the top of the kidney is the

________ gland.

a. adrenal

b. pituitary

c. thyroid

d. thymus

10. Active transport of K +in Malpighian tubules ensures

that:

1210 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 a. water follows K +to make urine

b. osmotic balance is maintained between waste

matter and bodily fluids

c. both a and b

d. neither a nor b

11. Contractile vacuoles in microorganisms:

a. exclusively perform an excretory function

b. can perform many functions, one of which is

excretion of metabolic wastes

c. originate from the cell membrane

d. both b and c

12. Flame cells are primitive excretory organs found in

________.

a. arthropods

b. annelids

c. mammals

d. flatworms

13. BUN is ________.

a. blood urea nitrogen

b. blood uric acid nitrogen

c. an indicator of blood volume

d. an indicator of blood pressure

14. Human beings accumulate ________ before excreting

nitrogenous waste.

a. nitrogen

b. ammonia

c. urea

d. uric acid

15. Renin is made by ________.

a. granular cells of the juxtaglomerular apparatus

b. the kidneys

c. the nephrons

d. All of the above.

16. Patients with Addison's disease ________.

a. retain water

b. retain salts

c. lose salts and water

d. have too much aldosterone

17. Which hormone elicits the “fight or flight” response?

a. epinephrine

b. mineralcorticoids

c. anti-diuretic hormone

d. thyroxine

CRITICAL THINKING QUESTIONS

18. Why is excretion important in order to achieve

osmotic balance?

19. Why do electrolyte ions move across membranes by

active transport?

20. Why are the loop of Henle and vasa recta important

for the formation of concentrated urine?

21. Describe the structure of the kidney.

22. Why might specialized organs have evolved for

excretion of wastes?

23. Explain two different excretory systems other than the

kidneys.

24. In terms of evolution, why might the urea cycle have

evolved in organisms?

25. Compare and contrast the formation of urea and uric

acid.

26. Describe how hormones regulate blood pressure,

blood volume, and kidney function.

27. How does the renin-angiotensin-aldosterone

mechanism function? Why is it controlled by the kidneys?

Chapter 41 | Osmotic Regulation and Excretion 1211 1212 Chapter 41 | Osmotic Regulation and Excretion

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 42 | THE IMMUNE SYSTEM

Figure 42.1 In this compound light micrograph purple-stained neutrophil (upper left) and eosinophil (lower right)

are white blood cells that float among red blood cells in this blood smear. Neutrophils provide an early, rapid, and

nonspecific defense against invading pathogens. Eosinophils play a variety of roles in the immune response. Red

blood cells are about 7–8 µm in diameter, and a neutrophil is about 10–12µm. (credit: modification of work by Dr. David

Csaba)

Chapter Outline

42.1: Innate Immune Response

42.2: Adaptive Immune Response

42.3: Antibodies

42.4: Disruptions in the Immune System

Introduction

The environment consists of numerous pathogens , which are agents, usually microorganisms, that cause diseases in their

hosts. A host is the organism that is invaded and often harmed by a pathogen. Pathogens include bacteria, protists, fungi

and other infectious organisms. We are constantly exposed to pathogens in food and water, on surfaces, and in the air.

Mammalian immune systems evolved for protection from such pathogens; they are composed of an extremely diverse

array of specialized cells and soluble molecules that coordinate a rapid and flexible defense system capable of providing

protection from a majority of these disease agents.

Components of the immune system constantly search the body for signs of pathogens. When pathogens are found, immune

factors are mobilized to the site of an infection. The immune factors identify the nature of the pathogen, strengthen the

corresponding cells and molecules to combat it efficiently, and then halt the immune response after the infection is cleared

to avoid unnecessary host cell damage. The immune system can remember pathogens to which it has been exposed to

create a more efficient response upon re-exposure. This memory can last several decades. Features of the immune system,

such as pathogen identification, specific response, amplification, retreat, and remembrance are essential for survival against

pathogens. The immune response can be classified as either innate or active. The innate immune response is always present

and attempts to defend against all pathogens rather than focusing on specific ones. Conversely, the adaptive immune

response stores information about past infections and mounts pathogen-specific defenses.

Chapter 42 | The Immune System 1213 42.1 | Innate Immune Response

By the end of this section, you will be able to:

• Describe physical and chemical immune barriers

• Explain immediate and induced innate immune responses

• Discuss natural killer cells

• Describe major histocompatibility class I molecules

• Summarize how the proteins in a complement system function to destroy extracellular pathogens

The immune system comprises both innate and adaptive immune responses. Innate immunity occurs naturally because of

genetic factors or physiology; it is not induced by infection or vaccination but works to reduce the workload for the adaptive

immune response. Both the innate and adaptive levels of the immune response involve secreted proteins, receptor-mediated

signaling, and intricate cell-to-cell communication. The innate immune system developed early in animal evolution, roughly

a billion years ago, as an essential response to infection. Innate immunity has a limited number of specific targets: any

pathogenic threat triggers a consistent sequence of events that can identify the type of pathogen and either clear the infection

independently or mobilize a highly specialized adaptive immune response. For example, tears and mucus secretions contain

microbicidal factors.

Physical and Chemical Barriers

Before any immune factors are triggered, the skin functions as a continuous, impassable barrier to potentially infectious

pathogens. Pathogens are killed or inactivated on the skin by desiccation (drying out) and by the skin’s acidity. In addition,

beneficial microorganisms that coexist on the skin compete with invading pathogens, preventing infection. Regions of the

body that are not protected by skin (such as the eyes and mucus membranes) have alternative methods of defense, such as

tears and mucus secretions that trap and rinse away pathogens, and cilia in the nasal passages and respiratory tract that push

the mucus with the pathogens out of the body. Throughout the body are other defenses, such as the low pH of the stomach

(which inhibits the growth of pathogens), blood proteins that bind and disrupt bacterial cell membranes, and the process of

urination (which flushes pathogens from the urinary tract).

Despite these barriers, pathogens may enter the body through skin abrasions or punctures, or by collecting on mucosal

surfaces in large numbers that overcome the mucus or cilia. Some pathogens have evolved specific mechanisms that allow

them to overcome physical and chemical barriers. When pathogens do enter the body, the innate immune system responds

with inflammation, pathogen engulfment, and secretion of immune factors and proteins.

Pathogen Recognition

An infection may be intracellular or extracellular, depending on the pathogen. All viruses infect cells and replicate within

those cells (intracellularly), whereas bacteria and other parasites may replicate intracellularly or extracellularly, depending

on the species. The innate immune system must respond accordingly: by identifying the extracellular pathogen and/

or by identifying host cells that have already been infected. When a pathogen enters the body, cells in the blood and

lymph detect the specific pathogen-associated molecular patterns (PAMPs) on the pathogen’s surface. PAMPs are

carbohydrate, polypeptide, and nucleic acid “signatures” that are expressed by viruses, bacteria, and parasites but which

differ from molecules on host cells. The immune system has specific cells, described in Figure 42.2 and shown in Figure

42.3 , with receptors that recognize these PAMPs. A macrophage is a large phagocytic cell that engulfs foreign particles

and pathogens. Macrophages recognize PAMPs via complementary pattern recognition receptors (PRRs) . PRRs are

molecules on macrophages and dendritic cells which are in contact with the external environment. A monocyte is a type

of white blood cell that circulates in the blood and lymph and differentiates into macrophages after it moves into infected

tissue. Dendritic cells bind molecular signatures of pathogens and promote pathogen engulfment and destruction. Toll-like

receptors (TLRs) are a type of PRR that recognizes molecules that are shared by pathogens but distinguishable from host

molecules). TLRs are present in invertebrates as well as vertebrates, and appear to be one of the most ancient components

of the immune system. TLRs have also been identified in the mammalian nervous system.

1214 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.2 The characteristics and location of cells involved in the innate immune system are described. (credit:

modification of work by NIH)

Chapter 42 | The Immune System 1215 Figure 42.3 Cells of the blood include (1) monocytes, (2) lymphocytes, (3) neutrophils, (4) red blood cells, and (5)

platelets. Note the very similar morphologies of the leukocytes (1, 2, 3). (credit: modification of work by Bruce Wetzel,

Harry Schaefer, NCI; scale-bar data from Matt Russell)

Cytokine Release Affect

The binding of PRRs with PAMPs triggers the release of cytokines, which signal that a pathogen is present and needs to

be destroyed along with any infected cells. A cytokine is a chemical messenger that regulates cell differentiation (form and

function), proliferation (production), and gene expression to affect immune responses. At least 40 types of cytokines exist

in humans that differ in terms of the cell type that produces them, the cell type that responds to them, and the changes they

produce. One type cytokine, interferon, is illustrated in Figure 42.4 .

One subclass of cytokines is the interleukin (IL), so named because they mediate interactions between leukocytes (white

blood cells). Interleukins are involved in bridging the innate and adaptive immune responses. In addition to being released

from cells after PAMP recognition, cytokines are released by the infected cells which bind to nearby uninfected cells and

induce those cells to release cytokines, which results in a cytokine burst.

A second class of early-acting cytokines is interferons, which are released by infected cells as a warning to nearby

uninfected cells. One of the functions of an interferon is to inhibit viral replication. They also have other important

functions, such as tumor surveillance. Interferons work by signaling neighboring uninfected cells to destroy RNA and

reduce protein synthesis, signaling neighboring infected cells to undergo apoptosis (programmed cell death), and activating

immune cells.

In response to interferons, uninfected cells alter their gene expression, which increases the cells’ resistance to infection. One

effect of interferon-induced gene expression is a sharply reduced cellular protein synthesis. Virally infected cells produce

more viruses by synthesizing large quantities of viral proteins. Thus, by reducing protein synthesis, a cell becomes resistant

to viral infection.

1216 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.4 Interferons are cytokines that are released by a cell infected with a virus. Response of neighboring cells

to interferon helps stem the infection.

Phagocytosis and Inflammation

The first cytokines to be produced are pro-inflammatory; that is, they encourage inflammation , the localized redness,

swelling, heat, and pain that result from the movement of leukocytes and fluid through increasingly permeable capillaries

to a site of infection. The population of leukocytes that arrives at an infection site depends on the nature of the infecting

pathogen. Both macrophages and dendritic cells engulf pathogens and cellular debris through phagocytosis. A neutrophil

is also a phagocytic leukocyte that engulfs and digests pathogens. Neutrophils, shown in Figure 42.3 , are the most abundant

leukocytes of the immune system. Neutrophils have a nucleus with two to five lobes, and they contain organelles, called

lysosomes, that digest engulfed pathogens. An eosinophil is a leukocyte that works with other eosinophils to surround a

parasite; it is involved in the allergic response and in protection against helminthes (parasitic worms).

Neutrophils and eosinophils are particularly important leukocytes that engulf large pathogens, such as bacteria and fungi.

A mast cell is a leukocyte that produces inflammatory molecules, such as histamine, in response to large pathogens. A

basophil is a leukocyte that, like a neutrophil, releases chemicals to stimulate the inflammatory response as illustrated

in Figure 42.5 . Basophils are also involved in allergy and hypersensitivity responses and induce specific types of

inflammatory responses. Eosinophils and basophils produce additional inflammatory mediators to recruit more leukocytes.

A hypersensitive immune response to harmless antigens, such as in pollen, often involves the release of histamine by

basophils and mast cells.

Figure 42.5 In response to a cut, mast cells secrete histamines that cause nearby capillaries to dilate. Neutrophils and

monocytes leave the capillaries. Monocytes mature into macrophages. Neutrophils, dendritic cells and macrophages

release chemicals to stimulate the inflammatory response. Neutrophils and macrophages also consume invading

bacteria by phagocytosis.

Chapter 42 | The Immune System 1217 Cytokines also send feedback to cells of the nervous system to bring about the overall symptoms of feeling sick, which

include lethargy, muscle pain, and nausea. These effects may have evolved because the symptoms encourage the individual

to rest and prevent them from spreading the infection to others. Cytokines also increase the core body temperature, causing

a fever, which causes the liver to withhold iron from the blood. Without iron, certain pathogens, such as some bacteria, are

unable to replicate; this is called nutritional immunity.

Watch this 23-second stop-motion video (http://openstaxcollege.org/l/conidia) showing a neutrophil that searches for

and engulfs fungus spores during an elapsed time of about 79 minutes.

Natural Killer Cells

Lymphocytes are leukocytes that are histologically identifiable by their large, darkly staining nuclei; they are small cells

with very little cytoplasm, as shown in Figure 42.6 . Infected cells are identified and destroyed by natural killer (NK) cells ,

lymphocytes that can kill cells infected with viruses or tumor cells (abnormal cells that uncontrollably divide and invade

other tissue). T cells and B cells of the adaptive immune system also are classified as lymphocytes. Tcells are lymphocytes

that mature in the thymus gland, and Bcells are lymphocytes that mature in the bone marrow. NK cells identify intracellular

infections, especially from viruses, by the altered expression of major histocompatibility class (MHC) I molecules on

the surface of infected cells. MHC I molecules are proteins on the surfaces of all nucleated cells, thus they are scarce on

red blood cells and platelets which are non-nucleated. The function of MHC I molecules is to display fragments of proteins

from the infectious agents within the cell to T-cells; healthy cells will be ignored, while “non-self” or foreign proteins will

be attacked by the immune system. MHC II molecules are found mainly on cells containing antigens (“non-self proteins”)

and on lymphocytes. MHC II molecules interact with helper T-cells to trigger the appropriate immune response, which

may include the inflammatory response.

Figure 42.6 Lymphocytes, such as

cells, are characterized by their large nuclei that actively absorb Wright stain

and therefore appear dark colored under a microscope.

An infected cell (or a tumor cell) is usually incapable of synthesizing and displaying MHC I molecules appropriately.

The metabolic resources of cells infected by some viruses produce proteins that interfere with MHC I processing and/

or trafficking to the cell surface. The reduced MHC I on host cells varies from virus to virus and results from active

inhibitors being produced by the viruses. This process can deplete host MHC I molecules on the cell surface, which NK

cells detect as “unhealthy” or “abnormal” while searching for cellular MHC I molecules. Similarly, the dramatically altered

1218 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 gene expression of tumor cells leads to expression of extremely deformed or absent MHC I molecules that also signal

“unhealthy” or “abnormal.”

NK cells are always active; an interaction with normal, intact MHC I molecules on a healthy cell disables the killing

sequence, and the NK cell moves on. After the NK cell detects an infected or tumor cell, its cytoplasm secretes granules

comprised of perforin , a destructive protein that creates a pore in the target cell. Granzymes are released along with the

perforin in the immunological synapse. A granzyme is a protease that digests cellular proteins and induces the target cell to

undergo programmed cell death, or apoptosis. Phagocytic cells then digest the cell debris left behind. NK cells are constantly

patrolling the body and are an effective mechanism for controlling potential infections and preventing cancer progression.

Complement

An array of approximately 20 types of soluble proteins, called a complement system , functions to destroy extracellular

pathogens. Cells of the liver and macrophages synthesize complement proteins continuously; these proteins are abundant

in the blood serum and are capable of responding immediately to infecting microorganisms. The complement system is so

named because it is complementary to the antibody response of the adaptive immune system. Complement proteins bind

to the surfaces of microorganisms and are particularly attracted to pathogens that are already bound by antibodies. Binding

of complement proteins occurs in a specific and highly regulated sequence, with each successive protein being activated

by cleavage and/or structural changes induced upon binding of the preceding protein(s). After the first few complement

proteins bind, a cascade of sequential binding events follows in which the pathogen rapidly becomes coated in complement

proteins.

Complement proteins perform several functions. The proteins serve as a marker to indicate the presence of a pathogen to

phagocytic cells, such as macrophages and B cells, and enhance engulfment; this process is called opsonization . Certain

complement proteins can combine to form attack complexes that open pores in microbial cell membranes. These structures

destroy pathogens by causing their contents to leak, as illustrated in Figure 42.7 .

Chapter 42 | The Immune System 1219 Figure 42.7 The classic pathway for the complement cascade involves the attachment of several initial complement

proteins to an antibody-bound pathogen followed by rapid activation and binding of many more complement proteins

and the creation of destructive pores in the microbial cell envelope and cell wall. The alternate pathway does not

involve antibody activation. Rather, C3 convertase spontaneously breaks down C3. Endogenous regulatory proteins

prevent the complement complex from binding to host cells. Pathogens lacking these regulatory proteins are lysed.

(credit: modification of work by NIH)

1220 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 42.2 | Adaptive Immune Response

By the end of this section, you will be able to:

• Explain adaptive immunity

• Compare and contrast adaptive and innate immunity

• Describe cell-mediated immune response and humoral immune response

• Describe immune tolerance

The adaptive, or acquired, immune response takes days or even weeks to become established—much longer than the

innate response; however, adaptive immunity is more specific to pathogens and has memory. Adaptive immunity is an

immunity that occurs after exposure to an antigen either from a pathogen or a vaccination. This part of the immune system

is activated when the innate immune response is insufficient to control an infection. In fact, without information from the

innate immune system, the adaptive response could not be mobilized. There are two types of adaptive responses: the cell-

mediated immune response , which is carried out by T cells, and the humoral immune response , which is controlled by

activated B cells and antibodies. Activated T cells and B cells that are specific to molecular structures on the pathogen

proliferate and attack the invading pathogen. Their attack can kill pathogens directly or secrete antibodies that enhance

the phagocytosis of pathogens and disrupt the infection. Adaptive immunity also involves a memory to provide the host

with long-term protection from reinfection with the same type of pathogen; on re-exposure, this memory will facilitate an

efficient and quick response.

Antigen-presenting Cells

Unlike NK cells of the innate immune system, B cells (B lymphocytes) are a type of white blood cell that gives rise to

antibodies, whereas T cells (T lymphocytes) are a type of white blood cell that plays an important role in the immune

response. T cells are a key component in the cell-mediated response—the specific immune response that utilizes T cells to

neutralize cells that have been infected with viruses and certain bacteria. There are three types of T cells: cytotoxic, helper,

and suppressor T cells. Cytotoxic T cells destroy virus-infected cells in the cell-mediated immune response, and helper T

cells play a part in activating both the antibody and the cell-mediated immune responses. Suppressor T cells deactivate T

cells and B cells when needed, and thus prevent the immune response from becoming too intense.

An antigen is a foreign or “non-self” macromolecule that reacts with cells of the immune system. Not all antigens will

provoke a response. For instance, individuals produce innumerable “self” antigens and are constantly exposed to harmless

foreign antigens, such as food proteins, pollen, or dust components. The suppression of immune responses to harmless

macromolecules is highly regulated and typically prevents processes that could be damaging to the host, known as tolerance.

The innate immune system contains cells that detect potentially harmful antigens, and then inform the adaptive immune

response about the presence of these antigens. An antigen-presenting cell (APC) is an immune cell that detects, engulfs,

and informs the adaptive immune response about an infection. When a pathogen is detected, these APCs will phagocytose

the pathogen and digest it to form many different fragments of the antigen. Antigen fragments will then be transported to

the surface of the APC, where they will serve as an indicator to other immune cells. Dendritic cells are immune cells that

process antigen material; they are present in the skin (Langerhans cells) and the lining of the nose, lungs, stomach, and

intestines. Sometimes a dendritic cell presents on the surface of other cells to induce an immune response, thus functioning

as an antigen-presenting cell. Macrophages also function as APCs. Before activation and differentiation, B cells can also

function as APCs.

After phagocytosis by APCs, the phagocytic vesicle fuses with an intracellular lysosome forming phagolysosome. Within

the phagolysosome, the components are broken down into fragments; the fragments are then loaded onto MHC class I or

MHC class II molecules and are transported to the cell surface for antigen presentation, as illustrated in Figure 42.8 . Note

that T lymphocytes cannot properly respond to the antigen unless it is processed and embedded in an MHC II molecule.

APCs express MHC on their surfaces, and when combined with a foreign antigen, these complexes signal a “non-self”

invader. Once the fragment of antigen is embedded in the MHC II molecule, the immune cell can respond. Helper T- cells

are one of the main lymphocytes that respond to antigen-presenting cells. Recall that all other nucleated cells of the body

expressed MHC I molecules, which signal “healthy” or “normal.”

Chapter 42 | The Immune System 1221 Figure 42.8 An APC, such as a macrophage, engulfs and digests a foreign bacterium. An antigen from the bacterium

is presented on the cell surface in conjunction with an MHC II molecule Lymphocytes of the adaptive immune response

interact with antigen-embedded MHC II molecules to mature into functional immune cells.

This animation (http://openstaxcollege.org/l/immune_system) from Rockefeller University shows how dendritic cells

act as sentinels in the body's immune system.

T and B Lymphocytes

Lymphocytes in human circulating blood are approximately 80 to 90 percent T cells, shown in Figure 42.9 , and 10 to 20

percent B cells. Recall that the T cells are involved in the cell-mediated immune response, whereas B cells are part of the

humoral immune response.

T cells encompass a heterogeneous population of cells with extremely diverse functions. Some T cells respond to APCs of

the innate immune system, and indirectly induce immune responses by releasing cytokines. Other T cells stimulate B cells

to prepare their own response. Another population of T cells detects APC signals and directly kills the infected cells. Other

T cells are involved in suppressing inappropriate immune reactions to harmless or “self” antigens.

1222 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.9 This scanning electron micrograph shows a T lymphocyte, which is responsible for the cell-mediated

immune response. T cells are able to recognize antigens. (credit: modification of work by NCI; scale-bar data from Matt

Russell)

T and B cells exhibit a common theme of recognition/binding of specific antigens via a complementary receptor, followed

by activation and self-amplification/maturation to specifically bind to the particular antigen of the infecting pathogen. T

and B lymphocytes are also similar in that each cell only expresses one type of antigen receptor. Any individual may

possess a population of T and B cells that together express a near limitless variety of antigen receptors that are capable of

recognizing virtually any infecting pathogen. T and B cells are activated when they recognize small components of antigens,

called epitopes , presented by APCs, illustrated in Figure 42.10 . Note that recognition occurs at a specific epitope rather

than on the entire antigen; for this reason, epitopes are known as “antigenic determinants.” In the absence of information

from APCs, T and B cells remain inactive, or naïve, and are unable to prepare an immune response. The requirement for

information from the APCs of innate immunity to trigger B cell or T cell activation illustrates the essential nature of the

innate immune response to the functioning of the entire immune system.

Figure 42.10 An antigen is a macromolecule that reacts with components of the immune system. A given antigen may

contain several motifs that are recognized by immune cells. Each motif is an epitope. In this figure, the entire structure

is an antigen, and the orange, salmon and green components projecting from it represent potential epitopes.

Naïve T cells can express one of two different molecules, CD4 or CD8, on their surface, as shown in Figure 42.11 , and

are accordingly classified as CD4 +or CD8 +cells. These molecules are important because they regulate how a T cell will

interact with and respond to an APC. Naïve CD4 +cells bind APCs via their antigen-embedded MHC II molecules and

are stimulated to become helper T (T H) lymphocytes , cells that go on to stimulate B cells (or cytotoxic T cells) directly

or secrete cytokines to inform more and various target cells about the pathogenic threat. In contrast, CD8 +cells engage

antigen-embedded MHC I molecules on APCs and are stimulated to become cytotoxic T lymphocytes (CTLs) , which

directly kill infected cells by apoptosis and emit cytokines to amplify the immune response. The two populations of T cells

have different mechanisms of immune protection, but both bind MHC molecules via their antigen receptors called T cell

receptors (TCRs). The CD4 or CD8 surface molecules differentiate whether the TCR will engage an MHC II or an MHC I

molecule. Because they assist in binding specificity, the CD4 and CD8 molecules are described as coreceptors.

Chapter 42 | The Immune System 1223 Figure 42.11 Naïve CD4 +T cells engage MHC II molecules on antigen-presenting cells (APCs) and become

activated. Clones of the activated helper T cell, in turn, activate B cells and CD8 +T cells, which become cytotoxic

T cells. Cytotoxic T cells kill infected cells.

Which of the following statements about T cells is false?

a. Helper T cells release cytokines while cytotoxic T cells kill the infected cell.

b. Helper T cells are CD4 +, while cytotoxic T cells are CD8 +.

c. MHC II is a receptor found on most body cells, while MHC I is a receptor found on immune cells only.

d. The T cell receptor is found on both CD4 +and CD8 +T cells.

Consider the innumerable possible antigens that an individual will be exposed to during a lifetime. The mammalian adaptive

immune system is adept in responding appropriately to each antigen. Mammals have an enormous diversity of T cell

populations, resulting from the diversity of TCRs. Each TCR consists of two polypeptide chains that span the T cell

membrane, as illustrated in Figure 42.12 ; the chains are linked by a disulfide bridge. Each polypeptide chain is comprised of

a constant domain and a variable domain: a domain, in this sense, is a specific region of a protein that may be regulatory or

structural. The intracellular domain is involved in intracellular signaling. A single T cell will express thousands of identical

copies of one specific TCR variant on its cell surface. The specificity of the adaptive immune system occurs because it

synthesizes millions of different T cell populations, each expressing a TCR that differs in its variable domain. This TCR

diversity is achieved by the mutation and recombination of genes that encode these receptors in stem cell precursors of

T cells. The binding between an antigen-displaying MHC molecule and a complementary TCR “match” indicates that the

adaptive immune system needs to activate and produce that specific T cell because its structure is appropriate to recognize

and destroy the invading pathogen.

1224 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.12 A T cell receptor spans the membrane and projects variable binding regions into the extracellular space

to bind processed antigens via MHC molecules on APCs.

Helper T Lymphocytes

The T Hlymphocytes function indirectly to identify potential pathogens for other cells of the immune system. These cells

are important for extracellular infections, such as those caused by certain bacteria, helminths, and protozoa. T Hlymphocytes

recognize specific antigens displayed in the MHC II complexes of APCs. There are two major populations of T Hcells:

TH1 and T H2. T H1 cells secrete cytokines to enhance the activities of macrophages and other T cells. T H1 cells activate

the action of cyotoxic T cells, as well as macrophages. T H2 cells stimulate naïve B cells to destroy foreign invaders via

antibody secretion. Whether a T H1 or a T H2 immune response develops depends on the specific types of cytokines secreted

by cells of the innate immune system, which in turn depends on the nature of the invading pathogen.

The T H1-mediated response involves macrophages and is associated with inflammation. Recall the frontline defenses of

macrophages involved in the innate immune response. Some intracellular bacteria, such as Mycobacterium tuberculosis ,

have evolved to multiply in macrophages after they have been engulfed. These pathogens evade attempts by macrophages to

destroy and digest the pathogen. When M. tuberculosis infection occurs, macrophages can stimulate naïve T cells to become

TH1 cells. These stimulated T cells secrete specific cytokines that send feedback to the macrophage to stimulate its digestive

capabilities and allow it to destroy the colonizing M. tuberculosis . In the same manner, T H1-activated macrophages also

become better suited to ingest and kill tumor cells. In summary; T H1 responses are directed toward intracellular invaders

while T H2 responses are aimed at those that are extracellular.

B Lymphocytes

When stimulated by the T H2 pathway, naïve B cells differentiate into antibody-secreting plasma cells. A plasma cell

is an immune cell that secrets antibodies; these cells arise from B cells that were stimulated by antigens. Similar to T

cells, naïve B cells initially are coated in thousands of B cell receptors (BCRs), which are membrane-bound forms of Ig

(immunoglobulin, or an antibody). The B cell receptor has two heavy chains and two light chains connected by disulfide

linkages. Each chain has a constant and a variable region; the latter is involved in antigen binding. Two other membrane

proteins, Ig alpha and Ig beta, are involved in signaling. The receptors of any particular B cell, as shown in Figure 42.13

are all the same, but the hundreds of millions of different B cells in an individual have distinct recognition domains that

contribute to extensive diversity in the types of molecular structures to which they can bind. In this state, B cells function

as APCs. They bind and engulf foreign antigens via their BCRs and then display processed antigens in the context of MHC

II molecules to T H2 cells. When a T H2 cell detects that a B cell is bound to a relevant antigen, it secretes specific cytokines

that induce the B cell to proliferate rapidly, which makes thousands of identical (clonal) copies of it, and then it synthesizes

and secretes antibodies with the same antigen recognition pattern as the BCRs. The activation of B cells corresponding

to one specific BCR variant and the dramatic proliferation of that variant is known as clonal selection . This phenomenon

drastically, but briefly, changes the proportions of BCR variants expressed by the immune system, and shifts the balance

toward BCRs specific to the infecting pathogen.

Chapter 42 | The Immune System 1225 Figure 42.13 B cell receptors are embedded in the membranes of B cells and bind a variety of antigens through their

variable regions. The signal transduction region transfers the signal into the cell.

T and B cells differ in one fundamental way: whereas T cells bind antigens that have been digested and embedded in MHC

molecules by APCs, B cells function as APCs that bind intact antigens that have not been processed. Although T and B

cells both react with molecules that are termed “antigens,” these lymphocytes actually respond to very different types of

molecules. B cells must be able to bind intact antigens because they secrete antibodies that must recognize the pathogen

directly, rather than digested remnants of the pathogen. Bacterial carbohydrate and lipid molecules can activate B cells

independently from the T cells.

Cytotoxic T Lymphocytes

CTLs, a subclass of T cells, function to clear infections directly. The cell-mediated part of the adaptive immune system

consists of CTLs that attack and destroy infected cells. CTLs are particularly important in protecting against viral

infections; this is because viruses replicate within cells where they are shielded from extracellular contact with circulating

antibodies. When APCs phagocytize pathogens and present MHC I-embedded antigens to naïve CD8 +T cells that express

complementary TCRs, the CD8 +T cells become activated to proliferate according to clonal selection. These resulting CTLs

then identify non-APCs displaying the same MHC I-embedded antigens (for example, viral proteins)—for example, the

CTLs identify infected host cells.

Intracellularly, infected cells typically die after the infecting pathogen replicates to a sufficient concentration and lyses the

cell, as many viruses do. CTLs attempt to identify and destroy infected cells before the pathogen can replicate and escape,

thereby halting the progression of intracellular infections. CTLs also support NK lymphocytes to destroy early cancers.

Cytokines secreted by the T H1 response that stimulates macrophages also stimulate CTLs and enhance their ability to

identify and destroy infected cells and tumors.

CTLs sense MHC I-embedded antigens by directly interacting with infected cells via their TCRs. Binding of TCRs with

antigens activates CTLs to release perforin and granzyme, degradative enzymes that will induce apoptosis of the infected

cell. Recall that this is a similar destruction mechanism to that used by NK cells. In this process, the CTL does not become

infected and is not harmed by the secretion of perforin and granzymes. In fact, the functions of NK cells and CTLs are

complementary and maximize the removal of infected cells, as illustrated in Figure 42.14 . If the NK cell cannot identify

the “missing self” pattern of down-regulated MHC I molecules, then the CTL can identify it by the complex of MHC I

with foreign antigens, which signals “altered self.” Similarly, if the CTL cannot detect antigen-embedded MHC I because

the receptors are depleted from the cell surface, NK cells will destroy the cell instead. CTLs also emit cytokines, such as

interferons, that alter surface protein expression in other infected cells, such that the infected cells can be easily identified

and destroyed. Moreover, these interferons can also prevent virally infected cells from releasing virus particles.

1226 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.14 Natural killer (

) cells recognize the MHC I receptor on healthy cells. If MHC I is absent, the cell is

lysed.

Based on what you know about MHC receptors, why do you think an organ transplanted from an

incompatible donor to a recipient will be rejected?

Plasma cells and CTLs are collectively called effector cells : they represent differentiated versions of their naïve

counterparts, and they are involved in bringing about the immune defense of killing pathogens and infected host cells.

Mucosal Surfaces and Immune Tolerance

The innate and adaptive immune responses discussed thus far comprise the systemic immune system (affecting the

whole body), which is distinct from the mucosal immune system. Mucosal immunity is formed by mucosa-associated

lymphoid tissue, which functions independently of the systemic immune system, and which has its own innate and adaptive

components. Mucosa-associated lymphoid tissue (MALT) , illustrated in Figure 42.15 , is a collection of lymphatic tissue

that combines with epithelial tissue lining the mucosa throughout the body. This tissue functions as the immune barrier and

response in areas of the body with direct contact to the external environment. The systemic and mucosal immune systems

use many of the same cell types. Foreign particles that make their way to MALT are taken up by absorptive epithelial cells

called M cells and delivered to APCs located directly below the mucosal tissue. M cells function in the transport described,

and are located in the Peyer’s patch, a lymphoid nodule. APCs of the mucosal immune system are primarily dendritic cells,

with B cells and macrophages having minor roles. Processed antigens displayed on APCs are detected by T cells in the

MALT and at various mucosal induction sites, such as the tonsils, adenoids, appendix, or the mesenteric lymph nodes of the

intestine. Activated T cells then migrate through the lymphatic system and into the circulatory system to mucosal sites of

infection.

Chapter 42 | The Immune System 1227 Figure 42.15 The topology and function of intestinal MALT is shown. Pathogens are taken up by M cells in the intestinal

epithelium and excreted into a pocket formed by the inner surface of the cell. The pocket contains antigen-presenting

cells such as dendritic cells, which engulf the antigens, then present them with MHC II molecules on the cell surface.

The dendritic cells migrate to an underlying tissue called a Peyer’s patch. Antigen-presenting cells, T cells, and B cells

aggregate within the Peyer’s patch, forming organized lymphoid follicles. There, some T cells and B cells are activated.

Other antigen-loaded dendritic cells migrate through the lymphatic system where they activate B cells, T cells, and

plasma cells in the lymph nodes. The activated cells then return to MALT tissue effector sites. IgA and other antibodies

are secreted into the intestinal lumen.

MALT is a crucial component of a functional immune system because mucosal surfaces, such as the nasal passages, are the

first tissues onto which inhaled or ingested pathogens are deposited. The mucosal tissue includes the mouth, pharynx, and

esophagus, and the gastrointestinal, respiratory, and urogenital tracts.

The immune system has to be regulated to prevent wasteful, unnecessary responses to harmless substances, and more

importantly so that it does not attack “self.” The acquired ability to prevent an unnecessary or harmful immune response

to a detected foreign substance known not to cause disease is described as immune tolerance . Immune tolerance is crucial

for maintaining mucosal homeostasis given the tremendous number of foreign substances (such as food proteins) that APCs

of the oral cavity, pharynx, and gastrointestinal mucosa encounter. Immune tolerance is brought about by specialized APCs

in the liver, lymph nodes, small intestine, and lung that present harmless antigens to an exceptionally diverse population of

regulatory T (T reg )cells , specialized lymphocytes that suppress local inflammation and inhibit the secretion of stimulatory

immune factors. The combined result of T reg cells is to prevent immunologic activation and inflammation in undesired

tissue compartments and to allow the immune system to focus on pathogens instead. In addition to promoting immune

tolerance of harmless antigens, other subsets of T reg cells are involved in the prevention of the autoimmune response ,

which is an inappropriate immune response to host cells or self-antigens. Another T reg class suppresses immune responses

to harmful pathogens after the infection has cleared to minimize host cell damage induced by inflammation and cell lysis.

1228 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Immunological Memory

The adaptive immune system possesses a memory component that allows for an efficient and dramatic response upon

reinvasion of the same pathogen. Memory is handled by the adaptive immune system with little reliance on cues from the

innate response. During the adaptive immune response to a pathogen that has not been encountered before, called a primary

response, plasma cells secreting antibodies and differentiated T cells increase, then plateau over time. As B and T cells

mature into effector cells, a subset of the naïve populations differentiates into B and T memory cells with the same antigen

specificities, as illustrated in Figure 42.16 .

Amemory cell is an antigen-specific B or T lymphocyte that does not differentiate into effector cells during the primary

immune response, but that can immediately become effector cells upon re-exposure to the same pathogen. During the

primary immune response, memory cells do not respond to antigens and do not contribute to host defenses. As the infection

is cleared and pathogenic stimuli subside, the effectors are no longer needed, and they undergo apoptosis. In contrast, the

memory cells persist in the circulation.

Figure 42.16 After initially binding an antigen to the B cell receptor (BCR), a B cell internalizes the antigen and

presents it on MHC II. A helper T cell recognizes the MHC II–antigen complex and activates the B cell. As a result,

memory B cells and plasma cells are made.

The Rh antigen is found on Rh-positive red blood cells. An Rh-negative female can usually carry an Rh-

positive fetus to term without difficulty. However, if she has a second Rh-positive fetus, her body may launch

an immune attack that causes hemolytic disease of the newborn. Why do you think hemolytic disease is

only a problem during the second or subsequent pregnancies?

Chapter 42 | The Immune System 1229 If the pathogen is never encountered again during the individual’s lifetime, B and T memory cells will circulate for a few

years or even several decades and will gradually die off, having never functioned as effector cells. However, if the host is

re-exposed to the same pathogen type, circulating memory cells will immediately differentiate into plasma cells and CTLs

without input from APCs or T Hcells. One reason the adaptive immune response is delayed is because it takes time for naïve

B and T cells with the appropriate antigen specificities to be identified and activated. Upon reinfection, this step is skipped,

and the result is a more rapid production of immune defenses. Memory B cells that differentiate into plasma cells output tens

to hundreds-fold greater antibody amounts than were secreted during the primary response, as the graph in Figure 42.17

illustrates. This rapid and dramatic antibody response may stop the infection before it can even become established, and the

individual may not realize they had been exposed.

Figure 42.17 In the primary response to infection, antibodies are secreted first from plasma cells. Upon re-exposure

to the same pathogen, memory cells differentiate into antibody-secreting plasma cells that output a greater amount of

antibody for a longer period of time.

Vaccination is based on the knowledge that exposure to noninfectious antigens, derived from known pathogens, generates

a mild primary immune response. The immune response to vaccination may not be perceived by the host as illness but still

confers immune memory. When exposed to the corresponding pathogen to which an individual was vaccinated, the reaction

is similar to a secondary exposure. Because each reinfection generates more memory cells and increased resistance to the

pathogen, and because some memory cells die, certain vaccine courses involve one or more booster vaccinations to mimic

repeat exposures: for instance, tetanus boosters are necessary every ten years because the memory cells only live that long.

Mucosal Immune Memory

A subset of T and B cells of the mucosal immune system differentiates into memory cells just as in the systemic immune

system. Upon reinvasion of the same pathogen type, a pronounced immune response occurs at the mucosal site where the

original pathogen deposited, but a collective defense is also organized within interconnected or adjacent mucosal tissue. For

instance, the immune memory of an infection in the oral cavity would also elicit a response in the pharynx if the oral cavity

was exposed to the same pathogen.

1230 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Vaccinologist

Vaccination (or immunization) involves the delivery, usually by injection as shown in Figure 42.18 , of

noninfectious antigen(s) derived from known pathogens. Other components, called adjuvants, are delivered

in parallel to help stimulate the immune response. Immunological memory is the reason vaccines work.

Ideally, the effect of vaccination is to elicit immunological memory, and thus resistance to specific pathogens

without the individual having to experience an infection.

Figure 42.18 Vaccines are often delivered by injection into the arm. (credit: U.S. Navy Photographer's Mate

Airman Apprentice Christopher D. Blachly)

Vaccinologists are involved in the process of vaccine development from the initial idea to the availability

of the completed vaccine. This process can take decades, can cost millions of dollars, and can involve

many obstacles along the way. For instance, injected vaccines stimulate the systemic immune system,

eliciting humoral and cell-mediated immunity, but have little effect on the mucosal response, which presents

a challenge because many pathogens are deposited and replicate in mucosal compartments, and the

injection does not provide the most efficient immune memory for these disease agents. For this reason,

vaccinologists are actively involved in developing new vaccines that are applied via intranasal, aerosol,

oral, or transcutaneous (absorbed through the skin) delivery methods. Importantly, mucosal-administered

vaccines elicit both mucosal and systemic immunity and produce the same level of disease resistance as

injected vaccines.

Chapter 42 | The Immune System 1231 Figure 42.19 The polio vaccine can be administered orally. (credit: modification of work by UNICEF Sverige)

Currently, a version of intranasal influenza vaccine is available, and the polio and typhoid vaccines can

be administered orally, as shown in Figure 42.19 . Similarly, the measles and rubella vaccines are being

adapted to aerosol delivery using inhalation devices. Eventually, transgenic plants may be engineered to

produce vaccine antigens that can be eaten to confer disease resistance. Other vaccines may be adapted

to rectal or vaginal application to elicit immune responses in rectal, genitourinary, or reproductive mucosa.

Finally, vaccine antigens may be adapted to transdermal application in which the skin is lightly scraped

and microneedles are used to pierce the outermost layer. In addition to mobilizing the mucosal immune

response, this new generation of vaccines may end the anxiety associated with injections and, in turn,

improve patient participation.

Primary Centers of the Immune System

Although the immune system is characterized by circulating cells throughout the body, the regulation, maturation, and

intercommunication of immune factors occur at specific sites. The blood circulates immune cells, proteins, and other factors

through the body. Approximately 0.1 percent of all cells in the blood are leukocytes, which encompass monocytes (the

precursor of macrophages) and lymphocytes. The majority of cells in the blood are erythrocytes (red blood cells). Lymph is

a watery fluid that bathes tissues and organs with protective white blood cells and does not contain erythrocytes. Cells of the

immune system can travel between the distinct lymphatic and blood circulatory systems, which are separated by interstitial

space, by a process called extravasation (passing through to surrounding tissue).

The cells of the immune system originate from hematopoietic stem cells in the bone marrow. Cytokines stimulate these

stem cells to differentiate into immune cells. B cell maturation occurs in the bone marrow, whereas naïve T cells transit

from the bone marrow to the thymus for maturation. In the thymus, immature T cells that express TCRs complementary to

self-antigens are destroyed. This process helps prevent autoimmune responses.

On maturation, T and B lymphocytes circulate to various destinations. Lymph nodes scattered throughout the body, as

illustrated in Figure 42.20 , house large populations of T and B cells, dendritic cells, and macrophages. Lymph gathers

antigens as it drains from tissues. These antigens then are filtered through lymph nodes before the lymph is returned

to circulation. APCs in the lymph nodes capture and process antigens and inform nearby lymphocytes about potential

pathogens.

1232 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.20 (a) Lymphatic vessels carry a clear fluid called lymph throughout the body. The liquid enters (b) lymph

nodes through afferent vessels. Lymph nodes are filled with lymphocytes that purge infecting cells. The lymph then

exits through efferent vessels. (credit: modification of work by NIH, NCI)

The spleen houses B and T cells, macrophages, dendritic cells, and NK cells. The spleen, shown in Figure 42.21 , is the site

where APCs that have trapped foreign particles in the blood can communicate with lymphocytes. Antibodies are synthesized

and secreted by activated plasma cells in the spleen, and the spleen filters foreign substances and antibody-complexed

pathogens from the blood. Functionally, the spleen is to the blood as lymph nodes are to the lymph.

Figure 42.21 The spleen is similar to a lymph node but is much larger and filters blood instead of lymph. Blood enters

the spleen through arteries and exits through veins. The spleen contains two types of tissue: red pulp and white

pulp. Red pulp consists of cavities that store blood. Within the red pulp, damaged red blood cells are removed and

replaced by new ones. White pulp is rich in lymphocytes that remove antigen-coated bacteria from the blood. (credit:

modification of work by NCI)

Chapter 42 | The Immune System 1233 42.3 | Antibodies

By the end of this section, you will be able to:

• Explain cross-reactivity

• Describe the structure and function of antibodies

• Discuss antibody production

An antibody , also known as an immunoglobulin (Ig), is a protein that is produced by plasma cells after stimulation by

an antigen. Antibodies are the functional basis of humoral immunity. Antibodies occur in the blood, in gastric and mucus

secretions, and in breast milk. Antibodies in these bodily fluids can bind pathogens and mark them for destruction by

phagocytes before they can infect cells.

Antibody Structure

An antibody molecule is comprised of four polypeptides: two identical heavy chains (large peptide units) that are partially

bound to each other in a “Y” formation, which are flanked by two identical light chains (small peptide units), as illustrated in

Figure 42.22 . Bonds between the cysteine amino acids in the antibody molecule attach the polypeptides to each other. The

areas where the antigen is recognized on the antibody are variable domains and the antibody base is composed of constant

domains.

In germ-line B cells, the variable region of the light chain gene has 40 variable (V) and five joining (J) segments. An enzyme

called DNA recombinase randomly excises most of these segments out of the gene, and splices one V segment to one J

segment. During RNA processing, all but one V and J segment are spliced out. Recombination and splicing may result in

over 10 6possible VJ combinations. As a result, each differentiated B cell in the human body typically has a unique variable

chain. The constant domain, which does not bind antibody, is the same for all antibodies.

1234 Chapter 42 | The Immune System

This OpenStax book is available for free at http://cnx.org/content/col11448/1.10 Figure 42.22 (a) As a germ-line B cell matures, an enzyme called DNA recombinase randomly excises V and J

segments from the light chain gene. Splicing at the mRNA level results in further gene rearrangement. As a result, (b)

each antibody has a unique variable region capable of binding a different antigen.

Similar to TCRs and BCRs, antibody diversity is produced by the mutation and recombination of approximately 300

different gene segments encoding the light and heavy chain variable domains in precursor cells that are destined to become