SK277 Revision Notes

SK277 Revision Notes
Book 1 Cells and Nutrition

Chapter 1 A Biological Basis for Health
Biological Determinism A belief that every characteristic or function of an organism is
determined by its genes.
is an example of a :
Reductionist View Interpreting complex phenomena from the viewpoint of a single
discipline (e.g. genetics, with sociology, psychology regarded as irrelevant or subsidiary
effects of the fundamental cause.) However, it misses other causes or aspects and the
interactions between influences and can undervalue side-effects, but has been very
effective in the development of drugs & vaccines.
Nature v Nurture The relative contribution of genetic inheritance & the environment
to the characteristics of an organism.
Example Phenylketonuria (PKU) As a result of a faulty gene, the enzyme that
converts phenylalanine to tyrosine is absent, so excess phenylalanine builds up in the
body, causing brain damage. Since PKU is inherited, it exemplifies Biological
Determinism; However, it can be treated by reducing the intake of phenylalanine and
giving tyrosine, so nurture can counteract the effect of nature.
Holistic Approach Describing or analysing a complex phenomenon taking account of
all levels of explanation and their interaction. Treating the phenomena as a whole rather
than the sum of its component parts.
Uses more resources, but the knowledge from one discipline can inform another.
Biological Evolution - The gradual changes to the structures and functions of living
things that have been occurring from the moment the earliest life forms appeared on
Earth, perhaps 35004000 million years ago.
Cultural Evolution - The gradual changes to the customs, beliefs, values, knowledge
and actions of human societies, which have been occurring for perhaps the past two
million years.
Darwinian Theory Individuals with the most adaptive characteristics in a particular
environment are the most likely to survive and reproduce.
Fitness Lifetime reproductive success
Selfish Gene Organisms are simply mechanisms for ensuring the survival of genes.
Epidemiology - The study of relationships between factors suspected of influencing
contraction of a disease, and measures of health in communities and populations.
Page 1 of 55
e.g. Southampton University investigated whether factors affecting infant health could
cause disease in later life. They looked at the relationship between birth & placental
weight and blood pressure etc. in later life. (Longitudinal study looks at data at different
stages of life) They found that a large baby with a small placenta is likely to develop into
an adult with lower blood pressure. Claimed that weight of baby & of placenta are better
predictors than lifestyle.
Programming Hypothesis - An embryo or foetus has sensitive periods in its
development during which environmental influences can exert irreversible effects, with
consequences for the future health of the individual, i.e. its developmental path is
reprogrammed relative to that of an embryo or fetus that did not experience such
conditions.
Also, malnutrition or hypoxia experienced by a developing embryo (e.g. due to smoking
or poor diet) can lead to hypertension in later life.
Cells The units from which all living things are made. The lowest level of biological
organisation capable of sustaining independent life.
Gamete Sex Cell (Ovum = Female, Sperm = Male). Zygote = Small, fertilized egg.
All cells have an outer membrane
They have several different components called organelles so that processes can take place
independently. e.g. Nucleus contains the DNA.
Many different types of cell
Tissues - Groups of cells with the same structure & function. e.g. muscular tissue,
connective tissue (including blood and bone), nervous tissue, epithelial tissue.
Organs are composed of different types of tissues, organised into precise structures with
a specific function.
Organ Systems A number of organs with complementary functions
Lymphatic System 3 Main functions:
To collect and return interstitial fluid to the blood

To defend the body against invading organisms by the immune system
To absorb the fatty components of the diet
The lymphatic capillaries are an extensive network of closed-end vessels called

lymphatic capillaries. Fluid leaks out of blood capillaries into the space between cells,
where it is known as interstitial fluid. It the drains into the lymphatic capillaries, which
Page 2 of 55

eventually return it to the bloodstream via a duct in the neck. (The fluid is moved by the
squeezing and pumping action of skeletal muscles.)
Musculo-Skeletal Protect & support the body and allow movements
Nervous Receives and responds to stimuli, coordinates body functions, communicates
information.
Endocrine Chemically coordinates and integrates the activities of the body
Digestive Digests food and absorbs nutrients
Circulatory Transports materials throughout the body
Respiratory Collects oxygen and exchanges it for carbon dioxide
Reproductive Produces sex cells and allows fertilization and development of the foetus
Immune Defence against antigens
Initial Development of Embryo
Zygote divides into 2 cells, each half the size. 2 further divisions result in 8 cells, all in
contact with the outside. Next division is asymmetric, i.e. get 16 cells of 2 different sizes.
8 largher on the outside, 8 smaller on the inside. The differentiation between cells is the
result of different cellular environments. The larger outer cells contribute to the placenta.
This organ supplies oxygen & nutrients to, and removes waste products from, the
developing foetus. Also protects against harmful agents (but not against alcohol, nicotine
or rubella)
Page 3 of 55

Book 1 Chapter 2 Wonderful Life
The molecules making up life range from small e.g. water, to very large macromolecules.
Four types of macromolecule, Carbohydrates, Fats, Proteins, Nucleic Acids
Carbohydrates and fats (lipids) provide energy. Both carbohydrates when stored as
glycogen, and lipids stored as fat in adipose tissue, can be used as a store of energy.
Protein Functions Enzymes act as catalysts for metabolic processes, some are chemical
messengers e.g. the hormone insulin. Some proteins are hormone receptors. Some
contribute to the shape of individual cells & structures. Muscle consists primarily of
protein.
Proteins (polypeptides) are made up of amino acids joined to one another in strings.
Short strings of up to 10 amino acids are called peptides; longer strings are called
polypeptides. There are 20 different amino acids in living organisms. thus the number of
different possible proteins is huge. each protein as a unique 3D shape. Cells producing
particular proteins (e.g. insulin or myelin) are called specialised cells.
Nucleic acids DNA is in the cell nucleus and is the chemical component of the genes.
RNA has a number of functions, including relaying the information from the nucleus to
the rest of the cell, and thus which proteins are to be made at a particular time.
Water is essential as it can dissolve so many substances, and transport them (e.g. oxygen
in plasma haemoglobin). The bonds holding water molecules together are polar covalent
bonds, i.e. have a negative end (O), and a positive end. This allows them to surround the
ions of the dissolved substance we say the ions are solvated. This weakens the ionic
bound and allows the ions to be mobile i.e. the substance dissolves.
Living organisms are self-regulating and direct their own metabolic processes.
(Aerobic) respiration is the process that provides energy using oxygen from the air and
glucose from food. (Can also have anaerobic respiration for a short time)
The cellular environment can only operate within prescribed limits of various parameters
such as temperature, acidity etc. For example, if temperature too high, chemical reactions
will speed up, and the nature of chemicals can change. Too low, and the fluids can turn to
ice crystals and pierce the cell membranes.
Homeostasis is the maintenance of a constant internal environment (e.g. temperature. pH
level, blood-glucose level) in the body. The important variables that are critical for life
are called regulated variables. The processes & variables that control regulated variables
are control processes (variables) e.g. shivering is a controlled variable that helps regulate
body temperature.
Page 4 of 55

When the outside temperature falls, we shiver to generate more heat (feedback) Putting
on more clothes in anticipation of cold is feedforward.
Cell Structure
The morphology (shape) can vary neurons tree structure allowing them to receive info.
from many neighboring cells. Immune cells spherical for easy circulation in blood
vessels. (Vessel tube in which a body fluid circulates)
The cell membrane (also called plasma membrane) keeps the internal fluids and
organelles separate from the extracellular fluid. e.g. inside an axon, high proportion of
K+, low CL- and NA+, outside, low K+, high Cl- and Na+. There is also a difference in
charge i.e. potential difference across the membrane called the membrane potential.
The membrane can selectively permit the transport of appropriate molecules and ions
across the membrane. Main component is a double layer of fatty molecules called
phospholipids. These have a positively charged hydrophilic head and flexible, uncharged,
hydrophobic tails. There are also integral proteins. Some small molecules can pass
through these by diffusion, whereas others are too large i.e. it is a semi-permeable
membrane). The membrane also contains protein receptors. These respond selectively to
specific molecules in the extracellular fluid e.g. by opening protein channels in the
membrane to allow specific ions into the cell. Sometimes this happens by diffusion; in
other cases, carrier proteins actually carry the substances across the membrane, often
working against the concentration gradient. This requires energy and is called Active
Transport. On the outer surface of cells, there are chains of sugars, forming compounds
with proteins and lipids - glycoproteins and glycolipids (glyco = sugar). The
glycoproteins act as receptors for hormones. Attached to the inner surface are
cytoskeletal filaments. The cytoskeleton helps the cell maintain its shape.
Inside the cell are the organelles, each with their own bilayer membrane, and the cytosol.
The nucleus contains about 2m of DNA, organised into linear units called chromosomes.
In humans, there are 46 chromosomes, 22 pairs of identical chromosomes, plus 2 sex
chromosomes (XX = Female, XY = Male) The ovum has an X chromosome, the sperm
has either an X or a Y chromosome. Functional segments of the chromosomes are called
genes.
There are also mitochondria, where the final stages in cell respiration (the oxidation of
sugars, fats and amino acids to produce ATP) takes place. ATP (Adenosine Triphosphate)
provides the energy currency of the body.
The Endoplasmic Reticulum (ER) is responsible for the synthesis of many important
molecules such as proteins and lipids. Smooth ER does not contain ribosomes and is
responsible for lipid synthesis. Rough ER is associated with ribosomes and is used in
protein synthesis. These proteins are passed to the Golgi apparatus (flat membrane-like
sacs close to round bags of membranes called vesicles) for modification and sorting. The
Page 5 of 55

proteins are packed into vesicles and transported to the appropriate part of the cell.
Alternatively, proteins in vesicles can be transported out of the cell by fusing the vesicle
with the cell membrane (Exocytosis). The reverse procedure can take place (Endocytosis)
(See Diagram). In this case the vesicles are transferred either to the Golgi apparatus or to
organelles called lysosomes, which are also responsible for degrading waste material or
unwanted organelles in the cell.
DNA (deoxyribonucleic acid) is a macromolecule made up of 2 strands of repeating
molecular units called nucleotides. Each nucleotide consists of 3 components a
phosphate, a sugar molecule & a base. The phosphate & the sugar are always the same,
but the bases can be one of 4 types Adenine (A), Guanine (G), Cytosine (C), Thymine
(T). The strands are held together by complementary base pairing A always matches T
and C matches G. Hence the sequence of bases in one strand determines the sequence in
the other. A section of DNA that codes for a protein is called a gene.
To produce a specific protein, the relevant section of one DNA strand is copied by a
process called transcription to yield mRNA which is transported into the cytosol. It is
then attached to a ribosome where its sequence of bases is translated into a sequence of
amino acids to produce the protein. A 3-base sequence (a codon) corresponds to each
amino acid. After translation, the mRNA is released from the ribosome and broken into
its component bases for recycling.
There are different varieties of the same gene. Each variety is called an allele.
Tissues
Although all cells have the same DNA, the expression of some genes is tissue specific, or
in some cases time-dependent, giving rise to the different types of cell.
Tissues classified by function
Type
Function
Epithelial
Covers & lines organs & structures e.g.

lines the digestive tract & blood vessels,
outer layer of skin.
Organise & maintain body structure e.g.
Bone, Cartilage, Fibrous connective
Energy store
Under skin and around organs
Contracts to provide movement
Direct cell communication
(Brain & Spinal Cord)
Transports exygen, nutrients, wastes,
antibodies, hormones
Reproduction
Support
Adipose
Muscle
Nerve (neurons)
Blood
Sex Cells
Page 6 of 55

Hormone producing
Immune system
Cell communication via bloodstream

e.g. thyroid glands, pancreas
Defence
Cells in tissues are held together by various types of junction e.g. epithelial cells are held
together by tight junctions which form a fluid-tight seal. Cells subject to stretching and
friction do not touch, but have anchoring junctions (connected via the cytoskeleton).
Smooth and cardiac muscle tissues have gap junctions, where the membranes do not
touch, but communicate using proteins called connexins.
Skin
Layers of cells divided into the epidermis (the epithelial cells), and the dermis, separated
by a single layer of cells. The blood vessels and nerves only extend to the dermis, but the
hairs on the skin can activate the associated nerves.
Epidermal cells are organised into hexagonal columns called Epidermal Proliferative
Units (EPUs) with a layered structure. Cells in the lowest (basal) layer are attached to the
basement membrane. They grow and divide and are displaced from the basement
membrane and move up into the higher layers, where they progressively flatten &
differentiate, proding more and more keratin (a protein which gives the skin mechanical
resistance and impermeability) until they finally lose their nucleus to become the
cornified layer. They die and are sloughed off the skin surface.
The dermis has nerves and blood cells, but fewer cells and more connective tissue. This
includes fibres of collagen, a protein with great structural strength. These form bundles
running in characteristic directions. There are also thinner elasic fibres made of the
protein elastin, which increase the strength of the connective tissue. The material between
the cells & the fibres is called the extracellular matrix (ECM). Cells called fibroblasts
produce collagen and other consituents of the ECM. The dermis also contains sweat
glands, sebaceous glands and hair erector muscles.
.
Cell Division Mitosis
The DNA double helix unwinds and splits into the 2 strands. Each strand serves as the
template for another strand. Thus 2 new DNA double helices are formed. These condense
into visible, compact structures in the nucleus. At this stage each chromosome is joined
with its duplicate. The nuclear membrane disintegrates and the chromosomes gather at
the centre of the cell. A special protein separates each chromosome from its duplicate and
moves them to opposite ends of the cell. A new nuclear membrane is formed around each
set of chromosomes, and the cell itself then divides into two.
The whole process is called the cell cycle.
Wound Healing
(Haemorrhage = Considerable blood loss from a wound)
Page 7 of 55

Rapid reflex to get the body away from the cause, plus pain!!
As soon as blood vessels are damaged & blood is released into the wound, the blood
clotting mechanism staunches the flow of blood, by the formation of a fibrin clot.
Platelets release histamine which causes vasodilation, which allows blood to contribute to
clot formation and white blood cells to fight infection. The increased blood flow,
vasodilation and action of white blood cells produces swelling, redness and heat i.e.
inflammation. Other processes promote tissue regeneration and repair. Blood platelets
release platelet-derived growth factor (PDGF) to stimulate cell division in the dermal &
epidermal cells, and in the white blood cells involved in clearing up cell debris and
engulfing bacteria. Fibroblasts differentiate into contractile cells which form a
contracting ring around the wound. Epidermal cells migrate over the surface of the ring.
The wound becomes closed, but is not yet normal skin. It is known as granulation tissue
with a dense network of blood vessels. The final process is restitution, the reorganisation
and remodelling of scar tissue to restore the original structure and properties of the skin.
Successful healing also requires good nutrition (heightened metabolic state and increased
synthesis of proteins) and the absence of infection. Stress can also influence healing rates.
Cancer
A disease where cells grow uncontrollably. Caused by accumulation of mutations to
specific genes. Cell growth & division are promoted by proto-oncogenes, and are kept in
check by tumour-suppressor genes. Cancer occurs when these mutate, but at least 5 or 6
different genes have to mutate before a cell becomes cancerous. So can take time to
develop. Predisposition to cancer may be due to a defective allele for just one of the
genes. e.g. RAS protein is a receptor that tells the cell when to divide. If the gene for
RAS mutates into an oncogene, the RAS protein will be defective and could be stuck in
the form that tells the cell to divide.
Once cells proliferate rapidly, they no longer differentiate to form the appropriate cells
for their area. (No gap junctions so poor communication with surrounding cells)
Carcinogenesis is the development and spread of cancer. A tumour is the growth of
cancer cells. If the cancer cells get into the bloodstream or lymphatic system, they can
initiate growths in other parts of the body (metastases). The main danger is from cancer
cells that grow arterioles into the tumour as they more readily get into the blood.
Chemotherapy is the administration of anti-cancer (cytotoxic) drugs that cause cell death
by altering DNA & preventing mitosis, or initiating the apoptotic (programmed cell
death) response. But non-discriminatory, so get side effects e.g. hair loss, skin problems,
fatigue, gastric problems. Radiography has similar effects. Hormone therapy (e.g.
tamoxifen) blocks the effect of oestrogen on cancer cells preventing them from growing.
Page 8 of 55

Book 1 Chapter 3 Nutrition
Nutrition The taking in and assimilation of food by chemical changes.
Balanced Diet
6 Key Nutrient Groups
Proteins Growth, Maintenance & Repair
Carbohydrates Source of Energy
Lipids Source of energy, component of cell membranes & signalling molecules, and as
myelin they insulate neurons.
Vitamins
Minerals
Water
Also require fibre to aid movement through the gut.
Essential nutrients Essential molecules that cannot be made by the body, so must be
part of the diet e.g. lysine
Dietary Reference values (DRV) given in kcals/day for males, females, different age
groups. These comprise Estimated Average Requirement (EAR), Reference Nutrient
Intake (RNI) satisfies 97.5% of the population, and Lower RNI (LRNI) satisfies only
2.5%. Hence 95% fall between the LRNI and the RNI.
Other factors as well as age, sex are size, occupation, metabolic rate.
Balanced Energy Intake
Metabolism = Chemical reactions in the body
2 types:
Catabolism = Breaking down larger molecules, often with energy release
Anabolism = Building up larger molecules from precursors, often requiring energy
Body requires energy for anabolic, mechanical, and transport process
ATP (Adenosine Triphosphate) is frequently synthesised when certain nutrients (Proteins,
Carbohydrates, Lipids) are catabolised. It is the energy currency of the body. Energy is
Page 9 of 55

released when it loses a phosphate and becomes ADP. ADP plus a phosphate ion +
energy can recreate the ATP, so it is rather like a battery that can be recharged.
Food in the gut is broken down into amino acids (from proteins), sugars (from
carbohydrates), glycerol & fatty acids (from lipids). These are then converted to ATP in
the cytosol and mitochondria (requiring oxygen and producing CO2). Fats provide 2.3
times the energy as carbohydrate and protein. NB Amino acids are normally used to
create proteins.
Basal Metabolic Rate (BMR) is the amount of energy required to carry out the basic
functions of life. Varies with age and sex. Total Energy Expenditure (TEE) includes other
everyday activities. Weigh stable if Total Energy Intake TEI = TEE.
Body Mass Index = Weight (kg)/Height2 (m2) is an indicator whether a person has a
healthy weight.
BMI between 18.5 and 25 is desirable range
BMI < 18.5 is underweight, >25 is overweight.
Obesity -> High blood pressure, cardiovascular disease and type 2 diabetes.
Carbohydrates
Can be Polysaccharides (starch & cellulose (cannot be digested) in plants, glycogen in
animals), Disaccharides (e.g. table sugar and lactose), or monosaccharides (e.g. glucose
and fructose). Monosaccharides (e.g. C6H12O6 Glucose, Fructose, Galactose are
isomers) do not need to be digested; Disaccharides digested in small intestine (by
sucrase). Polysaccharides first broken down by amylase in saliva to produce the
disaccharide maltose. So monosaccharides get into bloodstream very quickly, so quick
provider of energy. e.g. Chocolate has lots of glucose, so provides energy more quickly
than Baked Potato, which contains starch.
Can classify sugars as :
Intrinsic contained naturally within the cellular structure of the food, and extrinsic (not
contained within the plant structure e.g. table sugar, honey, sugar extracted from fruit or
added to refined foods.) Apart from lactose in milk, extrinsic sugars are thought to have
more adverse effects on health e.g. obesity, tooth decay, and increased blood glucose,
insulin and cholesterol levels.
We may enjoy sweet foods because breast milk is very sweet.
Blood glucose levels of 4-6 millimoles/litre must be maintained, to deliver glucose to red
blood cells and neurons, as this is the only fuel they can use, except in extreme starvation.
Any sugars not used immediately are converted into glycogen and stored in the liver or
muscle cells for later reconversion to glucose. If there is a large excess, they will be
Page 10 of 55

converted to fat stored in adipose tissue. These can be used to release fatty acids, which
can provide energy for many cells.
Starch can be divided into rapidly digestible (e.g. in cereals & white bread), slowly
digestible (e.g. in oats and pasta), and resistant. Slowly digestible takes longer to digest
and produces a smaller but more long lasting rise in blood-glucose levels.
Cellulose is insoluble in water and thus known as insoluble fibre. Soluble fibres are
pectins from fruit and mucilages from pulses.
Fibre increases transit time reduces chance of constipation, absorption of toxic
substances, chance of bowel cancer, less straining at defaecation (causes piles),
gallstones, appendicitis, diverticular disease (low fibre diets cause harder gut contents ,
producing pockets in the colon that can fill with faecal matter, allowing infection.)
High levels of glucose can bind to proteins (glycation) forming Amadori Product, which
can bind to further proteins leading to blindness, and nerve & tissue damage.
Lipids (Fats)
Concentrated Source of energy
Stored as triacylglycerols in adipose tissue for times of energy need
Prolong emptying time of the stomach
transport & store fat-soluble vitamins
Provide precursors for cellular structures & signalling molecules
Myelin insulates neurons
Cholesterol is a membrane component
Some hormones
Lipids consist of glycerol + 3 fatty acids.
Fatty acids with a double bond are unsaturated, (one double bond monounsaturated,
multiple double bonds polyunsaturated.)
Fatty acids without a double bond are saturated.
Polyunsaturated less dense than saturated
Some fatty acids are essential nutrients
Cholesterol & fatty acids are transported in the blood by lipoproteins. Low density (i.e.
lower protein) lipoproteins (LDL) supply cholesterol to cells, HDLs supply surplus
cholesterol to the liver. The greater the proportion of HDL, the lower the risk of
atherosclerosis (deposition of fat in arteries). Unsaturated fatty acids increase the
proportion of HDL, saturated fatty acids increase LDL.
Page 11 of 55

We have very limited requirement for fats need small amounts of the 2 essential fatty
acids (linoleic acid) contained in one serving of green vegetables/day or seed oil used in
cooking.
Too much fat leads to obesity, which in turn can lead to high blood pressure,
cardiovascular disease or type 2 diabetes. Increased levels of cholesterol, triacyglycerol
and LDL can also lead to cardiovascular disease e.g. atherosclerosis or blockage of
arteries.
Proteins
Function
Growth, Repair and maintenance of body tissues
e.g. Globular Proteins
Enzymes catalyse chemical reactions
Antibodies combat infection
Membrane proteins transport substances across the cell membrane
Haemoglobin in red blood cells transports oxygen around the body
Fibrous Proteins
Collagen in bone & Actin & Myosin in Muscles, provide support
Proteins are amino acid polymers (also called polypeptides). The bonds are covalent
(called peptide bonds), achieved by condensation reactions (elimination of water)
20 different amino acids, of which 8 are essential
They all have a carboxyl (COOH) group, an amino (NH2) group and an R group, which
differs for each acid.
Proteins are digested to produce amino acids (water required to break the peptide bonds),
which are then used to create new proteins as required by the body.
Protein deficiency causes PEM (Protein-energy malnutrition). Once the bodys fat stores
are depleted, muscle & organ protein are broken down to provide energy. Epithelial cells
& villi of the gut are also affected, so poor absorption of nutrients. Leads to severe body
wasting. Kwashiokor is protein deficiency in children. Pellagra is niacin deficiency get
skin lesions & diarrhoea. Phenylketonuria (PKU) is inability to convert phenylalanine
(found in milk) into tyrosine. Treated by special milk and tyrosine supplements.
Minerals
Cannot be synthesised by the body
Page 12 of 55

Major Mineral Elements
Mineral
Ca
Na
K
Fe
Mg
P
S
Cl
Function
Bone & tooth formation,
clotting, muscle contraction,
conduction of nerve
impulses
Main +ve ion in
extracellular fluid.
Conduction of nerve
impulses, absorption from
gut
Main +ve ion in cells.
Nerve impulses
Major component of
haemoglobin
Bone formation, nerve and
muscle cell function
In bones and teeth, needed
as component of ATP
Part of amino acids
Major negative ion in body
fluids. In stomach as HCl
Source
Milk, Cheese, Bread,
Cereals, Green Vegetables
Salt
Vegetables, Meat, Milk

Meat, Bread, Vegetables
Milk, Bread
Milk, Cheese, Bread
Cereals
Protein-rich foods
Salt
Trace elements include iodine, required for thyroid hormones and zinc, component of
many enzymes. Iodine deficiency causes enlarged thyroid (goitre) in attempt to produce
hormones. Lack of iron causes anaemia inability to supply blood cells with oxygen
increased heart rate, tiredness, breathlessness. Lack of zinc causes poor appetite and
increased vulnerability to infection.
Vitamins
Generally cannot be synthesized by the body
Fat-soluble (A, D, E & K) Absorbed with fats, excess can be stored by the body
Water-soluble (B & C) Absorbed with water, excess passed with the urine.
Vitamin
Function
Source
Lack of causes
Required for vision

Anti-oxidant
Growth of bones &
teeth
Carbohydrate
metabolism
Carbohydrate &
Liver, Fish
Night blindness
Nuts, Yeast, Egg

Yolk, Liver
Yeast, Green
Beri-beri, loss of
appetite
Blurred vision &
B1
B2
Page 13 of 55

protein metabolism
B3 (Niacin)
Carbohydrate & fat

metabolism
B12
Myelin sheath
formation
DNA synthesis
Red blood cell
production
Formation of
collagen in
connective tissue
Construction of teeth
& bones
Anti-oxidant
Blood-Clotting
D
E
K
vegetables, milk,
liver
Liver, cheese, yeast
Offal, Meat, Milk
skin cracking
Pellagra
Dermatitis,
diarrhoea,
dementia
Pernicious
anaemia
Green Vegetables,
Fruit
Scurvy, Bleeding
Gums, Slow
healing
Margarine, Oily Fish Rickets
Plant-seed oils
Green vegetables
Poor bloodclotting
Water
Essential as a solvent, transport system, constituent of metabolic processes and to
maintain ionic balance
Gained from metabolism, food and directly.
Dehydration leads to lack of concentration, headache and nausea
If untreated, leads to coma & death
Page 14 of 55

Book 1 Chapter 4 Digestion
Process of Digestion involved in eating specific foods
Digestion is the breakdown of food into smaller components to allow uptake/absorption
into the bloodstream. Essential as large molecules cannot pass through cell membranes
into the bloodstream. Both mechanical and chemical for potato involves breakdown of
the carbohydrate starch into monosaccharide glucose. Protein in cheese is digested into
amino acids and the lipid in cheese is digested into fatty acids & glycerol.
Mechanical digestion involves the physical movement & mixing of food with chemical
secretions. Starts in the mouth with mastication or chewing of food with the teeth,
controlled by the jaw muscles. This breaks the solid food into smaller quantities to allow
swallowing. Movement from the mouth down the gut occurs by peristalsis (successive
contraction & relaxation of muscle layers). This mixes the food and breaks it into smaller
chunks. The swallowed food travels down the oesophagus into the stomach where it
undergoes churning, so that the food is mixed with stomach secretions.
Chemical digestion involves enzymes throughout the digestive tract, acid in the stomach
and bile from the liver. Mastication increases the surface area of the food facilitating the
breakdown of starch by salivary amylase into the disaccharide maltose.
The food then enters the stomach, which prepares for this by the production of gastric
juice. This is very acidic (pH 1.5 to 3) due to the production of HCl by the parietal cells.
This helps to disrupt the physical structure (denature) the proteins, allowing the enzymes
easier access. Pepsinogen from chief cells is converted by HCl into the enzyme
pepsinogen which begins the breakdown of proteins into polypeptide chains and peptides.
Mucus from goblet cells prevents the HCl damaging the stomach. Following churning
with HCl, pepsin and other secretions, the food becomes a thick, soup-like mixture called
chime and leaves the stomach to enter the small intestine, under the control of peristalsis
and the pyloric sphincter muscle. The surface area of the small intestine is increased by
finger-like projections called villi, and tiny projections from epithelial cells called
microvilli. This allows greater area for absorption of nutrients into the blood system.
The acidity of the chime is neutralised by bile, produced by the liver and stored in the gall
bladder. (Bile contains bicarbonate ions which combine with the H+ ions from the HCL
to produce carbonic acid, which is very weak pH 6-7) This increase in pH is required to
allow the action of pancreatic enzymes. The pancreas itself also produces bicarbonate
ions. Bile also contains bile salts which emulsify fats, thereby increasing their surface
area available for enzymes.
There are a number of pancreatic enzymes secreted into the small intestine which would
be involved in digesting the food. These include those listed below.
Page 15 of 55

Enzyme
Substrate
Product
Trypsin, chymotrypsin,
elastase
Carboxypeptidase
Pancreatic amylase
Lipose
Proteins
Peptide fragments
Proteins & Peptides

Polysaccharides
Lipids
Nuclease
DNA & RNA in meat
Terminal amino acids

Maltose & dextrins
Fatty acids and
monoacylglycerols
Split nucleic acids
Further along the small intestine, the partially digested macromolecules are broken down
into molecules small enough to be absorbed through the epithelial cells into the
bloodstream. Enzymes in the brush border (microvilli) of the epithelial cells are involved
in this final stage. These are listed below
Enzyme
Substrate
Product
Aminopeptidase
Dextrinase
Sucrase
Maltase
Proteins & peptides

Dextrins
Sucrose
Maltose
Terminal amino acids

Glucose
Glucose & Fructose
Glucose
The free amino acids and glucose molecules cross the epithelial cell membrane by active
transport into the capillaries in the villi. The fatty acids, fat-soluble vitamins and glycerol
simply diffuse across the membrane due to their hydrophobic nature.
In the large intestine (colon), further absorption of water and mineral salts occurs,
concentrating the remains of unabsorbed food and waste into faeces. Bacteria in the colon
metabolise soluble fibre (contained in beans, peas and fruit) into fatty acids, and gases
such as hydrogen and methane. The fatty acids are absorbed and used by the colon as an
energy source. The bacteria can also synthesise vitamins such as vitamin K which are
absorbed. The faeces pass into the rectum, where they remain until expelled through the
anus.
Minerals are generally absorbed by active transport in the small intestine, but Ca needs
vitamin D and iron salts (in eggs & plants) need vitamin C. (Haem iron in meat & fish is
more easily absorbed)
Water soluble vitamins are absorbed by diffusion
Vitamin B12 requires the Intrinsic Factor protein produced by the parietal cells.
Water is absorbed mainly in the small intestine by osmosis
The Mouth & Oesophagus
Page 16 of 55
Teeth comprised of enamel (very hard & resistant), dentine with similar composition to
bone, pulp composed of connective tissue with blood vessels, nerves and lymph vessels.
Held in place by periodontal ligaments and cement. Healthy teeth require minerals such
as Ca and P, vitamin D and parathyroid hormone.
Mixture of saliva, food and bacteria covering the teeth is called plaque, and the sugars in
plaque provide food for plaque bacteria. These produce lactic acid and enzymes that can
dissolve the Ca salts in enamel producing a cavity. The underlying dentine is much more
vulnerable and more easily dissolved.
Saliva contains salivary amylase to start the digestion of starch, mucus acting as a
lubricant, and lysozyme to attack bacteria.
The tongue is used to move food around the mouth and help swallowing. It also contains
the taste buds. The taste sensation triggers the release of bacteria and the secretion of
gastric juice in the stomach (in anticipation!!) The tongue is also crucial for speech.
When swallowing, the trachea is closed off by the epiglottis, pharynx and larynx to
prevent food going down the respiratory tract.
There is a sphincter where the oesophagus meets the stomach, normally closed to protect
the oesophagus from the acidic contents of the stomach. If it opens inappropriately it can
cause heartburn or inflammation.
Stomach Problems
Peptic ulcers can form in the stomach if HCL gains access to the epithelial cells. This can
be caused by infection by a bacterium which gets beneath the mucous and damages the
cells, reduced blood supply, prolonged aspirin use. Treat by antibiotics, acidity reduction
and NSAIDs avoidance.
Gastritis is caused by too much gastric juice and too little mucous, with damage to
epithelial cells and bleeding into the stomach. It is caused e.g. by smoking, alcohol and
NSAIDs.
Stomach cancer destroys the mucosal cell layer resulting in reduced HCl secretion and
pH increase.
The vomiting reflex can be triggered by excessive distension of the stomach and small
intestine, and activation of chemoreceptors by harmful chemicals or toxins. Also
increased pressure in the skull and movements of the head that do not match other
sensory inputs (travel sickness).
Page 17 of 55

Pancreas
As well as producing digestive enzymes, the pancreas produces insulin and glucagon
from the islets of Langerhans. Insulin is produced as a response to high blood glucose
levels and glucagen as a result of low blood glucose levels. Insulin causes glucose to be
taken up by the liver and muscles and stored as glycogen. Glucagon reverses this process
by initiating the breakdown of glycogen into glucose and its release in the bloodstream.
The deficiency or impairment of insulin is called diabetes and results in high bloodglucose levels. (See Book 2, Chapter 3)
If the pancreatic enzymes are activated before leaving the pancreas, cell damage called
pancreatitis occurs.
Liver
Produces bile to help with digestion (bicarbonate ions reduce acidity & bile salts
emulsify fats)
High levels of insulin stimulate the liver to convert blood glucose to stored
glycogen
High levels of glucagon stimulate the liver to break down the stored glycogen,
releasing glucose into the bloodstream.
Stores many vitamins, plus Fe, Cu
Converts amino acids to fatty acids, & during fasting, turns fatty acids into
ketones which can be used as an energy source
Involved in the synthesis of blood plasma proteins and destroying old blood cells,
producing bilirubin, which is excreted in bile.
Metabolises alcohol and detoxifies noxious substances
Can be damaged e.g. by too much iron, paracetamol, anabolic steroids & alcohol
Jaundice Raised level of bilirubin in the blood
Hepatitis Cell damage caused by viruses, toxins or autoimmune
Cirrhosis is a consequence of liver disease scar tissue, nodules
Osmolarity & Osmotic Pressure
The concentration of solute (e.g. glucose) particles in water is called its osmolarity
(measured e.g. in moles/litre). Dehydrated person will have a high osmolarity & high
Page 18 of 55

osmotic pressure. If cells are bathed in water of higher osmolarity, then water inside the
cell will exit through the cell membrane until both have the same osmolarity. Osmotic
pressure refers to the pressure that would have to be applied to prevent this. The
movement of water across a cell membrane due to concentration differences is called
osmosis.
Page 19 of 55

Book 2 Control and Communication
Chapter 1 The Nervous System
Brain can be imaged using
Computerised Tomography (CT) Scanning cross-sections using X-Rays

Computerised Angiography Scanning blood vessels using X-rays + Dyes
Positron emission topography (PET) Detect active parts of the brain by injecting
radioactive material into the bloodstream.
Magnetic Resonance Imaging (MRI) Gives more detail. Uses a magnetic field
Functional MRI Detects changes in blood flow to brain areas
Structure
Brain and Spinal Cord = Central Nervous System
Remainder = Peripheral Nervous System
Neuron = Cell in nervous system whose function is to transmit information in the form of
electric changes in membrane potential
Sensory (sensory receptors to the CNS) = Afferent neuron, Motor (from the CNS to
muscles, heart and glands) = Efferent neuron (SAME)
Interneurons link neurons to other neurons
Glial Cells (e.g. Schwann cells, microglia, astrocytes) support the neurons e.g.
Myelination in PNS, defence against infection, barrier between blood and brain
Neurons comprise the cell body containing the nucleus, a long extension called an axon
or nerve fibre, carrying information from the cell body, and 1 or more dendrites that
receive the information and carry it to the cell body.
A nerve is a collection of axons in the PNS, physically located alongside each other and
extending over the same distance, like an electric cable.
Myelin sheaths with gaps (Nodes of Ranvier) increase the speed of transmission because
the signals jump across the gap. (Saltatory conduction)
In a resting neuron, the outer surface of the cell membrane has a +ve charge relative to
the inner surface the membrane potential is -70mV. The intracellular fluid is mainly K+
ions, with some Na+ and CL- ions. The extracellular fluid is mainly Na+ and Cl- ions,
with some K+ ions. Signals from other neurons or from sensory events cause ion
channels to open allowing Na+ ions to cross the membrane, driven by the Na+
concentration gradient and the membrane potential. This makes the membrane potential
less negative, and if it reaches a threshold value of -55mV, more ion channels open, and
Page 20 of 55

more Na+ enters the cell. The membrane potential loses its potential (depolarisation) and
becomes temporarily positive (20-30mV). Now the Na+ channels close and K+ channels
open, allowing the K+ ions to leave the cell so that the membrane potential becomes
negative again (repolarisation). The voltage spike generated once the threshold value is
reached is called the Action Potential. The action potential is strong enough to raise the
adjacent area above the threshold potential and thus the action potential is propagated
along the axon. NB The membrane potential drops back to a negative value temporarily
below -70mV. This period of hyperpolarisation is known as the refractory period and
prevents the action potential travelling in both directions at once. During the refractory
period, Na+ ions are pumped out and the resting potential established so that a new action
potential can be conveyed. Action potentials can travel at up to 100ms-1.
The junction between 2 neurons or between a neuron and muscle fibres is called a
synapse (or in the latter case a neuromuscular junction)
When an action potential reaches the end of an axon, it cannot cross over the synapse.
Instead, the action potential causes an influx of Calcium ions which trigger the release of
neurotransmitters across the gap. These become attached to specific receptors on the
postsynaptic membrane of the 2nd neuron or neuromuscular junction. The outcome of
binding can be either to excite or inhibit firing of the receiving neuron. There are
thousands of synapses on a neuron, and many different neurotransmitters e.g. dopamine,
serotonin, acetylcholine, adrenaline, noradrenaline. Acetylcholine is the neurotransmitter
used to activate muscles, and in the parasympathetic branch of the autonomic nervous
system. Noradrenaline is used in the sympathetic branch of the ANS. Adrenaline &
noradrenaline also act as hormones in the endocrine system. Neurons are characterised by
the particular neurotransmitter that they produce.
The effect of a transmitter can be imitated by a drug that occupies the same receptors and
has a similar action. These are called agonists. Conversely, a drug that blocks the
transmitters action is an antagonist. e.g. cocaine blocks the reuptake of dopamine.
The PNS is divided between the Somatic Nervous System (Voluntary) and the
Autonomic Nervous System.
The somatic nervous system controls the skeletal muscles and provides sensory
information from the body and the outside world. e.g. step on drawing pin this triggers
activity in a special neuron called a nociceptor, which connects in the spinal cord with 2
other neurons, one to the brain (pain!!), and one via an interneuron to a motor neuron
activating a foot muscle. This is a local reflex which can thus occur at higher speed. The
brain information is required e.g. if the pin needed to be pulled out of the foot.
Other actions are involuntary, using non-skeletal muscles e.g. heartbeat, peristalsis,
production of saliva, constriction of blood vessels etc., all using smooth muscle (in
contrast to skeletal muscle, it contracts spontaneously, in a rhythmic fashion.) These are
controlled by the Autonomic Nervous System (ANS).
Page 21 of 55

The ANS is subdivided into the sympathetic, parasympathetic and enteric nervous
systems. The sympathetic and parasympathetic nervous systems exert opposite effects on
organs, to maintain homeostasis. (Sympathetic = fight or flight, parasympathetic = rest or
digest) They use different neurotransmitters noradrenaline and acetylcholine
respectively. The ANS also controls the activity of endocrine and exocrine glands. e.g.
sweat response. The enteric nervous system is the neurons in the wall of the gut. e.g.
peristalsis.
In the somatic nervous system, single motor neurons, whose cell bodies are in the spinal
cord, link the CNS to the skeletal muscles. In the autonomic nervous system,
combinations of 2 neurons span the path from the CNS to the organ. There is an
automatic ganglion that houses the cell body of the 2nd neuron. In the sympathetic system,
the ganglia are close to the spinal cord; in the parasympathetic system, they are close to
the organ.
Page 22 of 55

Book 2 Chapter 2
The Special Senses
Smell (Olfactory)
Odorous chemicals reach the nasal cavity (sniffing speeds this up)
They dissolve in mucus covering the olfactory epithelium, and can then bind to receptor
proteins in olfactory receptor neurons. (350 different types) This causes an action
potential to be generated along the neuron to a part of the brain called the olfactory bulb
and thence to the thalamus and limbic system (which governs memory and emotion).
Taste (Gustatory)
Taste cells (receptors) are located in taste buds on the tongue. (5000 taste buds each
containing 50 taste cells) Different receptors are associated with sweet, sour, bitter, salty,
or savoury. (Sour = H+ ions, Salty = Metal ions, Sweet = Sugars)
Once a taste cell has been activated, neurotransmitter is released into the synaptic cleft
between the taste cell and the primary afferent neuron. Information is passed via the
medulla to the gustatory cortex and the limbic system.
Touch
There are a variety of receptors (sensory neurons) on the skin: (e.g. Merkels Discs
respond to pressure)
Hair follicle endings respond to displacement of hair. Others respond to vibration,
pressure, skin stretch.
There are also free nerve endings called nociceptors that detect pain.
There are also receptor cells in muscles and joints triggered in response to movements of
these tissues.
Sensory signals associated with nociceptors travel along a separate pathway on the spinal
cord from the other receptors.
Vision
Light first encounters the cornea, where it is focussed, through aqueous humour fluid,
through the circular aperture (the pupil) then through the lens, through vitreous humour
fluid and the image is focussed on the retina at the back of the eye.
The pupil is surrounded by iris muscles which control its size and thus the amount of
light entering the eye. It is dilated when the radial iris muscle contracts and reduced when
the iris circular muscle contracts. These are under the control of the autonomous nervous
system.
Page 23 of 55

The cornea performs initial focussing and the shape of the lens is adjusted by the ciliary
muscles (controlled by the parasympathetic nervous system) to focus the image (inverted)
on to the retina. (The muscles are relaxed for objects at infinity)
The retina contains receptors called rods & cones. Rods are sensitive to low levels of
light (e.g. night-time vision), whereas cones are for daytime & detect colour. L-cones
detect long wavelengths (red), M-Cones detect medium wavelengths (green), S-cones
detect short wavelengths (blue). There are about 125 million photoreceptors which turn
the light signals into biochemical signals. In turn these generate electrical signals and
pass via synapses down the optic nerve to the brain. (Primary Visual Cortex), where it is
processed according to shape, colour and movement.
Myopia is where the focal point falls short of the retina
Hypermetropia is where it falls beyond the retina
Presybyopia is where the lens cannot be adjusted to the full extent.
Tested by a Snellen Chart. 20/20 Vision means can read the smallest row at 20 feet.
When a bright light shines, the pupil contracts (the light reflex) due to the
parasympathetic nervous system.
Conversely, in dim light, the pupil dilates due to the sympathetic nervous system.
Tears lubricate the eye, wash away dust & debris and supply nutrients. They may also
remove toxic substances during emotional stress.
The blind spot is where the optic nerve meets the back of the eye.
Diabetes damages the capillaries and causes blood to leak into the eye. Blurred Vision
Cataracts are progressive clouding and swelling of the lens
Glaucoma Rise in pressure
Macular degeneration
Auditory System
Sound enters through the external ear compartments and the auditory canal to the
eardrum, which vibrates in response to sound. The vibrations are transferred to the
hammer, stirrup & anvil bones in the middle ear, which convey the vibrations through the
oval window amplifying them, to the cochlea in the inner ear. The cochlea is a spiral
fluid-filled structure containing hair-cell receptors. These have cilia which bend in
response to the vibrations. This triggers an electric current in the hair cell, causing a
neurotransmitter to activate the auditory nerve. The signal is then transmitted to the
auditory cortex via the medulla and thalamus.
The inner ear also contains the vestibular system with otolith organs sensing a change in
linear movements, and semicircular canals sensing changes in rotational movements.
Information is relayed to the brain via receptors and the vestibular nerve
Page 24 of 55
Build up of pressure in the inner ear (e.g. Menieres Disease) can affect both balance and
hearing and cause tinnitus. Disruption to auditory pathways can cause word deafness.
Conductive hearing loss affects all frequencies and can be caused by a blockage or
infection.
Page 25 of 55

Book 2 Chapter 3
The Endocrine System
The endocrine systems function is to maintain a stable internal environment within the
body (homeostasis). This is achieved using endocrine glands that release hormones into
the blood; they are then transported to their target cells, where they bring about a variety
of biochemical changes. At the target cells, hormones bind to specific receptors, rather
like the correct key in a lock. Each individual hormone affects a specific type or group of
target cells.
The idea of homeostasis is that controlled variables, such as the rate of uptake of glucose
from the blood, are used to maintain regulated variables, such as blood glucose level, at
near constant levels. This is generally achieved using negative feedback, whereby the
level of the regulated variable is monitored, and when it moves away from the set value, a
controlled variable is changed by the release of the appropriate hormone, which acts to
move the regulated variable back to its set value.
Example of negative feedback
Control of Acidity in the duodenum
Acidic chime enters the duodenum.

The low pH is detected by specialised epithelial cells lining the duodenum
These respond by releasing the hormone secretin in the capillaries supplying the
intestinal wall.
The secretin is transported in the blood to the pancreas where it stimulates
pancreatic cells to secrete water and bicarbonate ions.
These are transported via the pancreatic duct into the duodenum
They mix with the acidic chyme to reduce its acidity
The reduced acidity inhibits the release of secretin
(Drawing)
Example of Positive Feedback
Control of Uterine Muscle Contractions
An example of positive feedback is the role of oxytocin to stimulate uterine muscle
contractions during childbirth. Stretch receptors in the cervix send signals via the spinal
cord to the hypothalamus to produce more oxytocin as the cervix is stretched by the baby.
This continues until the baby is born and the placenta ejected. The uterine contractions
cease and so the stretch receptors are no longer activated.
Diagram
Page 26 of 55

Hormones
Hormones are secreted by glands. These include the endocrine glands, which secrete their
hormones into the bloodstream, plus exocrine glands such as the pancreas, which secrete
their hormones into a duct.
In many cases, homeostasis is controlled by the hypothalamus-pituitary axis, a 3-tier
hormonal system comprising the hypothalamus, the anterior & posterior pituitary glands,
and a whole raft of glands including the thyroid and adrenal glands, and organs such as
the ovaries, liver, kidney and uterus.
The neurohormones ADH and Oxytocin are produced by the hypothalamus and released
at the end of axons into the capillary network of the posterior pituitary, which acts as a
hormone-releasing site.
ADH (vasopressin) targets the kidney and is for maintaining water levels in the body. A
change in water level is detected by osmoreceptors in the hypothalamus. If it is too low,
ADH will be secreted via the pituitary gland, and will target kidney cells, increasing the
permeability of the collecting ducts to water, thus reabsorbing more water. If the level is
too high, ADH release will be inhibited. Stretch receptors in the cardiovascular system
also influence the production of ADH when loss of blood occurs. The hypothalamus also
has thirst receptors activated by an increase in osmolarity of extracellular fluid. These
receptors stimulate a feeling of thirst.
Other hormones produced by the hypothalamus are passed to the anterior pituitary via the
portal veins. These stimulate or inhibit the anterior pituitary to release specific hormones
to a whole range of glands, including the thyroid, adrenal, ovary and liver.
Thyroid Gland situated in the neck
The thyroid hormones control metabolic rate and the level of calcium in the blood.
Regulation of thyroid hormone levels in the blood begins with the hypothalamus, which
releases TRH (Thyroid-stimulating-hormone-releasing-hormone) into the capillary
network of the anterior pituitary. TRH stimulates the anterior pituitary to release thyroidstimulating hormone (TSH) into the bloodstream. TSH stimulates the target gland, the
thyroid, to release thyroid hormones. The thyroid hormones are thyroxin (T4) and small
amounts of T3. If T3/T4 levels fall too low, this triggers release of TRH; if they become
too high, release of TRH is inhibited.
Too high a level of thyroid hormones (hyperthyroidism) causes an increased metabolic
rate, heart rate, weight loss & intolerance to high temperatures. Too low a level
(hypothyroidism) causes lethargy, weight gain and intolerance to low temperatures.
Lack of iodine causes a reduction in the secretion of thyroid hormones. This stimulates
release of TRH and TSH and can cause enlargement of the thyroid gland (goitre).
Page 27 of 55

Graves disease is an autoimmune disease where the patients immune system produces
antibodies to the receptor proteins for TSH. The antibody molecules bind to the receptors
for TSH in the thyroid gland, which responds by continually secreting T3 and T4. This
produces hyperthyroidism systems including bulging eyes. (A substance that mimics the
effects of a natural chemical is called an agonist.)
Adrenal Glands Situated in front of the top of each kidney
Each has 2 distinct regions, an outer cortex and an inner medulla. The cortex secretes
corticosteroids such as cortisol (a glucocorticoid), aldosterone (a mineralocorticoid) and
small amounts of sex steroids (e.g. testosterone). Cortisol targets liver and fat cells, and
stimulates the production of glucose from glycerol and amino acids in liver cells. It also
facilitates the breakdown of non-liver proteins to amino-acids, and increases levels of
blood glucose by breakdown of glycogen. It also increases lipid breakdown into fatty
acids. Levels of cortisol can rise by a factor of 20 due to stress. Release of cortisol is
controlled by CRH secreted from the hypothalamus, and ACTH from the anterior
pituitary. Deficiency of cortisol (Addisons Disease) causes hypoglycaemia, lack of
tolerance to stress, skin pigmentation, weight loss etc. Overproduction of cortisol
(Cushings Syndrome) causes weight gain but thin limbs, hyperglycaemia, tiredness etc.
Aldosterone regulates the level of sodium and potassium in the blood.
The medulla secretes adrenalin and noradrenaline (also neurotransmitters). These prepare
the body for a fight or flight response.
Hormones outside the Hypothalamus-Pituitary axis
Gastrin is secreted by the stomach in response to distension of the stomach by incoming
food. It stimulates the stomach cells to release acid and pepsinogen, the precursor
molecule for protein-digesting enzymes. It is also secreted by stimulation of the vagus
nerve.
Leptin is secreted by adipose tissue cells to indicate a replete state to the hypothalamus.
This then has a negative feedback effect on secretion of the appetite stimulant
neuropeptide Y by the hypothalamus. Some obese people have mutant receptor protein or
mutant leptin. Another cause of obesity is downregulation, caused by lack of sensitivity
to leptin due to over stimulation of leptin receptors.
Regulation of Blood Glucose Levels
98% of the pancreatic cells secrete digestive enzymes, bicarbonate ions and water. The
remaining 2% are the islets of Langerhans.
Blood glucose levels are kept within a limited range by the hormones glucagon and
insulin, secreted by the and cells respectively of the islets of Langerhans in the
pancreas. Release of insulin is stimulated by high blood glucose levels. After a meal,
Page 28 of 55

blood glucose levels are much higher than those in tissue cells. The insulin binds to
receptors in target cells in the liver, muscle and adipose tissue, and increases entry of
glucose into these cells. In the liver, insulin activates glycogen synthase to convert
glucose to glycogen, and maintains a glucose concentration gradient between blood and
cytosol. It also stimulates glycogenesis in muscles and fat storage in adipose tissues. Two
feedforward mechanisms promote release of insulin into the blood during a meal.
Parasympathetic neurons stimulate insulin secretion during eating. GIP released by
intestinal cells in response to fatty acids and glucose in the intestine also stimulates
insulin release.
Glucagon, secreted when blood-glucose levels are low, promotes breakdown of glycogen
by the liver (glycogenolysis), which provides glucose for secretion into the blood. In
long-term starvation, glucagon also promotes synthesis of glucose from amino acids and
glycerol, and the breakdown of lipids to glycerol and fatty acids. Once glucose is
depleted, ketone bodies can be produced by the liver as an alternative fuel source.
Type 1 diabetes is caused by loss of function of the cells. As insulin activates transport
of glucose into target cells, this means that cells do not have access to glucose, even
though blood glucose levels are high. Hence the body starves. It is treated by insulin
injections.
Type 2 diabetes is caused by insensitivity of insulin receptor cells, possibly due to
downregulation. This is treated by dietary controls, exercise and medication.
Prolonged high blood-glucose levels can cause damage to tissues including formation of
Amadori product, damaged proteins. This can lead to cataracts, PNS damage and
arteriosclerosis.
Cytokines and growth factors are polypeptide signalling molecules not secreted by
endocrine glands or tissues, but by a diversity of cell types. Interleukins are secreted by
T-cells, causing them to proliferate. IGF-1 is secreted by the liver to stimulate
proliferation of cartilage cells in growth plates of children. Cartilage cells themselves also
secrete IGF-1.
Page 29 of 55

Book 2 Chapter 4
Body Organisation & Growth
Functions of musculo-skeletal system
Enables movement via the action of muscles

Provides support for soft tissues & organs
Protects delicate internal organs
Stores minerals within bone tissue
Produces blood cells from bone marrow
Osteoporosis is when the bones become more porous

Pros & Cons of bipedalism
Pros:
2 limbs free to do other things
Better Vision (higher up)
Cons
More work circulating the blood against gravity (->varicose veins)
More pressure on the spine (->vertebral disc ruptures - slipped disc)
Bone Structure
Skeleton of embryo made of cartilage consisting of cartilage cells in a jelly-like matrix
containing fibrous proteins such as collagen. (The matrix is secreted by the cartilage
cells)
During embryonic development, cells called osteoblasts are created which carry out bone
formation. These secrete collagen to form a framework in which calcium & magnesium
salts are deposited. These give bone its hardness, while the collagen gives it flexibility.
Osteoblasts eventually mature into osteocytes, which are incapable of further division.
Flat bones e.g. skull, ribs & breastbone start as membranous sheets rather than cartilage.
The shafts of long bones are hollow made of compact bone, with less dense spongy bone
at the ends. The spaces in spongy bone are often filled with red marrow, used in the
manufacture of red blood cells. The hollow shafts of long bones contain yellow marrow,
which is a fat store.
Osteoblasts build up bone . Osteoclasts break down bone fragments. The process of
remodelling replaces old, worn out bone tissue with new.
Page 30 of 55
Healing of broken bones
Pain
The fracture leads to severing of blood cells around the breakage
A large blood clot forms around the fracture, called a fracture haematoma
Swelling, Redness, Heat (Inflammation) occurs around the site of the break
Phagocytes in the blood and osteoclasts remove the cellular and bony debris and
new blood vessels grow into the haematoma. (Similar to wound healing)
The haematoma changes into granulation tissue (contains many tiny blood
vessels)
Fibroblasts lay down a network of collage fibres across the fracture and
chondroblasts form a fibrous cartilage. The ends of the bone are connected by this
fibrous callus, lasting for about 3 weeks.
Osteoblasts begin to build a web of spongy bone throughout the callus, changing
it into a bony pad after 3 months. Slowly this is replaced by compact bone around
the shaft and osteoclasts trim away any excess bony callus.
Bone Growth
During childhood and adolescence, long bones grow by the division of cartilage cells at
the end of each shaft, called epiphyseal plates or growth plates.
Genes influence height (e.g. achondroplasia mutated gene stunts growth. Identical twins
grow to same height even if raised apart), but so also does nutrition, social class, and
emotional neglect.
Growth during adolescence is due to hormones.
The major hormone is growth hormone GH. This is secreted by the anterior pituitary,
and stimulates the liver to produce signalling molecules called insulin-like growth factors
(IGF-1). These stimulate cartilage cell proliferation in growth plates. (Can administer GH
to children, but some batches, taken from pituitary glands of corpses, were infected with
a prion (infectious protein), and caused CJD)
Other hormones affecting growth are thyroxine (T3) and T4 produced by the thyroid
gland, which raise the metabolic rate and are involved in temperature regulation. These
increase protein synthesis and production of ATP, thus aiding growth. The sex hormones
increase the activity of osteoblasts and thus also promote growth. But they also cause the
epiphyseal cartilage to calcify, so eventually stopping further growth. Parathyroid
hormone (PTH), secreted by the parathyroid gland, promotes the breakdown of bone by
osteoclasts, thus controlling bone remodelling. It also causes the release of calcium,
magnesium and phosphate into the bloodstream. Calcium is required for muscle
contraction, bone formation, nerve signal transmission.
A balanced diet is also essential for skeletal growth. In particular, proteins, energy from
fats & carbohydrates, metals particularly calcium, magnesium and phosphorus, vitamin A
Page 31 of 55

influences the activity of osteoblasts and osteoclasts. Vitamin C, D and B12 are also
required for growth.
Exercise
Bones respond to exercise by increasing the amount of collagen produced and the amount
of mineral salts deposited into the collagen fibres. Inactivity can cause loss of collagen &
minerals from bones. Mechanical stress also increases the production of calcitonin by the
thyroid, which acts to keep calcium in the bones. Bone mass reduces with age older
people absorb less calcium and often suffer from vitamin D deficiency. Vitamin D
facilitates the transport of calcium from the small intestine to the blood, and controls the
deposition of calcium in bones. Post-menopausal women in particular can be calciumdeficient. Osteoporosis is where the level of bone mass falls below a critical point.
Joints
A joint is the connection between 2 or more bones e.g. the knee or elbow and allow
movement via muscles. The bones of the joint are held together by ligaments, which are
bundles of collagen fibres running in parallel. The ends of the bone are covered with
cartilage, and for synovial joints, the space between bones is filled with synovial fluid, to
allow the bones to move smoothly against each other. Osteoarthritis develops when the
cartilage wears out and bone rubs against bone. Sprain occurs if joint moved to exceed
capacity of its attachments. Dislocation if bones forced out of connection in the joint.
Muscles
Muscles provide the body with movement. 3 types Skeletal (attached to bone), Smooth
(found in hollow organs e.g. bladder, intestine and uterus) and cardiac. Most skeletal
muscle is under conscious control; smooth & cardiac muscle is not.
All muscle tissue:
Responds to stimuli & is excitable like nervous tissue

Contracts in response to a stimulus
Can be stretched without damage (but overstretching causes strain)
Elastic, i.e. returns to original shape after contraction
Skeletal muscles are attached to bones via collagen fibres called tendons
Muscle fibres contain many mitochondria to make ATP.
Skeletal muscles facilitate movement, raise body temperature by shivering, and help to
return blood to the heart (squeeze the veins when they contract)
Muscle fibres can propagate an action potential, activated by a motor neuron from the
brain or spinal cord. 1 motor neuron can activate a number of fibres (motor neuron plus
Page 32 of 55

the fibres it activates is called a motor unit). The synapse between the motor neuron and
muscle fibre is called a neuromuscular junction. Frequency of action potentials increases
rate of contraction of muscle and the number of motor units activated. The
neurotransmitter is acetylcholine. Myasthenia Gravis is caused by a loss of acetylcholine
receptors.
Running down the length of muscle fibre cells are protein filaments of actin and myosin.
When the muscle fibre is activated, these filaments move past each other and overlap,
thus causing the fibre to contract. The energy for muscle contraction is derived from the
hydrolysis of ATP (ATP + Water = ADP + Phosphate + Energy). This is derived from
cellular respiration (Sugar + Oxygen = Carbon dioxide + Water + ATP). However, the
blood flow through a muscle may be intermittent during contraction, so a second source
of ATP is provided via the breakdown of creatine phosphate, stored in muscle (ADP +
Creatine Phosphate = ATP + Creatine). However, in intense activity, there is insufficient
oxygen to meet the demands of the muscle cells, and ATP is generated anaerobically,
from glycogen stored in the muscles. This generates lactic acid and hydrogen ions,
leading to a lowering of pH in the blood. The accumulation of lactic acid causes aching
and heaviness of the limbs, leading to muscle fatigue. The lactate must be metabolised, in
the liver, and the creatine phosphate reserves replenished. Both require oxygen, which is
why we breathe heavily after exercise!!
Sprinters have lots of fast twitch fibres with few mitochondria and relying on anaerobic
breakdown of glucose. Marathon runners need fatigue-resistant fibres with many
mitochondria relying on aerobic catabolism of glucose and fatty acids.
Page 33 of 55

Book 3 Body Systems
Chapter 1 The Kidney
Functions:
Clean the blood by removing excess fluid, minerals and waste products
Regulate blood pressure
Secrete hormones involved in the maintenance of healthy bones and blood
The kidneys take in blood via the renal artery, filter it, reabsorb some of the water and
salts, and return the filtered blood and reabsorbed water & salts back to the main
bloodstream via the renal vein. The unwanted products leave the kidney and are expelled
from the kidney as urine via the ureter.
Each kidney has an outer layer - the renal cortex, a middle layer the renal medulla, and
in inner are the renal pelvis. In each kidney there are about 1 million nephrons, each of
which acts as an independent filtering unit.
The main processes are glomerular filtration, tubular reabsorption and tubular secretion.
Glomerular filtration At the renal corpuscles, about 20% of the blood plasma is filtered.
This includes water, mineral salts, amino acids, glucose and various waste products.
Blood cells, platelets, fatty acids and proteins are not filtered.
Tubular Reabsorption After filtration, passes down the tubule into the collecting duct.
Glucose, amino acids, mineral salts and vitamins are reabsorbed by active transport.
Water is reabsorbed by osmosis. Some ions, metabolites and drugs are also excreted at
this stage.
The volume of fluid filtered in unit time is the glomerular filtration rate (GFR). Typical is
about 180litres/day. The total amount of any substance filtered in unit time is the filtered
load = Concentration * GFR.
Renal function is measured by clearance = volume of plasma from which substance is
completely cleared from the kidney in unit time.
Clearance of X/min = (Amount of X excreted /min)/Plasma concentration of X
Creatinine is neither reabsorbed or secreted, so its clearance = GFR
Glucose is completely reabsorbed, so its clearance = 0.
Autoregulatory mechanisms responding to changes in pressure or flow rate maintain a
relatively constant flow of blood through the kidneys across a wide variation in arterial
blood pressure. The reabsorption of water can also be effected, by increasing the
permeability of the ducts. This is controlled by osmoreceptors in the hypothalamus
Page 34 of 55

responding to changes in osmolarity by secreting more or less ADH, which increases the
permeability of the collecting ducts. Stretch receptors in the cardiovascular system detect
changes in distension of blood vessels and hence changes in blood volume. When
distension is reduced, this also stimulates ADH secretion.
Sodium is the principle ion in extracellular fluid, so an increase in sodium will cause an
increase in osmolarity. This will cause water inside cells to exit through the cell
membrane to equalise the osmolarity. Thus plasma volume and blood pressure will
increase. Sodium levels are regulated by the action aldesterone produced by the adrenal
glands. This increases sodium reabsorption from the collecting ducts by increasing the
sodium transport proteins. Aldesterone also regulates the levels of Potassium reabsorbed
by the kidneys. Finally, the kidneys regulate the pH of body fluids, by changing the levels
of bicarbonate ions in the plasma. These neutralise, or buffer the hydrogen ions and so
reduce the pH.
Urine passes from the kidney to the bladder via the ureter. It is held in the bladder by
internal and external sphincters. As the bladder fills, stretch receptors are stimulated.
These cause contraction of the bladder muscle and signals indicating fullness are passed
to the brain. Once a certain volume is reached, the internal sphincter is opened and the
external sphincter is also relaxed. However, opening of the external sphincter is under
voluntary control. Once both are open, the bladder muscle forces urine out of the urethra.
The kidneys are also involved in calcium homeostasis. When calcium levels are low,
parathyroid hormone is secreted. This increases the reabsorption of calcium by the
kidneys, increases calcium release from bone and activates vitamin D, which increases
calcium absorption from the gut.
High blood pressure is treated by diuretics, which increase the amount of water excreted
by inhibiting sodium reabsorption.
Kidney disease can be treated by dialysis, where blood is diverted through tubing
immersed in dialysing fluid, which acts as an artificial kidney.
Page 35 of 55

Book3 Chapter 2
Circulation
Oxygen combines with glucose to provide energy for cell processes that allow work such
as muscular activity, digestion and brain activity to be carried out. The production of
energy results in carbon dioxide as a by-product. This would be toxic if allowed to
accumulate in the body. The combined circulatory and respiratory systems ensure the
efficient transfer of oxygen into the body and carbon dioxide out of the body.
The circulatory system also transports white cells and antibodies which attack invading
organisms. It is divided into 2 parts, the cardiovascular system and the lymphatic system.
The cardiovascular system is a closed system comprising a fluid (blood), a pumping
device (the heart), and a system of pipes (the vasculature)
Blood comprises red cells (erythrocytes), several types of white cells (leukocytes) and
platelets, all suspended in a liquid called plasma, which is 95% water, plus proteins, ions,
nutrients, hormones, gases and waste products.
Red blood cells live about 120 days and are renewed continuously. This is initiated by the
hormone erythropoetin, which stimulates the proliferation of precursor cells in red bone
marrow. They contain the protein haemoglobin, which transports oxygen.
Leucocytes (neutrophils, eosinophils, basophils, T & B lymphocytes, macrophages) play
a role in the bodys immune system. They are the mobile units of the bodies defence
against infection & disease.
Platelets maintain the integrity of the walls of blood vessels and are involved in the
control of bleeding.
Anaemia is a reduction in the capacity of red blood cells to carry oxygen.
Iron deficiency anaemia Erythrocytes have low haemoglobin content

Pernicious anaemia Lack of B12 leading to reduced production of erythrocytes
Haemorrhagic anaemia due to severe blood loss
Haemolytic anaemia Erythrocytes rupture
Sickle Cell anaemia faulty gene gives different haemoglobin
Leukaemia is a cancer of the bone marrow with proliferation of immature or abnormal

white cells inability to fight infection.
Erythrocytes possess inherited antigens (unique surface recognition molecules) that
define the blood group of an individual. If a person is given a blood group of
incompatible type, adverse antigen-antibody reactions occur, leading agglutination and
blocking of blood vessels.
Page 36 of 55
Type A blood has A antigens, anti-B antibodies

Type B blood has B antigens, anti-A antibodies
Type AB blood have both A & B antigens, No antibodies
Type O blood do not have either A or B antigens, but anti-A and anti-B antibodies
Antigens of donor must be compatible with antibodies of recipient
Type O blood is the universal dOnor
Type AB blood is the universal recipient
As well as the ABO system, 85% of people have the Rh antigen, and are called Rhesus
positive. The remainder are called Rhesus negative. Rh-negative people should not be
given Rh-positive blood, as they may produce antibodies against it.
Heart Operation
Blood Flows from:
Superior Vena Cava to
Right Atrium, which contracts, forcing blood through
Tricuspid Valve into
Right Ventricle, which contracts, forcing blood through
Semi-lunar valve into
Pulmonary Artery, taking it to
Lungs, where the blood absorbs oxygen and passes into
Pulmonary Vein. The blood then passes into the
Left atrium, which contracts, forcing blood through
Bicuspid valve into
Left Ventricle (the major pump), which contracts, forcing blood through the
Semi-lunar valve into the
Aorta, which transports the oxygenated blood to the rest of the body
The heart is encased in a fluid-filled sac called the pericardium, attached to the
connective tissue separating the lungs.
The Vasculature
Oxygenated blood flows from the left ventricle arteries to arterioles to capillaries, where
exchange of gases takes place by diffusion, to venules, to veins, to the right atrium. Blood
is pumped by the heart as an advancing pulse wave. Contraction of muscles helps return
the blood. One way valves prevent backflow in the veins. Sympathetic nerves using
noradrenaline cause contraction of the smooth muscles of the arteries or veins,
constricting them; Parasympathetic nerves using acetylcholine dilates them.
Page 37 of 55

Cardiac Output = Stroke Volume * Heart Rate = Volume pumped out per minute.
Systolic pressure = Max pressure
Diastolic pressure = Minimum pressure
Exercise increases the blood pressure and the stroke volume, as the muscles squeeze and
contract the blood vessels running through them.
Factors influencing cardiac output are given in the table below:
Factor
Effect
Sleep
Moderate changes in environmental
temperature
High environmental temperature
Anxiety & Excitement
Eating & Digestion
Exercise
Pregnancy (late)
Sitting up or standing (initial effect)
Rapid arrhythmia
Heart Disease
No change
No change
Increase
Increase (50-100%)
Increase (30%)
Increase up to 70%
Increase
Decrease (20-30%)
Decrease
Decrease
Changes in blood pressure are monitored by baroreceptors in the walls of the carotid
artery and aorta. Information is sent to the brain which stimulates the vagus nerve by
parasympathetic nerves using acetylcholine to decrease heart rate, or stimulates the SAN
by sympathetic nerves using noradrenaline to increase heart rate.
2 coronary arteries provide blood supply to the heart.
Blood to the brain is supplied via the carotid arteries and the vertebral arteries. The circle
of Willis is a circle of arteries supplying blood to the brain so that if a blockage occurs
anywhere in the circle, the blood can still be delivered to the brain.
The capillary networks that supply blood to the brain are specially adapted to create the
blood-brain barrier, which tightly controls what substances can enter the brain.
The circulation within fingers, toes, palms and earlobes has special shunts connecting
arterioles with venules, bypassing the capillaries. When body temperature increases,
vasodilation occurs, particularly in the shunts, so that flow of blood to the skin increases,
increasing heat loss.
Circulation Problems
Page 38 of 55

Non-drug therapies to treat high blood pressure include stopping smoking, weight
reduction, salt restriction, increased aerobic exercise. The first-line drugs are betablockers. These reduce the stimulating action of noradrenaline by selectively blocking the
receptors. Vasodilators reduce blood pressure by decreasing vasoconstriction.
Coronary Heart disease is caused by atherosclerosis of the coronary arteries, a gradual
narrowing of the arteries due to plaque (lipids, cellular debris & calcium salts) formation,
thus reducing the delivery of oxygen to cardiac muscle. Symptoms include angina (chest
pain) to heart attack, where a region of the heart muscle dies.
In congestive heart failure, cardiac output is insufficient to perfuse the body, caused by
CHD or high blood pressure. Treatment is by diuretics to reduce blood volume or
vasodilators.
Haemostasis, the process that stops bleeding, involves platelet aggregation and bloodborne chemicals involved in a chain of reactions that ultimately converts fibrinogen (a
plasma protein) into a fibrin net that captures erythrocytes to produce clots.
Haemophiliacs lack an essential blood-clotting factor a genetic condition.
A stroke occurs when the flow of blood to part of the brain is stopped for a period of
time. It can be due to blockage or rupture of a blood vessel. Predisposing factors are high
blood pressure, smoking, heart disease, obesity, high cholesterol, diabetes or stress.
Clot-busting drugs are used to treat thromboembolism. They may inhibit platelet
aggregation, stop the conversion of fibrinogen to fibrin, or rapidly dissolve clots.
Deep vein thrombosis is where blood clots develop in the veins of the legs due to poor
circulation.
A fall in blood pressure (hypotension) may occur as a result of circulatory shock. This
can be:
Hypovolaemic Sudden loss of blood

cardiogenic heart cannot pump enough blood
Vasogenic Due to vasodilation
Neurogenic Reduction in sympathetic nerve activity.
Page 39 of 55

Book 3 Chapter 3
Respiration
External Respiration The exchange of oxygen & CO2 from the body
Cellular respiration Oxygen + Glucose = CO2 + Water + ATP (Energy)
Main Organs The lungs, airways that deliver the air to the blood vessels of the lungs
Musculo-skeletal system that ventilates the lungs
The Respiratory System
Air enters the body through the nostrils into the nasal cavities. It is filtered by mucous &
cilia & warmed (Air through the mouth is not filtered or warmed). It then joins air from
the mouth at the pharynx (opening at the back of the throat). Here there are 2 openings,
one to the larynx and respiratory system, one to the oesophagus. A flap of tissue, the
epiglottis, closes the larynx during swallowing, to prevent food entering the respiratory
system. If this fails, the cough reflex occurs, expelling unwanted particles. From the
larynx, air passes into the trachea or windpipe. This divides into 2 tubes called bronchi.
These divide into finer & finer tubes bronchioles & terminal bronchioles (the
conducting zone, with mucus and cilia), then respiratory bronchioles, alveolar ducts and
alveoli (the respiratory zones). The conducting zone conducts gases to & from the
exterior; the respiratory zone performs the gas exchange. The repeated branching is to
increase the surface area for gas exchange.
The alveoli are surrounded by pulmonary capillaries. Oxygen diffuses from the alveoli
into the capillaries, while CO2 goes in the opposite direction.
The lungs are located within the chest cavity, formed by the chest wall of the ribcage, the
sternum and the diaphragm. Thin membranes cover the lungs and the inside of the chest
wall. Fluid separates the 2 membranes. The outer membrane attaches to the chest wall,
the inner layer adheres to the lungs. When the chest wall expands, surface tension means
that the lung pleura and hence the lungs themselves, will also expand.
On contraction, the diaphragm moves downwards, increasing the volume, the pressure
falls and air enters the lungs, on relaxation, the pressure rises and air is expelled.
Oxygen in the alveoli diffuses into the surrounding capillaries. CO2 diffuses into the
alveoli. This is due to differing partial pressures (i.e. concentrations of gases) between the
two.
Oxygen binds to haemoglobin (contains 4 iron ions which picks up 4 oxygen molecules),
forming oxyhaemoglobin. However the reaction can go in either direction. When oxygen
Page 40 of 55

is plentiful, e.g. in the capillary aleveoli, oxygen binds; when it is low, e.g. in the tissue
capillaries, oxygen is released.
Increased temperature and acidity decrease its affinity for oxygen.
CO competes with oxygen for haemoglobin, and CO binds more strongly, forming
carboxyhaemoglobin, preventing oxygen being made available to the cells.
CO2 is carried in the blood mainly as bicarbonate ions or carbonic acid. Some attaches
to haemoglobin and some is dissolved directly in the plasma. Again, the exchange is due
to concentration differences between the erythrocytes and the tissue cells.
Respiration is controlled by the respiratory centre in the brain, which modulates the
activity of inspiratory and expiratory neurons. Separate areas of the brain are responsible
for automatic control via the ANS, and voluntary control via the SNS. The respiratory
centre receives information from stretch receptors in the lungs, which inform the brain
when the lungs are fully expanded, and from chemoreceptors, which monitor the pH and
oxygen content of the blood.
The respiratory system performs additional functions such as speech, smell,
thermoregulation, defence against inhaled particles and the facilitation of blood flow (fall
in pressure in chest cavity reduces the resistance of blood vessels)
Diseases affecting the lungs
Pneumonia The alveoli filling with fluid
Respiratory Cancers
Asthma Narrowing of the airways and overproduction of mucus. Treat with
bronchodilators or corticosteroids.
Bronchitis Inflammation of the bronchioles
Emphysema Collapse of alveolar walls
Chronic Obstructive Pulmonary Disease Progressive, irreversible lung disease
The smoke from a cigarette contains over 4000 chemicals, including nicotine, CO, tarn
cadmium etc.). Heavy smokers have raised levels of CO; tar irritation causes chronic
bronchitis, where the air passages become repeatedly inflamed. This can lead to
emphysema. The walls of the airways thicken, building up scar tissue, reducing the
efficiency of lung function. Lung cancer, caused by both nicotine & tar, leads to
uncontrollable tumours.
Interaction of heart & lungs
Page 41 of 55
Increase on oxygen requirements, e.g. during exercise, will lead to increase in heart rate
& respiration rate. Many of the sensors that monitor these, such as baroreceptors and
chemoreceptors, lead to adjustment of both. The SAN receives parasympathetic inputs
from the vagus nerve, reducing the heart rate (vagal restraint). As we breathe in, heart
rate goes up, and down as we breathe out (sinu arrhythmia). This is due to stretch
receptors in the lungs linking to both the respiratory and the heart centres of the brain via
the vagus nerve. There are baroreceptors (blood pressure sensors) and stretch receptors in
the walls of the aorta and carotid arteries. These arteries also contain chemoreceptors that
sense the level of oxygen in the blood. Information from all these sensors passes both to
the cardiac and respiratory centres. For example, if the barocentres sense an increase in
blood pressure, there would be an increase in firing from the barocentres to the cardiac
and respiratory centres, causing an increase in parasympathetic activity of the vagus
nerve to the heart, and hence a decrease in heart rate. A decrease of sympathetic activity
would decrease the stroke volume. The respiratory centre would initiate a decrease in
ventilation.
Adjustments during exercise
Anticipatory
Release of adrenalin, increasing strength of heart contraction.
Vasoconstriction of arterioles increases arterial blood pressure
Vasoconstriction of venous system increases venous return, increasing stroke volume &
cardiac output.
Onset
Vasodilation of muscle blood vessels, to increase blood flow through the muscles.
Increased use of oxygen & release of CO2 is detected by chemoreceptors which causes
the rate of ventilation to be released. Fall in pH caused by increased CO2 causes quicker
release of oxygen. Stretch receptors in the muscles inform the respiratory centres of the
need for increased respiration. Muscle cells begin to respire anaerobically using
glycogen. Lactic acid builds up and this also increases the delivery of oxygen. If the
oxygen can break down some lactate to release energy, can get a second wind.
Adjustment to High Altitude
Partial pressure of oxygen decreases with altitude. Again, lower oxygen detected by
chemoreceptors. Cardiac output increased, ventilation maximised, and increase in blood
volume, blood vessels and number of red blood cells.
Adjustments during diving
Deep sea divers need to breathe in air at higher pressure, to prevent the lungs collapsing.
this forces nitrogen through the alveoli. On quick surfacing, the pressure is reduced, and
Page 42 of 55

the nitrogen can come out of solution, forming bubbles in the blood and tissues
(Decompression sickness or the bends). They can tear tissues or block blood vessels or
damage nerves.
When submerged, humans show a diving response whereby heart rate slows and oxygen
in the blood is only pumped to vital organs.
Page 43 of 55

Book 3 Chapter 4 Immunology
Antigen Any macromolecule, cell or organism that triggers an immune response
Pathogens An organism that can cause disease e.g. bacteria, virus, fungi, parasite
Leukocytes, Erythrocytes & Platelets originate from precursor cells in bone marrow
Innate Immune System
The response to pathogens & their products of all types of leukocyte apart from small
lymphocytes; these cells & their defensive mechanisms do not require contact with
antigens before they develop, and do not adapt following contact with an antigen.
Non-cell-based defences are:
Physical barriers such as skin and gut lining offer some protection
Chemical defences e.g. saliva
Lysozyme and complement attack bacterial cell walls
Interferons suppress protein synthesis around viral infections
The principal cell-mediated mechanisms of the innate immune system are:
Phagocytosis pathogens engulfed by neutrophils & macrophages
Cytotoxicity Membranes of target cells damaged by chemicals released from

eosonophils & NK cells
Inflammation Caused by chemicals released from mast cells and eosonophils

and by components of the complement cascade. It involves swelling, redness and
heat as plasma & leukocytes leak out of blood vessels into an infection site.
Adaptive Immune System (or specific immune system)

These rely on the small lymphocytes (T cells & B cells)
The response of the small lymphocytes to pathogens.
These cells require contact with an antigen before they develop their defensive
mechanisms. Following contact, they become increasingly effective at eradicating the
antigen.
Page 44 of 55

Antigens have small areas in their structures called epitopes, which do not occur in the
host animal. Small lymphocytes circulate around the blood and lymphatic system,
carrying antigen receptors with binding sites that fit epitopes.
On the first encounter with an antigen, the few small lymphocytes with complementary
antigen receptors bind to its epitopes (clonal selection)
During the primary adaptive response, the selected lymphocytes undergo clonal
expansion & differentiate into defensive cells, which eliminate the antigen & then die,
and memory cells, which survive to form an expanded clone.
This clone responds more effectively to a subsequent attack by the same antigen.
B-cells can differentiate into plasma cells, which release specialised proteins called
antibodies with binding sites for the same antigen that provoked the immune response.
Page 45 of 55

Book 4 Lifes Challenges
Chapter 1 - Diversity and Change
Sources of Variation
Gene Mutation
Point mutation Error in copying a single Base
e.g. sickle cell anaemia extra protection against anaemia, but red blood cells distorted
and different form of haemoglobin cannot carry oxygen as efficiently. Also, sickle shape
of blood cells leads to blockages.
Frame Shift Mutation Nucleotide omitted, can lead to complete loss of function of the
resulting protein.
Meiosis
We have 23 pairs of chromosome, 1 set from each of our parents. Meoisis occurs in the
ovaries and testes, producing 4 haploid cells called gametes (sperm or ova), each with
just 23 chromosomes.
Each chromosome replicates and 2 individual strands become visible

Homologous chromosomes pair up
Recombination of alleles takes place
Cell divides into 2 & independent assortment takes place (i.e. whole
chromosomes swap over)
The chromosomes separate into single chromosomes
Each cell divide into 2 giving 4 daughter cells
Men normally have XY genotype, women have XX, so sperm can have either X or Y,
ova must have X.
Errors in meiosis can produce chromosome abnormalities e.g. XXY genotypes
(Kleinfelters syndrome).
Thrifty Phenotype Hypothesis
Poor foetal nutrition leads to adaptive changes in physiology that prepare an adult for a
life of poor nutrition.
Obesity
Using whole room indirect calorimetry, it has been found that humans are not good at
recognising the difference between low & high energy diets. This may because we are
adapted to survive in a very different environment to the one currently prevailing in
Page 46 of 55

developed countries. Also fat is less good at inducing satiety than carbohydrate or
protein.
Palatable foods appear to stimulate the mesolimbic dopamine system. Obese individuals
have lower dopamine receptors in this system, but it is not known whether this is cause or
effect.
Increased weight with age may be due to reduced activity, decreased metabolic rate or
cultural eating habits.
Some racial groups may have a genotype that promotes increased fat storage because it
gives a survival chance in famine. However, in Westernised societies, it could predispose
them to obesity and type 2 diabetes. This is called the thrifty genotype hypothesis.
NB Thrifty phenotype shows how environmental trigger can cause obesity; thrifty
genotype shows how genetic difference can cause obesity.
Sometimes, obesity is caused by gene defects e.g. the inability to produce leptin, a
hormone which suppresses appetite.
Treatments include dieting, increased exercise, and cannabinoid antagonists.
Adipose Tissue
Consists of individual fat cells (adipocytes) containing lipids, together with connective
tissue, and innervation from the sympathetic nervous system.
Functions
Produces leptin to suppress appetite
Energy store to be used when low energy availability or during exercise
Homeostasis of fatty acid levels in muscles and liver
Ageing
Decreased elasticity of collagen has a number of effects:
Skin loses its firmness and begins to sag or wrinkle.

Wound healing is less effective
Filtration properties of the kidney are less effective
Reduced ability to fill out and empty the lungs
Decline in cardiac output->poorer supply of oxygen to tissues->decline in
function of temperature receptors make it harder to regulate body temperature.
Page 47 of 55

Water content of connective tissues reduces e.g. skin dries out
Cataracts
The cause of decreased elasticity is a consequence of cumulative cross-linking of
collagen molecules (glycation), particularly prone to occur when glucose levels are high.
Age-related deterioration may be beyond the reach of natural selection because they
occur well after reproduction has started, so the genes have already been passed on.
The menopause may be adaptive in preventing women from undertaking pregnancies
throughout their lives. Without the menopause, the last born might not have their mothers
around long enough to rear them. Also, the menopause may give women a period when
they can pass on their skills to relatives.
Page 48 of 55

Book 4 Chapter 2 Sleep
Circadian Rhythm An intrinsically produced rhythm that has a period of approximately
24 hours. (Shown by people in underground bunkers with all time cues removed still
having a 24 hour rhythm.)
Body temperature has a circadian rhythm
M-types alert in morning; Lowest temperature 3:50
E-types alert in evening; Lowest temperature 6:00
Neither gave lowest temperature at 5:00
Secretion of melatonin (hormone secreted by pineal gland) has circadian rhythm; levels
higher in blood during night time. Receptors in SCN in hypothalamus connected to light
sensors in retina, switches off melanin production when light intensity high. Melatonin is
involved in the control of seasonal breeding and hibernation of animals and is thought to
play a role in controlling human sleep. Humans given melatonin become sleepy. More is
secreted during winter and this may be connected to Seasonal Affective Disorder.
Adenosine increases during the day and causes drowsiness (blocked by caffeine &
nicotine). It is broken down during the night.
Sleep can be divided into REM sleep & non-REM sleep. Non-REM occurs early, REM
more at the end.
The timing and duration of sleep are controlled by a biological clock, located in the SCN.
Larks have period just under 24 hours; Owls have period over 24 hours. Shown by
experiment above, and by jet lag.
As we age, we sleep less, but take more naps during the day. Napping serves to augment
night-time sleep and improve performance. The proportion of REM sleep declines with
age. Micro-naps (< 5 mins) are not premeditated. Often unaware of it, which can be
serious. e.g. accidents.
Functions of sleep
Conserve energy (& keep out of harms way ancestral function)
Allow brain to recuperate
Maintain homeostatic equilibrium
Facilitate tissue repair
Help immune system (?)
Consolidate memory (?)
Sleep Disorders
Page 49 of 55

Persistent Insufficient Sleep Originally treated by barbiturates, but side effects e.g.
impair daytime performance & addictive. Later benzodiazepanes, but stimulate REM
sleep. CBT can be effective.
Sleep Apnoea Pause in breathing over 10 seconds. Treat by monitoring & lifestyle
changes.
Narcolepsy Tendency to fall asleep during the day treat with Ritalin
Shift work constitutes a health risk - more likely to get heart attacks & breast cancer
(Decreases production of melatonin, but melatonin switches on GnIH, so more oestrogen
produced, which increases chance of cancer.)
Page 50 of 55

Book 4 Chapter 3 Stress
The stress response A standard set of physiological responses, including the release of
cortisol, adrenalin and noradrenalin, and an increase in heart rate, that is brought about by
the perception of a threat or challenge. It is a common pathway linking many different
environmental or psychological events (noise, heat, restraint, change of environment,
predators, overcrowding, isolation, aggression), with many different physiological
outcomes (weight loss, ulcers, heart disease, immune suppression, loss of sexual function,
memory loss)
A stressful situation is called a stressor.
On detection of a stressor, the sympathetic nervous system releases noradrenaline causing
the heart to beat faster. It also causes the arteries to narrow and increases ling capacity. It
also causes the adrenal glands to release adrenalin, stimulating heart rate, acting as a
bronchodilator, reducing the motility of the gut. It also promotes the mobilisation of
glucose reserves; i.e. it prepares the body for fight or flight. Cortisol is also released from
the adrenal glands via signals from the hypothalamus-anterior pituitary axis. This causes
the breakdown of glycogen into glucose, and also appears to transiently enhance immune
system activity. Endorphins are released from the pituitary gland these blunt pain.
Distressing events are remembered more accurately than neutral events, possibly because
of the stress response tested by using beta-blockers, which blocks the receptors for
adrenalin and noradrenal; in this case there was no difference. Consumption of glucose
around the time of memorising a stimulus improves the memory for that stimulus.
So the immediate effects of stress are :
Increase rate of circulation of the blood

Increase blood-glucose level
Stop digestion
Stop reproductive activity
Blunt sensitivity to pain
Getting the immune system ready
Making the mind alert and ready to learn
But it uses up a lot of energy, and other processes have to be shut off.
However, long term stress :
Reduces immune system functioning and increases susceptibility to infection

Increases the risk of heart disease by hastening the formation of artherosclerotic
plaques
Can cause stomach ulcers More chance of H Pylori causing problems
Suppresses reproductive function
Page 51 of 55
Can cause loss of neural connections in the hippocampus and associated loss of
memory function
These are due to the effects of cortisol and the suppression of stomach acivity
Key mediators for stress are:
Predictability
Control
Outlets for frustration
More privileged social groups tend to have better health & longer life
Social support also helps to prevent stress-related disease
There are differences between individuals e.g. type A individuals are more prone to heart
disease
Stress can be managed by reframing the problem to emphasize aspects that can be
controlled.
Cortisil-like hormones are often used to treat auto-immune diseases like Graves disease.
Page 52 of 55

Book 4 Chapter 4 A Healthy Baby
Male Reproductive System
Comprises 2 testes, a prostate gland, and a duct system culminating in the penis.
Each testis is made up of large numbers of coiled seminiferous tubules, within which
sperm production occurs. Division of stem cells initiates spermatogenic cycles.
..
Fertilisation
The first sperm cell that penetrates the ova fertilises it, and no other sperm can then
penetrate it. The sperm tail is lost, which means that no paternal mitochondria are
transmitted to the offspring. One set of the maternal chromosomes is discarded as the 2nd
polar body. So the zygote now has 2 haplois pronuclei, one from the oocyte, one from the
sperm. The pronuclear membranes break down, and mitosis takes place. The embryo
remains in the fallopian tube for 3 days and undergoes mitosis, but no change in size, so
the size of the cells (blastomeres) decreases (cleavage). Then the embryo moves to the
uterus, wherecell division continues so that by 4.5 days there are 32-64 cells , when the
cells form a ball enclosing a cavity (a blastocyst) If the embryo splits into 2 during
cleavage, identical twins are produced. If 2 separate oocytes are fertilized by separate
sperm, non-identical twins are produced.
An ectopic pregnancy is where the embryo remains in the fallopian tube, and develops
into a blastocyst which implants in the wall of the tube. This is dangerous as the tube
could rupture, with internal bleeding causing hypovolaemic shock. Need to remove the
fallopian tube and the embryo.
Infertility in women
Female infertility due to blocked fallopian tubes can be detected by injecting a
radioactive dye into the uterus. Leakage into the abdominal cavity indicates open tubes;
dye remaining in the uterus indicates blocked tubes.
Blocked tubes are caused by scarring & adhesions caused by Chlamydia or Gonorrhea
that cause pelvic inflammatory disease. If surgery to clear tubes is ineffective, in vitro
fertilisation (IVF) is recommended.
To increase the number of available follicles, the patients own menstrual cycle is shut
down using a GnRH agonist (causes down regulation, so FSH and LH production
stopped.) FSH injections are then given to stimulate growth of up to 10 follicles. When
they have reached an optimum size, hCG is given to minic the effect of LH and stimulate
the follicles, which can then be harvested into a dish of warm culture medium.
Progesterone is then administered to the patient, to allow successful implantation. The
male partner is asked to produce a sperm sample by masturbation. They are washed to
Page 53 of 55

mimic uterine capacitation and then mixed with the oocytes. If fertilization has taken
place, they are transferred to the womans uterus 48 hours after collection, when they are
4-8 cells.
Disorders of Ovulation
Amenorrhea (Lack of cycles) & Oligomenorrhea (infrequent cycles)
Treated by drugs (Clomiphene) that stimulate the anterior pituitary to release FSH. May
first give birth control pills to induce cycles. If clomiphene does not work, inject with
FSH until follicles mature, then inject with hCG to induce ovulation. But side effects can
occur.
Polycystic Ovarian Syndrome Here, the ovaries contain numerous small immature
follicles and many cysts, producing large amounts of testosterone. Fertility treatment may
be successful.
Premature menopause can be treated by IVF using donated egges. The infertile recipient
takes oestrogen and progesterone to prepare the uterus for implantation.
Infertility in Men
Oligospermia (low sperm count) or Aspermia (No sperm)
May be caused by deficient production or blocked transport.
Temporary oligospermia may be caused by dietary deficiency, excess alcohol or X-rays,
increased scrotal temperature due to tight-fitting pants.
Chemical pollutants, especially by chemicals similar to oestrogen, can cause low sperm
counts.
IVF can be used to treat male fertility when counts are low. Sperm of normal appearance
are collected and mixed with oocytes. A hole may be drilled in the zona to facilitate
sperm penetration. For aspermia, if sperm can be collected, they may be injected beneath
the zona or a single sperm injected directly into the oocyte cytoplasm.
Following IVF pre-implantation, screening and genetic diagnosis can be used to identify
healthy embryos for transfer to a recipient.
A Healthy Baby
During pregnancy, a healthy diet & avoidance of alcohol, smoking, unprescribed drugs
and environmental pollution increase the chance of a healthy baby.
Page 54 of 55

Human Genetic Diseases include cystic fibrosis sticky mucus affecting lung function,
enzyme secretion by pancreas blocked, preventing digestion.
In late pregnancy, changes in lungs prepare the baby for breathing air. Closure of vacular
shunts in the blood circulation system divert a new born babys blood circulation from
the placenta to the lungs.
The Apgar score is a simple identification of babies with problems, based on heart rate,
muscle tone, reaction to pinching nose, colour.
Page 55 of 55

SK277 Revision Notes

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

SK277 Revision Notes

Uploaded by

Copyright:

Available Formats

SK277 Revision Notes

Book 1 Cells and Nutrition