# A-level Biology/Human Health and Disease/gaseous exchange

The gaseous exchange system has four functions:
* Maximise the surface area for diffusion of oxygen and carbon dioxide between the blood and atmosphere.
* Minimise the distance for this diffusion, and maintain adequate concentration gradients for it.
* Clean and warm the air that enters during breathing.

# Breathing

Mammals inhale and exhale air containing oxygen. Blood absorbs this oxygen in the lungs and is then transported around the body.

### Trachea, Bronchi and Bronchioles

Air for the lungs enters the body through the nasal cavity, which leads into the trachea. At the base of the trachea, it breaks into two bronchi which further sub-divide and branch, forming a bronchial 'tree'. Cartilage in the trachea and bronchi keep the airways open and prevent them from collapsing. The trachea has a regular arrangement of c-shaped cartilage, whereas the bronchi have irregular blocks of cartilage. The smaller bronchioles can relax using their surrounding smooth muscle, this is useful during exercise to allow a greater flow of air.
Airways in the human body have mucus lining them which helps to catch pathogens and other foreign material entering the body through the air passages. In the trachea and bronchi, it is the goblet cells of the ciliated epithelium that produces this mucus. Mucus is a slimy solution containing glycoproteins. Glycoproteins are able to trap inhaled particles e.g. pathogens and dust. Chemical pollutants such as sulphur dioxide can dissolve in the mucus to form an acidic solution that irritates the airways. The nasal passages have tiny hairs lining them as well.
Macrophages, phagocytic white blood cells patrol the surfaces of the airways remove particles such as bacteria.

## Lungs

The lungs provide a large surface area for gaseous exchange to take place. The lungs are surrounded by the pleural membranes which contain pleural fluid which allows friction-free movement. This ensures the lungs can be moved by the diaphragm and the ribs (the action of breathing).

### Alveoli

Alveoli have a very thin epithelial lining and are surrounded by many blood capillaries that carry deoxygenated blood. They provide a short distance and a large surface area over which oxygen and carbon dioxide can be exchanged. They also contain elastic fibres which expand to allow air in and recoil to help force out air. Alveoli must be kept moist to allow gasses to diffuse, this is done by a fluid produced by the wall of the alveoli. The surface tension of this fluid must be low else the alveoli may not expand when air is inhaled. To prevent this, the fluid contains a surfactant (a detergent like substance), to reduce surface tension.

### Breathing Rate

Changing the depth and rate of breathing enables us to adjust our intake of oxygen and exhalation of carbon dioxide to suit our level of activity. At rest, we require on average 6.0dm$^3$ per minute, and about 0.35 dm$^3$ enters the alveoli with each breath.
The lungs cannot be emptied of air - at least 1.0dm$^3$ of air will always remain, and is known as the residual volume.
* Tidal volume - the volume of air breathed in and out in a single breath
* Breathing rate - breaths per minute
* Ventilation rate - tidal volume x breathing rate
* Vital capacity - the maximum volume of air that can be breathed in and then out again.
Lung volume changes can be measured by a spirometer.

# Heart Rate

During exercise, heart rate must increase to provide more oxygen to muscles and expel carbon dioxide faster.

## Pulse rate

The stroke volume from the heart is defined as the volume of blood pumped out from each ventricle during each contraction, and per minute it is called the cardiac output. The pulse is the wave caused by the stretch and subsequent recoil of the aorta, and moves all along the arteries, and is identical to the heart rate. A high stroke volume and a low resting pulse is an indication of aerobic fitness, as it only requires a small increase in pulse to achieve a much larger blood supply required for heavy exercise.

## Blood pressure

When the left ventricle contracts to force oxygenated blood out of the heart, the maximum arterial pressure during this process is known as the systolic pressure - the pressure at which the blood leaves the heart. The minimum pressure is the diastolic pressure, and it reflects the resistance of the small arteries and capillaries. This can be due to hardened arteries from atherosclerosis. Typical blood pressure is 120/80 mm Hg.

### Hypertension

Hypertension is the condition in which both systolic and diastolic blood pressures are high at rest, and the heart is working too hard. In the short term, high blood pressure occurs because of contraction of smooth muscles in the walls of small arteries and arterioles, which is a result of the hormone noradrenaline. This hormone stimulates arterioles to contract therefore increasing the resistance, forcing the heart to work harder.
However, long term hypertension imposes a strand on the cardiovascular system and is not fully explained. If not correct, it can lead to heart failure. It has been closely linked to;
* excessive alcohol intake
* smoking
* high salt levels in the diet
* genetic predisposition
* obesity

# Energy and Exercise

ATP, as you will remember is the energy currency for all cells - muscles need it as well, but cannot store large amounts of it, and thus it is soon exhausted during exercise. Muscles will release will utilise chemical potential energy in other molecules to make ATP for exercise that lasts longer than this. These sources include glycogen breaking down to glucose in the muscles, liver stores of glycogen being converted to glucose and fatty acids in the blood from fat stores in the body.

## Respiration

Respiration is the process by which new ATP is produced, and there are two forms. If there is enough oxygen, aerobic respiration occurs, where glucose, fatty acids and oxygen are broken down to form carbon dioxide and water, releasing a lot of energy in the process - some is converted to ATP, the rest is lost in heat.
This respiration usually occurs in mitochondria, with the oxygen coming from two sources - oxyhaemoglobin in the blood and oxymyoglobin store in muscle. Oxyhaemoglobin readily dissociates and releases oxygen which diffuses into muscle tissue, some is used immediately by the mitochondria, some is kept by myoglobin which acts as an oxygen store since it has a higher affinity for oxygen, thus will only release it when oxygen levels in the muscle cells is very low.
Mitochondria can not function efficiently in anaerobic conditions, but glucose can still be respired to make ATP, forming lactate in the process.

## Aerobic exercise

Any exercise powered by aerobic respiration is called aerobic exercise. With training, the lungs and heart become better at oxygenating the blood and transporting it around the body.

### Changes

All the changes listed below are used to more efficiently supply the body with oxygen where it needs it the most during exercise.
Just before exercise
* Adrenaline - Causes heart and ventilation rates to increase
* Arterioles in your skin and gut constrict and those in your muscles dilate
* Glucose is released from the liver and fatty acids are released from fat stores.
During exercise
* Energy demand increases steeply as your muscles use up their supply of ATP
* The limited supply of oxygen forces your muscles to respire anaerobically, producing lactate.
* Lactate diffuses into the blood along with carbon dioxide, stimulating the arterioles to dilate further and increase blood flow to the muscles.
* Adrenaline stimulate the bronchioles to widen, reducing air resistance.
* Output of blood from your heart also increases.
* The Bohr effect allows oxyhaemoglobin's oxygen to dissociate better.

### Training

During aerobic exercise, especially if somebody starts rapidly, it can take up to four minutes for their heart and lungs to reach the oxygen demand placed on them by the muscles - and an unfit person may never be able to reach the demand and have to stop. During the time it takes for the heart and lungs to catch up, the person builds up an oxygen deficit, otherwise known as an oxygen debt - and the heavy breathing after exercising is 'paying off' that oxygen debt. It does the following;
* Respiration of the lactate produced (done in the liver)
* Reoxygenation of haemoglobin in the blood
* Reoxygenation of myoglobin in the muscles
* High metabolic rate, as the whole body is operating at above resting levels.

## Aerobic Fitness

There are a variety of factors that affect aerobic fitness.
* Initial level of aerobic fitness
* Intensity of training
* Duration of training
* How often the training occurs

### Benefits of aerobic fitness

Health benefits
* Loss of weight
* Improved infection resistance
* Slows down atherosclerosis
* Improvement in balance and strength
* Reduced chance of lower back pain
* Exercise releases endorphins which improve mood
* decrease in cholesterol concentration
* Reduced risk of osteoporosis, coronary heart disease and strokes
* Reduces hypertension
Muscles
* Increase in muscle size (including muscle fibres)
* Increase in capillaries - shorter diffusion for oxygen to muscles
* Increase in mitochondria
* Increase in myoglobin
* Increase in glycogen and fat in muscles
* Increase in respiratory enzymes
Cardiovascular Fitness
* Increase in stroke volume
* increase in cardiac output
* Increase in heart beat power
* Increase in heart size
* Decrease in resting blood pressure
* Decrease in resting heart rate
Respiratory Fitness
* Increase in vital capacity
* Increase in tidal volume
* Body 'catches up' with the muscles demand faster