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Homeostasis L1-4

Foundations of Biomedical Science (University of Sydney)

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INTRODUCTION TO BODY SYSTEMS

Why are we alive?

The ability to produce energy is fundamental to life.

ATP is adenosine triphosphate.

 Energy producing chemical reactions is used to attach phosphates to

adenosine.
 When the phosphate is removed from adenosine, energy is released.

ATP   ADP + Pi + energy

Where is the energy used?

It is used in cells throughout the body.

Cells are the fundamental unit of all living things.

In addition to ATP, what do cells need to function?

- An aqueous environment
Not much body fat – 70% of body is water
We could function without all the fat in our body, 50% of protein but will die
without 15% of the water in our bodies but the effects of dehydration kick in
much earlier (less than 2% dehydration can have an effect on performance,
5% it becomes very obvious)
- The correct instructions to control the growth and activity
External controls such as hormones play important roles in this
Cells beside each other influence each other
- The necessary structural elements to enable them to perform their functions
ORGANELLES e.g. mitochondria is responsible for producing the ATP,
abnormalities in mitochondria contribute to development of diseases such as
Alzheimer’s

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- The necessary raw materials to produce ATP and other products

- The correct environment
o available oxygen
o pH
o osmolality, electrolyte concentrations
^ all these levels are similar among people (normal level)

What do multicellular organisms need to live?

A coordinated group of structures that can supply the things cells need to function

- Organelles: specialized structures within cells

- Tissue: a collection of similar cells performing a similar function e.g. muscle
tissue – we have a whole lot of pretty much identical cells which are working
together to form a similar function and we find muscle tissue in other parts of
the body such as legs, airways
- Organ: a structural part of a body system composed of various tissues that
enable it to perform a particular function e.g. heart = muscle tissue, vascular
tissue, nervous tissue
- Body system: a collection of parts that, unified, make a whole
The reason we have these systems is for ATP production

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Checkpoint

1. ATP is the final, universal energy source for cells TRUE/FALSE

True
2. All the cells in the heart are unique to the heart TRUE/FALSE
False, cells themselves aren’t unique but their function is specific to the heart
3. The heart is a tissue TRUE/FALSE

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4. What does endovascular mean?

Inside (endo) blood vessels (vascular)
5. What is myocardium?
Myo – muscle
Cardium - heart
6. What is myometrium?
Myo – muscle
Metrium - uterus
7. Name body systems the cardiovascular system needs to function
Respiratory system: to supply oxygen and remove co2
Digestive system: to supply raw materials to energy production, repair and
growth
Renal system: control blood volume and eliminate wastes
Nervous system: to control blood pressure
Endocrine system: to control blood pressure
Cardiovascular system: to deliver blood to its own tissues
Skeletal system: to protect the vital structures
Brain: to anticipate changes in CVS demands

Manifestations of CVS dysfunction

Symptoms – you can describe e.g. headache

Sign – something that can be measured e.g. blood pressure

1. Angina during exercise.

symptom of restricted blood flow to the heart

Oxygen is required for ATP production but there is a lack of oxygen

Why do people develop angina?

Insufficient blood flow to the myocardium
Aerobic metabolism – uses oxygen
Anaerobic metabolism – still uses ATP but not oxygen, lactic acid is a result and
causes muscle pain
Restricted blood flow and lack of oxygen causes anaerobic metabolism to take place
and the waste (acid) causes the chest pain.

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Why does anaemia cause angina?

Because anaemia means lack of blood (not enough red blood cells which carry
oxygen)
Therefore it decreases myocardial oxygen supply

What happens in a myocardial infarction?

Myocardial blood supply is completely obstructed  as a result of a lack of oxygen
there is cell death.
It comes about when the blood vessels become obstructed – most common way this
happens is damage in the lining of blood vessels (endothelium – tissue inside/lining
blood vessels)
Once endothelium is damaged a clot starts and blocks the artery until eventually
the blood supply is completely cut off.

2. Accumulation of fluid in the lungs.

What is this condition called?

Pulmonary oedema
(increase in amount of fluids surrounding cells in the lungs)
- water is essential but you need to have the right amount

Radiographers routinely X ray for pulmonary oedema – the lungs look cloudy and
heart looks bigger

Why does it develop?

- Excessive leakage of fluid from capillaries – most common reasons:
Due to high pressure in capillaries is too high
if capillaries are excessively leaking due to inflammation causing swelling e.g.
inflammation in your nose makes you feel stuffy cause tissue in your nose is swollen
and this is cause fluid has escaped the capillaries and is sitting in the tissues

- Insufficient drainage of fluid from interstitial space – 2L of fluid a day moves

from capillaries into tissues
It cant just sit there or you would blow up like a balloon
We need to get rid of that fluid (lymphatic system)

What other parts of the body are commonly affected?

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Abdomen – called ascites

Legs/ankles - dropsy

Some of the adverse effects of disease are due to oedema.

The more oedema = the more scar tissue once healed which is NON-FUNCTIONAL

Lymphatic system
The lymphatic system is a 1-way system that returns lymph fluid via vessels to the
cardiovascular system.
Lymph is a fluid derived from blood plasma. (leaked out of blood vessels into the
tissues)
It is pushed out through the capillary wall by

 Capillary blood pressure or

 Osmotic pressure.

The lymphatic system’s main functions are:

 Removal of excess interstitial fluid and proteins and return to the blood
 Absorption of fats and fat-soluble vitamins from the digestive system
 Defense against invading organisms

The lymphatic system consists of:

 Lymph (fluid)
 Vessels that transport lymph
 Organs that contain lymphoid tissue (eg, lymph nodes, spleen)

Organ Function
Lymph Contains nutrients, oxygen, hormones, toxins and cellular
waste products
Lymphatic vessels Transport lymph
Lymph nodes Monitor the composition of lymph; location of immunologic
responses (filtering)
Spleen Monitors the composition of blood components; location of
immunologic responses

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First Aid for snake bite (St John’s Ambulance)

1. Apply a broad crepe bandage over the bite site as soon as possible.
2. Apply a pressure bandage firmly without stopping blood supply to the limb.
Start just above the fingers or toes of the bitten limb, and move upwards on
the limb as far as can be reached.
3. Immobilise the bandaged limb with splints.
4. Ensure the patient does not move.

Inflammation

The cardinal signs:

 Redness
 Pain – in the process of inflammation chemicals are released that sensitize
the nerves
 Swelling
 Heat
 Loss of function

Why does redness develop?

Red area – more blood flow to that area

More blood flow brings the cells that will assist in repair of that area

Why does the area become hot?

More blood flow = increase heat to that area

Why does swelling occur?

Capillaries have become more leaky

Increase of permeability of capillaries so that white blood cells can leave the blood
and go to the surrounding tissue for repair of damage but this also allows water to
escape into the surrounding tissue causing swelling

Some of the adverse effects of injury and disease are due to inflammation.

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First Aid: RICE

Rest, Ice – decrease blood flow to affected area
Compression - increase interstitial pressure
Elevation – decrease venous pressure, increase lymphatic drainage

Why do we use rice

Rest – more we exercise means more blood flow, moving body means using more
ATP whi8ch means produce more ATP which means we need more blood flow
If we have an area of inflammation, we rest it to minimize the blood flow and
minimize oedema

Ice – blood transports heat, skin becomes flushed

Cooling it down decreases the blood flow to that area, we need to change the
distribution of blood within our bodies

Compression – interstitial pressure is the pressure around the vessels, if

we compress this area and increase the pressure it would make it more
difficult for fluid to leak out
Elevation – pressure in the lymphatic system is very low
Gravity helps us drain fluid through the lymphatic system

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HOMEOSTASIS

Why is a blood test useful if we are sick?

Overtime, the composition of our blood Is constant, not much difference between
people
A lot of things in our body are kept under control with similar values within our
species

What happens if blood pressure falls too low?

Wont have sufficient oxygen to the brain – dizzy, faint etc.

What happens if blood pressure gets too high?

progressive damage to our body e.g. cardiovascular system and blood vessels,
damage progresses and can eventually cause a myocardial infarction/stroke

What things are homeostatically controlled?

 arterial PO2 and PCO2

 electrolyte concentrations
 core body temperature
 mean arterial pressure
 blood volume
 blood osmolality

Control of blood pressure is an example of negative feedback: changes in blood

pressure are resisted so that an appropriate blood pressure is maintained.

A homeostatic mechanism enables us to control important variables in the body.

Homeostatic system for blood pressure

 Controlled variable: blood pressure

 Set point: normal/target BP (depending what your body sees as normal e.g.
might be used to high BP)

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 Sensors: baroreceptors – collect info that will be sent somewhere else for
use (sensors do the measuring)
 Afferent pathway: nerves carry the info (A for arriving – info arrives at the
point where its going to be used)
 Controller: cardiovascular centre in medulla (controller is the decision
maker – sends instructions)
 Efferent pathways: autonomic nervous system, hormones (info/instructions
exit)
 Effectors: heart, smooth muscle in vessels (effectors are the workers)

Homeostatic mechanisms are not “on/off”. They usually involve changing the
balance of effectors.

Autonomic nervous system has two parts:

 Sympathetic
 Parasympathetic
2 rules to tell them apart -
1. They are always opposite
2. Any change that helps us when we’re exercising is sympathetic e.g. ^
heart rate when exercising

Increasing sympathetic activity and decreasing parasympathetic increases blood

pressure.
Decreasing sympathetic activity and increasing parasympathetic decreases blood
pressure.

During exercise sympathetic activity increases and parasympathetic activity

decreases.

Controlling body temperature.

Enzymes are temp specific – need to regulate temperature to make sure enzymes
function at their optimum.
If enzymes aren’t working as they should, chemical reactions wont function as they

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should
The body's core temperature is tightly regulated in the "thermoneutral zone" 36.5°C
- 37.5°C

Stable core temperature is maintained by balancing heat production and loss.

Control system

 Sensors: central, visceral, muscle

Central – in your brain
Visceral – in the tissues in your thorax/abdomen
Muscle – in the muscles
Sensors send info via afferent pathways
 Controller: hypothalamus
 Effectors (what we use to actually alter temp): blood vessels, skeletal
muscles(shiver to stimulate heat), hair (stands for insulation), behaviour
o immediate control via the autonomic nervous system,
o delayed control by the endocrine system

Effectors –

- Short term
Mainly controlled by nerves
- Long term
Mainly controlled by hormones
^However nerves and hormones are used in both but one is more
predominant than the other

What is hyperthermia? What is hypothermia?

Hyper – high
Hypo – low

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Hyper – body temperature is higher than the set point

Hypo – body temp is lower than the set point
* the set point changes among individuals

What happens when body temperature increases above normal?

Maybe no effect or a benefit – e.g. exercise

Maybe an adverse effect:

Altered cell function – decreased performance, seizures
Permanent cell damage
Death

Exercise increases core body temperature which optimises physiological

processes.

Increased muscle temperature due to warm-up:

 decreases tissue stiffness,

 increases nerve-conduction rate,
 alters muscle contraction characteristics and
 increases anaerobic energy provision

Fever

Fever is due to an increase in the hypothalamic set point.

From 37  39

Pyrogens – chemicals that induce fevers

Correct name for fever is PYREXIA

When inflammation occurs – body produces endogenous pyrogens

The bacteria produces chemicals that produce exogenous pyrogens
They have a combined effect on the hypothalamus which increases the set point by
producing a chemical called prostaglandins

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If your body temp was 37 but hypothalamic set point was 39 then your body temp
must also be 39 so your body conserves heat and produces more
If your body temp was 38 it is higher than normal but lower than the set point you
will feel cold (this is why you feel cold but your body is hot)
Anti-inflammatory drugs block the production of prostaglandins so they block the
occurrence of a fever
It is not good to block it because the elevated temperature helps you fight the
infection, its your body’s defence
However there are times you have to suppress the inflammation such as in young
kids eg. They van have fits when their temp increases as they’re more susceptible

Hypothermia

Hypothermia is core temperature < 35°C

At < 35o many temperature regulation systems start to fail

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Accidental hypothermia can cause death

 Very young and elderly are at increased risk of hypothermia – their

homeostatic mechanisms aren’t working as well
Children – not developed
Elderly – deteriorating

 Hypothermia is part of the ‘deadly triad’ in trauma patients (hypothermia,

acidosis, abnormal coagulation)
Acidosis – not enough o2 being delivered to tissues
Abnormal coagulation – blood doesn’t clot as well as it would at a normal
blood temperature

BUT it can also save lives

 Hypothermia during ischemia protects against the effects of lack of oxygen.

Ischemia – lack of blood

 Deliberate hypothermia is used to protect against injury in cardiac arrest and

neurological injury.

Precooling improved exercise performance by 7% in exercise performed in the heat

(>30o C)
e.g. after warming leg muscles, cool neck to cool blood going to the brain

Negative feedback systems sense changes in the controlled variable, and

implement responses to return the controlled variable back to the setpoint.

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Sessler, D. I. (2016). Perioperative thermoregulation and heat balance. The Lancet,

387(10038), 2655-2664.

Set point is in hypothalamus – can be altered by anaesthetic, age, menstrual cycle,

drugs, alcohol, circadian rhythm (changes in the day e.g. day vs night)
Effectors – behaviour, sweating, vasoconstriction, shivering

Checkpoint

1. You are driving at the speed limit which is 80 km/hr. You start to go down a
very steep hill. Design a control system to enable you to stay within the
speed limit. Include:

Controlled variable SPEED

Sensor(s): SPEEDO, EYES

Controller: BRAIN

Afferent pathway: NERVOUS SYSTEM

Efferent pathway: NERVOUS SYSTEM

Effectors: MUSCLES TO WORK THE BRAKE/ACCELERATOR

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2. Are fever and hyperthermia the same thing?

Fever- reacting to change in body temp, raising body temp deliberately

Hyperthermia – body temp is higher than set point and we are trying to lower it

Some of the adverse effects of disease are due to negative feedback.

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Negative feedback in heart failure

Heart damage  drop blood pressure  increase blood pressure by

homeostasis however these systems are causing more damage

In heart failure, most people die of homeostasis

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Feedforward – prevent it from occurring by anticipating it

We can anticipate changes that are going to occur: heart rate and respiratory rate
increase before exercise begins.

 Feedforward works in combination with feedback.

 Something has to happen before the controlled variable changes – this is the
disturbance. If a disturbance is detected, the controller can implement
changes to stop the controlled variable changing.

Are thermoreceptors inside the body used for feedback or feedforward?

Feedback – measuring what the actual body temp is

Are thermoreceptors in the skin used for feedback or feedforward?

Feed forward – measuring environmental temp

Feedforward responses are modified by adaptive learning (in the brain or reflex)
which results in ongoing improvements in performance.

Once a feedforward mechanism for motor commands has developed, simple cues
can trigger the movements.

First aid for hypothermia (St John’s Ambulance)

1. Warm the patient by placing between blankets, in a sleeping bag, or wrap in

a thermal/space blanket or similar, and cover the head to maintain body
heat.
2. Provide warmth to the patient aiming to stabilise core temperature rather
than attempt rapid rewarming.
3. Hot water bottles, heat packs may be applied to the patient’s neck, armpits
and groin. DO NOT use radiant heat such as fire or electric heater.

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Why is better to use a conservative approach to warming a hypothermic patient?

Rapid heating will cause feed forward system to kick in and slow the warming
down
Conservative approach will initially heat at a slower rate but will progress faster
than rapid heating would as rapid heating will slow down (stated above)

Feedforward detects disturbances that could change the controlled variable in the
future, and implement responses to stop the controlled variable changing.

Positive feedback

Does negative feedback prevent or accentuate changes in the controlled variable?

PREVENT/REVERSE

Positive feedback accentuates the change in the controlled variable once it has
begun

e.g. a woman in labour

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Clotting

Obesity

Why it matters

1. It is associated with poor health outcomes

2. Its prevalence is increasing in society
3. There is evidence that health professionals are biased against obese people
leading to errors in medical judgment and care.

Physiological responses to over and underfeeding suggest that the body tries to
maintain a constant weight.The responses involve maintaining available and stored
nutrient levels at optimal levels given the environment.

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The brain receives continuous information about

 stored energy and current and anticipated use

 what food is being eaten and absorbed
 what food is potentially available.

The brain in turn determines when and how much food will be eaten.

Weight is controlled by several complex systems responding to:

 internal metabolic and hormonal signals, PHYSIOLOGICAL e.g. amount of

glucose in blood, fat in fat stores
 hedonic properties of food, PSYCHOLOGICAL
 internal forces of valuation and self-control, and
 social factors. PSYCHOSOCIAL

Obesity ensues from an imbalance between energy intake and expenditure

Weight loss can be achieved through dietary restriction and/or increased physical
activity but most people regain weight. Maintenance of body weight is regulated

 homoeostatic factors
o hypothalamus integrate signals regarding food intake, energy balance
and body weight BUT
o hormonal systems promoting body weight homeostasis can’t balance
pleasurable (hedonic) influences these foods generate in higher
neurologic networks.
 environmental factors
o environment discourages exercise
o environment encourages unhealthy food
o sleep debt
o iatrogenic effects of medications
 behavioural factors.

Physiological adaptations to weight loss favour weight regain. These are

o changes in the levels of circulating appetite-related hormones

o changes in energy homoeostasis, (more efficient in storing energy)

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o changes in nutrient metabolism

o changes in appetite.

We need to overcome these adaptations behaviourally BUT it is difficult to

overcome physiology with behaviour.

How does obesity develop if body weight regulated by a homoeostatic mechanism?

Allostasis

(Disfunctional homeostasis)
Abnormal environment overcomes homeostasis
The challenges in our lives overwhelm our ability to maintain homeostasis

Dysfunctional regulation that occurs in response to artificial or pathophysiological

situations.

 exposure to a high calorie diet  obesity

 exposure to a high stress world  depression

The set point can change under some circumstances

Learning is part of allostasis

 we learn that eating will result in an increase in the blood [glucose]

 thinking about eating results in insulin release

An individual can benefit from past experiences to better anticipate future

challenges

ANSWERS

In addition to ATP, what do cells need to function?

 An aqueous environment
 The correct instructions to control the growth and activity.
 The necessary structural elements to enable them to perform their functions.
 The necessary raw materials to produce ATP and other products.

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 The correct environment

o available oxygen
o pH
o osmolality, electrolyte concentrations.

What do multicellular organisms need to live?

A coordinated group of structures that can supply the things cells need to function.

 Organelles: specialised structures within cells.

 Tissue: a collection of similar cells performing a similar function.
 Organ: a structural part of a body system composed of various tissues that
enable it to perform a particular function.
 Body System: a collection of parts that, unified, make a whole.

Name body systems the cardiovascular system needs to function

 Respiratory system: to supply oxygen and remove carbon dioxide

 Digestive system: to supply raw materials for energy production, repair
and growth
 Renal system: control blood volume and eliminate wastes
 Nervous system: to control blood pressure
 Endocrine system: to control blood pressure
 Cardiovascular system: to deliver blood to its own tissues
 Skeletal system: to protect the vital structures
 Brain: to anticipate changes in CVS demands

Why do people develop angina?

Myocardial oxygen demand in excess of supply

Why does anaemia cause angina?

It decreases myocardial oxygen supply

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What happens in a myocardial infarction?

Myocardial blood supply is completely obstructed  cell death.

Accumulation of fluid in the lungs.

What is this condition called?

Pulmonary oedema

Why does it develop?

Excessive leakage of fluid from capillaries
Insufficient drainage of fluid from interstitial space

Inflammation

Why does redness develop?

Increased blood flow to the affected area to deliver more white blood cells that will
fight infection and assist healing.

Why does the area become hot?

The blood transport heat-more blood flow means more heat delivery.

Why does swelling occur?

The capillaries become more leaky in order for the white blood cells to move into
the area of damage.

Why is a blood test useful if we are sick?

The levels of important components in the body are carefully controlled by
homeostatic mechanisms and are very similar in all healthy people.

What happens if blood pressure falls too low?

There will be insufficient delivery of oxygen to the cells.

What happens if blood pressure gets too high?

Excessive blood pressure causes tissue damage and increases the workload on the
heart.

What is hyperthermia? What is hypothermia?

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Hypothermia is a situation where the body temperature is higher than the setpoint.
Hypothermia is a situation where the body temperature is lower than the setpoint.

What happens when body temperature increases above normal?

Maybe no effect or a benefit – eg exercise

Maybe an adverse effect

altered cell function – decreased performance, seizures

permanent cell damage

death

You are driving at the speed limit which is 80 km/hr. You start to go down a very
steep hill. Design a control system to enable you to stay within the speed limit.
Include:

Controlled variable: speed

Sensor(s): speedometer, eyes

Controller: brain

Afferent pathway: visual pathway

Efferent pathway: motor pathway to leg muscles

Effectors: feet, accelerator, brake

Are fever and hyperthermia the same thing?

Fever is an increasing body temperature to a new elevated setpoint. Hyperthermia

occurs when the body temperature is higher than the setpoint. In fever you will not
try to lose body heat, in hyperthermia you will.

Are thermoreceptors inside the body used for feedback or feedforward?

Feedback

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Are thermoreceptors in the skin used for feedback or feedforward?

Feedforward

Why is better to use a conservative approach to warming a hypothermic patient?

You will not activate the feedforward system. In these circumstances the
feedforward system may anticipate that body temperature will become very high
and therefore slow the rate of re-warming.

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