Module-3: Bioengineering Design

MODULE-3

ADAPTATION OF ANATOMICAL PRINCIPLES

FOR BIOENGINEERING DESIGN

SYLLABUS
Brain As a CPU System, Eye As a Camera System, Heart As a Pump System,
Lungs As a Purification system, Kidney as a filtration System.

By,
Mrs. SMITHA.B.N, Asst. Professor.
Mrs. DIVYASHREE.G, Asst. Professor.

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HUMAN ORGAN SYSTEM AND BIODESIGNS:

The human body is a biological machine made of body systems, groups of organs that work
together to produce and sustain life. Organ systems are skeletal system, muscular system,
cardiovascular system, Respiratory system, Nervous system, Digestive system, Urinary
system, Endocrine system, Lymphatic system, reproductive system, Integumentary system.
Biodesign is the use of living organisms in design. Its processes can be used in the creation of
fashion, textiles, furniture, and architecture. Non profits, design companies and universities
around the world, including UC Davis, increasingly implement biodesign practices into
research and product development.
A bio-design embodies an emerging design movement which incorporates the use of living
materials, or moist media, such as fungi, algae, yeast, bacteria, and cultured tissue. This can be
as part of standard crafting methods or the more complex fields of biomimicry and synthetic
biology. The idea is to create a product whose properties are enhanced as a result of the use of
these living materials. Some examples are explained below:

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BRAIN AS A CPU SYSTEM:

Both CPU and brain use electrical signals to send messages. The brain uses chemicals to
transmit information. The computer uses electricity. Even though electrical signals travel at
high speeds in the nervous system, they travel even faster through the wires in a computer.
Both transmit information.
A BCI system is a computer- based system that takes brain signals, analyses them and translates
them into commands that are relayed to a device to trigger a desired action. A BCI system does
not use peripheral nervous and head muscles. The CNS (Central Nervous System), for example
is used to measure signals produced by the central nervous system. Thus, for example a sensor
that is activated by the voice or the movement of a muscle is not a BCI system. Also an EEG
is not BCI itself. Because it only records brain signals but it does not produce an output that
acts on the user’s environment. It is also wrong to think that BCI is a mind-reader. They do not
export information from unsuspecting users or users unwillingly using the system. They allow
users to act in their environment when they want it by reading their brain signals rather than
muscles. The user and the BCI system. The BCI then translates these commands and transmits
them into an output device. Brain computer interfaces have contributed to various areas of
research. Applications that are about medicine, neuro-technology and smart environment,
neuro-marketing and advertising., education and self-regulation, games and entertainment, as
well as security and identification.

The human brain can be thought of as a highly sophisticated and complex information
processing system, similar to a computer's Central Processing Unit (CPU). Both the brain and
CPU receive and process inputs, store information, and perform calculations to produce
outputs. However, there are significant differences between the two, such as the way they store
and process information and the fact that the human brain has the ability to learn and adapt,
while a computer's CPU does not. Additionally, the human brain is capable of performing tasks
such as perception, thought, and emotion, which are beyond the scope of a computer's CPU.

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Comparison between Brain and Computer.

Basis for Comparison Brain Computer

ICs, transistors, diodes,
Construction Neurons and synapses
capacitors, transistors, etc.
Increases each time by Increases by adding more
Memory growth
connecting synaptic links memory chips
Backup system is constructed
Backup systems Built-in backup system
manually
100 teraflops (100 trillion
Memory power 100 million megabytes
calculations/seconds)
Memory density 107 circuits/cm3 1014 bits/cm3
Energy consumption 12 watts of power Gigawatts of power
Stored in electrochemical and Stored in numeric and symbolic
Information storage
electric impulses. form (i.e. in binary bits).
The brain's volume is 1500
Variable weight and size form
3
Size and weight cm and weight is around
few grams to tons.
3.3pounds.
Transmission of Uses chemicals to fire the Communication is achieved
information action potential in the neurons. through electrical coded signals.
Information processing
Low High
power
Keyboards, mouse, web
Input/output equipment Sensory organs
cameras, etc.
Structural organization Self-organized Pre-programmed structure
Parallelism Massive Limited
Reliability and Computers perfor a
Brain is self-organizing, self-
damageability monotonous m job and can't
maintaining and reliable.
properties correct itself.

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Architecture:
Similarly, a computer's CPU also has memory units for storing information, and the human
brain has several regions dedicated to memory storage, including the hippocampus and
amygdala. Figure: Limbic system. Cross section of the human brain.

While the comparison between the human brain and a computer's CPU can provide useful
insights, it is important to note that the human brain is a vastly more complex and capable
system, with many functions that are still not fully understood.
The nervous system has two main parts : The central nervous system (CNS) made up of the
brain and spinal cord. The Peripheral Nervous System(PNS) is made up of nervous that
branch off from the spinal cord and extended to all parts of the body.
1) CNS: CNS includes the brain and spinal cord. The brain is the body’s “control centre.” The
CNS has various centers located within it that carry out the sensory, motor and integration of
data. These centers can be subdivided to Lower Centers (including the spinal cord and brain
stem) and higher centers communicating with the brain via effectors.
2) PNS: PNS is a vast network of spinal and cranial nervous that are linked to the brain and
the spinal cord. It contains sensory receptors which help in processing changes in the internal
and external environment. This information is sent to the CNS via afferent sensory nervous.
The PNS is then subdivided into the automatic nervous system and the somatic nervous system.
The automatic has involuntary control of internal organs, blood vessels, smooth and cardiac
muscles. The somatic has voluntary control of skin, bones, joints and skeletal muscles. The two
systems function together, by way of nervous from the PNS entering and becoming part of the
CNS, and vice versa.

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Fig:(CNS and PNS Nervous system)

SIGNAL TRANSMISSION:
A neuron sending a signal (a presynaptic neuron) releases a chemical called a neurotransmitter,
which binds to a receptor on the surface of the receiving (presynaptic) neuron.
Neurotransmitters are released from presynaptic terminals, which may branch to communicate
with several postsynaptic neurons.
Axon terminals are where neurotransmission begins. Hence, it is at axon terminals where the
neuron sends its Output to other neurons. At electrical synapses, the Output will be the
electrical signal itself. At chemical synapses, the Output will be neurotransmitter. The correct
outline for the sequence of transmission of an electrical impulse through a neuron is dendrites,
cell body, axon, axon terminal.

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ELECTRO ENCEPHALO GRAM [EEG]:

An electroencephalogram (EEG) is a test that measures electrical activity in the brain using
small metal discs (electrodes) attached to the scalp. Brain cells communicate via electrical
impulses and are active all the time, even during asleep. This activity shows up as wavy lines
on an EEG recording.
An EEG is one of the main diagnostic tests for epilepsy. An EEG can also play a role in
diagnosing other brain disorders. An EEG can find changes in brain activity that might be
useful in diagnosing brain disorders, especially epilepsy or another seizure disorder. An EEG
might also be helpful for diagnosing or treating.
• Brain tumors

• Brain damage from head injury

• Brain dysfunction that can have a variety of causes (encephalopathy)

• Sleep disorders

• Inflammation of the brain ( herpes encephalitis)

• Stroke

• Sleep disorders

An EEG might also be used to confirm brain death in someone in a persistent coma. A
continuous EEG is used to help find the right level of anaesthesia for someone in a medically
induced coma. Voltage fluctuations measured by the EEG bio amplifier and electrodes allow
the evaluation of normal brain activity including the posterior dominant rhythm (PDR), first
described by Hans Berger. EEG can detect abnormal electrical discharges such as sharp waves,
spikes or spike and wave complexes that are seen in people with epilepsy. Thus it is often used
to inform the medical diagnosis. EEG can detect the onset and spatio-temporal evolution of
seizures and the presence of status epilepticus. It is also used to help diagnose sleep disorders,
depth of anaesthesia, coma, encephalopathies, cerebral hypoxia after cardiac arrest, and brain
death. EEG used to be a first line method of diagnosis for tumours, stroke and other focal brain
disorders but this use has decreased with the advent of high-resolution anatomical imaging
techniques such as magnetic resonance imaging (MRI) and computed tomography (CT).
Despite limited spatial resolution, EEG continuous to be a valuable tool for research and
diagnosis. It is one of the few mobile techniques available and offers millisecond-range
temporal resolution which is not possible with CT, PET or MRI.

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Derivatives EEG technique include evoked potentials (EP), which involves averaging the EEG
activity time-locked to the presentation of a stimulus of some sort (visual, somatosensory, or
auditory). Event-related potentials (ERPs) refer to averaged EEG responses that are time-
locked to more complex processing of stimuli. This technique is used in cognitive science,
cognitive psychology and psychophysiological research.

Fig: EEG Process

ROBOTIC ARMS FOR PROSTHETICS:

Robotic prosthetic limb is a well-established research area that integrates advanced
mechatronics, intelligent sensing and control for achieving higher order lost sensorimotor
functions while maintaining the physical appearance of amputated limb. Robotic prosthetic
limbs are expected to replace the missing limbs of an amputee restoring the lost functions and
providing aesthetic appearance. The main aspects are enhanced social interaction, comfortable
amputee’s life and productive amputee to the society. With the advancement of sensor
technology, in the last few decades significant contributions have been made in this area.
Most current robotic prostheses work by recording from the surface of the skin-electrical
signals from muscles left intact after an amputation. Some amputees can guide their artificial
hand by contracting muscles remaining in the forearm that would have controlled their fingers.
If you are missing an arm or leg, an artificial limb can sometimes replace it. The device which
is called a prosthesis. Can help you to perform daily activities such as walking, eating, or
dressing. Robotic arms can be used to automate the process of placing goods or products onto

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pallets. By automating the process, palletizing becomes more accurate, cost-effective, and
predictable. The use of robotic arms also frees human workers from performing tasks that
present a risk of bodily injury.

ENGINEERING SOLUTIONS FOR PARKINSON’S DESEASE:

Parkinson’s disease is a progressive disorder that affects the nervous system and the parts of
the body controlled by the nerves. Symptoms start slowly. The first symptoms may be barely
noticeable tremor in just one hand. Tremors are common, but the disorder may also causes
stiffness or slowing of movement.
In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually breakdown or die.
Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your
brain called dopamine. When dopamine levels decrease, it causes a typical brain activity,
leading to impaired movement and other symptoms of Parkinson’s disease.
Parkinson’s disease can’t be cured, but medications can help control the symptoms often
dramatically. In some more advanced cases, surgery may be advised. Your health care provider
may also recommend lifestyle changes, especially ongoing aerobic exercise.

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ENGINEERING SOLUTION TO THIS DISEASE ARE:

Deep brain stimulation(DBS) - This involves surgically implanting a neurotransmitter that
sends electrical impulses to specific areas of our brain. This procedure has helped many people
with Parkinson’s reduce symptoms such as tremor, rigidity, and bradykinesia. There are six
main types of medications available to treat symptoms of Parkinson disease; levodopa,
dopamine agonists, and inhibitors of enzymes that inactivate dopamine (monoamine oxidase
type B [MAO B] inhibitors and catechol-O-methyl transferase [COMT] inhibitors,
anticholinergic drugs, and amantadine.
Engineering Neurons are another treatment method for this. Transplantation of embryonic
neurons can restore functional dopaminergic neurons in the brains of patients with Parkinson’s
disease. But while, promising, cell transplantation therapy is still out of reach to most patients,
in part because of the inaccessibility of human embryonic tissue.
First obtained neuronal stem cells from mouse cells transfected with a transcription factor that
encourages cells to adopt a neuronal fate. They then co-cultured the cells with astrocytes, which
release a factor that induces development into dopaminenergic neurons. The engineered cells
released dopamine and some maintained the characteristics of dopamineneritic neurons for up
to two weeks after implantation into mouse brain.

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EYE AS A CAMERA SYSTEM:

The human eye is a wonderful instrument, relying on refraction and lenses to form images.
There are many similarities between the human eye and a camera. A diaphragm to control the
amount of light that gets through to the lens. This is the shutter in a camera, and the pupil at
the centre of the iris, in the human eye. A lens to focus the light and create an image. The image
is real and inverted. In camera, film is used to record the image; in the eye, the image is focused
on the retina, and a system of rods and cones is the end of an image-processing system that
converts the image to electrical impulses and sends the information along the optic nerve to the
brain.
The human eye can be analogized to a camera system, as both the eye and a camera capture
light and convert it into an image

The main components of the eye that correspond to a camera system include:
• The Cornea: This transparent outer layer of the eye functions like a camera lens,
bending light to focus it onto the retina.

• The Iris: The iris functions like the diaphragm in a camera, controlling the amount of
light that enters the eye.

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• The Pupil: The pupil functions like the aperture in a camera, adjusting the size to
control the amount of light entering the eye.

• The Retina: The retina functions like the camera film or sensor, capturing the light and
converting it into electrical signals that are sent to the brain.

• The Optic Nerve: The optic nerve functions like the cable connecting the camera to a
computer, transmitting the electrical signals from the retina to the brain.

• In both the eye and a camera, the captured light is transformed into an image by the
lens and the light-sensitive component.

• The eye processes the image further, allowing for visual perception, while a camera
stores the image for later use.
It's important to note that the eye is much more complex than a camera and has several
additional functions, such as adjusting for different levels of light and adjusting focus, that are
not found in a camera.

The eye also has the ability to perceive depth and color, as well as adjust to movements and
provide a continuous, real-time image to the brain.

There are two photoreceptors: RODS and CONES

The photoreceptors are localized around an area near the centre of the retina called the macula,
which is the functional centre of the retina. The fovea is located in the centre of the macula.
The macula is responsible for high-resolution, colour vision, provided by different types of
photoreceptors.
Photoreceptors in the retina are classified into two groups, named after their physical
morphologies. Rod cells are highly sensitive to light and function in night vision, whereas cone
cells are capable of detecting a wide spectrum of light photons and are responsible for colour
vision. Rods and cones are structurally compartmentalized. They consist of five principal
regions: Outer segment, connecting cilium, inner segment, nuclear region, Synaptic region,
Rods are responsible for vision at low light levels (scotopic vision). They do not mediate colour
vision and have a low spatial acuity.
Cones are active at higher light levels (photopic vision), are capable of colour vision and are
responsible for high spatial acuity. The central fovea is populated exclusively by cones. There
are 3 types of cones which we will refer to as the short- wavelength sensitive cones, the middle-

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wavelength sensitive cones and the long-wavelength sensitive cones or S-cone, M-cones, and
L-cones for short.

OPTICAL CORRECTIONS:
A slight modification of geometrically correct lines (as of a building) for the purpose of making
them appear correct to the eye. Optical corrections refer to devices or techniques used to
improve or correct vision problems caused by a refractive error in the eye.
Refractive errors occur when light entering the eye is not properly focused on the retina, leading
to blurred vision. There are several types of refractive errors, including:
• Myopia (nearsightedness): Light is focused in front of the retina, making distant objects
appear blurry.

• Hyperopia (farsightedness): Light is focused behind the retina, making near objects
appear blurry.

• Astigmatism: Light is not focused evenly on the retina, leading to blurred or distorted
vision.

The ability to see images or objects with clear, sharp vision results from light entering the eye.
Light rays bend or refract when they hit the retina, sending nerve signals to the optic nerve,
which then sends these signals to the brain. The brain processes them into images, allowing

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you to understand what you see. When these light rays bend incorrectly, it results in a refractive
error and typically causes blurry or cloudy vision.
Since the primary cause of vision problem is caused by light bending incorrectly as it enters
the eye, virtually any method of treatment that changes this can be categorised as a form of
vision correction.
Eyeglasses and optical lenses- the most common types of corrective measures- are almost
always recommended as the first course of treatment for vision problems. While they are
considered a very basic method of vision correction, they are unable to control the refractive
error from progressing. Patients whose vision worsens over time need new glasses or contacts.
In these cases longer-term solutions are needed.
CATARACT:

A cataract is a clouding of the normally clear lens of the eye. At first, the cloudiness in your
vision caused by a cataract may affect only a small part of the eye’s lens and you may be
unaware of any vision loss. As the cataract grows larger, it clouds more of our lens and distorts
the light passing through the lens. This may lead to more noticeable symptoms. A cataract is a
cloudy lens. The lens is positioned behind the coloured part of eye (iris). The lens focuses light
that passes into our eye, producing clear, sharp images on the retina, the light sensitive
membrane in the eye that functions like the film in a camera.
As the cataract continues to develop, the clouding becomes denser. A cataract scatters and
blocks the light as it passes through the lens, preventing a sharply defined image from reaching
your retina. As a result, your vision becomes blurred. Cataracts generally develop in both eyes,
but not always at the same rate. The cataract in one eye may be more advanced than the other,
causing a differene in vision between eyes. Cataracts may be partial or complete, stationery or
progressive, hard or soft. Histologically, the main types of age-related cataracts are nuclear
sclerosis, cortical, and posterior subcapsular.
Nuclear sclerosis is the most common type of cataract and involves the central or nuclear part
of the lens. This eventually becomes hard or sclerotic, due to condensation on the lens nucleus
and the deposition of brown pigment within the lens. In its advanced stages, it is called
brunescent cataract. In early stages, an increase in sclerosis may cause an increase in refractive
index of the lens. This causes a myopic shift lenticular shift) that decreases hyperopia and
enables presbyopic patients to see at near without reading glasses. This is only temporary and
is called second sight.

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An immature cataract has some transparent protein, but with a mature cataract, all the lens
protein is opaque. In a hyper mature or Morgagnian cataract, the lens proteins have become
liquid. Congenital cataract, which may be detected in adulthood, has a different classification
and includes lamellar, polar, and sutural cataracts.

LENS MATERIALS:
Corrective spherocylindrical lenses are commonly used to treat refractive errors such as
myopia, hyperopia, presbyopia, and astigmatism. Both lenses and prisms are also frequently
most used plastic lens material for years was CR-39. It was first developed as a replacement
for glass lenses during World War II. It still has 55% of world market at age 60. The patent
was awarded to Muskat and Strain of Pittsburgh Plate Glass used to improve eye alignment
and treat diplopia in strabismus. Eye glasses also serve an important role in protecting the eyes
from physical trauma and harmful radiation. Lenses can be produced using a variety of
materials and designed with several optical profiles to optimize use in specific applications.
Critical lens properties include refractive index, Abbe number (chromatic dispersion), specific
gravity, and ultraviolet absorption.
The most common lens material is of course optical glass, but crystals and plastics are
frequently used, while mirrors can be made of essentially anything that is capable of being

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polished. There are 5 main types of lens materials for eyeglasses and sunglasses. Each type of
lens material can help correct refractive errors such as nearsightedness, farsightedness,
astigmatism, or presbyopia.

Types of lens materials:

CR-39: The most used plastic lens material for years was CR-39. It was first developed as
a replacement for glass lenses during World War II. It still has 55% of world market at age
60. The patent was awarded to Muskat and Strain of Pittsburgh Plate Glass Company (now
named PPG) in 1946. CR-39 is available in all lens styles and from multiple manufactures.
The basic monomer comes from PPG, and then each company adds their own materials to
create their lenses. Advantages include light weight, good optical properties and tinting
well. Disadvantages of CR-39 are that it is the thickest material and scratches easily.
Crown Glass: Is the most commonly used clear glass for ophthalmic lenses. In general,
glass is the most durable material used for lenses. Crown glass is used mainly for single
vision lenses and the distance carrier for most glass bifocals and trifocals. It has an index
of refraction of 1.523 and an abbe value of 59. It is approximately 4% thinner than CR-39
resin lenses and is 40% heavier than polycarbonate lenses and is slightly lighter than high
index glass. It blocks out about 10% of UV light.
Flint Glass: It uses lead oxides in its chemical make up to increase its index of refraction
to approximately 1.58 to 1.69. Its abbe value ranges from 30 to 40. This material is
relatively soft, displays a brilliant luster and has chromatic aberration. Although it was used
in the past as a single vision alternative for higher Rx lenses, its use today is often limited
to segments for some fused bifocals. The advantages of glass lenses include optical clarity,
resistance to scratches and it is the least susceptible to chemicals. The disadvantages
include that it is the heaviest material and it is less impact resistant than other materials.
Polycarbonate Lenses: Polycarbonate lenses were first developed by a company named
Gentex. Polycarbonate is a thermoplastic which means it is moldable under sufficient heat.
In the 1950’s it was marketed under the name Lexan and due to its extraordinary resistance
to impact was originally manufactured for safety devices.

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BIONIC EYES:
• Bionic eye, electrical prosthesis surgically implanted into a human eye I order to allow
for the transduction of light (the change of light from the environment into impulses the brain
can process) in people who have sustained severe damage to the retina.
• The bionic eye comprises an external camera and transmitter and an internal microchip.
The camera is mounted on a pair of eyeglasses, where it serves to organize the visual stimuli
of the environment before emitting high-frequency radio waves. The stimulator microchip
consists of an electrode array that is surgically implanted into the retina. That functions as an
electrical relay in place of degenerated retinal cells. The radio waves that are emitted by the
external camera and transmitter are received by the stimulator, which then fires electrical
impulses. The impulses are relayed by the few remaining retinal cells and are transduced as
normal to the optic nerve pathway, resulting in vision.
• The bionic vision system consists of camera, attached to a pair of glasses, which
transmits high- frequency radio signals to a microchip implanted in the retina. Electrodes on
the implanted chip convert these signals into electrical impulses to stimulate cells in the retina
that connect to the optic nerve. It is an expensive treatment and not everyone can afford it.
Since research is still going on results are yet not 100% successful.
• Its an artificial eye which provide visual sensations to the brain. It consists of electronic
systems having image sensors, microprocessors, receivers, radio transmitters and retinal
chips. Technology provided by this help the blind to get vision again.
• It consists of a computer chip which is kept in the back of effected person eye and
linked with a mini video camera built into glasses that they wear. Then an image captured by
the camera are focused to the chip which converts it into electronic signal that brain can
interpret. The images produced by bionic eye were not be too much perfect but they could be
clear enough to recognize. The implant bypasses the diseased cells in the retina and go
through the remaining possible cells.

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•
The device consists of 3,500 micro photodiodes which are set at the back part of the
retina. The electrical signal which is sent to brain is obtained from these miniature solar
cells array as they convert the normal light to electrical signal.

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HEART AS A PUMP SYSTEM:

Heart is a sort of like a pump, or two pumps in one. The right side of our heart receives blood
from the body and pumps it to the lungs. The left side of the heart does the exact opposite. It
receives blood from the lungs and pumps it out to the body. While an LVAD consists of thick
tubes and a pump connected externally to the heart muscle and aorta, percutaneous heart pumps
place a much smaller tube inside the heart’s chambers. These tiny heart pumps are placed in
the heart via a thin tube called a catheter that is threaded through a puncture site in the skin.
The human heart is very strong and is capable of pumping blood up to 30 feet distance. An
average heart beats maximum of 70-80 beats per minute and is considered healthy. The
efficiency of the heart can be maintained and improved by performing physical activity. The
heart is called double pump because because each side pumps blood to a different circulation.
Deoxygenated blood from the body drains to the right side of the heart. This is the first pump
that sends blood to the lungs, called pulmonary circulation, where it becomes oxygenated and
releases carbon dioxide.
Here is what happens as blood flows through the heart and lungs:

The blood first enters the right atrium. The blood then flows through the tricuspid valve into
the right ventricle. When the heart beats, the ventricle pushes blood through the pulmonic valve
into the pulmonary artery. The pulmonary artery carries blood to the lungs where it “picks up”
oxygen. It then leaves the lungs to return to the heart through the pulmonary vein. The blood
enters the left atrium. It drops through the mitral valve into the left ventricle. The left ventricle
then pumps blood through the aortic valve and into the aorta. The aorta is the artery that feeds
the rest of the body through a system of blood vessels. Blood returns to the heart from the body
via two large blood vessels called the superior vena cava and the inferior vena cava. This blood
carries little oxygen, as it is returning from the body where oxygen was used. The vena cava
pump blood into the right atrium and the cycle begins all over again.

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The human heart is a four-chambered muscular organ shaped and sized roughly like a man’s
closed fist with two-thirds of the mass to the left of midline. The heart is enclosed in a
pericardial sac that is lined with the parietal layers of a serous membrane. The visceral layer of
the serous membrane forms the epicardium.
The myocardium of the heart wall is a working muscle that needs a continuous apply of oxygen
and nutrients to function efficiently.
For this reason, cardiac muscle has an extensive network of blood vessels to bring oxygen to
the contracting cells and to remove waste products.

ELECTRICAL SIGNALING:
The sinus node generates an electrical signals that stimulates regularly, 60 to 100 times per
minute under normal conditions. The atria are then activated. The electrical stimulus travels
down through the conduction pathways and causes the heart’s ventricles contract and pump out
blood.
ECG MONITORING:
ECG monitoring system have been developed and widely used in the healthcare sector for the
past few decades and have significantly evolved over time due to the emergence of smart
enabling technologies.
Now a days, ECG monitoring systems are used in hospitals, homes, outpatient ambulatory
settings, and in remote contexts. They also employ a wide range of technologies such as IoT,
edge computing and mobile computing. In addition, they implement various computational
settings in terms of processing frequencies, as well as monitoring schemes. They have also

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evolved to serve purposes and targets other than disease diagnosis and control, including daily
activities, sports, and even mode-related purposes.
This massive diversity in ECG monitoring systems contexts, technologies, computational
schemes, and purposes makes it hard for researches and professionals to design, classify, and
analyse ECG monitoring systems. Some efforts attempted to provide a common understanding
of ECG monitoring systems processes, guiding the design of efficient monitoring systems.
However these studies lack comprehensiveness and completeness. They work for specific
contexts, serve specific targets or are suitable for specific technologies.
They do not consider the latest technologies trends and they target very narrow research niches,
such as wearable sensors, mobile sensors, disease diagnosis, heartbeat detection, emotion
recognition, or ECG compression methods. Hence, there is a need to provide a comprehensive,
expert-verified taxonomy of ECG monitoring systems, a common architecture, and a complete
set of processes to guide the classification, analysis, and design of these systems.

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Fig:ECG Monitoring System

The existing ECG classification algorithms usually include signal preprocessing, such as
wavelet transform and manual feature extraction, but the amount of computation will increase
the delay of the real time classification system. In recent years, deep learning algorithm with
their advantages of automatic learning features is increasingly used in the field of health care,
such as medical image recognition and segmentation, time series data monitoring and analysis.
At present, the outstanding algorithm can establish an end-to-end DNN network to learn the
characteristics of ECG records by using the extensive digital characteristics of ECG data, which
saves lots of signal pre processing steps. Because the performance of DNN increases with the
amount of training data, this method can make good use of the extensive digitalization of ECG
data. According to WHO , around 18 million people die yearly due to heart disease globally.
Due to the increasing prevalence of cardiac diseases, people are prone to prevent devastating
event from happening. They are used to diagnose a patients cardiac condition.

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Fig: (Electrocardiogram System)

Electrocardiography (ECG) is a quick and easily accessible method for diagnosis and screening
of cardiovascular diseases including heart failure(HF). Artificial Intelligence (AI) can be
used for semi-automated ECG analysis. The aim of this evaluation was to provide an overview
of AI use in HF detection from ECG signals and to perform a meta-analysis of available studies.
Evaluation of symptoms suggestive of HF currently demands physicians to evaluate various
parameters including imaging and laboratory data and the electrocardiogram (ECG).
Besides a standard examination that includes an ECG, imaging information, such as
echocardiography or magnetic resonance imaging, is seen as gold standard in diagnosis of HF.
The CEG is a well-established, quick and easily accessible method for diagnosis and careening
of various cardiovascular diseases. It provides specific features that indicate presence of HF or
prognosis in HF patients especially to rule out HF in case of a normal ECG. However, use of
an ECG as primary diagnostic instrument often only yields insufficient diagnostic specificity.

Further, general practitioner-based ECG reporting has varying results, introducing further
diagnostic uncertainty.
Devices providing medically relevant information generated directly by individuals outside the
healthcare system such as smart phones with health applications or wearables including
smartwatches are an emerging trend. This development promises that a growing number of
ECG data generated at home will be available for a diagnostic screening. Management of this
quantity of data however, might be challenge for the individual healthcare professional, as well
as for the healthcare system itself. The potentially beneficial use of artificial Intelligence (AI)
in cardiology in general has been discussed already. AI might also be able to help in
interpretation of ECG signals and could therefore used to analyse ECG data in specific cases
and on a large scale for early identification of cardiovascular diseases such as HF.
REASONS FOR BLOCKAGES OF BLOOD VESSELS:
Coronary artery disease is a common heart condition. The major blood vessels that supply the
heart (coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart
muscle. Cholesterol deposits (plaques) in the heart arteries and inflammation are usually the
cause of coronary artery disease.
Signs and symptoms of coronary artery disease occur when the heart doesn’t get enough
oxygen rich blood. If you have coronary artery disease, reduced blood flow to the heart can
cause chest pain (angina) and shortness of breath. A complete blockage of blood flow can cause

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a heart attack. Coronary artery disease starts when fats, cholesterols and other substances
collect on the inner walls of the heart arteries. This condition is called atherosclerosis.
The build up is called plaque. Plaque can be cause the arteries arteries to narrow, blocking
blood flow. The plaque can also burst, leading to a blood clot.

Fig: Blockages of blood vessels

Besides high cholesterol, damage to the coronary arteries may be caused by; Diabetes or insulin
resistance, High blood pressure, Not getting enough exercise (sedentary lifestyle), smoking or
tobacco use.
DESIGN OF STENTS:
A stent is a tiny tube that can play a big role in treating heart disease. It helps keep our arteries
the blood vessels that carry blood from our heart to other parts of the body, including the heart
muscle itself open.
Most stents are made out of wire mesh and are permanent some are made out of fabric. These
are called stent grafts and are often used for larger arteries. Others are made of a material that
dissolves and that our body absorbs over time. They’re coated in medicine that slowly releases
into our artery to prevent it from being blocked again.
Why would You Need a Stent??
If a fatty substance called plaque builds up inside an artery, it can reduce blood flow to heart.
This is called coronary heart disease and it can cause chest pain. The plaque can also cause a
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blood clot that blocks blood flowing to our heart, which may lead to a heart attack. By keeping
an artery open, stents lower your risk of chest pain. They can also treat a heart attack that’s in
progress.
Doctor usually inserts a stent using a minimally invasive procedure. They will make a small
incision and use a catheter to guide specialized tools through blood vessels to reach the area
that needs a stent. One of those tools may have a camera on the end to help your doctor guide
the stent. During the procedure, doctor may also use an imaging technique called an angiogram
to help guide the stent through the vessel. Using the necessary tools, doctor will locate the
broken or blocked vessel and install the stent. They will remove the instruments from your
body and close the incision.

DESIGN:
Most of these stents are constructed from a nickel titanium alloy. Balloon expandable stents
are susceptible to permanent deformation when they are compressed extrinsically, which is not
an issue in the coronary tree. Self-expanding stents do not have this limitation. Furthermore,
self- expanding stents have less axial stiffness and are thus more flexible and will conform to
the shape of the stent. Balloon expandable stents, by virtue of their design, resist expansion by
balloon, but they have less acute recoil when they are placed in a poorly compliant lesion.

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However, after the initial deployment, the stent is at its maximal diameter and cannot get larger,
whereas a self-expanding stent that is appropriately oversized for the vessel will exhibit a
chronic outward force on the lesion and may lead to a larger lumen over time. For the reasons
above, there are some coronary lesions where balloon expandable stents are not ideal, such as
aneurysmal, ectatic vessels, thrombus laden vessels and vessels that are tapering with a large
size mismatch between distal reference and proximal reference vessels.
PACE MAKERS:
A pacemaker is a small device that’s placed (implanted) in the chest to help control the
heartbeat. It’s used to prevent the heart from beating too slowly. Implanting a pacemaker in the
chest requires a surgical procedure. A pacemaker is also called a cardiac pacing device.
Types:
Single chamber pacemaker. This type usually carries electrical impulses to the right ventricle
of heart.
Dual chamber pacemaker. This type carries impulses to the right ventricle and the right
atrium of heart to help control the timing of contractions between the two chambers.
Biventricular pacemaker. Biventricular pacing, also called cardiac resynchronization therapy

is for people who have heart failure and heartbeat problems. This type of pacemaker stimulates
both of the lower heart chambers (the right and left ventricles) to make the heart beat more
efficiently. A pacemaker is implanted to help control our heartbeat. Doctor may recommend
a temporary pacemaker when you have a slow heartbeat (bradycardia) after a heart attack,
surgery or medication overdose but our heartbeat is otherwise expected to recover. A
pacemaker may be implanted permanently to correct a chronic slow or irregular heartbeat or to
help treat heart failure. Pacemakers work only when needed. If heartbeat is too slow, the
pacemaker sends electrical signals to our heart to correct the beat.
Some newer pacemakers also have sensors that detect body motion or breathing rate and signal
the devices to increase heart rate during exercise, as needed.

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Fig:(pacemakers)

A pacemaker has two parts:

1. Pulse Generator: this small metal container houses a battery and the electrical circuitry
that controls the rate of electrical pulses sent to the heart.
2. Leads (electrodes): one to three flexible, insulated wires are each placed in one or more
chambers of the heart and deliver the electrical pulses to adjust the heart rate. However,
some newer pacemakers don’t require leads. These devices, called leadless pacemakers
are implanted directly into the heart muscle.

Fig: (pulse generator)

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DEFIBRILLATORS:
Defibrillators are devices that send an electric pulse or shock to the heart to restore a normal
heartbeat. They are used to prevent or correct an arrhythmia, an uneven heartbeat that is too
slow or too fast. If the heart suddenly stops defibrillators can also help it beat again. Different
types of defibrillators work in different ways. Automated External Defibrillators (AEDs),
which are now found in many public spaces are used to save the lives of people experiencing
cardiac arrest. Even untrained bystanders can use these devices in an emergency.
Other defibrillators can prevent sudden death among people who have a high risk of a life-
threatening arrhythmia. They include implantable cardioverter defibrillators (ICDs), which are
surgically placed inside our body, and wearable cardioverter defibrillators (WCDs). Which rest
on the body. It can take time and effort to get used to living with a defibrillator, and it is
important to be aware of possible complications.
There are three types of defibrillators: AEDs, ICDs, and WCDs.
An AED is a lightweight, battery-operated, portable device that cheeks the heart’s rhythm and
sends a shock to the heart to restore normal rhythm. The device is used to help people having
cardiac arrest.
Sticky pads with sensors, called electrodes, are attached to the chest of someone who is having
cardiac arrest. The electrodes send information about the person’s heart rhythm to a computer
in the AED. The computer analyses the heart rhythm to find out whether an electric shock is
needed. Of it is needed, the electrodes deliver the shock.
ICDs are placed through surgery in the chest or stomach area, where the device can check for
arrythmias. Arrhythmias can interrupt the flow of blood from our heart to rest of the body or
cause our heart to stop. The ICD sends a shock to restore a normal heart rhythm.
An ICD can give off a low-energy shock that speeds up or slows down an abnormal heart rate,
or a high-energy shock to correct a fast or irregular heartbeat. If low energy shocks do not
restore normal heart rhythm, the device may switch to high-energy shocks for defibrillation.
ICDs are similar to pacemakers, but pacemakers deliver only low-energy electrical shocks.
ICDs have a generator connected to wires that detect our heart’s beats and deliver a shock when
needed.
The ICD can also record the hearts electrical activity and heart rhythms. The recordings can
help our healthcare provider fine-tune the programming of the device so it works better to
correct irregular heartbeats. The device is programmed to respond to the type of arrhythmia
you are most likely to have.

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WCDs have sensors that attach to the skin. They are connected by wires to a unit that cheeks
our heart’s rhythm and delivers shocks when needed. Like an ICD the WCD can deliver low
and high-energy shocks. The device has a belt attached to a vest that is worn under our clothes.
Provider fits the device to your size. It is programmed to detect a specific heart rhythm.

Fig:(AED functioning)

LUNGS AS A PURIFICATION SYSTEM:

Introduction:
Every cell in our body needs oxygen to live. The air we breathe contains oxygen and other
gases. The respiratory system’s main job is to move fresh air into our body while removing
waste gases. Once in the lungs, oxygen is moved into the bloodstream and carried through our
body. At each cell in our body, oxygen is exchanged for a waste gas called carbon dioxide. our
bloodstream then carries this waste gas back to the lungs where it is removed from the
bloodstream and then exhaled. Lungs and the respiratory system automatically perform this
vital process, called gas exchange. In addition to gas exchange, your respiratory system
performs other roles important to breathing. These include:
1. Bringing air to the proper body temperature and moisturizing it to the right humidity level.
2. Protecting our body from harmful substances. This is done by coughing, sneezing, filtering
or swallowing them.
3. Supporting our sense of smell.

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Lungs help in the purification of blood. Arteries carry pure oxygenated blood from the heart to
other parts of the body. Veins carry impure venous blood back from other parts of the body to
the right side of the heart. This impure blood goes to the lungs for purification.
When breathe is inhaled, oxygen from the air comes in contact with the impure blood and the
blood takes up oxygen. The waste matter in the blood releases carbonic acid and the blood is
purified. The purified blood is carried to the heart by veins.

The lung purifies air by removing harmful substances and adding oxygen to the bloodstream.
The process of purifying air in the lungs can be described as follows:

Filtration: The nose and mouth serve as a first line of defense against harmful substances in
the air, such as dust, dirt, and bacteria. The tiny hairs in the nose, called cilia, and the mucus
produced by the respiratory system trap these substances and prevent them from entering the
lungs.

Moisturization: The air is also humidified as it passes over the moist lining of the respiratory
tract, which helps to keep the airways moist and prevent them from drying out.

Gas Exchange: Once the air reaches the alveoli, the gas exchange process occurs, where
oxygen diffuses across the thin alveolar and capillary walls into the bloodstream, and carbon
dioxide diffuses in the opposite direction, from the bloodstream into the alveoli to be exhaled.

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This process ensures that the bloodstream is supplied with fresh, oxygen-rich air, while waste
carbon dioxide is removed from the body.
Overall, the lung serves as a vital purification system, filtering out harmful substances, adding
oxygen to the bloodstream, and removing waste carbon dioxide. It plays a critical role in
maintaining the body's homeostasis and supporting life
Architecture:
The lung parenchyma is mainly comprised of numerous air-containing passages and
intervening fine structures, corresponding to alveolar ductal lumens and alveoli, as well as
alveolar septa and small pulmonary vessels occupying 10% of total parenchymal volume. The
primary function of the lungs is gas exchange. However, the lungs perform several important
non-respiratory functions that are vital for normal physiology.
The lung, with its unique ability to distend and recruit pulmonary vasculature, acts as a
reservoir of blood, fine-tuning preload to the left heart to optimize cardiac output.
1. The lung acts as a filter against endogenous and exogenous emboli, preventing them from
accessing system circulation.
2. Pulmonary epithelium forms the first line of defense against inhaled particles.
3. Pulmonary endothelial cells are responsible for the uptake, metabolism and
biotransformation of several exogenous and endogenous substances.
4. Pulmonary metabolic capacity is easily saturated, but pulmonary endothelial binding of
some drugs alters their pharmacokinetics.

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Trachea: The trachea is the main airway that leads from the larynx (voice box) to the lungs. It
is lined with cilia and mucus-secreting glands that help to filter out harmful substances and trap
them in the mucus.

Bronchi: The trachea branches into two main bronchi, one for each lung. The bronchi are
larger airways that continue to branch into smaller airways called bronchioles.

Bronchioles: The bronchioles are smaller airways that eventually lead to the alveoli.
The architecture of the lung is designed to maximize surface area for efficient gas exchange.
The lung is divided into several parts, including the trachea, bronchi, bronchioles, and alveoli.
Alveoli: The alveoli are tiny air sacs that are lined with a network of capillaries. This close
proximity of the alveoli and capillaries allows for efficient diffusion of oxygen and carbon
dioxide between the air in the alveoli and the bloodstream.
They are surrounded by tiny air sacs called alveoli, which are the sites of gas exchange.
Overall, the architecture of the lung is designed to provide a large surface area for gas exchange,
while filtering out harmful substances and humidifying the air. The close proximity of the
alveoli and capillaries, along with the moist lining of the respiratory tract, ensures that the airis
properly purified and the bloodstream is supplied with fresh, oxygen- rich air.
GAS EXCHANGE MECHANISMS:
Air enters the body through the mouth or nose and quickly moves to the pharynx or throat.
From there, it passes through the larynx, or voice box and enters the trachea. The trachea is a
strong tube that contains rings of cartilage that prevent it from collapsing. Within the lungs, the
trachea branches into a left and right bronchus. These further divide into smaller and smaller
branches called bronchioles. The smallest bronchioles end in tiny air sacs. These are called
alveoli.

Fig:(Pulmonary Gas Exchange)

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Oxygen Diffusion: The partial pressure of oxygen in the air in the alveoli is higher than the
partial pressure of oxygen in the bloodstream. This difference creates a gradient that causes
oxygen to diffuse from the alveoli into the bloodstream, where it binds to hemoglobin in red
blood cells to form oxyhemoglobin.
The gas exchange mechanism in the lung involves the transfer of oxygen from the air inthe
alveoli to the bloodstream, and the transfer of carbon dioxide from the bloodstream to the airin
the alveoli. This process is known as diffusion and occurs due to differences in partial pressures
of oxygen and carbon dioxide.
Carbon Dioxide Diffusion: The partial pressure of carbon dioxide in the bloodstream is higher
than the partial pressure of carbon dioxide in the air in the alveoli. This difference creates a
gradient that causes carbon dioxide to diffuse from the bloodstream into the alveoli, where it
is exhaled.
SPIROMETRY:
Spirometry(spy-ROM-uh-tree) is a common office test used to assess how well our lungs work
by measuring how much air we inhale, how much we exhale, and how quickly we exhale.
Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD), and
other conditions that affect breathing.
175 years have elapsed since John Hutchinson introduced the world to his version of an
apparatus that had been in development for nearly two centuries, the spirometer.
Spirometers can be divided into two basic groups:
1. Volume-measurement devices ( eg: wet and dry spirometers).
2. Flow-measurement devices( eg: pncumotachograph systems, mass flow meters).

Principle: The principle behind spirometry is to measure the volume of air that can be exhaled
from the lungs in a given time period. By measuring the volume of air exhaled, spirometry can
provide information about the functioning of the lungs and the ability of the lungs to move air
in and out.
Working: Spirometry is performed using a spirometer, a device that consists of a mouthpiece,
a flow sensor, and a volume sensor. The patient is asked to exhale as much air as possible into
the spirometer, and the spirometer measures the volume and flow rate of the exhaled air. The
volume of air exhaled is displayed on a graph called a flow-volume loop, which provides
information about the lung function.

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fig: Spirometer Instrument

Interpretation Of Results
The results of spirometry can be used to determine if the lungs are functioning normally and to
diagnose lung conditions. For example, a decrease in the volume of air exhaled or a decrease
in the flow rate of the exhaled air can indicate a restriction in the airways, which can bea sign
of a lung condition such as asthma or COPD.
Requirements of an acceptable spirometer are:
1. Spirometers must be able to accumulate volume for ≥ 15s.
2. The measuring volume should be ≥ 8 L ( body temperature and pressure, saturated).
3. The accuracy of reading should be at least ± 3% (or ±0.05L ) with flows from 0-14 L/ s.
4. The total resistance to airflow at 14L per s should be < 1.5 cmH2O per L per s ( 0.15kPa
per L per s)
HOW TO CALCULATE THE NORMAL RATE OF RESPIRATION IN A
SPIROMETER
The FEVI/FVC Ratio ( FEVI%) parameter is calculated by dividing the measured FEVI
value by the measured FVC value. The measured column shows the absolute
(numerical) ratio, and the predicted column shows the ratio expressed as a percentage.
In healthy adults of the same gender, height, and age the normal predicted percentage
should be between 70% and 85%.

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ABNORMAL LUNG PHYSIOLOGY:

Percentages lower than 70% are considered abnormal. This is an important measurement
because obstructive disease such as COPD, chronic bronchitis and emphysema cause increased
airway resistance to expiratory airflow, and may result in percentages of 45% to 60%.
Restrictive diseases such as pulmonary fibrosis tend to reduce both FEVI and FVC values, so
the percentage can remain the normal range, or even increase.

COPD:
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough,
mucus(sputum) production and wheezing. It’s typically caused by long-term exposure to
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irritating gases or particulate matter, most often from cigarette smoke. People with COPD are
at increased risk of developing heart disease, lung cancer, and a variety of other conditions.
Emphysema and chronic bronchitis are the two most common conditions that contribute to
COPD. These two conditions usually occur together and can vary in severity among individuals
with COPD.
Symptoms:
COPD symptoms often don’t appear until significant lung damage has occurred, and they
usually worsen over time, particularly if smoking exposure continues.
Signs and symptoms of COPD may include:
• Shortness of breath, especially during physical activities

• Wheezing

• Chest tightness
• A chronic cough that may produce mucus(sputum) that may be clear, white, yellow or
greenish

• Frequent respiratory infections

• Lack of energy

• Unintended weight loss ( in later stages)

• Swelling in ankles, feet or legs

Tests may include:
• Lung (pulmonary) infection tests.

• Chest X-ray.

• CT Scan

• Arterial blood gas analysis.

• Laboratory tests.

Medications:
Several kinds of medications are used to treat the symptoms and complications of COPD. You
may take some medications regularly and others as needed.
• Bronchodilators
• Inhaled steroids
• Combination inhalers

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• Oral steroids
• Phosphodiesterase-4 inhibitors

• Theophylline
• Antibiotics

Mechanical ventilation is a lifesaving therapy in patients who have acute respiratory failure
due to chronic obstructive pulmonary disease (COPD). Mechanical ventilation either invasive
or non-invasive has an important role in the management of acute exacerbation of COPD(
AECOPD).
VENTILATOR:
Mechanical ventilators are machines that act as bellows to move air in and out of your lungs.
Your respiratory therapist and doctor set the ventilator to control how often it pushes air into
your lungs and how much air you get. You may be filled with a mask to get air from the
ventilator into your lungs or you may need a breathing tube if your breathing problem is more
serious. When we are ready to be taken off the ventilator, healthcare team will “wean” you or
decrease the ventilator support until you can start breathing our own.

Ventilators work by delivering pressurized air or oxygen into the lungs through a breathing
tube or mask. The pressure can be adjusted to match the patient's needs and to help maintain
adequate oxygen levels in the blood.
While ventilators can be lifesaving for individuals with acute respiratory failure, they also come
with potential risks and complications. For example, prolonged use of a ventilator can increase

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the risk of ventilator-associated pneumonia, and patients may experience discomfort or pain
from the breathing tube.
The use of ventilators is carefully monitored and managed by healthcare professionals to ensure
that the patient receives the appropriate level of support while minimizing potential risks and
complications.
HEART LUNG MACHINE:
A heart-lung machine, also known as a cardiopulmonary bypass machine, is a device used in
cardiovascular surgery to temporarily take over the functions of the heart and lungs. The heart-
lung machine is used during open-heart surgery, such as coronary artery bypass graft (CABG)
surgery and valve replacement surgery, to support the patient's circulatory and respiratory
functions while the heart is stopped.
The heart-lung machine works by circulating blood outside of the body through a seriesof tubes
and pumps. Blood is taken from the body, oxygenated, and then returned to the body. This
allows the heart to be stopped during the surgery without causing any harm to the patient.
The use of a heart-lung machine during surgery carries some risks, including the potential for
blood clots, bleeding, and infections. Additionally, there may be some long-term effects on the
body, such as cognitive decline, that are not yet fully understood. However, the use of a heart-
lung machine has revolutionized the field of cardiovascular surgery, allowing for more
complex procedures to be performed and greatly improving patient outcomes

Fig: (heart lung machine)

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KIDNEY AS FILTRATION SYSTEM:

Introduction:
Kidneys remove wastes and extra fluid from the body. Kidneys also remove acid that is
produced by the cells of the body and maintain a healthy balance of water, salts, and minerals-
such as sodium, calcium, phosphorus and potassium in the blood. Without this balance, nerves,
muscles and tissues in the body may not work normally.
Kidneys also make hormones that help
• Control blood pressure
• Make red blood cells NIH external link

• Keeps bones strong and healthy.

Architecture:
The kidneys are two bean-shaped organs each about the size of a fist. They are located inst
below the rib cage, one on each side of the spine. Healthy kidneys filter about a half cup of
blood every minute, removing wastes and extra water to make urine. The urine flows from the
kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of the
bladder. Your bladder stores urine, kidneys, ureters, and bladder are part of our urinary tract.

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Fig: (Representing kidney and Nephron)

The Nephron consists of several key structures:

• Bowman's capsule: This is a cup-shaped structure that surrounds the glomerulus
andfilters waste and excess fluid from the bloodstream into the renal tubule.

• Glomerulus: A network of tiny blood vessels within the Bowman's capsule that
filterswaste and excess fluid from the bloodstream.

• Proximal convoluted tubule: A segment of the renal tubule that reabsorbs

importantsubstances, such as glucose, amino acids, and electrolytes, back into the bloodstream.
• Loop of Henle: A U-shaped segment of the renal tubule that is critical for the
reabsorption of ions and water.

• Distal convoluted tubule: A segment of the renal tubule that regulates the levels
ofelectrolytes and other important substances in the bloodstream.

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• Collecting duct: A series of ducts that collect the filtrate from the renal tubules and
transport it to the renal pelvis, where it drains into the ureter and eventually into the bladder.
The nephrons are surrounded by a network of blood vessels, including the afferent arteriole
and the efferent arteriole, which bring blood into and out of the glomerulus, respectively. The
filtrate produced by the nephron passes through the renal tubules, where it is modified by
reabsorption and secretion, before being eliminated from the body as urine.
MECHANISM OF FILTRATION:
The mechanism of filtration in the kidneys is a complex process that involves multiple steps to
remove waste and excess fluids from the bloodstream. The following is a summary ofthe steps
involved in the filtration process:
• Blood enters the kidney through the renal arteries and flows into tiny filtering units
called glomeruli.

• At the glomerulus, the pressure in the blood vessels causes a portion of the plasma and
dissolved substances to filter out and enter a structure called Bowman's capsule.

• In Bowman's capsule, the filtrate is then transferred into the renal tubules, which are
the main filtering units of the kidneys.

• In the renal tubules, the filtrate passes through a series of specialized cells, such as
proximal tubular cells and distal tubular cells, which reabsorb important substances suchas
glucose, amino acids, and electrolytes back into the bloodstream.

• At the same time, the renal tubules secrete waste products, such as urea and creatinine,
back into the filtrate.

• Finally, the filtered fluid, now known as urine, is transported through the renal pelvis
and ureters to the bladder, where it is eventually eliminated from the body.

This process of filtration, reabsorption, and secretion helps to maintain the proper balance of
fluids and electrolytes in the body, as well as to remove waste and excess substances.

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Fig: (Representing the parts of Nephron.)

The blood vessel runs alongside the tubule. As the filtered fluid moves along the tubule, the
blood vessel reabsorbs almost all of the water, along with minerals and nutrients our body
needs.
How does blood flow through our kidneys?
Blood flows into the kidney through the renal artery. This large blood vessel branches into
smaller and smaller blood vessels until the blood reaches the nephrons. In the nephron, Blood
is filtered by tiny blood vessels of the glomeruli and then flows out of the kidney through the
renal vein. Blood circulates through kidneys many times a day. In a single day, kidneys filter
about 150 quarts of blood. Most of the water and other substances that filter through glomeruli
are returned to the blood by the tubules. Only 1 to 2 quarts become urine. When the kidney

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doesn’t function properly, chronic kidney disease occurs when a disease or condition impairs
kidney function, causing kidney damage to worsen over several months or years.
Chronic Kidney Disease (CKD)
Chronic kidney disease includes conditions that damage your kidneys and decrease their ability
to keep you healthy by filtering wastes from your blood. If kidney disease worsens, wastes can
build to high levels in your blood and make you feel sick. You may develop complications like,
• High blood pressure

• Anemia ( low blood count)

• Weak bones
• Poor nutritional health
• Nerve damage
Symptoms:
People with CKD may not feel ill or notice any symptoms. The only way to find out for sure if
you have CKD is through specific blood and urine tests. These tests include the measurement
of both the creatinine level in the blood and the protein in the urine.
Treatment:
Depending on the cause, some types of kidney disease can be treated. Often, though, chronic
kidney disease has no cure. Treatment usually consists of measures to help control signs and
symptoms, reduce complications and slow the progression of the disease. If your kidneys
become severely damaged, you might need treatment for end-stage kidney disease.
DIALYSIS:
Dialysis is a procedure to remove waste products and excess fluid from the blood when the
kidneys stop working properly. It often involves diverting blood to a machine to be cleaned.
Dialysis is a medical treatment that helps to filter waste and excess fluids from the blood when
the kidneys are unable to function properly. There are two main types of dialysis systems:
hemodialysis and peritoneal dialysis.

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There are 2 main types of dialysis:

• Haemodialysis involves diverting blood into an external machine, where it’s filtered
before being returned to the body. Hemodialysis is a procedure that uses a machine to clean
the blood. During hemodialysis, blood is removed from the body, passed through a dialysis
machine that filters out waste and excess fluids, and then returned to the body.

Peritoneal dialysis involves pumping dialysis fluid into the space inside your abdomen
(tummy) to draw out waste products from the blood passing through vessels lining the inside
of the abdomen.

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