1) Cardiovascular system consists of blood, blood vessels and heart. Human beings have a ‘closed circulatory system’. During its entire trip around the body, the blood remains in blood vessels and never comes in direct contact with the tissue cells.
Heart receives blood through auricles and pumps out blood from ventricles. Left and right auricles are communication chambers located on the upper half of the heart. Auricles receive deoxygenated blood from the body and then send it to the right ventricle that pumps it to lungs. Ventricles, located on the lower half are larger than auricles. Left ventricles have thicker walls as compared to right ventricles due to their functional differences. Right and left ventricles are demarcated externally by a groove called ‘inter-ventricular sulcus’.
Pulmonary arch, a large blood vessel arising from right ventricle of the heart divides into 2 pulmonary arteries each of which upon entering into lungs break into network of very fine blood vessels called ‘capillaries’ around the alveoli of the lungs.
Inside the lungs blood intakes oxygen, becomes oxygenated and then passes from 4 pulmonary veins, two from each lung. These veins return oxygenated blood from right ventricle to left auricle. Passage of blood from the right ventricle to left auricle of the heart through the lungs is called ‘pulmonary circulation’.
Left ventricle pumps oxygenated blood into great artery (artery coming directly from the heart) named ‘aortic arch’. This divides into arteries to all organs except lungs. Arteries give off arterioles in the organs branch repeatedly to form capillaries. As oxygen is distributed to tissue cells, the blood gets deoxygenated. This deoxygenated blood is brought to right auricles by great veins (superior and inferior vena cava) to the right auricle. The entire course of blood from left ventricle to right auricle of the heart via body tissues (except lungs) is referred to as ‘systemic circulation’.
Exchange of gases inside lungs: O2 inside alveoli in lungs has higher partial pressure than that in blood, due to which its diffusion into blood takes place. Diffusion of CO2 takes place in reverse direction its pressure or concentration in the lung capillaries is lower than that in the blood
2) If Jake starts smoking, he gets susceptible to the toxic effects of smoking. Air pollutants given out in tobacco smoke are harmful for blood cells and gradually affect their structure and normal functioning. Moreover, toxins released can damage the heart’s functional ability.
Smoking leads to formation of a waxy substance in the arteries termed plaque. With the hardening of this waxy substance, the annular space between arteries is reduced. Ultimately, the flow of oxygenated blood to Jake’s organs including lungs gets restricted.
Smoking reduces ‘vital capacity’ of lungs. Vital capacity refers to the maximum volume of air which a person can exhale with maximum effort after inhalation with maximum effort. Toxins released during the smoking process may lead to break down alveoli of lungs and may reduce surface area of gas exchange.
3) If Jake is diagnosed with high blood pressure it means his smoking habit has over the years disrupted the delicate cardiovascular system. Blood pressure is pressure against the walls of the blood vessel due to discharge of blood by contractions of left ventricle. High blood pressure is a case of circulatory disorder manifested due to factors such as reduced cardiac cycle efficiency, resistance offered by arterioles and capillaries to blood flow and imbalance between ‘systolic and diastolic pressure’. Systolic and diastolic pressure refer to rise or fall in pressure during the alternate contraction and relaxation of heart chambers( auricles and ventricles) which in turn respectively reduce volume and cause blood outflow and restore to size and receive blood.
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‘Emphysema’ is caused when there is irreversible impairment of the delicate linings present in the ‘air sacs’ of the lungs. It is also referred to as airflow limitation. As Jake begins to smoke; the disorder manifests itself as the tissues between air sacs are damaged beyond their healing capacity. This leads to development of air pockets. There is increased chance of emphysema when a person has been smoking for considerable period which applies to this case. Formation of air pockets in the lungs slowly leads to gradual expansion of lungs. Due to this the patient shall take more time to breathe.
4) Doctor finds it necessary to conduct more diagnostic tests because Jake(due to smoking habit) is prone to other serious diseases like chronicbronchitis, arteriosclerosis, anaemic hypoxia etc. Since Jake is already emphysemic, there can be chance of deterioration in cardiac performance and increased possibility of ‘coronary vasoconstriction’. Smoking has adverse effect on Jake’s ‘systemic and coronary heterodynamics’ besides the homeostasis of systemic and pulmonary circuit.
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Besides, regular and continued diagnosis is required to suggest adequate medication for Jake to enable him quit his smoking habits.