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in that they do not stop growing and dividing. The cells keep doubling, forming a tumour growing in size.

Schematic illustration of simple diffusion.

       Source: Tortora GJ, Derrickson B. Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley (2017).

Schematic illustration of channel-mediated facilitated diffusion of potassium ions (K+) through a gated K+ channel.

       Source: Tortora GJ, Derrickson B. Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley (2017).

Schematic illustration of osmosis. Water molecules move through the selectively permeable membrane; solute molecules cannot.

       Source: (a) Tortora GJ, Derrickson B. (2017) Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley, (b) David M. Phillips/Science.

Schematic illustration of tonicity and the red blood cell.

       Source: Tortora GJ, Derrickson B. Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley, with permission from John Wiley & Sons (2017).

      Cells perform chemical reactions essential for organism survival. The substances required for these reactions to occur (for example, oxygen and glucose) have to enter the cells and waste products must be removed from the cells. In humans, substances move into and out of cells by osmosis diffusion active transport; plasma membranes are selectively permeable. The cell membrane (see Chapter 5) acts as a gatekeeper, ensuring the cell’s cytoplasm remains in place, and will only permit entry to and allow exit from the cell as needed. Three transport systems will be discussed in this chapter: simple diffusion facilitated diffusion and osmosis.

      This is a type of diffusion in which molecules are transported across the plasma membrane with the assistance of membrane proteins because the molecules are too polar or highly charged to move through the lipid bilayer by simple diffusion. The molecule to be transported first binds to a receptor site on the carrier protein. The shape of the protein then changes and the molecule is transported into the cell where it is released into the cytoplasm. Once transportation is complete, the protein will then return to its normal shape.

      Endocytosis is an energy‐using process by which cells absorb molecules (such as proteins) by engulfing them. Endocytosis occurs in three different ways.

      1 Phagocytosis: pseudopodia engulf the particle to be imported.

      2 Pinocytosis: the cell membrane pinches in to engulf a portion of extracellular fluid containing solutes required by the cell. This process is non‐specific; any solutes in the solution will be engulfed.

      3 Receptor‐mediated endocytosis: this process allows the intake of large quantities of molecules that may not be in high concentration in the extracellular fluid.

      Exocytosis is the process by which the cell releases materials to the outside by discharging them as membrane‐bound vesicles passing through the cell membrane.

      Clinical practice point

      While phagocytosis is an effective defence mechanism, some pathogenic species can escape this process, including E. coli and S. aureus. Diminished phagocytosis can

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