the microcirculation. main concepts guido e. santacana ph.d. professor dept. of physiology
TRANSCRIPT
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THE THE MICROCIRCULATION.MICROCIRCULATION.MAIN CONCEPTSMAIN CONCEPTSGuido E. Santacana Ph.D.Guido E. Santacana Ph.D.
ProfessorProfessor
Dept. of PhysiologyDept. of Physiology
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MICROCIRCULATIONMICROCIRCULATION STRUCTURESTRUCTURE LAW OF LAPLACELAW OF LAPLACE TRANSCAPILLARY EXCHANGETRANSCAPILLARY EXCHANGE STARLING’S HYPOTHESISSTARLING’S HYPOTHESIS LYMPHATICSLYMPHATICS
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Structure of the Structure of the MicrocirculationMicrocirculation
Smoothmuscle
Arteriole
Venule
Metarteriole
Capillary
Endothelial cells
Precapillarysphincters
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Ultrastructure of a Ultrastructure of a CapillaryCapillary
Lumen
Intracellular channels
Endothelial cell 1
Endothelial cell 2
Basement membrane
Nucleus
Intercellular cleft
5-10 m
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LAW OF LAPLACELAW OF LAPLACE
T = P x r/wt
Tension = Pressure x Radius / wall thickness
Why do the capillaries in our feet don’t just burst from thepressure (about 100mmHg)?
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How does Laplace Work?How does Laplace Work?
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Less wall tension with Less wall tension with smaller radius?smaller radius?
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FLOW AND DIFFUSION LIMITED FLOW AND DIFFUSION LIMITED TRANSPORTTRANSPORT
PARTICLE SIZEAND FLOW
CELL
FLOW LIMITED PARTICLE SIZE &DISTANCE
CELL
DIFFUSION LIMITED
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REFLECTION COEFFICIENTREFLECTION COEFFICIENT
oncotic pressure = o RT (Ci - Co)
water=0 albumin=1
RT= gas and temperature constantsCi= concentration insideCo= concentration outside
REFLECTION COEFFICIENT = ACTUAL OSMOTIC FLOW/ THEORETICAL
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CAPILLARY FILTRATIONCAPILLARY FILTRATION
HYDROSTATICFORCES
OSMOTIC FORCES
ARTERIAL PRESSUREVENOUS PRESSUREPRE-POST CAPILLARY RES.INTERSTITIAL FLUID PRESSURE
ONCOTIC PRESSURE
ALBUMIN
BALANCESTARLING’S HYPOTHESIS
Qf = k (Pc + i) - (Pi + p)
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Graphic Representation Graphic Representation of Capillary Filtrationof Capillary Filtration
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Capillary Filtration in Capillary Filtration in Various Clinical ConditionsVarious Clinical Conditions
A B
C D
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What I cannot forget What I cannot forget about Microcirculation about Microcirculation
Four Forces known as Starling ForcesDetermine Fluid Movement Across the Capillary Membranes.
Pc= Capillary Pressure Tends to move fluid out of the capillaryPi= Interstitial Fluid Pressure Tends to move fluid into the capillary.Πc = Plasma Colloid Osmotic Pressure Tends to cause Osmosis of fluid into capillary.Πi = Interstitial fluid colloid osmotic pressure Tends to cause osmosis of fluid out of the capillary.Net Filtration Pressure = Pnet= ((Pc-Pi) – (Πc- Πi))
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More things that I cannot More things that I cannot forget about the forget about the microcirculationmicrocirculation
EDEMA or excess fluid outflow into the interstitium is commonlycaused by :
Capillary Pressure ( Pc ; Heart Failure)
Plasma Proteins ( Πc ; Nephrotic Syndrome, liver failure)
Capillary Permeability ( Kf ; Toxins, infections, burns)
Interstitial Fluid Colloid Osmotic Pressure ( Πi; lymphatic blockage)
Net Fluid Flow = Pnet (Kf)
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Pitting Edema of the FeetPitting Edema of the Feet
A Pit forms where theskin is pressured. It mayremain there for a few minutes
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The Lymphatic SystemThe Lymphatic System
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Elephantiasis or Elephantiasis or Lymphatic FilariasisLymphatic Filariasis