L5. Microcirculation..Dr Chillo

Microcirculation
Multicellular Vascular System
Arteriole
12/30/2014 Dr. Omary Chillo (MD, PhD) 2

Role??
- Transport of cells,
Constist of;
1. Arteriole (15-20µm) oxygen and other
2. Pre-capillary substances to/from
schincters the tissues
3. Capilaries (4-9µm) -Regulation of body
4. Venules (10-50µm) temperature
- Blood pressure
Hindlimb
Arterioles
• Consist of thin muscular walls (usually only one to two
layers of smooth muscle) and are
• Primary site of vascular resistance.
• Any pathology which constricts blood flow, such as stenosis,
will increase total peripheral resistance and lead to
hypertension.
• Total peripheral resistance refers to the cumulative

resistance of the thousands of arterioles in the body, or
the lungs, respectively.
• Total peripheral resistance = Mean Arterial Pressure /
Cardiac Output.
Capillaries in the gastrocnemius
Passage of Materials in Capillary
Endothelial cell
Basement
Membrane
Lumen (4-9 µm)

Intercellular clefts
1. Lipid soluble molecules (O2 and CO2)

2. Small water soluble molecules (glucose, Amino acids)
3. Large water soluble molecules (some proteins through vesicles)
- Continuous Capillaries No clefts or channels
- Fenestrated Capillaries  Clefts and Channels
- Discontinuous Capillaries Clefts and big channels
Fluid exchange across the capillary
The Frank Starling forces
1. Capillary Hydrostatic pressure – Pc

2. Interstitial fluid hydrostatic pressure – Pi
3. Capillary Oncotic pressure – πc
4. Interstitial fluid oncotic pressure – πi
Capillary Capillary
venous end arterial end
πc Pc
πi Pi
STARLINGS FORCES
The rate of filtration at any point along the capillary depends
on a balance of forces –
• 1. Capillary hydrostatic pressure (Pc)

Arterial end = 30 mmHg
Venous end = 10 mmHg
• 2. Plasma colloid osmotic pressure (πc) = 28 mmHg
• 3. Interstitial fluid pressure (Pi) = 3 mmHg
• 4. Interstitial fluid colloid osmotic pressure (πi) = 8 mmHg
Filtration force = K{(Pc – Pi) – (πc – πi)}

What is the What is the
filtration force filtration force
Intrinsic (local) control of blood flow
Blood flow varies in every organ of the body
1. Myogenic Hypothesis
- Vascular smooth muscle contracts when stretched
2. Metabolic Hypothesis
- Tissue supply of O2 is matched to tissue demand for O2
- Vasodilator metabolites (CO2, H+, K+, lactate, temperature and
adenosine, nitric oxide)
- Vasoconstrictor Endothelin produced by the endothelium
Extrinsic control of blood flow
1. AUTOMONIC nervous system, the sympathetic nerve

influence
2. Accomplished to lesser extent by hormonal influence over
arteriolar smooth muscle, Angiotensin II, Vasopressin
Lymphatic circulation
Lymphatic System
 One way system: to the heart

 Return of collected excess tissue
fluid
 Return of leaked protein
 “Lymph” is this fluid
 Edema results if system blocked
or surgically removed
 Lymph nodes destroy most
pathogens
Lymphatic circulation
• Lymphatic system is responsible for bringing

the interstitial fluid to vascular
compartment.
• Normal 24 hrs lymph flow is 2-4 L
• Lymphatic capillaries lie in interstitial fluid

close to vascular capillaries ,these capillaries
merge into large lymphatic vessels &
eventually into largest vessel, thoracic duct
which empties into large veins .
What is Edema?
• Accumulation of fluid
beneath the skin or in a
body cavity
• Palpable swelling produced

by expansion of the
interstitial fluid volume
Causes of Edema
• Increase capillary • Decrease colloidal

pressure (Pc) osmotic pressure (πc)
– Increase vascular – Increase loss of
volume proteins
• Heart failure • Nephrotic syndrome
• Kidney disease • Burns
• Pregnancy – Decrease production
• Environmental heat • Starvation,
stress Malnutrition
– Venous obstruction • Liver disease
• Thrombosis
• Liver disease
Causes of Edema
• Increase capillary • Obstruction of

permeability lymphatic flow
– Inflammation – Surgical removal of
– Allergic reaction lymph nodes
– Tissue injury – Malignant
– Malignancy obstruction
– Infection ( filariasis)
What would happen if
1. the liver stops synthesizing albumin
2. venous pressure increases significantly
3. arterial pressure drops to well below normal
levels.
Heart failure increases capillary pressure because it increases venous

pressure.
The Nephrotic syndrome and liver failure both induce loss of plasma
proteins with a consequent decrease in plasma oncotic pressure.
An abnormal increase in capillary permeability will produce loss of fluid
from the capillary through a greatly debilitated permeability barrier.
Lymphatic blockade can significantly raise intertitial oncotic pressure
producing fluid retention in the affected area. A common cause for this
problem in older times was elephantiasis.
What could happen
when the
microcirculation
becomes disturbed in
different places?

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Microcirculation

Multicellular Vascular System

12/30/2014 Dr. Omary Chillo (MD, PhD) 2

• Total peripheral resistance refers to the cumulative

Lumen (4-9 µm)

1. Lipid soluble molecules (O2 and CO2)

The Frank Starling forces

1. Capillary Hydrostatic pressure – Pc

• 1. Capillary hydrostatic pressure (Pc)

• 2. Plasma colloid osmotic pressure (πc) = 28 mmHg

• 3. Interstitial fluid pressure (Pi) = 3 mmHg

• 4. Interstitial fluid colloid osmotic pressure (πi) = 8 mmHg

Filtration force = K{(Pc – Pi) – (πc – πi)}

Blood flow varies in every organ of the body

1. AUTOMONIC nervous system, the sympathetic nerve

 One way system: to the heart

• Lymphatic system is responsible for bringing

• Lymphatic capillaries lie in interstitial fluid

• Palpable swelling produced

• Increase capillary • Decrease colloidal

• Increase capillary • Obstruction of

Heart failure increases capillary pressure because it increases venous

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