Microcirculation
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| Microcirculation | portion of teh systemic and pulmonary circulations adapted for the exchange of gases, nutrients and waste products
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| Anatamy of Micro circulation | Metarterioles -> Precapillary sphincter region -> Capillaries -> A-V Shunt -> Venules
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| Precapillary sphincter | smooth muscle cell
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| A-V Shunts | Arterial - Venous Shunt
Blood from artery shunts blood to venous side without passing thru the capillaries
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| Capillary Anatomy | 7-10micron diamater
Single layer endothelium and basement membrane
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| Low Continuous Exchange | Muscle, nerve adipose
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| High Continuous Exchange | Lymph and thymus
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| Open Fenestrated | Renal Glomeruli
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| Closed Fenestrated | Endocrines adn intestinal villi
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| Discontinuous | liver, bone marrow, spleen
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| Neural Control of peripheral circulation | Sympathetic Alpha-adernergic vasoconstriction
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| Sympathetic Alpha adernergic vasoconstriction work on | metarterioles
arteriols
some Beta 2-adernergic vasodilation
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| Local control of periphery | local metabolic control of precapillary sphincter opening and closing; AUTOREGULATION
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| Regulation of microvascular resistance | Myogenic regulation
activer hyperemia
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| Mygenic regulation | increased pressure causes active relaxation
relaxation causes active contraction
prevents edema with sudden BP increase
assists with organ AUTOREGULATION
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| Active hyeremia | increased blood flow with increased metabolism
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| Products that relax sphincter smooth muscle | H+
O2
CO2
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| Adenosine | potent dilator and especially important for the heart and brain
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| Increased pressure causes _____________ | active relaxation
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| Relaxation causes ___________ | active contraction
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| Encothelial cell shear causes synthesis of __ | NO
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| NO inhibits _____________ | smooth muscle contraction
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| NO activates | Guanylate cyclase
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| guanylate cyclase makes | cGMP
cyclic Guanosine Monophosphate
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| cGMP inhibits | smooth muscle contraction
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| NO released from endothelial cells by ____________ and _____________ | endothelial NO synthase and arginine
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| Fick's Law of Perfusion | J=PS(dc/dx)
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| PS | permeability and surface area
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| dc/dx | concentration difference between blood and interstitium
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| Permeability and surface area depend on | -temp, molecular radius and viscocity
-% of capillaries open
-type of endothelium
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| Types of Limited Transport | Flow Limited
Rate Limited
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| Flow Limited transport | diffusion is fast and transport is only changed by the rate of blood perfusing a tissue
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| Rate Limited Transport | Larger molecules have difficulty moving thru pores and thus diffusion is rate limiting
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| Pneumonia | Oxygen and CO2 are normally flow limited
Fluid adds diffusion distance and viscocity
diffusion of gases shifts from flow-limited to diffusion-limited
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| Water movement depends on (2) | pressure differences across teh capillary membrane
Hydrolic conductivity and area of diffusion
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| Starling-Landis Equation | equation for movement of water
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| Capillary filtration Coefficient | Water vol/ml/min per 1 mmHg P change / 100 g tissue
Compares how leaky different tissues are for water
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| Capillary filtration coefficent changes with _____________- | permeability of each capillary and which cross section is perfused
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| Burns | destroys capillary integrity so permeability increases, plus increase albumen leaks out
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| CHP | Capillary Hydrostatic Pressure
BP of capillary
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| THP | Tissue hydrostatic Pressure
Fluid pressure associated between fluid between the cells
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| TOP | Tissue Oncotic Pressure
Force of water trying to dilute the protein concentration of the interstital fluid
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| COP | Capillary Oncotic Pressure
Force of water trying to dilute the protein concentration of interstitial side
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| Two outward pressures driving water | Capillary Hydrostatic Pressure
Tissue Oncotic Pressure
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| Two inward pressures driving water | Capillary Oncotic Pressure
Tissue Hydrostatic Pressure
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| Water Pressure Equilibrium | CHP + TOP = COP + THP
THP ~ TOP ~ 0 mmHg
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| California Gangster Rule | CHP=COP
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| Increased capillary hydrostatic Pressure | CHP > COP
heart failure
DVT
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| Low Plasma Proteins | COP < CHP
Quashiorkor
Severe burns
nephrosis
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| Lymphedema | CHP+TOP > COP
Sinus infection plugs up lymph drainage
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| Quashiokor | protein malnutrition
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