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WVSOM -- Physio

Microcirculation

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