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Flashcards in Microvasculature Deck (21):
1

Calculating mean arterial pressure (MAP)

-MAP = CO x TPR
-Therefore MAP will increase if CO increases and TPR is constant, or if TPR increases and CO is constant
-MAP will not increase if one increases and the other decreases as long as the product is the same

2

Differences btwn arterial and venous systems

-Arterial: low resistance, high BP, low volume (10%), low compliance
-Venous: low resistance, low BP, high volume (70%), high compliance

3

Factors affecting venous return

-Residual BP after capillaries (Pv)
-Venoconstriction via sympathetic output on veins
-Skeletal muscle pumps
-Respiratory pump (negative pressure from expanding thorax during inspiration drives blood back to heart)
-Cardiac suction: movement of heart during early systole sucks blood into atria

4

Functions of microcirculation

-Regulates TPR
-Regulates distribution of blood flow
-Site of exchange of solutes btwn blood and tissue (regulated by permeability of vessels)
-Movement of fluid btwn vascular and interstitial space

5

Architecture of microvasculature 1

-There are arterial-venous shunts (anastomoses) btwn some arterioles and venues
-There are pre-capillary sphincters (vascular smooth muscle cuffs) at the entrance of capillaries (arteriole side), largely determine Pa

6

Architecture of microvasculature 2

-There are post-capillary resistance vessels that determine Pv
-Metarteriole connects arterioles to venules, but also sends out capillary branches to the capillary bed
-Arterioles, metarterioles and large venules/veins are innervated by sympathetics and have smooth muscles (less so in veins/venules)

7

Pre-capillary resistance vessels

-Small arteries and arterioles have high degree of tone at rest, but this tone is the major site of TPR regulation
-Arterioles change diameter in response to more or less sympathetic stimulation, and its the diameter change in arterioles that regulates TPR
-The resistance in these vessels is also controlled by local factors
-The vessels determine the number of capillaries open and perfused at any moment, and thus control the capillary surface area exposed for solute exchange

8

Physics of capillaries

-Due to the extremely large overall cross-sectional area, there is very slow flow thru capillaries to facilitate transport
-The blood has a greatly increased area of contact w/ surrounding tissue when it is in a small diameter vessel
-The ratio of pre-capillary resistance (resistance in arterioles, Ra) to post-capillary resistance (resistance in venules, Rv) determines the pressure in the capillary themselves (Pc)

9

Vascular tone

-The tone in pre-capillary beds is due to physical factors (BP in vessels), chemical factors (local metabolites), and neural input
-Some pre-capillary beds have high resting tone (SKM), some have low (renal)

10

Vascular smooth muscle categories

-Multi-unit: minimal electrical communication btwn muscle cells, depends on nerve impulses to initiate contraction
-Single-unit: capable of cell-cell propagation of APs and contains pacemaker cells (can be innervated)
-The pacemaker cells respond to stretch by increasing frequency of firing, which yields contraction of the vessel
-Single-unit vessels are very responsive to local environmental changes, while multi-unit muscles can respond to environmental changes but are mostly driven by innervation

11

Distribution of different SM unit types

-Large arteries have mostly multi-unit, with medium sized arteries having both and arterioles having mostly single-unit
-Capillaries do not have SM
-Small venues have mostly single unit, medium veins have both, and large veins have mostly multi-unit
-Key note: The blood vessels in the brain are all exclusively single units that are not innervated, therefore blood flow to regions of the brain depend solely on local changes

12

Neural control of blood flow

-Single units can be innervated by sympathetics, but the pre-capillary sphincters are not (local only)
-NE induces contraction of SM (alpha-adrenergic vasoconstriction)
-Inhibition of NE release leads to muscle relaxation and vasodilation

13

Hormonal control of blood flow

-Epinephrine at low concentrations combines w/ b2 receptors and dilates blood vessels, lowering TPR
-At higher concentrations the a1 affects outweigh the b2 effects and there is vasoconstriction, increasing TPR

14

Metabolic regulation of blood flow

-Most local metabolites will cause vasodilation, and the importance of each factor varies from bed to bed
-Increase in these factors leads to vasodilation and increase in flow
-The increase in flow decreases the amount of these factors, leading to more vasoconstriction and increased pressure

15

Myogenic regulation of blood flow

-Only in single-unit SM, which have pacemakers that respond to stretch
-The stretch is a function of the pressure across the wall and the compliance of the wall
-Increasing the stretch increases pacemaker firing, and the smooth muscle cells respond by contracting
-Usual reason for increased stretch is increased blood pressure

16

Autoregulation

-Only local factors impart the ability of auto regulation, where as neural and endocrine factors are extrinsic regulation
-The purpose of auto regulation is to maintain a constant blood flow, thus if there is increased pressure -> increased gradient -> increased flow then the body vasoconstricts (due to stretch-> increased pacemaker firing-> vasoconstriction) to increase resistance and restore flow to normal levels

17

Solute exchange

-The most important mechanism for solute exchange is diffusion
-Lipid soluble substance (including CO2, O2 and H2O) can pass through the endothelial cells and thus diffuse thru any type of capillary bed (freely diffusible)
-Small molecules and ions (glc, K, Na) can pass thru pores in fenestrated and discontinuous capillaries (restricted diffusion)
-Large molecules must move through large pores/channels or via pinocytosis
-Overall, small things diffuse thru capillary walls faster than big things (smaller diffusion coefficient)

18

Filtration-absorption 1

-The way in which fluid is moved btwn the circulatory system and interstitial fluid (ISF)
-What moves btwn the two is an ultra-filtrate of plasma not containing large proteins or cells
-This is a balance of essentially 2 factors: pressure in the capillary (Pc; pushing out) and oncotic pressure of plasma (due to plasma proteins/albumin; pulling in)
-Oncotic pressure is 25 mmHg, thus as long as Pc > 25 there is net filtration (fluid moves out of capillaries)
-If the Pc < 25 there is net absorption (fluid moves into capillaries

19

Filtration-absorption 2

-Generally, in the upstream areas of capillaries (near arterioles) the pressure is above 25 and filtration dominates
-As the blood moves further down to the venous side Pc falls below 25 and absorption dominates
-Pc is determined by the ratio of arteriole resistance to venule resistance (Ra/Rv)
-High Ra means less flow thru arterioles and thus lower Pc
-Low Ra means more flow thru arterioles into capillaries and thus higher Pc

20

Filtration-absorption 3

-If Ra/Rv increases (arterioles constrict), Pc decreases and absorption is more favored
-If Ra/Rv decreases (arterioles relax), Pc increases and filtration is more favored
-Since the resistance of arterioles is what most changes, Ra/Rv is largely determined by Ra (Rv is relatively static)
-It is worth noting that since Ra/Rv is generally around 5, a single unit increase in Rv has a 5x greater impact on the ratio as a single unit on Ra

21

Overview of transport

-Bulk flow of fluid btwn ISF and capillaries: filtration-absorption
-Movement of solutes in and out of the capillaries: diffusion
-The lymphatic system picks up and recycles the excess filtrate that is not reabsorbed by the capillaries (about 2-4L/day excess filtrate)