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Chapter 16:
The Microcirculation and Lymphatic System
The Microcirculation
Important in the transport of nutrients to tissues. Site of waste product removal. Over 10 billion capillaries with surface area of 500-700 square meters perform function of solute and fluid exchange.
Solute and water move across capillary wall via intercellular cleft (space between cells) or by plasmalemma vesicles.
Copyright 2006 by Elsevier, Inc.
Substance
Water NaCl Urea Glucose Sucrose Insulin Myoglobin Hemoglobin Albumin
Molecular Weight
18 58.5 60 180 342 5000 17,600 69,000 69,000
Permeability
1.00 0.96 0.8 0.6 0.4 0.2 0.03 0.01 .0001
Two major types of solid structures in interstitium are collagen fibers and proteoglycan filaments (coiled molecules composed of hyaluronic acid).
Almost all fluid in interstitium is in form of gel (fluid proteoglycan mixtures); there is very little free fluid under normal conditions. Advantages of tissue gel are as follows:
1. It keep the cells in the tissues held apart so that spaces are available for the movement of fluid. 2. Tissue gel prevents the movement of fluid from the upper part of the body to lower part due to gravity. 3. It immobilizes the bacteria so prevents the spread of infection
Figure 16-4; Guyton and Hall
Capillary hydrostatic pressure (Pc)-tends to force fluid outward through the capillary membrane.
Interstitial fluid pressure (Pif)- opposes filtration when value is positive.
Copyright 2006 by Elsevier, Inc.
Plasma colloid osmotic pressure ( c)- opposes filtration causing osmosis of water inward through the membrane Interstitial fluid colloid pressure ( if) promotes filtration by causing osmosis of fluid outward through the membrane NP = (Pc Pif)- ( p - if)
Copyright 2006 by Elsevier, Inc.
p(mmHg)
21.8 6.0 0.2 28.0
Filtration rate = net filtration pressure (NFP) multiplied by the filtration coefficient Filtration coefficient (Kf) is a product of surface area times the hydraulic conductivity of membrane
Copyright 2006 by Elsevier, Inc.
mmHg
17.3 3.0 8.0 28.3 28.0 28.0
Net filtration pressure of .3 mmHg which causes a net filtration rate of 2ml/min for entire body.
Copyright 2006 by Elsevier, Inc.
Lymphatic System
An accessory route by which fluid and protein can flow from interstitial spaces to the blood Important in preventing edema Lymph is derived from interstitial fluid that flows into the lymphatics
1. It carries excess of interstitial fluid from interstitium into the blood. Rate of lymph flow is more than 3 liters/day. So this amount is drained by lym phatic system. 2. It drains proteins and electrolytes from Interstitial space into lymphatic system. Lymphatic system drain 195 grams of blood proteins from interstitium back into the blood. 3. It provides lymphocytes and antibodies into the circulation 4. Removes bacteria and other microorganisims from the tissues. 5. Lacteals are involved in the absorption and transport of lipids. 6. Many large enzymes which are produced in the tissues get entry into the circulation through lymphatic system like histaminases and lipase. 7. It maintains the negative interstitial fluid hydrostatic pressure.
C. Decreased arteriolar resistance 1. Excessive body heat 2. Insufficiency of sympathetic nervous system 3. Vasodilator drugs
The development of edema is not an easy process. First the safety factor has to be overcome to cause edema. Safety factor is equal to 17 mm of Hg. It has three components i.e.
1. Negative Interstitial Fluid Hydrostatic pressure: which contributes -3 mm of Hg. 2. Capacity of Lymphatic System: Increased amount of tissue fluid formed by 7 mm of Hg increase in Capillary pressure can be drained by lymphatic flow 3. Increased Washout of proteins from Interstitium: it contributes 7 mmHg. When there is increased formation of tissue fluid there is increased amount of fluid along with proteins that will enter the interstitium and then lymphatics for washing out. So the interstitial fluid colloid osmotic pressure can decrease from 8 mm of Hg upto 1mm of Hg before edema can start.