capillaries: solute exchange Flashcards

1
Q

Describe the structure of the cell membrane

A

Lipid bilayer

Phosphate head is polar (hydrophilic)

Fatty acid tail is non-polar (hydrophobic)

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2
Q

Name 4 functions of the cell membrane

A
  1. Provides support and protection
  2. Cell-to-cell recognition (eg- immune system)
  3. Controls what enters and exits the cells (eg- ion movement in nerves)
  4. Regulates cell function (eg- insulin-mediated glucose uptake)
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3
Q

What are the 2 types of transport in the body

A
  1. Passive transport
    • The movement of molecules down a gradient
    • Does not require energy
    • Can be simple (O2 + CO2) or facilitated (ions + glucose)
      2. Active transport
    • The movement of molecules against a gradient
    • Requires energy (uses ATP)
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4
Q

What are the 4 passive transport processes?

A
  1. Diffusion
    • Has a concentration gradient
    • For example uptake of oxygen from the lungs—> blood
      2. Convection
    • Has a pressure gradient
    • For example blood flow from the heart —> blood vessels
      3. Osmosis
    • Has an osmotic pressure gradient
    • For example uptake of water by cells
      4. Electrochemical flux
    • Has an electrical and concentration gradient
      For example ion flow through the action potential in a nerve
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5
Q

Where does solute and fluid exchange take place?

A

It takes place in the capillaries

These vessels connect arterioles to venules; they’re an extension of the inner linings of the arterioles

They are one cell thick and are semi permeable

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6
Q

Name some properties of capillaries

A

· Smallest diameter out of the blood vessels
· One cell thick
· Semi permeable

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7
Q

Where are capillaries found?

A

Found near every cell in the body but higher density in highly active tissue (muscle, liver, heart, kidney, brain etc)

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8
Q

How does solute exchange occur in capillaries?

A

Solute exchange via passive diffusion for example oxygen, glucose, amino acids, hormones and drugs
Fluid exchange along pressure gradients

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9
Q

What affects the rate of solute transport?

A
  1. Properties of passive diffusion
    Rate
    Distance
    Concentration
  2. Properties of solutes and membrane
    Ficks law
  3. Properties of capillaries affect the movement
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10
Q

List the properties of passive diffusion

A

• DOES NOT require energy (ATP)
• Movement from a high —> low concentration gradient
• Efficiently transports lipid-soluble solutes over very short distances
Only short distances because the time taken (t) for a molecule to move a net distance (x) in one direction increases with the distance squared ( t= x^2/2D)

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11
Q

List some properties of solutes and membranes that affect transport

A
1. Solutes 
	• Concentration gradient 
	• Size of solute 
	• Lipid solubility of the solute (lipophilic or lipophobic)
	2. Membranes 
	• Membrane thickness and composition 
	• Aqueous pores in the membrane 
	• Carrier-mediated transport 
Active transport mechanisms
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12
Q

What is Fick’s law and what does it state?

A

It describes diffusion (for example: the movement of a molecule down the concentration gradient)
It states that the solute movement can be determined by four factors:
1. The diffusion coefficient of the solute (the ease of movement through the solvent)
2. The area
3. The concentration gradient
4. The distance

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13
Q

List the three types of capillaries and describe them

A
  1. Continuous capillaries
    • Moderate permeability with tight gaps between neighbouring cells
    • Have a constant basement membrane
    • Found in the blood-brain barrier, muscle, skin, fat and connective tissue
    1. Fenestrated capillaries
      • High water permeability with fenestration structures throughout the cells (hence a moderate disruption of the membrane)
      • Found in high water turnover tissues, such as salivary glands, kidneys, synovial joints, anterior eye, choroid plexus (spinal fluid), and gut mucosa
    2. Discontinuous capillaries
      • Very large fenestration structures throughout, and a disrupted basement membrane
      Found where the movement of RBC’s is required such as the liver, spleen and bone marrow
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14
Q

List some properties of capillaries that affect transport

A
  1. Intracellular cleft
    • 10-20 nm wide
    • Allows solutes and fluids to move through between the cells
      2. Caveolae and vesicles
    • Large pore system
    • For the movement of proteins across the membrane
      3. Glycocalyx
    • A negatively charged material that covers the endothelium, blocking solute permeation and access to transport mechanisms
    • Its highly regulated
      Glycocalyx is very dynamic and can be broken down and remade as required
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15
Q

What is permeability and what is its relation with diffusion?

A

Permeability is the rate of solute transfer by diffusion across a unit area of membrane per unit concentration difference (how freely a solute crosses a membrane)
A porous membrane interferes with the diffusion of lipid insoluble solutes in multiple ways:
1. A reduction in the area for diffusion
2. An increased path length through the membrane
3. Restricted diffusion in the pore produces hydrostatic issues

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16
Q

What is the dominant route of transport; diffusion or filtration?

A

diffusion

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17
Q

Describe the modification of Fick’s law for a porous membrane

A
Js = rate of solute transport 
P = permeability; involving pore size, length, diffusion coefficient 
Am = surface area of capillary involved in transport 
ΔC= change in concentration
18
Q

Describe the mechanisms of transport of glucose around the body

A

Filtration transport only accounts for 2% glucose transport

98% of glucose transport into interstitial space via passive diffusion (via GLUT transporter system)

19
Q

Name 3 things that increase diffusion rate

A
1. Increased blood flow 
	Increases solutes in capillaries 
	2. Fall in interstitial concentration 
	Increases the concentration difference 
	3. Recruitment of capillaries
Dilation of arterioles leads to an increased number of capillaries perfused
20
Q

What is the importance of fluid exchange?

A

Fluid exchange is important for normal physiological function, for example, we need H2O for chemical reactions

Fluid re-absorption from the tissues to the blood can maintain circulation during a haemorrhage

Abnormalities in fluid exchange can lead to oedema/swelling

21
Q

What is the cause of lymphoedema?

A

Causes by removal of lymph nodes OR lymph node damage due to radiotherapy for testicular cancer

22
Q

Briefly describe the fluid movement at the capillary wall in terms of hydraulic and oncotic pressure

A

The capillary wall is semi permeable

Fluid moves across the membrane into the interstitial space due to blood flow, which exerts a hydraulic pressure

Large molecules cannot pass through the membrane so they exert an osmotic pressure (oncotic pressure); creating a suction force to move fluid into the capillary

Fluid movement across capillary walls depend on the balance between hydraulic and oncotic pressure across the capillary walls

23
Q

What are the 4 pressures that determine filtration rate?

A
  1. Pc: capillary blood pressure
    1. Pi: interstitial fluid pressure
    2. Πp: plasma proteins
    3. Πi: interstitial proteins
24
Q

How do we calculate effective osmotic pressure?

A

Reflection coefficient x potential osmotic pressure

25
Q

What is the reflection coefficient for plasma proteins and what does this show?

A

0.9

This means that 10% of plasma proteins are conducted across the capillary wall into the interstitial space

26
Q

What does Starling’s law normally favour in capillaries?

A

Favours filtration
There are factors that favour filtration (Πi and Pc) and factors that favor reabsorption (Πp) however the balance is tipped more towards filtration. This is balanced by OTHER factors

27
Q

Describe how Pc and Πi change along the length of the capillary

A

Πi stays the same along a well perfused capillary
Pc is higher at the arterial end of the capillary and decreases towards the venule end of the capillary
Along the capillary at around Pc=25 mmHg tissue fluid leaves the capillary into surrounding cells to form excess fluid which is returned to the CVS as lymph via the lymphatic system

28
Q

How do you calculate the net filtration along a capillary?

A

P = (Pc-Pi) - sigma(Πp-Πi)
This is because in normal conditions (well perfused capillaries) Lp and A are constant so are not taken into account in the equation

29
Q

Describe the levels of filtration along the capillary

A

More filtration at arterial end

Less filtration at venule end due to pressure drop

30
Q

How does the lymphatic circulation relate to fluid exchange in capillaries?

A

Lymphatic system returns excess tissue fluid back into the CVS
Lymphatic system also contains immune cells at the lymph nodes

31
Q

How is lymph fluid carried to the CVS?

A

Lymph vessels has valves and smooth muscle; the smooth muscle contraction is what allows the lymph to flow
Surrounding skeletal muscle contraction and relaxation also contributes to lymph flow

32
Q

What 3 things does the overall control of extracellular fluid balance depend on?

A

Capillary filtration

Capillary reabsorption

Lymphatic system

33
Q

Starling’s factors determine changes in fluid balance in:

A

Circulation

Interstitial fluid

Lymphatic system

34
Q

What is hypovolemia?

A

Low blood volume

35
Q

Describe what happens in the capillaries during hypovolemia (for example due to a haemorrhage)

A

Drop in CO = drop in BP = Pc reduced = improper capillary filtration
In this case, you would transfuse interstitial fluid into the blood. This would be life preserving as it would:
- Support CVP
- Increase CO
- Increase BP
- Greater blood flow

36
Q

What is oedema and its causes?

A

Oedema is an excess of fluid within the interstitial space. This indicates an imbalance between filtration, reabsorption and lymph function
Increased Pc gives rise to oedema such as in a DVT (deep vein thrombosis)
Oedema can then cause:
- Increased capillary pressure (Pc)
- Decreased plasma protein oncotic pressure (Πp)
- Inflammatory response
- Lymphatic problems

37
Q

Give 3 clinical scenarios of what can occur due to increased capillary pressure (Pc)

A

Dependent oedema (standing for long periods of time)

DVT

Cardiac failure

38
Q

What happens during a DVT?

A

Thrombosis occurs resulting in prevention of venous return = increased venous pressure which results in back up of pressure = increased Pc = increased filtration

39
Q

What are some causes of low protein oedema?

A

Malnutrition or malabsorption: not enough protein to make plasma proteins to generate oncotic pressure
Nephrotic syndrome: urinary protein loss
Liver disease: not enough albumin production

40
Q

Describe how someone with low protein intake can develop oedema

A

Reduced protein concentration = reduced oncotic pressure
This causes fluid efflux from capillaries into the interstitial fluid resulting in oedema
This is also known as kwashiorkor

41
Q

Describe how an inflammatory response can lead to oedema

A

Inflammatory response triggered results in a LARGE increase in capillary permeability
Increased Lp = increased protein permeability (Πi) due to decreased sigma
Increased Πi = less reabsorption taking place = oedema

42
Q

Name some lymphatic problems and describe them

A

Elephantitis: nematode infestation migrate to lymphatic system and reproduce to BLOCK lymph drainage

Lymphoedema: caused by surgical testicular cancer treatment; removal if lymphatics causing swelling to leg