CVS: Capillary Structure and Function, and Solute and Fluid Movement Flashcards

1
Q

What does metabolism create a need for?

A

Transport of solutes + fluids

To do this, solutes + fluids must move across cell membranes which often acts as barriers

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2
Q

What controls the rate of solute transport?

A
  • Properties of passive and active transport across membranes
  • Fick’s law
  • Properties of capillaries

Together, these form the concept of permeability - Allowing solutes/fluids to cross capillary membranes

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3
Q

Describe passive transport

A
  • Movement molecules down conc/pressure/osmotic gradient
  • DOESN’t need energy
  • Simple (O2/CO2) or facilitated (ions,glucose)
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4
Q

Describe active transport

A
  • Movement molecules against conc gradient
  • NEEDS energy (ATP)
  • e.g. ATP-dependent pumps, endocytosis, exocytosis
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5
Q

Describe the 4 passive transport processes

A
  • Diffusion
    • Concentration gradient -e.g. O2 uptake from lungs into blood
    • Regulated by distance, time taken ∝ distance squared
    • Fast over micro m and slow >1 mm
  • Convection
    • Pressure gradient -e.g. Circulation
    • Requires pressure gradient, functioning heart - appropriate CO etc.
  • Osmosis
    • Osmotic pressure (water) gradient - e.g. water uptake by cells
    • Requires balance of filtration, reabsorption and functioning lymphatics
  • Electrochemical flux
    • Electrical and concentration gradient - e.g. Ion flow during AP
    • Requires - Active/other transport mechanisms to create electrochemical gradients and ion channels to provide ion movement across membranes
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6
Q

What does Fick’s law describe?

A

Properties of solutes and membranes affecting transport

Solute movement - Mass per unit time, m/t (Js)

Determined by 4 factors:

Js = - D A (deltaC/x)

D = Diffusion coefficient of solute – how easy it moves through solvent

A = Area

**DeltaC / x = Concentration gradient (C1-C2) across distance

x, negative value : flowing ‘down’ a concentration gradient**

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7
Q

What controls diffusion rate?

A

Linked to Fick’s law:

  • Increased blood flow
    • Increases concentration solutes transported to capillaries
  • Fall in intracellular concentration (more solute used, metabolism)
    • Increase concentration difference (greater concentration gradient)
  • Recruitment of capillaries
    • Dilation of arterioles - ⬆️number capillaries perfused
    • Increases total SA for diffusion (Fick’s law)
    • Shortens diffusion distance (faster diffusion)
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8
Q

At what vessel does most solute and fluid movement occur? Describe it

A

Capilaries:

  • Smallest diameter BV
  • Extension of inner lining of arterioles
  • Endothelium only 1 cell thick
  • Semi-permeable
  • Vessels that connect arterioles to venules
  • Found near every cell in body but higher density in highly active tissue
  • Solute movement (due to passive/active transport and filtration), e.g. O2, glucose, amino acids, hormones, drugs
  • Fluid movement (due to pressure gradients, osmotic pressure), e.g. regulation of plasma, interstitial, intracellular fluid
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9
Q

Describe the properties and function of continuous capillaries

A
  • Moderate permeability
  • Tight gaps b/w neighbouring cells
  • Constant basement membrane e.g. blood-brain barrier
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10
Q

Describe the properties and function of fenestrated capillaries

A
  • High water permeability
  • Fenestration structures
  • Modest disruption of basement membrane
  • E.g. ‘high water turnover’ tissues such as salivary glands, kidney, synovial joints, choroid plexus (cerebrospinal fluid)
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11
Q

Describe the properties and function of discontinuous capillaries

A
  • Very large fenestration structures
  • Disrupted basement membrane
  • E.g. when movement of cells is requires such as RBCs in liver, spleen, bone marrow
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12
Q

How does permeability change as you go from continuous → fenestrated → discontinuous capillaries?

A

Increasing permeability to solutes + fluids

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13
Q

What are the general properties of all capillaries that can influence solute transfer?

A
  • Intracellular cleft - 10-20nm wide
  • Glycocalyx - Covers endothelium charged material, acts as sieve for solute permeation
  • Caveolae + vesicles - Movement of large molecules, e.g. plasma proteins, lipoproteins
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14
Q

What are the different routes of solute transport?

A
  • Big gaps in inflammation
  • Trans-cellular channels
  • Vesicles
  • Trans-cellular
  • Inter-cellular
  • Fenestral route
  • Water channels
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15
Q

What is the dominant route of solute transport?

A
  • Diffusion, for example, filtration only accounts for 2% glucose transport
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16
Q

How does fluid move at the capillary wall?

A
  • Capillary wall semi-permeable - allows H2O pass through
  • Fluid moves across membrane into interstitial space due to capillary BP
  • Large molecules (e.g. plasma proteins) can’t pass, instead they exert osmotic pressure termed oncotic pressure
  • Oncotic pressure creates suction force to move fluid from interstitial space into capillary
  • Fluid movement depends on balance b/w capillary BP and oncotic pressure across capillary wall - revised Starling’s principle of fluid exchange
17
Q

Describe the revised Starling’s principle of fluid exchange

A

Jv = Lp A { ( Pc - Pi ) - sigma (pp - pg) }

Jv (net filtration) µ Blood/fluid pressures difference (Pc - Pi )

- Osmotic pressure difference (pp - pg)

LP - Conductance of endothelium

A - Endothelium plasma membrane area

Sigma - Reflection coefficient - related to intracellular gaps

Fraction (sigma) of osmotic pressure is exerted by gaps

Effective osmotic pressure = Sigma x potential osmotic pressure

Sigma for plasma protein = 1 so no conduction across

Sigma for plasma protein = 0 so free conduction across

18
Q

What does Revised Starling’s principle mean?

A
  • Less Pc than at arterial end
  • Means plasma proteins diffuse into subglycocalyx region
  • Pii - PiG which are also same as PiP
  • Filtration continues at venous end as even though Pc is low it is still greater than osmotic gradient to absorb
  • Filtration occurs across length of capillaries
19
Q

Describe the role of lymphatic circulation in constant filtration

A
  • Lymphatic circulation returns excess tissue fluid/solutes back to cardio-vascular system
  • Lymph vessels have valves and smooth muscle
  • Spontaneous contractions of smooth muscle contributes to lymph flow
  • Surrounding skeletal muscle contractions/relaxation also contributes to lymph flow
20
Q

What happens if Pc becomes very low?

A

Hypovolemia:

  • Drop in blood volume leads to drop in CO and BP, therefore Pc is reduces
  • Pip becomes dominant
21
Q

What does ECF balance depend on?

A
  • Capillary filtration
  • Capillary reabsorption
  • Lymphatic system
22
Q

What occurs when the balance between filtration, reabsorption and lymphatic function is not maintained?

A

Oedema - Excessive fluid in interstitial space

23
Q

Why does increased capillary pressure lead to oedema?

A

Increased Pc across capillaries (gravitational from standing too long, cardiac failure, DVT) causes increased flitration

24
Q

Why does decrease osmotic pressure lead to oedema?

A

Decreased osmotic pressure can be caused by low protein oedema or malnutrition/malabsorption, hepatic failure, nephrotic syndrome (this is protein loss in urine that is much greater than the amount of protein being produced by the liver)

Liver disease - not enough albumin being made

  • Reduced plasma protein concn
  • Reduce plasma oncotic pressure, greater influence of Pc
  • Excessive fluid filtration from capillaries into interstitial fluid
  • Oedema
25
Q

Describe inflammatory-mediated oedema

A
  • Swelling triggered by local chemical mediators of inflammation
  • Increase capillary permeability - become ‘leaky’
26
Q

What are problems caused by lymphatic dysfunction?

A

Lymphatic obstruction:

  • Filariasis/elephantitis - nematode infestation, larvae migrate to lymphatic system, grow/mate/form nests - block lymphatic drainage

Lymphatic removal:

  • Lymphoedema - caused by surgery, removal of lymphatics

Continued filtration leads to build up of fluid in interstitial space