💃 Physiology of the microcirculation. Functional organization of the microcirculation unit.

Organ-related peculiarities of the capillaries. Control of the microcirculation 💃

👣 Function: Transport of nutrients to the tissues and removal of cell waste matter.

💋 Structure: The walls of the capillaries are thin and single-layered, highly permeable
endothelial cells. Water, cell nutrients, and cell waste matter can all interchange quickly and
easily between the tissues and the circulating blood.

👄The microcirculation of each organ is organized to serve the organ’s need.

👄The arterioles branching from arteries branch further two to five times reaching diameters of 5
to 9 micrometers at their ends called metarterioles where they supply blood to the capillaries.

👄Each true capillary originates from a metarteriole, a smooth muscle fiber usually encircles the
capillary. The structure is called the precapillary sphincter. This sphincter can open and close the
entrance to the capillary.

👄The venules are larger than the arterioles and have a much weaker muscular coat but have a
lower pressure than the arterioles; this allows contraction despite the weak muscle.

👄The structure of the capillary bed in not the same in all parts of the body, although it may have
a similar arrangement and may serve similar purposes. The metarterioles and precapillary
sphincters are in close contact with the tissue they serve and are affected by the conditions of the
tissues (H+ion conc, conc of nutrients, end products of metabolism..)

🎁 Structure of a capillary wall:

🎉 The wall is composed of a unicellular layer of endothelial cells and is surrounded by a thin
basement membrane on the outside of the capillary. The thickness of the capillary wall is only
about 0.5 micrometer. The internal diameter of the capillary is 4 to 9 micrometers, barely large
enough for red blood cells and other blood cells to squeeze through.

🎉 Two small passageways connect the interior of the capillary with the exterior, also called the
intercellular cleft; a thin-slit, curving channel that lies at the top of the figure between adjacent
endothelial cells, each cleft is interrupted by short ridges of protein attachments that hold the
endothelial cell together but between these ridges fluid can percolate freely through the cleft.
Most water-soluble ion, water molecules and small solutes diffuse with ease between the interior
and exterior though the intercellular clefts.

🎉 Present in the endothelial cells are many minute plasmalemmal vesicles, also called caveolae
(small caves), they are believed to play a role in endocytosis (the process by which the cell
engulfs material from outside the cell) and transcytosis of macromolecules across the interior of
the endothelial cells.
🐫 Special Types of “Pores” Occur in the Capillaries of Certain Organs. The “pores” in the
capillaries of some organs have special characteristics to meet the peculiar needs of the organs.
Some of these characteristics are as follows:

1. In the brain, the junctions between the capillary endothelial cells are mainly “tight” junctions
that allow only extremely small molecules such as water, oxygen, and carbon dioxide to pass
into or out of the brain tissues.

2. In the liver, the opposite is true. The clefts between the capillary endothelial cells are wide
open so that almost all dissolved substances of the plasma, including the plasma proteins, can
pass from the blood into the liver tissues.

3. The pores of the gastrointestinal capillary membranes are midway in size between those of the
muscles and those of the liver.

4. In the glomerular capillaries of the kidney, numerous small oval windows called fenestrae
penetrate all the way through the middle of the endothelial cells so that tremendous amounts of
small molecular and ionic substances (but not the large molecules of the plasma proteins) can
filter through the glomeruli without having to pass through the clefts between the endothelial
cells.
🐳 The intermittent flow of blood is called vasomotion which means intermittent contraction of
the metarterioles and precapillary sphincters. This is regulated via the concentration of oxygen in
the tissues.

🐬 When the rate of O2 usage by the tissue is so high that the O2 concentration decreases below
normal, the intermittent periods of capillary blood flow occurs more often and the duration of
each period of flow lasts longer, allowing the capillary blood to carry increased quantities of
oxygen to the tissues.

🐬 The sympathetic nervous system activates the smaller arterioles, including terminals.
Noradrenaline and adrenaline have effects on alpha and beta adrenergic receptors. Other
hormones (catecholamine, renin-angiotensin, vasopressin, and atrial natriuretic peptide) circulate
in the bloodstream and can have an effect on the microcirculation causing vasodilation or
vasoconstriction.

🐦 Exchange of water, nutrients and other substances between the blood and interstitial fluid
occurs through diffusion.

🐤 Lipid soluble can diffuse directly without having to go through the pores, including oxygen
and carbon dioxide. Hence having a faster diffusion rate than lipid insoluble substances, such as
sodium ions and glucose that can only go through the pores with a higher permeability for a
lower molecular weight.

🐤 Hydrostatic and Colloid Osmotic Forces Determine Fluid Movement Through the Capillary
Membrane. The four primary forces that determine whether fluid will move out of the blood into
the interstitial fluid or in the opposite direction are:

1. The capillary pressure (Pc), which tends to force fluid outward through the capillary
membrane.

2. The interstitial fluid pressure (Pif), which tends to force fluid inward through the capillary
membrane when Pif is positive but outward when Pif is negative.

3. The capillary plasma colloid osmotic pressure (Πp), which tends to cause osmosis of fluid
inward through the capillary membrane.

4. The interstitial fluid colloid osmotic pressure (Πif), which tends to cause osmosis of fluid
outward through the capillary membrane.

🐤 If the sum of these forces—the net filtration pressure — is positive, there will be a net fluid
filtration across the capillaries. If the sum of the Starling forces is negative, there will be a net
fluid absorption from the interstitial spaces into the capillaries.