(14) lymphatic and microcirculation

Explain the regulation of microcirculations 1. Lymphatic system and regulations 2. Microcirculation and fluid regulations

A quantity which is increased or

decreased by an infinitely small quantity

is neither increased nor decreased

1 Lymphatic system and regulations

2 Microcirculation and fluid regulations

Lynphafic system

¢ Asimple lining of endothelial cells

¢ Very low pressure

* “Transport” lymph fluid

Pulmonary capillary network

Lymphatic Lymphatic capillaries

Interstitial fluid (IF)

Lymphafic vessel

How lymphatic vessels drain the lymph fluid?

¢ Lymphatic bulbs: Blind-ended tube

¢ Anchoring filaments Attach to tissue

¢ Passively drains from the tissue

¢ Lymph vessels

¢ Compression-Relaxation mechanism of the bulbs

& vessels creates the pressure

¢ Lymphatic valves blocks the backward flow

Open lymphatic valve Compressed/

contracting 2mm Hg p lymphatic bulb

Lựnmph vessels

Internal jugular vein

External jugular vein

cat Thoracic duct

>

Superior vena cava

& Specialized lymphoid organs

Mucosal-associated lymphoid tissues

tissue (GALT); Peyer's lymphoid tissue

& Specialized lymphoid organs

Thymus gland

¢ Well-developed in the young

¢ Atrophied while growing

4 Jnxi

° Develop “T- + all Vi phocvte€

LQ re url — ban Mord

Spleen Bursa of Fabriciu Houle

Liver-—— ‘dina, Ản+Ín dads

| Bursa of abricius ¢ Found in avian (not

| mammals)

Piece ott - ` Cloaca

Marrow ° Where firstly found théviBes deve\apadt aaa

fn aden

lymp hoc ytes i Bursa Poy ken 4n

By “Pores” in the capillaries

vale Many Su V4 941A 6a 04)

¢ Endocytosis/Transcytosis

Intercellular cleft Basement

membrane

¢ Gastrointestinal: Narrowed intercellular cleft size

¢ Kidney: Glomerular capillaries -> “Fenestrae” into endothelial

cells -> Filter ions and chemical substances

Tight junction

; Pore (no pores)

Water-lined Substance : assage Substance

pore _— “SỐ in blood P 9 In blood í

Carrier- mediated

Lipid-soluble Lipid-soluble Wanepors

substances substances

COE Saye ey, Z interes Cul ay

Padma ——( Interstitial) ——>" fluid

ICF \Aan+ WanWavs,

Id-soluble compound diffuse directly through

Substance Molecular Weight Permeability

() |thecellmembrane ; Water 18 1.00

Glucose 180 0.6

Wrsivin (ayy Na: Myoglobin 17,600 0.03

- Molecular size affects the permeability of Hemoglobin 68,000 0.01

the substances through the pore ,

pan tiuŸw fw tapn wactie?

* Net driving force depends on concentrat

gradients

l0 e3) vA9⁄4 A nee ong go

* Vascular thickness (Ax) | NS SI ed

Rate of diffusion = VA US), —ISM Novel Cap tlayles ” \

†ÚwiñÑ1ÂU WM igi umd aaral dats Aq ua dlav

Pulmonary capillaries

& Diffusion of Said molecules:

equation

Plasma colloid osmotic pressure

Interstitial fluid colloid osmotic pressure

Interstitial fluid press

J, = Rate of fluid flow

K, = Capillary iiltgation coefficient

4 v6 :

~ \(f9wì1f @nv 1 tr)

an

o

} atic DFeSSul

- f, inynyo tums fot andu

Ti, = Plasma|oncotic pressure | gg pecteiy ann No

= Interstitial

Hydro - = fluid

- Static = stable

Hydrostatic pressure: Pressure caused by

the unmovable water

skin: 0 mmHg

It is usually Subatmospheric: - /

mmHg

K B-=a colloid oncotic pressure

Plasma proteins cause colloid osmotic pressure

(oncotic pressure); Total = 5-8 g/dL

Oncotic pressure Is the force to hold water in

g/di Tip (mm Hg)

4.5 2.5 0.3 7.3

21.8 6.0 0.2 28.0

& Interstitial colloid oncotic pressure

Protein concentration in IF is usually 40% of that in plasma (3 g/dL)

Interstitial colloidal osmotic pressure Is usually 8-18 mmHg depends on the tissue

types

& Example of fluid diffusion in the capillaries

& Example of fluid diffusion in the capillaries

At the venous end

P.= 10 mmHg P;= -5 mmHg Tr,= 24 mmHg

Venous end

KŠ Ederg & Effusion: The fluid accumulation

Mininonind tive

Edema = Fluid accumulation in “~~ _ue”

e.g Pulmonary edema, Penpheral edema (Effusion| = Fluid accumulation in “7, -,-ace”

"6 0 Peritonedl efUs e sion, Pleural effusion, Pericardial

effusion Causes Abnormalities | in Starling forces, and fluid

_ -» tFiltration 4-~~~_ Interstitial Interstitial fluid

` đ J ~ fluid pressure colloid osmotic pressure

“ 1 t3 (Pit) (IIif)

pF t Interstitial

/ /

% he % + Ex: Heart failure, Intravenous

~ TLymph flow fluid

Me +Interstitial protein

concentration

TS Negative feedback

KẾ Ea pathophysiology

J, Adi Niềvh ¢ À aw cứ vin

i ¬

+Colloid osmotic pressure

|

dn

| A LD Ay SR: TD DD Ey LR, SR, A A, A A «AI TD RATT, LD -a.- Ăn ẶĂ—

Capillary Plasma colloid pressure osmotic pressure

-~> tFiltraton 4 - _ t ‘

ad ẢN Interstitial Interstitial fluid

Z | N fluid pressure colloid osmotic pressure

/ 7» ‘interstitial fluid volume ;

L i (edema) Ị

\ \ †Interstitial fluid pressure ¿

‘SS thymph 8 N | ~ Ex: Protein-losing enteropathy,

"%š: ‘Interstitial protein Protein-losing

26neenyalen nephropathy, Starvation,

=~» Negative feedback Liver disease; Poor protein

nradiictoan

v4 /

ý v9, nn400(Â9:

Interstitial Interstitial fluid

fluid pressure colloid osmotic pressure

(Pif) (IIf)

Jy = Ki(P: = Pir) — Ơ(7r 0)

Ex: Lymphadenopathy

: Pregnancy : Extraluminal mass

Capillary pressure

tCapillary permeability iArteriolar

to proteins resistance \ — — ~

| ' — — fF Ỷ

Interstitial protein TCapillary hydrostatic concentration pressure LA 4 fl € fluid pressure colloid osmotic pressure

cà ‘+.> tLymph flow Ì injuries

Nala Negi teudtick

K Ascite V0\Wlov eGrda bility nth

Albumin

+ Pressure In sinusoids = Portal hypertension J Oncotic pressure

2 2.5 g/dL ascitic proteins < 2.5 g/dL ascitic proteins Hypoalbuminemia

Presinusoidal Sinusoidal ~ Nephrotic syndrome

- Portal vein thrombosis - Cirrhosis - Severe malnutrition

- Liver metastasis ain

- Heart failure

- Budd-Chiari syndrome Pancreatitis

Infections, e.g., tuberculosis

Pơítal hypertension: Increased *00aw90 Hypoprotet la: Reduced tr,

p

C

l _Pleưnal cffu=ion

Vasculitis: Increased K;

pressure

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