Microcirculation and Lymphatics

Dr. Tooba Noor

Nov 4, 2023

Learning Outcomes

By the end of lecture, the student should be able to;

 Define the essential role of microcirculation as the site of exchange between blood and
tissue.
 Describe the basic structure of the capillary membrane.
 Recognize the basic composition of the interstitium.
 Enlist the factors facilitating fluid filtration through the capillary membrane.
 Illustrate the movements of fluid at the arterial and venous ends of the capillaries.
 Identify the role of lymphatic in the interstitial fluid balance.
 Discuss the causes and factors affecting abnormal interstitial fluid accumulation
(Edema).
Microcirculation

 The term “microcirculation” refers to the functions of the smallest blood vessels (diameter ≤
100µm²), the capillaries and the neighboring lymphatic vessels.
 5% of circulating blood volume is present in the capillaries at any given time.
 Important for the transport of nutrients and gases between the blood and tissues.
 Site of waste product removal.
 Over 10 billion capillaries with surface area of 500-700m².

Components of microcirculation (Structural Organization)

Arterioles:
• Highly muscular
• Changes in diameter

Meta arterioles (Terminal arterioles):

• Smooth muscles
• No muscle sheath

True capillaries:
• Smooth muscle fibers
• Pre capillary sphincters
Venules:
• Larger than capillaries
• Weak musculature

Pre capillary sphincters and meta arterioles

 • Pre capillary sphincters
• Present at the junction where the capillary arises from meta arterioles
• Regulation of blood flow through capillaries
• Depends on local condition of tissues

Vasomotion

• Intermittent contraction of meta arterioles and pre capillary sphincters.

• Because of this blood does not continuously flow through capillaries.
• Regulated by oxygen concentrations.
• Decrease in oxygen concentration (greater tissue demand), increase in vasomotion (increased
frequency with longer duration)

Capillaries

Capillary wall:

• Highly permeable
• Consist of single layer of endothelium
• Basement membrane
• Barely large enough passage for RBCs and other cells

Pores in the capillary membrane:

• Many minute vesicles called caveolae in the endothelium

• Formed from protein “caveolin”
• Play important role in “endocytosis”
• “Intercellular cleft” - Thin slit, curving channels

Particular capillary pores:

• Brain – tight junctions allow only very small molecules to pass through (Blood Brain
Barrier).
• Liver – sinusoids (wide open pores)
• Gastrointestinal – Intermediate sizes
• Renal glomeruli – fenestration within cells

Exchange of substance across the capillary walls occurs by

• Simple diffusion
• Bulk flow

Diffusion
 • Most important method of transfer
• Results from thermal motion of water molecules and dissolved substances in the fluid.
• Lipid soluble substance diffuses directly through the cell membranes of the capillary
endothelium
• Water soluble diffuses only through intercellular “pores” in the capillary membrane.

Factors regulating diffusion across capillaries

Effect of molecular size:

• Different permeability
• Tissue capillary dependent

Concentration gradient:

• Greater the difference in concentrations between inside and outside, faster the rate of
diffusion
• Rates of diffusion of most nutrients much greater than other materials

Interstitium and Interstitial Fluid

The space between the cells are collectively called “interstitium” and the fluid between the spaces is
called “interstitial fluid”.

Contains

• Collagen fibers bundle

• Proteoglycan filaments
• Fluid in the interstitium
• Derived from filtration and diffusion across the capillaries
• Same constituents as that of plasma
 • Except much lower concentration of protein
•
 Entrapped in minute space along proteoglycan filaments
 Formation of tissue gel
 Diffusion of fluid (95 – 99%) – moves across gel through molecule to molecule by kinetic thermal
motion
 Very rapid
 Free fluid - very small amount (less than 1 %)
 Small rivulets (free fluid vesicles) within tissue gel
 Edema - Expansion of free fluid rivulets stored in the interstitium (upto 50 % of fluid becomes
free of proteoglycan)

Fluid filtration across capillaries

Pressure
• Hydrostatic
• Physical pressure that forces fluid and solutes out of capillary via pores.
• Osmotic
• Concentration gradient of plasma proteins
• Regulates amount of fluid out of interstitial space

 Capillary Filtration coefficient

• Role of lymphatic

Fluid filtration across capillaries is determined by Hydrostatic and Colloid Osmotic Pressure and
Capillary Filtration Coefficient

1. The capillary hydrostatic 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 outwards when Pif is negative.

3. The capillary plasma colloid osmotic pressure (πc) 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.

Net Filtration Pressure

Net Filtration Pressure = Pc – Pif – πc + πif

Where,
• Fluid filtration to the interstitium if positive
• Fluid absorption to the blood of negative
Other factors,
Filtration coefficient depends on,
• Pore size
• Pore numbers
• Number of capillaries
Filtration = Filtration coefficient (Kf) x Net Filtration Pressure (NFP)
Forces causing Filtration at the arteriolar end of capillary

Forces Causing Reabsorption at the Venous End of the Capillary

Lymphatic circulation

• Accessory route
• Flow of fluid from interstitium to the blood
• Movement of proteins and large particles away from tissue to the blood
• Extremely critical
 • Lethal if no movement
• Drainage
• Channels
• Not present on skin, the CNS, endomysium, and bones
• Prelymphatics
• Structural design of lymphatic capillary
• Anchoring filaments
• Formation of valve
Lymphatic circulation

• Differences in protein concentrations from interstitial fluid

• Average 2g/dl (most tissues), Highest in liver i.e., 6g/dl
• Used for nutrient absorption (Lipids)
• Infectious agents (Destroyed)

Rate of lymph flow 100 ml per hour through thoracic duct

• Increased interstitial fluid pressure, increased lymph flow
• Changes in balance of fluid exchange

Lymphatic pumps determine Rate of lymph flow

• Contraction of smooth muscles surrounding lymphatic and large lymph ducts

Rate of lymph flow = Interstitial fluid pressure X activity of lymphatic pumps

Pumping caused by the External Intermittent Contraction of the Lymphatic

• Contraction of surrounding skeletal muscles

• Movement of the parts of the body
• Pulsation of arteries adjacent to the lymphatic
• Compression of the tissues by objects outside the body
• The lymphatic pump become very active during exercise often increasing lymph flow 10- to 30-
folds.

Edema

• Accumulation of fluid beneath the skin or body cavity.

• Palpable swelling produced by expansion of the interstitial fluid volume.
Factors causing Edema
• Increased Capillary Pressure
• Increased vascular volume
• Heart failure, Kidney disease, pregnancy, Environmental Heat stress
• Venous Obstruction
• Thrombosis, liver diseases
• Increased Capillary Permeability
 • Inflammation, Allergic reaction, Tissue injury, Malignancy
• Decreased Colloid Osmotic Pressure
• Increased loss of proteins
• Nephrotic Syndrome, Burns
• Decreased production of protein
• Starvation, malnutrition, malabsorption, Liver disease
• Obstruction of Lymphatic Flow
• Surgical removal of lymph nodes
• Malignant obstruction
• Infection (Filariasis)