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CAPILLARY EXCHANGE

AND EDEMA
Understanding swelling of
part(s) of the body…
drsherwanshal@gmail.com
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 Capillary Exchange
 There are approximately 10 billion
capillaries in the body. The major
means by which nutrients and waste
products are exchanged is by the
process of diffusion..
 In addition, a small amount of fluid
moves out of the capillary at the
arteriolar end, and most, but not
all, of that fluid reenters the
capillary at its venous end.
 At the arterial end of the
capillary, blood pressure and a
small negative pressure in the
interstitial spaces move fluid
from the capillary.
 The small negative pressure
exists in the interstitial spaces
because fluid moves into lymph
capillaries when tissues are
compressed during movement.
 When the tissues are no longer
compressed, the volume of the
tissue in­creases slightly, and
the interstitial pressure
decreases
 . One-way valves in the
lymphatic vessels prevent the
fluid from passing back from
the lymph capillaries into the
interstitial spaces.
 Fluid is attracted into the capillary
by osmosis. The concentration of
small solute molecules is
approximately the same in blood
and in the interstitial fluid.
 The concentration of proteins in the
interstitial fluid, however, is much
lower than in the plasma, and the
proteins in the plasma are too large
to pass through the wall of the
capillary.
 Theosmotic pressure caused by the
plasma proteins is called the blood
colloid osmotic pressure, and it is
much higher than the osmotic
pressure of the interstitial fluid.
 Edema is an abnormal accumulation
of interstitial fluid. Edema has many
causes. The underlying problem in all
types of edema is a distur-bance in
the normal balance between
hydrostatic and os-motic forces
at the capillary level.
 When a capillary is damaged,
 In acute starvation,
 Edema results from an increase in arterial blood
pressure, Edema can also result from problems with
other systems, such as the blockage of lymphatic vessels
or impaired urine formation:
If the lymphatic vessels in a
region become blocked, the
volume of interstitial fluid will
continue to rise.
If the kidneys are unable to
produce urine but the individual
continues to drink liquids, the
blood volume will rise.
Venous tone

 This is a continual state of partial


contraction of the veins as a
result of sympathetic
stimulation.
 Increased sympathetic
stimulation increases venous
tone by causing constriction of
the veins, which forces the large
venous volume to flow toward
the heart.
 Consequently, venous return and
preload will in­crease, causing an
increase in cardiac output.
 Conversely, decreased
sympathetic stimulation decreases
venous tone, allow­ing veins to
relax and dilate.
 As the veins fill with blood,
venous return to the heart,
preload, and cardiac output
decrease.
The periodic muscular compression of veins
forces blood to flow through them toward the
heart more rapidly.
The valves in the veins prevent flow away
from the heart so that when veins are
compressed, blood is forced to flow toward
the heart.
The combination of arterial dilation and
compression of the veins by muscular
movements during exercise causes blood to
return to the heart more rapidly than under
conditions of rest.