The Capillary Circulation of the Skin

Davis, Michael J.; Lawler, James C.

doi:10.1001/archderm.1958.01560060056011

Cited by 47 publications

(9 citation statements)

References 22 publications

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“…Characteristically, the arterial limb of the capillary is considerably smaller than the venous limb. Davis and Lawler measured the diameter of many skin capillaries, finding on the average that the venous limb is 50% larger than the arterial limb (15). The apex of the loop has generally the same dimension as the descending venous limb.…”

Section: Surface Areamentioning

confidence: 99%

Dynamics of Transcapillary Fluid Exchange

Wiederhielm

1968

The Journal of General Physiology

120

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Fluid balance at the capillary level has been simulated with an analogue computer program, based on experimental data on regional differences in capillary permeability, surface areas, and hydrostatic pressures. The program takes into account fluid and protein fluxes into and out of the interstitial space. Solutions are obtained for tissue hydrostatic pressure, tissue fluid osmotic pressure, interstitial space volume, and lymph flow. Simulation of a variety of physiological experiments and clinical disease states has yielded reasonable agreement between experimental data and data obtained by computer analysis. Dilution of the interstitial plasma protein pool with a consequent reduction of its oncotic pressure appears to be a major factor, which prevents edema unless plasma oncotic pressures are reduced by 10-15 mm Hg or, alternatively, venous pressures are elevated by a similar amount. The computer analysis in all instances yields positive values for tissue pressure, in agreement with experimental data obtained by needle puncture. The negative tissue pressures observed in subcutaneous capsules can be reproduced in the computer program, if the interface between the capsule and the surrounding interstitial space is assumed to have the properties of a semipermeable membrane.Partition of body fluids between the circulation, on the one hand, and the interstitial and intracellular spaces, on the other, is normally maintained within narrow limits. The mechanism maintaining this precise partition is still not well understood, but a balance of capillary hydrostatic and colloid osmotic pressures is generally acknowledged to play an important role, as originally pointed out by Starling (1). Current views on capillary water balance are summarized in Fig. 1, which is based on experimental data of Starling (1) and Landis (2). The graphs illustrate the relationship between hydrostatic pressures along the length of a capillary and the colloid osmotic pressure of plasma proteins.The oncotic pressure of plasma (7r,,) averages 25 mm Hg (3), corresponding to a plasma protein concentration of 7%. The hdyrostatic capillary pressures are averages based on extensive series of pressure recordings in skin capillaries of man by Landis (2). In arterial capillaries ( Fig. 1 A, left), the pressures averaged 32 mm Hg (Pa). The hydrostatic pressures in the 29 The Journal of General Physiology TRANSCAPILLARY EXCHANGES venous capillaries (Fig. 1 A, right) averaged 15 mm Hg (Pv). The transcapillary flux of fluid is governed by the difference in the hydrostatic and colloid osmotic pressure of the plasma; thus fluid is filtered from the capillary into the tissues in the arterial end of the capillary, and it is reabsorbed from the tissues into the capillary at the venous end. The hydrostatic pressures in the arterial and venous ends of the capillary bracket the colloid osmotic pressure, and the amount of fluid filtered at the arterial end is similar to the volume reabsorbed at the venous end. 20-In. This equilibrium of filtration and reabso...

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Section: Surface Areamentioning

confidence: 99%

Dynamics of Transcapillary Fluid Exchange

Wiederhielm

1968

The Journal of General Physiology

120

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“…2. In elderly people, without peripheral vascular disorders, the capillary bed of the medial part of the lower leg does not differ appreciably from that of younger individuals.…”

Section: Arterial Insufficiencymentioning

confidence: 93%

Vital Capillaroscopy

Fagrell¹

1972

Angiology

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There are few simple and clinically useful methods for studying the microcirculation in a region suffering from peripheral vascular insufficiency. Still, it is disturbances in this circulation e.g. in the skin, that are the final cause of tissue death.By studying changes of the capillaries in the skin, valuable information will be obtained about the local nutritional circulation and the viability of the tissue.Vital capillary microscopy for studying the surface capillaries in man is a well-known method. Already in 1917 lVIullerl introduced the technique as a clinical method of investigation. Most of the studies reported have been made on the nail fold, lip, ear, eye, gingiva and genitalia in man. In recent years the method has, however, been frequently used in dermatological practice,2-8 and for physiological studies of the skin microcirculation.9-17 Apart from the papers by Gilj e1S, 19 and recently also by Ryan2° on capillary changes in the skin of the lower leg in patients with venous insufficiency, there are few reports where changes of the capillaries are correlated to the peripheral circulation. The aim of the present investigation is to ascertain whether disturbances of the arterial or venous blood flow in the legs are followed by any typical structural changes in the microvascular bed of involved skin areas as evaluated by vital capillary microscopy. Preliminary observations, with application of the method in these two disease groups, were reported by Fagrell & Lund in 1969.21 METHODS Capillaroscopy A specially constructed Zeiss epi-microscope (Fig. 1), with a magnification of X 52 has been used. The skin has been illuminated by an ordinary microscope lamp of 15 W, at an angle of 45° to the surface. For heat elimination and better contrast between the capillaries and the surrounding tissue, one heat filter (Zeiss KG 1) and one blue filter (Zeiss BG 23) have been used. As the surface of the skin normally is quite irregular and reflects the light in all directions, it at Purdue University on June 8, 2015 ang.sagepub.com Downloaded from

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“…A third cousin (common great-grandparents) has similar symptoms. [26] TGT [3] AHG [26] Platelet factor 3 [26] Platelet morphology Platelet serotonin [27] Serum serotonin Capillary morphology [11] Clot retraction Thrombelastogram [13] Platelet adhesiveness…”

Section: Methodsmentioning

confidence: 99%

The Use of Plasma and Plasma Fractions in the Treatment of a Patient with Yon Willebrand’s Disease

Weiss¹

1962

Vox Sanguinis

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The Capillary Circulation of the Skin

Cited by 47 publications

References 22 publications

Dynamics of Transcapillary Fluid Exchange

Dynamics of Transcapillary Fluid Exchange

Vital Capillaroscopy

The Use of Plasma and Plasma Fractions in the Treatment of a Patient with Yon Willebrand’s Disease

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