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The Gastrointestinal Circulation 1st Edition by Peter Kvietys, Neil Granger, Joey Granger 1615041176 978-1615041176

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The Gastrointestinal Circulation 1st Edition Peter R. Kvietys Digital Instant Download

Author(s): Peter R. Kvietys
ISBN(s): 1615041176
Edition: 1
File Details: PDF, 3.99 MB
Year: 2010
Language: english
SKU: EB-2159582 Category: Tag:

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ISBN 10: 1615041176

ISBN 13: 978-1615041176

Author: Peter R. Kvietys, D. Neil Granger, Joey Granger

The microcirculation of the gastrointestinal tract is under the control of both myogenic and metabolic regulatory systems. The myogenic mechanism contributes to basal vascular tone and the regulation of transmural pressure, while the metabolic mechanism is responsible for maintaining an appropriate balance between O2 demand and O2 delivery. In the postprandial state, hydrolytic products of food digestion elicit a hyperemia, which serves to meet the increased O2 demand of nutrient assimilation. Metabolically linked factors (e.g., tissue pO2, adenosine) are primarily responsible for this functional hyperemia. The fenestrated capillaries of the gastrointestinal mucosa are relatively permeable to small hydrolytic products of food digestion (e.g., glucose), yet restrict the transcapillary movement of larger molecules (e.g., albumin). This allows for the absorption of hydrolytic products of food digestion without compromising the oncotic pressure gradient governing transcapillary fluid movement and edema formation. The gastrointestinal microcirculation is also an important component of the mucosal defense system whose function is to prevent (and rapidly repair) inadvertent epithelial injury by potentially noxious constituents of chyme. Two pathological conditions in which the gastrointestinal circulation plays an important role are ischemia/reperfusion and chronic portal hypertension. Ischemia/reperfusion results in mucosal edema and disruption of the epithelium due, in part, to an inflammatory response (e.g., increase in capillary permeability to macromolecules and neutrophil infiltration). Chronic portal hypertension results in an increase in gastrointestinal blood flow due to an imbalance in vasodilator and vasoconstrictor influences on the microcirculation.

Table of contents:

1. Introduction

2. Anatomy

2.1 EXTRAMURAL BLOOD AND LYMPHATIC VESSELS

2.2 INTRAMURAL BLOOD AND LYMPHATIC VESSELS

3. Regulation of Vascular Tone and Oxygenation

3.1 BASAL HEMODYNAMICS AND OXYGENATION

3.2 INTRINSIC VASOREGULATION: MYOGENIC AND METABOLIC

3.3 RELATIVE IMPACT OF MYOGENIC AND METABOLIC MECHANISMS

3.4 MEDIATORS OF METABOLIC VASOREGULATION

3.5 MEDIATORS OF MYOGENIC VASOREGULATION

3.6 SHEAR STRESS MODULATION OF METABOLIC AND MYOGENIC REGULATORY SYSTEMS

4. Extrinsic Vasoregulation: Neural and Humoral

4.1 NEURAL

4.2 CIRCULATING VASOACTIVE SUBSTANCES

5. Postprandial Hyperemia

5.1 GENERAL CHARACTERISTICS

5.2 LOCALIZATION OF THE POSTPRANDIAL HYPEREMIA

5.3 CONSTITUENTS OF CHYME RESPONSIBLE FOR THE POSTPRANDIAL HYPEREMIA

5.4 MECHANISMS INVOLVED IN THE POSTPRANDIAL HYPEREMIA

6. Transcapillary Solute Exchange

6.1 ULTRASTRUCTURAL PATHWAYS

6.2 Physiological (Functional) Pathways

6.3 FACTORS INFLUENCING VASCULAR PERMEABILITY

6.4 ULTRASTRUCTURAL CORRELATES FOR THE FUNCTIONAL PATHWAYS

7. Transcapillary Fluid Exchange

7.1 NET TRANSCAPILLARY FLUID MOVEMENT ( Jv,c)

7.2 CAPILLARY FILTRATION COEFFICIENT (Kf,c)

7.3 CAPILLARY PRESSURE (Pc)

7.4 INTERSTITIAL FLUID PRESSURE (Pt)

7.5 OSMOTIC REFLECTION COEFFICIENT (σd)

7.6 TRANSCAPILLARY ONCOTIC PRESSURE GRADIENT (πc − πt)

8. Interaction of Capillary and Interstitial Forces

8.1 INCREASED VENOUS PRESSURE

8.2 DECREASED ARTERIAL PRESSURE

8.3 TRANSEPITHELIAL FLUID ABSORPTION

8.4 TRANSEPITHELIAL FLUID SECRETION

9. Gastrointestinal Circulation and Mucosal Defense

9.1 GASTROINTESTINAL ACID LOAD

9.2 INTESTINAL LIPID LOAD

9.3 GASTROINTESTINAL RESTITUTION

10. Gastrointestinal Circulation and Mucosal Pathology I:Ischemia/Reperfusion

10.1 MODERATE REDUCTIONS IN BLOOD FLOW: DYSFUNCTION

10.2 SEVERE REDUCTIONS IN BLOOD FLOW: INJURY

10.3 ISCHEMIC TOLERANCE AND RESTITUTION

11. Gastrointestinal Circulation and Mucosal Pathology II: Chronic Portal Hypertension

11.1 THE GASTROINTESTINAL CIRCULATION IN CHRONIC PORTAL HYPERTENSION (PH)

11.2 COLLATERAL VESSELS: PORTOSYSTEMIC SHUNTING

11.3 GASTROINTESTINAL HYPEREMIA

11.4 TRANSCAPILLARY FLUID EXCHANGE

11.5 LUMINAL FACTORS MAY AGGRAVATE MUCOSAL INJURY DURING PORTAL HYPERTENSION

12. Summary and Conclusions

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Tags: Peter Kvietys, Neil Granger, Joey Granger, Gastrointestinal