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Copyright © 2004, Elsevier Science (USA) All rights reserved.

Functional Anatomy of the Microcirculation

The cardiovascular system exists for one fundamental purpose: the delivery of nutrients to, and removal of metabolic end products from, tissues. The exchange of solutes and water between blood and the interstitial compartment largely occurs in capillaries, which are ideally designed for this function. The numerous thin-walled and porous capillaries that are found in all tissues provide a huge surface area for exchange of gases (oxygen, carbon dioxide), water, nutrients (glucose, amino acids, fatty acids), and hormones, whereas other elements of blood (such as platelets and plasma proteins) do not leave capillaries readily. Although the magnitude and direction of capillary exchange is generally described in terms of simple physical principles such as diffusion and convection (bulk flow), active changes in the shape and function of vascular smooth muscle and endothelial cells in arterioles and capillaries can exert a profound influence on these exchange processes. Hence, capillary exchange is a dynamic process that often changes in relation to organ function. Furthermore, many diseases are associated with abnormalities in capillary exchange that may become so severe as to impair organ function (e.g., pulmonary edema) and cause death.

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