FLUJO SANGUINEO CUTANEO

EN REPOSO EN AMBIENTES
TERMONEUTRALES =
250 ml/min;
disipacion de calor de 80 – 90 kcal/h

En exposicion a calor o en ejercicio,

el aumento de la T* corporal produce
Vasodilatacion y sudoracion
Cutaneous circulation
• Low metabolism

• Blood flow serves mainly thermoregulatory role

8:04 PM Organ vascular beds 3

Numerous AV anastomoses

• Thick muscular layer

• Rich nerve supply
• No basal tone (can constrict maximally)
• No metabolic autoregulation
• Exclusively under SNS control (can close completely)
 thermoregulation

8:04 PM Organ vascular beds 4

 Countercurrent heat exchange
• Major skin arteries run alongside veins
• In cold: heat taken up from arteries by cooled blood in
veins before it reaches surface  heat conservation
• In heat: heat taken up by blood in the surface is given
from veins to colder arterial blood  heat not taken up
(+  temperature difference from skin to environment 
heat dissipation)

8:04 PM Organ vascular beds 5

 Other skin arterioles
• Some basal tone
• Dual control:
• SNS (more important)
• adrenaline & NA only vasoconstriction
• but sweat gland activation (controlled by ACh SNS terminals)  skin
vasodilation (bradykinin released from tissue fluid proteins by
enzyme in sweat)
• local metabolic & myogenic autoregulation
• no parasympathetic nerves

8:04 PM Organ vascular beds 6

Regulacion Neural
• Centros nerviosos superiores  SNS:
• Enrojecimiento con la verguenza o colera
• Palidez con la ira o el miedo

8:04 PM Organ vascular beds 7

Raynaud’s disease
• Vasoconstrictor hypersensitivity of fingers (&
sometimes toes) to cold
• Finger ischemia in cold
(tingling, numbness, pain)
• Blanching (no blood)  cyanosis (ischemia)  redness
(spasm subsides)
• Idiopathic (mostly young women)

8:04 PM Organ vascular beds 8

Rosy color in cold

• Cold vasodilation (relieving cold vasoconstriction)

• Reduced O2 uptake of cold skin (high Hb saturation)
• Cold-induced shift to the left
of the Hb dissociation curve

8:04 PM Organ vascular beds 9

HIPOTALAMO
Transferencia de calor central al periferico, aumento del G.C. y vasoconstriccion esplacnica
Circulacion cutanea es unica porque esta controlada
por 2 poblaciones de nervios simpaticos:
•Nervios adrenergicos vasoconstrictores
•Nervios simpaticos vasodilatadores

Nervios vasoconstrictores y vasodilatadores inervan areas

con vellos

Areas sin vellos (palmas, plantas y labios :

Inervados solo por nervios vasoconstrictores
Abundantes anastomosis arteriovenosas (paredes gruesas,
baja resistencia, alto flujo desde arteriolas a venulas)
Apertura o cierre de las anastomosis producen grandes
variaciones de flujo.
 Temperatura interna
Temperatura corporal

-
+

Vasodilatacion simpatica Vasoconstriccion simpatica

ARTERIOLA Norepinefrina, Neuropeptido Y
Oxido
CUTANEA
nitrico

Nervios sensoriales
+ _
(CGRP,SP,NKA)

Temperatura local
 MECANISMOS EN EL CONTROL DE CIRCULACIONES
% del G.C. Control Metabolitos Control simpatico Efectos
metabolico local vasoactivos mecanicos

Coronaria mas importante Hipoxia menos importante Compresion

Autoregulacion Adenosina mecanica en sistole
(5%)
Hiperhemia reactiva
Cerebral mas importante C02 menos importante Aumento en P.
Autoregulacion H+ intracraneal
(15%)
Hiperhemia reactiva disminuye flujo
cerebral
Musculo mas importante Lactato mas importante en Actividad muscular
Autoregulacion, K+ reposo (receptor comprime venas
(20%)
hiperhemia reactiva Adenosina alfa=vasoconstriccio
Receptor
beta=vasodilatacion

Piel menos importante mas importante

Regulacion
(5%)
temperatura

Pulmonar mas importante Hipoxia: menos importante Inflacion pulmonar

vasoconstriccion
(100%)